an astonishingly large percentage of women report that they have been sexually molested at some point in their lives. the figure usually quoted is 27%. (for the record, it's 16% of boys). some women and girls become pregnant as a result of rape, having had sex against their will. of course the majority of pregnancies conceived in sexual assault situations end up as abortions with the possible exception of marital rape; some of these circumstances are so very dangerous for women and many of them cannot leave their homes for fear of being beaten. sometimes we at the clinic, at the patient's request, work with law enforcement agencies to collect the pregnancy tissue for DNA testing at an independent lab. only occasionally do we ever hear the outcome since, unlike on TV, it is not uncommon for the final outcome to take quite some time before resolution.
the effects on women whose past medical history includes rape or molestation is heard, felt, observed almost every day at the clinic. the girl who is very fearful and anxious of being touched "down there" by the doctor, the woman who has not been to see a gynecologist for a pap smear in over 10 years, the shaking and terrified patient who says that she can only be examined by a woman doctor are all possible examples of a history of unwanted sexual encounters, some having occurred when the women were small children. our medical chart has a place for women to let us know if they have difficulty with exams or even if they have avoided them altogether. we then work with those patients to create an environment in the exam room that minimizes their stress level so that, at the very least, the abortion can be performed. it is our hope that, with our support, these women develop enough trust in us that they can return for regular gyn care.
but a less obvious yet more pervasive manifestation is the effect that sexual molestation has on women in their daily lives. often i talk to women who have never trusted their own judgement, who have an extremely hard time deciding most things in their lives. since pregnancy is such a major life changing event, some may find themselves almost frozen and unable to make a decision at all. or they may state that they do not feel that they are prepared for parenting since they cannot take care of themselves, but that they feel "unworthy" to make a decision that would allow themselves to be better prepared for assuming the responsibilities of parenthood because that might be deemed "selfish". or they might not have any experience in making important decisions throughout their lives.
just the other day i talked to a woman who ended up going home before her abortion was done. this time i did not "send" her home; she chose it. we had talked for quite some time and although she did not express any doubt that abortion would be best for her three very young children, she said that she was embarrassed to admit it, but she said she was not an "independent woman". i'll call her trudy and tell you that she is 25 years old, recently moved here with her boyfriend, who is the father of her children. they have not been getting along and trudy had been considering returning to the city where all of her extended family live. she said that sometimes she thinks the only reasons she has not already left him is that he is her kids' dad and also that her family, who never liked him, will say "we told you not to be with him".
right now, being new here, and more than a thousand miles from home, she has no real friends. her family is adamantly opposed to abortion but she said that that does not influence her decision. her religion is opposed to abortion, too, but she said she is firmly convinced that god knows that she should not have another child. two weeks earlier, trudy discovered her boyfriend in bed with another woman. this pretty much confirmed for her that she needs to leave him, and, as she said, returning home as sole support of three kids is maybe manageable, but with four she just could not make it. even if he does send her some child support, it will be a struggle for a long long time since all three children are so young.
so what was her hesitation? and why did she leave the clinc still pregnant? she said that she just could not carry out such a big thing on her own. she kept saying that she wanted to have the abortion, that she knew it was for the best, but she had no experience of doing anything without his permission and he did not want her to have an abortion. trudy is educated, well spoken, not shy, and feels humiliated that she cannot act against him. her past sexual abuse seems to have stripped her of her ability to act in her own favor.
she got as far as the operating room, was undressed and then said she could not do it. trudy got dressed and then i sat with her while she told me that she could not go forward. i told her that we would do whatever she wanted, either refund her money or go back into the procedure room. she eventually asked me if i would go into the room with her, and of course i agreed. once again, before the doctor even did an exam, she started to have a panic attack and said she could not do it.
i was willing to sit with her as long as it took, but she felt that she was done for the day, that she just wanted to go home. her own voice is not one that she trusts. when she is "just talking" about her feelings and her decision making, she is quite clear, but when it comes to carrying out her own desires, she cannot do it.
we at the clinic have to trust women to choose what they can best live with. unlike the last woman i wrote about who seemed hesitant, trudy expressed no hesitation about abortion, just about being able to trust her own voice. so many women are like trudy, knowing what they need to do, but being unable to move forward. sometimes it's the fear of what will happen to the children they already have that allows them to act. with women in abusive relationships who cannot bring themselves to leave for themselves, sometimes only fear of what might happen to their kids allows them leave. or to decide to not continue this pregnancy.
ps trudy did not return and is now beyond the time that we could offer an abortion to her. i cannot say what would have been better for her life and her children's life, but i do know that it was those early years of sexual abuse that stripped her of her sense of self so that she can "decide" only by not deciding. it's how she moved here, it's how she will end up with four children while her boyfriend brings other women into their bed. it does make me sad for her, that she seems unable to value herself.