Dr. George Tiller, 1941 - 2009

Dr. Tiller was one of the best abortion providers in the country. The world has lost an amazing doctor. He was a deeply compassionate and caring person who helped women who had nobody else to turn to.

He is a hero and he will be missed every single day.

UPDATE: Megan Evans at RHRealityCheck, in one of those too-true posts, honors Dr. Tiller and also writes:

If you are in the DC area, there will be a vigil to honor the life of Dr.George Tiller from 6:30pm at the White House (LaFayettePark side) on Monday, June 1st. We will honor Dr Tiller and all that he has done providing safe, legal abortion for thousands of women. Bring a candle with you and any words you would like to share.

your regularly-scheduled blogger is on emotional hiatus

Dr. George Tiller shot and killed this morning.

it's times like this when i get really inarticulate and all i can think of to say is FUCK YOU, ASSHOLES.

The documentarian is an abortioneer

Every rare once-in-a-while an abortioneer comes along with the sheer and immaculate ability to fashion a show that is both heart-wrenching and humorous, haunting and inspiring, meaningful and immediate. Angie Young is a hot hero and we are not one bit surprised her film is a 2009 Rosebud Film Festival Nominee, showcased Saturday, June 27, 2009 at the Rosslyn Spectrum Theater in Arlington, VA.

She says what we are trying to say--with background music and mad citations. Take a look. Be intrigued. Find inspiration and commonality and at least one more enlightening perspective in this documentary worth owning, sharing and giving to everyone you ever found sitting on a fence or dreamin' bout the olden days or interested in social trends, humanity, accessible health care, evolution, hope, etc, etc, etc...

Perspective

It's not uncommon for me to counsel women who are on the cusp of the gestational limits for abortions in my state.  That means they can tell me about their "babies'" kicks and their predictions about the "babies'" sex based on his or her behavior thus far.  I put "baby" in quotes because I speak the abortioneers' language of fetuses and craniums rather than babies with heads.  I also have friends with infants, and as I followed their pregnancies, I found myself referring to the 24 week baby and pointing at the tiny, very human fingers in the ultrasound.  Friends of friends even give birth to babies at 25 weeks, and they survive.  In my state, women can also have abortions at 25 weeks.  After counseling women who elect later-term abortions, I once tried to talk myself into being disturbed.  I tried putting myself in their shoes and wondered whether I could talk myself out of having a second trimester abortion.  

I've never had any desire to be pregnant or have kids.  I can recall being 15 years old, as far from sexually active as could be, and mentioning that I knew I would have an abortion if I got pregnant.  I have co-workers who would genuinely struggle with what to do if they got pregnant.  Some of them draw the line (for themselves) at the 13 week (second trimester) mark.  And they are all amazing, hardcore pro-choice women.  But as I considered my own hypothetical 25 week abortion, all I could think of was the desperation I would feel to get my own body back.  Call me selfish or call me self-aware, but the only one who really matters in that case is me, not my fetus.  I couldn't manage to be disturbed a bit because I know the terror and impossibility of an unwanted pregnancy.  

And then, I'm back in the counseling room, talking with a woman who is struggling with her late-term abortion, or even a woman who is struggling with her early abortion.  It's easy for me to talk with the woman who says, "No way can I be pregnant right now.  This was not a hard decision."  But it's another thing for me to stretch my mind to talk with the woman who just isn't sure.  It's not ambivalence, but it's sadness.  I consider myself dangerously empathic, but sometimes the biggest challenge of my job is getting to that place with the patient.  It takes self-training and on-the-job experience to learn that not everyone wants an abortion, but she might need one.  And to some women, it's a baby and it's a fetus.  But in the end, those are the counseling sessions that matter the most and teach me the best, and I can only thank every woman I see for risking opening up to me and opening my mind to the world outside of myself. 

To Our Googlers, Wherever You Are

why it's ok to have an abortion
tell me it's ok to have an abortion
how do you live after an abortion
how do you live with yourself after an abortion
how to live with yourself after an abortion
happy with abortion choice
happy abortion

These are some of the search terms that have led the Google-using public to our humble blog. Whoever you are, I will tell you: it's ok to have an abortion. I also want to tell you that you're not alone. In the US, 35% of women have an abortion by the age of 45 -- that's one in three women. Odds are, you know several women who have sought abortion care. And here are some strategies to, as you put it, live with yourself after an abortion:

• Talk to someone about the abortion, and about how you feel about it. It could be a friend or family member who you know will be emotionally supportive, or it could be a counselor or therapist that you see on a regular basis, or it could be a total stranger at Exhale, an after-abortion counselling hotline.
• Spend time with people who are good for you, even if you choose not to share your abortion experience with them. One of the biggest factors in a woman's wellbeing after an abortion is the acceptance and love of people around her -- not specifically about the abortion, but in general.
• Cope with the problems in your life. The other big factor in a woman's wellbeing after an abortion: her wellbeing before the abortion. If you were in a tough situation before your abortion, try to reach out to people or organizations that can help you. Other than Exhale, the referrals I give most often in my work are the Rape, Abuse & Incest National Network's online hotline or a local rape crisis center, Medicaid/Health Department contact info, and the National Domestic Violence Hotline. Additional useful links: suicide help hotlines, coping with job loss, substance abuse help.
• Read about other women's experiences with abortion. There are only a handful of whole blogs out there by women going through an abortion -- perhaps because once it's over, there's naturally less to write about. This one is about the first-trimester medication procedure, this one is about the first-trimester surgical procedure, and this one is about the second-trimester surgical procedure. There's also this blog post, and the great comments, contributed by readers of Feministing, and this one at RHRealityCheck. You can also read other women's stories or share your own at Project Voice, I'm Not Sorry, or Women On Waves's I Had An Abortion. There is also a documentary called "I Had An Abortion" (not related to Women On Waves).
  

And if you are reading this and not worried about how you will live with yourself after an abortion -- what can you do for the women who are, who may have found our blog in a time of crisis, and for all the women who will have abortions soon and forever? Here are a couple of ideas, one for right now and one for every day:

• Donate to Exhale so they can expand their resources for women seeking to share after an abortion. They are trying to do some unprecedented work that would be a real leap forward in the existence of a bit of community for women who want to talk to one another instead of write and read blog posts or call a counselor.
• Combat the stigma against abortion. Another major cause of feeling like shit after an abortion: being told you should feel like shit about your abortion. Watch your words when speaking about reproductive choices -- are you judging harshly or being callous or assuming too much? -- because you never know what impact they might have on a pregnant woman or her partner or parent or friend who happens to be in your company.

And to whoever got here by Googling "fist in uteras" [sic]: WTF?

Controlling Our Destiny

Women need to be able to control our destiny. When we cannot control our own reproductive abilities we lose the ability to control our lives. Our dreams are turned into someone else’s vision. Is it even worth living if you cannot control your destiny?

Most women in the world accept that bearing children is a part, or maybe the end, of their destiny. This is not optional, they will get pregnant and have babies. For lots of women they will get married. They will spend their life caring for others. Maybe they will have the ability to pursue work outside of the home or education. Maybe they will not have a choice about working nonstop because they have to feed their children. Most women accept that they will not control their destiny, it will happen to them and they will cope with in the best way they know how.

Suicide has been on my mind. At least 3 of my patients recently threatened to or eluded to taking their own life because of their inability to control their own destiny. Many of them make it clear the thought has crossed her mind in one way or another. I can give them a number to a suicide hotline but I’m not equipped emotionally or professionally to counsel them through these kind of thoughts. Many times a woman has suggested or even insisted she will just do the abortion herself, most often because of money. My response is, “ma’am, that is very dangerous and you would be risking your life." Oftentimes a woman’s response might be something like “well, that sounds like the next best option, there is no point in living any more.”

One person could not get enough money for her first trimester procedure and she spoke to me while at work with factory machines banging in the background. She continuously called and when it became real that there just wasn’t anything more I could do for her financially, she yelled “I guess I’ll just jump off a bridge” and hung up the phone on me. I tried to reach her but never could. She didn’t jump off a bridge but maybe another child at this point feels like death.

Safe abortion is a choice, but beyond that it is a necessity. Women must be able to control our destinies. When women do not have the ability to seek safe abortions, they will often find a way to do it anyway. They will risk their lives to control their destiny. At the very least their bodies and souls will be scarred, and at the worst their children will be left motherless.

World War, Never-Enough

The war on Abortion is not The War. There are not two armed sides rumbling in another country where we send our people in camouflage and tanks. Therefore, we don’t get a Memorial Day. We get a Roe day—an observation of a single Supreme Court decision that allows Abortioneers and pregnant women to proceed with great caution while riddled with pure sensibility and an overall desire to eradicate danger.

Lest we remind ourselves why abortion is a vital occurrence in every society 'til Kingdom come:

The reasons women give for having an abortion underscore their understanding of the responsibilities of parenthood and family life. Three-fourths of women cite concern for or responsibility to other individuals; three-fourths say they cannot afford a child; three-fourths say that having a baby would interfere with work, school or the ability to care for dependents; and half say they do not want to be a single parent or are having problems with their husband or partner. (Thank you, Guttmacher Institute for getting real, Facts on Induced Abortion in the United States)

Lest we forget the compelling casualties in this zealous, self-righteous, clinically-cookoo, schoolyard bullying that drives our otherwise hot president to ask us to find common ground as if we had fashioned our desire to provide sound health care on a battle field with intent to fire our canons and have sword fights WHILE ALSO trying to shepherd families through the whack-ass abortion process in the United States, care of the Anti-abortion, pro-war, sweet-baby-Jesus-fetishizing movement…

The women who die when they can’t access a clean, safe abortion with a skilled professional.

In remembering that each year about 67,000 women die worldwide due to unsafe abortion procedures, almost always occurring in countries where abortion is illegal,—therefore, leaving about 220,000 children motherless—the Abortioneers would like to honor the mothers who give their lives every year to preserve the dignity of life. (Facts on Induced Abortion Worldwide, the Guttmacher Institute)

Of course, Abortioneers never forget that about 2,700 women died in the United States in 1930 due to clandestine abortion.

Common ground? How about all the anti-abortion folk move to Tanzania?

Where Life’s Start is a Deadly Risk from the NY Times

Note to reader: Guttmacher conducts sound research and is therefore single-source-worthy for the purpose of this blog

The Dream Keeper

It is an incredibly strange thing to attend the annual conference for your former employer—an otherwise hostile work environment, trickling from the top to the bottom in strict linear detachment and communication via barking—and learn that the pain and dysfunction that seem to be crippling beloved abortion mavens, bohemian warrior doctors, women who abort, society at large, above all else—you, some of the ones you love most—that creeping feeling inside, that perpetual illness is *secondary* trauma seeping in.

You are choosing to work in a tornado because general consensus refuses to see how you see yourself hoeing in a garden.

So what: public opinion says support for abortion is on the decline in this country. I have never met a patient or man involved or mother, father, sister, brother, grandma, grandpa, aunt, cousin, friend, daughter, son, spiritual counselor or protestor who couldn’t get to a place where they accepted the humanity in their own abortion experience.

We needed an opinion poll about what people who submit to opinion polls think about abortion to prove that people who submit to opinion polls like abortion less today than yesterday or ever? Really? How much did that cost?

Can we conduct the next poll standing outside the abortion clinic recovery room? Sooner we can get there, sooner we can see your trauma and raise you a kite and a kaleidoscope, an open field for breathing deeply and rolling in grass and things.

The Dream Keeper, by Langston Hughes

Commitment

The city's health department placed an ad on the bus. The Healthy Mothers program, a public health cause that I whole-heartedly support, advocates nutrition and physical safety during pregnancy to ensure the health of both mother and child. This poster featured several happy and healthy mothers who shouted slogans at me. "Take your prenatal vitamins!" "Get an ultrasound every month!" "Commit to 40 weeks!"

Commit?

Now, let alone the existential contradiction that having an abortion would somehow yield an unhealthy child, the promotion of pregnancy as a commitment is a little hard to swallow. Commit to 40 weeks? This just comes so naturally from this beaming mother's mouth, as though there were something intrinsically healthful about having babies. We all know that abortions are safer than childbirth, and we all know that pregnancy wreaks havoc on a woman's body (fewer know that sociologists actually consider pregnancy a state of physical and psychological crisis for the woman; true story!). But the implication here is that women who have abortions can't commit: they're quitters. The mayor of my great city is telling women who don't carry to term that they're both unhealthy and suffering from commitment anxiety. Say what?!?!

Since when did pregnancy become a physical conquest and not a joyous experience for a woman? It's like a workout or diet program. You have to persevere! You have to be strong! You have to commit! So I guess all these pregnant women, irrespective of social and economic factors, just have to keep on truckin', because pregnancy is a commitment and what doesn't kill you just makes you stronger (not to mention healthier!). I guess they just commit to those 40 weeks and one fine day they push out this little life, and whatever happens beyond this point is irrelevant because she made it to the finish line. She followed through with her "commitment", and isn't she so proud, so fulfilled? She carried to term!

Now what?

Ambivalence

Ambivalence is hard. How many times have we all counseled someone who was ambivalent about her abortion decision? A lot of counselors I know get nervous when a woman shows up on the day of her abortion, when they're counseling several other people the same day, only to talk to someone who just-isn't-sure. The client can see the pros and cons of both having the abortion/not having the abortion. These aren't your average counseling sessions. This isn't to say each counseling session isn't unique; however, when you counsel several women a day, you do develop a 'spiel' which you become comfortable with, say, when describing the abortion procedure. Ambivalence, though, is a spiel-zero zone. They're just not going to work.

I'm generally uncomfortable with ambivalence in my own life, so I guess it makes sense that when I'm counseling someone unsure about her decision on the day of her abortion causes me to slow down. Pause. But recently, I've grown to have more understanding and compassion for those who are ambivalent. I've been ambivalent about quite a lot, just not sure what to do, waiting for my circumstances to provide an answer for me, rather than me providing the answer for me.

Maybe ambivalence keeps us safe for a bit. We're fluid and can easily move between decisions. We're in the middle place. On the fence. When a partner smiles lovingly and gives our child a big hug, we stop for a moment and think, "Maybe I can stick with this relationship a bit longer. Maybe he'll be a good dad after all." The next day, when our partner gives us the cold shoulder, says cruel things, dismisses us, we quickly change and think, "I don't know about this. Maybe abortion really is the best decision. Look at him. If he doesn't love me, how can he possibly love a new baby?" Our views shift with the wind, with our ever-changing circumstances, hoping to find an answer - any definitive answer - to our question, "What the hell am I supposed to do?" You just want someone to give you an answer. Tell you what the best thing is to do. Especially when you're just plain 'ol tired.

Tired of everything. Tired of trying to scrape every penny together to pay the bills. Tired of the kids being sick, of getting into trouble. Tired of trying to keep it all together. Tired of calling the clinic and getting directions/getting childcare/rescheduling appointment because "he" got his act together just long enough to make you think it will all be okay. The problem is, none of us know if it's going to be okay and we can't predict the outcome of our lives. All we can do is show up, be present, speak our truth, and let go of the outcome. (Apparently these are called the four truths. I'm sure there's more than four, though.)

Today something will shift in me. When a woman tells me her story, explains to me why she's having her abortion (though I don't need to know why and I don't need an explanation because I trust she knows what's best for her), I will understand, with true empathy, when she says, "I know I'm 16 weeks now. I thought things would be okay. But we split up. And so...well...I know I need to have this abortion now." I will be able to read between those lines. I will get she was waiting. To make sure. Because you need to be sure. As sure as possible, so the blurriness clears just enough so you can just make out something in the distance...and perhaps, just perhaps, it's your future winking at you.

The Abortion Girl

Sometimes, when my friends are introducing me to people, I am described as "the abortion girl." Or, if I meet someone, and then see them again at a bar a few weeks later, they remember me as "that abortion lady." That is the one fact a person can recall about me. Not my name, that we both love Hoegaarden, the fact we both love that episode of It's Always Sunny when Charlie and Dennis sing "Day Man," but that I am the Abortion Girl.

I am the Abortion Girl.

This is further complicated when I meet a new person I don't know at all. The go-to question in this situation is usually of the "What's your major" variety: "So... what do you do?" Talking about work is generally a very safe topic when meeting people, so it always, always, always comes up.

"Well... I uh..." and in my head the following script plays: Is this person liberal? Or, is this person Karl Rove disguised as a moderately attractive 27 year-old man in a t-shirt with the Five Alive logo?

Trying to crack the code based on where they work, or what their friends' political views are doesn't really even matter either, because abortion is a cross-political party issue. A Liberal can be "liberal," but not pro-choice. Republicans are mostly pro-life, but sometimes they are pro-choice. You can't tell. And obviously, the last thing I want to do on Saturday night is start up some huge ethical debate over abortion.

Usually, I just end up saying something pretty vague. "I work with low-income women." Sometimes, I say "I help low-income women get abortions." Interestingly, some of my friends actually pulled me aside and were like, "Hey you gotta tone that down, you know sometime you are gonna really piss someone off and they might hurt you." My initial reaction was "PSSHH If people wanna get in my face I ain't really carin'." But the more I thought about it, the more uncomfortable I became. What if I do unwittingly make some drunk dude totally enraged? I think the chances of that happening are relatively minor, but still. The fact is, I spend A LOT of time in Abortion Land and in my free time I like to take the train out of town, to places like Beer City and Funtimes, USA. Not places like Debate An Issue You Are Not Going To Change My Mind On City, or You Are Now Deeply Offended And Acting Weird Township.

And then, on top of all that, there is dating.

Dating the Abortion Girl. In my experience, it is pretty difficult trying to date generally, so when you throw an uber-controversial issue into the mix, it only complicates matters further. Could I go out on a date with a boy if I don't know his views on abortion? Sure! But what if he is really into the pro-life agenda and I find this out mid-date? That would kinda suck. Could I go out with a guy if he doesn't know what I do for living? I don't really feel comfortable doing that. My work, if you are pro-life, is probably going to really upset you or at least bother you on some level. And if you are pro-life, it is likely going to be a major issue if not a dealbreaker for me.*

Obviously, I consider the annoyance totally worth it, but it is a frustrating aspect of being an Abortioneer. Previously, I hated talking about work because my jobs in the past were really boring and pretty much stupid.** Now, I love talking about my job, but I never really know if it's "safe" to bring it up when it comes up in conversation. :-/

*DISCLAIMER: I would definitely date a pro-life guy that had really logical well thought out beliefs that made sense to me. I don't know if that guy exists, but I don't cross someone off my list based on that alone. Just sayin'.

**I used to edit test booklets for a state's department of ed. It. Was. Terrible.

lest anyone misunderstand: here's to escorts and guards

I was once escorted
Through the doors of a clinic
By a man in a bulletproof vest
And no bombs went off that day
-"hello birmingham", ani difranco



Percentage of Clinics Reporting Increases in Violence by Type Since July 1994 Pensacola Murders




Here's to James Barrett, the volunteer escort in Pensacola, who doesn't even have his own wikipedia page. Here's to John Bayard Britton, the doctor who died with him. Here's to Barnett Slepian, the Buffalo doctor to whom Ani Difranco alludes in that song up there. Here's to Robert Sanderson, the security guard who died checking that Birmingham clinic for bombs, and Emily Lyons, the nurse who suffered disfigurement and disability and still works there 20 years later. Here's to the women at my workplaces who have been the designated mail-openers, trained to look out for suspicious packages and life-insured by the office just in case they miss one.

Here's to the New York Clinic Defense Task Force, Washington Area Clinic Defense Task Force, the South Jersey Clinic Defense Coalition, Clinic Defense Richmond, the Louisville KY escorts and WENCH, whoever is starting this blog here, and all the other groups and individuals who don't have a presence on the web.

You do your best to get women through the columns of harassers that sometimes like to hang out at our clinics for fun. You absorb the blows and the screams so that hopefully, someone trying to get medical care can get on with her appointment. You try to keep dangerous people away from our clients and staff, knowing you are confronting each risk before the rest of us. Like a minesweeper. Thank you for spending your Saturday mornings (and other times) doing this work for the rest of us.

Client AND employee satisfaction

I'm an "old timer" at my clinic. I've been there long enough to have days where I run out to my car after an 8-hour shift and scream and rant on my way home and wonder why I'm doing what I do when it can be so thankless and so frustrating. And I've been there long enough for some of my newer co-workers to ask how and why I do it for as long as I have, and why I don't have plans to leave. And without hesitation, I answer, "The patients."

Of course I'm there for the patients. Without women in dire straits with unwanted pregnancies and the unstable lives that go hand in hand, and without the women who will only remain pleased with their lives as long as children aren't involved, I would just be a receptionist someplace. But it's more than that. It's what the clients give to me and what I can give to them and my constant wonder at how women connect with one another.

It's as simple as the woman at her wellness appointment recently, who called to me, "Hey, lady! Good to see you! I was looking for you," recalling our lighthearted counseling session before her abortion months ago. It's also about the woman who didn't crack a smile during her whole tragic appointment, but woulnd't stop clutching my hand when I saw her out to her car.

I've had a client seek me out at her follow-up appointment to give me a hug and tell me that despite her initial misgivings about her abortion, she's doing better than ever and has a renewed passion for her medical assistant school courses. Another client told me about how her abortion was a turning point instead of a struggle, and then she invited me to her birthday party (I politely declined). When my first interaction with a client was handling her phone call about her insurance coverage (post-abortion), her main concern was that I would have time to take it easy and take care of myself that night, since I was doing "so much" for her. More than one client has told me with a tearful smile that God will bless me for the work I do, which is a far cry from what the protestors want me to believe. One client called me an angel. I've managed to get through to the most hostile clients, who end up revealing the heartbreaking circumstances that made them put their guards up. And then they latch onto me and don't let go. Another counselee embraced her revelation that she was giving herself her life back, and mentioned changing her life plan to be more social-justice oriented. And you know, I've even helped women to equip themselves to continue the pregnancies that they so desire. One of those women told me, "If only people knew that an abortion clinic helped me to keep my baby."

If only people knew how diverse and wonderful women who have abortions are. I almost wrote, "how diverse abortion clients are," but each woman's identity is so much more than that one isolated event. Some are in crisis, some do use abortion as birth control (and that is fine), and some are as matter-of-fact as can be about the quick, safe medical procedure. And I am privileged to be a part of their lives for a day at the clinic, and that's why it isn't just my job, but my career.

Sweet Charity

Fed the homeless today.

I suppose after leaving Abortion Land there are some gaps in my good-deed-doings. So I hopped in a van with some folks from work and passed out soup and sandwiches to men lined up on the street. They knew the route, all the stops, exactly what to expect.

"Two ham and cheese, please."
"Sorry, only one per person. But you can have as many peanut butter as you want."
"But I've been waiting, I'm hungry!"
"Shut up man, we're all hungry."
"How come he got two meat sandwiches?"

They might as well have been asking for abortion funding. The bickering, the dissatisfaction, the occasional smiling face asking for "whatever you guys can give me". Same variety of attitudes as those poor pregnant women with nowhere else to turn but a bleeding abortion fund, but to a lesser degree. It seems that eating one fewer bologna sandwich isn't quite as earth shattering as having a baby. And then they can have as many PB&Js as they want, and save them for later. They can meet the van same time every day at a variety of locations, and know that they'll at least come out with a donut or a cup of chicken noodle soup. It's not much, but it's reliable. And there's always someone willing to ladle out soup for an hour once a week.

But Abortioneers? We are few and far between. Women can't just find us at a regularly scheduled stop. No snacks just waiting there for you, as many as you want but please wait until everybody else gets some first. No abortion van to sit on the corner and wait for to collect your funding (though oddly enough, our sandwich van happened to coincide with a mobile health unit). Abortion is hard to dole out; I would easily rather spend a day feeding mouths than cleansing uteri. It's almost glamourous in comparison. You know that the end result is a full stomach, at least for a while. You know that even after the nuclear holocaust Wonder Bread and Smuckers will survive to feed the masses. And the best part? There are no pro-hunger martyrs to bust your balls for helping another human being. A food van, comrades, is charity bliss.

So here's to the Abortioneers far and wide, who sacrifice themselves, their hearts and heads, to get their hands dirty and bear the brunt of human suffering. It's tough work, and there are tons of us who would rather be anywhere else in the world. But Abortioneers make a difference unlike any other, and I salute you for your courage and grace. Fight the good fight!

Emotionally Spent

Each day I am supposed to be the answer to someone’s problems. Today might be the end of their world if they don’t handle this right now and if I can't help them then it won't happen. Each and every person I talk to wants me to help them solve this problem, they need money and they need to get this abortion, fast. I feel scared and alone, even when there really isn’t any reason to feel that way. For years now my life work have been spent listening to people who are sad, angry, alone, and thankful or some culmination of many feelings.

I become a sponge soaking up other people’s pain and holding in my own. At some point I am saturated and begin dripping the manifestations of so many people’s anger. When someone asks me where I work I reply, “a woman’s health center.” I do not want to risk being chastised by someone, who quite frankly I could not give a rat’s ass about what they think. I don’t want to have to defend abortion, women, or my own choices. I dont want to spend the little bit of energy I have fighting with the world about what I have already decided is right.

Today a patient’s mom called to let me know she needed to reschedule again because of money. I answered the phone with a, “Hello, this is the Women’s Health Center” the caller says, “oh honey you sound horrible, what’s wrong?”

Very rarely does any one ask me how I’m doing or what’s going on with me. Nothing was wrong, I was a little more tired than usual but that’s it. I quickly rescheduled the appointment and talked to her about what they had already tried to come up with money. She has someone who could mail her money but it cost too much to wire it so it would be there a day late and the clinic only performs abortions once a week so her daughter has to wait until she is another week later in her pregnancy.

In Alabama there are no local funds. Really across most of the American South there are not local funds to support women in need in these communities. National organizations like the National Abortion Federation and National Network of Abortion Funds are umbrella organizations that support women financially in places like most of the American south where there are no local funds women can reach to for help in situations like the 16 year old whose mother called me again today. These national funds are helpful but are not able to meet the need especially in place like the south where poor is a concept beyond many American's consciousness.

I took a second to consider her comment. As much as I would like to think its not true, my job affects my mental, spiritual, and emotional health. I felt normal when I answered the phone today but the fatigue was communicated in my tone of voice. My soul is filled to the max. I am completely saturated. I loose the ability to feel compassion for the women I work with. Each person’s story is so similar to the last one. Many are difficult and painful and many are triumphant and empowering. The triumphant stories can be so few and far between, and sometimes they are the hardest.

For some women abortion will be the best thing that ever happened to her. She will escape a molester after years of abuse because of the biology of fertility and the molestation might finally end when she has to have an abortion. Or she will leave a violent lover because this is the last straw and she knows she cannot raise a child with a man who treats her like this. She will learn a valuable lesson about safe sex without contracting a deadly disease. No matter what the reason or outcome I will touch these women's lives and help them maneuver through many obstacles and they will fill me with rage and love. Hopefully I can figure out how to make it the best thing that ever happened to me, rather than a tired, "terrible" voice on the phone rescheduling appointments because no one has any money.

"If you want to pray for me, Tell God to send me some money"

I wonder how many women keep a certain amount of money in their savings as their "emergency abortion fund"? I've had two friends mention that they do this, almost subconsciously, to the tune of $400 because they'd heard somewhere that that's how much it costs. That's not a bad estimate, for a first-trimester procedure, though prices vary wildly after that.

But with most people I know outside the field, the first thing they ask me when they find out what I do is "How much does an abortion cost?" (Most of the time they don't ask "How do you do an abortion?" right off the bat, I guess because they worry that they'll seem clueless. Which they are, but it's not really their fault.)

And of course, this doesn't even touch on the clients I've worked with in the field. Some of them knew how much it cost from a friend who went through this recently; some of them thought they knew how much it cost from a previous experience ten years ago, and are shocked that the figure hasn't stayed constant (abortion fees have risen less than general inflation, but they have still risen); others really had no idea. But no matter the expectation, for I'd guess at least half of them, the idea of several hundred dollars set aside for an abortion -- or for anything, really -- is laughable, or a nice dream maybe.

I wonder how many people reading this (arguably not a representative sample of the general population!) keep an emergency abortion fund? If you're out there, give us your two cents. I posted a poll to go along with this, but feel free to comment too.

Rules and Realities

Maybe you've heard about President Obama's budget plan, which the White House released a few days ago for consideration by Congress. Points of note for people like us:

1) Strips public funding for abstinence-only education. This is probably the one everyone's heard about, and while it's good news for those of us who live in the real world, it's not going to be relevant to this post. I just mention it because we're excited for an end to government-sponsored lying.
2) Does not reverse the Hyde Amendment, a 1977 amendment to the Congressional budget which forbids federal funds from paying for abortions except in cases of rape, incest, or life endangerment to the pregnant woman (and even then, it usually doesn't).
3) Removes the Congressional prohibition (extant 1988-92, and again 94-present) on the District of Columbia using its own local funds to pay for abortions.

A lot of us are rooting for the repeal of the Hyde Amendment, because we see it as a violation of poor women's human rights: the right to health care and the right to reproductive freedom. However, a lot of us are also nervous about what its repeal might mean in practice, at least in the short term that you'd call the "transition period". Currently, women who do not have Medicaid coverage for abortion can turn to local and national funds in hopes of receiving emergency assistance. Will they fall through the cracks if the definitions of "eligibility" and "coverage" fall into limbo? We can only fret.

The problem is that the emergency funds we try to get women in contact with are not publicly funded and are not bottomless. They have to prioritize, and sometimes this means unfortunate blanket decisions like "women who are eligible for Medicaid payment [through funds allocated at the state level] must go to Medicaid, not to us," even if we know that this doesn't work out in practice, or difficult choices like "we have a twelve-year-old client who really needs our money, so this fifteen-year-old will have to cope for seven more months and make alternate arrangements."

In times when the whole economy sucks, fewer people donate money to social causes, and the ones who do usually donate smaller amounts. Of course this means a double-whammy on our clients, who are often poor to begin with and now will have less of a chance of getting help from the organizations they call. So even as I worry about a potential future where abortion access is publicly guaranteed only de jure but not de facto, I know that the present, in which small private funds are the only safety net for unhappily-pregnant women, is not sustainable.

So, yes, you should be following the politics behind Hyde and behind DC sovereignty, because they matter a lot in the broad view. But you should also be donating to your local fund, because they matter in the here and now, and in the in-between, and in the cracks, to the individual women whom our national budgets and their amendments do not even realize exist.

The DC Abortion Fund, a local fund serving the DC/Maryland/Virginia area, helps support (among others) women trapped in the complex Medicaid situation in Maryland. And they have recently written about their worries for the future. I invite every reader to make a one-time donation or perhaps commit to a repeated monthly sum. Rest assured, since DCAF is volunteer-run, almost all of their donations go straight to women in need. Even so, they say that they will have to shut down -- stop funding any procedures -- in a few months if their current trends continue.

But it's not just them, sadly; I heard from another manager who had to shut down in late February, so great was the need in their area and so few were the donations since the Great Economic Meltdown of 2008, and have heard from many more who are setting strict limits on the number of women they assist per week or the amounts of assistance they give to any one person. If you'd like to donate to your own local abortion fund, you can search the National Network of Abortion Funds' map. You can also contact national funds run by groups like Women's Reproductive Rights Assistance Project, the Third Wave Foundation, or the National Abortion Federation.

If you're wondering how you can make a huge difference in someone's life right away, or if your tax return is burning a hole in your pocket, please consider following these links and donating ASAP!

If they're cattle, am I an abortion farmer?

When I counsel women before their abortions, I do it with a sense of humor. It’s my nature to be a little bit silly, but when a client told me that my co-workers and I were the ones who let her know, through our demeanors and our passion, that her abortion did not HAVE to be a sad, traumatic, or morose experience, I knew that it wasn’t a bad thing to laugh about the things that we could. So when I end the counseling session, I tell the woman, “Next, the nurse will call you back to pre-op, where you’ll put a gown on and she’ll start your IV, and then you’ll wait in a different waiting room than before. And I’m not going to lie—sitting in a room full of other women while wearing a gown, with a needle in your arm, is the weirdest part.” And I usually get a laugh out of it.

The reason I’m hyper-aware of that atmosphere, though, is because that’s the subject of “acceptable” criticism in the pro-choice circles. Almost anyone who is “brazen” enough to talk about her abortion experience will allude to a cattle call or an assembly line or something equally dehumanizing, about when she had to wait, scared, and alone. Scared and alone, I get. Dehumanizing, I don’t.

Ann at Feministing recently posted about Neko Case’s abortion commentary, and as a New Pornographers fan and as an abortion fan, I loved that she was willing to talk about the A-word. And then I got to the inevitable:

"Years ago, I went to Planned Parenthood in New York -- for another reason -- and I saw these girls waiting there, and it was just awful. It was cold, they were in gowns that didn't really close, and their boyfriends and parents weren't with them, and they were sitting under these bright lights, and the people were mean."

And I hate it so much. The protestor who yells at me as I walk into work is never a part of my life, and his words mean nothing to me. But women like Case are a part of my movement, and their words come as a blow. My coworkers and I aren’t saints, and we have bad days, but I don’t think we’ve ever been mean to a client. And yes, pre-op IS “the weirdest part,” but because abortion is so stigmatized, there is no way we will ever have enough facilities or doctors or allies or FREEDOM to provide enough clinics to give every woman a completely private and individualized experience.

I want these women who are incensed at having to wait in a tiny, bright room in a tiny, faded gown to be incensed at the bigger picture. I want them to talk back to the ignorant friend who says that abortion is killing a child, to stop seeing the Ob/Gyn who gives referrals to a crisis pregnancy center, to vote for candidates endorsed by Planned Parenthood, to donate $5 to the clinic that helped them to safely terminate. Until then, my pre-op humor will suffice because who among us does not laugh so that she doesn’t cry?

Intermission: Seedless and fruitful

I eat tangelos at such peak edibility that I eat three for dinner without missing other foods for even a moment. They unpeel all-in-one. They are the seeded kind—two embedded per whole tangelo. First, I chewed naively before I realized the crunchy intrusion. Then I did it right—rubbed my thumb and forefinger across the skin on either side at the same time, identified the impregnated ones, removed their bean through juicy, inevitable pockets of space.

This is best because the seeds are bitter and distracting and the tangelo is otherwise absolutely delightful.

Privacy

It had just begun to warm up outside, and the antis were in full force. Spring is the season of rebirth, the perfect time of year to advocate for babies (it's a wonder they don't retreat in Autumn amidst the senescence). The escorts were outnumbered and, though they tried not to show it, anxious. I could tell from the way they bolted to the corner to guide a patient through the front door, the way they stood inches from her face, they way they shot verbal darts in her direction. What shocked me the most, though, was that this approach was remarkably similar to that of the antis.

"Ma'am, can I help you?"
"Are you going the clinic?"
"Come with me, please."

What an overwhelming exchange; if the escorts hadn't been clearly distinguished, it would have been nearly impossible to tell who was pro or anti. And the way this poor woman tried so desperately to avoid them, all of them! She walked quickly as though she were being pursued, with her head above eye level to avoid glances from both sides. You could just imagine the gears turning in her head and the pep-talk she was giving herself: Keep moving girl, just 200 feet more, 150, 100.... She answered in the affirmative to the escorts' questions, but the look in her eyes told a different story. I watched as she continued speed-walking towards the clinic entrance, ahead of everybody, thankful to be away from all of them.

She was in no mood for a prayer, nor was she interested in taking refuge behind the orange vests. She wanted to be left alone. How strange! This is something that we in the pro-choice world we don't seem to consider very often. Don't these women want, need our support? Aren't they thankful for having their own personal escorts? Doesn't this compassionate care philosophy just rock?

Could be. But for the silent sufferer, the lone ranger, the proud Mary, should we consider toning it down, backing off? This is just another medical procedure, yes? As mundane as a dental cleaning and as common as a sprained ankle. Where to draw the line? So I pose a question to the masses:

How do we know when we're loving and caring too much?

Unsung Heroes

So, yesterday's blog entry about Leila got me thinking about a film I recently watched called "4 Months, 3 Weeks, and 2 Days." The film takes place around 1987 in Romania, during the last days of Ceausescu's totalitarian regime. Abortion was still illegal, but it was not uncommon; not dislike the situation world-wide whenever abortion is illegal. The story is about two roommates in university. One is pregnant (Gabita) and the other (Otilia) is there to help her in any way possible to ensure her friend's abortion procedure is completed.

Because abortion was illegal, Gabita + Otilia had to jump through many hoops to obtain, basically, a black market abortion. Otilia never once winces or complains about borrowing money to help her friend pay for the abortion or helping to secure a hotel room where it can be performed. It's a dark film, not because it's about abortion, but because of what the two young women endure and struggle with in order to get, with absolute determination, the abortion itself. The film is about determination, spirit, and friendship...and less so about abortion; whatever your views about abortion were prior to watching the film, they'd still be firmly intact afterwards.

I don't mean to write a critique of this brilliant film; what I wanted to say is that I wished our Leila had an Otilia. Otilia never stops being the steadfast friend, never judges Gabita, is there for her, and does the unthinkable for her: she "agrees" even, to have sex with the horrible man that "performs" the illegal abortion so that Gabita can have one since they didn't have enough money to pay. Leila needed an Otilia. We all need an Otilia.

Fine, we don't live in a communist or totalitarian society and abortion isn't illegal. Women aren't going to come across a slimely, disgusting man who extorts sex for an abortion; but women DO have to navigate through borrowing as much money as possible for an abortion. They have to navigate trying to find a facility to go, a place where they won't be judged (like at Leila's hospital) since 87% of counties in the USA lack an abortion provider. Women have to jump through hoops to organize travel, organize the people in their lives, their jobs - nearly everything - to have an abortion. So, when it's hard, when it takes a lot of energy - especially when you don't have much of it because you're puking in the toilet every 20 minutes - it's good to have an Otilia. I wish for all the women we see to have a friend who does everything they can, without judgment, without flinching, to see their girlfriend/sister/niece/granddaughter/daughter is able to obtain her legal abortion.

Alone

This past summer, I was interning at a large, urban community hospital that also provided abortion care. As a future abortion provider, my purpose for this month-long excursion was to see and experience abortion care from the perspective of a provider. I knew, on paper, how the procedure went and I knew how the counseling was supposed to go, but I had never witnessed either. It was a truly incredible experience and one from which many future blog posts will most likely be about. However, I would like to focus this posting on something unrelated to my experience, but more of a disturbing incidence that occurred overnight with one of our patients. It’s an episode that deeply disturbs me and only further drives me to seek equality for women seeking that completely legal procedure known as abortion.

In the state I interned, parental notification laws for minors seeking abortions were on the books. A 15 year old girl, let’s call her Leila, had come in seeking a second trimester procedure one afternoon. She was not in a position to tell her parents of her current unwanted pregnancy and chose the judicial bypass course instead. The judge deemed her competent to make the decision to terminate her pregnancy, and thus she showed up alone to her appointment. Upon ultrasound examination, it was determined that the gestational age of the fetus was 15 weeks and 6 days. In this particular hospital, it was standard practice to insert laminarias in a women’s cervix if she was over 14 weeks gestational age. The woman would then go home, allowing the laminarias to slowly dilate her cervix over night, and then return to the hospital the next day to complete her second trimester abortion. However, there was one problem with this system. Leila couldn’t go home. Her parents would ask questions, wonder why she had to go to the hospital the next day, wonder why she was so uncomfortable, etc. After all Leila had already been through enough to conceal this secret from her parents, and going home clearly wasn’t the best option.

So Leila called a trusted friend, who knew her situation, and asked her to pretend she was spending the night at her house if her parents called looking for her. Leila then called her own parents and told them she would be staying at her friend’s house for the night. Instead Leila would be staying in the hospital overnight…alone.

When the resident tried to find a room for Leila (and there were plenty open), nobody would take her. Nobody. The Obstetric department didn’t want a young girl aborting in their ward and the surgery team refused to have Leila stay on their end of the hospital. After the resident pleaded and negotiated with the Ob department, they finally agreed to take Leila, but it was clear they were not happy about it.

Leila settled in to her room in the Ob ward…alone. Nobody was there to stay with her and nobody came to check in on her. Yes, let me repeat that, the nurses never once came to check in on Leila. When the resident came to see her the next morning, Leila has spontaneously aborted the fetus in the middle of the night and it remained in her vaginal canal until the resident found it there the next morning. Fortunately, Leila was ok medically. Although abortions are extremely safe, they still come with risks (ie. hemorrhage, infection).

I am so enraged with I think of this story. There is no other situation where nurses and physicians would refuse to provide a hospital bed and care for a patient. There would be outrage if hospital staff refused to provide care for a patient recovering from an appendectomy, for a 55 year old woman pregnant with triplets, or maybe for a 85 year old man recovering from a penile implant.

I can’t imagine being Leila-absolutely alone, knowing that the hospital staff does not want you there because of what you are there for, not knowing what is happening to your body and afraid to ask anyone for help. What a horrible and traumatic experience. I hope I never hear of another Leila or personally witness it in whatever hospital I end up doing my training. Although, the skeptic in me thinks that is highly unlikely.

The stigma behind abortion is alive and well. Which is why we segregate it. You get abortions there , not here! Leila had made a choice, a choice she was legally allowed to make, and yet she was punished for it and her health was in danger because of it. It will take a long time to destigmatize abortion, but the time to start is now. No woman should have to go through what Leila went through…and this was in the Northeast! Imagine what it could have been like somewhere else.