Sept. 21, 2009 -- Irene Vilar worries that her self-described "abortion addiction" will be misunderstood, twisted by the pro-life movement to deny women the right to choose.
Her book, "Impossible Motherhood," which will be released by Other Press on Oct. 6, chronicles her own dark choices: 15 abortions in 16 years, much of it as a married woman.
As press on the book has begun to leak out, Vilar -- a literary agent and editor --- says she has already sensed "an inkling of hatred."
Vilar has scheduled only closed-door interviews and will not do a book tour. At the urging of her husband, they have made sure all public property records do not reflect her name, so she cannot be targeted at their home.
"I am worried about my safety and the hate mail," she told ABCNews.com in a telephone interview as her home-schooled children were at work on a painting project.
"No book like this has ever been written," she told ABCNews.com. "I just imagine the 'baby killer' and I could be a poster child for that kind of fundamentalism. And there are my little kids in all of that."
Today, at 40, the Latina author has two young children, but her troubled past continues to haunt her well into motherhood.
She grew up in the shadow of her notorious grandmother Puerto Rican nationalist Lolita Lebron, who stormed the Capitol steps with a gun in 1954. Lebron served 25 years in jail for the crime until receiving a pardon from President Carter in 1979.
Her mother committed suicide by throwing herself from a moving car when Vilar was 8 and two of her brothers were heroin addicts.
Mass Sterilization in Puerto Rico
Vilar's story is set against the backdrop of the American-led mass sterilization program in her native Puerto Rico from 1955 to 1969, a fitting symbol for her struggle with her own reproduction.
By 1974, 37 percent of all Puerto Rican women of childbearing age had been permanently sterilized in that experiment.
"Women tend to repeat behaviors," Vilar said of herself. Her mother's forced hysterectomy without hormone treatment at the age of 33, led to depression and a Valium addition.
Vilar attended boarding school in New Hampshire and was just 15 when she left for Syracuse University, where she fell in love and later married her first husband, a tyrannical 50-year-old professor.
With a predilection for young women, he bragged that his relationships had never lasted more than five years and that having children killed sexual desire.
She says their emotionally dependent relationship was riddled with shame, self-mutilation and several suicide attempts.
1 in 2 Who Have First Abortion, Have Repeat
Although her personal history is unique, Vilar hopes through her painful memoir to trigger a public discussion on abortion and what leads women -- even after the feminist movement -- to use "procreation as power."
"Everybody is having babies, Hollywood has even developed some sort of motherhood fetish," said Vilar. "Yet, women are repeatedly told that they must be everything but mothers, everything but someone weighed down by motherhood."
About half of all pregnancies in the U.S. are unintended, and 40 percent of these are terminated by abortion -- 854,122 in 2002, the latest year for which data is available, according to the Centers for Disease Control and Prevention.
An estimated 50 percent of women who seek one abortion, will have a repeat one, according to the Guttmacher Institute, which promotes sexual and reproductive health. About 10 percent of those women will have three or more.
Its 2006 report found that most of these women were over age 30 and using contraception at the time of conception.
Little is known about these women, although they may be "perceived as having difficulty practicing contraception," or using abortion as a method of family planning, according to the report.
Mental Problems Not Tied to Abortion
"A lot of times the circumstances are unusual and complicated," said Rachel K. Jones, a senior research associate who co-authored the report. "There's always a lot more going on than someone who does not want to use contraception."
An American Psychological Association task force concluded that mental health problems are "not a direct result" of choosing to have one abortion.
But the 2008 report did note that many "confounding factors might indicate mental problems" in women who have repeat abortions.
"The research is not really great," said APA spokesman Kim Mills. "It's very hard to tease out."
Vilar's pregnancies became compulsively self-destructive: After her 9th and 10th abortions, she "needed another self-injury to get the high."
"In the beginning I was taking pills and I'd skip a day or two or give up one month," she said. "I'd think I'll be better next time. But slowly, my days took on a balancing act and there was a specific high. I would get my period and be sad, then discover I was pregnant, being afraid, yet also so excited."
Vilar said many women who have repeat abortions show a certain "recklessness."
Such was the case with Mary, a Florida college student who did not want to use her real name, who had her first abortion in 2006 when she was 21.
"It didn't seem like the right choice to have a baby then," she told ABCNews.com. But she got pregnant again with the same boyfriend a month later and without telling him, aborted.
"I felt it wasn't something I wanted to go through again, that I wanted to be more careful," said Mary. "It's a physically painful thing to do -- not something I'd ever want to use as a form of birth control. Who wants to go through that pain to end the lives of potential children?"
But at 24 with a new boyfriend, she got pregnant again and fantasized about motherhood, but he didn't want the baby.
"I felt like we were committing murder, that I was killing something that I wanted," said Mary. "I felt like I should feel the pain. I wanted to physically suffer."
After three abortions, she was left with lingering health problems and her doctor suggested she might not have a child again.
"When I was 21, it seemed easier," she said. "It was. It has a lot to do with my mental state about the situation. It feels like there is no healing for this."
Multiple Abortions Can Be Risky
Vilar, too, was warned by her doctor that she might never carry a child to term.
Women who have had multiple abortions face a potential risk for cervical damage and uterine lesions which can compromise future pregnancies, according to Dr. Louis Weinstein, chairman of the department of obstetrics and gynecology at Thomas Jefferson University Hospital in Philadelphia.
"Medically, in the proper hands, it's a very safe procedure and doesn't have much impact on future pregnancies until you get to four or more," he told ABCNews.com. "But in the long run, most do fine."
In Vilar's case, her final two pregnancies were healthy ones, and her daughters are now thriving at 3 and 5.
Her story is a reminder that more needs to be done to educate women about the proper use of birth control and providing better access, according to Dr. Lauren Streicher, clinical assistant professor at the Northwestern University School of Medicine.
Repeat Abortion Can Be Self-Mutilation
"This book really isn't about using abortion as birth control," she told ABCNews.com. "She is unconsciously sabotaging contraception for self-mutilation. It's a way of escaping feeling empty."
"It's an interesting book and she writes beautifully," said Streicher, who hosts the nationally syndicated radio show for medical professionals, Reach MD. "But by her very admission, she is a psychologically disturbed woman."
Ultimately, after some self-discovery and nursing her beloved dying dog, Vilar ends her dysfunctional marriage. She finds stability and love with a new husband, a writer and poet, and she builds a new family, reveling in the motherhood she once thought was impossible.
"Does that just end overnight? " asked Streicher. "The death of your dog, the birth of your child? You still fight your demons."
But Vilar blames much of her poor choices on a hypersexualized society that at once values the perfect mother, but also expects women to be sexually attractive to men and to achieve professionally.
"Women have a deep need for agency, for purpose and direction and society is not providing natural and healthy channels for creative action," she said.
"In school and on TV, every message I get is what I am doing as a mother or wife is wrong," said Vilar. "I should be thinking about a profession and not mothering. Everyone is having babies, and yet they don't want to care for them.
"Are many of the repeat abortions in part an embodiment of this mixed message? A lost, ambivalent attempt at an act of agency that cannot find its proper vessel? "
ABC writer Dominick Tao contributed to this report.