In her iconic song, Papa Don’t Preach, Madonna has to decide whether or not she should keep her baby…

I’m not keen on abortions. Look, I can’t bring myself to kill a spider. And I really dislike spiders. I prefer to use the cup and paper method, and then, voila, problem solved! If only an unwanted pregnancy could be dealt with that easily. Sadly, it’s not that simple; thank heavens for safe, legal abortions. Thing is, you can’t pick and choose who gets to have one. Not even when a woman seems to have had more than most. Because we must not forget that women don’t get pregnant unless there was a man. Who has probably skeddadled. And who might not have used protection, because, you know, he doesn’t like it, and anyway, contraception is her responsibility, plus she should just keep her legs closed if she doesn’t want to get pregnant… sure, so women can only have sex if they want to conceive? Way to go back in time! Also, if keeping her legs closed were a universally accepted way of saying no, well, wouldn’t that be great. It would solve the whole boring problem of non-consensual sex. But in the real world, women don’t just have sex to conceive. They have sex for the same reasons that men do: for fun, for pleasure, for connection, because why not, if both parties consent. But only women get pregnant. Whatever the backdrop to her unplanned pregnancy (whether or not contraception was used) she has literally 2 choices. Neither are partcularly desirable, but she alone can decide which option is the least hideous for her in this moment. The sperm donor faces zero consequences  for the fact he has caused fertilisation.  How dare he judge her if he failed to take basic precautions. How dare we judge her for not continuing with an unwanted pregnancy, no matter how often this has happened. We’ve all had scares. When it turns out to be more than a scare, how sodding glad are we to have plan B, even though plan B is frigging awful. And although none of us would ever wish it on our worst enemy, we are glad it’s an option for us, our sisters and our daughters. Some women get pregnant despite contraception, seemingly just by looking at a bloke. Don’t judge her for being promiscuous just because she’s more likely to catch a baby from sex than you are. It doesn’t mean she’s having more sex. And frankly, it doesn’t matter if she is. If men who routinely impregnate women faced properly tough penalties, that would at least be fair but that never happens.

So no. I wouldn’t want an abortion. Abortions aren’t a get-out-of-gaol-free card. They are a properly unpleasant medical procedure even when done safely and humanely and legally. They are a last resort. Preventing fertilisation is clearly better. No one disputes that. But I’m glad I could have had as many abortions as I needed. And survived. I want that for my daughter.

I wish there was a cup and paper way to deal with a sadly unwanted pregnancy. There isn’t. And if anyone is thinking just have the baby already, someone will gratefully adopt it…

Just. Don’t.

Pregnancy is tough. I’m a midwife, and the whole point of my (professional) existence is to try to mitigate the ever-present risks that pregnancy poses. To try to catch problems early and diffuse them. To keep pregnant women as safe as possible. As healthy as possible.  You can want the child more than anything, but still find pregnancy tough. It impacts every single system in your body, never in a good way. You will never be the same again. The fact that we submit to this pretty brutal and frankly, badly designed, reproductive system for a wanted child is one (highly laudable) thing. Doing so for an unwanted one is sick and twisted. It sucks for the baby too, because we know unborn babies do suffer at an epigenetic level if their mother is really stressed. Prenatal bonding, which is unlikely to happen in an adoption-bound pregnancy, is beneficial in many ways, because when the mother takes the time to focus on the developing child, she will engage in antenatal care, and know when to seek help when things aren’t right. Mothers who aren’t committed to their pregnancy have zero incentive to quit smoking, stop drinking, conform to the complex pregnancy dietary recommendations, let alone engage in baby Mozart (look it up, it’s a thing!)

So no, I don’t accept forced pregnancy. Look, I have mixed feelings about surrogacy (maybe a topic for a future post) but at least surrogate mothers are a tiny bit compensated for their pregnancies. Whether or not surrogacy should be allowed, at least surrogates have a certain amount of choice and control in deciding whether and when to become pregnant. This is not the case for women forced to go through with an unwanted pregnancy. However unpalatable I’d find an abortion (it’s an invasive procedure, the recovery time isn’t negligible , there’s the very real potential for regret) I’d find forced pregnancy worse on every level. But forced pregnancy might be my only reasonable option if I didn’t have access to safe, legal abortions, because the thought of a backstreet abortion is simply unconscionable. Too often, travelling out of state or indeed, out of country, to access care that no man will ever need even though he is the reason I need it, isn’t an option. What if I haven’t got a passport? What if I can’t take time off work? What if I don’t have any money for a flight and accommodation and food while I’m away? What if I have all the cash, documentation and annual leave I need, but the earliest appointment I can get (because the abortion clinic in the next state is struggling to cope with demand from my state) takes me past the legal limit? Do I risk sepsis/future infertility/death/ prison by going to an unlicensed, dubiously trained, ill equipped back-alley practitioner or do I become an unwilling surrogate? Or do I just suck it up and keep the child that I couldn’t even afford to terminate? Spoiler alert: children are expensive.

A woman’s fertility is usually, thank heavens, something she can control on her own terms through the use of modern contraception. This takes planning, access to good medical care, and often quite a lot of effort. Even when adhered to properly, none are 100% effective. Some carry real side effects and health risks. We do our best to avoid fertilisation without entering a convent or swearing abstinence or waiting til there’s a ring on it. We know how lucky we are to have these imperfect options.

While she is not with child, a woman is trusted to make decisions about her body. And yet, once fertilisation has occurred, some would expect her to relinquish bodily autonomy even when the pregnancy could ruin her physically, mentally and financially. That’s just the pregnancy, I’m not even talking about the cost of motherhood. Upon conception, even when she decides to proceed, she may well be shamed for her choices (too young, too old, too many, too few, too fat, too skinny, too poor, too ill, too single, too much career, not enough career, too selfish, too dependent) because being judged and found wanting is how it’s always been for women. If she does choose that baby, she should be celebrated and cared for. Should she decide not to proceed  simply because she doesn’t want to, that’s a choice only she can make. She must be trusted and actively supported to make it. No judgement. No matter how often. True freedom to continue with a pregnancy or not: that’s the dream. As Madonna once sang: Papa don’t Preach, I’m in trouble deep, but I’ve made up my mind…