How To Be A Woman

Chapter 15




Abortion




I think I have polycystic ovaries. That’s what I’m getting the ultrasound for. I’ve been to my GP three times with symptoms – acne, exhaustion, weight gain, disrupted menstrual cycle – and this is where they’ve referred me: the Ultrasound Unit at the Whittington Hospital.

Yes – with those symptoms, you think I’m pregnant, don’t you? But I did a test six weeks ago, and got nothing, and this is where my GP has sent me now. I’m eating two cans of tinned pineapple for breakfast, and cry when I see a sad squirrel in an advert. Of course I’m pregnant. But the test said not. And I’m still breastfeeding. And I don’t want to be pregnant. So I’m not.

I lie on the bed. The monitor is up on the wall, waiting to show me what’s inside. I don’t really know what polycystic ovaries look like, but I’m guessing I’ll see circles, like oxygen bubbles. Or maybe something more visceral: clusters; bracts.

As the nurse washes her hands, in preparation, the ultrasound screen looks like the view from the deck of the Millennium Falcon, when it’s parked up. Dark, black space, with occasional speckles of light. Still.

When they finally put the ultrasound to my belly, though, it’s like the Light Jump: the whole solar system roars into life. Lines and whorls and kidneys and guts. Moons with asteroids circling. And then, at the centre – low, deep, hidden – a pulsar. A signal. A clock that’s ticking.

That is a heartbeat.

‘You’re pregnant!’ the nurse says, cheerfully. Nurses must be told to always say this cheerfully. They always do – however pale the client is, or however loudly the client has just said ‘F*ck’ and started shaking.

She is doing calculations, with an on-screen tape measure.

‘I would say you’re around 11 weeks,’ she says, pushing the ultrasound monitor into my belly.

That really is it – there is nothing else that looks like a foetus. The curve of the spine, like an etiolated crescent moon. The astronaut helmet skull. The black, unblinking eyes, like a prawn.

‘Oh my God,’ I say, to the baby. ‘Oh, you outrageous thing.’

I am sure he is my gay son – the one I always wanted. His entrance is so showy – so jazz-hands, so ‘Ta-da!’ So sudden. So camp. An absolute blackout on pre-publicity until he can make his first appearance like this, on TV; like it’s f*cking Parkinson or something.

And his luck! This kid is clearly lucky – we only had one unprotected f*ck; that night in Cyprus, in the 20 minutes both girls were asleep. This kid is going to buck odds all his life: he’ll break casinos, and befriend millionaires in the deli queue. He’ll find gold the first time he pans the stream, and true love on the very day he decides he needs to settle down.

‘I can’t have you,’ I tell him, sadly. ‘The world will fall in if I have you.’

Because not even for a second do I think I should have this baby. I have no dilemma, no terrible decision to make – because I know, with calm certainty, that I don’t want another child now, in the same way I know absolutely that I don’t want to go to India, or be blonde, or fire a gun.

This isn’t who I’m going to be, again: another three years of being life support to someone who weeps for me, and rages against me, and who knows, when they’re ill, can only be relieved by resting their head on my belly, and dreaming they’re back inside. My two girls, who I walk backwards in front of – looking like I’m bowing down to them, keeping the wind off them, watching everything they do like a jealous camera – are all I want.

I used to fear their deaths – The car! The dog! The sea! The germ! – until I realised it need never be a problem: on the trolley, on the way to the mortuary, I would put my hands into their ribs and take their hearts and swallow them, and give birth to them again, so that they never, ever end. I’ll do anything for those girls.

But I will only do one thing for this baby – as quickly as I can, before it goes any further.

I thank the nurse, wipe the jelly from my stomach and go outside, to make a call.


In 2007, Guardian columnist Zoe Williams wrote a wholly clear-headed and admirable piece, examining why women always felt compelled to preface discussion about their abortions with an obligatory, ‘Of course, it’s terribly traumatic. No woman enters into this lightly.’

She went on to explain that this is because, however liberal a society is, it assumes that, at its absolute core, abortion is wrong – but that a forgiving state must make legal and medical provision for it, lest desperate women ‘do a Vera Drake’ down a back alley, and make things even worse.


Abortions are never seen as a positive thing, as any other operation to remedy a potentially life-ruining condition would. Women never speak publicly about their abortions with happy, relieved gratitude. There are no ‘Good luck with your morning-after pill!’ cards. People don’t make jokes about it despite the fact that all the truest jokes are about vexed topics and cover every other subject, including cancer, God and death.

Additionally, there is the spectrum of ‘wrongness’ to consider. There are ‘good abortions’ and ‘bad abortions’ – like Chris Morris’s sketch on Brass Eye, where he discusses ‘good AIDS’ and ‘bad AIDS’. Haemophiliacs who caught the virus from blood transfusions have ‘good AIDS’, and deserve sympathy. Homosexuals who picked up the virus from casual sex, however, have ‘bad AIDS’, and are accorded no solicitude at all.

A raped teenage girl seeking an abortion – or a mother whose life is endangered by the pregnancy – is having a ‘good’ abortion. She still won’t discuss it publicly, or expect her friends to be happy for her, but these women get away with barely any stigmatisation.

At the other end of the spectrum, of course, are the ‘worst’ kind of abortions: repeated abortions, late-term abortions, abortions after IVF, and – worst of all – mothers who have abortions. Our view of motherhood is still so idealised and misty – Mother, gentle giver of life – that the thought of a mother subsequently setting limits on her capacity to nurture, and refusing to give further life, seems obscene.

For mothers must pretend that they are loving and protective of all life, however nascent or putative it might be. They should – we still quietly believe, deep down inside – be prepared to give and give and give, until they simply wear out. The greatest mother – the perfect mother – would carry to term every child she conceived, no matter how disruptive or ruinous, because her love would be great enough for anything and everyone.

Women who decide to continue with pregnancies that endanger their lives – ‘Doctors told me another pregnancy would kill me – but here’s baby William!’– are written about in magazine features as admirable; the ultimate mothers. They are the truest embodiment of oxytocin, the pregnancy hormone of love and bonding that keeps the world full.

Women should be, essentially, capable of endless, self-sacrificial love.

I have problems with that assumption. For one thing, I believe something very elemental and, in the theological sense, non-Christian. One of the big dilemmas over abortion is trying to work out where ‘life’ begins with a foetus – concluding that if abortion could occur before ‘life’ begins, that would be a ‘right’ kind of abortion. But given that both science and philosophy continue to struggle to define what the beginning of ‘life’ is, wouldn’t it be better to come at the debate from a different angle entirely? For if a pregnant woman has dominion over life, why should she not also have dominion over not-life? This is a concept understood by other cultures. The Hindu goddess Kali is both Mother of the Whole Universe, and Devourer of All Things. She is life and death. In Sumeria, Inanna is the goddess of sex and fertility, but also turns into Ereshkigal, goddess of the underworld. On a very elemental level, if women are, by biology, commanded to host, shelter, nurture and protect life, why should they not be empowered to end life, too?

I’m not advocating stoving in the heads of children, or encouraging late abortions – but then, no one is. What I am vexed with is the idea that, by having an abortion, a woman is somehow being unfemale and, indeed, unmotherly. That the absolute essence of womanhood and maternity is to sustain life, at all costs, whatever the situation.

My belief in the ultimate sociological, emotional and practical necessity for abortion became even stronger after I had my two children. It is only after you have had a nine-month pregnancy, laboured to get the child out, fed it, cared for it, sat with it until 3am, risen with it at 6am, swooned with love for it and been reduced to furious tears by it that you really understand just how important it is for a child to be wanted. How motherhood is a game you must enter with as much energy, willingness and happiness as possible.

And the most important thing of all, of course, is to be wanted, desired and cared for by a reasonably sane, stable mother. I can honestly say that my abortion was one of the least difficult decisions of my life. I’m not being flippant when I say it took me longer to decide what worktops to have in the kitchen than whether I was prepared to spend the rest of my life being responsible for a further human being, because I knew that to do it again – to commit my life to another person – might very possibly stretch my abilities, and conception of who I am, and who I want to be, and what I want and need to do – to breaking point. The idea that I might not – in an earlier era, or a different country – have a choice in the matter, seems both emotionally and physically barbaric.

As Germaine Greer puts it in The Whole Woman, ‘to become a mother without wanting it is to live like a slave, or domestic animal.’

Of course, there was every chance that I might eventually be thankful for the arrival of a third child. He might have arrived, and forced me to discover new reserves of energy, dedication and love. She might have been the best thing that ever happened to me. But I am, personally, not a gambler. I won’t spend ￡1 on the lottery, let alone take a punt on a pregnancy. The stakes are far, far too high. I can’t agree with a society that would force me to bet on how much I could love under duress.

I cannot understand anti-abortion arguments that centre on the sanctity of life. As a species, we’ve fairly comprehensively demonstrated that we don’t believe in the sanctity of life. The shrugging acceptance of war, famine, epidemic, pain and lifelong, grinding poverty show us that, whatever we tell ourselves, we’ve made only the most feeble of efforts to really treat human life as sacred.

I don’t understand, then, why, in the midst of all this, pregnant women – women trying to make rational decisions about their futures and, usually, that of their families, too – should be subject to more pressure about preserving life than, say, Vladimir Putin, the World Bank, or the Catholic Church.

However, what I do believe to be genuinely sacred – and, indeed, more useful to the earth as a whole – is trying to ensure that there are as few unbalanced, destructive people as possible. By whatever rationale you use, ending a pregnancy 12 weeks into gestation is incalculably more moral than bringing an unwanted child into this world.

It’s those unhappy, unwanted children, who then grew into angry adults, who have caused the great majority of human-kind’s miseries. They are the ones who make estates feel feral; streets dangerous; relationships violent. If psychoanalysis has, somewhat brutally, laid the responsibility for psychological disorders at parents’ doors, the least we can do is to tip our hats to women aware enough not to create those troubled people in the first place.

But, of course, we don’t. In the last two years, three bills have been tabled in the Commons seeking to curtail women’s access to termination. The Times reported that ‘Unprecedented numbers’ of doctors are opting out of terminations, dismayed by the increase in operations.

A great deal of the reason why anti-abortion sentiment is allowed to hold ground is that the debate is just that – an ideological, religious or socio-political debate on abortion. It is rarely discussed in terms of personal experience, despite record numbers of women – 189,100 in the UK in 2009 – having them. Every year, an estimated 42 million abortions occur worldwide – 20 million occurring safely, with proper medical supervision, and 22 million occurring unsafely. Across the world, women are doing what they have always done, throughout history: dealing with a potentially life-altering or life-threatening crisis, and then not talking about it afterwards. In case anyone near to them – those people who are not bleeding, and who have not just had an abortion – get upset.


Women – always loath to talk about the more visceral elements of female reproductive physicality – are too ashamed, or unconfident in their reception, to discuss their terminations, even with friends, or partners. This brings about the curious situation in which, while pretty much everyone must have someone dear to them who has had an abortion, the chances of them actually discussing it with their more conservative elders, or menfolk, are remote.

Consequently, we have a climate where anti-abortionists can discuss abortion as something that ‘they’ do, over ‘there’, rather than the reality – that it has, in all likelihood, been a calm, rational, well-thought-out act, which has statistically occurred very close to home.

When I wrote about my decision to have an abortion in The Times. I was amazed at the reader-response – more than 400 online comments, and over 100 letters and emails. By a rule of thumb, those who were anti-abortion cited no experience of pregnancy or abortion, while those who were pro-abortion, did.

The response that I found most surprising, however, was a wonderful letter from a well-known feminist columnist who said that, although she had written about abortion many, many times, she had never mentioned her own terminations.

‘I always feared what would happen if I did. I presumed no one would forgive me. I thought it would – somehow – invalidate my argument.’

And – as a woman reconciled in her own body – I feel I can argue with anyone’s god about my right to end a pregnancy. My first conception – wanted, so badly – ended in miscarriage, three days before my wedding. A kind nurse removed my wedding manicure with nail-polish remover, in order to fit a finger-thermometer for the subsequent D&C operation. I wept as I went into the operating theatre, and wept as I came out. In that instance, my body had decided that this baby was not to be and had ended it. This time, it is my mind that has decided that this baby was not to be. I don’t believe one’s decision is more valid than the other. They both know me. They are both equally capable of deciding what is right.


I want to end the pregnancy as quickly as possible, and go straight to see the consultant I had for my last birth. During an awkward five-minute consultation, he has to point out to me that the hospital we are in – St John & St Elizabeth’s, in St John’s Wood – is a Catholic hospital, and I have just, in effect, asked the Pope for an abortion.

Back home, the world’s least-fun Google search suggests a consultant in Golders Green, followed by a ‘procedure’ out in Essex. There are two viable options for the abortion itself – I can either be knocked out, and wake up to find it all over, but then spend the night in hospital; or I can stay conscious, but go home the same day. I am still breastfeeding my youngest – so staying conscious, then going home, it is.

There is the third option – the ‘medical abortion’, where you take two pills and then miscarry, at home – but, asking around, anyone who’s experienced it says, ‘It tends to freak you out quite a lot. You just walk around your house bleeding for days. And there’s a chance it won’t work, and then you’ll end up having to have a D&C anyway. Just go in, and get it over and done with.’

The clinic we go to is out in Essex, in an area that has that light suburban air of wife-swapping, and neat brothels run by bosomy women. I suppose, given its air of offering harbour to humanity’s shameful physical needs, this is the right place for an abortion clinic. Inside, it reminds me of a Victorian Youth Hostel – the atmosphere of the ‘clients’ being up to no good, and the staff watching them quietly, from the landing above, purse-mouthed and disapproving.

In the waiting room, there are four couples, and two women on their own. The younger woman is from Ireland – she arrived here this morning, and apparently – I gather, from what she is whispering to the receptionist – will go back on the ferry tonight.

The older woman looks in her late forties, maybe even early fifties. She cries without making a sound. She has the air of a woman who hasn’t told a soul, and never will.

The couples are silent, too – all possible conversations have been had, before you get here. My husband is red-eyed but solid, just as he was through two births and a miscarriage. He made his definitive statement on all this years ago: ‘It seems wildly unfair that, for us to reproduce, you have to go through all this … shit.’

In the peerlessly unromantic conversation we had, when I phoned him from outside the ultrasound clinic, there wasn’t even a debate. He said, ‘What do you want to do?’, I said, ‘No,’ and he said, ‘Yeah.’

We knew how we both felt – God, we’d lain in bed the week before, after spending the day with friends and their newborn, going, ‘She’s got that Thousand Yard Stare, and he looks half dead. You forget how much attention they need, don’t you? How you’re just … stuck.’

The nurse calls my name, and I leave his hand to go to that room. As I walk, I levitate up, up, up into a panic attack, and in a telescopic rush, I know – coldly know – that I am making a terrible mistake, and that I must keep this baby, no matter what. But I also know panic attacks, and I know they lie. Every single other thought you have had has brought you, unfailingly, here, I tell myself. This isn’t a last-minute revelation. This is just fear. Tell it to stop.


I don’t know what I thought abortion would be like. When I had a D&C after my miscarriage, they knocked me out – weeping – and I woke up – weeping – with it all over.

‘Where’s the baby?’ I kept saying, off my face, as they wheeled me into a room and told me – as gently as possible – to shut up. The only real knowledge I had of that procedure were the after effects: sore, obviously, and aware of the pregnancy hormones leaving me, hour by hour. Taking away the oestrogen floatiness, and making me feel heavy – my proper gravity – again: like when you stay in a bath, reading, as the water drains away.

This time, I’m awake for all of it. The whole thing is a bad surprise. I suppose I thought the one thing it would be was ‘clinical’ – doctors just doing their job, coldly and quickly; procedure precise and fast. But as I lie on the bed – the last appointment of the day – the doctors have the air of people who’ve spent far too long doing unpleasant things, in order to rectify the mistakes of others.

You wanted to become a doctor to help people, and feel better at the end of your job, I think, watching them, as the nurse takes my hand. But I don’t think you do feel better at the end of the day. You look like humans have constantly disappointed you.

The abortion itself is not what I had expected, in that it is both painful, and seems fairly crude. The cervix is opened manually, with some manner of ratchet. Then a speculum is inserted, and they start to perform the abortion, which appears to be just smashing stuff up with a spoon. It’s wincingly violent. Like breaking the yolk of an egg with a chopstick, I think, doing the breathing I learned for labour, which is, of course, a very bad joke.

It’s quite painful – like labour, five hours in. The painkiller has been absolutely useless, but complaining about pain, given what you are doing, seems inappropriate. Even if you yourself don’t believe you should experience pain whilst having an abortion, there’s a distinct atmosphere that the staff here do.


‘You’re doing fine,’ the nurse says, holding my hand very hard. She is kind, but she is also, obviously, already putting her coat on, and thinking about getting out the door. She can smell the weekend from here. She is already far away.

The doctor then uses a vacurette to hoover my womb out, which is pretty much exactly as you’d imagine having the contents of your womb vacuumed out to feel like. In the months after, it makes me repeatedly demur from the purchase of a Black & Decker Dustbuster.

The whole process has taken maybe seven minutes – it is brisk – but the longing for every instrument and hand to retreat from you, and allow you to quietly knit back together, and heal, is immense. You want everyone to GET OUT of you. Everyone.

The doctor turns the vacuum off. He then turns it on again, and does one last little bit: like when you’re doing the front room, finish, and then decide to give the sofa cushions a once-over, while you’re at it.

Finally, he’s done, and I let out an involuntary ‘Ahhh!’ as his hand withdraws.

‘See!’ he says, with a firm smile. ‘Not too bad! All done!’

Then he looks down into the dish, which holds everything that was inside me. Intrigued by something, he calls his colleague over, from the sluice.

‘Look at that!’ he says, pointing.

‘Hahah – unusual!’ the other says.

They both laugh, before the dish is carried away, and the gloves are peeled off, and the cleaning up starts. The day is now done.

I don’t want to ask what it is they have seen. Maybe they could detect he was gay, even at this early stage.

The best thought is: perhaps she’s hideously deformed, and I would have miscarried her anyway.

The very worst thought is: perhaps something was struggling to stay alive – perhaps he’s running out his last piece of luck as I lie here, feeling pale as paper on the outside, and red and black on the inside, like bad meat. That’s the worst bit. The very worst bit. I wish these doctors would shut up.

When they take you into the next room – the ‘Recovery Room’ – you lie, wrapped in a towelling robe, on a reclining chair. They give you a magazine, and a cold drink. There is a potted palm tree in the corner. It looks like the worst re-make of Wham!’s ‘Club Tropicana’ video ever.

The girl from Ireland leaves after five minutes – she has to catch her bus, to catch her coach, to catch her ferry back home. She walks sore. It’s blatantly obvious that she shouldn’t have had to come to another country to get her life back on track. I wonder if the judges in Ireland have ever seen a woman as pale as this, counting out fifties onto the reception desk in a country where she doesn’t know a soul, and then bleeding all the way from Essex to Holyhead. I wonder if her father approves of the law because he doesn’t think it applies to her – and whether he would hate that law if he knew it did, and has brought her here.

The older woman – who was crying, silently, in the waiting room – is here now, still crying. We all seem to have agreed, at some point, to pretend that we’re not here, so no one catches her eye. We just read the magazines until the 40 minutes’ ‘recovery time’ is up, and the nurse says, ‘You can go.’

And we drive away – with my husband driving dangerously, because he’s holding my hand very, very tight – and I say, ‘I’m going to get the contraceptive version of Trident fitted, I think,’ and he says, ‘Yeah,’ and holds my hand even tighter. And that is the end of that day.


Given the subject matter, it seems odd to say that this is the happy ending – but it is.

All accounts of abortion that I have seen always had, as dolorous coda, how the procedure left a mark. However female-sympathetic the publication, there is a need to mention how the anniversary of the abortion is always remembered with sorrow – the baby’s due date marked with a sudden flood of tears.

The narrative is that whilst a woman may tell herself, rationally, that she couldn’t have that baby, there will be a part of her that does not believe this – which carries on silently marking the baby that should have come. Women’s bodies do not give up their babies so easily, and so silently, is the message. The heart will always remember.

This is what I expect. But this is not how it is. Indeed, it’s the opposite. I keep waiting for my prescribed grief and guilt to come – I am braced, chest out, ready – but it never arrives. I don’t cry when I see baby clothes. Friends announcing pregnancies don’t make me jealous, or quietly blue. I do not have to remind myself that sometimes, you must do the ‘wrong’ thing for the ‘right’ reason.

In fact, it’s the opposite. Every time I sleep through the night, I am thankful for the choice I made. When the youngest graduates out of nappies, I’m relieved there isn’t a third one, following behind. When friends come round with their new babies, I am hugely, hugely grateful that I had the option not to do this again – and that that option didn’t involve me lying on a friend’s kitchen table, after the kids had gone to sleep, praying I wouldn’t get an infection, or haemorrhage to death before I got home.

I talk to other friends about this, after a few drinks, and they agree.

‘I walk past playgrounds thinking, If I’d gone through with the pregnancy, I’d still be sitting on that bench, fat, depressed, knackered, and just waiting for my life to start again,’ Lizzie says.

Rachel is, as always, brisker. ‘It’s one of the top four best things I ever did – after marrying my husband, having my son, and getting a fixed quote on the loft conversion.’

I suppose what I’d been given to believe is that my body – or my subconcious – would be angry with me for not having the baby. And that, additionally, their opinion on the matter would, in some way, be superior – more ‘natural’, more moral – to the rational decision my conscious mind had made. That women were made to have babies, and that each one that is not brought to fruition must be accounted and mourned and repented for, and would remain unforgiven forever.

But all I could see – and all I can see now, years later – is history made of millions of women trying to undo the mistake that could then undo them, and then just carrying on, quiet, thankful, and silent about the whole thing. What I see, is that it can be an action with only good consequence.