In the current political environment — in which Trump has articulated some very disturbing positions regarding women’s rights — it is perhaps even more important that the story of abortion be rescued from secrecy and placed firmly back in control of the women who seek them.

When you consider that there are nearly 1 million abortions provided each year, for a rate of nearly 15 out of 1,000 women of reproductive age, it’s clear there are millions of women who could effectively advocate for rational reproductive healthcare policy if they felt safe to do so.

In “ About Abortion : Terminating Pregnancy in Twenty-First-Century America,” Sanger makes a compelling case for how a private matter — choosing to have an abortion — has been so politicized and stigmatized that it has been transformed into something that women feel they must keep secret, lest they set themselves up for public shaming. That opens the space for groups like Dannenfelser’s to shape the narrative around abortion and, ultimately, public policy.

But there is another element at work too, one suggested in a thoughtful new book by Columbia law professor Carol Sanger: Women’s reluctance to talk openly about their reproductive lives — and particularly about having had an abortion.

With the elevation of outspoken foes of reproductive freedom, one might think that support for legal abortion has waned. Yet polls show that public support for abortion rights remains strong , with 57 percent of Americans saying abortion should be legal in “all or most cases.”

To top it all off, Trump has named two prominent anti-abortion and anti-birth control crusaders to top positions in the Department of Health and Human Services — including one, Teresa Manning, who will be tasked with overseeing a federal program that provides birth control to low-income women.

While the bill is still far from passage, President Donald Trump took immediate action to weaken the ACA’s birth control mandate that for the first time facilitated no-cost birth control for some 55 million women .

The last couple of weeks have not been good for millions of American women. On May 4, House lawmakers passed their version of a new healthcare law that if adopted would eliminate many of the gender-leveling provisions mandated by the Affordable Care Act. It also includes a measure to defund Planned Parenthood, threatening basic services for more than 1 million women on Medicaid.

JS: You write in the book about “normalizing” abortion. And it occurs to me that the privacy/secrecy dynamic becomes weaponized in this debate when women won’t talk about their experiences.

From 1973–2016 there have to be millions of women, including grandmothers now, who have had abortions. And that’s before we even go back to illegal abortions. What I find so distressing is that Vice President Mike Pence has said that we’re going to consign Roe v. Wade to the “ash heap of history where it belongs.” I can’t believe we’re going to go back because that ash heap had a lot of women in it who died from illegal abortions or were maimed, became sterile.

CS: What it does is it shuts down dialogue. So a part of secrecy is silence. A lot of people think they don’t know anyone who ever had an abortion, and we know that about one-third of all women will have had an abortion by the time their reproductive years are over, because that’s a really long period.

There are two forms of non-disclosure, and I say privacy is a good one. But when somebody keeps something private, not because it’s within their domain of personal power, but because if they don’t they’ll lose their job, they’ll lose a relationship, their parents won’t love them anymore and they’ll be stigmatized, then that’s something different. And we shouldn’t confuse the two.

But as I say in the book, I think there is a very big difference between choosing to do that because it’s good for you, because you’re in charge of your own life and you’re exercising your own agency, versus not disclosing something because you fear that if you do you’ll be harmed. The difference in motivation seems to me very important. If we say something’s private, that’s OK. But when it gets pushed into secrecy to be a shaming mechanism by all these laws that tell you that what you are doing is wrong, and would then try to persuade you out of it, that’s what changes the decision.

Carol Sanger: I think it’s so important to realize that there are a lot of reasons why we think talking about an abortion is a private matter. It’s your body; it’s sex; it’s reproduction; it’s a medical treatment. Those are all things that people like to keep private. Whose business is it if I have sex or a medical procedure, or even a cosmetic procedure?

Jordan Smith: One of the things that is really fascinating about your book is an argument I’ve never heard put so plainly, which is this idea of privacy versus secrecy. Having an abortion should be a private health matter, just like any other private thing, but the fact that women keep it private has allowed abortion opponents to hijack the narrative around abortion, transforming it into this secret thing. And it occurs to me that this process is what has also allowed onerous abortion restrictions to pass again and again and again.

In Texas, for example, I can’t tell you how many legislative hearings I’ve been in where I have seen the same group of women testify over and over about how damaged they are by having had an abortion. I am not saying that I don’t have sympathy for them, but it’s very stark when it’s always the same women making this argument. The whole scheme gets really one-sided and then it becomes much easier to justify passage of abortion restrictions. So my question is, What does normalizing abortion look like?

CS: That’s a good question because normalizing takes many shapes. There’s a journalist named Lindy West who started a movement called Shout Your Abortion. She said, I know everything about my friends and their boyfriends and their parents and everything. I know nothing about anybody having an abortion. So she started telling women not to hesitate to bring it up.

Now, I’m not a shouter — I usually talk more quietly. So my suggestion is just that people could start talking about abortion when it’s appropriate, within their families. For a long time women never talked about their miscarriages because it was shameful, it meant that you weren’t a woman, you couldn’t deliver the pregnancy. It had that social stigma attached to it. Women felt extremely isolated and over time began to talk about it and found great comfort knowing that actually they’re not the only ones on their floor at work who had this experience. So I think that is a good analogy — to have something that slowly creeps out, and it requires bravery.

I also think that sometimes you have to risk the conversation with someone you love or someone who loves you. My hope, and I don’t think it’s imaginary or fanciful, is that if people were to learn that their mother had an abortion — would they stop loving their mother? Would they break off their relationship with their mother? I think not.

I taught in England for quite a while and I was giving a class on abortion there and the students there just didn’t get the controversy over abortion in the U.S. One of the students raised her hand and said, well, two weeks ago I went to the National Health Service and had a termination, and I brought my friends with me for a support group. And I thought, Whoa! She just said that in class! But nobody blinked. So, that was a very important moment for me.

Just to your point about the women in Texas, that you begin to see the same women testifying at the capitol, the South Dakota legislature sponsored an abortion task force where they had the report of a study involving about 2,000 South Dakota women and 99 percent of them said that abortion was the worst thing that had ever happened to them and that they felt it should not be legal. I say, I don’t doubt those 2,000 women, but I have to believe that somewhere in the state of South Dakota there are other women who were relieved that they didn’t have to marry a no-goodnik, relieved that they didn’t have to have five children instead of four, relieved because this was just the wrong time and they were able to control this part of their life. So it’s not that you doubt the women that you see in Texas or that I doubt the 2,000 in South Dakota, but that it’s an incomplete story.

This is a topic that can be discussed — it’s not compulsory to discuss it, but it can be discussed as you would another subject that you might want to share with someone.

I’m not in favor of outing anybody, but I do think if we could reframe how we talk about it — this is why I wrote the chapter on fathers and fetuses, because I wanted to say, can we shake gender out of this for 15 pages? Can we just regard this as a parenting decision and not murder? Not selfish women doing what’s best for them? Could we learn something?

JS: I want you to explain that a little bit, because I think it’s fascinating this idea of taking gender out of it. When you work in this area you always hear people say, well, if men had to have babies this wouldn’t even be a question — or some variation on that.

CS: I wanted to think, is it possible to know anything about what men do when they actually are in charge of a fetus or an embryo? And the closest I could come were frozen embryo cases. These are cases where couples who are using artificial reproductive technologies to get pregnant create embryos … and then, sadly, within a few years they divorce. But part of what they own, in a sense, are these frozen embryos that were not used. The question is, what becomes of them? There have been quite a few cases where judges have had to decide.

Roe v. Wade played a role in some of the cases because the court said we have a decision from 1973 that says that women should not have to become mothers against their will, so by the same token, men should not have to become fathers against their will, and they should have a right to not have the embryo implanted in anybody.

That’s the situation in which these cases came up and what I found is that men were not reluctant at all about why they wanted to have the embryos destroyed, which is interesting. As I read all the background information about these cases, men said things like, “I certainly don’t want to have an ongoing relationship with that woman.” That was one. Another was, you know, I’m a young man and I want to have some fun before I have a family and have to be financially responsible. Now, I just want to say, you would never hear a woman say that — you would never hear a woman say, “I want to have an abortion because I want to kick up my heels.” We just find that completely unacceptable.

I found that the reasons that men want to destroy frozen embryos really parallel the reasons that women give for having an abortion — with the exception that men will talk about it, and the other exception is that nobody calls men selfish for their decision. You’re going to destroy your embryos instead of implanting them in a stranger or your wife? Outrage, picketing the clinics — no, there’s none of that.

I wanted to see whether it could be comprehensible to other people why a woman might choose to terminate a pregnancy. That if we heard a man say the same thing — I’m defrosting these embryos because I already have four children and I know I can care for them, but I’m not sure about five — whether that sounds so very terrible. And I think it doesn’t. I think it actually sounds responsible.

This interview has been edited for length and clarity.