I've often thought that this song is about girls who've "been bad", and are now pregnant and possible getting abortions - the "cold waiting room", the "flimsy blue gowns" (hospital gowns?) - and they are alone, "not a soul to take your hand in theirs". Neko, or the speaker (I conflate them), is exhorting them to not let others shame them with what happened. "They blame it on you, pretty girls" I take as people saying it's these girls' faults for getting knocked up, and so Neko's determination to defy those who judge is similar to her earlier song "Mood To Burn Bridges", which is a great f**k you to smalltown busybodies.

I'd agree with Peaches, and add about the TV verse -- I don't know if this is NC's intention, but I think that if there's a cultural culprit, it's the media (TV), and in particular the advertising that is constantly telling young girls they're not enough as they are, that their greatest commodity is their looks, and that being found attractive on the outside is the most important thing. The "blaring and angry" TV reminds them that they're not good enough, "as if [they] don't know" what's missing -- the lesson has been pounded in until it's second nature. And the logical conclusion must be that if you're not a superstar like girl X in the commercial, then it's your own fault and you should feel guilty. Guilt, of course, is the point, because if it's your fault, then you can do something about it, like buy those beauty products and those clothes! But the brains behind those TV jingles and enticing images never show themselves -- instead they hide behind the screen, immune to their own hypnotic spells, refusing to take responsibility for the influence they hold over young minds and emotions. "Those without sin" can then sit above it all, living vicariously, and then judge harshly while their victims suffer the consequences.
Anyway, diatribe over, and now I have to work out just who and where is this person that says, "Come chain yourself from my ankles"? Ankles? A girl who died on the abortion table? Or is my imagination just a little too worked up at the moment?

i tend to agree that this song is probably about girls getting abortions, but i also wonder if it could be about rape? more specifically, girls going to the hospital after being raped. even though the harsh condemnation these girls are receiving seems more fitted to abortion, think of how people will say "well, dressed like that she was just asking for it" or rapists will insist that "they wanted it" etc. Also, i think the lines about "lovers who won't understand" ties in better to the long lasting effects of the trauma of rape, and how it can affect later relationships.

Gillianizmo, I've always thought the line was "Come chain yourself round my ankles", though I could be wrong, and so I pictured this as Neko's offer to let the 'pretty girl' attach herself to Neko and ride in her wake (figuratively, I pictured it as soaring freely over the land), seeing the world from Neko's perspective and thus freeing the girl from the hellish waiting room she's trapped in. I like your comments about guilt. Guilt is definitely a presence here, especially in the penultimate stanza with the 'and lovers who won't understand' - so Neko underscores her understanding of the girls and their feelings of guilt with the repeated "and I won't say that I told you so", because 'i told you so's are all about creating or encouraging guilt and shame.

I never thought of the girls as dead, because this song is about overcoming the stigmas and restrictions people want to put on you, and it's hard to overcome this when you're gone.

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i also think it is about abortion, possibly rape. the part about lovers not understanding could be in reference to the loneliness that girls often experience after an abortion. if you are still hurt about it afterwards, people often wonder why and say it's your fault for putting yourself in that situation.

and i like the imagery of peaches' statement of neko rescuing the girls.

I think is about calendar girls, pin-ups, and how their humanity is lost in the perception of the big public.

But there's millions to count you and keep you

I recently realized this line could refer to collecting pin-ups photos or playboy centerfolds.

and also:

Don't let them tell you you're nothing
'Cause you'll change the world pretty girls

could be a reference to those girls seen only as sexual objects but that end up being a symbol of a whole decade or generation.

i was thinking this song was about abortion too but
i always thought this song was kinda bitter and sarcastic, like she was being ironic when she sings "your too good for this".

but after reading all these comments it's now seems likey i was off about that. i especially agree that its about rape and the social stigma attached. the lines about not a soul taking your hand in theirs and "they blame it on you" a giveaways of this.

but now i look at some of the other lyrics i'm a bit reluctant somehow to throw away my first theory. "as if you don't know why you're here" sounds a bit accusing. i dunno, i'm ambivalent about this. maybe so's niko and that's the point?

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Neko said in the NY Times a couple weeks ago that the song's about abortion, or more specifically about girls she saw waiting alone at a Planned Parenthood clinic to get abortions. I don't see the "TV... blaring and angry/ as if you don't know why you're here" line as an indictment of the girls, but of the TV/media: the girls aren't stupid, they get why they're there, and don't need a bunch of sanctimonious talking head pundits preaching at them.

"Those who walk without sin are so hungry" - this points to what persimmon said about religious pundits. I think this is a VERY powerful song about abortion and how messed up it is in the political and religious arena.

"Curves so comely and sinister" - it is a woman's fault for being a woman and tempting men.

This song is so, so incredible.