"Do you think I will go to hell for this?"
The young woman sitting across from me asks this question half in jest, but she is clearly worried.
We are in a counselling room at the Morgentaler Clinic in Toronto. She has come for an abortion, and it is my job to counsel her about the procedure, to calm her if she is nervous and to make sure she is certain about her decision.
I have worked part-time as a relief counsellor at the clinic for seven years, after retiring from 20 years at Toronto Public Health, where I was a sexual-health educator and counsellor. Each time I mount the steps of the clinic, I enter another world.
Shoppers, families, people young and old go about their business on the street outside, oblivious to the human drama playing out on the second floor of the office building on the corner. When I have finished my work, I re-emerge into what I think of as the real world, but the women I've met that day stay in my mind: the 15-year-old who has come with her mother from Barrie, Ont.; the 20-year-old student who, when the condom broke, took the morning-after pill but it didn't work; the 43-year-old mother of three with an unemployed husband who, after using the rhythm method as she always has, knows she can't welcome another child at this point in her life.
Women of all ages come. Women of every colour and every religion come. Sometimes they come more than once. They come alone or with partners, with mothers or aunts or sisters or friends. They are often astonished to see how many others like them sit in the waiting room.
Some days are difficult. Women enter my office on the verge of tears. They try not to cry, but inevitably they do, and that is a good thing. The tension leaves, and they are able to begin the journey to calmness. Some women's lives are so complicated - so much has happened to them, most of it not good - that I can only admire their strength. "You are a strong woman," I say, or, "You are a smart woman," or, "You are a loving mother who wants to care for the family you have." I am not dissembling; I am truly in awe.
In the world outside the clinic, everyone has an opinion on abortion. In our society, in spite of a long struggle to make it legal and safe, abortion is still viewed by many as a selfish and damnable act. Women are supposed to feel guilty. And many women do. Others feel guilty for not feeling guilty. The world outside is quick to judge. How often I have heard well-meaning people say that no one needs to get pregnant these days if they don't want to. "Why don't they just use contraception?" If they were sitting in my chair they would understand why.
They would understand that not every woman can use the Pill or even afford it. They would know that there are men who won't use a condom, even though it puts their partner at risk of a pregnancy neither of them wants. That there is so much ignorance about fertility, among men and women both, that couples are often playing Russian roulette every time they have sex.
Most women have no idea when they are fertile, so it is hard for them to figure out what kind of contraception to use and how to use it effectively. And when I explain to women how to determine when they can conceive (which has little to do with using the calendar), their eyes widen. "I didn't know that," they say. "No one ever taught me."
As a counsellor, I try not to judge the women I see. I admit that I get frustrated sometimes. And then I remind myself that human beings don't always act rationally where sex is concerned. That's part of being human.
In the early 1970s, when I became interested in the reproductive rights of women, my mother was firmly on my side. "Abortion is a woman's decision, and it should be legal," she said. Perhaps her unwavering belief came from the knowledge that, when abortion was illegal, her friend had had two abortions on the kitchen table.
A friend told me, when we were both young mothers, that she'd had two illegal abortions before she was married. Twice, she had to seek that questionable help, frightened and alone.
At least three of my married friends had abortions after bearing children. I knew their marriages were rocky, and later they divorced. We all know women who have had abortions, although we may not know it.
That may be why it is easy for some people to condemn women for deciding to have an abortion, labelling them irresponsible or selfish. Even women who have had an abortion themselves sometimes condemn other women for having one, in the belief that another woman's reasons are not as compelling as their own.
Our attitudes to sex cloud our thinking when it comes to women's health. A moral issue? Yes, of course. But is it moral to ask a woman to risk injury or death rather than be able to have a safe abortion? Or to force her to have a baby she never meant to conceive? It's complex, I know. But when I am sitting with a woman who has found her way to our clinic, I am grateful that here she can have a safe procedure that is relatively simple and that can restore her peace of mind and her life.
"Do you think I will go to hell for this?" the young woman asks.
We smile at each other. "No," I say.
Ruth Miller lives in Toronto.