Our Visuality: Abortion Care Work and Photography

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Five gestational sacs of five to nine weeks in one petri dish. Tissue removed using manual aspiration; weeks refer to gestational age. Image courtesy of MYA Network.

What is the visuality of abortion care? Though I am writing this text for a publication based in Los Angeles—once my home for many years—I have now lived in Columbus, Ohio for nearly a decade. As with many of its Midwestern neighbors, my state has been whittling away abortion access since long before I arrived in 2014 (in that year, Ohio had 29 clinics; now there are 10).¹ As I write this in August 2023, our power struggle plays out in real time: Ohioans have gathered nearly half a million signatures, putting an amendment enshrining abortion rights in our state constitution onto the ballot. To threaten that outcome, Republicans have called for a special election to change the simple majority constitutional vote from 50 to 60 percent, a far higher threshold to pass.² I voted on it yesterday; I sat down to start writing today.³

I teach at The Ohio State University in an art building that sits directly on the central open space on campus. Several times a month, I come into direct contact with anti-abortion activists there, stationed on the grass, kitty-corner from my place of work. When these folks are around, their presence is perennial: I encounter them multiple times a day on my way in and out of teaching classes, meeting with students, or getting coffee, and can often see them from my office window. “Have you ever been pregnant?” they ask me as I pass. Their strategies are familiar and consistent: Oversized poster board printouts of so-called aborted fetuses announce the protesters’ presence and are detectable from the length of a city block away. It is impossible not to be confronted with these images—given their scale and the graphic nature of their subject— which is, of course, the point. Still, I attempt to steer around them, refusing to make contact of any kind, refusing to tell them that I have had two children and one abortion in between, thinking all the while—while I am en route to teach photography a hundred feet away—just how successful they have been in weaponizing the same medium.

I wonder if they know of, or care about, Lennart Nilsson, the Swedish photographer who invented those types of in-utero photographs—that way of seeing? Oddly enough, I have used Nilsson’s photographs in my work, too, if to very different ends. Nilsson, who died in 2017, developed the photomicroscopic technology (using a wide-angled endoscope, tiny fiber optics, and electric flash) to make the world’s first photographs of fetuses floating in their amniotic sacs.⁴ Hyper-detailed and remarkably sensuous, the pictures are notable for the way the fetuses float in a vast world all their own, disaggregated from the mother’s body altogether.⁵ The photographs, long described as “cosmic,” were sent up on NASA’s Voyager space probes in 1970 and 1977 alongside music by Bach, recorded brainwaves, and pulsar maps, should the probe intelligent life. In the 1980s, Nilsson was shocked to discover that anti-abortion activists were using his pictures on protest posterboards. The irony is that across his decades of photographing in this way, all but one of his fetal subjects were either miscarried or aborted fetuses obtained from ectopic pregnancies (in which an embryo grows outside of the uterus, endangering the life of the pregnant person).⁶ In other words, the pictures were only made possible because pregnancies had been terminated to save women’s lives.⁷

In January, The New York Times published an essay titled “Early Abortion Looks Nothing Like What You Have Been Told” by the co-founders of My Abortion Network, a clinician-led organization. The accompanying photographs were of petri dishes atop a ruler, each containing early pregnancy tissue and uterine lining removed via aspiration procedures (gentle suction) during the first five to nine weeks of pregnancy. Dr. Jeffrey Levine, a professor of family medicine and director of reproductive and gender health programs at Rutgers Robert Wood Johnson Medical School, spoke of his experiences with fellows, residents, and medical students: “‘When we examine the tissue after a procedure, everyone is consistently surprised. They expect to see an embryo, fetus or at least some body parts, [and they are] underwhelmed.’”⁸ Photography has so long been strategically wielded as an ideological tool in the anti-abortion struggle that even doctors-in-training were caught off guard by the conflict between what they saw in their microscopes and the images of fetuses, embryos, and/or body parts in their cultural milieu, from high school textbooks to anti-abortion propaganda. Though there were only seven photographs in The New York Times article, each small and modestly shot, they exploded my image-based understanding of pregnancy and its termination, from Nilsson on down.

Pictures are powerful in this way. Intellectuals from Hervé Guibert to Roland Barthes to John Berger have differentiated photographs from all other art forms for their function to furnish depictive so-called evidence of truth and lived experience rather than interpretation. “The painter constructs, the photographer discloses,” wrote Susan Sontag in 1977.⁹ Like biofeedback, photographs can change our minds about our bodies.

In 2018, long before the Dobbs v. Jackson Women’s Health Organization decision was leaked but decades into the slow and steady assault on abortion access, I began thinking about making a project that centered the question of visuality vis-à-vis abortion. Ohio’s then-Governor John Kasich (still seen by many as a “moderate” Republican) had signed into law one of the most restrictive abortion bills at the time, banning most abortions at 12 weeks with no exception for rape or incest.¹⁰ During that period, I was meeting a group of pro-choice protesters every weekend at the Columbus Statehouse. We circled the city block again and again with our signs in hand; I had my small newborn strapped to my chest, who slept throughout. As we walked, and occasionally were confronted by counter-protesters, I began to wonder: How might we countermand their photographic stratagem? What would that look like? What are the effects that only pictures can achieve?

Though it began to crystalize then, this is a question that I have carried, that has evolved along with me, for decades. I have long been interested in the visual material that attends and describes motherhood and birth, and am only beginning to understand the ways that abortion access and care work are a central piece of that practice—the ways that the right to be pregnant has everything to do with the right to be unpregnant. Like 60 percent of the women who get abortions in this country,¹¹ I am also a mother, and was already a mother when I got an abortion between the births of my two children. We—those of us who gestate and feed babies from our bodies and bleed for months after birth—know most of all what it takes.

Human fetus in amniotic sac at 34 weeks. At this stage, all of the fetus’ internal organs are almost fully developed. The placenta is at the lower left. Image courtesy of TT/Science Photo Library. Photo: Lennart Nilsson.

Perhaps because photography has not historically been hitched to abortion rights (beyond the image of the wire clothes hanger), my frames of reference for abortion experiences in art were, and still are, largely non-photographic. I am returned in perpetuity to painters like Paula Rego and Juanita McNeely, and the poet and sci-fi writer Marge Piercy, who depict narratives of fear and indignant rage (“A woman is not a basket,” Piercy begins her poem “Right To Life”).¹² Rego famously created 10 large Abortion Series paintings in 1998, after a referendum failed to legalize abortion in her home country of Portugal. The works, each of which pictures a single figure in a backstreet abortion clinic—many of them on single beds or improvised operating tables—are dark, confined, and dank-feeling. One haunts me the most of all: a muscular woman wearing a red bandana, sitting up with her back to the wall. She pulls her legs up, ready, and holds our gaze. The viewer is positioned as her illegal abortionist in a confrontational scene that is at once erotic and painful. I am so grateful for these works, which are unflinching.

As a person born in California in 1983, my experience with reproductive rights has been different than Rego’s, McNeely’s, and Piercy’s. Thanks to these brave artists, and so many women in the struggle, I inherited a world where, for the most part, abortion was safe and legal. My own abortion took place in a clinic with a physician rather than a back alley with God-knows-who; I went home a few hours later instead of bleeding out on a dirty motel floor. That perspective—of abortion care as safe and ordinary rather than trauma-laced—has informed the art I want to make about it. And in a larger sense, I believe that this is now our political imperative and site of resistance as artists: to normalize, rather than sensationalize, abortion care.

In August, I opened my first solo museum exhibition at the Minneapolis Institute of Art, a project that aimed to center the very regular (heath)care work that abortion doctors, staff, and volunteers undertake daily. My research—which took the form of collecting archival photographs from clinics as well as making images of staffers at work—offered me the great gift of getting to know and build relationships with these folks and their feminist histories. In this way, the project moved slowly, and with tremendous care. In other ways, it moved far too quickly: In just three years, the project had become a race against time, and against the right-wing political machine. The Dobbs decision leaked in May 2022, causing such ripples of grief in me that I had to put the work on hold for some time; the ruling was issued a few months later, officially overturning the constitutional right to abortion established by Roe v. Wade in 1973 and Planned Parenthood v. Casey in 1992. Clinics I was working with in Indiana and North Dakota began to shutter in real time. Over and over, I heard clinic staffers repeat a version of the same sentence: “We will provide the last safe abortion in ____.” (Ohio, Indiana, Iowa, North Dakota, Nebraska, fill in the blank). It struck me as the most resolute and elegiac phrase I could imagine. A matter of when, not if. Returning to the quotidian photographs I’d collected and made—of everything from staff birthday parties to sterilized medical equipment—I held onto this phrase, eventually giving my exhibition this title: The last safe abortion.

As an artist who makes a subject of radical social movement building, I am often ambivalent about what art can do. It is said that Rego’s Abortion Series, of which she created etchings so that images could be widely distributed, helped to persuade the national debate towards the legalization of abortion in the country in 2007.¹³ I desperately hope that is true. I do believe that visuality is a tool to be harnessed in liberation struggle, reproductive or otherwise; the anti-choice movement has been demonstrating as much, quite effectively, for decades. And it is not incidental that photography, a tool of visual evidence-making different from all other forms of visual representation, has been their weapon of choice.

While it is clear that photography plays a singular role in abortion care work, I still wrestle with art as an ideological and political solution to such an acute and urgent crisis. As I have gone about my project collecting and making photographs of abortion workers in their jobs, I have been amazed by the number of pictures of women answering the phone. (When I was in the clinics, I was likewise struck by the phones ringing off the hook.) Answering the hotline: It is such a basic act, isn’t it? The most banal and lifesaving thing, and, in some ways, the least photographic. But, as I stand there with a camera in my hand, I also can’t help but wonder: Will deliberately non-sensational photographs of abortion care effectively countermand the shockingly grotesque (and misleading) way that photographs are instrumentalized by the anti-choice right? And, in either case, why am I taking pictures of other women answering the phone, rather than answering it myself?

In addressing that question, I am reminded of the NGO Women on Waves, founded and run by the heroic and visionary Dutch physician Rebecca Gomperts, which brings (largely pill) abortion services and education to countries with restrictive abortion laws by operating on a boat under international maritime law. Women on Waves—a mobile feminist empowerment and medical operation—also exists as an art project, using art as one of “multiple strategies to promote the message that women have fundamental autonomy over their own bodies.”¹⁴ The organization has participated in international biennials and exhibitions, delivered presentations at art summits such as Creative Time, and initiated a guerilla art installation at the Vatican. Their artwork often not only speaks to their mission and history, but also involves distributing abortion pills, sometimes using “abortion robots,” as they have done in Mexico, Ireland, and Poland.¹⁵ Women on Waves moves me greatly. By merging art and abortion access rather than using one to make art “of” the other, they have set an example for us. In making work about care, we can and must do the work of caring.

What is the visuality of abortion work? As ever, I can’t say that I know the answer. I can attest that I’ve found a way to make inroads into the question, entangled as it is with the politics of care itself. I am certain that it must center the representation of labor—of real people doing real aid work as opposed to fetus pictures which deliberately void the pregnant person. I am convinced that the volume of pictures matters, as we organize to build our own networks of widespread solidarity. And, as illustrated through the tireless work of Women on Waves, the task of representation must be coupled with action and groundwork. The reality is that these kinds of pictures—of steadfast women answering the phone, for example—will never shout as loudly as anti-abortion propaganda, but that is okay. In fact, it’s the point. Our visual vocabulary needs to reflect our ideological movements. As The New York Times story demonstrated, quiet, illustrative pictures have a germane place in this struggle as an ideologically cogent force. And so, I carry on: making pictures and, where I can and in my own way, answering the call.

This essay was originally published in Carla issue 34.

Preterm, Cleveland, Ohio (2023). Photo: Carmen Winant.

Emma Goldman Clinic, Iowa City, Iowa (2023). Photo: Carmen Winant.

Carmen Winant is an artist and the Roy Lichtenstein Chair of Studio Art at the Ohio State University. Her work utilizes installation and collage strategies to center modes of feminist exchange and social movement building, with particular emphasis on intergenerational and multiracial solidarity. She is a mother to her two sons, Carlo and Rafa, shared with her partner, Luke Stettner.

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