Abortion Access and Rachamim: Cultivating Empathy

This sermon, Abortion Access and Rachamim: Cultivating Empathy, was shared by Rabbi Elle Muhlbaum on Yom Kippur Morning, September 25, 2023. 

I have a friend I’ll call Chanah, who was a young college student in the mid-1960s. Chanah and her boyfriend had been together for a while. She was tracking her cycles, and thought she had outsmarted her own ovulation. But her period was late, so she went to her pediatrician for a pregnancy test. It was negative, so she went to her summer job at camp. She felt like something was off, and she went back to the doctor. This time she had a positive pregnancy test. There was a conversation with the rabbi, and a family meeting. Her boyfriend’s parents knew a doctor who knew a doctor.  

In the 1960s, abortion was illegal. Chanah and her boyfriend and her parents piled in the car, and they drove to a hotel parking lot in a different town. There, they met a man with a white carnation. Chanah and another girl got into the car with the man, and they drove to a motel. They circled the block a few times, to make sure they weren’t being followed. They went into the motel, where they found two rooms set up, one each for the procedure and recovery. Both young women were put under anesthesia, and woke up next to each other in the recovery room, no longer pregnant. Chanah’s parents paid $400 cash.  

Chanah had all the support a person could want. Her family system was supportive. They had resources. She and her boyfriend were committed to one another. In fact, they decided that summer they wanted to commit to a future, and to live together on their campus, so she made her own wedding dress and they wed that very summer before they returned to college.  

Now they have children and grandchildren. Chanah told me she doesn’t have the slightest twinge of regret. That her abortion wasn’t a big deal, but continuing that pregnancy and having that eventual baby would’ve been the end of her world. Chanah told me she and her partner didn’t really ever talk about the abortion afterwards. It was illegal, but not shameful. It simply hasn’t been a subject of conversation. 

Today, abortion is the conversation. Abortions are legal in the state of Ohio up to 21 weeks and 6 days gestation, but access is highly vulnerable right now. On Wednesday, our state supreme court will begin hearings to determine if the injunction that blocks the abortion ban on procedures once fetal cardiac activity is observable will hold. If the state supreme court removes the injunction, almost all abortions will be banned in Ohio.  

The Jewish people, and even our own community, are not monolithic in our approaches to any issue, including abortion access. Abortion access is a Jewish value, because I feel the weight of our tradition supports autonomy, dignity, and access to care. Since I believe nobody should be forced to birth against their will, nor forced to be pregnant against their will, I consider myself pro-abortion access. Today, I will focus on what happens when we humanize the conversation around abortions.  

I’ve had the incredible opportunity this summer to build relationships with several key leaders in this field: medical professionals; abortion fund workers; criminal defense attorneys, and other legal experts. Their intention is clear: to protect abortion access and ensure that abortion care is safely available to the people who seek it.  

When I spoke with criminal defense attorneys Ian Friedman and Madelyn Grant about their leadership and advocacy work in this field, they helped me understand that there are egregious cases being brought against children and adults who have been pregnant, criminalizing pregnancy outcomes. There are stories of young teenagers who conceive. Maybe they tell a parent. Maybe they get prenatal care.  

Imagine, then, the person delivers at home and the pregnancy does not survive, or, the person miscarries prior to delivery. A parent calls 911 for assistance, not sure how to provide medical care at home. If the police come and decide proper medical care was not provided, they may be able to charge this child with a crime. And in Ohio, there are minimum sentences for these types of offenses including Murder and Involuntary Manslaughter: 3-11 years, or possibly more.  

The wealthy will continue to be able to defend themselves. Bans on abortion access exacerbate issues of patriarchy, race, and wealth. And these bans have ripple effects throughout society. In states with abortion restrictions, residency and fellowship applications from physicians decrease, not only in OB GYN positions, but across all specialties. This is already happening in Ohio.  

I spoke with one lawyer who reflected on the reality in their hospital system last summer after the Dobbs decision, which triggered Ohio’s six-week abortion ban.  In our state law, there is no exception for rape, incest, or fatal fetal abnormalities. The only exception is for saving the pregnant person’s life–but at what point is someone considered to be actively dying?  

Non-physicians were getting called to make decisions only physicians are qualified to make and physicians felt that the legitimacy of their medical decision-making was being undermined.  Did they have to call legal or compliance if a complication occurred during a ruptured ectopic pregnancy? What if someone got it wrong? How do you tell a patient something was the correct clinical pathway but legally not permissible? A feeling of helplessness has permeated not just the population of people seeking abortions, but care providers as well.  

Jessie Hill, an attorney and abortion access advocate who helped co-create the amendment that will be on the ballot in November, told me the 6-week ban isn’t the only law currently on hold because of the injunction. Among them, there is a law in Ohio that requires the cremation or burial of abortion remains, which cannot be in a mass grave. This law attempts to force people to see the remains as a human being, something that conflicts with Jewish views on when life begins. 

Folks may remember the horrifying case that made headline news across the country last year, when a 10-year-old Ohioan had to travel to Indiana, a state which now has a severe abortion ban in place. People remember the story because the patient was a child. But there were hundreds of other pregnant people in Ohio that were not able to access necessary abortion care between when Dobbs fell and the injunction.  

And even needing to qualify that a 10-year-old should have access to abortion is horrendous. As one abortion access advocate puts it, [we act] “As though there is some threshold of age or circumstance or tragedy beyond which it is acceptable to force a person to have a baby…we fall into the trap of qualifying certain abortion restrictions as more extreme or more inhumane than others, when the unshakable reality is that if you are a person who is unable to access abortion for any reason, your state is total disenfranchisement and your right to life has been stripped from you.”1  

In the book of Exodus, we begin our people’s story of redemption with Shifrah and Puah, the Hebrew midwives. Pharaoh tells them directly to kill any baby boy born to a Hebrew. Pharaoh knew girls grow into women who can be forced to give birth to future generations of slaves. The midwives let the Hebrew boys live and saved the Hebrew people by refusing to follow Pharaoh’s decree.  

In the rabbinic imagination, Shifrah and Puah are actually the mother-daughter team, Yocheved and Miriam, Moses’ own mother and sister. I imagine them as full-spectrum midwives, assisting pregnant people at each stage of their reproductive journeys.  

This summer, I had the privilege of spending time at Northeast Ohio Women’s Center in Cuyahoga Falls, an abortion clinic headed by Dr. David Burkons, one of only a few abortion providers left in Ohio. Dr. Burkons generously met with me to talk me through abortion care in today’s climate.  

As Dr. Burkons put it, “It’s a medical procedure. There are no good or bad abortions.” He reflected with me about how gratifying it is to be an abortion provider, and how it’s amazing to be able to change someone’s life every 5 minutes. Because that’s how long a surgical abortion, called a dilation and curettage, or d&c, can take. Just five minutes.  

Dr. Burkons invited me behind the scenes of one of his centers, and as I walked into the clinic I was unsure of what to expect. I walked into the short hallway and saw a tattoo on the back of a nurse’s arm. It said, in a simple serif font: pro Roe.  

Moments later, I met another nurse, who had the dissent collar of Supreme Court Justice Ruth Bader Ginsburg, of blessed memory, tattooed on her forearm. I came to find out they were a mother daughter team. A real-life Shifrah and Puah.  

I walked through the clinic, past cabinets filled with mifepristone and ibuprofen. Questions peppered throughout the small space: Is this your first or second appointment? Do you want to see the ultrasound? Do you understand your procedural options? What are your plans for birth control following your abortion? Is there someone here to drive you home?  

I sat with our modern day Puah, the daughter of the team, as she explained procedure options to her patients. We sat in a dimly lit and cozy but clinical room, with relaxing spa music on and Vote No in August signs on the walls. Puah’s chair put her lower than her patients, and her compassionate presence helped patients feel safe. She explained to one patient with polycystic ovarian syndrome who hadn’t had a period in over a year and was on birth control but still got pregnant, what to expect during their surgery.  

Puah showed the patient the tools that would be used through the procedure, explained what they’d feel along the way, and reviewed which medications the patient would take before and after their abortion.  

I watched as Shifrah, the mom of our duo, restocked pregnancy tests and medications. I witnessed as she coordinated interpretation for two patients, one from Rwanda and one who only spoke Spanish. I saw how she lovingly and nonjudgmentally helped patients navigate funding options and helped schedule procedures. 

There were other Shifrahs and Puahs there that day. One was 36 weeks pregnant, and she waddled between patient care spaces and the reception desk. I asked her what it was like to be a pregnant abortion provider, and she told me about how she had had an abortion shortly before her current pregnancy, and that she felt happy to be able to help people end pregnancies in a safe way. The patients came from all walks of life, all socioeconomic backgrounds. Some had traveled from out of state to receive care, and others lived 10 minutes from the clinic. 

Each and every Shifrah and Puah interacted with patients in gentle tones, answering questions, tenderly making space for the wide gamut of feelings people seeking abortion feel, and simply providing care, in every sense of the word. 

Shifrahs and Puahs are medical professionals, clinic escorts, abortion fund volunteers, and full-spectrum doulas. These folks are the miracle workers of liberation who provide care every step of the way so that people can intentionally decide if, how, and when they may choose to become parents. 

On Rosh Hashanah morning, we read the story of Chanah from the book of I Samuel. Chanah is desperate to conceive a child. God closes her womb, and, to add to her tragedy, she is the subject of humiliating taunting because she can’t conceive. We see her grieving and crying, unable to eat and distraught. She goes to the Temple and prays, and the priest, Eli, sees her praying. Only her lips move, and Eli thinks she’s drunk. When he confronts her, and tells her to sober up, she says to him, “I am a very unhappy woman. I have drunk no wine but have been pouring my heart out to God.  I have been speaking all this time out of my great anguish and distress.” Eli prays that God grant her what she has asked for. She conceives, and bears a son.   

This is one moment in Chanah’s reproductive life. I imagine her at other moments: much earlier in her life when she was relieved to start her menstrual cycle after a pregnancy scare. Maybe later in her life when she conceived and didn’t want to be pregnant, so she terminated a pregnancy. It’s possible; after all, there is evidence in writings from the Ancient Near East that abortions occurred, and recipes for how to accomplish an abortion can be found in Assyrian and Babylonian texts.2 

In recent months, I’ve met many wonderful Chanahs. I met one Chanah, who is also a rabbi, who got pregnant, found out something was wrong with the pregnancy, and had the pregnancy removed. If she hadn’t acted, she would have died. So she acted.  

I met another Chanah, who got pregnant towards the end of college with a long-term boyfriend with whom she didn’t see a future. She told him, “I’m pregnant, I’m going home for an abortion. I’ll be with my parents. Don’t come.” She had bigger dreams than parenting at that moment.  

The doctor she was seeing for general well gynecology sent her to a clinic for an abortion. Years later, when she was pregnant on purpose, the same doctor provided her OB care. He said to her, “all things at the right time can be beautiful.” His empathy and compassion meant the world. 

I met another Chanah who got pregnant as a newlywed. She and her partner announced the pregnancy excitedly to their families, but at around 10 weeks gestation, she knew something was wrong. Because of her financial circumstance, she opted for medication to end her pregnancy, but she ended up needing surgery. She got pregnant again right away, and there was no fetal cardiac activity at the 8-week ultrasound. That time, she opted to have the surgery immediately. Her choices took a toll on her relationship with her parents, who she says chose conservative politics over supporting her. She says the hardest part of her journey hasn’t been the abortions, or even the thousands of dollars of medical bills she’s had to pay off because she’s had to terminate two very desired pregnancies. Instead, the hardest part has been managing her parents and their lack of empathy for her. The stigma was so great in her family, she didn’t even tell her parents about the second pregnancy or miscarriage.  

I met another Chanah who received kind, competent, non-judgmental care from her providers, and after her procedure she felt relieved, grateful, and powerful, the author of her own life, not forced to bear a child.3  

I met another Chanah who had already scheduled a tubal ligation when she got pregnant. She drove from Kentucky to Ohio for abortion care. Now, she’s not pregnant, and she won’t be again.  

I met another Chanah who has five sons, ages 2 to 14, at home. She didn’t want to be pregnant again. So she came to a clinic for an abortion. She had to schedule it around her son’s football game.  

I spoke with another Chanah, whose first abortion experience was to accompany a close friend as a hand-holder during an abortion in grad school.  This Chanah experienced secondary infertility, difficulty conceiving after a first child, and eventually had a pregnancy with unclear viability. When there was no detectable heartbeat at an 11-week scan, she chose a D&C to end the pregnancy and not wait for it to pass without intervention.  She had two other abortions for wanted pregnancies. She remembers twilight anesthesia for the procedures, and feeling relieved to be on the other side, ready for life to begin again.  

She and her partner endured a few failed rounds of IVF before they conceived spontaneously. This Chanah told me there was another powerful moment of choice: what to do with the leftover embryos? Today, Ohioans are already moving embryos out of state, for fear of what future legislative restrictions might bring as extreme legislators try to grant constitutional protections to embryonic tissue from the point of conception.  

The procedures done after a miscarriage are identical to the procedures done for an abortion. These are procedures that, should the injunction fall, will be illegal to perform in the state of Ohio after 6 weeks gestation or once fetal cardiac activity is observed. Even for wanted pregnancies. Even when the fetus is incompatible with life.  

In her book, You or Someone You Love, abortion doula Hannah Matthews beautifully frames the importance of abortion access today. She writes, “an unintended pregnancy is not a weakness or a moral failing; it is not a consequence, it is not a punishment.”4 It is not upon us to judge how or why or when a person seeks abortion care for intended or unintended pregnancies. It is, however, upon us to make sure that people who seek abortions can get them, safely and expediently.  

In Hebrew, the word for womb or uterus is rechem. One of the attributes of God which we recite repeatedly throughout the days of Awe is el rachum; God of mercy. Rachamim is a word that occurs often in our tradition, and we translate it as compassion and mercy. These words, rechem, rachum, and rachamim, all share a root. Womb and mercy, hand in hand. 

In the biblical Chanah’s story, we see a less merciful version of God; we read the phrase ‘vadonai sagar et rachmah” God closed Chanah’s womb. Chanah is described as aggrieved, distraught, disenfranchised, and unwell. When we control the rechem, the womb of someone else, we withhold rachamim, mercy, from them. When we disenfranchise someone from their own reproductive health, when we tell them they have to carry to term and birth a baby they didn’t want to conceive, or can’t afford to feed, or physically or mentally can’t handle, when we send them out of state at their own expense to get medical care, when when tell them their womb belongs in our legislatures or is our business in any way–we lose our rachamim. We lose merciful compassion for our fellow humans. We lose a piece of our own divine humanity.  

Our tradition teaches us repeatedly, “you shall not wrong a stranger or oppress the stranger, for you were strangers in the land of Egypt”5. Mitzrayim, the place of our affliction, that narrow space of restriction and forced servitude, is the touchstone for our people. We are supposed to remember our time there, and use that experience to treat the stranger with fairness and justice.  Imagine your own story in the story of the stranger, our sages teach us. Be empathetic. 

When we think about abortion access, we don’t even need to focus on the stranger. Because the one who seeks an abortion is not a stranger to us. People of all backgrounds, religions, races, income levels, and gender identities get abortions. Statistics show us that about one in four American people who can become pregnant will have an abortion and that most of those who do are already parents. The reasons that people seek abortions are as diverse as the people themselves.  

I spoke with Maggie Scotece, who serves as the CEO of the Abortion Fund of Ohio, or AFO. The AFO helps with community care; they focus on the person who seeks the abortion and provide comfort, support, and funding.  

Maggie and I spoke about the destructive power of abortion stigma. She said, “if you haven’t heard someone’s abortion story, you haven’t shown them you’re a safe person to share it with.”6  

People who have abortions are our mothers, in-laws, aunts, children, and siblings. They are our physicians, our own abortion providers. They are our rabbis and cantors. Our baristas, Uber drivers, tech support professionals. Our sound engineers and our babysitters, our chefs and our servers, our manicurists and our dry cleaners. They are our librarians and our neighbors who are stay-at-home parents. They are our educators, administrators, lawyers, and accountants. Our coworkers. Our friends. They are everyone. 

Someone you love has had an abortion. If you haven’t heard someone’s abortion story, consider ways you can cue to the people around you that you are a safe person to speak to. As Maggie said to me, “our silence hurts the people we love.”7 If you believe that nobody in your life has ever needed or wanted an abortion, think again. 

Writer and social commentator, Lindy West, reminds us that “personal storytelling is an engine of humanization, which is in turn an engine of empathy… we [must] unleash our stories [and] destroy the stigma, …. Our stories are ours just as our country is ours just as our bodies are ours.”8  

One of the first commandments we read in Torah is to be fruitful and multiply. The book of Genesis is replete with stories of our generations, fertility and infertility. The book of Deuteronomy is designed as a tool to help us teach the lessons of Torah to our children, l’dor vador, from generation to generation. Abortion is a piece of this constellation. Supporting abortion access supports future generations, because abortion allows parenting with intention. It prevents forced birth. It allows us to create generations with intention, with freedom, with autonomy. 

Abortion access is on the ballot this November in Ohio. A majority vote on Issue One will enshrine abortion access into our state constitution, and will allow patients to have the freedom to work with their doctors to make appropriate choices. Abortion access is more than procedures, statistics, and legislation: it is care. Show you care at the polls and beyond. 

Begin by joining me at Fairmount Temple on Monday, October 30. That evening, I’ll be in discussion with Dr. David Burkons, attorneys Ian Friedman, Madelyn Grant, and Jessie Hill, and temple member, Yael Casselberry. We’ll be having a humanizing and engaging conversation about the state of abortion access in Ohio, looking ahead to the possible outcomes of the election in November, and hearing first hand perspectives on the impact of this work and how to get involved.   (RSVP here)

Abortion touches us all. This Yom Kippur, say the word abortion. Let the teachings of our tradition guide you towards increasing your empathy and compassion. Signal to the people around you that you are a safe person to share stories with. Find someone to share your abortion story with. Look into abortion funds and see if you can be a partner in community care, by volunteering your time or making life-saving donations. Be merciful. Be gentle. Be empathetic. 

On this Day of Yom Kippur, Jews around the world come into prayer spaces to stand shoulder to shoulder and confess, communally, our sins. We beat our chests. We bare our souls before God. And, often, the sins to which we confess are not really our own sins. These are communal failings, phrased in the collective plural. We have sinned.  

Nobody is singled out. Nobody is made to feel their deeds stigmatized. We are responsible for our own behavior, but we confess in solidarity.  

Today, I offer these words on behalf of our community. I’ll say them in the collective plural, because they are all of our sins. Together, they represent the sins we have committed: 

Al cheit she’chatanu l’fanecha:
The sins we have committed before you by politicizing healthcare. By passively allowing our representatives to use us as bargaining chips for power. By our passive disengagement from the democratic process. 

Al cheit she’chatanu l’fanecha:
The sins we have committed before you by stigmatizing abortion. By not being a safe person for someone to share their story with. By not realizing and not harnessing the power of our stories.  

Al cheit she’chatanu l’fanecha: 

The sins we have committed before you by dehumanizing the conversations around abortion access. By feeling an ownership over pregnant bodies. By forgetting that every pregnancy requires consent to be viable.  

Al cheit she’chatanu l’fanecha:
The sins we have committed before you by putting physicians in situations where they are unable to provide necessary healthcare. By separating abortion from a holistic vision of wellbeing. By judging other people’s decisions to abort pregnancy. 

V’al cheit she’chatanu l’fanecha:
The sins we have committed before you by ignoring the systemic racism that impacts the way we relate to abortion care. By forgetting that abortion access affects everyone. By not doing everything in our power to effect positive change and protect safe access to abortion. 

V’al kulam Eloah selichot, slach lanu, m’chal lanu, kaper lanu:
For all these sins, God of forgiveness, forgive us, pardon us, lead us to atonement.  

On this day of Atonement, let us be not like the womb-controlling depiction of God in our Chanah story. Let us instead strive to be like El Rachum, the God of compassion. Let us be merciful. The human hands of rachamim. May the final t’kiya g’dolah which we hear at the conclusion ne’ilah be our call to action. May we move forward into this year 5784 committed to fighting for abortion access. May we center human stories, and celebrate the divine humanity of rachamim. Then, God willing, may we be worthy of forgiveness.  

Rabbi Elle Muhlbaum

 

1   Lindy West, The Witches are Coming, page 174.
2   https://www.thetorah.com/article/abortion-in-the-ancient-near-east-and-greco-roman-world
3   Lindy West, The Witches are Coming, page 166
4   Hannah Matthews, You or Someone You Love: Reflections from an Abortion Doula, page 64
5    Exodus 22:20
6    In conversation on 9/1/23
7    Ibid.
8    Lindy West, The Witches are Coming, 178-9