There’s a mistaken belief that legislating barriers to pregnancy termination, or overturning Roe v. Wade, will end abortions. Precedent doesn’t suggest this—in the 1950s up to 1.2 million unsafe abortions were performed annually. According to the Guttmacher Institute, the rate of abortions declined from 2000 through 2008, in spite of their legality. But breaking down the numbers is important. For women in poverty, abortion rates increased 18 percent. For wealthy women, abortion declined by 24 percent. That means poor women are getting pregnant when they don’t want to. In fact seven out of ten women who terminated a pregnancy made less than $22,000 a year. In 2004, three-quarters of women surveyed said they had an abortion because they couldn’t financially care for a child. No study to date has asked if improving socioeconomic conditions for these women would decrease the number of abortions.

For this book, I interviewed pro-life advocates. They were not religious zealots; they were men and women whose conversation I enjoyed and who were speaking from a place of deep personal conviction. All of them were appalled by acts of violence committed in the name of unborn children. They told me they wished that pro-choice advocates knew that they weren’t trying to circumvent women’s rights or tell women what to do with their bodies. They just wanted the women who made that legal choice to realize that life was precious, and that their decision would affect an innocent.

I also interviewed 151 women who had terminated a pregnancy. Of those women, only one regretted her decision. The majority thought about the abortion daily. When I asked them what they wished pro-life advocates knew about them, the responses were heartfelt. Many wanted to convey that a woman who makes this decision is not a bad person. As one woman said, “I don’t need people shaming me because of a choice that already hurt my heart to have to make.”

I met with the staff at the Pink House. I also had the privilege to shadow Dr. Willie Parker as he performed abortions at the West Alabama Women’s Center in Tuscaloosa, Alabama (and yes, the fictional Dr. Ward bears a close resemblance to Willie). Dr. Parker is one of the fiercest champions of women I have ever met, and he is a devout Christian. He chose this work because of his faith—not in spite of it. He feels that the compassion in his religion means he has to act on behalf of others instead of judging them. It is Dr. Parker who invented what he calls verbicaine—the conversation meant to relax a patient during the procedure. It is not intended to trivialize what is happening. It is meant to put the event into context. An abortion, he feels, should not be the benchmark by which a woman will measure her entire life. I urge you to read his book, Life’s Work: A Moral Argument for Choice, to learn more about his journey.

In Birmingham, thanks to the generosity and grace of three patients, I observed a five-week abortion, an eight-week abortion, and a fifteen-week abortion. The first two procedures took less than five minutes each, and yes, I saw the products of conception, and there was nothing that would suggest, to the naked eye, a dead baby. The fifteen-week procedure was more complicated, and took a few minutes longer. Mixed amid the blood and tissue were tiny, recognizable body parts.

Dr. Parker believes in transparency in his work. He understands that a fetus is a life. He does not believe it’s a person. His question comes down to the moral responsibilities we have to each other. While pro-life protesters are protecting the rights of the fetus, who is protecting the rights of women?

The woman who had come in to have that abortion at fifteen weeks had three other children under the age of four. She could not afford another child without compromising the care of the ones she already had. Did coming to the clinic make her a terrible mother, or a responsible one?

I myself have not had an abortion. I always believed myself to be pro-choice. Then, I got pregnant with my third child, and at seven weeks, began spotting heavily. The thought of losing that pregnancy was devastating to me at that time; in my mind this was already a baby. However, had I been a college sophomore with a seven-week pregnancy, I would have sought out an abortion. Where we draw the line shifts—not just between those who are pro-life and pro-choice, but in each individual woman, depending on her current circumstances.

Laws are black and white. The lives of women are a thousand shades of gray.

So can we solve the abortion debate without legislation? Let’s begin with the principle that nobody wants to have an abortion; that it’s a last resort. If we assume that the pro-life camp wants to reduce or eliminate procedures, and that the pro-choice camp wants women to be able to make decisions about their own reproductive health, perhaps the place to start is before the pregnancy—with contraception. In the United States, in 2015 there were 57 teenage births per 1000. In Canada it was 28 per 1000. In France, 25. In Switzerland, 8. The difference is that those other countries actively promote contraception without judgment. This isn’t the case in the United States, because of religious beliefs that favor procreation; however, if the endgame is to reduce abortions, promoting contraception would be the easiest solution.

If the greatest number of women choosing abortions do so because of economic issues, then this, too, is an area to consider. If pro-life advocates could prevent abortions by raising taxes and volunteering to adopt, would they? If pro-choice advocates believe women should be able to make a decision without external pressure, would they give up some of their income so that women who are financially strapped but want to continue their pregnancies can?

To that end, it’s worth asking what would happen if we made social services more readily available to pregnant women. Increasing the minimum wage would give women the financial security to raise a baby, if they so choose. Government-funded daycare would eliminate the threat of losing their jobs. Universal healthcare would allow women to believe they could financially afford not just the birth of a child, but its continued existence.

There are other avenues to explore, too, that might reduce the number of women who end up having to terminate. Employers who drive away pregnant women should be penalized. Guaranteed prenatal care at no charge might encourage women to carry to term, and could be set up through a network of adoptive parents who foot the bill in return.

Honestly, I do not believe we, as a society, will ever agree on this issue. The stakes are too high, and both sides operate from places of unshakable belief. But I do think that the first step is to talk to each other—and more important, to listen. We may not see eye to eye, but we can respect each other’s opinions and find the truth in them. Perhaps in those honest conversations, instead of demonizing each other, we might see each other as imperfect humans, doing our best.

—JODI PICOULT

MARCH 2018

For Jennifer Hershey and Susan Corcoran

If you’re lucky, you wind up with colleagues you love.

If you’re luckier, they feel like sisters.

XOX