i.

The mid-1960s - dark winter in a suburb of Chicago. My mother is recently divorced and on her own for the first time in her life. She's in her 30s, very pretty, but still young in many ways. Now she's a single mom, caring for four lively girls, all born before she was 22 years old. For the first time, she is working full-time - as a bookkeeper, for very low wages.

Divorce and extramarital sex (even desire) were still a cause for shame, especially for women. Reliable contraceptives were not available.

Diaphragms even with spermicide were not always effective.

Anxiety, depression and spousal abuse were not openly discussed... modern antidepressants were not part of the cultural scene.

During the 1950s and much of the 1960s, the concept of “depression” barely existed for submelancholic conditions, and “antidepressant” medications were reserved mainly for serious depressive conditions found in hospitalized patients. Post-traumatic stress disorder had not been named yet, let alone recognized as something women could get from an accumulation of “adverse events” or life stressors. (It would be years before I recognized the courage it must have taken for her to leave her husband, his abuse, and his own mental illness resulting from his father's harsh treatment.) The cultural revolution of that decade was still incubating.

Decades later, I have a very clear memory. I remember a time that she was very, very sick, lying quietly on her daybed in the dining room where she slept. My grandmother is there with supper, a meatloaf, and is …

I remember very clearly a wet patch of thick blood on the bedspread, and a strange, earthy odor.

In my thirties, my mother revealed that she had had an illegal abortion. She came very close to hemorrhaging to death. She and my grandmother had never spoken of it.

In the spring of 1969, my freshman year of high school, she had what we might now call a psychotic break associated with severe clinical depression. She left her four young girls and ran away.


ii.

The mid-1970s. I'm home from college. My boyfriend and I have become sexually active, and I've been on birth control pills for a couple of years. There is a shadow over the household, as there so often was been since my father and stepmom took over the raising of my sisters and me after my mother's abandonment. Things are often tense at home - actually more often than not in those days. My father calls me into his room to speak to me. Heavy, heavy, heavy dread. He glowers as he shares the news that my younger sister, still in high school, has become pregnant by her boyfriend. It now falls to me, the shamed sexually active one, to take my sister to my gynecologist for an abortion...an abortion of which he in no certain terms disapproves. “Why buy the cow when you can get the milk for free?” he tells me, clearly saying that nice girls don't get into this kind of trouble.

When I tell my younger sister that I know about her pregnancy, it is a kind of intimate conversation we have never had before. I remember her literally flushing crimson with shame. The house is filled that summer with a dark guilt pulsating from my dad. My sister is terrified of our father, and so am I.

I drive my younger sister to my university town to see my OB-GYN. She has never had a pelvic exam. He is himself - unfailingly kind and gentle - the man who gave me my first pelvic exam, and explained each small step of the procedure beforehand.

When he comes back to me in the waiting room, he seems flustered. He is still drying his hands. He speaks to me like a grown woman, and explains that the pregnancy is far enough along that she will need to schedule the abortion as quickly as possible.

Decades later, I have no memory of what my sister and I talked about on the ride home. But now that 50 years have passed, I just learned for the first time that her “boyfriend” had forced her to have intercourse.


iii.

It is 2022. I am a credentialed reproductive biologist, and have been a university professor for several decades. I am years past my own fertility, and I now hold a position teaching basic reproductive principles to second-year medical students in Idaho. Topics to be covered include fertility, the menstrual cycle, pregnancy, the prevention of pregnancy, and the management of life-threatening risks of miscarriage, complicated pregnancy and labor, and the relationship between women's life stressors, trauma and the risks of fetal and maternal death.

Roe v. Wade has been overturned. The University of Idaho, including the medical college, is abuzz with the implications of the new laws in Idaho including a “beating heart” rule and forbidding instructors on campus from teaching about contraception (and possibly about pregnancy altogether) unless it is in the context of the prevention of sexually transmitted disease. No one is really sure what we medical instructors can teach, but technically we may be considered to be a “clinical” setting that the state does not yet regulate. I have already had to walk a fine line between advocating for medical pregnancy termination, since our student population runs the gamut from liberal feminists to very conservative Mormons and Calvinists. We essentially punt these topics to be taught via pre-recorded video lecture by the mothership, the School of Medicine of the University of Washington in Seattle, which remains a bastion of “wokeness.”

I can no longer even teach the board-approved, evidenced based standard of care for women of reproductive age and their families.

I retired last winter. I am trying very hard not to wallow in despair.