The instinctive dualism between the rejection of pregnancy and the desire to become pregnant is a very special feature of the extremely ambiguous situations typical of women's nature and constitution. The problems related to the confrontation between women's aphrodisiac side and the maternal instinct ( their demetric side ) are extremely complex, so the existence of a conflict here is perfectly understandable. Faced with this situation, I usually remark that women's nature divides itself in two "halves": one remains more linked to their aphrodisiac side, and the other to the maternal side. ( For more details on this subject, see "The Possibility of Becoming Pregnant and its Implications for Women". )

Female eroticism is, to a considerable extent, self-eroticism related to the woman's body itself and to its aesthetics, possessing a strong narcissist component. For women, this creates a great concern with the preservation of the aesthetics, the shape and fitness of their bodies. The great care with which women beautify themselves clearly demonstrates this fact. On the other hand, for the fulfillment of the maternal instinct, a considerable sacrifice of the female body is demanded ( not to mention the other implications and problems resulting from motherhood in other areas of women's lives ). From my point of view, the main reason for women's ambiguity between desiring and rejecting pregnancy lies just here.

It is an undeniable medical fact that pregnancy and childbirth greatly sacrifice women because, besides the physiological overcharge and even the risk of death they cause, they produce in women's bodies great distortions and stretching of tissues which do not always return to normal during and after puerperium. This fact conflicts with the great female effort to preserve the aesthetics, the shape and even the health of their bodies. From the corporeal point of view, pregnancy and childbirth do not benefit women in almost anything except for some reduction on the incidence of breast cancer ( See Note 1 ). In fact, they are much more prejudicial, since they necessarily imply considerable anatomic and physiological "aggressions" to the female body. ( By the way, I use to call them "the physiological 'aggressions' of pregnancy and parturition". )

The aforementioned duality of female attitudes regarding avoiding and desiring pregnancy has several consequences both on women's lives and gynecologic practice. Among them we can mention the irregular use of contraceptives, the occurrence of conflicting pregnancies and the problem of abortion.

Now, let us talk about abortion.

I consider the right to the interruption of undesired pregnancies, that is, the right to abortion, a fundamental right of women. This right is even related to the self-preservation of the female body against the arduous sacrifices that gestation and childbirth impose upon it. Here, I think that the so frequently debated rights of the embryo cannot prevail over the rights of the woman who houses it inside her body - a body that has to be considerably sacrificed so that the embryo can develop and be born - especially if this happens against the woman's will. The physically injurious aspects of pregnancy and childbirth for women are always ignored by those who, many times with fanaticism, are against the legalization of abortion or discriminate against it. Nevertheless, as I said above, these physical injuries are a medical fact, a medical reality, and all of us, gynecologists, know them quite well.

We live in a culture that excessively mythicizes the "wonders" of motherhood and tries not to see its negative side - and everything in life has its positive and negative sides. In spite of its pleasant, fulfilling and constructive aspects when it is fully desired, we have to recognize that pregnancy also has a considerable harmful side. As to the recognition of this fact I would like to remark that, depending on the presuppositions through which we view determined situations, reality may appear to us in considerably different ways and some of its usually unperceived aspects may acquire completely different features. In this way, what I am about to say may be shocking but, biologically ( though "naturally" ), the embryo invades and plunders the woman's body. And birth is a violent event ­ not only for the mother but also for the child ( See Note 2 ).

The several sequelae that gestation and parturition can leave on the female body are, as I said before, well known to all of us, gynecologists, and also to women themselves. Therefore, a woman has to desire very much to be a mother if she is up to tolerating willingly and with satisfaction all of the sacrifices and risks inherent to pregnancy and parturition and if she is up to receiving the child with love.

Besides this aspect of the preservation of the female body against the "natural aggressions" of pregnancy, there are all of the other reasons that have been much discussed by everybody and that, in my opinion, also give women the perfect and entire right to abortion. However, it seems to me that the facts emphasized here ( often forgotten or not correctly conceptualized by most of those who debate the issue ) are the ones that can finally put an end to the debate, recognizing once and for all this fundamental right of women regarding their bodies.

Faced with the accidental occurrence of an undesired gestation, abortion is the only way a woman has to preserve herself against the corporeal aggressions of pregnancy. In such a circumstance, considering the very peculiar biological situation of the embryo, its rights cannot prevail over those of the woman who carries it inside her body.

For a pregnancy that is left to evolve under conditions of strong rejection, I would like to emphasize that the implications of this fact for the child who will be born are also considerable and, therefore, should not be neglected. Unfortunately, this is another aspect that those who oppose women's right to abortion naively or tendentiously often forget.

Briefly returning to the subject of the female instinctive duality between rejecting and desiring to become pregnant, I would like to observe that the absence of awareness of this natural ambiguous situation by most women has several consequences in gynecologic practice. Among them are: 1) the incorrect use of contraceptives with all of its consequent worries, creating many difficulties for a safe, calm and pleasant sexual life; 2) the frequent occurrence of undesired pregnancies ( or desired on the one hand and rejected on the other, consciously or unconsciously ) that have to be solved through abortion; 3) the problems resulting from pregnancies that are left to evolve under strong rejection and, consequently, in adverse emotional conditions.

Note 1: It is well known that, according to several statistical studies, women who have more than two or three children - mostly if the first gestation takes place earlier in life - have a minor incidence of breast cancer. From the corporeal point of view, this seems to be the only beneficial aspect of pregnancy to women. This relative protection is due to the specific hormonal patterns of pregnancy and their effects on the mammary glandular structures. Even so, given the high incidence of the disease, the number of women with children who develop breast cancer is also enormous.

Note 2: As to the traumatic aspects of pelvic parturition for children, see Stanislav Grof's studies on the "perinatal matrixes of the unconscious." According to Grof, they consist of unconscious mostly traumatic psychological contents clearly related to the phases of childbirth blended with archetypal and mythological elements, and are detected at deep psychical research ( Grof, S. - "Beyond the Brain - Birth, Death and Transcendence in Psychotherapy" - University of New York, Albany, 1985 ).

P.S.: The text above is a further development of "The Possibility of Becoming Pregnant and its Implications for Women".

Nelson Soucasaux is a gynecologist dedicated to Clinical, Preventive and Psychosomatic Gynecology. Graduated in 1974 by Faculdade de Medicina da Universidade Federal do Rio de Janeiro, he is the author of several articles published in medical journals and of the books "Novas Perspectivas em Ginecologia" ( "New Perspectives in Gynecology" ) and "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ( "The Female Sexual Organs: Shape, Function, Symbol and Archetype" ), published by Imago Editora, Rio de Janeiro, 1990, 1993.

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