From the front line of the abortion wars

Abortion is the subject of many books, but it's highly unusual when a volume that looks like yet another partisan salvo actually contradicts the expected "party line" in important and revealing ways.

Such is the case in Susan Wicklund's This Common Secret. Wicklund enlisted as a front-line soldier in America's abortion wars in 1989, when the conflict was most intense. Extreme right-to-life groups like Operation Rescue physically besieged abortion clinics, and many abortion providers feared for their personal safety.

Wicklund was an unusual recruit. She started college as a 26-year-old single mother, but went on to win admission to medical school. In 1988 she completed her professional training and took a job at her hometown hospital in Grantsburg, Wis.

Wicklund replaced her own family doctor, who was retiring after a long career that included the quiet provision of abortions both before and after Roe v. Wade's nationwide legalization in 1973. The Grantsburg hospital forbad elective abortions, and so Wicklund soon found herself assisting old childhood friends with unwanted pregnancies after hours and then treating their ensuing miscarriages. Her own experience in obtaining an abortion in 1976 had cemented Wicklund's pro-choice stance even prior to medical school. (However, here the book's ugly depiction of a doctor who told her to "shut up and lie still" differs radically from an account Wicklund gave to a Washington Post reporter in 1993 when she spoke instead of "a real kind physician.")

But Wicklund relates how, during her internship year, she witnessed a late second trimester abortion of a fetus whom ultrasound had shown suffered from a fatal abnormality. She already knew that "an eight-week embryo is about the size of my thumbnail," but "the visual reality of a twenty-one week fetus" undergoing disarticulation in what physicians call a "D&E" (for dilation and evacuation) abortion was something else entirely. A glimpse of one of the fetus's arms during the procedure almost undid her. "One of the nurses in the room escorted me out when the color left my face."

Wicklund had no second thoughts about early abortions like the one she had sought, but "confronting a twenty-one week fetus is very different," she honestly admits. "It was not something I could be comfortable with. From that moment, I chose to limit my abortion practice to the first trimester," with an absolute ceiling of fourteen weeks.

In April 1989, during her first year at Grantsburg, Wicklund attended a huge women's rights march in Washington, D.C., an experience that left her thinking she should be doing more as a doctor than she was. Two weeks later she telephoned an abortion clinic in nearby St. Paul, Minn., and offered to work at clinics that needed a doctor. In June, Wicklund began providing abortions one day a week in Milwaukee, and in July she added a second clinic in Appleton, Wis., to her busy weekly schedule. Come October she gave up her Grantsburg job and expanded her travels to encompass three more clinics in St. Paul; Duluth, Minn.; and Fargo, N.D.

"My schedule required daily flights or drives of two hundred miles or more. At least three nights a week I was in a motel room," Wicklund recalls. But far more draining than the travel was the almost constant presence of antiabortion protesters intent on persuading – or coercing – doctors to stop providing abortions in the far-flung locales that made up Wicklund's weekly circuit. "At every airport I had to run their gauntlet," and she donned outlandish disguises in order to pass unrecognized.

Wicklund's one refuge was her home, in a rural setting at the end of a long, dead-end road, but one morning in October 1991 she was awakened by the cry "Susan kills babies" outside her bedroom window. The protesters also blocked her driveway with cement barrels to prevent her from traveling. Armed with a loaded pistol, Wicklund sneaked through the woods in the early morning darkness to rendezvous with a friend and then drive to Fargo in time for that day's scheduled abortions.

In February 1992, Wicklund was featured on CBS News's "60 Minutes" and her appearance buoyed her spirits. "Never again would I feel as alone or exposed as I had before I spoke out publicly."

Two years later, enactment of the powerful new federal "FACE" statute – protecting Freedom of Access to Clinic Entrances – curtailed obstructive protests and intimidation with its threat of significant prison sentences. By then Wicklund had opened her own clinic in Bozeman, Mont., but she later closed it in order to care for her mother during a terminal illness.

Wicklund resumed work, first at the St. Paul clinic, then at several in Montana, but her frank account of how the St. Paul clinic now "prioritized billing protocol over patient well-being" ends with Wicklund herself being "fired for putting a patient first" after she treated a woman who could not pay in advance.

That story, like Wicklund's blunt confession of her aversion for second-trimester abortions, makes this gripping, deeply moving book a compelling memoir rather than a dogmatic pro-choice tract.

• David J. Garrow, a senior fellow at Homerton College, University of Cambridge, is the author of 'Liberty and Sexuality: The Right to Privacy and the Making of Roe v. Wade.'