Abortions in Greece
by Alexandra Halkias
(From The Empty Cradle of Democracy, Sex, Abortion and Naturalism in Modern Greece, Duke University Press)
In the operating room:
On Cows, Greece,
And the Smoking Fetus
|I was wearing a white shirt buttoned up to
the next to last button, with a white T-shirt showing underneath. I was also wearing khaki pants, a black and beige small-checked blazer, and a pair of flat pumps instead of my fieldwork shoes. My fieldworkshoes no doubt cost me a bit in terms ofmaking some people feel safe
with me and my research, but they gave
me enough sense of strength to be worth
it. They looked like ordinary men’s shoes. My pair was dark brown and had a thin rubber sole. I was able to walk tall and still have a very solid footing at the same time, without looking as if I was at all interested
in making a pass at anyone.
300,000 to 400,000
abortions for up to
Greece first or second
countries. . .
These shoes moved me out of the category of the “permeable,” or sexually available. In fact, I think my “research uniform” had the effect of desexualizing me, in Greek straight terms at least. Anticipating all the layers of scrutiny I would encounter before being permitted entry into the high-security bowels of the clinic, which is where abortions take place in three main private ob/gyn clinics of Athens, I decided my flat pumps were a better choice for today. Thin ankles showed under my serious pants, the better to encourage the paternalism ob/gyn seemed to feel most comfortable putting on display when faced with women who are conscious. Including, sometimes even in a more pronounced form, when they were dealing with a researcher inquiring after what constitutes the bread and butter of most ob/gyn practices: abortion. For them to be even mildly cooperative with the research, I needed to put them at ease-as much as possible, that is, given the usual reaction to my research topic.
As I’ve noted, Greece is often reported in its own media and at Greek ob/gyn medical conferences as having the highest rate of abortions in Europe. One more symptom of phenomenon of the Greek para-economia, the huge but hidden part of the Greek economy, is that very few abortions are actually formally reported. Greece’s para-economy consists of a fully organized and well-functioning economic system that exists out of the view of the Internal Revenue Service. Thus, for example, stores may “cut receipts” for a fraction of the merchandise they actually sell and use those for tax purposes while keeping their main business off the books. Clients who want a receipt are quoted a different price than those who don’t ask for one. In general, both the doctors performing abortions and the clinics in which they are performed do not declare abortions so that they won’t be taxed for them. Also, as the doctors are always quick to note, the women want to maintain their privacy and anonymity and are not themselves to document the abortion in any way. I was told this so often, I am sure, to give the doctors an alibi for their failure to help build my sample by allowing me to come in contact with their patients. But it is true that there is a generalized aura of secrecy surrounding abortion. Several doctors told me that most women would rather avoid a state-run clinic and prefer to pay for an abortion in a private clinic, thus avoiding having the abortion stamp put in the public health services book all insured citizens carry “for life” (isovia, a midwife said, the same word used for a criminal sentence). This was confirmed by many of the women I spoke with. What all this means is that there are no reliable formal statistics on abortions in Greece.
In addition to the snowball sample of thirty middle and upper-class professional women that I built mostly thanks to friends and their friends, I also conducted interviews at a state-run clinic in Athens, considered by experts to be the prototype for all Greek state-run Family Planning Centers, where I had been granted formal permission to do research on abortion (a feat accomplished largely, I think, by virtue of my willingness to sit in the director’s waiting room “just in case” he had a spare moment for each of the full five working days that his secretary told me there was no time for a proper appointment with him). Of the ninety women with a written record of two or more abortions whom I interviewed at the clinic, most of them lower and middle-class, all reported having at least one of their abortions in a private clinic and most had had all of them there. Certainly this was partly a product of the fact that abortion was illegal until 1986, when PASOK passed the law 1609/86, and hence performed only-if quite abundantly and safely in private clinics. But even most of the younger women I interviewed said they preferred to have their abortions done in a private clinic. They might visit the state-run clinic for their routine gynecological examination and Pap test, though always under the guise of being interested in beginning to use some form of Center-sanctioned contraception. The Family Planning Center at the clinic was not authorized to offer routine gynecological services to women unless they were coming in for advice about contraception. The midwives who staffed the center saw to it that this rule was upheld at least enough so that the women who came in had to act as though they cared about both contraception and the Center’s advice on it. But a private clinic seemed to be the preferred site for abortions for women of all social classes. Of course, as I found out later, even the public clinics did not regularly report abortions, despite the fact that on a whole they did not need to adhere to the state’s bureaucracy to some extent to be reimbursed for services to insured people. Only abortions deemed “therapeutic” were systematically reported. Those account for approximately 1 percent of all abortions performed in Athens each year.
The figures of the National Statistical Service (1993) show that during 1992, two years before my fieldwork, there were 1,642 abortions performed in all of Greece. Yet, there was a consensus among the thirty doctors I interviewed in Athens that the more accurate figure was probably in the vicinity of 300,000 to 400,000 abortions for each year up to the mid 1990’s. This, for a population of 10 million, placed Greece first or second among European Union countries with high rates of abortion throughout the 1980s and 1990s. The effects of the European Union-funded anti-AIDS campaign considered by many laypersons and experts alike to be a strong, if inadvertent, force against abortion-had not kicked in until later. Actually, 1993-94 was the period many doctors identified as marking a drop in Greece’s rate of abortion to approximately 200,000 to 300,000 per year-still many more abortions than the number reported.
As I was told by Marina Meidani, a scholar at Panteio University in Athens and a member of the Board of Editors of Dini, the only feminist scholarly journal published in Greece, this discrepancy between the formal discourse of the state and the daily practice of Greeks is typical of everyday life. However, I suggest that this discrepancy is not so easily located in the disjunctions between a firmly bound state and the supposedly similarly separate stuff of either daily life or civil society. Rather, what I often encountered, even in my discussions with individual women, was a different tension: the tension and reversibility of “truth” as it is paraded in variously disguised forms through a minefield of erratically extended trust and distrust. Greeks, whether living in Greece or abroad, sometimes refer to their culture as “paranoiac.” Be that as it may, it is clear that trust is a core issue, and with good reason, as there has been a long national and personal history of often quite violent breaches of trust. I think the difference between stated facts and lived practice, or experience, has to do with fear.
The heart of what is seen locally as the problematic disjunction between formal words and informal (hence, it is implied, real) practice lies in the success, or lack thereof, involved setting and defending boundaries that will be respected. Deciding just which boundaries should be set and defended is itself often tricky and fluctuating business. The domestically prevalent stereotype of yelling Greeks not withstanding, the confrontational approach typically used for assorted negotiations can also be misleadingly calm, when the ammo is a strategically flung “Whatever you think,” for example. Either way, it tends to maximize harm to all parties even as it is fueled by a concerted attempt to avoid incurring the loses suffered in the past and, above all, to preserve face. Opos nomizeis. Where people’s hearts are close to the skin, put on the line with a show of bravado, and then hurt, there remains little room to negotiate conflict arising at a later date without automatically upping the ante and resorting to a variety of subtle, or not so subtle, terrorist tactics. No longer as easily accessible, the heart may go underground, content to mastermind from there the infinite intricacy of the doings of the mind, with cunning, poniria, or its cheap substitute koutoponiria. The common reference to the evil eye (which can be cast, even unwittingly, when one says something very good about someone or a possession and feels some envy, or if one quite simply does not want the good of someone else) stands as good evidence of the wide range of strategies that can be used for dealing with perceived threats.
Having arrived early at the clinic, I was
playing my part in a little dance with Dr.
Aspridaki. Not all anesthesiologists help
during abortions, as I had been told she
did. Although abortion in Greece is
common and routine at one level, it
is nonetheless not at all a simple matter
to be making part of your living from it. A
Greek Orthodox version of shame attached
to abortion is one reason. Another is what
the mass media call the demografiko. This,
as I’ve noted, a statistical and cultural
phenomenon perceived--mostly in the
mainstream press and occasionally in
Parliament as well--to be of unique propor-
tions at the present and of great gravity:
Greece’s major national problem, as it is
said, with a birth rate that, accord-
ing to demographic conventions, is not
high enough to “reproduce the genera-
tions” (which is, of course, presumed to
be a positive and necessary goal for the
Greek nation’s welfare). In the con- text
of public discussions on this issue in the
press, TV and radio, abortion occasionally
came up as an important factor, contribut-
ing to “the demographic problem.” In
some contexts, abortion is actually likened
to an act of treason.Surprisingly, it was the
centrist press, and of course the far right’s press, that stated this more than the
papers of the mainstream right. All of which
is to say that, while Tasi was likely flattered
to be facilitating research sponsored by a
U.S. university and pleased to be accruing
favor with my aunt (perhaps paying off
some unknown favor extended to her in
the past), she also had good reason to be
cautious with me.
"I AM A MAN"
As I had been directed to, I told the front desk of the clinic that I was there for Dr. Aspridaki. They called her and then told me to wait; she would be up to get me shortly. The lobby/waiting room of the clinic was packed. It had a slightly different feeling than that of the other private, northern suburb ob/gyn clinics. In one corner of Artemis’ front lobby that morning was a fiftyish women dressed in black holding a bag of potato chips in one hand and a soda in the other. She was nodding emphatically toward one of the two men sitting with her. One was wearing a black band on his sleeve that few Greek men still wear when they are in mourning. It continues to be common practice in many villages, and among women, even in Athens, wearing black for one or more years is a routine part of mourning for the death of a husband. The other man sitting with them was very young. As I watched, another woman walked up to them, her hair pulled back in a big bow barrette, with more food. She has brought them some cheese pies from the canteen. A little further down on the couch-like furniture of the lobby was an older man with his head rolled forward on his chest, snoring. She woke him up and handed him a cheese pie.
I wondered whether it was a sister of one of these parties, or a brother’s wife, who was giving birth. Of course, it might also be that a relative of theirs was there for an operation, a hysterectomy or the removal of a tumor. In fact, there was something about their energy; they exuded a sense of distinction for being present. It was in some way “big of them” to be there. Also, the joyous undertones to the anxiety that usually accompany a birth vigil were missing. Their pleasure was due to everyone facing and obstacle together, pulling together to overcome something. Tha to perasoume mazi. They were taking a stand in solidarity. Na tis sibarastathoume. But, as in the case with many such stands taken in all sorts of situations in Greece today, there was a vehemence to the gesture that seems a little too strong, driven perhaps by a guilty pleasure that the plight of the other is not one’s own or, possibly, by the prejudicative comprehension that the plight of the other may in fact be a reflection on the ostensibly “innocent” other. What the vehemence was covering up in this particular case was anybody’s guess. One thing was clear: were it a simple birth this group was waiting on, the pride would not have the same pitch. Their presence would have been expected, something that honored them, but not the something others should be especially grateful for. Also, the joy felt in waiting for the arrival of yet another addition to the extended family was not animating this group. But perhaps it was a difficult labor. Whatever they were there are witnesses for was likely not life threatening, but there was some miasma attached. It showed in the bustle.
I paced through the lobby a few times. I read the signs on the wall with the little arrows: “ultrasound,” “prenatal examinations,” “external laboratory.” I noted the absence of an “abortion” sign and wondered what direction the abortion rooms might be in. Then I heard my name over the loudspeaker. It was Kyria Halkia na erthi stin resepsion. My aunt’s friend was at the desk. She was wearing one of the long white jackets, a roba, over her “citizens clothes,” as the midwives at the state-run center called their street-clothes.
Ta politika. The juxtaposition implied that being a mid-wife was more like being “a citizen,” more like being part of an army instead. I shook hands with Tasi and we exchanged brief pleasantries. She told me to follow her and we walked down a flight of stairs, through a small hallway-cum-waiting room where she was greeted by a doctor wearing blue pants and a blue shirt. From there, we turned to a big closed door that had a little square of glass with wires running through it at face level. It looked like what I imagined a prison door would look like. She looked quickly, punched a number on a pad to the right, the door clicked, we entered.
To the immediate left was a women behind a desk with a computer monitor or screen of some sort placed on it. Next to this women, to the right as we walked in, was a young man. Tasi nodded at them and indicated that I was with her and we were “just going in.” As we turned into another corridor I saw doors, probably three or four on each side. We were walking fast. I glanced into one as we went by and several beds with women lying on them. In another room, I saw a women wearing a bright pink uniform tucking in the sheets of one of the beds. The women looked up at Tasi, greeted her warmly, and then looked over at me quizzically. Tasi called out “Hi there, I’ve got a friend with me today,” and kept walking. Then a male doctor walked by us wearing a green longish shirt over street clothes. He called “Hi” to her, and then asked, “Who is this with you?” Tasi was cool with him. First she said “Hi” back to him and then she added, “Oh, the niece of a friend.” The doctor continued , “What’s she doing here?” and then “Are you sure she isn’t with the IRS?” Plaka, Plaka den xereis apo pou tha sou tinferoun kamia fora. He smiled a little, as did Tasi, nodding her head a bit. We kept walking.
Finally we got to a door on the left that was jammed open. We entered a small room that had three doors leading off it. Directly in front of us was a long basin with several water taps. One of the three doors was on the wall to the right, immediately next tot he basin, another directly opposite it on the wall to the left. Opening off from the wall in front of us, a little to the left, was the third door. The change from loud voices, and the smell of cigarette smoke. Tasi greeted her telling somebody that I was my aunt’s niece, “You remember her from Evangelismo Hospital, she’s a colleague anesthesiologist.” I followed her through the door across from us into another room, almost as small as the anteroom with the three doors and sink. Here she introduced me to four people who seemed to be simply hanging out.
There were two women wearing pink uniforms, another one in pale blue, and a man in green pants and shirt. She told me the first names of the two women and said they were midwives. Then she told me the first name of the other women and explained that she was the one who would help with the anesthesia, unless something came up. I later learned that it was fairly routine for a helper-sometimes one of the mid-wives, sometimes a technician not performing any of the mid-wives’ duties-to perform the anesthesia in abortion cases. A specified anesthesiologist would be officially responsible and on call, though not present in the operating room. Meanwhile, about a third of the payment going to the anesthesiologist would be passed along to this substitute. Tasi introduced the man in the green as “Mr. Filias” one of our doctors here.” Somebody handed me one of the green shirts folded up neatly by the door and told me to put it on. I squeezed my big shoulder bag behind one of the chairs by the sink and hung my blazer on one of the nails by the door. I pulled on the green shirt. “Have a seat,” Tasi said, and I did, increasingly aware of the butterflies in my stomach. Clanky metal medical instruments make me queasy. Blood I don’t mind, but scientifically sanctioned butchering equipment gives me such more pause than any machete. The butterflies I felt in my stomach were exacerbated by my phobia. But, I realized, they are also a result of my feeling of being a complete fraud. What am I doing here?
Tasi turned to the doctor who had just asked me exactly that question. She told him pointedly that I was doing research on the women who come here, “for abortions” (gia ektroseis) She enunciated the words very carefully. Now that it is being researched, it seems, its real name can be pronounced loud and clear. Usually medical personnel of all ranks prefer today diakopi, which means “interruption,” or amvlosi, which is more formal, or simply epemvasi, the word for surgery that also means intervention, as well as a military operation. I myself have learned to carefully emphasize my interest in the women in particular, rather than abortion per se, when communicating with the medical practitioners involved in abortions.
The doctor asked, “Research, what kind? Is she a journalist” I quickly explained that I am a sociologist, as I have gotten into the habit of saying to avoid questions and curious looks I am confronted with if I say my Ph.D. is in the field of communication. Because my B.A. and M.A. from Bryn Mawr were in sociology, and because most of the members of my doctoral committee at UCSD are sociologists or political scientists, I don’t feel this is an out-and-out lie. Anthropology, in some ways the better “home” for the type of fieldwork I was conducting in Artemis, would have made little sense here because the lay understanding of the field in Greece remains strongly linked to archaeology. “The research is for my doctoral dissertation.” I explained to the doctor. “It will be filed at the University of California,” having learned that nobody listens to the whole long title of University of California at San Diego. “Oh,” he said, looking away slowly toward the door. Then his head swiveled back and his eyes met mine head on. “What is it you are trying to learn?” Always that question. Again, as I have learned to do, I said that I am interested in “the women’s psychological profile,” especially what their emotions are with regard to the unwanted pregnancy and it’s termination. “However,” I went on in an even voice (deflecting), “my approach is not psychoanalytic. What I am most interested in is how they consciously perceive of, and respond to their situation.”
Meaning what, I wondered? Meaning that I am trying to convince my interlocutors that I successfully walk the straight and narrow path of not being somebody who will judge badly the doctors providing abortions-neither an overly zealous Greek Orthodox woman (theousa) nor some implicitly crazy feminists (feministria) who would think abortion is a good thing but would have similarly negative approach towards the doctors making money from it. “My primary unit of analysis,” I said as I concluded my answer to the doctor’s question, “is the discourses that Greek women who have had two or more abortions articulate: the stories they tell, not their psyches.” As though those are so easily distinguishable.
Highlighting my interest in the women’s perspectives served to assuage the doctor’s apparently quite deep concern that they, and their participation in abortion, may actually be what is under examination. In fact, the doctors have never been my central concern, though they did become a site of great interest as my research progressed. In addition, my firm disavowal of the deep unconscious, a domain that is clearly not the doctors’ turf, works to accomplish two things. On the one hand, this suggests a respect on my part for the territorial boundaries of categories of knowledge in general (an issue at the core of professional life in a modernizing Greece, where regulatory boards’ scant and impromptu patrolling devices operate opportunistically at best and where it is often said that “whatever you call yourself, that is what you are”). Min benoume se xena xorafia. On the other hand, it also serves to put doctors at ease about volunteering their own (quite unpsychoanalytic) accounts of women’s feelings as they have been exposed to them in the context of their practice. To be sure, it also grants me a little more respect, as neither psychoanalysis nor psychology enjoys the recognition and respect due to them in Greece.
I remember vividly that a close friend told me several years ago that “Americans are constantly going to psychologists because they don’t have any friends. Imagine that you have to pay to have someone listen to you! Since then, I have heard similar statements from other friends. I don’t think that the higher concentration of psychologists now practicing in Greece has done much to change a “formal level” disbelief in the contributions of psychology. It is commonly felt that visiting a psychologist is potentially even a dangerous thing to do and that it might, in some important way, harm your soul. Yet, in the classic love-hate dynamic
(Greek American Review, Mar. 2005, pp24-28--Part Two to appear in the April 2005 issue)
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