Guest post: Caring for the Ones Who Never Call

I'm incredibly pleased to introduce a guest writer today. Amy Littlefield is a former abortion counselor and founder of The Provider Project: Stories From the Abortion-Providing Community, an excellent and groundbreaking endeavor that really strikes a chord with our own blog's founding mission.

Stay tuned to the Provider Project, where Amy's piece is cross-posted, and you might see an Abortioneers post there soon!

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Amy Littlefield

Caring for the Ones Who Never Call

It can be a scary prospect to call up an abortion clinic and make an appointment for what has become one of our society's most stigmatized -- and yet one of its most common -- medical procedures.

Which is probably why some patients don't immediately admit that's why they're calling.

As a former phone counselor at a clinic, I used to hear a lot of: "Um...I wanted to know how much it costs?" and "Hi...I'm looking for some information about...abortion?"

(This last one was spoken as a question, with the word "abortion" issued in a whisper, like a big, bad, ugly secret.)

I sometimes tried to use the word as much as possible when I answered those tentative calls.

"I would be happy to answer any questions you have about ABORTION! What type of ABORTION do you think you might be interested in having?"

Often, these patients weren’t simply calling for information; they knew they wanted an abortion, but they were scared and confused about what the process might entail.

I sometimes felt like women called just to test us out. Maybe they had always believed abortion was murder and they wanted to know whether we would tell them what they were doing was wrong or try to make them feel guilty. Maybe they were wondering whether the women who worked in the Big, Bad Baby-Killing Center were human beings like them. Many were scared they wouldn't be able to have children in the future, or that we would do something violent and terrible to remove their unwanted pregnancies.

They were certain we would judge them, just as others in their life had judged them. They were wondering whether they could trust us with their stories.

They ached to justify themselves.

"Look, I have to do this, I have a nine-month-old at home."

"I'm homeless and I already have two kids."

"I've never believed in abortion, but I just can't have a baby right now."

I was sometimes amazed at how relieved women were to tell their stories. To a stranger. Over the phone. And to have that stranger accept their stories Without judgment. Without telling them what was right and what was wrong. So listening became part of the process of making an appointment. When I finished booking the appointment and asked if they had any other questions, I could sometimes hear the relief in their voices.

Given how terrifying that first step can be for many patients, I often wondered how many women wanted to call, but never did.

The abortion rate has been declining among almost all groups of women across the country (although a recent study [pdf] showed that the global abortion rate has stalled after a period of decline). Many in the abortion-providing community believe this decline is a result of rising stigma, not of improved access to birth control or sex education (since, by and large, those things are not improving). Nor is it happening because women's economic situations have magically improved, since the abortion rate is still rising among poor women (which proves, by the way, that you can't advocate for reproductive justice without combating capitalist exploitation of the poor).

Brigit Ordway, a veteran counselor whom I interviewed as part of an audio project compiling voices from the abortion-providing community told me she thinks women face more stigma now than they did back in the decade or so after it was legalized.

She said:

"That's the biggest difference now -- women aren't telling each other about this. We all did and we got support, for the most part. Now, probably most women would get support from their friends and family, but they’re assuming that they won't. They're assuming that everybody is not pro-choice and that they're going to be judged and maybe even worse, you know, maybe somebody's going to come throw something at them. So women are silent about it now. They don't get the support of each other or society, because they don't talk about it, I think. It's a huge difference. It's all now secret and shameful for people."

So abortion counseling, for me, whether it was done on the phone or in person, became largely about trying to lift the burden of guilt that women thought they were obligated to feel for having an abortion. It was about helping them realize that they were still good, still loving, still worthy of respect. They drove past protesters and graphic posters of chopped-up babies to get into the clinic, but once they were inside, they were treated with respect.

Every so often we would get a call from a woman who wanted to come to the clinic, but couldn't bring herself to enter the doors after she saw the protesters' signs. Those women reminded me how limited my understanding of abortion is. I saw women who were beating themselves up emotionally for having an abortion they felt was necessary. But I never saw the women who were too scared to come in, too scared to even call.

One abortion provider whom I interviewed has found a way to help those women.

Dr. Deborah Oyer, who owns a clinic in Seattle, Washington, created a series of videos describing the process of an abortion at her clinic. In a soothing and straightforward voice, she describes the steps a patient goes through, from the moment she enters the door until she leaves. This is the kind of education I tried to do with patients over the phone -- but she has found a way to do it without requiring women to take that scary first step. Instead, wrapped in the Internet's comfy blanket of anonymity, they can learn that abortion is not as scary as they might have imagined.

The videos provide basic education about abortion and birth control that counteract common and harmful myths. They also show women that -- contrary to popular mythology -- the doctor who will be performing their abortion is a friendly and approachable woman, not a crazy, rabid devil-monster with horns (Oyer told me she often sees women relax visibly after she enters the room, since she is so un-monsterlike). She has one video that consists entirely of her introducing herself. That video, uploaded two years ago, has 550 views on YouTube.

The video about surgical abortion has 58,816.

The one on medication abortion has 27,668.

Clearly, people need this information.

I'm grateful to Deborah Oyer for putting her voice and face out there, despite the risks that it could mean for her in a world where abortion providers are targeted with hate speech and harassment, and even sometimes with bullets. I'm grateful that there is accurate information out there about abortion for everyone -- of every gender -- who wonders how it is done. But I’m especially grateful that there is education for the patients whom I never got to talk to -- for the ones who never call.

Listen to Deborah Oyer discussing the videos at The Provider Project, www.theproviderproject.org.

Abortions "To Go": Modernizing Abortion Services

We had a client yesterday who asked if she could get in and out of the clinic within an hour or so. I told her it wasn’t possible since the sedation alone would require her stay about thirty minutes after her abortion just to make sure she was feeling okay…let alone all the paperwork and labwork we’d need to do prior. She still wanted to get in and out within a maximum of two hours. She was busy and had a lot to do.

I think some clinics have entire abortion appointments that last about two hours. At our clinic, it usually takes four. I mean, of course, the abortion only takes a couple minutes, but women are usually waiting around FOREVER. I often think there’s something wrong with how either we schedule people or how we organize the appointment flow since sometimes people are at our clinic for even more than five hours. Patients complain a lot about this and I can’t blame them. It’s not like our waiting room is super comfortable or welcoming (sadly, I find this is true in a lot of clinics).

On one hand, as abortioneers, we want to spread the message that abortion is a simple and common procedure (it is!), but we make women wait ages in either over- or under- heated waiting rooms between labwork, counseling, and their abortion. They fill out millions of pieces of paper that ask for a lot of the same information repeatedly. We definitely are sending mixed messages: if abortion is simple and common, why would you be in the clinic for over three hours?

The abortion-to-go girl is right, in my opinion. If a patient is totally sure of her decision (most are by the time they come in, or else they just don’t show up for their appointment…usually), then we should be able to accommodate them and get them through their appointments quickly. That might mean clinics need to think outside the box a little and be more creative in scheduling and in how they process appointments, but they should do that then. Let women fill out their paperwork online, for example. (Or clinics should move to electronic medical records!) What if patients could make payments online before their appointment? I think clinics are so far behind technology now…imagine if a client could even book her appointment with her iPhone because the clinic has an app for that. I think it could happen.

Anyway, I really think we can all do better at actually providing abortion services in a more quick and efficient manner while holding onto warm and kind staff (who of course will be more kind and warm if patients are happy and not complaining!). What do you guys think?

I hate Santorum.

Here's why:











And here's why I hate pretty much all conservatives:

Raising Abortion Money Creatively

Recession. Tough economic times. We all hear about it. All the time. It’s daunting and scary. Many have lost jobs. Unemployment rate has increased. It impacts clients, too; it’s harder to come up with money for abortions now. I used to hear that patients were able to borrow money more easily from friends and family than they are able to now. More and more, you hear how people’s support networks are being drained. Women have to be more creative with raising funds…like in the photo at the beginning of this post.

I think having a keg party to raise money for an abortion is one of the most brilliant ideas I’ve ever heard and I’m so going to tell all my patients who need money for their procedure about it! The thing is, though it’s funny, the keg abortion fundraiser probably was a real event. There’s a website called Texts From Last Night where you can submit funny (most likely real) text messages. Those that are especially humorous get posted by area code. You can also search under many keywords, like abortion. Love it!

A shortlist of some of the more creative ideas I’ve heard from patients for raising money are:
1) Yard Sale
2) Bake Sale
3) Church collection
4) Student loans
5) Tax returns
6) Borrowing small amounts of money from multiple people (like $25 from four people = $100)
7) Selling rims from a car
8) Selling stuff off Craigslist
9) Braiding hair/hairstyling (utilizing a talent to earn extra money on the side)
10) Cleaning houses

Sadly, we hear about all the tragic things people have to do, too, like sell food stamps, their wedding/engagement ring, their kids’ toys, etc. Hopefully some of these ideas will help your patients come up with creative ways to save money towards their abortion…

Any other suggestions?

Fear Tactics!!!

Fear Tactics, scare tactics, fear-mongering, etc etc etc. More and more we see fear tactics being used in public health to educate, motivate, guide, and shape fill-in-the blank behavior change. Living in New York City I am quite familiar with the Department of Health and Mental Hygiene's constant assault on innocent subway riders with their love of smokers using talking machines, legless diabetics, HIV-infected individuals who also have anal cancer, soda pop that turns into mounds of fat, and the list goes on and on (but read here for a quick overview).

In the abortioneering world, I have seen many fear-based campaigns regarding sex, and specifically on avoiding teen pregnancy and HIV/STIs. How many of you have seen the ad with the crying baby? Or the billboard that tabulates how much a baby costs in their first year alone? Or the genitalia laden with sores? I think just about every high school or college sex ed course shows those squicky STI slides. What about images/videos of the penis swab testing that used to be standard for male STI testing? Any of this sound appealing?

Ok, so then lets say you either ignored those messages or were not scared by them...and you wind up with an unwanted pregnancy. Where do I even begin to list all the scare things we are told about abortion? Breast cancer anyone? Perforated uterus? Lifelong infertility? Depression? Suicide? Our family/friends/lovers/clergy will be disgusted with us? Have you heard these?

So, the million dollar question is, do these fear-based campaigns work? Well, the research is mixed, and it generally depends on the health issue and the duration and saturation of ads. In the field of sexual and reproductive it ultimately does not matter, because until there is universal access to family planning and safe sex, all the scare tactics in the world do not matter. Same goes for abortion. And then there are the large numbers of people who are raped, so once again a fear tactic about an itchy crotch won't change things.

What fear tactics have you heard of or seen (or used yourself to persuade others)???

The Birth Control MANDATE!!! *@!*$

Obama says religious nonprofits will not be mandated to cover birth control in employee benefits. However insurance companies will be required to offer the services free of charge to any employee who requests them.

Call me crazy but I feel like its a good compromise. Personally I don't agree with religious organizations who don't want to include birth control, however I don't feel like they need to be mandated to provide contraception if its against their religion. However it must be available to those who want it or need it.

It seems to me that it makes since that birth control is a standard service that should be covered. The thought that religious groups don't want to include it in insurance plans is asinine to me. I respect the compromise that Obama seems to have come up with though.

I had a relative in town all week...

...and I just have some questions for my fellow abortioneers.

Is this how it usually goes down for you?


Sub-questions:

• Which one of you avoids bringing it up -- you or the relative(s)?
• Which one of you subtly changes the subject?
• Which one of you decides to end the conversation?
• Which one of you lets the other person have the last word, and/or decides to leave it at "agreeing to disagree"?

...Or do you just have an all-out fight?
...Or is everything hunky-dory with all your relatives? (Congratulations!)

These aren't rhetorical questions, I'm just curious about the whole spectrum of experiences (from people I know personally, it's already quite broad). So tell me how it is for you.

Prejudice

I am reading an article today from the Journal of Personality and Social Psychology. I'm not a psychologist, but this article hit pretty close to home: Do you Believe in Atheists? Distrust is Central to Anti-Atheist Prejudice

This only really appealed to me because I generally identify as an atheist, or at least a Humanist if I'm feeling Vonnegutian. Just reading the abstract I learned that other people, particularly steadfast Christians, aren't so much disgusted by me (as they are by homosexuals) as they are distrustful of me. Turns out I'm about as trustworthy as your everyday rapist.

Flattered.

I'm not going into the many, many, many reasons why this is illogical, or how you can believe that a godless life is necessarily an immoral one. I just have a lot of questions about how this affects the lives of Abortioneers. It seems like a lot of the prejudice against non-religious folks stems from the really religious folks, as does the prejudice towards abortion and Abortioneers. Does that mean, then, that:

1. A religious Abortioneer is more trustworthy than an atheist one?
2. Antis will target atheist Abortioneers more than religious ones?
3. It is more "sinful" to abortioneer if you are religious than if you are not?

For example. I mean, my overall impression is that antis suck and won't really give you the benefit of the doubt just because you go to church. (Dr. Tiller much?) And when the majority of anti sentiments are religious ones, it's clear that they think we all have topsy-turvy moral codes. So maybe it doesn't make a difference.

But still, I can't help but feel doubly judged. These people hate my guts because I'm an Abortioneer, but also because I don't share their general philosophies on what happens when you die and what you should be doing with your weekends. And every time I'm handed a rosary or prayed for by an anti, I just feel so angry. I know there is nothing wrong with me, and yet these folks are convinced that there's a major bug in my system.

I have to say, I can't help but feel a little bit "off the hook". I'm spared all the debates about whether or not religion is accepting of abortion because all I can contribute is





And more importantly, to the people I serve, I am trustworthy. My views may certainly clash with theirs, but I'll escort them through the hellfire and brimstone if that's what it takes. And they thanks me for it every time.

Also Effective Immediately: Abortion

Re: Karen Handel Exits Susan G. Komen: The Resignation Letter

I would guess Karen Handel’s about to go tell breast cancer’s secrets downstream where they don’t cry because they’re sociopathic; and live lies; and worship poppas, but their toilets do flush.

In week’s review, it’s endearing to watch people stand for accessible health care. Hundreds of thousands of patients remembered their roots and paid forward. Facebook blew up with hot pink everything. Top news lines questioned the scape-goating of Planned Parenthood health centers*. Mayor Bloomberg wrote a fatty check.

Meanwhile, most Abortioneers just kept working. Their donations made daily, care of their modest paychecks and additional hoops they navigate to stay safe (see also: last week's Staying Afloat ). It’s nice to know we have Planned Parenthood Federation of America to rally the country and collect the support, but victories and non-victories aside, we’re still hoping for the love for abortion.

Bright Light of Hope: On Prop 8 Decision, we love when people are seen as people

*Just in-case you forgot:

The Voice of Choice

Anti-choicers get a lot of attention and often credit for being strong mobilizers for their agenda. They are able to get effectively get their fellow antis to spread the word about a campaign, a candidate, a protest etc. I always find it frustrating, annoying, you name it. Now the pro-choicers have shown that we are just as, if not more effective.

Recently, two high profile issues have come about and forced response and change from major corporations/organizations. First we had the issue with Siri, which was brought to light on this blog by Abortioneer Mr. Banana Grabber. Through social media, the pro-choice movement was able to get out the word, mobilize big-name organizations, and get the attention of national media. We didn't give up and were able to get a response from the CEO of Apple (and hopefully a solution).

Now, we have just had the Susan G. Komen/Planned Parenthood debacle. Thanks to PP for outing the problem, pro-choicers again took to social media, got national media to write news articles and opinion pieces, and even got the attention of 26 US Senators who agreed that a "women's health organization" should care about women's health over politics. Very quickly Komen realized what a grave mistake they made and reversed their decision.

I am proud of my fellow pro-choicers for being strong, vocal, and persistent. Watch out antis. A new generation of pro-choicers are active, and we will fight every day, every campaign for the rights of women to choose for themselves what type of contraception is right for them, and whether abortion is right for them. The anti-choice lobby may have always been a strong one, but the pro-choicers are showing just how powerful we can be.

Abortion, A Gift from God

I love the Super Bowl. Really, I do. While the general population curls up to watch larger-than-average men in tights pile-up on a field somewhere, there is a stillness outdoors, a vacancy on the streets, an unlikely but pleasant solitude.

I do also enjoy the rude, anti-abortion controversies that threaten everyone’s chip-dip and light-beer, good times. And by enjoy, I do mean, loath.

No doubt, Abortioneers can appreciate an aggressive, even extreme campaign for change. To prove this, we’ll share an extreme campaign that aims to change the state of pregnancy, motherhood, and (imagine this) working conditions around the world: Mispolis, Abortions for Successful Living.

While the content may be shocking, it is a parody designed to bring light to alllllll kinds of labor injustices. Alternatively, the shocking anti-abortion commercials desecrate a motherly sacrifice and exploit the loss of human life.

The biggest difference between anti-abortion Super Bowl commercials and Misopolis, however, is that you have a choice whether or not you wish to view our recommendation. It won’t appear without warning and it’s aimed at helping women, real women living and breathing on this round earth. Also, working their asses off. Also, having desire.

We know Randall Terry is a deprived man deeply afraid of sensual, assertive women. Just a tad psychotic, just a tad. We know he threatens the lives of every single Abortioneer. A godly devil, if you will, with way too much money and an army of dummies.

We’re wary of such sad beings, such losers, such beasts. But we’re not afraid. We know the world is getting smart.

MISOPOLIS

Abortions for Successful Living

For more information:

Women

on Waves

Fashion Industry Violates Women's Rights

We interrupt this program

As much as I'd LOVE to keep talking about the SGK crisis, there is an equally important crisis going on that's not getting as much publicity:

Pfizer Issues Statement On Voluntary Recall

The recall affects Lo/Ovral^®-28 (norgestrel and ethinyl estradiol) oral contraceptive pills. If you are a user, talk to your provider and use a backup method!

Susan G. Komen Idiots

Seriously, this Susan G. Komen stuff is offensive and crazy. So many of us have dealt with breast cancer first hand. My grandmother died from breast cancer. Even had a double mastectomy, but that ugly cancer spread to her lungs. A friend from high school, in her 20's, died from breast cancer. I'm sure most of you can relate.

Why the fuck Susan G. Komen would ever try to defund any organization that helps detect breast cancer, is beyond me. Beyond all of us. And we all know there is no correlation between breast cancer risk and abortion. Even the CDC and WHO...oh, and the National Cancer Institute have said so. RH Reality Check's Editor-in-Chief, Jodi Jacobson, wrote a great piece here. What's uber scary about this, is that she points out that they've hired individuals who are blatantly anti-abortion and politicize abortion themselves. Like their new VP who was quoted writing on her campaign blog (oh, and she was endorsed by fucking Sarah fucking Palin), "I will be a pro-life governor who will work tirelessly to promote a culture of life in Georgia.... I believe that each and every unborn child has inherent dignity, that every abortion is a tragedy, and that government has a role, along with the faith community, in encouraging women to choose life in even the most difficult of circumstances.... since I am pro-life, I do not support the mission of Planned Parenthood." Her name is Karen Handel and is the former pro-life gubernatorial candidate for Georgia. Seriously? Read more here.

I'm so frustrated by all this fucked-up bullshit, that I can hardly write straight about it. There will be better articles than mine. And Vegan Vagina wrote a very good one yesterday. I used to feel good when I'd buy products that went to support the Susan G. Komen foundation. Fuck that shit now. I will refuse to support them in any way.

Screw 'em.

Extra Extra Read All About It: Pinkwasher screws over Planned Parenthood

You all read the news yesterday, right? It was all over facebook and the blogs and I even received a "personal" email from Cecile Richards about it. Well, in case you don't know what I'm talking about, you can get caught up here at Slate or here at Planned Parenthood

I have felt for years that Komen is one of the worst offenders when it comes to Pink Washing. They seem to be willing to slap a pink ribbon on just about any marketable product, regardless of its health benefits. I have seen cookies, makeup, Mikes Hard Lemonade, propane trucks, etc etc the list goes on and on. I remember a few years ago when the Komen KFC chicken bucket came out. I am still so disgusted every time I see that image (hence, I did not post it here...but feel free to google "komen KFC"). I'm over Komen's bullshit pinkwashing and their bullshit politics. If you want to help women then help women. It is that simple. Now leave us alone and let us figure out how to deal with this gaping hole in preventative services that you have created.

Please please please consider donating to support Planned Parenthood and the great work they do. This is from Planned Parenthood:

Over the past five years, Susan G. Komen for the Cure Foundation funds have enabled Planned Parenthood health centers to provide nearly 170,000 clinical breast exams and referrals for more than 6,400 mammograms. These cancer detection and prevention programs saved the lives of women who often had nowhere else to turn for care.

Now, after facing criticism from anti-choice, anti-women's health groups, the Komen Foundation has decided to stop supporting women seeking care at Planned Parenthood health centers. We are determined to make sure that these women can continue to get the care they need — and, as always, that means we are counting on you.

Please make your emergency contribution today to help us defend access to care and continue to protect and promote women's health.

Click here to donate

P.S. What are some of the most ridiculous forms of pinkwashing people have seen? Please share in the comments!