The story of the time I was a dick

Why does she keep shouting ABORTION at me? 

Yesterday our guest blogger Amy mentioned that phone calls about abortion care often sound like this:

"Um...I wanted to know how much it costs?" and "Hi...I'm looking for some information about...abortion?" (spoken as a question, with the word "abortion" issued in a whisper)

And that her responses sometimes sounded like this:

"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?"

I can totally relate. Who hasn't had this kind of call? It was one of the first patterns I noticed about callers when I started working on the phone lines.

Maybe Amy was more mature or less self-centered than me when she started her clinic work. But for my part, there was a real evolution in how I understood such callers. Initially, I felt frustrated to pick up the phone at my work and hear that the person on the other end of the line couldn't bring themselves to speak about my work. I experienced it as stigmatizing of ME, like they were attempting to distance themselves from my work even as they were asking me to tell them about it.

Sometimes they would ask with words like "terminations" or "D&C" instead of "abortion" -- maybe those words sounded more genteel or more like medicalese.

I'm ashamed to say that, early on, if someone called and said, "Hi, I need to know how much it costs," I would reply, "For what kind of services?" Even though it soon became clear that, if someone was calling about, say, a Pap smear, they simply said "Hi, I need to know how much a Pap smear costs." For a brief period of time, I believed that it was more important for the caller to say the word abortion than to feel comfortable asking about it.

At least that phase ended rather quickly. When a woman called and I heard echoes as she asked me questions, I mentioned her voice was sounding funny, as though she was in a bathroom or something -- and she said yes, she was at work and this was the only private place she could duck into. Duh, me.

Whether because they're not sure they've called the right place, they can't believe they're in this situation, or they can't risk being overheard by a coworker or family member, callers can't always discuss abortion openly and explicitly over the phone.

There will be time for that at their appointment, if they make one, when they meet with the counselor or health educator to express any questions or concerns about their health, the procedure itself, their experiences leading up to the appointment and how they will fare afterward. Usually patients can bring a loved one or support person into the counseling/education session, but a portion is also dedicated to one-on-one time with the staff person, in case the patient has something that might not be easy or safe to express in front of their companion. These sessions can be conducted as part of an abortion appointment, or prior to deciding whether or not to have an abortion. It's dramatically different from a phone call that might by necessity be taking place in public.

So now I know better. I learned to respond to "I need to know how much you charge" with something like, "Sure, I can talk to you about our different fees, but we provide many kinds of care here. Were you asking about a Pap smear, or...an abortion, or...?" If they are asking about an abortion, they normally stop me there and say "Yes, that's it." Easy peasy. It's okay for me to do the talking, if that's what the caller is looking for.

Not that every caller is in this situation! It runs the gamut: on one end is this (or even, as Amy writes, the ones who never call), and on the other end is someone calling to set up their appointment while also ordering dinner for five from the drive-through. But that's a story for another post.

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.

Guest post: Telling my patients "No"

Happy Friday! Please warmly welcome Candid Cannula, a fellow abortioneer who's graciously joined us for a guest post this morning. I loved reading about her counseling dilemma -- one that we all grapple with, I think -- and hope you will too.

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“I hope this is the right thing to do,” my patient – let’s call her Nicole – said right off the bat, instantly setting off warning bells. I asked her to elaborate, and her next sentence did nothing to alleviate my concerns: “Well, I’m basically being forced to do this.”

Those two sentences told me all I thought I needed to know, and I was sure that Nicole was not going to be seen today. But I pressed further, asking her all the standard questions to get a better picture of her situation. How had she felt when she first found out she was pregnant? Who had she told? Who was forcing her to be there, and in what way? Had she talked to anyone who was supportive? Had she considered continuing the pregnancy? How did she think she would feel after an abortion?

My role as an abortion counselor has two distinct parts: providing informed consent for abortion procedures, risks, aftercare instructions and contraceptive options; and discussing patients’ decisions to terminate their pregnancies, ensuring that they are confident it is the right choice for them and that they are not being coerced. I have the awe-inspiring right to turn patients away if I feel the latter criteria are unfulfilled, and it is that right that I struggle with when faced with patients like Nicole.

Her story came out in bits and pieces as we continued to talk: like so many of my patients, she had always considered herself to be against abortion and never imagined that she would wind up across from me in this counseling room. She did not think she would cope well after the procedure and she was struggling with whether it was the “right” thing for her to do. At twenty-one, she was a few years removed from legal childhood yet still dependent on her parents, and she said that they were the ones making her terminate the pregnancy. “My parents will kick me out if I have a baby,” she told me. “I’ll be homeless. I won’t have anywhere to go.”

What would you do if your parents were supportive of you either way?

“Honestly,” she said wearily, “I wouldn’t be sitting here right now.”

Nicole was not going to have a procedure that day. I was sure of it. But when I brought up the idea of her leaving, her tune changed.

“No,” she said urgently. “I have to do this.”

You told me you’re being forced. You told me you don’t want to have an abortion. We can’t see you when you’ve told me those things.

“I’m being forced, but I have to do this. I don’t WANT to do this, but I HAVE to. You don’t understand! It’s my decision too. I came here for an abortion, and I have to have an abortion.”

Nicole, what you’ve told me worries me. We find that women cope best after an abortion when they’ve been able to come to terms with it as their decision. Take some more time. The procedure, the cost won’t change between now and next week. Come back next week if you decide this is the right thing for you. We’ll still be here.

“NO!” she exclaimed. “I planned for this today. I can’t come back next week. Nothing’s going to change! You don’t understand, I don’t HAVE a choice. Yeah, I’m going to feel awful afterwards, and yeah, I’ll probably regret it in a way, but it’ll be worse otherwise – I have to have an abortion today!”

I spent a very long time with Nicole gathering the pieces of her story, asking the same questions, asking different questions, offering her resources to be able to continue the pregnancy, alternately trying to convince her to reschedule her appointment and feeling terribly conflicted about whether that was the right thing to do. I had little doubt that she would end up having an abortion, but maybe she could be in a better place with more time to own the decision. Or maybe another week would only create additional obstacles and difficulty, needlessly complicating her life further.

Where does the patient’s constitutional right to choose an abortion intersect with the counselor’s responsibility to screen and refuse service due to perceived ambivalence or coercion? What do ambivalence and coercion mean for women who lack the emotional or financial support to continue a pregnancy they may otherwise have welcomed? I came to feel that Nicole’s claim of being forced to be there was her way of coping with needing an abortion so that she didn’t lose her family and her home. She may have made a different decision if her family supported her either way, but the reality was that they didn’t, and she wanted to keep them in her life more than she wanted to continue the pregnancy. Many women are “forced” to have an abortion by various life circumstances; does it matter whether those circumstances are other people or faceless considerations like financial constraints, age, or health problems?

I’ve turned abortion patients away who have returned a week or two later, grateful for the extra time to think about the decision and better equipped to cope afterwards. I know that sometimes, it truly is better to wait when ambivalence is detected; patients can’t change their mind after the procedure. But I struggle with exercising my right to turn patients away when they protest. How do I know which patients will truly benefit from it? Doesn’t the patient ultimately know what’s best for her? Why should it be my right to deny a patient the service she insists on accessing?

Nicole had her procedure that day. Like many of my patients, I imagine no pregnancy outcome would have been positive for her. Many patients will never feel 100% confident or at peace with the decision to have an abortion. But no one would have subjected her to an assessment of ambivalence or coercion in order to continue the pregnancy, and that’s one thing that makes abortioneering such a uniquely challenging kind of work. In the counseling room, it’s often a delicate balancing act: trusting the patient to know what’s best for her, and stepping in when I judge that she is simply not ready to take the step that day.

You've got mail

Dear Patients,

Maybe I met you years ago or days ago, and maybe I'll meet you tomorrow or years in the future. I hope I made or will make a positive impact on you, but your abortion experience really wasn't or isn't or won't be about me. And that's one of the things I want to say to you. Your abortion is YOURS--your story to tell, your experience to shape. You have no obligation to justify your decision to anyone. You have a right to be informed, even when it means asking uncomfortable questions like, "What happens to the fetus afterward?" You don't need to be sad if you're not, nor do you have to be happy just because you exercised bodily autonomy. We might talk about how we'd like you to be grateful and advocate for others, but my wish is that you will make the choice for you and you will honor yourself and your choice in the best way for YOU. You have every right to be scared, and you also have every right to the safest and most caring healthcare, which is what we want to give you. You are strong enough to do this, whether "this" is having an abortion or not having one. You are allowed to dwell in as many gray areas as you'd like. We, as staff, might bristle when you ask things like, "Are your instruments clean?" but you have a right to wonder and to ask and to use your voice in whatever way you can or want. You do have a voice, but your abortion doesn't have to be a political act, either. You can be selfless or selfish or both at once. You can yell at me or hug me, and I will find some part of you, large or small, to care for. Your privacy is protected and so is your dignity, and we wish for the clinic to be a safe space for you. You might have just one abortion or just fourteen, and there is not a thing wrong with either one. There is nothing wrong with YOU.

Again, this isn't about me. But I want you to know that I don't forget you, and I am so very honored to be a part of your choice, process, justice, and life.

All the best,
Desembarazarme

Nurturing Choice

I've heard the argument for parental notification/consent laws that reasons, "Why shouldn't the parent be involved in the daughter's life and decisions and choices?" It sounds so innocuous and Norman Rockwellian when it's stated like that, but we Abortioneers all know that sometimes it's more like, "This girl is going to be beaten into next week and into the foster care system and into teenage parenthood if lawmakers require consent/notification."

But laws and barriers to reproductive justice aside, I wanted to give a shout out to the parents of all abortion patients (not just minors) who are so involved and so loving. I've always known that if I had an abortion, my mom would be my first choice as a driver/support person. Even when I was in a long-term relationship, I would have chosen her. Above anyone else, I would want her comfort and humor and company. And I have absolutely no doubt that even if it meant taking a day off from work and driving a few hours to my city, she would be there for me.

My friend had an abortion a few years ago, and she came to my clinic with her mom in tow. She, too, had a partner, and she was well above 18, but her mom was her first choice. I could tell her mom was glad to be at her side, but it wasn't easy for her. I knew from past conversations that my friend's mom was pro-choice, and she had even had an abortion and a D&C (for miscarriage management) herself, but that day was hard for her. Although I was friends with the mom, too, I didn't delve into it, but I can only assume that her tears were from memories of her experiences or from the fierce desire to protect her daughter. But whatever baggage she carried, she was at her daughter's side, trying not to cry and trying to make the day about her adult child.

I also remember fathers of clients who were or were not required to accompany their daughters to the clinic, but who were obviously distraught. They weren't distraught because their daughters were killing their grandchildren (anti-choice rhetoric, right there), but because their daughters were faced with their first major adult decisions or because it was the first time their adult daughters had come to them for help or support. They didn't have to say what was running through their minds, but it was evident from the way they softly asked me, "How is she doing?" or implored, "Take good care of her." More than one burly man had tears in his eyes.

I've also seen a mother who accompanied her very young daughter to the clinic and whose boyfriend was responsible for the pregnancy, unbeknownst (until now) to the mother. In another case, the mother's son had brokered the rape of her daughter, also unbeknownst to the mom. Both mothers were clearly heartbroken over the complexities of the situations, as well as the implications of blame that they shouldered. In each of those cases, I made it a point to take the mothers aside and hug them and whisper simply, "You're a good mom."

Thank you, endlessly, to all of the good parents who support their daughters who chose abortion or who chose parenthood or who chose adoption. And thank you to all the parents who chose abortion, parenting, or adoption in order to give better lives to their daughters and sons.

Some details of each of these stories have been changed in order to protect client privacy.

What I hear you saying is...

Part of the pre-abortion process at my clinic is counseling. Clients talk with a counselor one-on-one to review their medical histories, discuss the details of the procedure, ask questions about the aftercare instructions, and work thorough any lingering doubts or concerns they have. Some clients latch onto this idea and want to use it as an in-depth therapy session for things that really should be handled by a professional, while other clients roll their eyes at the idea and assume that counseling is yet another law with which the clinic must comply, a law created with the assumption that women don’t understand what an abortion is or that every human was once a fetus.

But the majority of the clients welcome the opportunity to talk with someone whose job it is to listen and to be pro-choice. I value it because it gives clinic staff a chance to develop a rapport with a client. (Not to mention the chance to debunk myths about having to slice someone stem to stern to perform an abortion.)

I actually took the counseling portion of the program for granted until I learned that some very compassionate, professional clinics don’t offer counseling to their clients. It could be a trick to save time (clients always complain about how long the process takes) or minimize cost (we ARE in a recession), and it could simply be what has worked and continues to work for individual clinics.

So, readers, I’m curious: If you’re an Abortioneer, does your clinic offer counseling? If you’re a friend of the Abortioneers, would you opt for counseling, given the choice? And if you’ve been a patient, did you have a counseling session? What have your experiences been?

What's love got to do with it?

"Sex is painful, but I'm fine."
"He said he'd pull out, but I guess he didn't."
"I don't think I've ever orgasmed."
"I don't really enjoy sex, but I just get through it because that's part of being a woman."
"I told him I was pretty sure I was ovulating, but he didn't listen."
"I have to put the medication IN my vagina?! Which hole is that?"
"He doesn't think it's important to use birth control."

I don't think that a lot of abortion clients are having particularly good sex. At all. I've heard all of the above statements from women I've counseled and my co-workers and I have had meetings about expanding birth control discussions to include questions about sexual side effects since so many women seen hesitant to bring those up if they even recognize them in the first place.

Our clients aren't dumb, and I'm not blaming them for the lack of sexual empowerment I've seen from working at the clinic. But they live in a society that values male sexual satisfaction to the extent that Viagra is lauded as a discovery tantamount to the Polio vaccine (vaccine/autism debate notwithstanding). They live in a society that only refers to vaginas as "down there," and limits related dialog to freshness, which brings right back to the obsession with male sexuality. We all know the axiom that if men could get pregnant, abortion would be a sacrament," and I bet you that if a man experienced pain during sex, a full-scale, multimillion dollar investigation wold be launched.

And that male-centric sexual society is the one that values the cuuuute little baybee fetus and refuses to even acknowledge the enormous amount of women's rights involved in the need for choice and the need for abortion. And sex is about communication and bonding and mutual pleasure (usually about these things. I know it's not 1956.), so if the sex complaints above are any indication, of course the couple is in no position to bring a baby into the relationship. And I'm so glad there's a choice available, but that choice sure doesn't exist in a vacuum. (No pun intended.)

Trust

I'm not an optimist by nature, but by God, I force myself to be one. There's enough negativity in and around abortion care; no one needs me to be a grumpy, jaded provider. I dance at work and joke with clients and hype up my co-workers and proclaim my love for the clinic from the rooftops. And sometimes, it's the most exhausting part of the work I do.

I wear a "Trust Women" button like the one worn by Dr. Tiller. I believe it with all my heart and it's the reason I go to work every day, ignoring the protesters, ignoring my lower back pain and sciatica after 12+ hour days. I've sacrificed relationships and friends and sleep and food and health and leisure time and luxuries and vacations for this job. I do it because I trust and love every woman who enters my clinic, and I value the work I do. And I know that the clients appreciate all of us providers. But they don't always trust us.

Women constantly ask us if our clinic is clean, if real doctors perform the abortion, if they'll be infertile, if they'll get breast cancer. They call afterward and accuse us of "leaving something inside of me," they blame their stubbed toe on something we did, they call us money-hungry whores because we can't secure enough funding for them. And it hurts so much and it makes me so angry to constantly be the enemy, no matter what. Providers aren't perfect, but we're good and selfless people and we deserve trust and respect.

I'm sorry I can't be your regularly scheduled, sunny Desembarazarme, but I'm human and I struggle, and I trust you to be here for me.

What's your Story?

Please enjoy this one last wise blog by our guest guru, deliverance:

“How can you feel so much for another person, a complete stranger?”

Recently this question was posed in my Abnormal Psychology class. It resonated with me because it seems to articulate one of the most significant obstacles in the

complex world of abortion, which is that we see each other as separate.

"She is different," the woman says, who is 6 weeks and was in the waiting room with another woman who is "showing." "How can she do that to a baby?"

"They aren't like me. I am 40 and done having children. I've never planned on coming here," she explains, as if all other patients have visions of their reprodutive futures.

"I am different than them. I care," she tells me, angered by patients in the waiting room who have the nerve to laugh in an abortion clinic.

Nobody plans to have an abortion at 22 weeks, or at 40 years old. The way people deal with having to make tough decisions is not uniform; some laugh, others cry, and a few might not even acknowledge the difficulty of making such decisions until years later.

When I began training for my job, I also wondered what it would be like to talk about intimate details of a "stranger's" life. When I found myself invested in the most essential part of my job, though--making sure patients are listened and attended to--all such reservations disappeared.

I suppose what I'm saying can be put into two words: Trust women.

Sympathize, imagine, discuss, do what you have to do--but I am as you are.

There are differences among us, such as class, race, and most importantly in this case, gender, but we all want to feel like we are creating happy and fulfilling lives for ourselves and those we love.

If we are supplying someone else's ability to live, and decide we cannot continue to do such, know that it isn't easy--but it's also not your place to judge. At the risk of sounding preachy, let go of that which you cannot control (and how sad it is that control over women's bodies has become sanctioned by law).

If I had to identify the single most important thing abortion care has taught me in the precious 13 months I have been benfitting from it, it is that we should never judge others, for we never know another person's story, unless we ask.

Image: One Heart, One World

(Un)Comfortably Numb

Sometimes when I'm counseling, clients will use the session not only as an opportunity for their questions and fears about surgery, recovery, and choice, but as an opportunity to try to get information about those mysterious other women filling the waiting room. "How far can you do this to?" they ask cryptically, grammatically ambiguously. "How could someone do that?" they continue, pitting their own 6 week abortion against another possibly 23 week abortion. And then I explain choice and circumstances and sometimes they get it, sometimes, they don't. Recently, as I described to the client what to expect, anesthesia-wise, she blurted, "Why would someone want to be awake for this?! That just sounds awful. Knock me out, please."

My opinion doesn't matter, but in the interest of full disclosure and biases, if I were to have an abortion, I'd go with general anesthesia, no contest. Sure, I'd like to know exactly what's going on, partially so that I would better be able to inform clients. But I know myself, and I would be way too tense, way too uncomfortable for my own good, for the doctor's good, for anyone's good, just because that's how I am at any medical appointment. A first-trimester (6-12 weeks) abortion takes five minutes, tops. With general anesthesia, the patient is monitored by a nurse-anesthetist the whole time -- all of ten minutes. The anesthesia travels into the body through an IV in the arm -- no masks, no machines doing the breathing for you. Yes, the medications include Propofol, the notorious Michael Jackson drug, but it's not something the client takes home with her, and if there's anything slightly sketchy in her medical history, we have a long discussion about the risks and benefits of general anesthesia. But generally (no pun intended), a clinic's anesthesia is less intense than what's used for wisdom tooth removals. Clients love it because they don't feel nor remember anything, and they wake up relatively quickly. They hate it because they give up some control, they can't eat or drink anything, they need to have a driver, and because anesthesia is scary. Most of the clients at my clinic choose to be asleep.

Being awake, on the other hand, involves BEING AWAKE. Some clinics offer sedation or narcotics, but my clinic is not one of those. And some clinics offer ONLY local anesthesia -- my clinic is not one of those, either, but it illustrates just how manageable being awake can be. It isn't for everyone. But again, it's a five minute procedure, and because there's no cutting ("surgery" is a misnomer), only minimal dilation of the cervix, being awake is do-able. And in that case, the doctor administers a local anesthetic like Lidocaine via injection into the cervix. The sensitive cervix is numbed, but numbing the entire uterus just isn't possible, and the uterus is going to cramp during an abortion -- it's just the nature of the muscle. Woman have described the cramping as stronger than menstrual cramps, but not as intense as childbirth. And based on my hand-holding experience, those evaluations seem to be pretty accurate. Some women carry on conversations with a few winces, and others nearly break my hand as they scream. Some of the clients choose to be awake because they value being present in their abortion experience. It gives them some power. Others opt for a few minutes of discomfort over the nausea they historically experienced post-general anesthesia. And some just don't see the whole procedure as that big of a deal -- why be asleep for a simple, safe gynecological procedure? Other women would rather be out of it, but with no one to accompany them to the clinic, local is the only choice. And some women opt to be awake just because it's less expensive, which breaks my heart. And speaking of heartbreak, let's not even get into the mothers of teens who insist that their daughters need to be awake so that they can be punished for getting pregnant.

I'm intrigued by this aspect of abortion -- a choice within a choice, as it were. And as a fellow Abortioneer pointed out, the choice of being asleep versus awake varies widely from clinic to clinic, city to city. Readers, what are your experiences with clients' preferences? Have you, yourself, made that particular decision? Does your clinic offer anesthesia experiences other than what I described above?

And stay tuned -- in the coming weeks, we'll also explore things like abortion by pill and why some women love it, some women hate it, some providers heart it, some eschew it. And we take requests: What abortion mysteries or intricacies would you like to know more about?

Lean on Me

I was fortunate enough to have several friends come to me recently to tell me their abortion stories. I had only mentioned my work in passing and they approached me separately to confide in me. Their abortions weren't particularly recent, but they were still hurting. Some women hurt, some don't, and neither response is wrong. (And for the love of Mike, some fillings hurt, but that's no reason to outlaw them, so can it, antis.) My friends were and are glad they had a choice, they don't regret their decisions, but they were living quietly with their grief. I jumped into counselor mode in the middle of the coffee shop and I listened, offered resources, and suggested healing and coping techniques. And we hugged and I gave them instructions to call or email me whenever they needed an ear.

After I counsel women at work, I give hugs or a pat on the back or a few pamphlets or a souvenir flowchart we developed together that details a plan for healing. And I write my phone number at the clinic on the handouts with my name next to it, and I give the clients the same instructions to call me whenever they need to. Only a handful of women have taken me up on it, and I love hearing from them because even if they're sad, they usually are calling to also say thank you or tell me about the good things going on in their lives, or because they're open to talking. The rest, I think about and send a wish into the universe for their well-being. I don't forget them. And the thing that struck me the most when my friends came to me was the hope that they had a counselor who listened to them and walked with them through their abortion experiences. And I worried that they didn't.

A couple of weeks ago on PostSecret there was a postcard that said something to to the effect of, "To the nurse who held my hand last year as I lost my baby and told me eventually I would be OK: I am. Thank you." I wish I had saved the image, but it came and went like the postcards do every week. I loved that card, though. (And maybe it was about a sick infant or a miscarriage, but the beauty of the site is that it's open to interpretation.) It was like getting to hear the happy ending of every client I've ever wondered about. And I like being a part of the beginning, middle, and end for my friends.


Update - Thanks to a couple of lovely readers who let us know where to find that PostSecret submission! Here it is:

Close your eyes and imagine something for me

welcome to your new home

What if you moved to another country and had no family there, and your first language was one that very few people in your new home had even heard of, and you spoke very little of theirs? You might be relieved and happy to find someone who shared your mother tongue and your host country's language, someone who could help you navigate this new place as well as be a friend who understood where you came from.

You might start dating this person, move in with him, end up relying on him in most aspects of your life. He might be a lot older than you, take advantage of your dependence, control your access to food or transportation or a phone, and refuse to use birth control. 

What if you got pregnant? What if you got pregnant and had always looked forward to having children and this person who had final say in your life was not a fan of the idea? And what if you couldn't get your own job or lease or even typical social services -- shelter, healthcare, food for an infant -- because your immigration status wasn't clear? What would you do? 

You might decide that, as much as you'd rather have a child, the only feasible course of action is to seek an abortion, just like he is telling you. You might have to rely on him to translate during the counseling session, and there's really no point trying to say how you really feel, because he already knows it, and he won't translate it to the counselor, and anyway what you'd rather do doesn't change what you must do. 

After the abortion you might try to spill your guts, in spurts, and using a combination of elementary vocabulary and charades, to the various staff in the recovery room. Unfortunately, if you talked to me, I might have a really hard time understanding the full extent of your situation, and try to comfort you with tissues and talk about the hope of having a child when you're in better circumstances -- not realizing that the road to better circumstances isn't visible from here. (It's a lot harder for me to write about this failure to listen well than to read J's story of a failure in his early days as an aid worker: why?) But I'd notice that you kept saying you didn't feel strong enough to get dressed and be discharged yet, even though your vital signs were normal three times in a row. 

If you talked to my more perceptive colleague, she might try to ask you if you had "somewhere else to go" -- but you don't know anyone or anyplace other than this man. She might call in a counselor and make a bunch of phone calls to informal assistance resources, trying in vain to find someone who spoke the right language. The three of you might make a plan to have you come back in a few days for "a check-up" and hope that this guy at least respects medical orders and will give you another ride to the clinic. 

All of this, to our regret, would happen after the abortion that you wished you didn't have to have, because while antis are lately fixated on stopping "coerced" abortions, they are apparently completely clueless about the forces and circumstances that actually make women have abortions they wish they didn't have to have. When language barriers don't prevent women and girls from telling us what's in their heart, when immigration laws don't leave the most vulnerable with nowhere to turn, when men don't take the opportunity to take advantage, when families don't make their daughters believe that can't possibly come home pregnant, (you fill in the blank): that's when women will only have the abortions they want. 

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

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

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

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

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

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

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

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

8. A medical history is no place for forgetfulness
nor creative writing
Oops! When you wrote, "No known allergies, no history of major health problems," it turns out that you really meant, "Allergic to every item you will use at this clinic and a history of weekly seizures since birth." Details, details! And my friends, those details are what cause those major complications. I could say, "I'm 5'9" and I've never had any mental health issues," and it sure would be fun to say those things for a change. But that doesn't make them true.

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

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

Sisterhood of the traveling mesh underpants*

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

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

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

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

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

Happy pills

The other day when I answered the phone at the clinic, a Spanish-speaker was on the other end of the line asking about "the pill that brings on your period." I've gotten used to breaking it down on the phone after chatting with clients who ask for a Pap smear, then end up incensed that the Pap didn't test for HIV because that's really what they wanted to check out, and what do you mean that "Pap smear" doesn't translate into "all things vaguely gynecological"? (But that might be another post for another day.) I asked her a series of questions about "Did you take a pregnancy test?" and "Is this the first period you've missed?" because maybe she really DID want to start birth control that would regulate her period. But no, she definitely was referring to the series of pills that would cause an early miscarriage and soothe the conscience into believing it's only a late period, not an abortion.

Women of all demographics are drawn to the RU486/Mifeprex & Misoprostol regimen because it's kind of like Abortion Lite, but women from conservative, Catholic countries where abortion is illegal and money is scarce especially like this route. And when they end up here, in a country where they don't speak the language and they don't have the time to navigate the laws of choice, they often do the familiar thing and buy the pills (usually only one type of pill--the cheaper one that doesn't really cause an entire abortion) on the street. Of course this is dangerous for a variety of reasons, and it ends up being pricey when they have to come to the clinic for a D&C, anyway. So, on the one hand, I appreciated this woman on the phone calling a clinic so that she could get the medication from a medical provider and be overseen by a doctor.

On the other hand, though, I struggled with the desire to give her accurate information and be straight with her with the lingo of "abortion," not "inducing a period" and also respecting her need for coping with this unintended and unwanted pregnancy in a way that she knew how, and especially, not scaring her off an into the streets where she would acquire the tablets from someone who would fully go along with her "bring on the period" plan. Women aren't dumb, and they know full well that a period of this type comes along with a fetus, but where does that leave as as providers and as advocates for women? Readers or co-bloggers, have you ever been faced with this situation? Do you fully disabuse the woman of this notion of the innocuous pill since eventually, they will end up having an ultrasound that clearly diagnoses a presence in the uterus? (That's what I ended up doing.) Or do you go along with the plan a little bit, allowing the woman to see the experience as she wants to see it?

Heath Educator?

Part of my job description is health education, and I totally own it. Some of my co-workers aren't big fans of counseling our teenage clients because the time that could be spent on "we recommend 800 mg ibuprofen" is, instead, spent on "your cervix is the opening to your uterus," but I particularly love teenage clients because they're eager and interested to learn about their bodies, and sometimes, I even get to meet them before they've been exposed to the idea that the vagina is gross. I also often introduce myself as a health educator whether or not I disclose the abortion element of it because it's just a cool job and a succinct description. I health educate off the clock when I get together with my middle school best friend and she genuinely wants to know how an abortion procedure works and today when I got my eyebrows threaded, as the aestheticians spoke in their native language, I caught "birth control pills" and itched to interrupt and say, "What are you talking about? Can I answer any questions? Or give you my number if you need a refill?"

But there are only 40 hours in my work week, and maybe two additional volunteer hours when the above situations arise. During my off hours, sometimes I like to pretend that abortion is just a fact of life and focus on my downtime activities of reading or working out. And mostly, the thing is that like differently-abled people don't exist to be spokespeople for how to treat someone in a wheelchair and people of color aren't here to educate the masses about what is or isn't racist, sometimes, I'm just here to do my job, not to explain to you that there's no such thing as partial-birth abortion or why it's infuriating for you to say, "Abortion just shouldn't be used as birth control." I educate about health and rights, not about ignorance and human decency. And most of all, I'm over the "Hey, I just want to have a friendly, intelligent discussion about pro-live versus pro-choice" defense. Because honestly, I would have to be on the clock and be paid a litigator's hourly wage to even begin to be able to stomach that.

To Abortioneers: Help Out About A Girl!

Dear Abortioneers Out There:

I have a confession. I'm having a mini - tiny even - crisis. OK. "Crisis" is a bit dramatic; but I could totally use your help. The dilemma: I can hardly relate to clients who worry about god and if this god is going to forgive them for their abortion(s). Why is this a mini crisis? Well, because:

a) where I live, some of our abortion clients seem to be concerned about this (at least on some level), and
b) because I'm meant to have a counseling session with someone tomorrow to further discuss her spirituality and her abortion decision-making decision.

I hardly feel qualified. I used to be religious. Perhaps even zealous. I've probably even blogged about it before. I was super conservative....a long, long time ago; but that religiousness has now been out of my life for as many years as it had been in it. So I find myself at this...strange place....where I can sort of/kind of remember when I worried what god would think of me, but mostly, I just can't.

Not remembering and grasping onto this I'm-concerned-about-what-god-would-want-me-to-do thing isn't helping me at work right now. When I was a bit religious (occasionally going to church) and still holding down my abortioneer job, I loved it when women mentioned god during counseling sessions. I could relate. I could talk about god and spirituality easily. I wasn't in the slightest offended by the idea of a god or by religion itself (whereas now, religion offends me). So it seems like some twisted act of fate (or perhaps god has a sense of humor? Ha!) that I'm meant to talk to a bright, capable, young woman tomorrow who holds in her hands her very future, and the only thing stifling her is something I think is imaginary: god. I don't understand. I just want to say to said bright, capable young woman, "You know. I hate to break it to ya, but there is no god. Or if there is a god, this god is sooooo not going to care about if you have an abortion or not. If there's a god, it might be a teensy bit more caught up with more important matters like, um, global warming, civil wars across the world, genocides. That sort of thing." Yet, I can't bring myself to say that (at least not to her), because....well, she believes in some god who is going to care if she has an abortion or not.

I'll be frank (or - um - even more frank). I'm not really sure what to do. I keep re-reading literature from RCRC (Religious Coalition for Reproductive Choice) and other documents, but it's not really helping me get back to understanding this spiritual concern she has. I want to give her some words of wisdom, of comfort. I want to be able to say something she can relate to, that helps her heart feel at ease: whatever decision she makes. Yet the reality is, it doesn't - I don't think - really matter what I tell her because it truly only matters what she thinks/believes. Problem is: I just can't relate.

I suppose I need to get over myself a bit. Not expect that I have to have words of wisdom. But I still am supposed to say SOMETHING to her, RIGHT? If she comes to our counseling appointment talking about god and her spirituality and reconciling that with her abortion decision (which is exactly what she told me she needs help doing!), I really don't know what I'm going to say. (BTW - I am trying to find clergy or something willing to talk to her!)

So, sisters in abortionland, maybe you can help me out. Do any of you relate to what I'm talking about? I know there are abortioneers out there who are religious/spiritual. What kind of wisdom do you give to women? Do you have some advice for me? I appreciate it. Thanks!

Much love,
About a Girl.

Lessons on Assumptions, Altruism, and Abortion

Without violating HIPAA, let me just tell you that I've interacted with several clients who are a little bit unlike me. Let's say that maybe they're sorority girls or Baptist ministers or aspiring rappers or women very much hooked on drugs. And without violating BIPAA (Blog Insurance Portability and Accountability Act, coined by me and referring to my wish to remain an anonymous blogger), let's say that I'm a casual, quirky, non-religious loner. (Also, not on drugs, for the record.) And I've counseled a handful of women who I could probably hang out with, but honestly, I've counseled more women who fall on the other end of the spectrum. I don't judge them when I see their Louboutins (I was going to say "when I see Greek letters," but it just occurred to me that I've rarely, if ever seen letters come through the door. Is there a code in sorority bylaws that states no Phi, no Omicron may pass through the doors of an abortion clinic? Let's look into this.), but I do subconsciously think, "Well, she's different than I am."

A few years ago, before my era of abortion 24/7 began, I would definitely think, "Not my friend." I would still be nice, but I would probably dwell on how snotty that one Greek girl was in college, or I'd silently judge the druggie based on what I'd read allll about in the news. I was still a feminist then, but my feminism was a little bit more narrow, including the ideas that porn is always bad and a feminist should look like me, or at least similar. But then I got more involved in the feminist movement and I learned about why sex workers' rights are a feminist issue, that feminism is for anyone, and so are abortion rights. I learned a lot of this from local activist groups and friends, but I learned more of it first hand from our clients.

I've talked feminist philosophy with escorts, I've bonded with debutants, I've listened to the dreams of a woman who wasn't a "drug addict," but a "woman addicted to drugs," I've learned about Christ and abortion from a preacher, and I've discussed Lil Wayne with a rapper-to-be, possibly even betraying my own stereotype of a white girl in Chuck Taylors who's into My Bloody Valentine. (I contain multitudes.) And these clients are some of my favorites because of what they've shown me, and also simply because of who they are. This isn't just tokenism where I thank them for being soooo brave and for showing me what it's like outside of the suburbs, but it's me thanking them for being who they are and for abortion as the great equalizer and for trusting me. And now, we will all sing "Kumbaya," if I can find a Lil Wayne remix.

Friday morning at the movies: praise and pans

Recently I organized a local screening of If These Walls Could Talk. If you've ever seen it or remember its HBO premiere in 1996, you know it's maybe a little hokey but also pretty powerful. Like, in the third vignette, the (married, distant) "man involved" is Coach of Coach, and Dr. Cher tells Anne Heche all about her commitment to providing abortions and sounds just like a hero.* But, you know, what Dr. Cher says is also surprisingly true to life. I wondered if the movie's writers might have had a modern-day abortioneer consultant, and who it was.

"I won't be leaving my wife after all. Here's two hundred bucks; take care of it." 

If These Walls Could Talk centers on the reproductive crisis moments of three different women living in the same house in different decades: a desperate widow in the 1950s, a harried married mother in the 1970s, and an embittered college student in the 1990s. After the movie there was a lot of conversation -- about the time before abortion was made legal, about "what it's like in an abortion clinic," about violence against providers and so forth. I was surprised to learn that about half our little discussion group hadn't heard of Dr. Tiller's murder -- they had gasped when they saw Dr. Cher take off a bulletproof vest to change into scrubs. (For me, that scene was actually a reminder of the doctor -- it might have been Dr. Carhart -- who was quoted saying there was no point wearing a bulletproof vest because the antis aim for the head. How Dr. Tiller was killed.) In any case, it was a good occasion to have a conversation about abortion issues with people who aren't part of the field and don't know a lot of the details.

Here's part of a scene that we discussed a good deal:



Some things I particularly liked (mostly remembering from the final vignette):
-Dr. Cher, as mentioned above. Her words are simple and true and familiar.
-Anne Heche's best friend (Jada Pinkett!), who at first is really shitty to her for even considering an abortion, eventually decides to support her friend and accompanies her to the clinic. It does happen! About A Girl's post about this is still my favorite.
-There's a wide range of protester behaviors in the real world, and the movie did portray a couple of different ones. The protesters in the previous day's scene were less numerous and less rowdy. This giant crowd is more typical of big clinics in the Midwest, say, or of staged "Summer of Mercy" type events, back in the 90s before the FACE Act was passed. Unfortunately, it took a lot of clinic violence to convince Congress to take action, not soon enough.
-It was nice that they showed the role of clinic escorts, who as you know are awesome. This clip doesn't show much of the clinic's single escort, though.
-In an earlier vignette, well, "liked" is a bad word for this scene, but I appreciated how well the interaction between Demi Moore and the pre-Roe illegal abortionist (from whom she requested a kitchen abortion) depicted women's lack of choices in finding safe and dignified care. It was a truly tense scene:

-The women are in different situations and have different decision-making processes, and not all the vignettes end with an abortion decision. (Imagine that!)

Some things that were a little ridiculous:
-Sissy Spacey (the 1970s mom) has a teenage daughter who's the perfect caricature of a feminist activist -- righteous, but a nosy pest; automatically believes that the best option is abortion; acts as though an individual woman's every personal choice is a political statement. She even practices yoga, which I think in the 70s was pretty far-out.

-Anne Heche's best friend, who goes to the clinic with her but is still an anti, ends up having an argument over abortion, with a clinic staff person, at the front desk. I guess you've got to lay out the conflict narrative in a movie, but no way would any of that happen in the environments where I've worked.
-The protester crowd outside Dr. Cher's clinic grew by the hundreds from one day to the next, without much explanation about why that would happen, which might have made it seem implausible. I wish they'd explained that events like "Summer of Mercy" really did overwhelm clinics suddenly and dangerously.

...And then I went home and watched Juno. I promise I don't normally do this! And, although I have always really liked Juno for its silly dialogue and sweet friendships and Kimya Dawson soundtrack (of course), this time I was again thinking about the things that first struck me when I saw it in the theater. The things that would've stuck in my craw had the soundtrack not washed them down.


Unfortunately, this clip is the closest one (chronologically) to the damn clinic scene that I could find!

Most particularly:

The clinic counselor. Of course. What the fuck is up with her?? She seems unqualified, untrained, uninterested, and unnerving. Just plain unprofessional. Over the hamburgerphone, she supposedly asked Juno how long she's been "sexually active" (mostly a device to allow Juno to rant about that phrase), which no one would need to ask just to make an appointment. In the clinic, she's playing a handheld videogame and doesn't make eye contact, has a "withering" expression if I ever saw one, and tells Juno that her "boyfriend's junk smells like pie" when he wears the clinic's boysenberry condoms.

I know it's only supposed to be funny, and she's not even the reason that Juno leaves the clinic (that was because of all the fingernails she noticed, which is also silly but funny), but wow! The friends I went with teased "Hey, that's you!" and I felt sort of sad because yeah, that's probably what some people think. Whereas it couldn't be further from my experiences with abortion work. Sure, you're tired some days or have periods of feeling un-challenged by your work, but even coworkers who are suffering burnout try not to take it out on patients.

Of course, aside from that and how un-scary the single (shy, teenaged) protester is, that's practically the only ridiculous abortion-related thing in that movie...because there's no other discussion of abortion in the movie. Well, except the stepmom asking, "Honey, have you considered..y'know, the alternative?" Man, I love Kimya Dawson, but give me another Obvious Child any day!

Obvious Child from Gillian Robespierre on Vimeo.



*Note: After drafting this post, I realized that Cher directed that vignette! Haha.

Richness

Sometimes, I think about other lines of work I could go into. I think about it not because I'm irreparably damaged by the alleged horrors of my work (sorry, anti-choicers, I'm not), but because of the meager income I make at the clinic--I hover just above the poverty line, as do most of my colleagues. (sorry again, anti-choicers who think we're in it for the money and it's all about the Benjamins).

And other lines of work appeal to me a little bit, but none as much as abortion does. Abortion is so much more than a surgical procedure, more than choice, and more than feminism. It's about domestic violence and helping women come up with plans to leave their abusers after they end their unwanted pregnancies. It's about building up a child again after incest brought her to the clinic before she even entered her teenage years. It's about collecting irrefutable DNA evidence after a rape that WILL be prosecuted.

We see classism in healthcare and try to even the playing field in our particular brand of healthcare. We know why it's called reproductive justice rather than pro-choice because we've seen the disparities and barriers women of color face. We find funding and build trust with homeless women and we work to connect with the privileged, upper-class white woman who flippantly says, "I can't believe all these women are having abortions! I wish they wouldn't use it for birth control. My situation is different."

We've seen demographic data--it's not just heterosexual women having abortions, but queer women who also need a choice or who got pregnant through donor insemination, then were faced with fetal anomalies. For every macho man who's bored with having to spend his day at a clinic, we've seen men cry and express fear.

We know women who drive H2s have abortions, but so do women who have been exposed to environmental toxins that affect a pregnancy in terrible ways. We meet women who need D&Cs because of demanding work environments that caused them to miscarry.

We know how mental illness works. We come up with plans of care for women who deal with depression and anxiety, we evaluate and alter treatment, language, and protocol for women who are developmentally disabled. When we talk about post-abortion coping, we also talk about emotional, binge eating or exercise and restricting food, as well as body image and body autonomy.

As I wrote in my last post, we see undocumented immigrants who can't believe abortion is legal in this country they've adopted that hasn't fully adopted them. We also see women in the military who forgo this pregnancy so they can serve their country, proudly or bitterly.

We've met women who are staunchly childfree and women who need to be able to care for their large families by not adding to them. We see tired women who thought they were safely and squarely in menopause as well as teenagers who thought they couldn't get pregnant the first time they had sex.

And all of these diverse women are the reasons I don't mind buying thrifted clothes, driving an aged car, and living simply. Their experiences and their willingness to share them with me make me better, and that sure isn't near-poverty to me.