Reflections on Being an Abortion Provider

After well over two years with Austin Women’s Health Center providing abortion care and reproductive healthcare to the women of Texas I learned many lessons I’d like to share with you, dear reader, and to leave for myself as a reminder why I must always remain in the fight for Reproductive Justice and bodily autonomy. It was a lot to learn, and will be a lot to take in, so bear with me.

Austin Women’s Health Center

All women have abortions. Every age. Every race. Every religion. Every class. Every marital status. Every sexual orientation. Every ability. Every education level. Everyone has abortions. Period.
If someone does not want to be pregnant she will go to extreme lengths, even risking her health or life, to terminate the pregnancy. All the ridiculous laws do is make it more difficult for women to obtain a safe, timely abortion.
October 3rd 2014 was the worst day of my life. On that day my colleagues and I were forced to call, and face, patients who had scheduled abortion procedures with us to tell them the state of Texas would not allow it. We referred them to what was (and could be) the only provider in Austin-Planned Parenthood, and providers in San Antonio, Houston and Dallas. It was utterly heartbreaking and many times many of us erupted into tears alongside our patients, because even though we were not the ones needing an abortion, we were also furious that Texas had allowed this to happen.
While the cost of an abortion in Austin this year has gone up for the first time since the 1970s, the $600-1,200 it costs to have an ultrasound and terminate a pregnancy is insurmountable for so many individuals and families.
Many, many women have more than one abortion. And that’s totally ok.
A majority of women who have abortions already have children. They get it, they know how emotionally, physically and financially draining parenting is.
The range of emotions around abortion is as varied as the human experience. For some women their abortion is the most difficult, tragic thing they have ever done; for others the idea of being pregnant is laughable and therefore their easy decision comes with overwhelming relief. I’ve learned that people who have abortions feel like they don’t have the right to grieve because they are choosing to end their pregnancies. This is just so wrong on so many levels. There is no “should” when it comes to emotions.
Women expect to be treated like shit by their healthcare providers, both their abortion provider and their regular doctor, because they chose abortion.
It takes an especially thick skin, a sick sense of humor, and a fierce passion to be an abortion provider, whether you’re “just answering phones” or the MD performing the surgery.
All people deserve quality healthcare from providers who respect their choices and their knowledge of what is best for themselves, their families and their lives.
Adoption is not an alternative to abortion. Adoption is an alternative to parenting. A huge number of women who have abortions do so because they do not want to be pregnant.
The smallest bit of kindness, whether from healthcare providers, from friends or family, or just in general conversations about abortion, can make a huge difference to someone facing an unplanned and/or unwanted pregnancy. Try compassion, I promise, you’ll like it.
A majority of folks who have abortions were using birth control when they got pregnant. I’ve talked to patients using every single kind of birth control from the pill to vasectomy.
Don’t trust doctors who tell you that you cannot get (someone) pregnant. The human body is an incredible thing and folks who were told that their endometriosis or bike accident as a kid meant they would never have children can and do. Tubal ligation and vasectomies can and do heal. The only way for sexually active folks to prevent all pregnancy is to only engage in homosexual sex. Now if only we could prevent rape….
The Republican Party does not care about women’s health, nor respect our individual autonomy as human beings, therefore if someone votes Republican they are saying that they too do not care about human rights. If you think that women deserve to make their own medical choices, that all consenting adults have the right to marry whomever they love, and that education and medical care should be prioritized over border patrol and prisons, it’s time to vote with your conscience.
Laws restricting abortion, birth control, cancer screenings and access to general reproductive healthcare are not really about women’s health given that abortion is one of the safest procedures in the country. Hell, they’re not even about abortion, or god, or the church, they’re about greed. Forcing women to give birth to children they cannot afford ensures a cheap labor force by perpetuating the cycle of poverty. This ties into for-profit prison systems, lack of solid public education, etc. The whole thing is disgusting.
Women trust their doctors… and the internet. Factual, reliable, medically accurate information around abortion and its risks is not easily accessible, especially when doctors are forced by the state to lie to their patients.
Women who have abortions for medical reasons are generally truly heartbroken. They are not looking for understanding or blessings from the Religious Right but silence would be appreciated.
Protesters just piss people off. With the exception of umpires, referees and prison guards I can’t think of any other profession where people are yelled at and have their lives threatened just for doing their jobs.
A huge number of anti-choice protesters and outspoken opponents of abortion have had abortions!
Most patients who choose to view their fetal tissue after a surgical (machine vacuum aspiration) abortion are shocked by it. Early in the pregnancy, under 9-10 weeks or so, they are shocked by how small it is. Later in the pregnancy they are shocked by what they can identify. As we know many of the photos of fetuses that end up in protesters’ signs were late-term miscarriages so don’t think that at 12 weeks you’re dealing with a newborn, but being able to identify appendages and facial features is normal. Viewing the tissue is an incredibly personal decision, and one that most patients don’t even consider, but anyone reading this who is going to have an abortion, I strongly encourage you to ask yourself what it is you’re hoping to gain from viewing the tissue, and prepare yourself for what you might see.
The medical abortion, abortion pill, Mifeprex, Mifepristone, RU-486, Misoprostal, Cytotec or Cyto–whatever you want to call it–is a long, drawn out process for many people. I would not choose it unless a surgical abortion was unobtainable but for many people, this very safe, very effective method of termination is the preferred choice. For women who live in places where abortion is illegal or practically unobtainable Cyto may be a lifesaver.
The ONLY good thing about a mandatory waiting period and Texas’ requirement that the same doctor who will perform the abortion is the one who does the ultrasound is that it gives patients a chance to meet the staff and the doctor and take some of that initial fear of the unknown away.
Many women do want to see their ultrasound, some even want a copy of it. There are medical reasons for ultrasound dating of the pregnancy, but politicians want to force women to have –and view– vaginal ultrasounds to embarrass, humiliate and shame them. Does humiliating someone into becoming a parent sound like a good idea to anyone?
The sentimentality around getting “a picture of the baby” and the fetal “heartbeat” are overwhelming. We forget, or were purposely never taught, that a single cell can beat like a heart in a petri dish, so the idea that a five-week embryo has a “heartbeat” does not mean what politicians want us to think it means.
LMP vs. conception: When dating the pregnancy the doctor want to know when the FIRST day of a woman’s last menstrual period was, thus LMP. Doctors date pregnancy from this point, not from when a patient thinks conception was, because the date of sex ≠ the date the egg was fertilized. Sperm can live in the human body for up to three days, that’s why Plan B can be taken up to 72 hours after unprotected sex (but seriously the sooner you take it the more effective it is!). Therefore when your doctor tells you that the pregnancy is measuring 6 weeks and zero days, that means roughly one month from intercourse. And at that point the embryo is about the size of a single grain of rice.
Most people feel the need to justify their decisions to the staff at abortion clinics because there is so much stigma around abortion. While I love hearing people’s stories, and they all matter, why you’re having an abortion is none of my business, all I need to know is that you don’t want to be pregnant right now.
Women will always have abortions. BIRTH CONTROL WILL FAIL, partners will change their minds or leave or die, pregnant folks will change their minds, illness will come up, jobs will go away, partners will be abusive, etc. Even for women who planned to get pregnant, things can and do and will always come up that make continuing the pregnancy a non-option. Abortion will always be a necessity.
I want science to figure out a way to put a pause button on pregnancy. Of course if the pregnancy is with the wrong person or there are health reasons or if someone simply doesn’t want children pausing it won’t do any good, but if someone just wants to finish school, or get ahead in their career, or make enough money to pay for diapers, being able to pause the pregnancy could reduce the number of abortions.
No one gets pregnant to have an abortion.
Not wanting to be pregnant, or not wanting to parent, or not wanting to be pregnant or parent *right now* does not make you a bad person. Sometimes… a lot of the time, abortion is the responsible choice.