One in three (but not me!)

People talk to me about abortion, theirs and others. They talk to me because they know I am a “safe space” of sorts, and you, my dear abortioneers reader can relate, right? We are the people who friends, family, family friends, and strangers on the street confide in about their friend’s abortion, their sister’s abortion, their mother’s abortion, THEIR abortion.

I meet people, usually men, who say they don’t know anyone who has had an abortion. And I always reply, “oh yes, you definitely do, they just haven’t told you”. And then, I meet the women who are always willing to divulge their own abortion story, or their birth control experiences, or who seek advice on reproductive health topics. In fact, one of my favorite get-to-know-you topics is what kind of birth control someone is on (for those engaged in the type of sex that could lead to a pregnancy of course).

We in abortion land often quote the “1 in 3 by age 45 will have an abortion” statistic. We parade it around—our banner of pride that demonstrates the ubiquitous nature of abortion. This statistic can be debated over and over, and it will vary by race, class, sexuality, etc…but whether it’s 1 in 10 or 1 in 2 it’s still a lot of fucking people. And we all know a lot of fucking people right? So we all know someone who has had an abortion. But for most people they clearly would never know it.

Someone I work with sent an email out at work today stating that he was leaving early for an emergency dental appointment. I dream of the day when I get a similar email from a coworker leaving early for an abortion. Because I know it’s happening.

Do people talk to you about their abortion? Do you talk to people about yours?

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.)

Lord, Excuse me...

Sometimes at work we talk about religion. Several of the people I work with are quite religious and the balance between their work and spiritual beliefs is complex. One of the medical assistants has made it clear several times that she is only there because it is a job and she knows that "God knows where her heart is." I believe she is right that her God does know where her heart is; I also know that her God is much cooler than she thinks. She is doing God's work, right in the abortion clinic. But not everyone who works in abortion clinics is staunchly pro-choice like the people on this blog.

The nurse at my clinic is Catholic and when asked how she feels about abortion she is unsure. She has verbalized, off the record, that sometimes she is not sure about her personal beliefs around abortion. Her job is separate from her life and most people don't know exactly where she works, they only know that she is a nurse. But -- most importantly -- her internal struggle between her work life and personal life has never been apparent in her patient care. Her ability to provide quality patient care despite contradicting personal beliefs amazes me.

I'm agnostic; I've just figured out that this is the best way to describe my personal beliefs. I believe in a higher power and I believe awesome people existed, like Jesus for example. At the same time I don't claim to know one universal truth. I believe that reproduction is sacred thus Women's bodies are sacred. Abortion is one part of reproduction, it is a sacred decision and only an individual woman can know if it's right for her.

I can't believe in the modern day institution of Christianity or in almost any of the various denominations. I can appreciate some values of Christianity. However, modern-day Christianity as a religious institution contradicts who I am. I'm a lesbian, I'm an abortion provider, I swear, and I'm sure I am full of other sins. When people call abortion provision "baby killing" it's a joke to me because I am 100% confident there is no murdering involved in abortion provision. In fact, I believe abortion it is often life-giving for women and their families. I cannot relate to the shame I have seen some women express due to religious values. I can reassure them. I often ask women who express these kinds of thoughts whether their God is a forgiving God. Although I don't believe they have done anything that warrants being forgiven.

There are several groups that seem to have the complex relationship between religious values and abortion worked out. There is a group called Faith Aloud that offers counseling for women who are pregnant or who have had abortions. This organization also came up with "40 days of prayer to keep abortion care safe and legal" in response to the "40 Days For Life" anti-choice protesters. The Religious Coalition for Reproductive Choice is another great organization that brings together people of various faiths to advocate and educate about reproductive choice.

*Christianity is the only religion mentioned because this is the primary religion with which I have come in contact in the context of abortion provision.

Plug for a fellow blogger: more on fathers

Sparky's had an unexpected travel-related contretemps these past couple of days, but that doesn't mean the pro-choice summer reading stops! I urge you to visit Every Saturday Morning, the blog of a team of clinic escorts in Kentucky, where today Dan has written on the intersection of fatherhood and escorting, and about a confrontation with

disapproving men willing to abandon their daughters during their moment of deepest emotional distress, embarrassment, and fear, and leave them to walk through this gauntlet of hatred with a complete stranger, a man who will be in her life for only a few minutes, but is willing and able to be her surrogate father.

The post is both heartfelt and heart-rending. Dan, thank you for writing about your struggle that day, and thank you for being a pro-choice dad and a compassionate escort. And happy Fathers' Day to you!

Legislators think they are our daddies (and good daddies make things harder on their children)

Happy Fathers' Day! I was going to write you a post about dads, but it'll have to be tomorrow, because I got distracted by an entirely different kind of paternalism. Today I'd like to direct your attention to this post at The Curvature: Anti-Choice Ultrasound Laws Don’t Change Abortion Rates, But Continue Getting Tougher. It's about the wave of state-level legislation that's been passed in the last year or so, much of it having to do with forcing a woman to pay for a medically unnecessary ultrasound, look at it, and/or hear a description of it from the sono tech.

Now, many clinics use ultrasound as a way to determine at what point in the pregnancy the abortion is going to be performed -- there are important technical distinctions between, say, six weeks and sixteen weeks, though ultrasound is not the only way to figure this out -- and I'm all for patients having access to their own medical records if they want it. However!

(a) There is really not that much to see on a sonogram that's made for the purpose of determining gestational age. The screen is pretty dark, the image is fuzzy, and 90% of abortions are performed in the first trimester, a time when all the print-out shows is a roundish grey blur. 

(b) Instructing, as some laws now do, that the technician must turn the screen to face the woman but the woman "may avert her eyes" is pretty ludicrous. So is the idea that a woman averting her eyes must still hear the doctor or tech "describe the fetal development at that stage" (no provision for "averting her ears" in such laws!). If it's in some way relevant to care, a doctor should -- and would -- explain this sort of thing. If it's not relevant to care, well then, it sounds to me like legislators are trying to alter medical practice for political purposes, and as we know that's not OK. Actually it sounds to me like our state reps are practicing medicine without a license -- which happens to be illegal, you know? 

(c) Most of the laws make no provision for victims of sexual trauma who may be re-traumatized by this process. In fact, the Oklahoma bill which was vetoed by the governor even specified that if the abortion is taking place very early in pregnancy, the ultrasound must be done with an intra-vaginal wand, rather than over the abdomen, to "give a clearer image." I was struck to the core when I read this. Like the state was mandating a second rape -- yes, that's what it's called when someone puts something in you that you don't consent to -- if you wanted an abortion. 

(d) Most strikingly: I have never seen a patient change her mind about her abortion because of an ultrasound. My clinic does perform a sonogram before every procedure. By law, clients fill a form indicating whether they want to see the image, listen to the "fetal heart tones if present," both, or neither. We get back forms with all sorts of answers, meaning plenty of clients do choose one or both, but I don't know of anyone who has said, "Oh my god, you know what? I had NO IDEA there was an embryo in there! I thought an abortion was something to do with my bladder! Now that I know, there's no way I can go through with this." 

(e) Which brings us back to the conclusion at The Curvature: it's probably not at all about changing patients' minds, but simply yet another approach in the campaign to guilt, shame, isolate and traumatize women who choose abortion. To punish them for having made this choice that we know she will go through with, because women are not stupid and women are not children, they understand their lives better than a stranger ever could and they already know in their guts what they are capable of at this moment. 

Sometimes that's giving birth and giving her parental rights to another family. 

Sometimes it's leaving high school or going on public assistance in order to afford a wanted, or perhaps unwanted, child. 

And sometimes it's selling her furniture to scrape together 400 or more dollars (have you ever had someone count dollars and nickels on your desk for a medical appointment?), facing a crowd of clueless shame-mongers, listening to maudlin scripts written by state legislators while her pants are down and a high-tech stick is moving around in her vagina, watching a video about a screaming fetus, spending six hours in a crowded waiting room, and having a safe five-minute procedure before going back into the world, back through the clueless crowd, back to her loved ones and not asking them for reassurance that she is still a worthy human being, because they might rebuke her, because they might not understand, because they've heard from ten thousand shame-mongers that anyone in their right mind who's seen an ultrasound would change her mind and leave the abortion clinic. Yes, sometimes women are capable of all that. But god forbid we make it any easier on them. 

Reserving all the judgment for ourselves

You know that saying: the best-laid plans of mice and men go oft awry? Well, because of our extensive experience with the going-awry, many of us abortioneers have pretty firm ideas of safer sexual practices, and some of us might have a certain trepidation about using anything other than "highly effective contraceptive methods" (see here for a ranked chart of options and explanation of its use in contraceptive counseling). 

At the same time, we all spend our days hearing every version of sexual history under the sun, and recognizing that women are not evil or dumb or fuckups when their practices or situations diverge from our own. We counsel clients about methods that are easier to remember or longer-lasting or invisible to an abusive partner; we brainstorm with them about ways to approach a partner about getting testing for STIs, condom negotiation, and respect for boundaries; we remind them about transmission methods of various infections and how to treat or manage existing diseases. We don't scold or scoff. The words "stupid" and "crazy" and "irresponsible" may exist in the world outside our walls, but not in here. 

But have you ever seen what happens when WE fuck up? 

This weekend I had a crazy, stupid, irresponsible experience: unprotected sex. The first of my life. I've been with my partner for ages, but we hadn't had sex in quite a while, and -- it seems crazy but -- somehow this time protection just slipped my mind. And afterward my partner asked if I had gone back on the pill, because he'd been expecting me to pause for condom-time but then I didn't. OMGWTFBBQ, said I. How can someone spend years and years trying so hard to avoid pregnancy, working in the world of unplanned pregnancy, and devoutly practicing protection habits -- then just FORGET? Needless to say, I was about as embarrassed and irritated at myself as your average patient who sheepishly tells you her story of one night of abandon, or one vomited pill. 

Well, I headed right to my medicine cabinet, looking for the pack of emergency contraception that I obtained nearly four years ago and set aside for just this purpose -- or more likely, I thought, for some friend who had a more unpredictable social life and might find herself unprepared. Ha. What was that I said about best-laid plans? I couldn't find the pack! I've moved three times since I first picked it up, and it must be in a box somewhere. So I texted a couple work friends, thinking they were likely to have a spare too -- but they didn't, and our clinic is closed on Sundays so it wouldn't be a snap to get it for cheap or free. No problem: I'll skip down to the pharmacy and buy it over-the-counter---Holy shit! I forgot the full price was fifty dollars. And my insurance doesn't have any coverage for non-prescription meds. 

It's so weird being one of the hoi polloi, the everywoman who faces everyday obstacles and needs to decide if she can afford to protect herself and has to deal with an awkward pharmacist. And really weird realizing I'm judging myself for being "such a dumbass" when I would never think that about someone else. 

Later that day, I heard from a friend: 

               um, how much do you know about herpes?

               i engaged in some high risk irresponsible behavior last night due to drunkeness

               ughhhhhh

               i feel like i need to kick myself out of my [sexual-health-related occupation]

My god! We all make mistakes sometimes, and here we are feeling like something is deeply wrong with us -- like we don't belong in the profession! -- now that we have joined the ranks of those who "should have known better [but presumably didn't]."

Well, good thing it was my turn to blog, said my friend: 

              write about how we in sex/repro health expect ourselves to be models of responsibility and healthy sexuality

               but get down on ourselves when we slip up

               you can talk about your plan b

               and my herpes!

Well, there you go. Turns out this unpleasant incident was a good reality-check: it only takes a weird moment of forgetfulness and some bad luck to end up in the patient's seat or the pharmacy, and I must have had some unacknowledged belief that I was "too smart" to wind up there, or maybe "too smart" to get a pass on making a mistake. 

I know some of us have had the good fortune (so to speak) of being in a "dumb" situation early on, and having lots of compassion as a result. If you'd like to tell that story, please do so in the comments...and I promise I won't think you're stupid!