Blogging for choice

Just under the wire! And not very edited so pardon the typos and possibly not most well connected thoughts...and grammatical superlatives. Credit is due to my sister A___ who has spent countless (literally) hours talking with me about this and related issues. Specifically, she is the one who introduced me to the notion of emotional/societal cannibalism (for lack of a better not ambiguous term) and women's roles as consumable goods.
"If moon were cookie..."


Blog for choice day, it’s the anniversary of Roe V Wade, one of the landmark decisions in establishing a woman’s right to an abortion. The topic of this year’s blog for choice is to say why you are pro-choice.

When I was 17, I began working part time as a unit secretary in a hospital near Boston. It was a small hospital in an affluent town with a teaching affiliation with Tufts University’s medical school. My unit was the surgical unit, inpatient, back in the days before drive by surgery was the standard. The charts were color coded, red ink on the labels for patients who were on a teaching service and black ink on the labels for patients on a private service. There was usually a fairly equal mix between teaching and nonteaching patients. The patients were also broken down by type of specialty their surgical team or doctor belonged to.

I labeled their charts and transcribed their diagnoses as they were admitted or returned from surgery. I learned words like “cholangiotomy” and “pyelonephritis”. I didn’t always know what each term specifically meant, but I could tell you what body part it referred to. Sometimes I would ask for more details, sometimes I wouldn’t. Sometimes it was relevant to my job and sometimes it wasn’t. I tried not to be too nosy and to get my job done.

Some words stood out. Those were the ones I transcribed a lot. “Salpingoophorectomy”, “transvaginal hysterectomy”, “total abdominal hysterectomy”, “diagnostic laparoscopy”. They were all gynecological terms. At some point, I started to wonder why we had so many gynecology patients since it was a general surgery floor. I asked the nurses. It was like I had asked “where do babies come from?” They looked at each other knowingly, a couple gave me smiles that ranged from condescension to something like regret. One of them replied “Most of the treatments, the only treatments, for gynecological problems are surgical.”

This stunned me. I mean I remember stammering out something, being totally shocked. I always thought of surgery as something that was done only if it had to be done. Only something that was done when other less invasive and risky things had failed. At that time, we had MRIs. We had CT scans. But we also had women who were being cut into because nothing had been developed to adequately image them, their parts, or their parts' pathologies without surgery. We had women who were having parts cut into, out, and off because this was the best option. It was the best option because years of medical research, since there was medical research, had largely ignored women’s health. Make a pill for erections, a pill for hypertension, a pill or new test for angina (as it presents in a man), a blood test for colon cancer. Develop new technology to view and fix clogged coronal arteries without needing to crack open someone’s chest. Do all those things because they are big health issues, and they are big health issues because, largely, men are more prone to them. Do all that, but don’t find ways to diagnose and treat diseases and disorders which quite commonly affect more than half of the human population.

This sunk in more and more over the years. I put it together with why none of my aunts could have kids. Bad endometriosis, back in the day, meant a hysterectomy. A hysterectomy meant they took everything out too because, the reasoning went, why leave it in? She can’t have babies anymore after all. Why spend money and time finding ways to treat her when it’s more efficient to just remove or cut into the offending useless part, even if cutting into her does mean putting her through the higher risk of an operation sometimes just to tell her “we couldn’t see anything (because we don’t know what we’re looking for) so we don’t know what’s wrong with you”. And when I say "sometimes" I mean lots of times. Endometriosis in particular can be difficult. It's hard to see unless the doctor is very well trained in what to look for. Many doctors overlook it. Many doctors remove it wrong and it grows back. Thus the only option is surgical (for diagnosis at least) and yet when they're in there poking around, grabbing your cervix with a clamp so they can wedge your uterus up, away, around, and over, more often than ought, they don't even know what they are looking for.

But I digress.

The only options were surgical because on some level women’s parts are considered not women’s property. My aunts’ parts, their reproductive organs, were not theirs. Their organs belonged first to the duty of making babies and second to my aunts as individuals. I know this because the physiological influence of those organs was ignored once the parts were declared useless for public use, i.e., makin’ babies.

For example, my aunt M____ got very sick after she had her hysterectomy. Her thyroid had been removed prior to the hysterectomy. When they gave her the hysterectomy, no one thought to adjust her dose of thyroid medication. The whole endocrine system is, well, a whole system. Give a woman a hysterectomy and a bilateral salpingoophorectomy and you are messing with that system. This has repercussions up the line and then back down it again…all the way down to the dose of thyroid medication you need to adjust to make sure the woman does not go into a health crisis. Not only was this not considered in advance but my aunt got sick, and sicker until finally a younger doctor realized the oversight.

Like a hysterectomy, surgical termination of a pregnancy is a medical decision. Like a hysterectomy, it is somewhat “old tech”. It’s a hold over from the days when there were no reliable, safe options for contraception. It remains because the options we have now are still not 100% effective, safe, or usable. Like a hysterectomy, terminating a pregnancy is sometimes the only option when others have failed. It is sometimes the best option given the circumstances. And like a hysterectomy, terminating a pregnancy is not a decision any reasonable person would make lightly. And yet, in the case of pregnancy termination, and even in the case of pregnancy prevention, the decision is not left to the typical manner of medical decision making.

If we as a society believe women’s parts belong to making babies, it stands to reason that unless her parts are declared insufficient for that task, she can’t opt out of that job. So unlike a hysterectomy, the choice to terminate or prevent a pregnancy is public policy. It’s ideology, it’s everyone’s concern, not just how or when you decide to regulate your reproductive affairs but even whether you should have that choice at all. We have laws prohibiting or limiting that choice, in many forms. We have laws which allow people to jump in and decide for you that you will NOT have access to the means to make these decisions or to exercise them.

How do these two apparently disparate standards mesh? Because in the case of the hysterectomy, the woman’s parts have already been determined to be of no use to society. Therefore, they are of no use to the woman, if that even enters into it. When a doctor says a woman’s woman parts are no good, it’s ok to cut into her and out of her. It’s ok to take out her uterus, her fallopian tubes, her ovaries.

The unifying attitude which underlies both apparently discrepant approaches to women’s health (promoting the “surgical option” in one case and denying it in the other) is one where women are considered only in terms of their reproductive capacity, where pretty much everything else that is attached is overlooked or relegated to a much lower priority. What can be attached can be the rest of her body, her physical and emotional well being, her autonomy, or her existence.

There is a whole other essay on why that prioritization exists. The short version is we live in a society that has grown up around a truly disgusting and inhuman role for women. It’s not as easy to pinpoint and classify as straight up misogyny, and that is the mistake too many feminists make when they try to argue this with others. The mistake being that it is easy enough for someone to argue that not all men are rapists and not all women are raped, that not all men shit on women, and that some women shit on women. All true and all only relevant if you think the only reason that women are second class citizens is simple, raw misogyny. The real cause for women’s lower class status is not that simple. The root cause is something which breeds misogyny and excuses misogyny but it is not just a hatred of women and womankind. This is apparent in that it can be seen to feed laws which exist “for our own good” and which take away our autonomy, which reduce us, keep us out, or in, or down lest we bump our pretty little heads on the glass ceilings we should be thankful are there to protect us.

The real root cause is that women are considered goods. Women’s bodies are goods. Women’s attention is goods. Women’s emotional support is goods. Women both create and are the resources which run society. A strange but ultimately appropriate analogy is that women are seens as being like trees. Cultivate us to be cut down and turned into your furniture, your paper, and your decoration. We are traded, bought, sold, co-opted, and consumed. Our reproductive capacity is just another woman byproduct, albeit a very significant one. The bigger issue though is that when it comes to this one, when push comes to shove, even your average leg shaving “not a feminist but” woman is a hell of a lot less accommodating than your average tree. Even she will expect that she can say no, she can say yes, she can say “I need to think about this”. Even she will expect that what she says and what she decides will be respected at least when it is about her and not about you or them.

I’m not anyone’s furniture. My early life was filled with discouraging moments as I realized things like “because you are female you are expected to smile all or most of the time” (because you have to look like you are enjoying being the footstool), you are expected to be consumed and you are expected to at least act like that is ok with you.

I’m a crazy optimist because despite those realizations so early on, I still believe that when push comes to shove or even to gentle nudge, I have a right I can at least fight for. I believe having personal, reasonable, sensible autonomy about my health care and my body are basic human rights, not a man’s right, not a privilege, not a special interest, not something a woman can do only if she gets a note from her doctor, her father, and her priest. And this is why I am pro-choice.