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About Abortion: Terminating Pregnancy in Twenty-First-Century America

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One of the most private decisions a woman can make, abortion is also one of the most contentious topics in American civic life. Protested at rallies and politicized in party platforms, terminating pregnancy is often characterized as a selfish decision by women who put their own interests above those of the fetus. This background of stigma and hostility has stifled women's willingness to talk about abortion, which in turn distorts public and political discussion. To pry open the silence surrounding this public issue, Sanger distinguishes between abortion privacy, a form of nondisclosure based on a woman's desire to control personal information, and abortion secrecy, a woman's defense against the many harms of disclosure.

Laws regulating abortion patients and providers treat abortion not as an acceptable medical decision--let alone a right--but as something disreputable, immoral, and chosen by mistake. Exploiting the emotional power of fetal imagery, laws require women to undergo ultrasound, a practice welcomed in wanted pregnancies but commandeered for use against women with unwanted pregnancies. Sanger takes these prejudicial views of women's abortion decisions into the twenty-first century by uncovering new connections between abortion law and American culture and politics.

New medical technologies, women's increasing willingness to talk online and off, and the prospect of tighter judicial reins on state legislatures are shaking up the practice of abortion. As talk becomes more transparent and acceptable, women's decisions about whether or not to become mothers will be treated more like those of other adults making significant personal choices.

320 pages, Hardcover

First published March 27, 2017

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Carol Sanger

21 books4 followers

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Displaying 1 - 13 of 13 reviews
Profile Image for Sarah.
1,227 reviews32 followers
March 27, 2017
Although written from a strong pro-choice perspective, this book was very interesting. It discussed the way our culture perceives images of the preborn baby (she only uses the term "fetus" of course) and how that impacts the abortion debate. Also interesting stuff on abortion's stigma, parental notification, ultrasound laws and other issues. I feel like I learned a lot and the author's style was very readable. She made the material interesting and had good insights, even though I did not agree with a lot of what she said.
Profile Image for Kathleen.
425 reviews2 followers
May 9, 2017
This is seriously an incredible book, and a must-read. Prof. Sanger has done the impossible in creating a fresh and engaging discussion of the most over-discussed topic in America: abortion. It's also remarkable for being both scholarly and accessible--I can see this book being assigned on college and law school campuses as easily as becoming a mass market favorite.

You know how you can sometimes be reading a book and you'll have to put it down just to think about one of the points it made for a bit? Reading About Abortion was like that. Considering the way abortion privacy would differ from abortion secrecy, or the ways men would handle abortion, not through over-the-top hypotheticals, but through real world examples like surrogacy contracts. The chapter on judicial bypass procedures for pregnant teenagers who want to abort was mind-bending. If a pregnant teen is determined by a judge to be too immature to get an abortion, then that judge is necessarily saying she's mature enough to endure pregnancy, childbirth, and potentially parenthood. I'm going to be mulling that for some time.

Highly recommend!
205 reviews11 followers
May 18, 2017
This is a book about the law and meaning of abortion. Sanger points out that, even direct regulations of abortion aside, American law rewards childbirth over abortion, for example, when the Supreme Court upheld a law treating foreign-born children of citizen mothers differently than foreign-born children of citizen fathers, Sanger notes that it pointed out that “even before the child has been born, its mother had already engaged in deserving conduct” by choosing childbirth over abortion, which the Court recognized as a real alternative even where locally illegal. Likewise, our immigration policy for a while favored victims of China’s one-child policy, both men and women; then it faced accusations of incentivizing illegal entry, especially by men who claimed derivative protection from coercion against their wives but might never in fact send for those wives. In the second Bush administration, the AG told the BIA that spouses couldn’t get the same protections as women who actually had been forced into abortion or sterilization. Sanger also tells the story of a woman who was kept in jail awaiting sentencing on an unrelated charge by the judge specifically so she couldn’t get out and have an abortion, as well as similar instances of judges using unrelated events to coerce women into giving birth. Graphic images have their own legal roles to play—while policymakers insist that forced ultrasounds will make women reconsider abortion (they don’t), graphic photos of allegedly aborted fetuses have caused First Amendment disputes in advertising as well as in prisons, where one warden was allowed to bar the display of such images because they upset inmates.

There are a lot of horrible stories of pressure and shaming in the book, such as the woman who applied for a job at the police department and was given a polygraph asking whether she’d had an abortion and with whom she’d gotten pregnant. “In civil, criminal, and family law custody cases, evidence of a prior abortion has been admitted in court to show that a woman litigant is undeserving, untrustworthy, or unmotherly and that she should not prevail”; while sometimes these cases are reversed on appeal, the fact is that abortions are used against women. One divorce case allowed the husband’s attorney to attack the wife’s credibility because either she was “traumatized by the abortion … or worse, she wasn’t traumatized by it.”

Sanger argues that abortion is presently more about secrecy than about privacy because of this shame connection. “Privacy is valued for what it provides to those who choose it: a decision taken for privacy is credited as reflecting a person’s will; it is an exercise of autonomy…. By contrest, the decision to keep a matter secret in the context of abortion is often a response to the threat or prospect of harm, whether harassment, stigmatization, or fear of violence.” But silence about abortion is part of what keeps it shameful: because very few women talk about their abortions, “it seems as if it isn’t exactly happening, or at least it isn’t happening to anyone you know or care about,” just as Justice Lewis Powell in 1986 thought he’d never met a gay person when he’d had gay clerks.

Sanger also includes fascinating accounts of the history of fetal representation—as tiny men (of course) moving to the famous Life photos, which were of dead fetuses that had been placed against a background that made the womb disappear. But women’s bodies had been erased “centuries before ultrasound images obscured fetal connection to the woman.” (She also tells stories of taking or painting pictures of dead babies/children as a mourning practice in earlier times—the rise of photography allowed middle-class families to access the kind of remembrances already available to the wealthy; the lifelike pictures of dead children could cost up to ten times as much as a standard studio picture.) Also, I wasn’t really aware why early miscarriages weren’t recognized as such: “the embryo is typically enclosed by membranes which have to be peeled away to see the actual entity,” and early on also looks reptilian “so that the expulsion was often regarded not as a failed pregnancy but as a ‘monstrous birth.’” Now, however, with the spread of ultrasounds, at least for wanted pregnancies a child’s social birth—“the incorporation of a child into its family—often precedes biological birth.” (Sanger doesn’t spend much time on race and class.) Still, her story is one of continuity—images weren’t necessary for fetal images to override women’s choices and lives.

The few discussions of non-US abortions are largely about how abortion doesn’t have a fixed meaning: abortion is a crime in Thailand, but in 2010, over 2000 fetal corpses were found in a Buddhist temple in Bangkok, where the clinics had been sending the corpses for cremation. “[R]eports of hauntings by disrespected fetal spirits began to spread. Apologetic local citizens came to the temple with gifts of milk and bananas …. After deciding that the spirits had been appeased, worshippers began to regard them as harbingers of good luck ….”

And the trend in fluid meaning in the US is anti-choice; opposition to abortion on moral grounds has increased, especially among younger women, and Sanger connects this to the “increased moral status of the fetus” along with their inability to remember the fallout from illegal abortions. Forced ultrasounds are used to coopt women into the social category “mother” because of the role of the ultrasound in wanted pregnancies. Lawyers for minors seeking judicial bypass of a parental consent or notification requirement routinely tell them to look at the ultrasound so that they’ll seem mature enough to the judge.

One of the most compelling chapters in the book, in fact, is about the meaning of bypass hearings. What happens? Either they’re rubber stamps—pure humiliation rituals—or the judges impose their own morality on girls, reasoning that the act of becoming pregnant signals immaturity sufficient to deny the bypass request. Sanger emphasizes that even the success stories, including states in which nearly every application is granted, are about forcing young women to expose and demean themselves by recounting the circumstances of the pregnancy, explaining their life plans—in ways teens often can’t no matter what their situation, especially not in the intimidating environment of a courtroom full of strangers—and even answering questions about what contraception they’re using. The procedure “makes her appear an unreliable sort of girl from the start,” given that by definition she’s had sex and is trying to make an end run around her parents. The anonymity of the procedure, which is important for a young woman’s protection, nonetheless contributes “to the aura of furtiveness.” “There is irony amidst all this sneakiness, for these are not the girls who typically turn up in court for misconduct.” Judges punish young women for sounding like teenagers, for example vowing not to have sex again and also saying that they plan to get on contraception. And judges “never” approve petitions from minors who appear a second time—connected to the remorse a minor must show to be deemed mature enough to avoid parental notice/approval. In 1992, a judge said that he rarely grants bypass petitions, but he would if a white girl were raped by a black man; he was censured by the state supreme court, but Sanger points out that his racist example was an exception to his general policy of denying bypasses due to his personal beliefs about abortion, which went “undiscussed and uncensored.” Even when the bypass is granted, it’s punishment for having sex and seeking an abortion; some parents know about the abortion but deny consent even knowing that their daughter will succeed at a hearing: “This is your responsibility, not mine.” Sanger compares this to counseling regimes in European countries where no one else’s consent is required, but notes that they probably wouldn’t work as well in the US, where even county court clerks feel justified in denying marriage licenses to couples they don’t approve of.

Sanger connects bypass procedures to the history of seeking pardon in court—women are less often petitioners for forgiveness in court proceedings because excuses like being drunk or becoming overcome with rage at an insult weren’t considered as exculpatory for women, and “because subjection was an everyday feature of women’s lives,” symbolic submission such as pleading on one’s knees was less impressive coming from them than from men. The absence of female pardon-seekers also resulted from substantive law—capital crimes most associated with women were the unpardonable witchcraft and infanticide.

Another interesting chapter asks, somewhat seriously, how would men think about abortion if they were the ones who got pregnant? This is a difficult counterfactual because if men got pregnant they’d be, socially, women. But focusing on women’s bodies as the locus of abortion’s meaning obscures the gender-based judgments that motivate abortion regulations, and make it harder to see the post-pregnancy consequences of motherhood as relevant. Having, and probably raising, a child is what makes many mothers’ adult lives different from most fathers’, which is why unwanted pregnancy is an equality issue. Sanger examines how men in relationships react to abortions—cohabiting men “generally support whatever their partner wants to do,” and most exes of women who aborted “report that they were unready for fatherhood and wouldn’t have wanted a kid with her anyway.” But Sanger thinks that even more information is available from men’s actual behavior regarding the disposition of cryogenically frozen embryos; abortion clauses in commercial surrogacy clauses; and cases where men have to decide whether to withdraw care from brain-dead or comatose pregnant women.

Sanger concludes that men give basically the same reasons for choosing not to bring a fertilized egg or fetus to term that women do—the interference with their life plans and the interests of their current children; their unwillingness to extend a relationship with the other parent or create a relationship with the future child, including the creepiness or tragedy of knowing that there’s someone genetically related to you out there even if you give the infant up for adoption; the difficulties of caring for a disabled child (the most common scenario for the commercial surrogacy cases, where the child is usually wanted, but only if it’s conventionally healthy). These scenarios aren’t exactly analogous, because the social meaning and obligations of fatherhood still differ from that of motherhood, but they’re probative of how men would think about abortion if they were pregnant. Men who want embryos destroyed are allowed to speak more crassly about how they want to be able to have a lot more sex with different people in these cases than young women are in bypass cases, but they both want freedom to act without the constraint of a child. And men in the surrogacy and embryo cases are generally well-off (that’s how they afforded these procedures in the first place), so they aren’t generally worried about current finances, but they do worry about the effect on existing children’s inheritances. They are also concerned with disability; men in surrogacy contracts were “less concerned about adding children than about adding certain kinds of children.” By contrast, women choosing abortion often find financial concerns to be central—three-quarters of women seeking abortions in one study said that they couldn’t afford a baby at present, often because of the needs of existing children.

Similarly, men didn’t fear the disruption of their education and careers in these scenarios, because they were not as subject to those risks, but women regularly did. Women, like men, desire to have children they can provide for—both materially and emotionally—and when they think they can’t, they may prefer not to have those children. “In sum, it turns out that most of men’s reasons for terminating a pregnancy or destroying an embryo—wrong time, wrong partner, enough kids, too tired, already committed enough—are strikingly similar to the reasons given by women for ending an unwanted pregnancy…. Differences seem to fall less along absolute gender lines than along such markers as situational stability, relationships, support networks, finances, and stamina.” But in our public discourse, the impact of “sex, stigma, and [perceived] selfishness” lead women’s choices to be condemned. Men didn’t suffer for being revealed to have had sex; they were willing to assert the right to enforce abortion clauses in surrogacy contracts and be publicly identified as fathers who rejected disabled children. Women are expected to do more caring work, and so their abortion choices are deemed selfish when they are acts of profound self- and other-care.

Sanger ends the book with meditations on abortion revelations as a means of diminishing the shame and stigma surrounding abortion. People who hear abortion secrets tend to have a more accurate understanding of how common abortion is and the reasons women have them. While Sanger doesn’t argue that women have an obligation to disclose, given the potential consequences, she does argue that more openness will lead to more understanding of the truth of abortion. Open secrets—such as the prevalence of abortion and the prior use of maternity homes—have social value in “let[tting] a disfavored practice go on without anyone having to acknowledge or condone it”—but that’s not good enough. Among other things, these practices can lead to “preference falsification,” where people wrongly think that their private beliefs aren’t widely shared. This is an issue in US politics, as well as in the sudden collapse of the Berlin Wall, where Communism’s support proved much weaker than many people thought.
Profile Image for Debbie.
359 reviews
September 24, 2019
A well written legal analysis of the issues and conversations that arise from the subject of abortion. The book is a little dense so it takes some time to read but it provides a good historical perspective on the subject of abortion and looks at alternatives to having better conversations about this subject.
6 reviews2 followers
May 3, 2017
About Abortion is the most interesting and relevant book on the topic of abortion in America today. The writing is excellent and the ideas are new, even for those who think they know all there is to know about the issue.
There is no question that the book supports legal abortion, but there is a clear linkage between the right to choose and the Supreme Court ruling in Roe v. Wade, supporting that right as a matter of U.S. law.
The book covers the legal, social and historical aspects of abortion going back centuries, all the way up to the possible defunding of Planned Parenthood by the current administration. For example, because I live in a fairly progressive state regarding this issue, I didn’t realize now how many states have added condition after condition aimed at making it more difficult for patients to have access to abortions. These conditions include mandatory waiting times between consenting and having an abortion, having to be offered the opportunity to view their "baby" after a mandatory ultrasound, being required to bury or cremate fetal remains, and being humiliated in a variety of other ways, especially for teenagers. The amount of ongoing litigation on these matters is incredible.
The book is very even-handed in laying out the concerns of pro-choice and pro-life people. The author believes that deciding what to do about an unwanted pregnancy is a deeply personal, uniquely intimate decision that is up to every woman to make based on her own circumstances and beliefs. However, how the law treats a woman’s decision ought to be measured in the context of the current laws, and in the U.S., the right to decide about abortion stems from a constitutional concept of personal liberty to make decisions about such important matters in one’s own life.
The most interesting and unexpected part of the book addresses incredible social changes that swept over American society in the latter part of the 20th century and the 21st century to date, but that seem to have left abortion out. These include the change in how divorce is now mostly universally accepted, the change in how the LGBT community is recognized, the acceptance of same-sex marriage, the way cancer (or divorce or depression) has found its way out of the closet and into the open, and many other examples. While this massive transformation has occurred, abortion has remained a secret, hidden in the shadows and still felt by many to be overshadowed by shame. The reasons for this phenomenon are discussed extensively and I found them fascinating. To make her points clearer, the author has also woven novels and movies throughout the book, from Frankenstein to Revolutionary Road. These came as a surprise to this reader, but suddenly books I had read before were took on a new perspective.
I think this book should be read by everyone, regardless of where you stand on the abortion spectrum. It is very hard to make an informed judgment about any controversial issue unless you understand both sides of the debate. For those that believe that life begins at conception and that abortion is murder, it may be difficult to understand the position of those who, for religious or scientific or social reasons, feel differently. Yet even if your opinion remains unchanged, hearing stories of women who exercised their right of choice, for whatever reason, serves to humanize those women who are making a difficult but compelling decision based on personal circumstances that many might recognize.




Profile Image for Annika Reno.
34 reviews1 follower
May 3, 2017
Anchored in contemporary case law but enveloped in examples from popular culture, medicine, politics, government and religion, About Abortion gives voice to every woman who has considered, pursued or had an abortion. By revealing America’s muddled history and consequent warped perception of the right to terminate pregnancy, Sanger makes the case for more “abortion talk.” Compared to other closeted subjects of the late twentieth century— including homosexuality, divorce, miscarriage, even breast cancer—abortion is still a risky subject of conversation that demands secrecy. Sanger says we know why women are reluctant to discuss abortion; in many communities admittance of abortion could cost a woman her safety, reputation, family and closest relationships. Speaking sensitively Sanger is distinctly balanced in her discussion of both pro-life and pro-choice perspectives and ultimately calls on Americans to recognize abortion as an acceptable choice in the context of unwanted pregnancy. More often then not abortion regulation limits women’s life options, obliging motherhood and simply making women’s lives more difficult. This book is sure to ignite conversation about abortion and rid women of the painful secrecy attached to what should be considered a common medical procedure.
Profile Image for Emily.
20 reviews20 followers
October 28, 2017
This was a great history of court cases and extremely informative. However, it did not take much of an intersectional perspective. I felt like if there was not a court case, it was not discussed - which is very middle-class and white-centric, as lawsuits are not cheap or easily accessible. I felt like more socioeconomic and racial effects of lawsuits and abortion access could have been discussed. Overall, it was very informative and I learned a lot. But I'm highly disappointed in the whitewashing of the discussion.
Profile Image for Dawn Serra.
55 reviews71 followers
July 9, 2017
I had the immense pleasure of having Carol on my podcast recently. It was a powerful conversation full of tidbits about the book as well as stories from my audience about their own abortions.

This book may seem like it's only for pro-choice/pro-autonomy folks, but it's actually delicious accessible and fascinating for anyone curious about the politics, language, and imagery associated with women's bodies.
453 reviews14 followers
December 4, 2018
Sometimes a bit meandering, but the last three chapters are worth the wait. Jam packed full of information and well written.
Profile Image for Anne.
13 reviews4 followers
August 13, 2019
Very original work on a topic I've (sadly) read all too much about.
Author 3 books342 followers
May 1, 2017
A brilliant examination of abortion and the political, legal, ethical, scientific, historical,and personal issues it implicates. Carol Sanger is not only an original thinker and scholar, she is a first rate writer. A stunning achievement.
Displaying 1 - 13 of 13 reviews

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