Picturing Abortion Work

Jan Haaken, Ph.D.

Our Bodies Our Doctors tells the story of abortion care from the perspective of providers, taking viewers into clinic spaces where procedures are performed and into the thinking of providers about the challenges and joys of their work.

As a feminist activist, clinician, field researcher and academic, as well as a former staff nurse at a Feminist Women’s Health Center in the 1970s, I brought a somewhat unique set of skills to this documentary. This feature-length film began with my two shorts, Being There and Kuwepo, produced for the Providers Share team at the University of Michigan Ann Arbor—a group led by Jane Hassinger and Lisa Harris that has been carrying out research on abortion stigma for over a decade. The team invited me to create the two short films to convey some of the key findings in their research, for example, how stigma operates through the disavowal of dependency. The dominant group maintains power through projection of the “bad” onto the marginalized group, whether women, people of color, farm workers, immigrants, or in this case abortion providers. This oppressive dynamic includes attacks on the despised object of dependency. Anti-abortion activists for decades have used images of fetal parts and fully formed babies to advance this idea that abortion providers are baby-killers, pushing this idea to absurd lengths with the ‘heartbeat’ laws—such as the one recently passed in Texas and upheld through a “shadow ruling” of the Supreme Court on September 1st.   

Our Bodies Our Doctors is informed by psychoanalytic principles through various phases of the process, from participatory methods of developing the concepts, interviewing and editing, to working with the dynamics of audience responses. One psychoanalytic principle that I work with centers on focusing on images cast to the margins, or repressed, on the stage of consciousness. I look for meanings in the overlooked and more quotidian aspects of human experience. Second-wave feminists fought for abortion-on-demand, refusing to keep the decision “just between the woman and her doctor” or to produce a redemptive explanation to justify terminating a pregnancy.  In many states before Roe v. Wade, securing a “therapeutic abortion” meant presenting your story to a panel of physicians and convincing them that you would harm yourself or your child if you were forced to carry the pregnancy. While outrage against the new “Texas Heartbeat Act” understandably includes its lack of exceptions in cases of rape and incest, focusing on these tragic stories is itself a kind of trap. (In my September 20th Left & the Law KBOO segment with attorney Mike Snedeker, we take up this new Texas law and the political landscape for fighting back.)

To counter anti-abortion forces, many pro-choice films and media portrayals emphasize the fact that most people terminate pregnancies in the first trimester.  But the norm that became the compromise decision of Roe v. Wade, where the first trimester seemed most secure legally, accepts as a premise that “responsible” women act within this short time frame. In Our Bodies Our Doctors, I wanted to transgress this fetishized temporal boundary where lines get drawn between “good” abortions and “bad” abortions, between the good responsible patient and the careless one. Providers in the film show how race, social class and other social factors mediate who gets placed in these morally charged categories. For people with fewer resources or who live under highly stressful conditions, or whose life circumstances change abruptly, time holds different meanings. In no other area of healthcare is there this societal condemnation of people who hesitate for various reasons. Even with vaccine rollouts, there are major public health campaigns encouraging empathy toward those people who may need more weeks or months to decide.  

As a feminist filmmaker, I wanted to tell a story about the relational aspect of abortion work as well and to structure the arc of the story around work relationships rather than on solitary heroes. Many of the providers in the film are indeed heroes. But such portrayals can carry their own burdens of over-idealization, reinforcing a sort of exceptional outsider status, or can downplay how acts of courage depend on forms of affinity. I wanted to capture the intimacy of abortion care as well and how this clinical work is very hands-on. People who carry out the procedures have to be comfortable touching women’s bodies and with the emotional intensity that often accompanies this work. As one of the doctors explains in comforting a patient, “just because you are sad doesn’t mean it’s the wrong thing to do.”  The emotional and circumstantial meanings of terminating a pregnancy vary, and some people do experience loss or grief.  One physician describes to some medical students his disturbed reaction when he completed his first procedure at around 24 weeks. The head came out and he jumped back reflexively. He goes on to tell the story of how this patient wanted to see the fetus and of his own protective hesitancy. But the emotional tone of this scene centers on the doctor’s caring for this patient and his respect for her own process. This was something that came from her body, he explains, and it was her right to determine what she needed for her own sense of closure. He and other featured physicians in the film were part of Medical Students for Choice (MSFC), an organization that has fought to include training in abortion procedures as part of the normally required OB/GYN curriculum. The organization also brings many of the principles of the feminist health care movement into the medical field and we see in the film how these physicians transmit both ethical commitments and medical skills to the next generation of doctors.  In countering campaigns for “conscientious objection” to performing abortions among some conservative doctors, including in countries such as Ireland, Spain, Mexico and Argentina where abortion has been recently decriminalized, MSFC has organized internationally around the ethical obligations of physicians to provide care, what Dr. Willie Parker and others featured in the film term “conscientious provision.” 

Audiences at screenings often ask how we approached people who agreed to have their procedures filmed. There were 9 women who agreed.  All were approached in clinic waiting rooms and provided information about the documentary in compliance with HIPPA rules that include confidentiality and privacy provisions but also the rights of patients to communicate with the media. (This right to tell your story in a public way is also a feminist principle!) Patients were told the documentary focuses on the providers and that the patients’ personal identities would be concealed. Further, they were told that their choice of whether or not to participate would not affect the care they received. Those who agreed—a minority of patients for sure—offered that they were grateful that these providers were there for them. For many, it was an expression of that deep gratitude. 

The anti-abortion forces rely heavily on villainizing feminists and the film itself takes up different feminist ways of thinking about abortion—how abortion-without-apology was part of a broader radical movement before Roe v. Wade and how Black feminists brought the concept of reproductive justice into abortion politics—that reproductive justice means demanding the resources to care for the children we do bring into the world as well as the right to end pregnancies, and it includes choices around sexual freedoms.

One of my favorite questions from audience members, one that has become predictable, goes something like this: “This is a beautiful and powerful film. But are you concerned that you’re preaching to the choir here and that the people who really need to see this are not going to come?”  My typical retort:  “No, I think it’s important to preach to the choir, particularly when the choir needs to be louder and to rely less on old worn-out tunes!” As we mobilize to defend abortion rights in the face of what seems a likely death of Roe v Wade at the hands of the rightwing courts, the big vision of reproductive justice that Black feminists have insisted on for decades must guide our spirits. I hope this film will inspire us to sing more loudly and with deep conviction. 

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