Monday, August 31, 2009

"Welcome! Welcome! This clinic will stay open!"

This past weekend Operation Rescue, an extremist anti-abortion group, planned to gather outside the doors of Dr. Carhart’s clinic where later abortions are provided in Omaha, Nebraska. However, pro-choice folks organized and showed up to counter-protest, providing support to the clinic and the women going to the clinic. In addition to pro-choice bodies on the defense lines, over $7,000 was raised through this pledge-a-picketer program.

This is incredibly inspiring, and I hope that folks continue to stay mobilized; the safety of our clinics and of women in need of services at abortion clinics is at the forefront of our minds in the wake of Dr. Tiller’s murder. However, access to abortion is about women’s lives and I hope that as time goes on we can still continue to prioritize keeping our abortion clinics open and safe.

Please check out this blog, written by one of the pro-choice activists who traveled to Nebraska this past weekend, for some footage of the wonderful folks helping welcome patients to Dr. Carhart’s clinic. It is people like these activists that help provide support for people in direct service, both in the clinics and at the many funds around the country, who are working tirelessly to get women the health care they need and deserve.

Friday, August 28, 2009

Media Friday!

As you may or may not be aware, there is going to be a huge protest at Dr. Carhart's clinic this weekend. This is the first full scale gathering of this nature since Dr. Tiller's assassination, so obviously, we are all a bit nervous how this is going to go down. Anti-choicers are claiming they'll be "peaceful," but you know, I guess that depends on what peaceful means to you. Personally, I think screaming, shouting, harrassing, and threatening is the antithesis of peaceful, but hey, maybe that's just me. *Insert bitter glare toward the religious right*

Rachel Maddow recently interviewed Dr. Carhart on this matter.

To Dr. Carhart and his staff - you are all in our thoughts and prayers. To the wonderful counter-protestors showing up to support Dr. Carhart, please be careful!

Thursday, August 27, 2009

My dearest Cliche,

Disclaimer: This critique of mainstream media blasphemy and the raw dissection of another human being's lived experience is in no way reflective of The Abortioneers' over-riding belief that every human being is unique and valuable and that overcoming isolation is the key to de-stigmatizing abortion. Furthermore, in addition to the anti-abortion movement, so-called reality television, as well as glossy magazines full of manipulated sound and visual bytes (such as People magazine) are the bane of this author's existence and she has no idea who this woman is or what her show is about. Please excuse her temporary lapse in righteous advocacy.

Do not take this with a grain of salt.

She is many women in one. All slightly mistaken.

Abortion is a literary minefield. Abortion is ironic because it is as common, safe and liberating as it is stigmatized, limited and unsettling.

As an abortioneer, I can be artful and abstract but I can also be intensely demanding of downright truth. This article was riddled with untruths and not in an Alice in Wonderland kind of way. Instead of burning down a newsstand, I have provided commentary.

Kourtney Kardashian's unplanned pregnancy forced the shocked reality TV star to make one of the most difficult decisions in her life: Would she have the baby or terminate the pregnancy?

You mean: Would she have a baby? If we are going to be so brief as to discuss a woman's difficult decision in her life in the matter of nine repetitive paragraphs then we also don't have space to dive into why some women prefer to call a non-viable embryo or fetus a baby. Along the lines of commonality, we will assume Kourtney made this decision in her first trimester of pregnancy so she was deciding whether or not to have a baby. Her actual pregnancy wasn't a baby she could abort because women can't abort babies--that's murder.

"I definitely thought about it long and hard, about if I wanted to keep the baby or not, and I wasn't thinking about adoption," Kardashian, 30, who was shooting E!'s Kourtney & Khloe Take Miami at the time, tells PEOPLE exclusively. "I do think every woman should have the right to do what they want, but I don't think it's talked through enough. I can't even tell you how many people just say, 'Oh, get an abortion.' Like it's not a big deal."

And I can't tell YOU how many people just say, "Oh, just drive to Target." Like it's no big deal. But the real question is: when will consumption of fossil fuel and support of degrading labor practices be as stigmatized and grossly distorted as women’s experiences regarding abortion and family planning?

But pardon me because I’m value-judging and part of living in this beloved country is accepting others’ values.

Scott Disick, the baby's 26-year-old father, was supportive either way. The pair had split in November after two years of dating, but reconciled shortly after finding out she was pregnant. "He wanted me to talk about it more, but I just kept to myself," she says. "He said, 'I really want you to keep it, but I will support you whatever you decide to do.'"

You know what abortioneers call Disick? A future man-uninvolved. I dare you to track him for three years or five--IF they accrue money and fame because of the child.

Confused and concerned, Kardashian says, "I called my best friend crying, and I was like, 'I don't know what to do.' She said, 'Call your doctor, and at least find out the risks and stuff.' " So Kardashian discussed abortion with her physician, and then headed to the Internet to do further research.

FYI: Abortion is one of the safest surgeries performed on earth. In the United States, the most common complications include infection which is preventable and treatable, followed by the possibility of a missed pregnancy and/or retained tissue which is also preventable and treatable.

Many women having abortions are mothers or plan to be mothers and their decision to abort weighs heavily on their head and heart. However, a primary experience of a majority of women choosing to terminate their unplanned pregnancy is a strong sense of relief following the abortion and the ability to move forward with other crucial long-term goals with a renewed sense of courage and determination in life.

"I looked online, and I was sitting on the bed hysterically crying, reading these stories of people who felt so guilty from having an abortion," she recalls. "I was reading these things of how many people are traumatized by it afterwards."

I feel traumatized after reading anti-abortion blasphemy online as well and cry hysterically about it even when I'm not pregnant.

After scouring the Internet, Kardashian says she started to realize that an abortion wasn't an option for her. "I was just sitting there crying, thinking, 'I can't do that,' " she says. "And I felt in my body, this is meant to be. God does things for a reason, and I just felt like it was the right thing that was happening in my life."

I feel in my body that abortions are meant to be and that women who have abortions are sometimes guided to do so through their love of a supreme being or guidance from a doctrine or prescribed faith and that abortion is the right thing happening in their life. Great.

Kardashian says she did some intense soul-searching. "For me, all the reasons why I wouldn't keep the baby were so selfish: It wasn't like I was raped, it's not like I'm 16. I'm 30 years old, I make my own money, I support myself, I can afford to have a baby. And I am with someone who I love, and have been with for a long time."

Merriam-Webster definition of a parent: one that begets or brings forth offspring. People magazine definition of a parent: famous, rich people in-love who don’t like to consider themselves selfish. (Also, score one for the rape survivors and minors, per usual.)

Although Kardashian sought out the advice of others, she says it was her decision – and hers alone – that was the most important.

See also: God

"I really wanted to think it through for myself, and not hear what my sisters were saying, or what Scott was saying. Even though I took it all in, I wanted it to be my decision," she says. "My doctor told me there is nothing you will ever regret about having the baby, but he was like, 'You may regret not having the baby.' And I was like: That is so true. And it just hit me. I got so excited, and when I told Scott he was so excited. But I think if I had said I'm not going to keep it, I really think he would have pushed me into keeping it."

Life is full of regrets however fleeting. For instance, I regret this woman's doctor is a practicing physician.

See also: Post-partum psychosis

PS. Octomom makes my cortisol boil and my oxytocin weep. There! I said it.

Wednesday, August 26, 2009

Othering Abortion

After reading Monday’s post by About a Girl, I reflected on my own dreams for the future of abortion access.

As a future abortion provider and Ob/Gyn, I feel like it is my duty to provide all services for my patients. I refuse to be that doctor who has to send a patient away for a procedure I am perfectly capable of doing-ie. an abortion. I want to provide comprehensive services to all my female patients-whether that be preventing pregnancy, helping a patient to become pregnant, or terminating a pregnancy. I want to help my patient through whatever stage of life and or whatever situation she finds herself in.

My dream is that all women have this kind of access, this kind of experience. Although abortion clinics are fantastic and much needed, we have managed to segregate abortion. As compared to women’s health services and prenatal care, we have othered abortion. Thus, a woman establishes her care with her Ob/Gyn and seeks all her female needs with that provider. If she has an unintended pregnancy, and determines an abortion is the best option for her, she must go to a strange clinic with new providers and new staff to receive her care. Although, this isn’t always the case, it definitely is the majority. As a culture, we separate abortion from primary women’s health.

If we continue to other abortion, we will continue to stigmatize it. And there is no reason to stigmatize a procedure that 1 in 3 women will receive in her life time.

There is so much work to be done to make this happen: medical, nursing, and PA students need to be taught abortion procedures. Ob/Gyns, internists, family medicine clinicians, and even pediatric residents need to be trained in abortion procedure. Insurance companies and governmental insurance programs need to pay for abortion procedures. Planned Parenthood and other abortion clinics should always be available, but when possible, abortions should take place in clinicians’ offices as an available service.

So much to be done, but we can do it together. Let’s make this dream a reality.

Tuesday, August 25, 2009

Devil's Advocate

I'm all about abortion. I love that it's an option. I love that it's legal. I love that it's so common.

But then again....

While I do dislike those ambiguously pro-choice statements (e.g. abortion should not be used for birth control), and wish they didn't pervade anti- and borderline pro-abortion rhetoric, I can't say I disagree 100%. And it's not because the thought of abortion weirds me out, or because I have moral/ethical limitations on my pro-choice stance.

The primary reason I will concede that abortions should occur less frequently in this country has to do with the state of health care. Our providers and facilities are operating in a free market system, virtually unregulated. Abortion services, like any other material goods, follow the rules of supply and demand, and subsequently price, in this lame for-profit health market. A high number of abortions, like a high number of any other type of procedure or health service, drives up the cost of health care in the United States and makes all types of health services prohibitively expensive, even for us insured folk. Condoms: cheap. Abortions: expensive. And even though abortion procedures have taken the smallest blow as far as inflation, they are still expensive enough to raise eyebrows.

Let's say Heaven smiles upon us and blesses us with a single-payer system (thanks, God! We knew it would take nothing short of a miracle!). While the proverbial public option would open doors (literally!) for millions of people, we would have to control costs. That means no coverage for certain services, potentially salary caps for providers, and the promise of some red tape. In the family planning/reproductive health segment, cost-cutting can be accomplished most easily by providing damn good preventative services and reducing the demand for abortion. I'm all for that. It's analogous to providing nutrition and exercise counseling to obviate the potential for open-heart surgeries and diabetes testing supplies. And I don't think anyone can argue with me that gastric bypass should not be used as "obesity control". It's just downright risky. Why treat when we can prevent? And not that we can prevent everything, and not that good treatment ain't worth it's salt. It most certainly is. But either way we make sacrifices; I am willing to sacrifice a few abortions if I knew that equally many pregnancies could be avoided. And it's not just pregnancies we avoid. Do you know how many teenagers are infected with chlamydia and gonorrhea every year? Hundreds! Literally hundreds! These kids need education, they need treatment, they need to understand that CT/GC are the least of their troubles, and that the HIV/AIDS prevalence in the District of Columbia is three times the national prevalence. Yikes! If a new health plan can make health information and services accessible to young people, minorities, rural folks, everyone, then we wouldn't need to fight so hard and so tirelessly to keep abortion legal.

Monday, August 24, 2009

I Had a Dream: Abortion Style

"The only difference between the American anti-abortion movement and the Taliban is about 8,000 miles."

Dr Warren Hern, MD

I have to admit that sometimes I get nervous doing this work. I try not to. And I do things purposefully not to freak myself out about potential violence towards me or my colleagues by generally avoiding news articles on individuals like Scott Roeder, who murdered Dr. Tiller. Take today, for example; I read part of an article posted by Center for Independent Media entitled "Des Moines Anti-Choicer Hopes to Free Alleged Tiller Assassin." Firstly, I don't like the title. This "anti-choicer" is a terrorist who advocates "justifiable homicide" (the disgusting term used by said terrorist group[s] who state murdering abortion doctors/workers is just fine and dandy). This individual actually publishes a newsletter called "Prayer Action and News" which promotes murdering doctors. This asshole is trying to get Dr. Tiller's murderer (not assassin) acquitted. Asshole.

So, though I was annoyed by the title of the article because I believed it was too soft/forgiving, I also I thought it was disarming (excuse the pun!) to read about yet another publication advocating the murder of abortioneers; as a result, I felt a bit scared and didn't want to finish reading the article. This doesn't help with my general distrust - and sometimes paranoia - about the general public. I mean, how many people have bomb threat cheat sheets next to their phones at work (to document bomb threats), let alone actual protocols and procedures on how to handle such calls. How normal is it to have one of the local US Marshal's cell number programmed into your phone? Today, I noticed the purple "ANTHRAX" brochure next to the designated area where we open mail (because, yes, we must have a "designated area" and a designated person who opens all mail. This person is trained to open mail.)

Usually, I don't really notice this stuff. It becomes normal. Every once in awhile, though, I stop and think, "Shit. This really isn't normal. It's really f^cked up we have to deal with this everyday." I spoke with a family planning nurse today who works for a different organization. She said, "People think we do abortions here. We get nasty looks sometimes. I don't know how you can publicly say what you do. How hard that must be." Up until that point in the day, I had been living in blissful abortion-la-la land where I thought everyone was happy to talk about abortion, where no one was judgmental, and no one would be a target of hate or violence. Swiftly, my little la-la land bubble burst and I fell solidly onto the ground, picked myself up and re-entered reality.

But I hate this reality. I hate this schism. I hate that I get scared sometimes because there are literal lunatics out there that live and thrive off of hate (which is sooo not what abortionland is about: abortionland is filled with the most compassionate, loving, generous people I know). So I agree with the statement made by Dr. Hern at the beginning of this post. The reality is, we need to be protected. We need to have a terrorist watch list. And we need to feel safe to go to work and not have stupid purple ANTHRAX brochures, or how-to-open-the-mail trainings, or feel nervous/scared to say aloud, "I work for xyz." I don't like that I live in a very safe, quiet, family-friendly neighborhood but must get an alarm system for my house (not because of fear of breaking-and-entering, but for fear of being followed home by crazy antis).

My biggest wish at the moment is this: to come up with an "I Had A Dream" speech, like MLK's, but instead of it being about racism, have it be about abortion. I think I would start it out like, "I had a dream where doctors, nurses, healthcare professionals, clinic escorts, fund-raisers, all abortion providers, could work free from fear, free from harm, free from worry. A dream where abortion workers could drive safely to their homes, without concern of being followed/video-taped/harrassed or having their homes broken into. A dream where doctors were not murdered outside the lobby of their church. A dream where receptionists were not murdered at their place of work. A dream where bombs didn't go off in garbage cans outside clinics. A dream where protesters did not exist. I had a dream that women had access to abortion in every county and that they were free of charge, without parental consent or 24-hour waiting periods. A dream where clinic workers could arrive safely to work, without need of video cameras, alarm systems, bullet-proof windows and doors. A dream where doctors did not have to wear bullet-proof vests and could freely do their life work, with passion and love, far from fear. A dream where little girls and grown women could hold hands and say aloud, "I had an abortion" and feel proud, and not faded by stigma...." I could go on...and on...for ages.

But maybe that's what we all need: an I HAD A DREAM - an ABORTION Dream, speech. No one thought MLK's speech would make a difference. It has. Who knows. Maybe it could help all of us, too. I had a dream...

Sunday, August 23, 2009

I need a laugh...

One of the hardest parts about being an Abortioneer is what you hear -- working in the field, you hear some pretty awful stuff, anything including and not limited to: extreme poverty, rape, incest, domestic violence.... and that's just the tip of the iceberg. I have heard so many sad terrible stories of what women have gone through to obtain an abortion. I am definitely lying awake at night more often than I'd like to admit.

With this in mind, I thought it would be nice to have a lighter post -- just some of my favorite pro-choicey buttons, stickers, pictures, comics, etc. A montage if you will.


I love the "I should not have to be here" sign!

What have you done today? ;-)

In the wake of Dr. Tiller, this one is especially poignant. I have a really hard time wrapping my head around the utter hypocrisy of the Right to Lifers.

Par for the course

Abortioneers out and about make me smile <3

What are everyone's favorite slogans/buttons/etc?

Thursday, August 20, 2009

Post-Abortion Care

"Do y'all just throw the baby in the garbage when you're done?"

After almost three years at the clinic, that question still jars me.  And depending on how my day is going, I sometimes struggle not to say, "Yeah, and we also store our dirty instruments in this desk drawer right here and release lists of client names to the public."  On better days, I let clients know that pathology examines the tissue/fetus/baby and then a funeral home picks it up and cremates and buries it, which is the truth.  (And for the record, the other truth is that we autoclave instruments and handle them with sterile techniques and we're the most HIPAA-compliant bunch you'll ever meet.)

When I "reveal" what happens after the suction, clients usually say, "Aww, I like that."  I don't know if it's as "sweet" as they think it is, but I like it too.  I like it because some days, I am pathology.  We rotate jobs at the clinic, according to comfort levels.  Because I have no limits when it comes to abortion comfort, I get excited when I do path.  I've always been the type to watch surgery shows on  TV and I loved dissection fetal pigs in college biology.  Pathology, to me, is nine parts science, one part humanity.  When I get home from a day in path, I sometimes have to get out my old-fashioned paper journal and write about what I saw and learned, since my friends and family, supportive as they are, don't want to hear about it.  I'm fascinated by development and abnormalities and by the fact that tissue doesn't really smell bad.  As for the humanity part, while I don't see the fetuses as "babies," I see it as an honor that I'm trusted with this most controversial and taboo element of choice.  I'm one of the few people in the world who will ever see this fetus.  And the clients who know enough or are curious enough to ask, trust me to treat it with respect.  

Anti-choicers hold up posters of what I see in pathology.  Even though their photos are larger than life, I'm not bothered by them.  But I know so many pro-choicers who are, and honestly, this rubs me the wrong way sometimes.  On the one hand, I know fierce pro-choice advocates who would never watch open-heart surgery on the Discovery Channel, so why would they really want to see this other aspect of surgery?  On the other hand, my stubborn brain wonders why they must yell at the protesters, "That's disgusting!  Why would I want to see that!?"  Because I'm pretty sure that's exactly what the antis are going for.  They're all about discomfort and the wrong kind of "humanity."  Even if you're not as comfortable around fetuses as I am, why advertise that the protesters' techniques might be working, on some level?  Abortion isn't always pretty.  I'm one of the few (I say that not self-righteously--sometimes, I wonder if I should force myself to be a little bit uncomfortable.)  who is able to counsel AND to assist the doctor in the OR.  The less glamorous side of choice is not for everyone, but freedom and an amazing clinic staff and empowered clients are beautiful.  

Wednesday, August 19, 2009

Who Knew Funding Abortions Was So Easy?

Last Thursday, an article was published on Slate, “Fetal Extraction: Could a private abortion fund save health care reform?” I found a number of things in this article repugnant, and was so angry I couldn’t even put it into words. Now I would like to.

This first thing that pisses me off was this comment, “Abortions, at an average of $413 a pop, are cheap.” First, if you’re lucky enough to find out you have an unwanted pregnancy under 12 weeks, you may be able to get it for around $400. However, they typically increase in price about $100-$150 each week after that (maybe more, maybe less – it really depends on your clinic). Second, that’s cheap? If you are like many women seeking an abortion, you may have recently lost your job, be on food stamps, have kids, living paycheck to paycheck. If you have a couple of weeks to get $400-$500 together (if you’re under about 12 weeks), that’s not cheap. Then there are those women and girls who find out later in their pregnancy, and the price is anywhere form $500-$2000+. If you’re comparing it to a complicated medical procedure that required hospitalization (like she does in this article), then yes, it will cost a lot less. I would still never say it’s “cheap”. If it were so cheap, we wouldn’t need abortion funds.

Then the author says this, “It wouldn't be much of a stretch for a nonprofit organization with deep-pocketed donors to cover the cost of abortions for America's low-income women.” Excuse me? Now, I don’t know much about what it takes to operate an abortion fund, but I think anyone who does anything in the abortion world knows what a ridiculous statement this is. There’s a reason why there are small abortion funds throughout the country, strapped for cash, doing their best to help women get abortions about $50 at a time. If you doubt this please, go visit the website for the National Network of Abortion Funds.

In this article she estimates the amount of money needed to fund abortions for low income women (in her words “those at or below 200 percent of the poverty line”). She estimates (remember she thinks all abortions cost around $413) a private abortion fund would need “just $311 million per year”. Just? JUST? I’m sorry, but that seems like a lot of money to me. “Could private funders cover that cost? Absolutely.” Really, is that true NNAF? If that’s true, where are all of these private donors with their millions of dollars? The women I talk to would love to speak to them. Seriously. She goes on to say that over $1 billion is donated to reproductive health charities. What she fails to look into is where that money goes. There’s a big difference between funding an organization that advocates for reproductive health, and one that actually funds abortions. There’s a reason why rich people/rich orgs or companies have the money they do. Funding abortions, openly or privately for that matter, would seriously hurt them. Think of the massive boycotts and how much money they could potentially lose. Rich people/orgs/companies, did not get so much money being stupid.

She also says that “supporters of health care reform” would be willing to help fund abortions. Does she have facts to back this up? Once again, WHERE ARE THESE PEOPLE? GIVE ME THEIR PHONE NUMBERS!!!!

“Better yet, progressives could reduce the abortion fund's costs through family planning.” She says these “progressives” (I think it’s pretty clear by now that she wouldn’t identify herself in this group) believe that contraception is the best way to prevent an unwanted pregnancy. Sure. There are hormone supplements, if you’re into that kind of thing. Condoms, if you’re into that kind of thing. There are some options, if you can afford it. However, the problem is that “conservatives” tend to frown upon contraceptives and the public funding of them. Extra- and pre-marital sex is frowned upon by these conservatives, so they really tend to be opposed to funding anything other than abstinence. And I think we all know how effective that is.

“If the family-planning and sex-education programs these pro-choicers support through legislation don't work, the money for the resulting abortions will come out of their own pockets.” Excuse me? Can we properly fund comprehensive sex education and abolish abstinence-only? Also, can we PLEASE STOP DEMONIZING ABORTION? There are women who have a hard time with this decision, they feel bad – like they’ve done or are doing something wrong. Is this because abortion is wrong or because society has decided it’s so and forced people to look at abortion this way? I think it’s the latter, thank you.

The point of this awful article is that she thinks that if progressives give up having abortions funded through a public health care system, that this public option might go somewhere. She thinks that conservatives care so much about abortion that they’d give up other important things, like higher taxes and bigger government. Even if we gave up having abortions funded (which quite frankly we shouldn’t have to), a public health care plan is a long way off – if it ever actually happens. This article was clearly written by someone with means, someone who didn’t grow up having to think how to get $400+ together quickly. She clearly doesn’t work with low-income women. She is lucky. She has a choice and she can exercise it.

If she knows of all these people with all the money to fund private abortion funds, can she have them all contact NNAF? Thanks.

Tuesday, August 18, 2009

Being There

(Note: It didn't actually look like this because I was there in the room; I think only fancy hospitals have real observation rooms.)

For once there's an article in Newsweek that doesn't make me want to put on my asshole cap and critique the hell out of it. In Watching My First Abortion, Sarah Kliff writes about a visit to Dr. Carhart's clinic* in Nebraska that culminated in her accepting the opportunity to view an abortion procedure.

The author writes that she had expected the observation experience to be gruesome, or uncomfortable, or difficult in some other way. But, it turns out, she doesn't get queasy, either physically or morally; the procedure isn't violent or brutal, even less so compared to many other routine surgeries (tooth extractions come to mind); and it's over in a matter of minutes.

My first time watching a first-trimester abortion was much the same. In my case, the patient had opted to receive a sedative medication, so she was asleep during the aspiration. But it is such a short procedure -- indeed, I recall three minutes of soft whirring, with soft-rock radio playing in the background like in any other O.R. -- that the dose of sedation required is quite small, so she was awake ten minutes later in the recovery room, feeling the giddy/dizzy medication aftereffect and some post-aspiration cramps. For women who don't receive sedation, there is more to remember, and certainly it can be intimidating if you've never had an abortion before -- yes you are in a gown in a sterile room with several people attending to you, and yes there is cramping or strong pressure on your uterus -- but they overwhelmingly report it is uncomfortable, but bearable. In short, the procedure itself, 99.xx% of the time, is extremely non-monumental. (A doctor once told me that one of her trainees was hesitant to offer abortion services because he'd never seen a complication in an abortion procedure, and thus doubted his own background in complications-management!)

The interesting thing: the simplicity of the medical aspect of abortion, and how little the author needs to "process" it, allows subtle complexities of abortion's personal aspect to shine through. She seems to become aware that even in the operating room, every patient remains an individual woman with distinct reasons and reactions, circumstances and emotions, in relation to this experience she now shares in common with 50 million other individual women.

I know that not everyone's experience with the first (or fiftieth) observation is necessarily the same as mine or as Sarah Kliff's. Maybe there was that rare complication; maybe the patient was in pain; maybe she had a bicornuate uterus which made the procedure more complex; maybe you were shocked to learn that you faint at the mere sight of someone else's blood (that's a story for another time). If you're an abortioneer who'd like to share a first-abortion experience, I'd love for you to do so in the comments!

*IMPORTANT NEWS: By the way, the past two weeks Dr. Carhart's clinic has come under siege by an influx of protesters and harrassers, who have responded to a call by anti-choice spokespeople to travel to Nebraska and make Carhart the next Dr. Tiller. By saying this I don't mean to imply a gruesome comparison -- I admit that none of the "big names" in the anti-abortion have explicitly called for violence against Carhart -- but they have asked their supporters to refocus efforts onto Carhart because he has been public about his plans to open a practice in Kansas after George Tiller's murder. And yes, that does make me worry.

So if you are or can be in Bellevue, please go out to the Abortion and Contraception Clinic of Nebraska and join Kansas NOW's effort to support the clinic's patients and staff -- be an escort, a counter-protester, or whatever else they may need you to be in this moment. (If you're curious, the Kansas chapter of NOW is organizing this because Dr. Carhart and Dr. Tiller used to work together, and Operation Rescue has explicitly talked about "moving the fight to Nebraska" or some such nonsense. OR targeted Dr. Tiller for many years and became a local foe of Kansan pro-choicers when they moved their HQ to Kansas for that purpose.)

Monday, August 17, 2009

Prayer For My Sisters




























































Friday, August 14, 2009

Magical Realism

Last chart. Saturday mayhem following a full moon eclipsed. Along with method of termination, sedation option, payment status, it has been noted in red: needs to speak with Daughter of Wands.

This stunning, personable, ambivalent woman asks to involve her brooding, chill man-involved (MI).

First, she mentions the wait—the two hours she has spent checking-in, completing five pages of pre-counseling paperwork, lab tests, her ultrasound and exam. I explain the provider shortage complex and it suffices because this is what she really wants to talk about:

She is a mother of three—two biological, all his. He is seemingly firm but silent. She glows. She has become soft. She loves children. She bunches up like an adoring mother ogling one hundred babies. She’s going to school. She’ll start her career. She’ll probably want more fascinating children.

Religion isn’t her burden. She doesn’t say she never thought it would happen to her, doesn’t say she’s not like all the rest. They collectively gasp when I affirm the immensity of family planning throughout the life cycle. Menstruation to menopause. I have counseled an eleven year old. I have counseled a fifty-two year old.

She isn’t sure how she’ll go on after this. He says nothing. As she unravels close to me, she rolls her eyes to the right. To him. He is seated twelve inches behind. He cannot see her indications. I am certain he knows why he is there and why she is struggling.

I have asked her 25 questions, answered 56 and affirmed her ideals and future aspirations over three dozen times. I both enjoy her and lament for her. She is warm and passionate. Terse. Nervous. Wanting to love everything. I have addressed her misperceptions. Challenged her viewpoints. Circled her reasons.

I am not the dangling modifier in the room.

He is withholding. Stewing . There. She is choosing alone because he doesn’t want to either.

I want to wave my wand.

I ask him his reasons for NOT wanting an abortion. He is quiet, thoughtful, stern. Short on selfless support, he says, I don’t believe in them.

Oh, well, I say, I assure you they do exist.

Antiabortion Extremists

For Friday's media day, I thought I'd share a piece that recently aired on the Rachel Maddow Show. She discusses one of my least favorite parts of being an abortioneer: antichoice extremists.

I'm really glad Maddow did a piece on these terrorists and how they impact the daily lives of abortioneers -- it does not get enough media attention. Dr. Carhart has ALREADY had his federal marshal protection removed, barely two months after Tiller's murder! Not to mention all the "minor" day-to-day activities providers have to go through. BLERG.

Thursday, August 13, 2009


Been thinking a lot recently about patients' appointment-making habits. They come in all different shapes and sizes here:

1. The patient who calls bright and early with a freshly-sharpened pencil in her hand and an extra behind her ear, with her Day Runner open to the page that represents the day she'd never take lightly. Inside the lines are neatly printed numbers and bullet points, names and contact information, addresses, directions, and price ranges to encompass any possible abortion procedure.

2. The patient who can't quite remember the name of the receptionist she talked to, but it was something like Stacey (Tracey?). She can't remember the clinic name off the top of her head, but has the number circled in the phone book and could access it in a few seconds ("Janie, pass me the yellow pages!"). She may have to reschedule the first appointment she made, but will, rest assured, make the one next Wednesday.

3. The patient might have called three weeks ago. Might have been wrote down pricing information on a Taco Bell napkin while riding shotgun and balancing the cell phone on her shoulder. Said napkin was then used to blot garish lipstick, or so blow a baby's nose, or inadvertently tossed into the bag full of discarded burrito wrappers and cinnamon twist crumbles. An appointment is never actually set.

Having spoken to hundreds of women over the course of my abortion career, I can safely guess by having a quick conversation with them which ones will be OK and which will need some help. I try to be extra careful with those ones. I also try to pinpoint the determinants of patient organization: what is it, demographically, psychosocially, that makes a patient more likely to put all the necessary information in a safe place and stick to a plan to make the appointment happen? Does this have to do with the patient's actually willingness to go through with the abortion? Her sense of self-efficacy for actually achieving an abortion? Or is it a general lack of organizational talent and communication skills? Anything else, or a combination of the above?


Wednesday, August 12, 2009

I've recently read the poem, "The Abortion" by Anne Sexton for the first time. Strange that I am someone who does this work and happens to love poetry, has not come across this poem before.

The beauty of poetry is that it can be so incredibly personal for the reader. This poem, I feel, could probably be interpreted different ways. Is she sad? Is she angry? Is she being sarcastic? Is she being factual? Is it just about the abortion, or is it about lots of things (her story, her life, her relationship) all at once? A fabric of life, woven with complexity? I suspect it is. All of it. As it - abortion - usually is about "all" of it. Our life in its entirety.

So, what do you Abortioneers think this poem means? Can mean?


Anne Sexton

Somebody who should have been born
is gone

Just as the earth puckered its mouth,
each bud puffing out from its knot,
I changed my shoes, and then drove south.

Up past the Blue Mountains, where
Pennsylvania humps on endlessly,
wearing, like a crayoned cat, its green hair,

its roads sunken in like a gray washboard;
where, in truth, the ground cracks evilly,
a dark socket from which the coal has poured,

Somebody who should have been born
is gone

the grass as bristly and stout as chives,
and me wondering when the ground would break,
and me wondering how anything fragile survives;

up in Pennsylvania, I met a little man,
not Rumpelstiltskin, at all, at all . . .
he took the fullness that love began.

Returning north, even the sky grew thin
like a high window looking nowhere.
The road was as flat as a sheet of tin.

Somebody who should have been born
is gone

Yes, woman, such logic will lead
to loss without death. Or say what you meant,
you coward . . . this baby that I bleed.

*Photo: Anne Sexton's scrapbook.

Monday, August 10, 2009

The Secret

A group of women sat around a quietly gurgling fountain on a dry summer day, waiting for the door to the church conference room to be unlocked. These women were all devoutly devoted to their church and its wellbeing and often spent their free time discussing ways to improve it over coffee and baked goods. Their ages ranged from early 40s to late 60s, and although they found common ground in their work for the church, some differences simmered just beneath the surface.

As they waited for a member of the maintenance staff to unlock the conference room doors, chatter topics went from children, to weekend activities, to politics. The women found they agreed on most issues surrounding the political discussion, that is until one older woman brought up the topic of abortion.

“How could anyone choose to have an abortion?” she stated. “I just don’t understand it and never will.”

Mrs. Jones absorbed these words her friend spoke and let them rest on the inner depths of her soul. She had an abortion over two decades ago. A difficult decision which had remained a secret, a secret she shared with few. But for the first time on that summer day, she felt different about her experience. Like so many women before her and after her, she chose to have an abortion for a reason that was personal and challenging. No one had the right to tell her how she should feel and what she should have done, she thought. And then it happened, those four powerful words emerged from her lips: “I had an abortion.”

The older woman looked up at her, surprised and speechless. Mrs. Jones proceeded to share with her the details of her own experience; how the pregnancy was unplanned but wanted, how the doctor’s told her because of her use of Coumadin, her baby would most likely be born with severe anomalies, how abortion was an open option for her to pursue. She described the difficult decision, the pain, the relief, the heartache, and the joy when she had a healthy baby girl just over one year later.

By the end of the story, the elderly woman was in tears. She had never known a woman who had an abortion, although I am sure they were all around her just like Mrs. Jones.

After the coffee was drunk, the baked goods consumed, and the meeting completed, Mrs. Jones returned home. She reflected on her discussion with the elderly woman and felt only peace with her decision to disclose her own abortion. She knew abortion was a very personal decision and the ability to choose was important, necessary, and powerful.

Later that evening, she received an email from her elderly friend that simply said “Thank you so much for sharing your experience with me this afternoon. I have reconsidered my stance on this very important issue.”

Mrs. Jones was overwhelmed by the immense impact she had on just one person. As she drank her glass of wine that evening she realized her story was for sharing, for empowering, and for normalizing such a personal and profound experience. Her secret was sacred, but no longer for keeping.

This was based on a true story.

Wednesday, August 5, 2009

The Walk to Work

Jesus loves you!
Doesn't carry well
through the misty
Saturday morning air
that smells like
leaves and otherwise
like hope.
You have a beautiful life!
You should be GIVING life!
I am.
I give it to women 
daily.  I help
to give their lives back. 
I do have
a beautiful life.
Your mother didn't abort you!
But she wanted me and
she had a choice.
As a child, a child of God, 
you didn't dream of growing up to do this!
I never dreamed
that I would be
so lucky as to do this work.

He prays 
silent prayers at my back
and I pray back
to my pro-choice God
to deflect 
his hatred.
Push my cheap
faux tortoise shell
abortioneer sunglasses
up on my nose,
from the camera
pointed at my profile.
As long as
he doesn't capture
Give me the burden 
of the hate
as long as
I don't collapse.

Tuesday, August 4, 2009

The purse strings are so close, yet so far: Abortion coverage and DC sovereignty

Yellow = no lifesaving needle-exchange programs. White = go for it!

I used to live and work in Washington, DC, a place where you'd think people are powerful and have the ability to make important decisions. But the city of the District of Columbia is not the same as what people call "Washington" when they are thinking of Congress and the White House and the Supreme Court and, you know, the halls of power.

Not everyone knows that the residents of DC do not have a single vote in Congress. (They have one non-voting delegate in the House of Representatives, Eleanor Holmes Norton.) Also, not everyone knows that until 1973, DC did not even have an elected mayor or city council, but was directly administered by federally-appointed commissioners -- and Congress can take away that privilege at any time. Congress also has the power to decide how the District can and cannot spend its own income, i.e. money raised from city taxes. Of course, if DC were a state, this would all be very unconstitutional, but the Constitution dictates that the District of Columbia be governed in this way.

It might seem very arcane or very trivial -- why would senators and House reps from other parts of the country care to get involved in someone else's city budget issues, and if they did would their decisions really be so bad for residents anyway? Unfortunately, the residents of DC do indeed feel the repercussions of this lack of sovereignty, repercussions which often hit the poorest among us the hardest.

Every year, Congress writes and passes a new federal budget. And every year, members of Congress use DC as a place to make cheap political statements about where they "stand" on "issues." A timely example: since the late 1990s, DC was prohibited from using its own money to pay for needle exchange programs to combat the spread of HIV, while several of the "real" states were supporting such programs using not just their own funds but federally-allocated funds as well! Basically, conservatives scored political points with their constituents back home using citizens who are politically impotent and thus expendable; meanwhile, the Washington Post reports that "At least 3 percent of District residents have HIV or AIDS, a total that far surpasses the 1 percent threshold that constitutes a 'generalized and severe' epidemic".

In 2007, Congress finally reversed that ban, but now the House is considering a bill with an amendment that restricts where DC can locate needle exchange sites: they cannot be "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, university, public swimming pool, park, playground, video arcade or youth center." The image you see at the top of this post is a map [pdf] 0f what those restrictions would look like: in the white parts it's OK to provide clean needles in exchange for used ones, but not in the yellow parts. (And, um, the blue is water.) How many people can that possibly reach?

OK, so what does this have to do with abortioneering?? As you might guess by now, abortion is another favorite controversy to take out on the residents of DC. Until 1988, the District was using some of its own funds to include abortion coverage as a Medicaid benefit. Since that year (with a brief break 1994-96), Congress has prohibited the District from spending any of its own revenue to pay for abortions, despite the fact that its residents and city council clearly appear to favor it. Again, conservatives scored political points with their constituents back home using citizens who are politically impotent and thus expendable. This year it appears that the Democratic majority in Congress may finally reverse that position and allow DC the choice to resume covering some abortions, and the city probably will choose to do so.

When I worked in DC, most of my clients were on Medicaid, and the vast majority of those were not from jurisdictions that allocated funds for abortion care. They were on Medicaid because their government acknowledged they were too poor to afford health care, but they were going to have to afford an abortion all on their own. Yet abortion care is a part of health care, and we don't suddenly get richer when we have an unwanted pregnancy! It broke and still breaks my heart to know that so many of my neighbors are getting screwed over by people who go to work just a couple blocks or a couple miles away from them.

Living in the nation's capital, you constantly pass monuments, walk right by the White House, and see other stuff that should make you feel like huge decisions are being made in your backyard; yet all that proximity never gets you any closer to meeting those decisionmakers or participating in those decisions. In fact, aside from the euphoria of Election Day and Inauguration, I doubt any of my clients ever thought about the federal government. So maybe it's no wonder that Congresspersons are making terrible decisions about the drug addicts, pregnant women, gay couples and cancer patients of DC as though the latter lived in some tiny shit village thousands of miles away that no one expected Congresspersons to care about in the first place: they don't feel any closer to the residents of their host city than their hosts do to them.

Yes, Congress legally can do all these things. But it still feels like your landlord showed up at your door, set up camp in your nicest bedroom, then went around to all the other rooms and shat on the carpets. Don't forget rent is due on the first.

EDIT: Also, don't you love it when the House minority leader posts a "Statement of Republican Policy" on the party's more-or-less official site for Congressional workings (hosted at a .gov address) and it's got typos and bad logic and unflattering cut-n-paste aesthetics and everything?!