Client AND employee satisfaction

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

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

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

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

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

Sweet Charity

Fed the homeless today.

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

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

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

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

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

Emotionally Spent

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

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

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

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

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

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

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

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

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

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

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

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

Rules and Realities

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Intermission: Seedless and fruitful

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

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

Privacy

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

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

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

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

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

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

Unsung Heroes

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

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

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

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

Alone

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

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

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

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

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

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

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

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

Termination counseling 101

What do I do when I disagree with a woman’s reasons for choosing an abortion?

Funny you should ask: This does not happen to me. I don’t and can’t see why anyone would ever doubt a woman who did not wish to grow life inside of her body, to raise that child in this world.

I think I do what I do—I can’t be entirely sure—because I can easily find a woman where she is when she’s in an abortion clinic. I can’t do this for others or myself always in the rest of my life, but when I sit down to talk about pregnancy termination, I can take whatever comes from her and ask a woman to admire herself for what I hear she is doing.

I would say it’s a thing inside my blood but it’s not. It’s a spirit thing.

Don’t get me wrong. I’m not tooting my saintly horn—sometimes I don’t like the woman. But, let’s be honest: in those cases shouldn’t I agree with her even more?

Sanctity

Reproduction is sacred.

Moon cycles are sacred, they are not a curse.

The ability to bear children is sacred.

The choice to bear children is a sacred choice that should be faced with courage and good intentions.

13 weeks pregnant with a baby she wants, facing felony charges.

6 weeks pregnant, sad, knowing this is not the path she meant to take, unsure of what to do, medical seems easier to swallow, literally

11 years old, threw up this morning and her panties are bloody, She got to stay home from school, and the women around her will celebrate her first step into womanhood.

Thank God for reproduction.

Thank God for choices.

Oops, you're a psycho

One beautiful Fall afternoon in 2006, an anti confronted me and demanded that I "pick on someone my own size" as she attempted to stuff pamphlets in my clenched fist.

She was a large woman, in both height and girth. Larger, in fact, than I. The irony was overwhelming.

You Fight Me, I Fight For You

I was fortunate enough to go to an excellent college. I transplanted myself from my co-ed high school in the southwest to an all women’s college in the northeast.

Now this grand education I had opened my eyes to the idea of women’s equality, women’s power, and women’s control over their bodies. Admittedly, I did not become interested in reproductive rights until this school or until that women’s studies course. And thank heavens for these introductions, for who would I be without them?

After college, I moved into the city before graduate school and volunteered at the local Planned Parenthood as a clinic escort. I essentially helped women and their partners get into the clinic safely and successfully amidst the sometimes hostile crowd. To me, reproductive choice was a right protected by the law and protected by me. The protestors would say horrific things to women to get them to change their minds, to get them to turn around and leave the clinic. They took a women’s personal, difficult choice and turned it into a street mockery and shouting match. Those women’s faces I escorted into the building are burned in my mind. I could see the fear and I could feel it. But they had a choice-a choice for their bodies and their future. A choice. What did these protestors want of these women? An unwanted child? An unsafe, back alley abortion? Not the right to make decisions over their own body.

One morning of escorting, a new protestor emerged. She was known to the staff at Planned Parenthood, but not to me. She was slightly older than me, brown hair that touched the back of her thighs, and a loud, intimidating voice. She would bring anti-choice literature with her every Saturday and stand less than a foot away from escorts, reading her rhetoric. Mind you, we were trained not to engage with the protestors, but damn it was difficult. Our objective was getting the patients into the clinic. However, this particular protestor was hard to ignore. She would follow you around, reading into your ear with her booming voice.

It was one day that she announced she went to a well known all women’s college, the same college I had attended just under a year ago. I, of course, never told her I was also a graduate of said institution-that would only bring unwanted attention to our battle ground. It was such a disappointing moment, though. I credit this institution for my reproductive health awakening, my fierce advocacy and activism, and my desire to always protect a women’s reproductive freedom. And this woman, my “sister,” credited the same institution for her anti-choice motives. How could we have come from the same place and have such different views?

I think about that woman from time to time. Not all women view choice as an absolute right-even her with such a liberal, mind-awakening education. The realization I came too is that regardless of what she thinks or what she protests against, I fight for her reproductive rights as well. I cannot pick and choose which women I stand with and which I stand against. All women have a beautiful, divine choice over their bodies and their reproduction, all women. And I will fight for that choice as long as it takes, even if some women will fight against me.

All for One

I am a woman. I am presumably fertile. As are you. And you. And especially her. She's even had an abortion before. How unfortunate.

Some women don't get pregnant. They pray and wail and envy the ability to conceive that others so regret. One woman's trash, another's treasure. How unfortunate.

And yet, these women on opposite ends of the have something very much in common; the desire to be in control and the inability to do so. A woman's woe indeed.

So they play God to get what they want. Impede her own fertility. Take somebody else's. Both cost lots of money and are completely unnatural but damn, doesn't it feel good to get what you want out of (or into, as the case may be) your body. Take that, will of God. She's got bigger plans.

We women all want different things, but all to the same end: to get whatever it is we want however we can. And isn't that what women are good at? Chasing things and wrestling them to the ground and keeping a souvenir so we can point to it later and say "Yeah, I did that"?

Just a thought.

Failure

I wrote this a while ago and kept it in a place where only my closest friends could see it. Because I felt ashamed and because there was no right place to make something like this public. But this, among other things, is what this blog is for. So now in the interest of being really honest, I will share the story of failing to help someone, and the privilege of going to bed with my life un-fucked afterward.

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Friday turned out to be maybe my worst day in abortionland, ever. I was working with a woman who was traveling out of state to have an abortion, and she ran into problems at every turn (money, escort, gestational age, new escort, clinic staff, money again), and each time she and I would pull things together and get her out of her bind, and then at the last minute, just short of me being able to do anything to fix it, she got fucked over one last time. And now she needs to start getting prenatal care, because in a few months she is going to have twins.

Yes, I know there are a lot of reasons she was not able to have that abortion. I know that I couldn't have known, before all this stuff happened, how badly she needed me to break the rules for her, how badly things would go if we complied with the logic that a client should try all the most affordable options first, and waste precious time in the process. There are a lot of ways to absolve myself of all of this, none of them completely honest. Everyone is telling me these things: it wasn't your fault that x, y, z happened; you couldn't have known what would go wrong; you can't do everything for every client; you succeed at helping people more times than you fail.

All these people are both right and wrong. These are things that people in the social-service fields tell ourselves because we need to justify putting away the client files after a day of failures, and we need a reason to open them up again in the morning. They are true things to say, but they are also not enough sometimes. Around 7 I collected myself, left my office with a couple of colleagues, and proceeded to get drunk, meet up with several more people, have a fun and noisy time, and stumble into bed at several o'clock in the morning. Then I woke up and it was Saturday and I thought about the rest of my weekend and how Monday was after that and then I suddenly couldn't bear the thought of going back to work.

And Monday I did go to work, and I couldn't bear being there. I heard myself being a horrible person every time I picked up a patient's call, slumped low in my chair, thought about how soon I could drop this gig. Couldn't humor my coworker who makes terrible jokes that I usually laugh at. So I arranged to take the day off today. And my partner called in sick to stay home and take care of me: because I need taking care of, like I am sick or something. We spent all day in bed then went out to get a book my partner wanted, and now I'm making an apple pie. I know I am really lucky to be able to give myself a vacation for fucking up. Where me fucking up means a woman's life will be changed forever; she is barely getting by with just her own mouth to feed, and now she will have three. How do I reconcile these things and go back to my work?

To have and to hold or to not stick around to see the never-ending

Reason number two a woman is having an abortion: unreliable partner.

These days, for me, exemplify rarely anything short of distant men.  Men who have gone inside themselves, or somewhere completely away.  Men who were never there to begin with. Sometimes I wonder if I ever could have done something else.

Chosen a different career.

The great new-age, theorizing men who trip and adventure and write, will suggest we find ourselves within ourselves, the world, move-on in all things—ourselves, autonomous, personally thriving, hopeful for even more life to explore on other planets. Children are the world’s children. We can only evolve our matter, mater, make ourselves light. They are men. They overwhelming generally take the kids for a day?

What if I don’t get a lover until more lovers accompany their lovers to the abortion clinic. Instead of chronically dwelling in lone one-time loverville where the women are pregnant and off or on.  Oh.

Men who oppress. Yesterday: Mom and nineteen-year-old daughter. Devout Christian mother asks me how a virgin gets pregnant. She doesn’t. I look directly into the young woman’s eyes. Say, rarely sexual foreplay leads to ejaculation close enough to create pregnancy. Her eyes. That’s not it. Say, pregnancy can occur when a woman is sexually assaulted or raped. Her eyes well. She says, I think. I was drinking and I just can’t remember after the bathroom.  We speak of time-released inebriation, the need for a buddy, to never go alone with a new man under the influence and then, most importantly, the definition of date-rape. Finally, impaired judgement does not excuse assault, no-way, no-how, never. I see an immense shadow lift from this young girl, another deep and winding shadow settling in.

What if Virginity was every time a man and woman faced one another sober and respectful and the man said, yes  and the woman said, yes and they made love or whatever with all intentions of thriving on their own for one another?

Men who leave. Yesterday: Two friends have sex and she gets pregnant and he never wanted the baby or to pay for an abortion. So he doesn’t. Same man has two kids he takes every once in a while, delights for a day, then retracts to go hunting or something gamey like shooting wolves or marbles or loaded semen.

Children are the world’s children. But what about being made of certain pieces of two by two by two beings?

Men who love. Yesterday: Lovers. Thank goodness. The last patient has a lover. He asks questions. She asks questions. They openly agree to try new things. We laugh and get sentimental. They pay cash--half and half. She has an abortion. I finish my day. I exit to a bright, fresh sun. The lover is awaiting his lover outside the recovery-room door and calls, Thank you, Daughter, waving and gracious. Thank you, too, I call. For loving your girl. 

Gratitude

When I told my Mormon mother I was going to work at an abortion clinic, I could’ve heard a pin drop. She was confused, didn’t really know exactly what to think, and was wondering what she did wrong to make me work in such a place. Mostly, she tried not to say anything about it, but occasionally she would ask me when I was going to get a ‘real job.’ She was certain I was just going through a phase. That was 16 years ago.

I could’ve never anticipated how my work would change my life, my philosophy. I went straight from a very patriarchal upbringing, landing hard and fast into a very feminist organization. It couldn’t have been any more different. Over years, I had been taught not to rely or trust my own feelings or intuition; and that in fact, my intuition wasn’t really ever my own. All of a sudden, I heard a different message: that women can and should be trusted; that as women, we know what is best for us at any given time; and that when applied to abortion work, it was never, ever our place to question a woman’s decision whether to or not to continue a pregnancy. She knew best. We were there to provide information, so she could make a choice that was in her best interest. We were not to be guides, knowing what was best for her, quietly helping her make the ‘right’ decision. We were there to trust her. To support her. To listen, and to provide a service to her. With dignity. With respect. Without judgment.

I was hired as an abortion counselor. Quickly, I felt incredibly honored to listen to women’s stories, to gain strength from them, and even have the opportunity to learn about myself. I have been privy to quite possibly one of the most private moments of many women’s life. Sometimes, no one else in their life would know about her abortion.

16 years on, I have not forgotten how special it is to be part of a woman’s abortion. What takes place in counseling is sacred ground and I am grateful to the women who have touched my life, and continue to do so, with their infinite courage and strength.

We love abortion like we love babies

The darling, soft and joyful baby kept rushing toward my open arms...

Sunday afternoon.  You dawdled in civic square and I lamented this economic down-turned truth: those who love babies, those who hate abortions will, in fact,  seek termination and the resources to so.

Happy families enjoying the new, spring air, the sunshine, the breeze and blossom--will reconsider their once-fertile efforts. I know this because I have begun to navigate new and not-so-once-needy territory.

Oh, laughing and precious baby! How I love your mushy hands and pint-sized body. How I long to embrace your zest for life, your non-judgmental wish to hold my hands and bounce about. Thank goodness you are here and loved. Thank goodness you will go on to thrive. Thank goodness for your cuddly flesh. Thank goodness you come bearing divine gifts, the truth, a new kind of refreshing true love...

systemic ass kicking

She didn’t call you back because her ultrasound read that she is 36 weeks.

This particular patient told me she was 6-8 weeks but actually she is going to give birth to a baby in about a month.

I find this scenario perplexing. I told someone at work about the woman and she said, “I just don’t understand, I mean didn't she get bigger as she got later?.”

Some people might argue that some women truly never show. This sounds ridiculous to me, lots of people in my life are pregnant and no matter what by week 36 they end up with more than what could be considered a beer belly. But every woman’s body is different and just because she gained some weight, maybe even in her stomach does not mean she knew exactly why. Lots of people’s weight fluctuates for all kind of reasons. This woman was definitely disconnected from what was going on with her physical body in same way. But I don't have the right to judge her experience of her body pregnant or not.

I wondered to myself if that woman would be ok, Will she find someone else to care for this child she did not want to bring into the world? Will she rise to the occasion? Or just become more lost and disengaged from world? Mostly I just hope she will figure out something that works for her and that might find a way to provide the kid with a life worth living. Adoption could be one option, except she is a brown woman so adoption would more than likely mean foster care of some kind. I take a moment to say a silent prayer for her and the child she will give birth to.

The mental, physical, emotional, and spiritual disconnection of people’s lives is so apparent in stories like these. The world we live in does not breed an environment that is conducive to holistic health and well being. An individual’s life is constantly determined by outside structures. So many people do not have the space to focus inward in order to rectify each part of their self or do any kind of healing physical or otherwise.

While trying to maneuver through the healthcare system a woman who needs an abortion may come in contact with the religious system when people protest her personal choice, she will come in contact with state laws that determine waiting periods and parental consent laws, she might be facing utility shut offs, her kids might need clothes for school and she will have to face the educational system and retail because their uniforms are just too expensive and the old ones don’t fit, she might deal with housing if she is facing eviction, or maybe she just got out of jail or the man involved is in jail and can’t give her any money. The criminal justice system isn’t about to chip in on the cause.

Each person’s life is structured based on their interaction with multiple institutions which make up multiple systems, creating a social structure. This is paraphrasing of an explanation of society found in most American sociology textbooks. Women who need abortions, particularly when they are poor, are dealing with multiple systems kicking them in the ass all at once. I guess it’s much easier to ignore a seemingly pudgy belly up until your due date when you are consistently occupied with survival. There really is never time to think about how you are feeling or what that cramp in you back is, or why your periods have seemed so light, it’s probably just from stress anyway.

How do you live with yourself

Today a woman told me she had enough money to buy diapers for the rest of the month--laid-off for the past few months, homeless, living and eating with a friend, her child. The man involved is long gone. (yawn/ouch). She has sold everything she owns to make it to here. Pause.

Oh. That sucks, I say... But how much is that? Twenty dollars. She has twenty dollars. Her co-pay, right? :(. The surgery will cost from $250 to $7,000. No matter anything. No time. No loans. No payment plans or claims. Cash. Credit card. Money order. She’ll have to find at least $100 more than she couldn’t find yesterday and I will fall short of suggesting she offer sexual favors. Though, that solution may pass between us in silence when I tell her there is nothing left for me to do or suggest, that she’ll have to find that cash in her life amongst those she knows. Nevermind the diapers.

Suppose some abortions are meant to be. Sacrifices. Motherhood. Reflective. Not having an abortion means being a selfish mother. It's important women reclaim/frame this experience from within. The spirit.

Suppose some abortions are a tragic reminder that our society doesn't just fail some women, we burn them at the stake. Pointedly, women who are occupied with surviving--deemed unworthy of assets that float in space in their name, entangled by invisible webs lightly but chronically capturing their most basic human rights. Breaks the heart. Not the spirit.

Suppose I talk to one more woman who has less than $0 in her pocket. Suppose ground zero is different than the newscaster will tell you. Suppose I'll let you know when the recession bottoms out.

Happy Abortion Provider Day!

I had a hard day at work and realized throughout this day that I hadn't really thought about how it's National Abortion Provider Day. I want everyone reading this to think about and remember all those who put themselves on the line for women trying to access safe abortion care. Doctors, nurses, administrators, receptionists, counselors - these people walk through picket lines every day. They get death threats, bomb threats. They are harassed and threatened, but they persevere.

I want to say thank you to all abortion providers, to all involved in any way in providing abortion care. Thank you to the people who post on this blog. Thank you for risking yourselves for others' health and safety.

I also want to post a shout out to clinics escorts and encourage anyone so moved to look into local escort groups in their area. You could contact your local abortion provider perhaps, or if anyone knows a website where people people can look this up, please comment.

Upon Our Shoulders

Why, as women, do we seem to carry so much responsibility/burden/guilt on our own, strong shoulders? We care for our children, our aging parents, our partners, our friends, our co-workers, our communities. The more we take care of others, the heavier the weight becomes, making it so easy to quietly become that "caretaker," blurring the vision of ourselves, stripped away, as we really are. Who we really are.

The reality is, though, for many of us, we don't even have the luxury or time to consider who we are beyond "caretaker." The reality is, for many of the women I speak with daily, they just try to get some semblance of food on the table so their kids can eat, manage getting their kids to school and try - somehow, somehow - to obtain their abortion. Meanwhile, you'd be forgiven to think most of them got pregnant all by themselves. The "man involved" is often off, off and away...somewhere...with a change of telephone number; a change of address; change of heart; and a great, big, firm "Fuck-you-very-much-I-don't-want-anything-to-do-with-this-so-called-pregnancy." So, all too often, the unwanted pregnancy becomes her unwanted pregnancy, her problem.

Though she wasn't alone at the time of conception, life carries on as though she was. And it might've well been that way, too, because it's not like she's going to get any help from him: the him who can't even bother to spend $5 on a gallon of milk for their nine month old daughter who just had open-heart surgery; who sneakily slipped off his condom and came inside her before she even realized what happened; who just told her, once he found out she's pregnant, that he's married with children; who's incarcerated for smacking her around.

Despite all this, women usually tell me it's their own fault they're pregnant. Every day, they say:

• I should've known better and not had sex (even though in the last ten years, she had never been pregnant);
• I shouldn't have had any alcohol at my cousin's wedding (because, then, maybe she wouldn't have been raped);
• I shouldn't have had sex without a condom (even though her husband had a vasectomy);
• I should've had an abortion two months ago instead of waiting until I was 18 weeks (despite only being three weeks late because she was still having her period).

Much of my day, I say something like, "So, since your husband had a vasectomy and because you often go three months without a period, it's only reasonable for you to have expected that you were not pregnant, let alone 20 weeks pregnant."

Her: (Big, long sigh.) "God. I know. You're right." (Big sigh.) "But, still." (Pause.) (Deep breath.) "I still should've known. "

And so, yet again, another large, heavy weight gets hurled onto our shoulders; onward we carry these responsibilities/burdens/guilt as though we're alone. As though it's our job. And we barely notice how heavy it gets. We barely notice ourselves.

Responsibility Rant

You know how MSN and AOL have those little article blurbs on their front pages, Top Cities To Live In, Toddler Saved By Squirrel, Study: Men's Brains Are Bigger Than Women's? The other day there was one called Ten Ways NOT To Find Money In Troubled Times. Well, I read it -- probably because I have a peverse sense of curiosity, and I speak to a lot of pregnant women who need Money In Troubled Times.

Sadly, but not surprisingly, most of these Don'ts are suggestions that I have to give to women every day.

Or, OK, half of them: Cash Advance On Your Credit Card (if you have a credit card); Tax Refund Anticipation Loan (very popular right about now); and the old standbys, Payday Loans, Car Title Loan, Pawn Shop. Yes, the terms are very unfavorable to the person asking for money. They are unfavorable because you will get the money right away, and the payer knows how badly you need the money right away.

A couple are things I had never thought of: Cash In Your Life Insurance; Gold Parties. Apparently "gold parties" are like a reverse Tupperware party -- someone hosts a get-together, and you show up with all your gold, and they give you too little money for it.

And the remainder are things that pretty much wouldn't apply to the situations I am talking about, things that are almost laughable: Loan on your 401(k); Home Equity Line of Credit; Break A Certificate of Deposit. Just in general, if you can afford to save after you've shelled out for basic needs each month, you can probably afford an abortion. I mean, there are exceptions: if you were, say, 28 weeks pregnant or in very fragile health, you might have to be treated in a facility that charged five thousand or ten thousand or fifteen thousand dollars. But most of the time, I mean.

So anyway, I love how even when a woman finds help paying for her abortion thanks to an emergency-funds organization, we use the language of "responsibility." We remind the woman that the Women's Medical Emergency Fund of Springfield (for example) will be assisting with $50 of her fee today, and she is responsible for the remainder. Well, of course she is; but we sort of glibly toss this word at her that probably means a whole hell of a lot more to her than it does to us in this second.

A pregnant woman experiences the word responsible in so many ways at once. She should have been more responsible than to get pregnant in the first place. You shouldn't have sex unless you're prepared to be responsible for a child. She'd better be acting responsibly toward the unborn child everyone assumes she will be carrying to term (no drinking smoking cursing fucking...). And now, she is responsible for the remaining (approximately, for a first-trimester procedure) three hundred and fifty dollars of her abortion fee.

Which has been a struggle for her to find, because she is poor, because she is not financially responsible, because she had to resort to a payday loan to tide her over one month and has been paying it back with more payday loans every since. Because she doesn't read WalletPop, presumably, and doesn't know that you should not turn to payday loans for Money In Troubled Times.

If only she had read Eleven Ways To Find Extra Money NOW! Then she would have known to join Netflix, stop paying for cable, host dinner parties at home instead of going out with friends, and sell her poorly-performing stocks. Yes, really: the way to find extra money is to spend too much money on things you don't need, then STOP spending that money. Voila, free money! Duh.

Abortion Run-In

What a day.

Decided to investigate my insurance coverage re: abortion. Like most women I've spoken to, it had never occurred to me just how an abortion would be paid for until it became a relevant part of my life. Sure, we all agreed that abortion was a fantastic right and if we ever needed one we'd pick up the phone and hop the next train to Abortion Land. But alas, the elusive middle-step always rears its head at the most inopportune moment: PAYMENT.

So I took a preemptive strike against the four-letter seven-letter word and checked out the internets for abortion providers covered by my insurance. Got a couple. All looked mighty fine with one group, except when I looked at their website there was no hint of the word "abortion". I checked again: maybe it was hidden somewhere so as not to offend their more upright clientèle? Nope. It was nowhere! My potential abortion doctors don't perform abortions! To make matters worse, I clicked on the link for pregnant woman to find this cheerful message: Congratulations on your pregnancy!

True Story! I will continue to investigate this further tomorrow, to see what's really going on. I guess I'll start putting away a few dollars into an emergency abortion piggy bank. Break in case of emergency.

And then...

On my way up the elevator back home, a sweet-looking older lady stared at my bag. I was only half paying attention when she asked me, "Which clinic?" After a few seconds I realized she was referring to the button attached to my bag, which proclaims "Jesus says this clinic stays open!" Now, I tend not to wear my beliefs on my sleeve, and I typically don't blabber about my political inclinations with people who don't know me. I wasn't quite sure what to say. Did she know what the button was hinting at? Did she mind? I'm sure it was the "Jesus" that caught her eye to begin with; maybe she was religious. I had to come up with something to tell this lady so as not to break her heart. Should I watch my step, play it safe? Meh. I decided on an answer that I rarely give to perfect strangers: The Truth.

"Oh, just all abortion clinics in general."

"Oh! Well that works, too!"

Phew! Score one for Team Abortion.

True love awaits

Imagine my horror to discover my reward was seventy male virgins last time I died and went to heaven. Imagine the mess. Imagine those who kill to deflower seventy virgins become your mother's backyard garden.Imagine a savior as the result of mutual and passionate love.

Thing is, the women are having different kinds of sex: consensual,respectful, joyous intercourse. One-time desire. Bored submission.Curiosity. Recreation. To not say, no. Downright rape. Occupation. To de-stress.

It is best to let nothing in the vagina for at least two weeks following the abortion. The cervix is slightly stressed and she is more susceptible to infection. No tampons, no penises, no fingers, no toys, no submerging in water. (This was a considerable challenge for a competitive swimmer in February once.) It can be a challenge for many women, scenarios spiraling around the kind of sex she's having. 

These days, an all-american abortion, will rarely rarely rarely effect a woman's ability to conceive again. The contents of her uterus are removed through modest manipulation and suction, her reproductive parts oblige. Her ovaries and his sperm go untouched. Where life begins.

Some women will intend to abstain following their abortion. Ashamed. Disillusioned. Discontent with that entire realm of life. Confused. Depressed. Thing is, abstinence is not necessarily 100% effective because it's not enjoyable but some women aren't enjoying sex. Furthermore, Abstinence-only isn't preventing unintended pregnancy. 

For the love of life and her beautiful working body, I will suggest she give herself pleasure. De-flower herself into a flowery field.