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| Book cover for the book "Life's Work: A Moral Argument for Choice" by Dr. Willie Parker. Image source. |
Well, I finished reading this book a few months ago but hadn't had time to write a review yet because *gestures at the disaster that is the Shanghai lockdown*. But we've just found out that the Supreme Court plans to overturn Roe vs Wade, so, I have to say something. We have to fight.
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Life's Work: A Moral Argument for Choice, by Dr. Willie Parker, is a book about Parker's experiences as an abortion doctor, mostly in the southern United States. It covers his own life story, growing up in poverty with a single mother, then getting lucky enough to have opportunities to go to college and become a doctor, and then the decision he made to change his career path to focus on providing abortions in the places where there is the least access. It talks about Parker's Christian faith, and how that was a huge part of his decision to do abortions. He was also inspired by Dr. King, and sees abortion access as a civil rights issue, and by abortion doctors like Dr. George Tiller, who was murdered in 2009. The book talks about the women who come seeking abortions, how their stories intersect with issues like poverty and race, and how their choices are informed by their own personal life goals. And it describes the actual medical procedure, how a surgical abortion is performed.
I definitely recommend this book to pro-choice people. It shows that it's not enough to just have rights on paper- in practical terms, abortion is not accessible to many people because of things like poverty or where they live. Don't just write off the South. There are people there (doctors, activists, clinic owners) working hard to fight for abortion access.
Do I recommend this book for "pro-life" people? (I put the scare quotes around "pro-life" because it ain't about life- if it were, then "pro-life" people would be the loudest voices in support of accurate sex ed, access to contraception, paid maternity leave, and universal health care.) Uh, I don't know... I don't really think it will change their minds. I think it's good that it shows the real-life struggles of women who need abortions; perhaps a "pro-life" person might come to the conclusion that we need a better safety net so that being poor doesn't mean being stuck in these kinds of difficult situations. The book doesn't tackle the "but, it's killing a baby" argument head-on, so I don't think it would convince "pro-life" people that abortion can be an acceptable choice.
All right now I'll go into more details about the different topics in the book:
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Poverty, the South, and race
Dr. Parker grew up in Alabama. He says his family was "so poor we didn't know how poor we were" [p 42]. No one in his family had gone to college; Parker was the first. Initially he thought he could become a biology teacher, but at college he met professors who recommended he go to medical school, and helped him find resources to help people from low-income backgrounds (for example, financial assistance with paying application fees).
He writes about how many of the women who he sees in his work at abortion clinics are college students with their own dreams, just like he had at that age. He was lucky to have the opportunities that he did, and he hopes that young women with unplanned pregnancies also get to have those opportunities. Which is why abortion access is so necessary.
This is really important, and it's something that I can't relate to, due to my own privilege. There was never a possibility that I wouldn't go to college. I had no awareness that not everyone had the opportunities that I had. And the idea that being forced to continue a pregnancy can just totally derail your life- no, I had no idea about that.
Race also plays a role in this- for a lot of the examples in the book, Parker mentions the race of the people that he met. Lack of access to abortion, due to poverty or geographic reasons, disproportionately affects black women.
There are states in the South that have only 1 abortion clinic, in the entire state. (The book mentions Mississippi- this was published in 2017 so I don't know if that's still true or not.) There are so many hurdles that pregnant people have to overcome- having the money to pay for the abortion itself, finding the time to travel to the clinic, travel expenses, having to go to the clinic twice because the law requires a "waiting period" of 24 or 48 or 72 hours... Parker talks about sometimes when he was in college and owed a few hundred dollars for tuition and couldn't come up with the money- that's the reality for a lot of poor people in the US. He says that ThinkProgress calculated that the cost of a first trimester abortion in Wisconsin, after you factor in money for "gas, hotel, child-care expenses, and the lost hours of work" is $1380 [p 76].
It's hard for me to imagine not being able to come up with a thousand dollars or so for an emergency, but this is the reality that a lot of people live in. For me it would be no problem at all spending that money- I mean, obviously I don't want to spend a thousand dollars on something, but if it's an emergency, then yeah of course I would. But poor people, through no fault of their own, just don't have the money, and it just adds more and more problems as they have to continue suffering through pregnancy.
And different states have different laws. There were examples in the book where Dr. Parker had to tell someone he couldn't perform her abortion, but if she had been in a different state, she could have had an abortion.
This matters. Too often I see "progressive" people wanting to just dismiss the whole South. "Just move" or whatever. That's not right- the people who live in "red states" matter, and we can't just ignore them. And also, remember that poverty is a big issue- just because abortion is accessible for you doesn't mean it's accessible for everyone who needs it.
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Christianity
Dr. Parker talks a lot about his Christian faith throughout the book- how initially he was opposed to abortion because of his faith, and then in his work as an ob-gyn he gradually became aware of how abortion access is necessary, but he personally still wasn't willing to perform abortions, and then eventually he recognized that there is a need and he should be the one to help.
For example, he talks about how he was inspired by the parable of the good Samaritan. He says that women who come to him for abortions are in need, and he should help them, like the good Samaritan helped the injured man who was in need.
I think this is great, and I love how you can see from the book that Parker is a Christian and his faith is very important to him, inspiring the work that he does. It's great to see an example of being pro-choice for Christian reasons.
At the same time, though, none of this is going to be convincing to a "pro-life" conservative Christian. The way Parker talks about his faith is just so completely different from how conservative/evangelical "culture war" Christians talk about their faith and "what the bible says about abortion" and all that. This book shows an example of what it looks like to be a pro-choice Christian, but it doesn't include any arguments to refute "pro-life" ideas about what Christians are supposed to believe about abortion.
The idea that women who seek abortions are "people in need" and he should help them by doing abortions, because Christians are supposed to help people in need- this would sound completely absurd and incomprehensible from a "pro-life" perspective. "Pro-life" people very much DO NOT see women seeking abortions as "people in need"- they're seen as potentially violent criminals who have taken a hostage and need to be talked down by any means necessary- even lying is okay, to save a life. To some extent, "pro-life" people will donate diapers and things like that, to some extent they recognize women with unplanned pregnancies as being in need of pregnancy/baby supplies, but it never comes close to the actual financial cost of carrying a pregnancy/ having a baby. (I know I'm making a really big generalization here, and maybe I shouldn't do that- if you show me a pro-life movement in the US which advocates for free prenatal health care, free health care for young children, guaranteed maternity leave, and affordable daycare, I will take back what I said. And, also, as a pro-choice person I absolutely support those things. Make it more affordable to have a baby, and that opens up more choices for pregnant people who want to keep their baby. I absolutely support that.)
Anyway, my point is: It's great seeing how Dr. Parker's Christian faith is such a big part of his life and his work performing abortions. But nothing he said in this book is going to change a "pro-life" Christian's mind.
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Descriptions of how abortion works
The book gives detailed descriptions of the actual medical process of abortion. It shouldn't be stigmatized or shameful; we can be honest about what it is.
I think it's good that these descriptions are in the book- but at the same time, I personally don't like it. So, that's a reason that I personally would not get an abortion- but of course other people have the right to make their own decision.
I think... I have heard pro-choice people saying, "Oh I hate the argument 'don't say pro-choice people are pro-abortion, no one is pro-abortion', well hey, I am pro-abortion." I don't really agree with that. I think it's good that it exists as a safe medical procedure, because people really do need it- but I'm still sad about it. It's not just a medical procedure, there are a lot more ethical complications, because it is ending a life. And I don't take a position on "when life begins" (which, in this context, means something more like "when does it become a person whose life has value") or whatever- there's no way we can possibly know that. There's not an easy answer I would feel comfortable using as a soundbite to fling around in political debates.
And because it's a complicated ethical question, the only person qualified to make that decision is the pregnant person. It has to be their choice. They know the situation better than anyone else in the entire world. They can weigh all the factors- their health, their financial situation, their obligations to the children they already have, their relationship status, their career. I trust them.
And yes, for some people the decision to get an abortion is easy, and it's not a big deal. To them, it's not a big ethical question. That's also fine, I trust them.
Yes, maybe there's someone out there choosing to have an abortion for reasons that I would say are unethical. But there's no way to prevent that- if you don't let pregnant people be in charge of their own decision on abortion, who would you have instead? A bunch of male lawmakers deciding whose reasons are "good enough" to justify getting an abortion? No, they would do a much worse job than the actual pregnant person. It has to be the pregnant person's choice. Even if there might be a hypothetical pregnant person who chooses "wrong", no one else in the world is capable of doing a better job.
So... I don't really think abortion is a good thing- but you know what else is not a good thing? Pregnancy. Oh my gosh, when I was pregnant, I had to throw up over a hundred times in order to turn that embryo into an actual baby. Being pregnant was awful for me- but worth it because now I have a perfect child. So, yeah, pregnant people can weigh that and make their own decision about it.
I feel like, there's pressure that if you're pro-choice, you have to believe abortion is awesome and can't talk about any complicated feelings about it. Any hesitation is "giving ground" to the "pro-life" side. I don't agree with that. And actually, I think that kind of thinking is why we end up with people saying nonsense like "I'm pro-life, but I would never try to force that decision on other people" um excuse me THAT IS CALLED BEING PRO-CHOICE. People don't want to label themselves as pro-choice if they think it means you have to be all gung-ho about "abortion is great all the time" (which no one actually believes- we believe it should be a CHOICE, ie, if you choose to NOT have an abortion, we 100% support that choice).
My pro-choice philosophy is more like, I don't like abortion, but also I didn't like being pregnant! (In my case, I decided it was worth it, to have a baby.) And if you say that in your situation being pregnant would be worse than getting an abortion, I believe you, and you should have that right.
Anyway I've gone off on a tangent here- none of this is in the book. I was trying to say, the book describes the actual medical procedure of how an abortion is done.
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"Do not judge" and situations where Parker refuses to do an abortion
In one of the early chapters in the book, Dr. Parker talks about how he doesn't judge women who come to him for abortions. Often they will try to explain or justify it to him- talking about what goals they have that are incompatible with pregnancy, or saying they don't usually have sex and it was just a one-time mistake- and he says none of this is necessary. He doesn't need to hear any excuses or reasons like that. He doesn't judge, he says, because the bible says "Do not judge."
And then, later in the book, there's a chapter called "Ethical Abortion Care", which is about the circumstances where Dr. Parker will refuse to do an abortion. He gives the example of a 12-year-old girl who was sexually abused by her foster father and became pregnant. He did not perform her abortion that day; the clinic staff reported it to CPS, the girl was removed from her home, and a few weeks later she came back to the clinic and he did the abortion for her.
He also says, "I will not terminate a pregnancy beyond twenty-five weeks. ... If you're twenty-eight weeks and you just don't want to be pregnant, or you just don't want to give birth- that's not an appropriate use of my skills." [p 194] This is totally judging! Just about bowled me over, reading this- what happened to all that "do not judge" rhetoric?
I mean, I agree with him- by 25 weeks, the pregnancy is really far along (full-term pregnancy is 40 weeks), and the unborn baby has already developed a lot, so I don't like the idea of having an abortion at that point. As I said, I trust women- so I wouldn't want to make a law about it, because the law would be much more likely to cause huge problems for people in desperate, heartbreaking situations, with a wanted pregnancy where a terrible medical problem was just discovered, than to catch the hypothetical evil person who wants to abort a perfectly healthy 28-week fetus for no reason. (No one does that in real life, it only happens in "pro-life" propaganda.)
So yes, it makes sense to me that a doctor can say he personally is not willing to do that. Dr. Parker says in that situation, he would refer the patient to other doctors. I'm just pointing it out because he says he doesn't judge, but turns out he does. Which is fine- I agree that there are situations where you should judge. But then it's ridiculous to claim "I don't judge." What he actually means is there are specific categories of reasons which he doesn't judge you for (your financial situation, how/why/with whom you had sex, whether or not you used birth control, etc), while there are other types of reasons that he totally does judge. (He also says he refuses to do abortions if the reason for it is the baby's gender or the baby's race.)
And he refuses to do abortions in situations where he believes the patient is being coerced into it. This is a good intention, but honestly I find it hard to believe that he can really tell. He gives examples like if a woman says "if I don't have this abortion, my boyfriend will kill me"- okay that's obviously coercion- but if there's not some giant red-flag statement like that, how on earth would you know? Parker seems confident that he can tell. He says that it's normal for people to feel conflicted about their decision, or to wish they could keep the baby but realistically they can't- he says that's fine, that still counts as them being resolved in their choice to have an abortion, and he can totally tell that's different from being coerced. I am skeptical.
He says that for women who have an abusive partner forcing them to have an abortion, he will refuse to perform an abortion for them, but instead help them get to a shelter to get away from their abuser, and then after that, if they decide they still want an abortion, then they can come back to the clinic again. This is a different situation than when a woman has an abusive partner and she knows that if she's pregnant, she will be even more stuck with him- in that case, it's not "coercion" and Dr. Parker will do the abortion. Again, I'm kind of skeptical- yes, I recognize that these are different situations, but how can a doctor really know with confidence which one it is just by talking to a patient for a few minutes?
He also talks about pregnant teenage girls who come in with their mothers. He makes sure to talk to the girl alone to ask if she really wants an abortion. Oftentimes, if the girl says no, and Dr. Parker refuses to do the abortion, the mother gets mad and there's all kinds of arguing. I had a lot of feelings about this one- imagining myself in an alternate universe, where I get pregnant as a teenager, and a loving relative brings me to get an abortion... It would never even cross my mind that I should have a choice about it. At that age, I just followed along and did what the adults said to do, be a good kid- especially with doctors- I often felt like I wasn't "being good" because I couldn't tolerate invasive medical procedures.
If this had happened to me, like what Parker describes in the book, I would have felt like "I'm so scared and I don't even want to be here, but I am trying to be good and do what the adults say, but I've failed so badly at it that I've actually triggered the doctor's consent detection, oh no, this is just getting worse and worse, I'm not being a good kid." The idea that it actually matters if I consent or not, that I actually have a choice- as a teenager, I just didn't have that at all.
So... yeah Parker is doing the right thing, but also that is just such a huge decision to put on a teenager. At that age, there's no way I would have been able to understand what pregnancy would actually mean for me, and what having a baby would actually mean for me. So... it has to be the pregnant teenager's own choice, because no one else in the world is qualified, but wow that is a situation that teenagers are not ready for. I don't have a good solution for this.
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Conclusion
Yes, I recommend this book to pro-choice people. Overall it gives a good reminder about why this is so important and what's at stake. Don't just write off the South- people there need abortion access, and we have to fight for their rights.
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