It was with some trepidation that I recently read A Botched Operation, the New Yorker piece by Eyal Press exploring the life and career of abortion provider Steven Brigham, and grappling with why and how he is still in business. (Full disclosure: the author is my brother-in-law, by marriage to my husband’s sister).
The piece is a tome—at 10,000 words, it took me nearly an hour to read, but felt like required reading of the good sort. For those of us who live and breathe the world of women’s health day in and out, I daresay we don’t take enough time, on a regular basis, to read and explore and challenge and contemplate new ways of approaching the work. In my mind, our collective lack of reflection happens largely because women’s rights, particularly reproductive health and rights, seem constantly under attack. Even if the attack is not frontal in nature, like those who picket outside our clinics and harass women who seek and need our services, it’s still there… lurking in the shadows, trying to convince listeners that contraceptive coverage under the Affordable Care Act is about the dissolution of the American family. Or that the fight for equal pay is tearing apart the fabric of our nation.
Lest I digress, let’s return to Mr. Press and his contribution to my required reading list. I shared the article with my colleagues, and a few responses came back my way that made me think, “Let’s get clear what this is really about.” A few observations worth sharing and, quite frankly, a few myths worth debunking:
1. “This kind of piece is bad for us; just gives the anti-choicers more material to slam us with.” Time and again, it has been proven that those who oppose abortion rights ignore facts, dismiss evidence, and make plenty of their own fuel to feed the fire of their irrational discontent. Despite this piece being painstakingly fact-checked and written with a voice of reason, candor, and deep curiosity, of course it will still be used by the anti-choice establishment. To prove what? I’m not sure, beyond the sad fact that individuals exist who seek to exploit those less powerful. Further restrictions on abortion won’t phase someone like Dr. Brigham, who isn’t letting rules get in the way of profit. But they will drive reputable doctors and clinics out of business, further limiting women’s options for safe, quality care.
2. If you didn’t get how much of this is really about stigma, shame and discrimination, listen up: A LOT. The story of Sarah Tombler-Gimpel will drive it home for you. Embarrassed, determined not to repeat the cycle of poverty in which she had grown up, seeking a secret procedure in order to protect her anonymity, she risked her life essentially out of fear of what others would think of her seeking a second abortion. That is madness and intolerable. If combatting shame and stigma are not top of your agenda for this work, put them there.
3. Local is global is local is global. The face of a woman who struggles with ill-trained (and sometimes ill-intentioned) providers, inadequate medication, and hard-to-access clinics could be the face of an economically disadvantaged woman in Baltimore, Botswana, or Bangladesh. A woman already living on the margins. We are fighting these battles from Texas to South Dakota, and we need to be linking arms with those who are fighting the same battles from Guatemala to Spain. In my mind, the struggle for safe and legal abortion has no borders—the enemy is the same, and our champions must transcend boundaries.
4. There are standards for quality care and if you don’t meet them, our allies will remove you from their professional consideration and communities. The reason Dr. Brigham makes news is because he is an outlier, an exception, and a disgrace to the many hardworking abortion providers that operate to serve women’s best interests. You don’t get a free pass to the National Abortion Federation (NAF) because you know how to terminate a pregnancy. Go NAF for locking the door on Brigham. Go, Nancy Osgood, for investigating further and refusing to put Brigham’s clinics on your referral list. Quality has many faces: equity for youth and the poorest in society, empowerment in all aspects of decision-making, real contraceptive choices with both informed consent and mix of available methods. It’s not a box you get to check – it’s a lifelong pursuit of excellence for your patients.
5. One of the more troubling aspects of Dr. Brigham is how delusional he is about the professional space he occupies. Again, back to #4: You aren’t a hero because you know how to terminate a pregnancy. You can’t be automatically deified for your “courage” to enter the picketed clinic. You earn your stripes through continual and unglorified acts of bravery, compassion, generosity, basic courtesy, and continual pursuit of both knowledge and justice. Is money motivating him? No, he could have done far better in another space. This is where everyone always misses the lead, because it seems almost too obvious: he’s doing this because he’s a misogynist and power-hungry.
I’m fortunate in that the passion I always bring to this issue is further advanced by the passion I feel for Eyal’s work and the integrity he brings to his life’s journey. Let’s honor his 10,000 hard-fought words and do justice to the challenge he is putting in front of us: Do not miss this opportunity to look deep within the darkest corners of our community and rid what needs to be rid. Abortion should be safe and legal, and what Dr. Brigham provides is not the first and barely the second. Dr. Brigham is not serving women, not serving a life-saving procedure that is being marginalized into non-existence, and ultimately not serving our movement, which seeks to bring equity and power to those who can right the world. For women we stand.