Integrating Men into Abortion Care

In her provocative piece "Why Men Should Be Included in Abortion Discussions," Courtney E. Martin poses an important question: "Where is a pro-choice man who wants guidance, community, or counseling around his experience [with abortion] to turn?" She goes on to say:

In the public sphere, the most vocal mention of men and abortion comes in virulently unsympathetic forms: government officials' ethically indefensible... attempt to chip away at Roe vs. Wade...In the clinical sphere, already spread-too-thin therapists and medical staff pay little attention to men's involvement...In the private sphere, men struggle to reach out to one another about their experiences for a variety of reasons...they just don't seem to have the language to talk about (this).

In the most comprehensive study of men and abortion to date, Arthur Shostak, a professor of sociology at Drexel University who describes himself as ‘unswervingly pro-choice,' found that men's single greatest concern was the well-being of their ...partner and further, that a majority of men would like to accompany their partners throughout the procedure, but most clinics don't allow men beyond the waiting room.

Martin then turns to the pro-choice movement, and feminists in general, and observes this:

(They) seem to have historically shied away from the difficult but imperative task of involving men in conversations about abortion, (since) no hot-button issue brings out more manipulation than this one, (but)...there must be a way to talk about men's perspectives and experiences without compromising women's bodies.

Indeed. How do we acknowledge men's emotions while balancing the fundamental fact that the ultimate choice is not theirs?

Though the Aradia Women's Health Center in Seattle is now closed, its staff, including myself, had developed a thoughtful and comprehensive method of integrating men into the experience, as Martin suggests clinics do. When it was in harmony with the woman's decision, feelings, and needs, we did include men in the entire spectrum of abortion care, including the ultrasound, the counseling session, and the procedure itself. We explored with the couple how they thought they would act together during the procedure and what they needed from each other. Was she "punishing" him by wanting him to be in the room during the abortion? Was he asking to be there because he truly wanted to be there, or because he thought he should be there as a "good" partner?

As providers, we also possessed the ability to veto a partner's (or any significant other's) presence during the abortion procedure if we believed that that person would have a disruptive effect. We emphasized that our role was to ensure the safety of the procedure. It was important that both felt that being together during the abortion was an important part of healing and was for "healthy," not punitive, reasons. This gave the men opportunities to be frank about what they saw as their role for their partner during the abortion.

We gave explicit instructions to the partner: speak gently, hold her hand, focus on her (not the procedure), breathe slow and deep, and always stay seated. Of course, he always had the option of deciding not to be in the room during the abortion (some men said it could be too emotional to see their partner in pain); in that case, the counselor could bring him in right afterwards. It was also explained that if there was an emergency, we had the authority to ask him to leave the room.

Claire Keyes, executive director of Allegheny Reproductive Health Center in Pittsburgh, Pennsylvania, is a pioneer in welcoming men into the abortion clinic as support for their partners. She would like to see clinics focus on what they "could offer men, rather than what they could not."

No matter how thinly a clinic's staff is stretched (and we always are), if men see brochures that are created specifically for them, if they can pick up notebooks directed to them explaining the different types of procedures, they will know that you care. Having a journal in your waiting room that says ‘For Men Only' will provide an opportunity for [them] to start writing about their feelings...You can also probably free up a room a few hours a week for a male counselor to meet with men who (want to do so). Simply having a male counselors' card available (especially if the clinic staff do not feel qualified, or organizational resources are too limited, to work with men or couples) makes a (powerful) statement that you have not forgotten them.

Keyes also encourages men to access the supportive and excellent web site www.menandabortion.com to gather information about the spiritual, factual, and emotional nature of abortion. Men can read other men’s stories and also post their own.

Keyes identifies the very practical reasons to include men in abortion care: "[Men] can partner with us in aftercare for the women (after the abortion); we can supply them with brochures on birth control. Also, we can inform them why it is important for them, and not just women, that pro-choice candidates be elected."

When I first started in this dynamic field 37 years ago, I honestly didn't see the true value of incorporating men into the abortion process. It was, after all-and still is-ultimately the woman's choice to have an abortion. I saw the woman and her needs as the top priority and I still believe that. But I also now see that women have healthier outcomes when it is requested, and appropriate, to include a supportive, non-abusive partner into her abortion care.

At Aradia, men and women often thanked us for being so open to them both. I now understand that men have their abortion stories and feelings too, and that they will be healthier for having found a place where that could be acknowledged and honored. Including men helps them to integrate the abortion experience into their lives and helps destigmatize abortion.

Men, we are listening. Respect our feelings and we will respect yours. What is it that you want to tell us about abortion?