Abortion - Mixed Feelings: We Aren't All Nicely Wrapped Packages

We know that women have abortions for many reasons. And we know some women feel a myriad of emotions about having abortions. Sometimes, they don’t; but I’m going to talk about complexity today. Sometimes the “abortion feelings” are wrapped so tightly, are so entwined with the “everything that’s going on in my life” feelings, that they aren’t separate at all. Yet, they kind of are. It’s like the ying and yang. It’s usually the “everything that’s going on in my life” that turns a woman toward abortion. Life/Abortion. One not quite existing without the other. If things were different…different decisions might be made. (Always the conundrum of life, really.)

I’m not telling you anything new; but sometimes, abortioneers like to make the abortion decision - and the feelings about the decision – nicely wrapped into a fine package of “I’m going to be okay. Everything’s fine. I am woman. Hear me roar.” But it isn’t always so simple. It’s not always wrapped up so nice and sweet, delivered into the palms of clinic workers with a smile on the face and a “here you go. You don’t have to worry about me! I’m your text book feminist having an abortion.” Sometimes, the decision is dead easy…but attached to a heavy heart. Sometimes, it’s sad. Sometimes, it’s terrifying and feels wrong. Wrong, because your life wasn’t supposed to be like this. You weren’t supposed to be one of those girls. You didn’t grow up saying, “One, day, I want to have an abortion.” But life can take twisty turns down dusty roads. Shit happens. He happened. It happened: whatever “it” is. The “it” is not the same for everyone. And trust me, we get it.

Sometimes, just sometimes, the experience – or multitude of experiences – that brought her to stand in front of us, asking for an abortion, can’t even be dealt with at the time. Just getting the abortion completed (money in hand, ride at her side, pads in the car, kids taken care of) might be all that can be handled with right then and there. Don’t fuck with her about her relationship or question if she’s sure she doesn’t want to try a new birth control method (because, this one failed. Right?). If she sighs deep, looks like she hasn’t slept, seems distant: just fucking hold her hand. Show her kindness. Let her breathe. Let her deal with the other shit when she can.

We (women/people) can’t always handle life all at once. We can’t always be expected to be strong. We can’t always be expected to carry the heavy, heavy weight bearing on us. So we take out strips of our life from our pockets and face what we can. Piece by piece if we have to. Year by year, if needed. Maybe he hurt you in ways you never told anyone. And though I don’t think women have to heal from an abortion, it might sometimes seem like it, because we may have to heal from all the hurt that surrounded “it” happening to us. And it’s not that it’s confusing: we shouldn’t have to separate, really, the possible pain/sadness/hurt/regret (that things weren’t different) about the abortion from what our life was like at the time of the abortion. To let go, to grieve what you’ve lost in your life – that “what could’ve been” – is okay. It’s equally okay to have mixed feelings about an abortion during a mixed up part of life and still feel solid and certain that abortion is the best decision, while feeling so…unraveled.

We’re women. We’re complicated. And we don’t fit in neat little boxes, wrapped up nicely, with smiles on our faces. All of the time.

Thanksgetting

I don't do it for the thanks. If I did, there are plenty of days that I might have quit! I've had women shout at me, swear at me, tell me I wasn't a good feminist, I hadn't secured enough financial assistance for them, I didn't answer my phone often enough, I wasn't checking them in fast enough, doing enough, caring enough. When in fact I care really hard and I try really hard. Sometimes I'd hear a coworker have a similar interaction -- maybe just an abrupt goodbye after she phoned to delivered news of a donation toward a patient's abortion costs -- and hang up and mutter, "A little gratitude would be nice." Idunno, I say screw that. Women have a right to choose abortion; I don't have a right to clients' gratitude just for providing their care. It's a matter of social justice that women have access to abortion, and they don't owe me thanks for their rights. They weren't mine to give anyway.

Don't I appreciate a word of thanks from a patient who, by all rights, ought to have her mind on anything but my feelings? Of course--quite a bit. It's wonderful to hear, "You all have been so kind and so professional; thank you for making this so much less stressful and scary than I expected." It's wonderful to get letters that read "This means the world to me. God Bless and may heaven smile upon you guys. Thank you."

But it's the part that comes before it that keeps me doing this work: "Due to my pregnancy I was discriminated against at work, they cut my weekly hours from 40 to 15 and I could barely afford rent, let alone paying for an abortion or even having a baby."
"I'm involved in domestic violence and have had no one to turn to. You have saved my life from eternal abuse and my child from growing up with violent torture."
"This year I earned a sports scholarship to go to college, but when I found out I was pregnant I was afraid I wouldn't even get to graduate high school."
[Excerpted to protect privacy, but these are women's own words.]

Those women don't owe me thanks! We, as a society, owe them all that we can do to reverse workplace injustice, end domestic violence, increase educational opportunities, AND make reproductive freedom a reality. And I thank them: for not giving up, for seeking to make their own life, for being patient with the unfairly long process of seeking a provider, an appointment, the money, the ride, the babysitter, the day off to recuperate.

Thank you, so much, for the compassion and companionship that I hear you offer each other in the waiting rooms and the recovery room.

Thank you for the times I was training and you consented to have me in the room, even though my presence was of no particular use to you that day. Thanks for everything you continue to teach me and my coworkers as we strive to support you and connect you with what you need. In short, thank you for the privilege of being involved in your care -- I will try to earn it.

Staying Motivated

We know doing direct service abortion work can take its toll. After reading our dear Desembarazame's recent post, Trust, I got to thinking: what can we do to keep ourselves motivated? We've talked about how to not burn out, how to take care of ourselves; but what can we do to stay on fire, to keep "burning-in" day in and day out?

I loved what Desembarazame said about wearing her "Trust Women" button (and believing in it to her bones) and about dancing around in the building. I can imagine her - as I'm sure you can, too - bringing a lot of happiness and light to her clinic. I totally wish I worked with her!!! (She would completely rock as a co-worker, wouldn't she?!) I relate to how despite believing so much in what we do, it can be exhausting. Especially in times of change. Especially when co-workers are all up in eachother's business. Especially when I'm annoyed with some decision that someone has made.

Some motivation tips:
1) Share client stories with co-workers (even when they're being - err - a bit challenging. I'm talking about your co-workers, not the clients!).
2) Try to have direct contact with clients, make a connection (remember why you're doing what you're doing).
3) Pick people's brains that have done the work longer than you: ask them for stories from "back in the day." (They'll probably love a skip down memory lane.)
4) Read the Abortioneers Blog!! (Cheeky, I know!)
5) Or...STOP reading about abortiony stuff and abortionland! Take a break! (But not from our blog. OK? Please? Oh, well, alright. If you need a break, it's okay. We won't judge.) :)
*5) Take a long weekend off. No, not just from our blog...from your job, too! Yes, I'm serious! Play hooky! You have our permission! (Uhm...just don't tell your boss!)

In all seriousness, sometimes we need more than a weekend hiatus. Sometimes we need a few months. Or a year. Or longer. It's okay. Honestly. It is.

What kind of things help all of you not just avoid burn-out, but get you to BURN IN (per Jack Kerouac, per Daughter of Wands), to stay motivated?

*PS: We don't endorse lying to your employers. But we know everyone plays a little hooky-hooky sometimes. Just don't call in on a super busy day, like, when people are on vacation or you have clinic!!!!! Be a good co-worker and play sick responsibly!

*PPS: No, don't show this to your HR Manager. And no, we don't offer sick notes: fresh out!

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.

My father the reluctant pro-choice hero

I suspect my dad never meant to raise a pro-choice feminist. I wonder if he had no idea what he was in for when he had a daughter. He often seems taken aback by my opinions if I don't ease into them or don't take a mild tone defending them. He's uncomfortable with abortion -- knows it's necessary in some cases, but wishes that someone else's daughter were doing the dirty work of "facilitating that." For a while, he seemed outright sorrowful that I had chosen this field.

But I must have gotten these values from somewhere. It always just sort of made sense in my head that it came from him and my mom. The particular differences of our family have always made me appreciate openmindedness and strive to respect others' background and situation. My parents value justice, rights, the common good, public health, and medical truth-telling. And it's because of them that I have always tried to understand all aspects of a person's narrative -- more than is probably possible. So I don't feel bad or wrong when my dad doesn't see it my way -- just sad -- because I know that he knows we are starting from the same values. And finally, in the past year or so, he's stopped asking if I'm considering changing specialties, and started acknowledging aloud that I've found a calling of sorts. 

And yet! Even though we've reached a point where he seems to accept the stories I share with him as good-enough reasons to continue my work, there are certain things that he doesn't seem ready to let go of. Not so surprisingly, they seem related to him as a man, as a father or a potential father: 

1) What if a minor has an abortion without telling her parents? That's wrong, and therefore "parental consent" laws are good. I would want to know if my daughter were pregnant or seeking an abortion, and it's my right as a parent to be involved in her medical care. 

2) What if a married woman has an abortion without telling her spouse? That's unfair to a husband, particularly if he has wanted a child, and therefore wrong, and therefore there should be a law against it. I would want to know if my wife were pregnant or seeking an abortion, and it's my right as a potential parent to have a say in what happens to my potential child. 

Compelling hypotheticals, but I'm forced to disagree with him every time. The number of negative situations that could be dangerously exacerbated by parental consent or "paternal" consent is so overwhelming, and so non-hypothetical, that I just can't abide by the argument that we should pass coercive laws based on the assumption that all families/couples have healthy relationships. It's not just that, fundamentally and morally, abortion is not up to a parent or partner's decision; it's also that women and girls may very well die if we let it be someone else's decision to make. Remember the 13-year-old in Pennsylvania who was hospitalized this month, because she induced an abortion with a pencil rather than comply with her state's parental involvement law. Daughters get kicked to the curb or worse for being pregnant. Adult women get shoved around and beaten up and their abusers threaten their children or pets, all to keep them under control, and impregnating a partner (child or adult) is a sadly common weapon to ensure she's stuck with him. 

That's why, if you're a parent (or partner), the onus is on you to make your relationship with your daughter (or partner) one that she knows she can trust for support in making difficult decisions, and then hope that she decides to share that part of her most private life with you. Like you're supposed to do in your relationship in general, for everything. Ensure in advance that she always knows you are there for her, for any eventuality, whether or not she'd choose what you'd choose -- like I know my dad is. That's really all you can ethically do. If you're already doing it, I thank you from the bottom of my daughterly heart. 

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. 

Cool Abortiony Vids

As a volunteer at the Global Health Council Conference, I had the opportunity to peruse the booths of other global health orgs and reproductive health ones. Always a fan of Ipas (see our previous posts referencing Ipas), I stopped by their booth and grabbed some literature, plus the obligatory "I <3 Reproductive Rights" swag. Then I went stopped by their YouTube channel, and I strongly recommend you do the same, if for no other reason than the following -- take 30 seconds and watch*:

Think About It


I assume this was filmed in Brazil, which is great because it sheds light on the situation in a heavily- Catholic and anti country.

Did you finish? Good. Let's discuss.

I've always had this theory that people who are not intellectual/politically involved/generally thoughtful just regurgitate things that they are taught. I've spoken with lots of folks who, when asked to explain their views on certain subject, respond "just because". It's simple recitation. You can tell that the person has never truly considered what he/she believes, or why, but just believes so because they were taught so by mom, dad, Father Flynn, or whomever else. That's what I love about this spot; everyone has an automatic reaction to they way they feel about abortion, simply because it's against Catholic doctrine. But when asked to consider the morality of the issue, they're stumped!

Granted, this spot was probably edited to emphasize the point, but I can't imagine that this attitude is rare in Brazil or other Latin American countries. It's crazy! Especially considering the Brazilian government's commitment to health and relatively good health indicators. And the way they've managed the HIV epidemic is laudable. It's sad how religion trumps health/human rights. Those minor details.

ANYWAY. Please check out the channel for other videos and promotions. A treasure trove at your fingertips!

*(Clip also available in Spanish!)

Thank You Dr. Tiller

It’s hard to believe that one year ago, on May 31st, I received a phone call from a fellow abortioneer around noon. Dr. George Tiller had been murdered in his church by a radical anti-choicer. Not only was the devastation felt in the pro-choice community, but it was felt all around the world. Vigils held in packed churches and city parks represented how far Dr. Tiller’s work and compassion spread. Women and their stories of late-term abortions surfaced on radio stations, newspapers, and tv stations.

It was Dr. Tiller that provided care to these women-women who were carrying a severe fetal anomaly, women whose life and health were at risk, and women who had complicated social issues that prevented them from receiving care earlier in their pregnancy.

We will never forget what profound service Dr. Tiller provided. He truly was an incredible physician and an American hero. As a future provider, I will never forget the legacy he left behind and the service he provided to women all over this country.

On this Memorial Day, we remember him for the man he was. A man who stood up for what he believed in and trusted women.

Thank you Dr. Tiller. You are missed.