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Internal Logic

The test was supposed to be a precaution. I had an IUD, but my period had been light that month, only a few drops of blood. When I put the white stick on the counter, two lines appeared instantly. I was pregnant.

This was in the bathroom, in our house in South Philly. A floor-to-ceiling mirror stretched almost the length of one wall. During my first pregnancy, I’d taken weekly selfies in that mirror, from the front and side, wearing my bra and underwear. The selfies were not meant to celebrate the generative powers of the female form, of which I’d heard enough, but a way to track my body from the outside. In a photograph, I could observe my protruding belly and swollen breasts without being trapped beneath them.

Popular culture had led me to believe pregnancy would be part miracle and part nuisance, a mix of melodrama and flatulence, alternately played for tears or laughs. Among my friends, pregnancy was revered, and the midwives and mothers of our group recounted birth stories in zealous detail. But nothing I’d read, seen or heard had prepared me for the alienating otherness of my pregnant body or the existential terror of labor.

Now, my reflection was slim and flat-chested. I’d regained my rightful place as my body’s sole occupant and ruler. I would not be prisoner to another pregnancy.

It was early evening, and my nine-month-old son was asleep in the next room. I Googled “abortion clinic Philadelphia” and clicked on the top result. They were still open. I called and made the first available appointment, which was in five days.

My husband was in the basement, where he liked to be alone after the long day of work and childcare.

“You’re not going to believe this,” I said from the bottom of the stairs. “I’m pregnant.”

He turned with a stricken look.

“The abortion is on Tuesday.”

Zack had witnessed my discomfort during pregnancy. He’d been there for our son’s traumatic birth. He knew my struggles as a parent, how motherhood sometimes felt like an itchy costume. So he deferred to my decision without hesitation. He crossed the room to hug me.

“What about the IUD?” he said.

“It’s not one hundred percent effective.”

“How are we supposed to have sex now?” he said, meaning, now that we knew IUDs were unreliable.

He was half-joking, but I didn’t have an answer.


I got my first birth control prescription at seventeen. My high school boyfriend and I were waiting to have sex until I had that added protection. When my mother found out, a few months later, she assured me that, were the pills to fail, abortion was covered by our health insurance.

Her support—though tempered with concern—confirmed what I already felt to be true: my body was under my sole jurisdiction. I chose how and to what extent and with whom to share it, whether with a boy or a future baby.

As for contraception, my mother needn’t have worried. My boyfriend and I were hyper-vigilant, using condoms in addition to the pill. And those early sexual experiences were some of the sweetest I would ever have, a mutual exploration.

He was a year older and already out of high school, so I used to drive to his house during lunch for twenty minutes of joyful fucking. I’d return to school smelling of sex with my hair in a rat’s nest. Sitting in class with his sweat on my skin, my body was both more porous and more contained, as if I’d learned my borders through opening them. Contrary to what I’d been taught, my virginity (that outdated concept) had not been a sacred thing in need of preservation. In fact, the sacred thing lay on the other side. Our intimacy was a deepening and a continuation. A way to connect with him and to know myself better. Free to inhabit my sexuality, I was curious, fearless, funny. It felt like nothing could take that from me.


In the days before the abortion, I developed a cold, which turned into a tickle in the back of my throat, which turned into coughing fits so violent I thought I was going to throw up. This was pre-COVID, so my symptoms were only unsettling, not terrifying.

On Friday, on my way home from work, I had to get off the subway to cough and heave beside a trash can. My eyes watered, my nose ran, people stared. When the fit passed, anxiety seized me. What if I started coughing during the abortion?

At home, I called the clinic. They said they wouldn’t see me if I had active symptoms.

“I’ll be better by Tuesday,” I promised. “It’s just the tail-end of a cold.”

That night, my coughing continued, and I slept on the couch so I wouldn’t disturb Zack. Every few minutes I guzzled water to ward off another fit. When I wasn’t coughing, I tossed and turned, trying to prop myself in a way that relieved the tickle in my throat.

In our dark living room, the appointment became a far-off light, flickering unsteadily. I was desperate to reach it.

Abortion was (and still is, for now) legal in Pennsylvania until twenty-four weeks. I calculated I was six weeks pregnant; I could reschedule. But anyone who has had an unwanted pregnancy knows that abortion is urgently time sensitive in a way no law acknowledges. Inside me, without my consent, the embryonic cells multiplied. I couldn’t feel them, but I knew they were there, growing, expanding, changing. I had to stop them.


Like many women, I’ve spent much of my life navigating birth control, desire, and the ambiguous encounters where the two fail to overlap. After high school, contraception was often an unreliable combination of condoms and withdrawal, and the threat of pregnancy drew a scrim between me and my enjoyment. There was the boyfriend who was too big for a condom, the others who lost their erections with condoms, and more who just plain didn’t like condoms. These were men I liked; I wanted to be intimate with them, and I didn’t want to create tension, hurt their feelings or end the night altogether. Most women who have sex with men are well-acquainted with these negotiations, and much has been written about them.

To mitigate, I went on and off the pill regularly. During the on times, my period shrunk to a couple days of barely perceptible spotting. In the off times, my cycle took months to recover. Twice I didn’t get my period for a full year.

Concerning articles posited the risks of long-term hormone treatment, and I worried about my increased chances of scary cancers and blood clots. But even more disquieting than medical side effects was the sense that my body was under foreign control, its natural rhythms suppressed and altered.

Because my period was irregular, I didn’t know when to expect it, and I burned through pregnancy tests to confirm my birth control strategies were working. Sometimes, if my immediate anxiety was too much, I took Plan B, just to be certain. The countless hours in CVS lines. The tense moments at the counter, avoiding the pharmacist’s eyes. The hundreds of dollars in tests and pills. The bathrooms where I read and reread those familiar directions. All so my male partners could fuck with impunity.

Zack was a willing collaborator, but the weight of procreative responsibility still fell to me. By my first pregnancy, I’d been monitoring my reproductive well-being for eighteen years.

After my son was born, I decided an IUD would put an end to it all. I was tired of doing questionable things in the name of male pleasure.


IUDs are inserted at regular gynecological appointments, without anesthesia or medication. For mine, I went to the midwifery practice where I’d been seen during pregnancy. On the exam table, with my feet in stirrups, I prepared myself for pain. A friend had passed out when hers was inserted.

“You’ll feel pressure,” said the midwife from between my legs. “Then you may feel a pinch or a cramp. Are you ready?” She was calm and no-nonsense. Behind her, the shelves were lined with feminist-leaning books. Above her head was a closeup of a pregnant belly, the skin etched with stretch marks.

I nodded.

The pain was brief but breathtaking. A searing, aching, burning that defied internal logic. My cervix contracted, my uterus protested—they would deny entry—but the IUD forced through.

I sat up from the exam table, shaken but triumphant. My IUD would last twelve years; I’d be forty-eight then and almost definitely too old to conceive. In the meantime, I’d made my final reproductive decision. There would be no more condoms, no more withdrawal, no more pregnancy tests. I’d had one child; I would not have another.

But for weeks, I could sense the IUD there, like a tampon that was not in properly. A reminder of the object lodged within me.

I called the midwife.

“That’s impossible,” she said. “There’s no way you can feel an IUD.”

Yet I did. The sensation was unpleasant, but eventually I got used to it.

Six months later, that tiny wire device had betrayed me. I wanted it out, along with the embryo. I wanted all things out of my body.


By Tuesday morning, my cough was less frequent. Zack and I drove to the clinic, which was in a nondescript office building on an out-of-the-way street I’d never been to. I was lucky, with privilege on my side. The clinic was nearby. Our car had gas in the tank. Zack and I could both take the day off work. We did not need to borrow or steal or lie to find the $300 it would cost.

The clinic’s waiting room was crowded with women. Many were much younger than I was. Some seemed to be with their own mothers, others had children with them. Only a few had brought boyfriends or husbands, like I had.

The receptionists, also women, were seated behind bulletproof glass. One of them checked me in and explained that the wait might be long, that a nurse would call my name. When she did, for security reasons, no one could accompany me.

I’d brought a book, but it was difficult to focus. I sucked cough drops until my cheeks were sore. Beside me, a woman entertained her toddler while her infant slept in its carrier. Across the room, two teenage girls curled in their seats, their heads close together, whispering.

Occasionally a nurse emerged, and the room hushed to hear who she would summon. The chosen woman stood, determined but impenetrable, and followed her through the clinic door.

On the other side of that door lay freedom and opportunity and control. The freedom to inhabit ourselves fully, the opportunity to move through the world with certainty, as men did, and the control over which potentially-lifelong consequences would result from our moments of passion or trauma or stupidity or birth control dysfunction.

But in the waiting room, those moments haunted us. Although I was in a cheap blue chair, scrolling my phone, my mind had been sucked backwards to a time of patience and prayer. My prayer, such as it was, was to pass through that clinic door and return to the present.

My first pregnancy had not exactly been unwanted, but it had been a surprise. Zack had been resolute in his desire for a child. I wasn’t ready, but I’d agreed reluctantly to try. At thirty-five, with an irregular period, I assumed it would take six months or more to conceive. Instead, I was pregnant within a month.

The first trimester was permeated with a queasy uncertainty as I weighed my options. Would I keep the pregnancy? Would Zack and I break up? In which way would my fate be shifted? These questions took physical form in the malaise that radiated through me: a feeling that wasn’t exactly nausea but something adjacent to it. The sickness saturated my clothes, the rooms of our house, and the city itself. Random objects and places repelled me. Synesthesia of the gut.

Through those dull, muted months, the fetal cells continued to divide, and I plodded toward parenthood with fearful resignation. Ahead of me were the petrifying gateways of labor and delivery, then the sleep-deprived slog of infancy and breastfeeding, followed by a blur of caretaking, through all of which I was expected to dispense unconditional love on demand.

Then my pregnancy ended with an emergency C-section, ten weeks before my due date. Bald and skinny with that classic Winston Churchill face, my son was fragile and adorable in his NICU incubator. For weeks, we fed him through a tube and changed his doll-sized diapers and held him to our chests for skin-on-skin. Later, home from the hospital, I hugged him and kissed him and sang snippets of every song I could remember.

But as the days went by, and the full weight of motherhood settled on me, a constant hum of responsibility filled every waking hour. Gone were my carefree days, the ones I used to squander so deliciously. Zack and I no longer explored the city on a whim. I no longer curled on the couch to waste a whole morning with my thoughts and a cup of tea.

These are small sacrifices, I know. Many have given up much more; many live with much less. Conventional wisdom tells us any sacrifice is worth the radiant blessing of a child. But once I was living it, I wasn’t so sure. Those little luxuries had filled my days with meaning. I couldn’t trade them wholesale for meaning of an entirely different kind.

I didn’t wish my son out of existence, but my life was irrevocably changed, and the new one wasn’t entirely mine. I loved my son, and I hated being a parent.


Finally, the nurse called my name. She ushered me to an office, where I was required to meet with a counselor, another young woman who might have been my friend under different circumstances.

“Is it your choice to have an abortion?” the counselor asked.

It was.

“Are you using any birth control?”

I was.

She nodded sympathetically about the IUD; she’d heard my story before. “Would you like a prescription for the pill, to begin after the procedure?”

“OK.” I didn’t want to go back on the pill, but it seemed like a good idea to keep my options open.

“Will you be awake for the procedure or sedated?”

“Awake.” I’d been put under for my C-section, and the thought of anyone’s hands in my unconscious body horrified me.

Next, I was given a hospital gown and directed to a group changing room with three other women. One was the whispering teenager. Another wore a headscarf. None of us wanted to undress in front of each other. The clinic must not have had space for multiple changing rooms, but the lack of privacy was unnerving. We turned to the walls and stripped quickly, wrapping our gowns tight so they wouldn’t fall open at the back.

A nurse came for us one by one. When it was my turn, she led me to a small exam room and told me to lie on the table. As in all medical situations, I became passive and obedient.

Two nurses and a doctor surrounded me. More sentinels in this land of women.

The doctor explained the procedure in a kind, even voice. First I would feel the pinch of the needle with the anesthetic, then an intense pressure. It would be over in under five minutes.

“Are you ready?” she asked.

“Yes.” I’d come here to reclaim my body; I could withstand this one thing.

“Scoot down as far as you can and splay your knees apart,” she said.

That’s what the doctors always say, and I’ve followed their instructions dozens of times. It’s a practical, medical request, but it’s also a request for complete submission, for total vulnerability. The women in that room were on my side; they were doing what I wanted. But they were strangers, and I hated exposing myself to them.

Then came the familiar humiliation of the speculum, the doctor’s gentle, unwelcome touch, and the needle’s searing jab. A machine made a loud whooshing, and the procedure began. Something clawed through me, raw and ragged, much worse than I’d expected. My insides did not feel suitably numb.

The nurses stood on either side of me, carrying on a conversation over my head.

“We go to Rehoboth Beach every summer,” said one.

“Oh I love it there,” said the other.

They were just inured to this experience, not neglectful, but their indifference shattered me. I tried to project out of my defenseless body, to watch from above. People say that’s possible, but I’ve never been able to do it. I began to cry.

 “My mother-in-law has a place in North Carolina,” the nurse continued. “So we like to go there.”

“Ooh, I’m jealous,” said the other nurse.

Five minutes seemed endless. My uterus was a fire, the tender coals raked over and over. Then it was done.

The nurses glanced down at me, as if remembering I was there. “Are you doing ok?” one said.

“Yes.” My pain and indignation smoldered, tempered by relief. I was no longer pregnant.


During my son’s birth, when I was in premature labor, my sister-in-law asked what I was looking forward to. It was a question we often posed; she was trying to distract me. But I couldn’t think beyond the agony of my next contraction. With each one, a sadistic fist squeezed my breath and thoughts and being into a pulsing knot of panic. I tried to see around that panic, to the days and weeks ahead, but there was nothing there.

When I began this essay, abortion had just become functionally illegal in Texas. As I edited, the Supreme Court’s draft opinion on Roe v. Wade was leaked. Before I could finish, Roe had been overturned. In the months ahead, thousands of women will carry unwanted pregnancies that may damage their bodies and will irreversibly upend their lives. Thousands more will seek illegal abortions, despite all obstacles and perils. I know because I would have been one of them, if I’d lived in Texas or Mississippi or Tennessee, in 2022 instead of 2019.

Because when I considered another pregnancy, another labor, another child, I thought of that moment when my future no longer existed, and I was filled with a dread so deep I would have gone to any lengths to terminate.


The nurses helped me gingerly to a wheelchair, and one pushed me to a narrow room where two rows of cots faced each other. She offered her arm for support as I pulled myself into bed, then she covered me with a sheet.

“On a scale of one to ten, ten being the worst, how bad is your pain?”

I didn’t know how to rate my seared core. “Eight?”

She gave me a pill and a glass of water. “You have to wait at least forty-five minutes. Then I’ll check your bleeding, and if everything looks good, you can go.”

In the bed across from mine, a woman woke from sedation. Her head rolled perilously on her neck, and she puked down her hospital gown. The nurse gave her a cloth to wipe her face. Around me, other women were propped on pillows, staring at phones as if the screens could erect walls between them. I would have liked to smile, to nod in solidarity, but no one returned my gaze.

Ours was a silent, secret cohort. Some would call us murderers; others would consider us victims. But we were neither. The abortion was a necessary violence, committed against our own bodies in order to survive.

For me, that survival hinged on this essential, visceral knowledge: I am not a vessel. Nor

am I a blank page on which to write the many myths of motherhood. My health and vitality depend on these truths.

I took out my phone, texted Zack, then stared dumbly at the screen. The edges of the pain were softer now, the ache already subsiding. I scanned my mind for grief or regret but found nothing. There was no imagined world where another me cradled a second child.

Only I did lose something in that exam room, and it wasn’t a baby. It was the sensual self who had awakened back in high school. She’d taken hormones for years, endured pregnancy, labor, IUD insertion, and an abortion. Now she finally understood. No matter how enthusiastically I consented, the cosmic trick of my female biology remained. Even the most satisfying, pleasurable encounters could have physical repercussions that would be impossible to escape. The abortion had given my body back. I couldn’t comprehend sharing it again.


One by one, the other women departed. New ones arrived in wheelchairs and on gurneys. Some were still unconscious, their faces so slack and vulnerable, I couldn’t bear to look at them.

The nurse returned, lifting the sheet to peer between my legs for blood. Yet another indignity. But I was free to go. There were no private rooms here either, and I dressed in front of everyone.

Discomfort pulsed where the cells had been, but I could walk normally—from the recovery room, behind the receptionists’ cubicles, back to the waiting area, which was as crowded as I’d left it.

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