This Common Secret: My Journey as an Abortion Doctor

  Table of Contents

  Title Page

  Copyright Page

  Dedication

  Praise

  chapter one

  chapter two

  chapter three

  chapter four

  chapter five

  chapter six

  chapter seven

  chapter eight

  chapter nine

  chapter ten

  chapter eleven

  chapter twelve

  chapter thirteen

  chapter fourteen

  epilogue

  afterword

  Acknowledgements

  appendix: further information and factual resources

  Copyright © 2007 by Susan Wicklund and Alan Kesselheim.

  Published in the United States by PublicAffairs™, a member of the Perseus Books Group.

  All rights reserved.

  Printed in the United States of America.

  No part of this book may be reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles and reviews. For information, address PublicAffairs, 250 West 57th Street, Suite 1321, New York, NY 10107.

  PublicAffairs books are available at special discounts for bulk purchases in the U.S. by corporations, institutions, and other organizations. For more information, please contact the Special Markets Department at the Perseus Books Group, 2300 Chestnut Street, Suite 200, Philadelphia, PA 19103, or call (800) 255-1514, or email special.markets@perseusbooks.com.

  BOOK DESIGN BY JEFF WILLIAMS

  Library of Congress Cataloging-in-Publication Data

  Wicklund, Susan.

  This common secret : my journey as an abortion doctor / Susan Wicklund with Alan Kesselheim.—1st ed. p. cm.

  Includes bibliographical references.

  ISBN-13: 978-1-58648-480-4 (hardcover) ISBN-10: 1-58648-480-X (hardcover)

  eISBN : 97-8-158-64862-7

  1. Wicklund, Susan. 2. Physicians—United States—Biography. 3. Abortion—United States. I. Kesselheim, Alan S., 1952- II. Title.

  [DNLM: 1. Wicklund, Susan. 2. Physicians, Women—United States—Biography. 3. Abortion, Legal—United States—Biography. 4. Abortion, Legal—history—United States. 5. History, 20th Century—United States.

  6. History, 21st Century—United States. WZ 100 W6375 2007]

  R154.W47A3 2007 610.92—dc22

  [B]

  2007016594 First Edition 10 9 8 7 6 5 4 3 2 1

  In honor of all the clinic staff, doctors,

  volunteers, and escorts who routinely brave

  harassment and personal attack in order to

  make sure that American women can continue

  to freely exercise their reproductive rights.

  Unless events are matters of public record,

  names, dates, and locations have been

  altered to protect patient confidentiality.

  A woman’s life can really be a succession of lives, each revolving around some emotionally compelling situation or challenge, and each marked off by some intense experience.

  WALLIS SIMPSON

  DUCHESS OF WINDSOR

  (1896-1986)

  chapter one

  When I drove into Grandma’s driveway, all I could think about was how she would react. I had started out to tell her many times over the last few years. On so many visits I had meant to have that conversation but had never found a way. Something had always intervened. Some other errand had always come up. I had found a way not to face her judgment.

  It didn’t matter that I was rock solid in my resolve and in my chosen profession. This was my grandma. My Flower Grandma. What she thought of me mattered a lot, and I had no idea how she’d take it.

  It was February of 1992, a Saturday afternoon. The next day the 60 Minutes segment I’d done with Lesley Stahl would air. Grandma never missed 60 Minutes. I had to tell her before she saw it—before she saw her oldest grand-daughter talking about the death threats and stalking and personal harassment my family and I were enduring.

  The harassment wasn’t the issue that mattered now. It was the fact that I was, as a physician, traveling to five clinics in three states to provide abortion services for as many as one hundred women every week, and that I had been doing this work for four years already.

  I wasn’t at all ashamed of my career. In fact, I always considered it an honor to be involved in reproductive choices, this most personal and intimate realm for women. I just never felt the need to make it public. Very few of my family and friends were aware of what I did.

  Within a day, however, everyone I had grown up with, everyone who knew my family, and every member of my family would know the truth. Would I be isolated and ostracized? Would I get support or condemnation?

  I pulled off the highway and into the drive leading to the house I’d grown up in. Mom and Dad still lived in the white, two-story, wood-frame home.

  Dad had worked as a precision machinist in the town of Grantsburg, ten miles away. His love had been the gunsmithing, hunting, and fishing he did in his free time. My three siblings and I had always been included. We were as competent with firearms, field dressing a deer, or catching a batch of sunfish as anyone in the area. Dad was retired now and not feeling well. It was painful to watch him, the strong man who starred in my memories, struggling with simple tasks.

  Mom was retired too, from her elected position as clerk of court for our county. She was the one everyone—especially women—turned to for advice and support. Mom had been instrumental, many years earlier, in starting a shelter for victims of domestic abuse. In her job she had seen so many situations in which women and children had nowhere to go for help. It was just like Mom to tackle a need that everyone else ignored.

  I grew up in the unincorporated village of Trade Lake, Wisconsin, a small gathering of about six houses, several of which were the homes of my relatives. The only business left was one small gas station/grocery store. When I was a kid, there had been a feed store and creamery and a meat market, but those had been gone for better than thirty years. Only rotten shells of buildings remained.

  Even now, Trade Lake is a very rural place. People still raise chickens in backyards, drive tractors to the little grocery store. Chimneys puff wood smoke in the winter.

  The small river that wound its way through our yard came into view. Behind it were the woods where I’d built forts and climbed oak trees with my sister. She and I each had a horse and spent the bulk of our summers out of doors. Grandma and Grandpa had lived just down the road. We picked mayflowers every spring with Grandma. In the summer we fished with Grandpa for sunfish and crappies using cane poles baited with worms dug out of the garden.

  Mine had been a good childhood. This was a safe place. Turning into the driveway had always been a good thing—a coming home. This time was different.

  I felt myself sweating under my coat. My racing heart pushed against my throat. I had to reveal something to my dear grandma that could change everything she believed and loved about me.

  Grandma had moved into a trailer house in the backyard of the family home. Grandpa had died fifteen years earlier, and Mom wanted her mother even closer—just steps across the yard. I saw the clothesline hung with rugs, the twine still strung up on the porch to hold the morning glories that filled the railings in the summer.

  Flower Grandma. My daughter, Sonja, gave her the name when she was three and there were too many grandmas to keep track of. Sonja spent many days baking cookies with her great-grandmother and playing outside, just as I had as a young girl. She ran back and forth constantly betw
een the houses of her two grandmothers. This grandma always had flowers growing in every nook and cranny, inside and out.

  Flower Grandma she became, and Flower Grandma she stayed. Before long my entire extended family called her Flower Grandma, and even her friends at the local senior center fell into the habit.

  I coasted to a stop at the bottom of the slope. I sat there long enough to take a deep breath and fight back a few unexpected tears. I didn’t know where the sadness came from. The car engine ticked. I was alone, vulnerable, aching. Was I longing for those simple childhood days, whipping down the hill on my sled? How far I’d come from that.

  I peeled myself out of the car, shed my coat, and left it on the seat. It was unusually warm for February in Wisconsin. The hardwood forest was all bare sticks and hard lines. I knew it would soon be time to tap the maple trees and cook the syrup we all loved on Grandma’s Swedish pancakes.

  I turned and deliberately moved up the steps to the trailer house. I was terrified of what Grandma would say, but there was no avoiding this moment.

  The big door was already open by the time I got to the top step. Out peeked her welcoming smile. She was giggling.

  “Hi, Grandma!”

  “Oh my goodness! What a surprise! What a sweet, sweet surprise! Did I know you were coming today?”

  I hugged her in the doorway, held her tight, stepped inside.

  “Did you somehow know I was making ginger snaps?” she teased as she set a plate full on the kitchen table. She poured me a glass of milk, and I sat down on the wooden chair next to hers. I tried to bury myself in the smell of her place, a mixture of ginger cookies, Estée Lauder perfume (the one in the blue hourglass bottle always on her dresser), and home permanents. She and Mom always gave each other perms, trying to get just the right curl in their hair. The smell never left the place.

  I think she sensed that I had come to talk about something important. I started talking a few times about other, inconsequential things; then, finally, I plunged in.

  “Grandma, you know I work as a doctor.”

  “Of course. And we are all so proud of you.”

  “Yes, but I don’t think you know the whole story. I’m a doctor who works mostly for women, helping women with pregnancy problems.”

  Flower Grandma hesitated just a second, pushed back her chair, stood, and held out her hand for me to follow. She went to sit in her rocker, the same one sitting in my living room today. The rocker I have sat in so many hours since. The rocker I sit in right now, writing this down and trembling as I do.

  She seemed distant. I moved to the old leather hassock beside her. She took my hand and placed it on top of one of hers, then covered it with her other one. Our hands made a stack on the arm of the rocker—old skin, young skin. We sat in silence a minute. She turned to look directly at me. Her eyes, framed by gentle wrinkles, were full of some deep trouble.

  After a moment, she stared straight ahead and started to speak. Slowly. Deliberately. In a very quiet voice. At the same time she began stroking my hand. It was as if the gentle stroking was pushing her to talk.

  “When I was sixteen years old, my best friend got pregnant,” she said. A chill went through me.

  “I always believed it was her father that was using her,” she went on, “but I never knew for sure. She came to my sister, Violet, and me, and asked us to help her.”

  While I listened, thoughts whirled through my head. Stories I had read of women self-aborting and dying of infections when a safe, legal option was not available. The women who came to the clinics where I worked, many of whom still had to overcome huge difficulties to end an unwanted pregnancy.

  It isn’t uncommon to have patients confide in me that prior to coming in for an abortion, they had used combinations of herbs to try to force a miscarriage. These home remedies can be extremely dangerous and have caused the deaths of many women.

  I felt myself tighten and withdraw, anticipating what Flower Grandma was going to tell me. I wanted to see her eyes, but she kept them straight ahead. And she kept stroking my hand. So soft. I only wanted to think about those hands. Hands embracing and caressing mine—strong, gentle, soft.

  “The three of us were so naïve. We knew very little about these things, but we had heard that if you put something long and sharp ‘up there,’ in the private place, sometimes it would end the pregnancy.”

  In spite of myself I conjured the modest room: a dresser in the corner with a kerosene lamp and maybe a hairbrush or hand mirror beside it. I saw three young, scared girls, still children, acting on old wives’ tales and whispered instructions.

  My stomach turned. Was this my grandma? Was I really here in her trailer house hearing this? I could barely breathe. She kept talking, all the while stroking the top of my hand, her eyes looking off into space, traveling back in time. Occasionally a pat-pat with her hand would break the rhythm of the stroking. Such old skin, full of brown age spots and paper thin. Stroking my hand in perfect measure with her words.

  Please just stop, Grandma. Don’t tell me anymore. Just hold my hand, and let’s talk about what you’ll plant in the spring. Tell me about the oatmeal bread you baked yesterday. Are there many birds coming to the bird feeder? I was flushed all over. And still she stroked while she talked. Pat-pat, stroke.

  “We closed ourselves, the three of us, in one of the bedrooms late one morning. We didn’t talk much, and she didn’t ever cry out in pain. It took a few tries to make the blood come. None of us spoke. We didn’t know what to expect next, or what to do when the blood kept coming. It was all over the sheets. All over us. So bright red. It was awful. It just wouldn’t stop.”

  She was still stroking my hand. I was shaking uncontrollably. I stared at the African violets under the plant light, trying to make them the focus of my attention. Her voice was a monotone, never a pause.

  “We put rags inside of her to try to stop the bleeding, but they soaked full. We all three stayed in her bed. We just didn’t know what to do.”

  My hand was trembling so hard it was all I could do to keep it on top of hers. She grasped it briefly, held it tight, patted it a few times, and then went on.

  “We stayed there together, unable to move, even after she was dead. Her father found us, all three of us, in the bed. He stood in the doorway, staring. No words for a long time. When he did speak, he told my sister and me to leave and that we were never, ever to speak of this. We were not to tell anyone, ever. Ever.”

  She stopped stroking my hand and sat still before turning to look directly at me. “That was seventy-two years ago. You are the first person I have ever told that story. I am still so ashamed of what happened. We were just so young and scared. We didn’t know anything.”

  Terrible sadness welled up inside me. And anger. I couldn’t picture my grandma as someone responsible for the death of anything, much less her best friend at the age of sixteen. She had carried this secret all her life, kept it inside, festering with guilt and shame.

  I wondered if the pregnancy was indeed the result of incest. Would it have made a difference? What were friends and family told about the death? What had they actually used to start the bleeding? What had the doctor put on the death certificate as the cause of death?

  I knew, through the patients I had met, that no one has to look very far into their family history to find these stories tucked away, hidden from view. But it didn’t lessen the shock of finding it here, so close, in the heart of my own family.

  Flower Grandma sighed and held my hand tight. Tears welled in her eyes.

  “I know exactly what kind of work you do, and it is a good thing. People like you do it safely so that people like me don’t murder their best friends. I told you how proud I am of what you do, and I meant it.”

  » In 1930, illegal abortions were recorded as the cause of death for 2,700 women, 18 percent of all maternal deaths in that year.

  » Before 1973 and the passage of Roe v. Wade, an estimated 1.2 million women had illegal abortions in the Un
ited States yearly. As many as 5,000 died each year as a result.

  » Between 1973 and 2002, more than 42 million legal abortions were performed.

  » Risk of death during childbirth is eleven times higher than the risk of death from legal abortion.

  chapter two

  Flower Grandma is gone now. So is my mother. I can share the story my grandmother kept inside from the time she was a young girl. Her story and hundreds of others like it desperately need to be told. We need their legacy so we don’t forget, and to remind ourselves that every family has a similar tale somewhere in its history.

  It has been my privilege and honor to hear many women’s stories and to participate in their unfolding. As a young woman, the idea that I might be in such a position would have seemed far-fetched indeed. No, actually, it would have seemed impossible.

  In April 1980 I was a twenty-six-year-old mom living in Wisconsin, raising a daughter alone, working part-time at a VFW bar and part-time in a natural foods co-op. I was on welfare, medical assistance, and food stamps. My post-high school education consisted of a handful of community college classes, none of which fit together or qualified me for anything, with one exception.

  I had given birth to my daughter at home just north of San Francisco, where her father and I were living. To prepare for the event, I took birthing classes, which led to an interest in midwifery. Since Sonja’s birth, I had been involved in many births, both in homes and in hospitals, volunteering as an advocate for women in labor.

  I knew from my own experience how empowering it was for women to be informed. With that information, women feel secure about expressing their needs. Their active participation changes the entire dynamic. I loved the energy of those births. By the late 1970s, however, midwives were being prosecuted for practicing medicine without a license, so I had resorted to teaching birth classes in an effort to optimize the hospital experience for women.