Tuesday, August 31, 2010

Her Body, Her Life

Working in an abortion clinic is a job, but its also more than a job. In my job I have to answer questions for women about their bodies and personal lives. I believe that my roll is to give them as much information as I can in the short interaction we have. Women need to control their bodies and life decisions in order to control their lives. There is a great book that most of us feminist, abortioneering womyn already own and love but its worth recommending here called Our bodies, Ourselves.

The clinic I work in only does abortion into the very early second trimester. There are many reasons we can't do procedures farther including the availability of doctors who will do the procedures. The state I live in is also quite conservative in regards to abortion and attempts to pass and enforce anti-abortion legislation almost on an anual basis.

We often get call from women much farther along in their pregnancy. I try to make sure to give women as much information as possible when the clinic I work in does not offer the services she needs. I recognize that I operate as a gatekeeper who has information that people need. I often hear co-workers act as though women should not get abortions beyond 16-18 weeks. The same people make a judgement of women who have multiple abortions. I wish that every single person working in abortion care understood that our job is about making sure women know they can decide what to do with their bodies for themselves regardless of any one elses personal views.

The other day I had a 17 year old express her wish to keep her pregnancy so I wrote gave her information regarding seeking medical care and advised her to take care of herself and her body. I also spoke to a woman in her third trimester and informed her of the safe haven laws. Dozens of times a week a woman will ask me"so, whats better the surgery and the pill?" Now, personally I think if I need an abortion I would get a surgical abortion over a medical(pill). However, when I answer this question at work or even among friends, I explain its about a personal preference and offer a few reasons someone might prefer each type of procedure.

This work is about abortion, but abortion is about reproduction and women's lives. When women have control of our lives our families are strong and so are our communities.

Monday, August 30, 2010

What are you doing here? Go read this Nation article!

In the past year-and-a-half-ish, there's been a lot of noise (well, relative to the usual silence, at least) about women self-medicating with misoprostol to induce an abortion. The first piece, the New York Times article "For Privacy’s Sake, Taking Risks to End Pregnancy," was short on data (which is unfortunately bound to be the case with reports of activity that is both rare and hidden) and long on extrapolation (which is unfortunately bound to be the case with NYT trend pieces). It implied that lots of Dominican women in New York are endangering themselves via illegal abortion despite easy access to cheap legal procedures. (Lots of broad brushstrokes in there, don't you think? Technically a self-induced abortion isn't even "illegal" in NYC!) The letters to the editor included some thoughtful additional information (most of it anecdotal), by the way. More to the point, there were substantive critiques (like "Side Effects: Complications at The New York Times from DIY Abortions" at RH Reality Check) of how the paper was written and that extrapolation I mentioned, including objections from the researchers involved in the study cited.

This summer, Nicholas Kristof wrote a surprisingly nice column ("Another Pill That Could Cause A Revolution") about misoprostol's revolutionary power to save women's lives in multiple ways. Considering that he's been reluctant in the past to even mention abortion, even when writing about pregnancy-related mortality, and considering that his writing tends toward simplistic reduction of complicated problems and even toward cavalier moralizing about the decision-making of the poor, well, that was a pretty nice column, considering.

And this week, Laura Tillman at the Nation brings us "Crossing the Line," which explores in a bit more depth the reasons that in many situations -- even among US residents, even among speakers of English, even among US-born women -- it might be entirely logical to obtain medication under the table and induce an abortion at home. I'll just post an excerpt here to give you an idea, but you should read the whole piece.

A single mother of two boys, Diana was unemployed and in the hospital when she began to suspect she was pregnant. It was December 2006, and she had missed her period for two months. Her doctor conducted a urine test, which came back negative, but when Diana still hadn't gotten her period in January, she started to panic. She knew it wasn't the right time for another baby. She wasn't working and had been suffering severe symptoms of brittle diabetes, a rare form of diabetes that requires frequent hospital visits and brings bouts of depression. She felt unstable and wasn't able to afford her medications. "I thought, If I am pregnant, I want to take something to not be pregnant," she says.

For most women in the United States, this would mean a trip to a doctor or abortion clinic. But where Diana lives, in Brownsville, Texas, just north of the border, Mexican pharmacies are only a few miles away. Items said to be abortifacients—including pills, teas and shots—are well-known to be cheap and accessible just across the bridge. Misoprostol, a pill that makes up half of the two-drug combination prescribed for medical abortions in the United States, is easy to purchase over the counter in Mexico because of its effectiveness in treating ulcers. When used alone and taken correctly, it will produce a miscarriage between 80 and 85 percent of the time. ...

Go read the rest! And have a good week!

PS: Lots of very interesting research has been done on misoprostol (and mifepristone too) in the past year or few -- on both clinical and psychosocial aspects of medication abortion -- and I hope to talk more about all that in a few upcoming posts. Hope that sounds good to you :)

Thursday, August 26, 2010

All I Need to Know About Life I Learned from Working at an Abortion Clinic

Item #9:
1. It pays to be nice
When I'm taking payments, some clients are a few dollars short. If they've been a pleasure to work with at every step of the process, I comp the difference and send them on their way. But if they've been a pill, a pain, and a pest (as my grandma used to say) to everyone they encountered, I'm going to insist that they go borrow some cash from their driver or else reschedule. You better believe I'm nice to cashiers and sales associates, and I tip super-well.

2. Sometimes, the most important person to forgive and the most difficult person to forgive is yourself
Clients can forgive their ex-boyfriends for poking holes in the condom, they can forgive their sisters for not replacing their last pack of Plan B that was on reserve, and they can be at peace that God will forgive them. But when it comes to forgiving themselves, all bets are off. And when they can finally do it, good things happen.

3. Plato was right: We must "[b]e kind, for everyone you meet is fighting a hard battle."
Even the obnoxious clients mentioned above in item #1 have their stories to tell. And I don't relish the thought of counseling the woman who declares, "I don't believe in abortion, but I have to do this," but when she tells me why she "has to," it's difficult for my heart not to melt a little bit. And it makes me appreciate all the compassion I've been shown in my life.

4. Listening is a valuable skill to have
Oh, so when you made your appointment, no one told you that you couldn't drive after anesthesia, that you couldn't eat or drink anything the day of your appointment, and that we don't take payment in the form of IOUs? My co-workers and I could give those instructions in our sleep. Just admit you weren't listening. That's why I always carry around a notebook and pen.

5. Maybe we don't know what we REALLY want until we've wanted both things
A friend of mine once told me about her unplanned pregnancy. She knew right off the bat that she was going to have an abortion. Until she saw a glowing pregnant woman. It was only when she really considered both realities, she said, that she could make the most informed and honest decision. She had the abortion.

6. When you miss a period, take a pregnancy test immediately
Don't assume it's a fluke, don't assume your body's being wonky. Especially, don't take a test, see a positive result, and then believe that if you ignore it, it'll go away. That's how you end up to be 25 weeks pregnant. And that's fine, but the procedure could have been quicker and cheaper if you had just taken that first test all those months ago. My co-workers and I sure make use of the free tests at the clinic.

7. You will make a decision when you are meant to make a decision
I learned from a wise, veteran counselor that some women know what their ultimate decision will be, but they don't know how they will arrive at that decision. It can be a long process, and a painful process, but it's a process that needs to happen. I've never had to deal with an unintended pregnancy, but I sure have dealt with tough decisions, and I took my sweet time.

8. A medical history is no place for forgetfulness
nor creative writing

Oops! When you wrote, "No known allergies, no history of major health problems," it turns out that you really meant, "Allergic to every item you will use at this clinic and a history of weekly seizures since birth." Details, details! And my friends, those details are what cause those major complications. I could say, "I'm 5'9" and I've never had any mental health issues," and it sure would be fun to say those things for a change. But that doesn't make them true.

9. Wear what you love
When we schedule your appointment, we suggest wearing comfy clothing since you'll be groggy and crampy. The first time I saw a client step out of the recovery room in 4" platform heels and a mini dress, I doubted the comfort level and practicality, but she rocked it and she was proud of it, and groggy, crampiness be damned. I, on the other hand, will wear hoodies and sweatpants whenever possible, but it's just my personal jam, and no one else's.

10. Some of the best people work in abortion clinics
When clients express nervousness or when they ask if the next person they see will be nice, I sometimes tell them that I honestly work with some of my best friends. And every person in the field that I've met has been amazingly compassionate, passionate, kind, giving, determined, and an absolute champion of women.

Wednesday, August 25, 2010

Accidents Will Happen

Oh, Canada!

I've been enjoying one of my guiltiest pleasures, Degrassi: The Next Generation, via Netflix. Not only do I enjoy the melodrama of teenage life in Toronto, but I was also in search of the missing link: an elusive episode that addresses abortion. This episode (of course!) was not aired in the States, so I was dying to know how it went.

Manny Santos, resident grade 9 hottie, has an affair with sensitive rocker Craig Manning, and becomes pregnant. There was the obligatory misunderstanding during the liaison - he thought she was on the pill, she didn't know she could get pregnant her first time/couldn't identify a condom. Manny's BFF is Emma Nelson, know-it-all and buttinsky supreme. Emma was born when her mother was 15, so of course she is an anti because she knows that teenage pregnancy results in pleasant children like herself. Manny and Craig consider running off to start a little family; Manny is sure that her mom would exile her to the Philippines if she hung around, and Craig wants to repair his own broken home. After more consideration, however, Manny starts leaning towards abortion when she realizes she wants to fulfill all her plans for the future. I don't have a video clip of the throwdown, but it goes like this:

Manny: I can't do this. I thought I could, but having a baby now is just....
Craig: You're not making any sense.
Manny: Someday you're gonna be a great dad, and someday I hope I'll be a mom. But now, now isn't someday yet.
Craig: No. No, you're not. Manny, stop! No, I won't let you!
Manny: Please!
Emma: Craig!
Craig: Emma, you butt out! What she's doing is wrong!
Emma: I agree with you, OK? If she was just some stranger I would be furious with her, but she's my friend. And it's her choice.
Craig: It's my baby!
Emma: In Manny's body; what about her?
Manny: I just...I just...I can't.


Let's rehash my favorite part: If she was just some stranger I would be furious with her, but she's my friend.

God bless that little moral crusader. Emma is just so bright and insightful. She figured it out all on her own that abortion is OK, provided that you actually know and care about the person going through it. It's just so logical!

What Emma doesn't realize, and never will because she's stubborn and a brat and super annoying, is that Manny is a stranger to someone too. Even if you are supportive, someone out there is thinking that Manny is evil and is stomping on her right to choose. But that's cool, because people should only support their friends' abortions? Being selectively pro-choice is not pro-choice! You are still a jerk, Emma! Placenta Sandwich has also addressed this issue on a post referencing the clinic scene from "If These Walls Could Talk". Jada Pinkett plays a friend escorting a patient to the clinic, but is actually stewing in her juices about having to be there.

Granted, I can't blame Emma for this poor choice of words. She is not a real person. But there are plenty of folks out there who feel similarly. I've talked to dozens of them! Women who think that abortion is wrong except when it's herself or a close friend or relative. I exhort those women to consider that all those people outside the clinic, shouting slurs and harassing you or your loved one, might as well be you. Because guess what: YOU'RE STILL AN ANTI.

I think this clip, from the original Degrassi series, handles the topic much better. Lucy, the awesome one, makes my favorite point ever: "So women are just baby factories?" Ah, feminism! TRIVIA: The spiky-haired one is Emma's mom, who admits that just because she is a teen mom doesn't mean she knows what's best for other women. Hooray!

Tuesday, August 24, 2010

The Key to World Peace

Lately, I have had quite a commute to the hospital in the morning. Fortunately, this gives me plenty of time to catch up on the real world. I, of course, listen to NPR and often find myself regretting ever complaining about any aspect of my life. People in other parts of the world have real problems-they are enduring an epic flood, have lost their house and home, and are fighting to survive. Meanwhile, I’m dealing with traffic.

And then there are the stories of women being persecuted because…well…they are women. The most recent headlines focus on a pregnant woman being executed for adultery. Except, we in the states wouldn’t really classify it as adultery since this woman’s former husband had died and now she was with another partner. And then there was the Time Magazine cover of the Afghan woman who had her nose and ears cut off from trying to leave her abusive husband.

These stories haunt me, as they should everyone. I sometimes imagine that I have super powers and can fly over to X city and do X, X, and X to these perpetrators. I feel so much anger towards men, in the states and around the world, who feel they can control and terrorize women.

And then I wonder. What if all women had reproductive freedom over their body? They were able to decide when and if they wanted to be pregnant. They had access to birth control and prenatal care. They were able to decide with whom they wanted to bring a child into this world with. Their bodies would not be used as weapons of war. They would not be forced into sex work through promises of a better life. Their partners would treat them as equals.

What a different world we would live in.

Reproductive freedom and equality for women is the key to every major issue around the world. I truly believe that. And I will continue to fight for that freedom, for all women. I hope you and others will join me.

Sunday, August 22, 2010

The Only Moral Abortion is My Abortion

For today's post, I'd like to share something a friend sent me that I found very moving. It's an article called, "The Only Moral Abortion is My Abortion: When the Anti-Choice Choose," written by Joyce Arthur.

I think sometimes it's important to take a step back, and just consider all the stories of women who have had abortions. Particularly those who are "against" it, yet choose abortion for themselves anyway. Sometimes, we when are talking about abortion rights, we forget that we are also fighting for abortion rights for antis as well. Sure, they are hypocrites, but if an anti-choice protester gets pregnant and cannot afford the child, or whatever, I want her to be able to have access to a safe abortion. I want her to do what is right for her. Even if in her spare time she spends her time harassing my coworkers, colleagues, and friends.

Please enjoy the article below.

Abortion is a highly personal decision that many women are sure they'll never have to think about until they're suddenly faced with an unexpected pregnancy. But this can happen to anyone, including women who are strongly anti-choice. So what does an anti-choice woman do when she experiences an unwanted pregnancy herself? Often, she will grin and bear it, so to speak, but frequently, she opts for the solution she would deny to other women -- abortion.

In the spring of 2000, I collected the following anecdotes directly from abortion doctors and other clinic staff in North America, Australia, and Europe. The stories are presented in the providers' own words, with minor editing for grammar, clarity, and brevity. Names have been omitted to protect privacy.

"I have done several abortions on women who have regularly picketed my clinics, including a 16 year old schoolgirl who came back to picket the day after her abortion, about three years ago. During her whole stay at the clinic, we felt that she was not quite right, but there were no real warning bells. She insisted that the abortion was her idea and assured us that all was OK. She went through the procedure very smoothly and was discharged with no problems. A quite routine operation. Next morning she was with her mother and several school mates in front of the clinic with the usual anti posters and chants. It appears that she got the abortion she needed and still displayed the appropriate anti views expected of her by her parents, teachers, and peers." (Physician, Australia)

"I've had several cases over the years in which the anti-abortion patient had rationalized in one way or another that her case was the only exception, but the one that really made an impression was the college senior who was the president of her campus Right-to-Life organization, meaning that she had worked very hard in that organization for several years. As I was completing her procedure, I asked what she planned to do about her high office in the RTL organization. Her response was a wide-eyed, 'You're not going to tell them, are you!?' When assured that I was not, she breathed a sigh of relief, explaining how important that position was to her and how she wouldn't want this to interfere with it." (Physician, Texas)

"In 1990, in the Boston area, Operation Rescue and other groups were regularly blockading the clinics, and many of us went every Saturday morning for months to help women and staff get in. As a result, we knew many of the 'antis' by face. One morning, a woman who had been a regular 'sidewalk counselor' went into the clinic with a young woman who looked like she was 16-17, and obviously her daughter. When the mother came out about an hour later, I had to go up and ask her if her daughter's situation had caused her to change her mind. 'I don't expect you to understand my daughter's situation!' she angrily replied. The following Saturday, she was back, pleading with women entering the clinic not to 'murder their babies.'" (Clinic escort, Massachusetts)

"We too have seen our share of anti-choice women, ones the counselors usually grit their teeth over. Just last week a woman announced loudly enough for all to hear in the recovery room, that she thought abortion should be illegal. Amazingly, this was her second abortion within the last few months, having gotten pregnant again within a month of the first abortion. The nurse handled it by talking about all the carnage that went on before abortion was legalized and how fortunate she was to be receiving safe, professional care. However, this young woman continued to insist it was wrong and should be made illegal. Finally the nurse said, 'Well, I guess we won't be seeing you here again, not that you're not welcome.' Later on, another patient who had overheard this exchange thanked the nurse for her remarks." (Clinic Administrator, Alberta)

"We saw a woman recently who after four attempts and many hours of counseling both at the hospital and our clinic, finally, calmly and uneventfully, had her abortion. Four months later, she called me on Christmas Eve to tell me that she was not and never was pro-choice and that we failed to recognize that she was clinically depressed at the time of her abortion. The purpose of her call was to chastise me for not sending her off to the psych unit instead of the procedure room." (Clinic Administrator, Alberta)

"Recently, we had a patient who had given a history of being a 'pro-life' activist, but who had decided to have an abortion. She was pleasant to me and our initial discussion was mutually respectful. Later, she told someone on my staff that she thought abortion is murder, that she is a murderer, and that she is murdering her baby. So before doing her procedure, I asked her if she thought abortion is murder -- the answer was yes. I asked her if she thought I am a murderer, and if she thought I would be murdering her baby, and she said yes. But murder is a crime, and murderers are executed. Is this a crime? Well, it should be, she said. At that point, she became angry and hostile, and the summary of the conversation was that she regarded me as an abortion-dispensing machine, and how dare I ask her what she thinks. After explaining to her that I do not perform abortions for people who think I am a murderer or people who are angry at me, I declined to provide her with medical care. I do not know whether she found someone else to do her abortion." (Physician, Colorado)

"In 1973, after Roe v. Wade, abortion became legal but had to be performed in a hospital. That of course was changed later. For the first 'legal abortion day' I had scheduled five procedures. While scrubbing between cases, I was accosted by the Chief of the OB/Gyn service. He asked me, 'How many children are you going to kill today?' My response, out of anger, was a familiar vulgar retort. About three months later, this born-again Christian called me to explain that he was against abortion but his daughter was only a junior in high school and was too young to have a baby and he was also afraid that if she did have a baby she would not want to put it up for adoption. I told him he did not need to explain the situation to me. 'All I need to know', I said, 'is that SHE wants an abortion.' Two years later I performed a second abortion on her during her college break. She thanked me and pleaded, 'Please don't tell my dad, he is still anti-abortion.'" (Physician, Washington State)

"The sister of a Dutch bishop in Limburg once visited the abortion clinic in Beek where I used to work in the seventies. After entering the full waiting room she said to me, 'My dear Lord, what are all those young girls doing here?' 'Same as you', I replied. 'Dirty little dames,' she said." (Physician, The Netherlands)

"I had a patient about ten years ago who traveled up to New York City from South Carolina for an abortion. I asked her why she went such a long way to get the procedure. Her answer was that she was a member of a church group that didn't believe in abortion and she didn't want anyone to know she was having one. She planned to return to the group when she went back to South Carolina." (Physician, New York)

"I once had a German client who greatly thanked me at the door, leaving after a difficult 22-week abortion. With a gleaming smile, she added: 'Und doch sind Sie ein Mörderer.' ('And you're still a murderer.')" (Physician, The Netherlands)

"My first encounter with this phenomenon came when I was doing a 2-week follow-up at a family planning clinic. The woman's anti-choice values spoke indirectly through her expression and body language. She told me that she had been offended by the other women in the abortion clinic waiting room because they were using abortion as a form of birth control, but her condom had broken so she had no choice! I had real difficulty not pointing out that she did have a choice, and she had made it! Just like the other women in the waiting room." (Physician, Ontario)

"A 21 year old woman and her mother drove three hours to come to their appointment for an abortion. They were surprised to find the clinic a 'nice' place with friendly, personable staff. While going over contraceptive options, they shared that they were Pro-Life and disagreed with abortion, but that the patient could not afford to raise a child right now. Also, she wouldn't need contraception since she wasn't going to have sex until she got married, because of her religious beliefs. Rather than argue with them, I saw this as an opportunity for dialogue, and in the end, my hope was that I had planted a 'healing seed' to help resolve the conflict between their beliefs and their realities." (Physician, Washington State)

"I had a 37 year old woman just yesterday who was 13 weeks. She said she and her husband had been discussing this pregnancy for 2-3 months. She was strongly opposed to abortion, 'but my husband is forcing me to do it.' Naturally, I told her that no one could force her into an abortion, and that she had to choose whether the pregnancy or her husband were more important. I told her I only wanted what was best for her, and I would not do the abortion unless she agreed that it was in her best interest. Once she was faced with actually having to voice her own choice, she said 'Well, I made the appointment and I came here, so go ahead and do it. It's what's best.' At last I think she came to grips with the fact that it really was her decision after all." (Physician, Nevada)

"We have anti-choice women in for abortions all the time. Many of them are just naive and ignorant until they find themselves with an unwanted pregnancy. Many of them are not malicious. They just haven't given it the proper amount of thought until it completely affects them. They can be judgmental about their friends, family, and other women. Then suddenly they become pregnant. Suddenly they see the truth. That it should only be their own choice. Unfortunately, many also think that somehow they are different than everyone else and they deserve to have an abortion, while no one else does." (Physician, Washington State)

Although few studies have been made of this phenomenon, a study done in 1981 found that 24% of women who had abortions considered the procedure morally wrong, and 7% of women who'd had abortions disagreed with the statement, "Any woman who wants an abortion should be permitted to obtain it legally." A 1994/95 survey of nearly 10,000 abortion patients showed 18% of women having abortions are born-again or Evangelical Christians. Many of these women are likely anti-choice. The survey also showed that Catholic women have an abortion rate 29% higher than Protestant women. A Planned Parenthood handbook on abortion notes that nearly half of all abortions are for women who describe themselves as born-again Christian, Evangelical Christian, or Catholic. (4)

According to a 1987 article, Abortion Clinics' Toughest Cases, "Physicians and clinics frequently terminate pregnancies for women who believe abortion is 'murder' and 'a sin' but who are not anti-abortion activists. Demonstrators, organizers, and leaders in the [anti-abortion] movement are seen less frequently, ranging from perhaps once or twice a month to a few times in the course of a professional career." The article contained the following anecdotes:

An administrator at a Missouri clinic recalled a woman blurting out in the recovery room, "It should be illegal." The other women's mouths fell open, said the administrator. "They couldn't believe it."

The medical director of an Indianapolis clinic recalled one prospective patient who phoned to ask whether the clinic had a back door. He said no. How, she asked, could she get inside without being seen by fellow picketers outside? Pointing out that two orthopedists practiced with him, the doctor told the woman "she could limp and say she was coming to see the orthopods."

The medical director at a Dallas abortion clinic told this story: A white woman from an affluent north Dallas neighborhood brought her black maid in for an abortion and paid for it. While the maid was in a counseling session, a commotion was heard in the waiting room outside. The maid's employer was handing out anti-abortion leaflets to other women waiting for abortions.

From a clinic director in a mid-western state: "One of the most remarkable cases was a woman who came [from another part of the state] and said she was the Right-to-Life president in her county. 'But,' she said, she 'had become pregnant and had to have an abortion.'"

From a counselor in Virginia: "[The patient] was disturbed and upset and insisted she couldn't carry the pregnancy to term. She opposed abortion -- and in fact had picketed this very clinic -- [but] felt the abortion was something she had to do."

Many anti-choice women are convinced that their need for abortion is unique -- not like those "other" women -- even though they have abortions for the same sorts of reasons. Anti-choice women often expect special treatment from clinic staff. Some demand an abortion immediately, wanting to skip important preliminaries such as taking a history or waiting for blood test results. Frequently, anti-abortion women will refuse counseling (such women are generally turned away or referred to an outside counselor because counseling at clinics is mandatory). Some women insist on sneaking in the back door and hiding in a room away from other patients. Others refuse to sit in the waiting room with women they call "sluts" and "trash." Or if they do, they get angry when other patients in the waiting room talk or laugh, because it proves to them that women get abortions casually, for "convenience".

A few behave in a very hostile manner, such as calling clinic staff "murderers." Years ago, a clinic counselor in British Columbia told me that one of her patients went into the procedure room apparently fine with her decision to have an abortion. During the abortion, at a stage when it was too late to stop the procedure, the woman started screaming "You murderers!" and other invectives at everyone in the room.

A few doctors actually refuse to provide abortions to anti-choice women for liability reasons. In the words of a Kansas physician:

"Early in my career, I thought I was obligated to provide an abortion for every woman who arrived at my doorstep requesting an abortion. My experience in general medicine, surgery, and abortion has led me to believe differently. Not inadvertently, women give either me or my staff an uneasy feeling about their ambivalence or their anxiety about the abortion process. Since I have never been sued for an abortion I did not perform, my policy is to acknowledge my gut feeling, which is more often right than wrong."

A clinic counselor from Georgia stated:

"I have long felt that anti-abortionism is a psychological contraindication to the abortion procedure. And that we don't have to give everyone who asks an abortion. An anti-abortion woman is likely to be uncooperative and will probably not follow post-op instructions or instructions on how to deal with complications. There is actually a case where an anti-abortion patient failed to go as directed to Emergency for an unrelated complication. She ended up dying, and her family sued the physician and badgered him publicly. Additionally, if you have a complication that day, it will be the anti-abortionist. I'm not talking about the patient who says, 'I was against abortion until it happened to me', or 'I'm really against abortion, but I have to do this'. I'm talking about the picketer, the activist, the totally anti-creature who will come back to haunt us."

In fact, an anti-abortion organization called Life Dynamics Inc., of Denton Texas, specializes in malpractice suits against abortion providers. They advertise for and exploit women who regret their abortion decision or who had complications, and try and persuade them to file suit against the doctor or clinic. Many of these women are vulnerable and suffer from emotional problems, but others are anti-abortion, or at least very ambivalent about their decision to have an abortion. The message that abortion is murder has had a profound influence on them, and it may leave them with a legacy of guilt and shame after their abortion, too often borne alone and in silence. When these women find themselves unable to cope with their abortions, they may look for somebody else to blame, and doctors become a convenient scapegoat.

At times, clinic staff understandably become frustrated and angry when they have to deal with abusive, hostile, or hypocritical patients. And it is rare for anti-choice women to express appreciation for the service they've received. But most clinics perform abortions on anti-abortion women because they feel it's their obligation to help all women. They provide more thorough and specialized counseling to these women to ensure they take ownership of their decision, as far as possible. Here's a couple of examples of counseling techniques:

"When a patient comes in with my 'favorite' sentiment: 'The only moral abortion is my abortion,' I try to expand her understanding that a few more of us have had and deserve a 'moral' abortion. When a woman expands her need for care beyond herself, you no longer have an 'anti'." (Clinic Administrator, Louisiana)

"Sometimes I say to patients who have that 'I have no choice, I know I'll regret it, just do me' attitude: 'You may not care, but we do. We only do abortions on women who want our services. We will not knowingly contribute to any possible trauma of any woman.' They seem surprised that we care how we do our work, but they also accept it." (Counselor, New York)

Some anti-choice women who have abortions do make peace with their decision and even become pro-choice, or at least more forgiving of other women seeking abortions. A Louisiana patient who was anti-choice before her abortion, wrote a warm and grateful thank-you letter to the clinic, admitting that she had been a hypocrite:

"I never dreamed, in my wildest nightmares, that there would ever be a situation where I personally would choose such an act. Of course, we would each like to think that our reasons for a termination are the exception to the rule. But the bottom line is that you people spend your lives, reputations, careers and energy fighting for, maintaining, and providing an option that I needed, while I spent my energy lambasting you. Yet you still allowed me to make use of your services even though I had been one of your enemies. You treated us as kindly and warmly as you did all of your patients and never once pointed an 'I told you so' finger in our direction. I got the impression that you cared equally about each woman in the facility and what each woman was going through, regardless of her reasons for choosing the procedure. I have never met a group of purely non-judgmental people like yourselves."

On occasion, an abortion turns out to be a momentous, life-affirming experience for an anti-choice woman. A doctor from a north-western state shared the following personal story with me:

"I was born into a very Catholic family, and was politically pro-life during college. After dating my first real boyfriend for three years, we broke up, and the day my boyfriend moved out, I discovered I was pregnant. It was an agonizing decision, and something I never thought I would do, but I decided an abortion was the only realistic option. Thanks to Planned Parenthood counseling, I worked through some very tough conflicts within myself. I had to learn that my decision was a loving one. That 'my god' was actually a loving and supportive god. And that men don't have to make this decision, only women do. That it is a very personal, individual decision. I had to own it. I became much more compassionate towards myself and others as a result of my experience. Two years later I began medical school. When it came time to choose a practice, an abortion clinic opportunity came up. In working there, I began to feel that this was my calling. Having been in my patients' shoes, and coming from an unforgiving background, I could honestly say to patients, 'I know how you feel.' Deciding to have an abortion was THE hardest decision I've ever made in my life. Yet it has brought me the greatest transformation, fulfillment, and now joy. I am a more loving person because of it, and a better doctor for having experienced it. I love the work that I do, and the opportunity to support women seeking to end an unwanted pregnancy. My patients and my work are life's gifts to me, and I think my compassion and support are my gifts in return."

Amen, sister. Amen.

Thursday, August 19, 2010

Guest post: Sons

A warm welcome-back to deliverance, who joins us again with a new guest post :)


“wishes for sons” by Lucille Clifton

“i wish them cramps.
i wish them a strange town
and the last tampon.
i wish them no 7-11.

i wish them one week early
and wearing a white skirt.
i wish them one week late.

later I wish them hot flashes
and clots like you
wouldn’t believe. let the
flashes come when they
meet someone special.
let the clots come
when they want to.

let them think they have accepted
arrogance in the universe,
then bring them to gynecologists
not unlike themselves.”

Male privilege is something I encounter on a daily basis at my job. It often comes in the form of a phone call with a curious son on the other line—“If my girlfriend and I had sex on the 8th, but she also had sex with someone else on the 12th, how could it be *my* child?!” In this process of protecting himself, he is avoiding the responsibilities which come with being a sexually active adult.

Women don’t have the option of walking away. Our bodies are bound to such consequences.

In other instances, male privilege oozes from the walls of the waiting room. Impatient sons position themselves on our comfy couches in ways which look all too forced—they appear pouty, bothered, and cast rude stares. “What takes this long? I have things to do!” If only he could know how inconvenient it is to have something unwanted growing inside of you.

When I was in college, one of my Women’s Studies professors shared with me one of her hopes for third-wave feminists: “You need to involve boys and men. We need to make them aware of how gender roles influence their own lives, too.”

Lucille Clifton and my college professor both were communicating something similar: These are our sons. We need to be teaching them better.

Every once in awhile I am reminded. A son comes into a session, scoots his chair close to his partner’s, and listens intently. He does not interrupt her, talk over her, or insert his own opinion wherever he feels compelled to make his voice heard.

He does, however, sincerely ask—with open and interested eyes—“What can I do to take care of her?” This kind of son sometimes asks a myriad of medical questions, about the process her body has to go through. He holds her hand, the entire time.

There are sons who are concerned about the well-being of women. There are sons who honor women. I just wish there were more.

Tuesday, August 17, 2010

Secret Keepers

We don't strap women to tables and violate them. We walk them through a medical process. When I speak to a woman and reassure her that if she wants to keep her pregnancy, then she should, I feel most effective. I know that I can walk women through safe medical procedures. I know that I can answer questions and offer a compassionate ear. When I help a women think and decide to wait a week until her abortion or not to have one I know I do my job well. My job is to help that woman reflect on her own thoughts and life. I do not make any decisions for her, I answer medical and logisitical questions and then I help each woman reflect on what she needs not what I think she needs.

I often feel like my job is to be people's secret keepers. I don't believe you can put a face on who gets abortions. All different kinds of women from all walks of life grace the doors of clinics across the country. As an abortioneer, friends and family members seek information from me consistently.
As an abortioneer I am a secret keeper who helps women reflect on their own lives and needs. People who claim to be radically against abortion might assume or pretend we are evil people who enjoy human suffering. But, really abortioneers every where are the best kind of people. We are people who know how to listen rather than just hear. We are the kind of people who know how to set aside our own judgments and opinions so that someone else can make a decision about their own life.

Monday, August 16, 2010

Reading and ranting: when theory doesn't meet practice

So I'm reading this paper. It's about desired and actual fertility levels in developing countries. And it's written by...an economist.

No offense to any economists reading this, but y'all say a lot of funny things. You base a lot of your reasoning on the idea that people make "rational decisions" and everything else follows logically from there, but underneath that you have a very restricted sense of what rational decisions might be.

An example: this paper posits that there is "a very small influence of contraceptive access on fertility levels .... The decision to have another child is simply too important and too costly for contraceptive costs to play a major role.

I kind of hesitate to name this paper and author, because in fact it's a very interesting paper with some thoughtful research behind it and some good points to make. But I just need to say it: are you fucking kidding me? 

Sure, it's easy for you to say from your armchair, "It just doesn't make sense to behave any other way; if a woman can't afford birth control, she certainly can't afford a child, so she should be sure to get on birth control because it's a tiny investment compared to the cost of a kid." Well, duh. 

But I mean: has this guy EVER spoken with an actual woman of reproductive age (as they say) during his career? Here in the first world, where theoretically there is a pharmacy around every corner and Medicaid for poor people, I have met SO MANY women who would have loved to buy contraceptives in the month they got pregnant, but couldn't afford it because diapers or seizure medication or a new (used) tire had to come first. The thing is, if you can't afford birth control this month, the fact that you could even less afford to have a child doesn't matter -- you still can't afford birth control right now. And then accidents happen. 

This doesn't even get into all the pseudo-consensual sex that occurs even in the U.S. -- not to mention more resource-poor countries -- meaning you may be afraid of getting pregnant and unable to get birth control but you may also have little agency in sexual decisions. Your abusive partner is actively trying to get you pregnant as a control tactic. The guy you depend on for child support comes around every few weeks and maybe gets a little pushy. You support your four siblings by trading sex for food. You live on the street and cops routinely harass you until you'll fuck them! 

I'm just saying. The fact that it's cheaper doesn't always mean birth control is cheap enough

The paper goes on to use other, more sound arguments to propose that the well-known idea of "unmet need" for contraceptives is more or less moot, because "actual fertility" levels are nearly identical to "desired fertility" levels in most developing countries. Really, they are interesting points, but then he doesn't even address the extremely high rates of unsafe abortion in those same countries -- a pretty strong indicator of desperately not wanting to be pregnant, I'd say, and of a need (an unmet need, if you will) to avoid pregnancy in the first place. I mean, stuff like that: WTF, economists?

So I am still trying to understand how a person can write about the real-life problems of real-life individuals, overlook critical aspects of the situations many of them are in, and write off an entire sub-field of health as irrational or unnecessary. I mean, I feel like if someone asked the author about the abortion thing, he'd dismiss it by saying he is only looking at the "big picture" of births per woman, and his point is that women on average are still having as many children as they say they desire and that point still holds, and micro-level issues such as death and disability due to unsafe abortion are only details to be worked out by someone else who takes an interest in that stuff. And that's as may be -- perhaps you just wanted to show something interesting about these national-level birth-related indicators -- but really, even if it's just carelessness, you shouldn't let your theory errantly piss all over others' actual practices. 

Better strategies:
1) Acknowledge that there is an unmet need for contraception so long as unsafe abortion is widespread, or
2) Acknowledge that abortion is an important part of your finding that women are meeting their "desired" fertility levels, and include in your recommendations section that it be made safer and more accessible.

To put it less wordily -- those women your science can't understand: they are nevertheless real and you haven't managed to math them away.

Thursday, August 12, 2010

Sisterhood of the traveling mesh underpants*

"Tell your abortion story!" we implore you. "Erase the stigma!" "I'm here to listen." In nearly every counseling session with a client, I slip in the statistic that one in three American women will have a least one abortion in her lifetime. I sometimes add that it's a huge sisterhood, but one that no one talks about.

Most women don't end up walking around proudly with an I had an abortion T-shirt, but as clinic staff, I have been fortunate enough to encounter more than a couple of women who are OK with telling their truths.

I've seen clients months post-abortion at pro-choice activist events. I don't say anything to them other than "Hi" if they catch my eye, because anything more would be a HIPAA violation. But later on, I send them a psychic thank you. While working in the recovery room at the clinic, I've witnessed patients exchanging phone numbers and making plans to get together. I've watched plenty of acquaintances spy each other in the waiting room and then hide behind magazines in a panic, but I've also seen acquaintances connect and old friends reconnect after seeing a familiar face in a frightening place. After learning where I work, people in my life confide about their abortion experiences or their friends' tales, maybe intuiting that I'm a walking safe space, maybe desperate to share something that shouldn't be a secret. You, readers, have trusted us and mentioned your own abortions in our comments section.

Women talk, and women have rich stories to tell. Our job, as pro-choice warriors, is to listen, listen, listen, and believe me, we are all ears. I have seen it.

*At my clinic, we give out little disposable mesh underpants to clients to use if there's a bleeding on the underwear situation.

Wednesday, August 11, 2010


Doing some research at work on contraceptive prevalence in some developing countries to appease a lazy donor (duh, measuredhs.com), and we decide to give them some abortion data as well. The reasoning: if our programs increase contraceptive prevalence, then it also reduces abortion prevalence. Since the DHS doesn't capture abortion data (unclear on why; political issues?) we find some Guttmacher data. Initially I was concerned that this info might confuse our donors; since ab laws have been relaxed in many places over the last decade, abortion prevalence might increase and lead them to believe horrible things about contraception and the ineffectiveness of our programs. And it's not easy to talk a donor down from a ledge.

But check it! Worldwide, ab prevalence has actually gone down. From this particular data I can't say why, but of course we'll speculate that it has to do with increases in method use, especially long-term methods (IUDs and such). But read further: though overall abortion rates have fallen, rates of illegal/clandestine abortions have stayed the same!


So the situation is actually pretty bleak. Because the most relaxed laws occur in the most developed countries, the women at greatest risk for complications from abortion are not granted access. This report mentions 19 countries have reduced restrictions, many in the developing world, but with the same access barriers and so on that have existed forever. God bless pro choice de jure.

With all the resource allocation and funding for ab in the states, what is the prognosis for that kind of support in the rest of the world? My org is not allowed to; which orgs are? Does anybody know of prospects for abortion access overseas? Is it too much of a hot button issue? I'm so confused. So many countries' women are dying and they don't care! How is it that the world has managed to (for the most part) get on board with HIV/AIDS within a decade, but has taken centuries to do so for ab? If you ask me HIV is as tricky an issue as ab, by which I mean it's not tricky at all. Give people things so they don't die.


If I were Miss America, I wouldn't wish for world peace. I'd wish for world abortions.



I just received an email stating the following:

"New rule from Dept. of Health and Human Services: women with pre-existing conditions like breast cancer, AIDS and diabetes will be banned from buying insurance coverage for abortion in
high-risk insurance pools. They won't even have the option to buy coverage with their own money. Outraged? So am I."


End the madness!



As long as I keep getting distracted at work by checking email and IMDB and other distracting sites, I found the following while reading the Wikipedia entry for Nick Cannon (don't ask):

"Cannon's music video for Can I Live? reveals that he was almost aborted by his mother, but she panicked in the abortion clinic and decided to have the baby."

Sigh. I love when people talk about this stuff as though it's an argument for abortion banning. Not that this entry was explicitly anti-choice in any way, but it reminded me of other instances in which "My mom almost aborted me and etc etc" comes into the discussion. Remember when it's "pro-choice" and not "pro-strapping-women-to-tables-and-forcing-things-between-their-legs"? Why would we not want women to have babies if they want to have them? Ack ack.

Tuesday, August 10, 2010

Moving On

I am grateful for Sparky's last post about "Dr. Rude." I, too, have run into a Dr. Rude, and it's so not fun.

What I - sadly - feel of more often is the need to advocate for patients within my own clinic. It's true that many clinics are suffering across the country. Most are seeing fewer clients. We're worried about healthcare reform and Obama selling us out. We want to keep our doors open so we can serve women. I believe, however, when a business focuses so much on the operations of running a business, and forget the women, forget their stories, forget why they're here in the first place...then they lose sight of why our work is so important, and they'll ultimately lose business, too. (Unless, of course, they're the only provider in the area!)

I was recently told, "you advocate for all the women," as if that's a bad thing. Seriously? Are you kidding me? Since when is it a barrier to be passionate about this work? Since when is it a barrier to completely care with all your heart and soul about the women we see? Since when is it bad to go the extra mile, find a little more funding for a woman, and ensure she has a safe abortion in a compassionate setting?

Like Moral Pilgrim, one of our avid readers/commenters, I am very passionate about patient advocacy. It's what motivates me. It's what puts a fire in me. I think about the women. I fight for them because I give a shit. I don't forget that pregnancy impacts every.single.aspect.of.their.entire.lives. I don't forget that. I treat each woman with respect and kindness. Even when I'm fucking tired and would like to go home. Even after getting it in the ear about spending time with someone who is making one of the biggest decisions of their lives. Because guess what? You spend the fucking time, you give a shit, you put your heart on your sleeve, you are compassionate and genuine...and (as if, by fucking magic!) you'll have a good clinic, with good staff, and with patients who are fucking grateful and will go tell all their friends how great xyz clinic is.

Oh. And since most of us clinics get their referrals from friends/family, it's probably not a terrible idea to forget why we're here doing abortions. Because it's not about abortion. It's not about how fast the doctor can finish his job so he can sod off home for the day. It's not about the bottom line. It's about giving a shit. It's about LIFE. I will say that again: OUR WORK IS ABOUT LIFE. It's about EVERYTHING. And if you don't get THAT, you shouldn't be doing this work. And if you're in this work just because of a paycheck, or because you can't be bothered to look for a new job in a bad economy, or because you feel you have to be loyal to your business (even though you're finished and done with it all), then this is my suggestion: move on. Get a new job. Quit wasting your time. And a note to those of us in companies where maybe we're not so excited with the current philosophy of where we work: maybe we, too, should find a new clinic where clients come first. Really. Or start our own clinics!

Monday, August 9, 2010

some abortion clinic

I recently saw a quote from a president of a I hate women and their reproductive freedom organization. The quote goes as follows: “No one goes to medical school with the intent of working in a Planned Parenthood or some other abortion clinic.”

I love (actually hate) when anti-choicers make such blatantly false blanket statements as if they have any knowledge of this particular topic.

The truth is, many people go to medical school for the purpose of becoming abortion providers, as well as all-encompassing women’s health care providers. I am one of those people. I knew before medical school that I wanted to offer abortion services in my practice, and I was determined to get trained during medical school and pursue a residency that would train me to be a competent women’s health care provider.

I’m sure Mr. Wrong would like to believe that we reluctantly step into the abortion provider role because no one else will, or because we are after the money (which isn’t there) or because we like being harassed by psychos. The truth is, we believe abortion is a right and each woman should have the chance to make an informed decision among all her options. I believe that I can only be a good physician to my patients if I offer them all services surrounding their reproductive freedom, not just some.

Unfortunately for Mr. Wrong, there are more and more of us each year. Not all of us enter medical school with the hopes of having the honor to serve women in this way, but many more of us are leaving medical school with that very ambition. This is especially thanks to organizations like Medical Students for Choice and certain residency programs that support medical students throughout their years in medical school and beyond.

Sorry, Mr. Wrong. We are here to stay, and I would be honored to work in a “Planned Parenthood or some other abortion clinic” one day.

Sunday, August 8, 2010

Let's Watch a Video

So, this young lady has a lot of opinions on abortion. Many of which are ridiculous and laughable. I would like to highlight my favorites and discuss it with you all.

Early on, she says, "It's obvious that biology says that a human being becomes a human as a zygote." According to the dictionary, a zygote is "the cell produced by the union of two gametes, before it undergoes cleavage."

So a cell. A zygote is a cell.

Later, she is asked what is the best argument she has heard from the pro-choice side? She replies, "The very best argument is that a fetus is not a human being... it's a clump of cells. That's a thesis. What is the evidence for that?"

Um, doesn't biology "obviously" tell us something about zygotes? That zygotes are cells? How do you need evidence to prove that a clump of cells is a clump of cells? If a zygote is a cell then it is a cell. I think she is trying to suggest what is the evidence that it is not a human being? I would suggest the evidence that it is not a human being is because it is not living outside the womb. Also, it is a clump of cells according to biology but I won't bother with that point.

This fetus-or-human is a very important distinction. There are those folks who think that once the egg is fertilized, bam, human. No ifs ands or buts. There are those who think that once a woman becomes pregnant, it's not a human until it is born. There are some who think that it's human in third trimester. There are some who think after 24 weeks it is human. People are ALL over the map on this. Probably because there isn't a way you can actually prove when humanness begins. I don't know if we can all agree to disagree, but we can definitely agree pinning down when exactly a human is a human would be extremely difficult.

What I do know, is that I value the life of someone who already exists in the world, and is living -- I value that more than a clump of cells. I value that more than a fetus. I value that more than a baby who is still in the womb.

Later, Ana talks about abortion in cases of rape, incest, and to save the mother's life, and how those are indefensible because then you could kill anyone.

Actually, no, not really. An abortion to save the life of the mother is to preserve the life of someone who is already alive in the world versus a fetus/clump of cells/whatever you want to call in her stomach. I don't see how creating an orphan and letting the mother die in childbirth is really keeping the justice. Sure, the fetus has no say, but that's because the fetus is not capable of rational thought or discussion. The mother is already alive. She can reason, and think about things, and decide what she wants for herself.

Ana later in the video says that prochoicers support the murder of a newborn child if it is was in the way of the mother's life. Well, if that was the case, the baby could be put up for adoption. If a 40 year old was somehow in the way of the mother's life, maybe that guy should finally move out of the house? Those comparisons are not helpful because you are comparing apples and oranges.

I guess mostly these types of videos and commentaries disappoint me because I try to be open to listening to other people's beliefs and values and while this girl claims to be a listener, she seems really closed minded. Blerg.

Thursday, August 5, 2010

Guest post: My Truth with Abortion

Hi everyone. We'd like you to meet deliverance, who's graciously agreed to be our guest here for several upcoming Thursdays. As deliverance says, The name means relief from something, and sometimes liberation. Please extend your warmest welcome to our friend and colleague!


potentially problematic

Hello, dear readers and writers. This is my first post in this special sliver of cyberspace, as I will be guest-blogging for the illuminating Daughter of Wands in August and September.

I started working in the honorable field of abortion care exactly one year and a day ago. Never had I expected to become so bonded with abortion. For quite a long time abortion was, for me, a distant political issue. I was committed as an activist to do my part in protecting abortion rights, but I never had any emotional investment.

When I reflect on how I thought about abortion before my days as an insider, I understand. Mainstream messages don't convey the heart that is in abortion care. That would be radical. Instead, we flaunt, we debate, we yell, and we condemn. There is no story-telling.

It is not new for women to have their stories and lives ignored. In my work, I have been able to honor the lives of many women. I have also come to this realization: Abortion care is soulful; it deepens the heart and opens the mind.

On a daily basis I get to discuss the "big questions" -- questions about life, death, rebirth, loss, and love. Recently, I have been thinking quite a bit about the topic of parenthood and how people make the decision to become parents.

I have been seeing advertisements by the Ad Council to encourage more foster parenting. Each commercial ends with the statement, "Kids in foster care don't need perfection, they need you." So basically, as long as your kid doesn't carry your genes, there's no need to do anything above mediocre. (You can find these ads on the right side of this webpage under "Campaign Materials"):

Choosing to raise a child is a huge responsibility, but these ads make parenting seem like it's something anyone can do, and it's not all that important to strive for anything above the ordinary. Perhaps we should consider the impact we have on our communities when we don't work to raise our children in the best way we can. Also, what kind of impact does it have on a child who hears, essentially, that they don't need anything special from a parent?

In my work at the clinic, I sometimes talk with women who feel obligated to carry out a pregnancy because they aren't in desperate situations. They often feel a bit ambivalent, and figure that if they try hard enough, they could accomplish being a parent.

Shouldn't parenthood be a conscious decision, one which involves a certain amount of desire and motivation? Parenting involves raising a person -- teaching someone about the world, helping them acquire life skills, and instilling values and morals. It shouldn't have the same weight as choosing which dinner entree you want from a menu.

I am not saying I support the ever-popular argument that "It is good to have abortion because there are certain people who just shouldn't have children." But I am noticing, partly through my work at the clinic, that sometimes parenting isn't seen as a profound act.

Recently I came across a poem which made me think of one way to look at parenting. It is from a book called Earth Prayers.

"I'm going to plant a heart in the earth
water it with love from a vein
I'm going to praise it with the push of muscle
and care for it in the sound of all dimensions.
I'm going to leave a heart in the earth
so it may grow and flower
a heart that throbs with longing
that adores everything green
that will be strength and nourishment for birds
that will be the sap of plants and mountains."
-Rosario Murillo

My work with abortion doesn't always have to do with the absence of children. It does, however, always have to do with love.

Wednesday, August 4, 2010

Abortion on TV

I found out recently that the a couple of shows, both on major networks, produced episodes featuring abortion as a main story line. And not only did the story lines feature abortion, both characters had an abortion. One of them was shown on tv, the other did not.

Friday Night Lights, not a show I've ever watched before, centers around high school football in a fictional (smallish?) town in Texas. While football is the main story line, there are, of course, various personal story lines. One of them involves two teenagers, Luke and Becky.

"I Can't" centers mostly around Becky finding out she's pregnant and trying to figure out if at 15 she wants to have a baby or have an abortion. While during the episode Becky is obviously torn up about the abortion and telling her mom (who was a teen mom), she seems pretty clear throughout on her decision. She does find solace in the support and objective counseling of the high school football coach's wife, Tami, who doesn't try to talk her out of her decision but does encourage Becky to tell her mom after asking if it's safe for Becky to do so.

The show doesn't delve into a lot of specifics but does a pretty good job of portraying the story realistically and objectively. There's a brief scene with a doctor, at the clinic where Becky will have her abortion, giving the state mandated counseling. Like I said it doesn't go into specifics, so we don't see too much of the counseling process. I do think the show gave a pretty well rounded view, albeit packed tightly into an hour tv show that dedicates much of it's time to various story lines. I can't find any clips to put on the website, but I saw it on the NBC website and thought it was a pretty good episode that portrayed an abortion experience objectively.

The other show, had a slightly different portrayal of an abortion experience - the Family Guy. The Family Guy is a satirical cartoon, made for adults, that isn't afraid to take any controversial topic and poke some fun.

In the episode, "Partial Terms of Endearment", which Fox won't air but is coming out on dvd, Lois goes to a class reunion and runs into an old friend. This friend asks her to be a surrogate for her and her husband. Lois agrees and an embryo is successfully implanted in Lois' uterus. However, not long after, Lois' friend and husband are killed in a car accident. Lois isn't sure what to do and ultimately decides to have an abortion. While Lois does have the abortion in the end, there is a moment where Peter, her husband, tries to convince her not to have the abortion after talking to anti-abortion protesters outside the clinic. This leads me to my favorite scene from this episode. I did watch the entire episode, broken into parts on You Tube.

Tuesday, August 3, 2010

"With all that you have to deal with..."

"Can I ask you a question? With all that you have to deal with, why do you still do this?"

"Because I remember when it was illegal for women to make this decision. I don't want to see those days come again. And also when a woman comes to me and says that she doesn't know what she would've done without my help...I know I'm doing the right job."

Sounds totally cheesy, right? Like, 100% fresh-squeezed saintly shit, not from concentrate.  (Ack, I'm already mixing my metaphors.) No one ever says stuff like that outside of movies. Probably anyone watching "If These Walls Could Talk" at this point rolled their eyes at the pro-abortioneer bias of the movie, because doctors don't talk like that.

And the part right before that, where Dr. Cher finally gets through the crowd of protesters and into her office, and takes off her coat and then her bulletproof vest: another eyeroll. Who actually uses those? Get over yourselves, filmmakers -- amirite?

"There are all sorts of dangers [for] postal workers, firemen, police officers -- everything has a risk to it. I would prefer, personally, to have a challenging, stimulating and emotionally and spiritually rewarding career that is short rather than having a long one that is filled with ho-hum, mundane mediocrity -- feeling as if you don't make any difference to people."

Dr. Tiller said that. I often have these moments of sharply realizing, all over again, how much we lost when the antis murdered him last year. Many of my friends say that brilliant blue-sky days always remind them of hearing the news that day; isn't that shitty? And I feel that way about Memorial Day weekend in general: from now on it's a time to remember one veteran in particular.

After Barnett Slepian ― an abortion provider in suburban Buffalo, New York ― was murdered in 1998, police brought the Carharts bulletproof vests. They wore them until, as Carhart drily noted, "we realized that the antis usually shoot providers in the head."

And then they killed Dr. Tiller, who wore a vest to work but was shot in the face at church. So his friend Leroy Carhart was right. But that doesn't mean Dr. Carhart has stopped providing abortions. Even if sometimes he carpools to work with U.S. Marshals.

Dr. Hern hasn't stopped either, but his blinds are always drawn and he never sits with his back to a window in a public place and every morning he checks the clinic roof for snipers. And at my clinic the (far less famous) doctors call ahead to let us know they'll be standing outside the back door in two minutes, the nurses are circumspect when registering their home addresses with the state, we get rides to work in others' cars during high protest times.

A lot of older doctors and nurses started learning to provide abortions when they were either mostly or entirely illegal. I think they got murdered less then, because antis tend to get violent when they start losing their legal domination. But they sure had to deal with the police. Why would those providers have risked prison, and today's providers risk death, to offer a relatively low-paying service that universally lacked in prestige among their colleagues?

Almost to a one, the providers who talk about it cite reasons like this:

and this

Gerri Santoro, dead in a hotel room at 29, leaving behind two daughters; she never made it to the emergency room, but doctors saw countless others like her, particularly in septic wards.

We talk and write a lot about how it isn't right or normal or reasonable or legitimate that we work behind bulletproof glass and incorporate security routines into our daily life in order to do something that is both legal and very much needed by a great number of people. It isn't normal. Take a minute to think about how not-normal it is! A lot of people seem to assume it naturally comes with the territory -- "occupational hazard," as one editorialist wrote about Dr. Tiller's death, right before comparing him to a mafioso -- and then on the other hand, others somehow seem so surprised to hear that it does.

Last night I told someone that I'd probably have assumed the Dr. Cher character was an absurd caricature of an impossible saint, if only I didn't know people who actually talk just like her and indeed wear bulletproof vests to work. And at the vest thing he said "Wait, really?" People say that a lot!

But they don't then say "that's ridiculous." They often say (always in the same voice), "Oh, wow..." and trail off meaningfully (I guess). And I don't need that. Like, thank you acquaintances, but: making it socially unacceptable for my life to be in danger would be SO much more helpful than voicing your admiration for my doing something that "must be so hard" as you put it. It isn't hard! It just is what I need to do. And it's wonderful, actually. I can be profoundly useful to others, learn a lot about medicine, learn a lot about people's hearts, spend time with great colleagues who share my values and, similarly, are just doing what they need to do.

As Sparky wrote yesterday, some providers are surly, some are sexist, some are looking out for the bottom line. But by and large, those are the people who probably find this work the hardest. To most of us -- whether doctors or counselors or administrators or whatever -- it's worth it, because and because and because. But that doesn't mean we wouldn't appreciate going to work free of firebombs and shotguns. Thanks for taking note.

Monday, August 2, 2010

Dr. Rude

Within the field of abortion it can be very challenging to have conversations about the difficulties we face, because there is a fear that anti-abortion radicals will take our words and misconstrue them. Once an anti took one of my blog posts about being burned out, posted a few sentences about it and turned my point into their own point. It's a fear based on experience.

One of the doctors where I work is rude. Sometimes doctors are rude no matter what they specialize in. It's challenging because doctors who will do abortions are so few and far between that we have to accommodate doctors even when they are inconsiderate. It feels like we have to be thankful they are willing to provide safe abortion care and just put up with their ugly attitudes. This doctor is one of the few who will provide abortions in my area, and he will do second trimester procedures. I am thankful he is willing to practice and provide safe care.

Abortion care is under such attack in this country that there is limited space for us to figure out how to keep improving services, because we are constantly fighting just to keep our clinic open. We are constantly defending our very existence rather than putting our energy towards perfecting the care we provide. I don't feel like I have any answers, but I wish that abortion care providers had space to work through the daily challenges that could come up in any old job without being under the constant scrutiny of anti-abortion activists. We try to do some of that constructive conversation right here on the blog, but as you've probably noticed it often gets crowded out by posts about anti-related stress. QED: They're such a drag.