Providing Abortions in the Deep South
Willie Parker is an imposing ob-gyn who has been traveling across the deep South providing abortions since 2012. At times, he has been one of the few providers in the only abortion clinic for hundreds of miles. Though he had been flying down from his home in Chicago twice a month to provide abortions in Mississippi and elsewhere, he recently moved to Birmingham, Alabama—closer to the center of the abortion wars.
He is also a practicing Christian, and he frequently refers to his faith as being the reason why he does what he does. It’s the argument he lays out in his recently published book, Life’s Work, and in his new position as board chair of Physicians for Reproductive Health, a prominent pro-choice advocacy group.
I recently sat down with Parker to talk about how attitudes toward abortion are changing at a time when access to the procedure is on the decline in many parts of the United States. Abortion is at an all-time low in the United States, but in some places it’s also harder to come by: More than 30 percent of the 334 abortion restrictions enacted since the 1973 Roe v. Wade decision came in just the last six years.
I interviewed Parker about what performing abortions in conservative states looks like today, what might be to come, and how he thinks about abortion as a Christian. A lightly edited and condensed transcript of our conversation follows.
Olga Khazan: I’ve talked with former abortion providers in the South and a lot of what they talked about was, frankly, the stigma that they dealt with. So what is that process like when you’re trying to encourage new doctors to provide abortions? What kinds of fears do people have that you have had to assuage?
Willie Parker: I’m modeling how to right-size the risk. I would not dare tell somebody that it’s not risky. We know people have been killed doing the work.
I think what’s been critical to me ... has been the unwitting support. It’s not the person who goes to Planned Parenthood or works there, it’s been the person at the barbecue joint, who when they find out who I am, what I do, they say, “I support what you do.” So, I think helping people understand that those types of relationships are there to be had, gives them the sense of assessing for themselves what is the risk and benefit of doing what they know is right.
Khazan: What are some of the risks that people are usually worried about?
Parker: Well for people who have kids, they are worried about people showing up at their kids’ school and saying, “your mom or dad is a murderer.” For people who send notes like, “I know where you live,” or people who are always taking pictures of you to try to intimidate. There’s people, you know on Friday night you’re watching a movie and you order a pizza and somebody knows that you’re an abortion provider and them refusing to deliver a pizza to your house.
So it’s the disruption of your normal life functions and those are real. But there are also merchants who give you discounts because they like the fact that, for them that feels empowering. You know, “I don’t work at the clinic, but I can make sure you eat well.”
Khazan: Not long ago I interviewed a bunch of teen moms in Texas. Something I had to ask them, sort of delicately, was, “Did you ever consider abortion at any point? You were 14, was that something that came up for you?” And almost to a one, they recoiled in horror and said, “I would never do that.”
Pro-life sentiment seems steeped in the culture there. It wasn’t clear from the interviews that people really wanted these inaccessible abortions. Do you see that in Alabama and Georgia, the states where you’ve worked, and where do you think that feeling comes from?
Parker: Certainly one of the roles that Planned Parenthood has played is not just in terms of abortion access, but just apprising people of what their options are.
There are pockets where people never even have options presented to them. They may differ by geographic locality, by race and ethnicity. But when you have the perfect storm of poverty and isolation and a high degree of religiosity, I would bet if you were interviewing young women in the Mississippi delta ... that you would see the same thing.
When they have a positive pregnancy test, [it’s] like, “So when are you gonna enroll in prenatal care?” There’s no sense of that there’s anything else to do. They weren’t even apprised of the fact that three hours away they could have gone to a clinic to have an abortion or an adoption because the delta is primarily poor, indigent, African American women. The most unadoptable babies around, with exceptions of a few, are black babies. So, there really are no options other than, you become pregnant, you’re going to continue this pregnancy even at the peril of your health. And you’re gonna have a baby and you’re living in abject poverty and that’s going to be intensified by you having more mouths to feed.
Khazan: Something a lot of people who struggle with the issue of abortion wonder about, I think, is the question of adoption. As in, “why can’t these women just give their babies up for adoption?” What do you say to that argument?
Parker: Adoption and abortion don’t have anything to do with each other. When a woman’s pregnant she has two options. She can continue her pregnancy or she can end it. For a woman who decides she can’t end the pregnancy, she can then consider parenting or adoption.
But that doesn’t inform a woman who’s decided that she’s gonna end a pregnancy. It’s not acceptable to her, or we shouldn’t expect it to be acceptable to her, to continue her pregnancy and then to relinquish custody. There are people who know that they could never give up a baby that they gave birth to.
Khazan: Earlier you mentioned religiosity, and that’s certainly such a huge part of the abortion debate. I know it’s impossible to condense down to a couple of minutes, but how would you explain how you came to be pro-choice while maintaining your faith? And what would you advise to other people who struggle with this issue and also have a faith practice?
Parker: I grew up in the South in the early ’70s. I refused to perform [abortions] because I wasn’t clear about what the appropriate role should be as a Christian.
[When I was] on faculty at the University of Hawaii, for the first time in my career [I was] forced to take a more critical look at my faith identity and what it actually said about abortion. And what I found is that Christianity says nothing about abortion in its sacred texts.
So I would say anybody who thinks that there is a question, that they need to look deeper, and they may see that there’s really no question in their faith identity. It’s just a question of how others are choosing to interpret their faith tradition around reproductive control of women.
Khazan: A few people have brought up the idea that there actually are prohibitions against killing and on sexual immorality in the Bible. One post brings up the fact that the Didache, an early Christian treatise, explicitly prohibits abortion. How would you respond to those arguments?
Parker: You cannot take a text, pull it out of context, and go back and make it mean something that you want it to mean.
Most of the effort to delegitimize abortion based on religious understanding has been the citation of passages of sacred text or Christian text that don’t speak to abortion. It did not address reproduction or procreation because that understanding of how humans reproduced wasn’t held. I’m saying that you can’t just cherry pick and pull and pick every part of a sacred text and put it together to make your argument.
... Especially when the Bible has gone through multiple translations, what constitutes an authentic text has gone through political processes. There’s something violating of the notion that women and men aren’t held equal in their humanity. Any understanding of sacred text that leaves you with the ability to believe that you can subordinate or tyrannize or control women, is a text or is an understanding that I don’t subscribe to. If that’s what you’re reading in the text, you need to put that in context and figure out if that can be extrapolated to the present time.
Khazan: Russell Moore, president of the Ethics and Religious Liberty Commission of the Southern Baptist Convention, quotes you as saying in your book that “the problem is, in part, ‘liberal women with children who themselves became enraptured with the sonogram images they saw at the obstetrician’s office and who wept when they heard the fetal heartbeat.’ This is, Parker argues, a ‘fetishization of motherhood and children that I don’t quite understand.’”
Can you elaborate on what you meant by that?
Parker: Yeah, well I don’t think those words are exactly mine, but the spirit of it is correct, and that is part of patriarchy and controlling women’s reproduction is to make it primary that a woman’s most essential role and duty is determined by her biology—that is, her ability to carry and to give birth. Reproduction plays out in a woman’s body. What it means is ... that there’s some sort of divine charge to procreate. That means that any woman who doesn’t embrace that as her primary identity, she’s, one, immoral because she’s going against the central tenets of what her original design is. As well as she is now in the position to embrace non-procreative sex because you don’t get pregnant unless you have sex. That raises the question of the morality of a woman.
When I say that the fetishization of motherhood ... a woman who may have no intentions of having a baby or becoming a mother ... the hope is that she can be coerced or her mind can be changed by viewing an ultrasound image. My notion is that when women cannot envision themselves in any role other than becoming mothers, it leaves them in a position that even when they may be faced with an unplanned pregnancy or the like, the women who end up acquiescing to becoming mothers can find themselves in the position of judging other women who don’t make that same decision.
What that means from the standpoint of someone who’s in a situation where they have all of their economic needs met or they’re in a situation where they have safe housing and environment, say if you live in a city where you have access to abortion and the like ... then you may not understand the implications of a law that requires a woman to wait an additional 24 hours when she’s doing the best she can to scramble all the resources she needs to reach her reproductive goals.
Khazan: You mentioned the overturn of Roe v Wade being a real possibility. Walk me through how you would see that happening and how that would be reverted back to the states and what the states would likely do.
Parker: We get two more justices appointed. We have legislation, we have cases already in the judicial system set to appeal up to the Supreme Court so that there can be a ruling that would functionally overturn Roe. So, if Roe is overturned then abortion is no longer mandated to be legal in every state in the first trimester.
There are states now that already have laws in place that would say, “In the event of the overturn of Roe, abortion will become illegal in this state.”
What happens functionally is we go back to January 21, 1973, before [abortion] was legal, which meant that a person’s access to abortion care depended on their zip code.
Which means that the only people who will have abortions will be people who have access to means, which will mean like pre-Roe, poor women and women of color will be the people who’ll experience the harms that we dread with illegal abortion.
Khazan: What technological solutions or innovations are you seeing in your field that might make abortion access easier—or, more likely, just open up new debates about abortion access?
Parker: We’re expanding the efficacy of medication abortion, which means if we can relax the rules around women being able to access this medicine that has a higher safety profile than aspirin ... Some people struggle with the notion of what would it mean to make very safe medication around ending pregnancies available to women, that they didn’t have to access through the health system.
That’s a scary thought for some because they see that as liberalizing something that’s a societal ill. But noninstrumental ways of ending pregnancies, which most of them happen at such an early gestational age, it could be done safely. More importantly, it could be done privately. And I think the dread of most folk is that if women could safely access ways to terminate pregnancies without the scrutiny of the public, there would be no place to picket.
Khazan: I think some people are worried that women would take the pills in their second trimester or way too late or improperly.
Parker: We trust women when to take aspirin for a headache, but we don’t trust them to take a drug that’s safer? I think it really comes down to “Do we trust women?” I think those concerns are driven by very paternalistic notions of whether or not women can be trusted with important and complex decisions.
The same notions of moral fitness and intellectual capability were asked of black people, when they were once enslaved. So I find strong parallels to the very paternalistic thinking of, women can’t be trusted. We trust them to have babies, we trust them to go to war, we trust them to drink alcohol, we trust them to buy guns, but we can’t trust them to decide whether or not to end a pregnancy. Just rings a little hollow to me.
Khazan: The idea with that is that you would still see a doctor to get the prescription for the abortion pill, right?
Parker: Well, not necessarily.
Khazan: How would it work?
Parker: Women right now [are] accessing the web for regimens of how to end pregnancies without the supervision of the medical system or without the scrutiny and the harassment of folk who are opposed to their decision. The question is, if those medications that are safe and are accessible, and women can make that decision, that may be where we’re going.
Khazan: Do you mean over the counter?
Parker: There’s technically no reason why a person who is appropriately instructed around using a medication, like, we trust people ... Probably one of the most dangerous drugs over the counter is Tylenol. And yet we don’t question people’s ability to go to the store and to get Tylenol for its appropriate use.
Khazan: I just want to be sure I understand, would they be able to buy the pill over the counter or would they need a prescription? Or is it more like the morning-after pill?
Parker: That’s a health-services question. That’s a question that will be reflected by our collective values, our ability to monitor the safety of medications. What I’m intentionally avoiding giving you is what my personal opinion would be about how that system should be structured.
Khazan: You don’t want to give your opinion?
Parker: No, ’cause with my opinion and $5 you can get a Starbucks coffee. The notion that I’m saying, “Abortions for everybody, just kinda do your thing,” I’m not saying that. There’s a way to create medical literacy so that people understand how to make decisions about the situation that they’re facing. And I think what I’m pushing back against is the additional scrutiny that’s imposed on this issue, because it's unique to women.
Khazan: Something that I’ve heard a lot from abortion opponents is this idea that, because so many African American women have abortions, some of them have taken this up as a sort of a Black Lives Matter kind of cause, in that if black lives truly matter, then black women should be discouraged from getting abortions. What do you make of that argument?
Parker: I think it’s very interesting that all of a sudden black lives and the lives of black women, black babies, matter and that the loudest voice is coming from nonblack people. The women that I see, they’re advocating for having more resources to control their lives, not less. They place abortion in the context of the things that help them fulfill their reproductive destiny.
[Often] those are the same people who approve of the death penalty, who want to cut off Medicaid and all the other, housing, childcare, education, all the things that would go into raising those babies that they insist be born and that would allow for the uplift of women of color. It just rings hollow to me that out of one side of your mouth you’re advocating that women continue pregnancies that they didn’t plan or didn’t want and then you cut off the very resources they need. It’s just, it’s a thin veneer.
Khazan: There have been some African American people who have spoken out on this. For example, Nick Cannon, who is a rapper ...
Parker: Rappers shouldn’t be speaking out about health issues when they don’t study health.
Khazan: The Americans United for Life, when I wrote about them, they were trying to connect with African American groups in the South to promote this Black Lives Matter, antiabortion idea. They did find some African American advocates for it.
Parker: Black Americans have never been a monolith and will never be. There’s no spokesman for black people. That you can find people who are, will say anything or do anything ... doesn’t say very much to me.