abortionclinicdays

response to concerns

i have read the concerns that a number of you have posted and i would like to respond both about the law and also about what some readers might fear shows a lack of respect or honor of the people involved. i want to tell you all i can in the hopes that you will be re-assured that no violations are taking place on this site. and, at the same time, i apologize for taking so long to get this up. while i admire those who do daily postings, i just can't!

first of all, i consulted both attorneys and physicians about our postings and have been told that the kinds of personal stories being told (and they are, of course, personal, which is kinda the point of the site) are permitted under both the old and the new patient privacy acts. the act says that as long as NO identifying information is written, the cases can be written up and shared for education and counseling purposes. for example, if i am writing about a 23 year old college student with brown hair and brown eyes in a major university, i need not hide as much information as i did with my last posting, where you can see that not only did i not tell her country, i did not even tell her continent. because her identity might more easily be determined, i am obligated to take additional steps to protect her, her partner, guests, family. i am writing in much the same way that doctors discuss cases when they are teaching or consulting with other doctors, or how therapists, psychologists do as well. in fact, most therapists continue to have supervision even though they are themselves experts in the field. if you watched "the sopranos" you saw dr melfi go a number of times to her own supervisor when she felt she needed another sounding board. so, since none of the patients written about could be identified because names, locales, descriptions were all changed, the women and their stories remain confidential.

equally important to me is the personal part of the postings, the "oh my god, if i go to that place, maybe i will read my own story posted for all to see." i suppose there is a tiny, tiny chance of that, but i would defy any reader to be able to say, with absolute certainty "that's me that they're writing about". you yourself would never know for sure because of the careful protection of the patient's identity and therefore no one else would either. and you will notice, if you re-read the postings, that the postings are always, always done with love and respect. in fact, i can say that that is the reason i do my work, the reasonn i created this site. i truly love the women and want others to know how universal the feelings are, sometimes how similar the thoughts are whether the woman decides to continue the pregnancy or not. those who judge the women have not listened to them with an open heart. in fact there is a doctor i know who has said "until you listen to the heart of a woman, you cannot understand abortion at all". i believe i see, day after day, year after year, good women trying to make good, honorable choices and that is the message i want the readers to know, too. these are the stories of real people, people who often anguish before making their choice, knowing that whatever they choose, they will live with it forever. that is why it is rare for women to regret their decision. if they listen to their own heart, go to a clinic where they can take as much time as they need to talk, are encouraged to put forth their own feelings and opinions without judgment, they will always know that they made the best decision they could at that time in their lives. it is my hope that this site, which will continue to tell the stories of the women we serve, will help you or a friend to accept your own choice, whatever it may be.

peace,
lu

far, far from home

when i first saw gala, a college student from another country, i was struck by how blank her face looked, how tight her body appeared. i knew that i had to find out why she seemed to be so "frozen" so that we could begin her counseling. i could tell she was scared, but then, most patients are scared. after all they are entrusting complete strangers with both their physical and emotional care. as she began to talk to me i started to get the picture of how she had never made a big decision alone before. i needed to listen intently because i was not familiar with her country nor its customs. i began by asking her to tell me what would be different if she were unmarried, a college student, but in her own country. she replied, very emotionally, "my mother would be at my side!" she then told me how her whole life that had the case for her. coming to this country was an honor, a great responsiblity (because her village had paid part of her expenses), a committment (she could not even imagine not completing her studies because it would shame her family); it was also very lonely, more lonely than she could have imagined. although her english is excellent, she finds herself often longing for home and sees our country as a country of isolation. although i do not know all about her country's (and her village's) ways, i do study cultural differences realizing that i cannot help women to know their own hearts unless i can get them to tell me how being pregnant really is for them. when i asked gala if she would be considering abortion if she were in her own country, she said, "it would not matter what the choice would be. if we made it as a family, it would be right!" however, not only does she not have benefit of this process, she has not seen her family for 2 years and will not see them for 2 more! phone calls are very expensive and are therefore infrequent and brief. but in time, as she was able to talk, she affirmed that she wanted to have the abortion and so i explained everything to her.

when i went to visit her in the recovery room afterwards, she asked if i would talk to her boyfriend before she left the clinic. of course i welcomed the opportunity to meet with him as well since he is also from the same country and might have his own concerns. gala asked me to tell her boyfriend, vee, that he needed to understand that she, by her request, could not be alone for the next few days, also that he hopefully would understand if she were "moody". gala felt that she would be ok eventually if she did not have to be isolated afterwards. (note: although all women are different, many many american women say, when asked what they might need afterward, that they want to be alone. so it is important to ask, always ask).

then i asked vee what he thought he might need afterward, he did not respond, but only looked at his feet. although his not making eye contact could be a sign of respect in his country, i still needed to hear his words because i felt that he wanted to tell me something. then, he tried to talk, but could not get the words out. i asked him if he wanted me to guess what he needed to say. he shook his head affirmatively. i asked him if it was about the pregnancy, about the relationship, about the decision, but he shook his head no to each. next i asked him if it might be spiritual in nature. he shook his head affirmatively and i could feel what i thought was panic. so i asked him if he thought he was in *spiritual crisis*. he exclaimed loudly, "yes, yes"!

patient's (and their support person's) spiritual issues have long been of particular interest and concern for me. sometimes i can walk a person through the immediate issues and then refer them to their own clergy. sometimes, the last person they want to talk to is a clergyperson. and we do have lots of brochures available on spiritual matters from different religious groups since making peace with god/allah/supreme being/the universe is often very important to women. this situation, however, was different and way over my head. fortunately i have developed relationships with clergy and referrals that allowed me to make a phone call on the spot, get a name and number for vee so that he could make an appointment for that very day. in addition, i got a name and number for gala as well.

today i hope to talk to both of them to see how they are doing. but they really are on their own. i have encouraged them to reach out to other students, their friends, others from their country who are in this city, but what they really want are their families. it's so hard to be so far, far away from home, particularly when you need your family the most.

lu

Infertility

It may seem odd to talk about infertility at an abortion clinic, but if so, that's the warped view of what we do surfacing again. Here's two stories from today's patients that make that clearer.

The first woman is in her late 30's. a bit red faced and obviously holding back some feelings. She tells me that they have a treasured son, now 8, and that they went through a prolonged quest to conceive him over about 7 years of trying. She has been diagnosed with PCOD--polycystic ovarian disease, where there is so much scarring and cystic activity on the ovaries, that the eggs can't develop and get spit out into the Fallopian tube to get fertilized. PCOD women are usually overweight in that "apple" body kind of way, and some are "hirsute" which means have extra facial hair. One of the things that drives me crazy is that doctors don't really explain much about this--for instance, once the weight is gained, it rarely can be lost, so it's important to not gain it if possible. Also, if someone has this diagnosis early enough, they should have kids sooner rather than later, before the ovaries get all plugged up.

A word about infertility.....I have come to understand how horrible this really is. In a culture where femininity is practically defined by a blurry, soft focus notion of motherhood, these women begin to doubt their femininity and worth as a woman, even the evolved smart women. It puts an incredible strain on relationships, and in fact, many don't survive it even after a child is born. Can you imagine the pressure of making love according to the calendar? Even worse, taking lots of medications that can make you a little moody, to say the least, then add the pressure, for both man and woman.

Also, there are levels of intervention. First the woman usually gets checked out, which might include ultrasounds, hormone levels, and possibly a salpingogram, injecting dye into the tubes to see if they are blocked. A sperm count is also essential, tho you'd be surprised how often that doesn't happen. No, you probably wouldn't be surprised. Sometimes guys have an enlarged vein that presses against the vas diminishing the amount of sperm available. Relatively easy to fix surgically, but that certainly tests the commitment of the guy. (OK honey, let's do artificial insemination...) There are other things, but too complicated for this blog.

Then come the drugs. Chlomid is a relatively benign drug that creates nice fat eggs and lots of them. You want to maximize your chances. Then there is Perganol and some next generation versions of same, that are injections you have to give yourself, that, by all reports, are not fun. That creates multiple eggs (think twins and triplets) and sometimes it happens that you have to think about a reduction, essentially aborting one so the other two can survive. Big moral dilemma. When/if that fails, you look at egg harvesting, sperm donation, artificial insemination, and test tube babies--or ART--assisted reproductive technologies.

Well. To me, the real issue is the emotional roller coaster--the pressure of sex, but also the failure--in this woman's case 7X12= 84 periods that meant she was not normal and could never have the affirmation of motherhood. Where most of the people we see breathe a sigh of relief when the period comes, these women despair of the most essential definitions of womanhood at the sight of menstrual blood.

So, when I saw this woman's tears well up, I tried to imagine all that, the final excitement, but also thinking that it would get snatched away again. In her case, a difficult pregnancy that had long term physical problems for her, but luckily resulted in a healthy child. Then, randomly, an egg meets sperm, easy-peasy, and how do you make sense of it? They thought long and hard about it, her health and their ages were a big part of it, but as so many women say, for so many different reasons, it was just bad timing for a pregnancy.

I always give these folks--and anyone else who is very stressed-- the VIP treatment, which in our case, really means a more private place to hang out, away from the craziness of the waiting room. I figure no one else "gets" what they have been through, so I give them whatever I can, which is mostly some more attention. One thing I did want to tell them was about sorting out the feelings here. "It's like a ball of string with lots of different colored pieces. One is about your health, maybe--whew, it's not going to get worse like it did last time. Another is the sadness of wanting something for so long and not getting it, and then when you do it's the wrong thing for that time. Another is for the pregnancy. And, don't forget to count the blessing of your son. It's all in there and it's your job to tease it all out and give each piece its due."

Enter the next patient-- a charming ball of nerves who had great fertility--3 pregnancies-- 2 abortions and a miscarriage. She felt bad about being pregnant again, but also knew that she was not ready for a child just yet. She wanted to do it right and so, reluctantly, she presented to us. Unremarkable so far, but then she says that she had donated her eggs three times, resulting in 2 of 3 pregnancies for some woman who could not have a child any other way. She had some relatives who had a hard time getting pregnant and that moved her to do it. She didn't say so, but I had the feeling it was her way of evening the score in her mind. We were all impressed and gave her lots of encouragement for her courage and compassion.

So much of our discussions with women are about fertility. Some have a lot of it and some don't, and if it was like lending a cup of sugar, women would even it out so everyone was happy. But it isn't and mother nature has her own plan that has little to do with what we want, which is why we exist and probably always will.
--Bon

response to selma

selma, i am posting my answer to you here because many people may have the same question you did. you wanted to know if i corrected the information about adoption that one of the "perfect" women had. i did. we not only refer women to a local private adoption agency, we also refer to an attorney who specializes in private adoptions. she is pretty much an expert and even teaches the specifics of our state's laws. we also sometimes give contact information about people who are looking to adopt. there are many different ways that a woman seeking to place her baby for adoption can do so and we try to tell her of all of them so that she can choose the one that best suits her (or her and her partner or her family).
lu

two perfect women

yesterday's counseling included two very different, very difficult, but ultimately very rewarding sessions. since they are both still in my mind today, i want to write about them. the first woman, whom i'll call josie is a student at a local catholic college. although she was very sure that abortion was the right decision for her, she had had to think long and hard as well as pray about it. because she did not want to become pregnant, they had been using condoms. she herself did not feel ready for parenting, she could not bear the thought of adoption because the child would always wonder why his/her mother didn't want her. that, she said, was as important as the total inability to even imagine telling her parents because she could not bear to disappoint them. and, like many young perfectionist women who are struggling with anorexia. the stress of having to deal with the pregnancy was pushing her backwards and she confessed that she had been unable to eat and knew it was not good for the baby or herself. but still, what she was having the most trouble with was that she had had sex. she, like many young women i have counseled, have made the pledge of chastity. i was immediately concerned that, with the way she was feeling about herself, her anorexia could prompt a hospitalization if she could not eat. as we talked about how she might forgive herself for not being perfect, she also agreed to talk to her eating disorder therapist about her pregnancy and abortion. having read recently the results of a study of young people who had taken the pledge of chastity, i was able to tell her that more than half of those who took the pledge had had sex within two years and that what was important now was for her to protect herself against pregnancy and STD's. but, even though she is still going to be with her same boyfriend, she is hoping to return to abstainance instead of birth control. and she still is wanting to be perfect. she was, though, very grateful for the many brochures we have for catholic and christian women who feel that they want to preserve their relationship with god. because that is a major concern for so many women and men we see here at our clinic, we address how the woman and/or her partner or parent will place themselves in god's grace. she thanked me for giving her some of the brochures and then chose more herself.

the second woman, whom i'll call denise, was older. at 33 she already had two children, one of them with a very very severe chromosome disorder. denise now knew that any child she would ever have could also be blind, deaf, and have the multiple handicaps that her youngest has. besides not feeling able to care for another special needs child, she knew that it would take time and attention away from her other two children. but still, she could not stop weeping. when i asked her to tell me ALL the reasons she was crying, she began to see that for her this was not only about abortion. she was giving up her the possibility of ever having another child and her partner had agreed to have a vasectomy as soon as he could arrange since he did not want her to have to suffer the way she was then. also denise said she was crying for herself, for how hard her life is, for having to choose abortion when she hadn't previously believed in it, for having to give up that part of herself that would love to have another child. then, although none of the facts of her life at that moment had changed, she stopped crying, said she felt ready to go forward because she had to live her life in the present. she said that that is one of the things that having a severely handicapped child does is that you can't live in the past, the future is completely unknown and is unlikely to get better, so you have to stay in the present. it was then i saw the strength that gets her through her days, one at a time. she said that she knew that god would forgive her, in fact already had since he alone knew about her situation fully. but she said that part of her that wants to be perfect, to be able to handle everything that comes might take longer to forgive herself. and, she said with a little smile, that that's just the way she is--that people always tell her that she is too demanding of herself. with a little shrug, she said "thanks for reminding me that this is what i do to myself. so, let's go. i'm ready."