abortionclinicdays

katha, saletan and alito

The 33d Roe v Wade anniversary seemed quiet this year, considering it may well be the last celebration of legal abortion. Among providers, there is a grim despair as all efforts to alarm, persuade, appeal, filibuster, and more have been lost. As a provider in Ohio said, "We can hear the clock ticking on legal abortion."

Interestingly, though, abortion beat reporters and many organizations fundraising for abortion rights are enjoying a resurgence. Fundraisers are well attended; people are paying attention to their disappearing rights. And after decades of trying to get reporters to cover something OTHER THAN the anti-abortion arguments are beginning to write the people involved in abortion experiences back into the stories.

Most amusing to me is the sniping between Wm Saletan, author of Bearing Right, How the Conservatives Won the Abortion War, and Katha Pollit of the Nation. Both are pro choice, both make a lot of sense to me, and yet they are screaming at each other about who is losing abortion rights for all of us.

Saletan, who has analyzed opinion polls about abortion and understands better than anyone how all kinds of Americans feel about abortion, and how that affects policy, says that we should just acknowledge that abortion is bad and focus on getting to zero abortions, better birth control etc etc.
Pollit strongly trumpets the need for legal abortion and the positive good it does for women in providing for their children, contributing to the economic and social well being of our society, and for basically saving women's lives.

It's so odd to live in the day to day world that is so talked about, screamed about, killed over, and agonized over. And of course, I think I have the answer, not only to reconcile Saletan and Pollit, but also our society, or most of it, about the divisive issue of abortion. You see, every single day, I talk to women who do not think abortion is a great thing-- they feel bad, they cry, but they face something that the opinionated public does not: a decision about how to have life, how to bring life into the world. Every single woman wants to make life better and their conclusion is that by ending the potential life inside them, they can better provide, or realize their dreams, or contribute, or just be healthier. They don't love that they have to make such a decision, they know that society looks down on them, that their family or partner or co worker might judge them, but they cannot avoid a choice so they look at their lives and make the best choice, the least bad choice, their choice. And if anyone can tell me how to put that on a bumper sticker or in a sound bite for middle America, please let me know. In the meantime, I will continue to post what I see and hear on the real Abortion Front--in the hearts and minds of women who are pregnant and don't want to be.
Thanks for listening.
--bon

hope for the future

folks who read these entries can't help but think of the sadness that the women are experiencing as they come for their abortions.  it's true.  abortion is often sad.  but what the readers are missing is that abortion is also a vote for the future.  so there is often an air of optimism at the same time in counseling sessions. a woman that i spoke with today talked about how she knew she had to sacrifice the child within her so that her other two children could live.  that sounds rather drastic, but is it how many women view their choice.  this particular woman, i'll call her shamika, has had a very tough life.  at birth she went to live with her grandparents because her mom was, as she put it, "a crackhead".  shamika lived there until grandma died and then her mother came to get her at age 13.  life suddenly got worse.  i will spare you the details, but trust me when i say that she had to leave and live on her own, boarding with whoever would have her.  luckily she managed to get a GED while also having her own two kids.

shamika's goal right now is to get certified in the field she is studying because then she will be able to support her kids, something that no one in her family has ever been able to do.  her own experiences have led her to believe that "everyone has a hard life" since that is all she knows.  no one has a smooth, easy life in her world.  she loves her kids and feels that because she remembers grandma's love for her, she knows what love is and conveying that feeling to her kids is what she lives for.  she said, "let's face it.  i do not want to have an abortion.  but who is going to adopt a black child?  i do not want my child living in foster homes and having who knows what done to it."  she said that those who have lived in foster care know how awful it can be.  and so, she told me, she decided to sacrifice the never born child so that her other two kids can live.  her presentation of her story was very stark, but she said that no one who hasn't lived her life can judge her.

shamika confided that she felt a great war going on inside her, the war between her head and her heart.  she said that her heart was begging for the baby to be born, but her her head told her that she and her kids could end up homeless since their lives are very precarious.  now, it's true that this is a very sad story.  but, if you were there with her in that counseling room, you would have also seen that she is an optimist.  she believes that things will be better when she completes her program and gets her job.  she is very determined and very dedicated to her goal, that of creating a better life for her kids.  her partner has actually been with her since she was 14, more than a third of  her life, but she says she cannot depend on him. the only thing that keeps him there is his love of the girls and despite the fact that he is not the greatest partner, he is a great dad.  allowing him to stay is a part of what she has chosen so that her girls will have all the possible love they can get.

so shamika talked of how she was talking to god, hoping that he would understand that she lived her life not for herself, but for her girls, and that her sacrifice of their sibling would allow the three of them to stay together, to keep working toward their goals.  i left the session filled with the same hope for her future that she had.  she made me believe that she will be able to move her life forward, one day at a time.

lou

missing mom

yesterday i spoke to a woman, age 28, who began her story by telling me all the reasons that she could not continue her pregnancy.  she had no doubt that abortion was a better choice for the baby since she felt that it would be neglected and possibly even at risk.  her older children had learned to avoid dad, an abusive alcoholic, when he was drunk.  and the patient, whom i'll call rachel, supported the family as sole wage earner.  there would be no income when she had to take maternity leave and her job would not permit her to work once she was showing because of the physical hardships of the job.  she felt that she could not risk leaving the baby alone with her husband at any time because he was not responsible and had lately been getting worse.

then she began to sob and told me that if her mom were still alive, it might be different.  both times that she was pregnant in the past it was her mom who encouraged her to continue the pregnancy, telling rachel that she could do it, that she, mom, would help her.  the day before had been mom's birthday and rachel told me she went to the cemetery to talk to mom, as she often does.  she had been telling mom about her situation, how much she missed her, how she wished she did not have to have an abortion.  rachel told me, it was all ok because her baby would be with mom.  mom knew that the baby was coming to join her in heaven, which made rachel feel at peace.  then rachel said, "the hardest thing for me every day is to be without my mom.  that's what i'll never get over."

Why Clinics?

A reader has asked an important question: Why do we need abortion CLINICS, why not just go to a hospital or your doctor's office?

Here's the historical development. Abortion was illegal until it was nationally legalized by the Supreme Court in Roe v. Wade January 22nd, 1973. It was legal in three states prior to that, New York, California, and Colorado. There were always some doctors who did abortions on the sly, or who did a D&C for their patients (oops, I guess they were pregnant!). But it was risky and in the medical community there was a stigma both about the procedure and who got abortions, but also about breaking the law and risking losing your license or a jail term. There is a wonderful movie called "Dear Dr. Spencer" about a doc in a small town in Pennsylvania who operated an office for abortions openly, under cover, so to speak, but mostly it was really cloak and dagger stuff. Some doctors gave their patients an antibiotic and referred them to an abortionist, who might be a midwife, or an ex Army medic, or a funeral home director. Frequently the Mafia controlled access to abortion services.

When abortion became legal in NY, clinics were set up over night and they sometimes worked 7 days a week, 24 hours a day just to keep up with the demand as people travelled from all over the US. Early clinics were an interesting hybrid of medicine and politics. Some of the early advocates of legal abortion were feminists, clergy, and doctors, so they inserted some of that desire to let people talk about their sistuation into mandatory counseling. They also introduced an informed consent process, which meant that everyone needed to be told what was going to happen, what the risks were, what the alternatives were. This was an innovation at the time.

When the rest of the country started to provide abortion services, a mix of the same people, with some entrepreneurs, founded clinics based on the same strategy as any other specialty business: VOLUME. At that time there were still many doctors who performed abortions for their own patients, perhaps one or two a week, or even up to 10 a week, but there was that stigma attached to it, and most doctors realize that getting along in the community is very important to survival. But some people hate to go to hospitals because they can so easily lose their confidentiality or run into a hostile nurse or someone else who knows someone they know, for instance. Also, as larger practices started to form, for reasons of on call coverage, economy, and other factors, it was inevitable that one person in the practice would object to abortions. In larger cities it is still possible to find a private doctor who will do an abortion. (Like on ER the other night Dr. Coburn said, "Abby, I will help you whatever you decide.")

But that is rare, in large part due to the anti's. In the 80's anti abortion activists would call each doctor in town and pose as a patient, ask about ob care, and then ask about abortion. If they said they did that, they would start yelling and screaming at the nurse/receptionist. They picketed doctor's offices and hospitals and mostly it was just not worth it to do abortions in your office. If you wanted to continue to offer it, it was easier to work in a local clinic. More often, especially in smaller cities, you had to bring doctors in from out of town because no one locally would offer the service.

There are a lot of good things about the clinic model however, in spite of the isolation from mainstream medicine that many clinic experience. One is that people who work at clinics really get that pregnancy decisions are very complex and are usually good at understanding what their clients need. (Not always true, some clinics seem to adopt the stigma we are trying to change. I don't get why they are still in business...) Unfortunately, this frees people who just do obstetrics or birth control to miss part of the picture. Like every sub specialty, though, you can assemble a staff that really knows what they are doing, medically and emotionally. I remember talking to one doctor who worked in a hospital setting who said that it was nightmarish having to work with different nurses in the hospital who hated what he was doing or who would inadvertently hand him the wrong medicine because they were inexperienced.

And of course, there is the business part of the story. There is great economy of scale if you can bring all the right staff, resources, patients, and medical people to one session. Some Planned Parenthoods, for instance, schedule several visits for the convenience of staff and patients complain that they have to take off work or school, or find child care twice or three times.

I have given you the long answer. The short answer is stigma. Abortion clinics exist because those in the regular practice of medicine cannot withstand the heat or the stigma of providing abortions. In a society so divided about a subject, and with so much heat about the issue, you need people whose job it is to withstand the pressures, the negative attention, and who are not beholden to referral pressures in the medical community. If that same facility can evolve as an understanding place to go with a pregnancy crisis, then that's turning lemons into lemonade.

Thanks for the question.
--bon

Dear Reader, It's 2006.

2006. How did that happen? I've been going back through this blog reading old posts and comments and trying to reflect on the blog phenomena and abortionclinicdays.com for a possible submission to an anthology. (I just published two articles that someone didn't actually get posted. sorry)

Well, dear reader, we haven't posted as much as we might have liked, particularly in more recent weeks. I can't chalk it up to Christmas, I mean HOLIDAY shopping.... It's just hard to do the work and report it and be circumspect about it all at the same time.

I notice that we have done a few rants but mostly we have told stories. Our work is mostly stories and the power of hearing them. Even if we didn't say a thing to women, and men, that would be enough help for them. But the more stories you hear, and the more you can listen to them both in the particular and in the aggregate, it turns out that there are helpful words you can pass from one person to another. Like a non wandering minstrel offering news that others are too isolated to hear. The patients are the wanderers and we just sit there, attentive and connecting where we can.

Two years ago, we had truthfully never even seen a blog much less written on one. We figured that we would give it a year and see what the medium was like, whether we had anything to say, whether anyone would read it. We didn't know what trackbacks and pings were, or how the comments would take on a life of their own.

Now it's 2006 and it seems that everyone is focused on whether abortion will continue to be legal. It's the question that everyone wants my opinion on but strangely, I don't have an opinion. I have always thought that Roe v Wade would not get struck down because of 30 + years of counting on reproductive freedom means that it is in the fabric of our lives to stay. Even Randy Terry, the irritating founder of Operation Rescue said that if abortion was not illegal by 2000 it would never be, because 25 years was too long to have something and then not have it. (Not that he has any inside track on anything.) Now I just don't know. Everything is so wacky.

Part of me would like to see it go down just to watch everyone scramble. All those mealy mouthed politicians would have to step up to the plate and really vote for what everyone knows we need. Of course, the part that knows the panic and misery even a few weeks of illegal abortion would bring wouldn't be worth watching any politician squirm.

Of course, I have that blue state feeling of insulation, but I also don't want to be much busier than we are because then we wouldn't be doing the work that we want to do. When abortion was legal in NY before it was legal in other parts of the country, there were 24 hour abortion clinics and it really was a "mill." Of course, women were less stigmatized and more sure of their decision. But what fascinates me is the experience of it--the complex decision making, how people make sense of inconsistencies and new situations, how people help each other out, or not. It could be about anything I suppose, but there is something about a decision about a pregnancy that brings it all together--life death sex the universe. If I couldn't take the time to consider all that with people I would probably quit.

I don't do New Year's Resolutions, so I can't say, "I will write more on this blog" but we will see where the energy takes us, won't we? Thanks, everyone for tuning in.
--bon