abortionclinicdays

sending her home 3

This "sending her home" phenomena is one of the hardest we have to deal with and we have written about it here before. It is a judgment call to some extent and we never want to create another barrier for women seeking abortion services. When I talk to a woman that is ambivalent she usually comes to see that she is not quite ready, or that there is some unfinished business that would be better dealt with before something that cannot be undone like an abortion is done. I assure you we don't suugest that people re-schedule often; sometimes it is a deciding point for a woman. I had a young woman just yesterday like that. She was saying contradictory things like "I really want this baby." and "I loathe being pregnant." So I encouraged her to take more time if she needed it to be sure. She thought a minute and then straightened up and said, "I'm staying." It may be like flipping a coin and when the opposite of what you want comes up, you realize what you really wanted.

I think when you have talked to women--not that many fortunately-- who return to say, "if someone there had just said, 'are you sure?'" you really want to be cautious about women who just want to "get it over with because I might change my mind" or "I can't come back here again." Decisions made out of desperation really are not optimal. The bottom line is that we are not moral arbiters but we do need to pay attention to both physical and emotional health. If someone persists in "wanting it but dealing with the emotions later" I go over coping strategies very carefully, and detail all that we know about poor outcomes post abortion. Particularly if the abortion is a secret or major players have not weighed in (and this is a source of anxiety for the woman), or if the people around her are in opposition, you could expect some problems down the line.

And unlike other health care, the problems will come back on our door, not just individually but collectively. Has anyone ever stopped to wonder why 1.3 million women every year since 1973 have had abortions and yet we are on the verge of losing legal abortion? I believe that this is one of the issues that have clouded people's commitment to legal abortion. If they feel ambivalent or cannot sort out the situation that caused them to have an abortion, or feel emotionally troubled, it is not only a poor emotional outcome for many women, it is also a political nightmare.

I have experienced some incredible transformations with women who took more time after talking with us. I have learned, like lou, to trust my gut, and to share what I know with the women I talk to. The other piece is that we care about what we do too. It is our signature on the consent form that assures the doctor that she has resolved her ambivalence and is ready for the abortion. If we abdicate this thorny question and don't offer our best information and advice then we really are working at a mill.
--bon

sending her home 2

the woman (angela) from another country that i sent home called a few days later and said that she felt that she had worked through her concerns with her boyfriend who lives in her home country.  angela made a new appointment, then further reported that she felt that the right decision was for her to have the abortion because they were not ready for parenting, completing her education was her primary concern and that talking to him made her clearer.  when she called she had asked for me so i made the appointment myself and we had an opportunity to review her previous concerrns, but  she assured me that she now felt resolved.

the appointment was for yesterday.  she did not show up, but called to today to tell me that the longer she sat with the decision the worse she felt about it.  she said that she and her boyfiriend have had more opportunities to talk.  one of the reasons that i had felt it best to send her home initially is that angela was and is in a committed long term relationship.  yet, she had made her initial decision so quickly that they had not as a couple really talked things through because she did not want to "bother or upset" him while he was completing his oral exams for his dissertation.  the mutuality was, in my opinon, lacking.  now, not all women are in a relationship that functions on that plane, true mutuality, but when they do, it is, in my experience, important that the two of them work through the decision.  i have also seen many times a woman changing her mind a number of times.  since abortion decisions are made with both the head and the heart, it can look one way from the head and another from the heart.  what may look to others as "flip flopping" can be sometimes be a classic "head vs heart" battle.  in angela's situation, i think her original decision was made in her head, without "consulting" her heart.  when she did, and because both her family and her boyfriend were supportive of her continuing the pregnancy, the decision looked different.

i do not know if her decision is final or not.  she may continue thinking and talking.  it is ever so difficult having your boyfriend halfway across the world when trying to decide  what is truly a major life decision.  i hear her words, know her struggle, understand her belief system and her conflicted personal goals.  i don't know what she will ultimately choose.  but only she can decide.  all i can do is listen.

lou

sending her home

the other day i talked to a woman who was determined to have an abortion that very day.  our state has a mandatory delay built in so she had already waited a certain number of hours, had to hear a speech read to her by a doctor, but she was in a big hurry to just get it over with.  those words "just get it over with" always make me a little cautious with patients because sometimes it means that they have thought it over very carefully before arriving at the clinic and talked to the people who they think can help them make a wise decision.   but sometimes it just means that they don't want to think about it, just do it.  it is part of my responsibility as a counselor to determine which it is for any woman i happen to be talking to so that women do not end up regretting their choice.  in this woman's case, i was very reluctant to be the one to sign off on her because i felt that she was moving too quickly. 

she is a graduate student in my city, is 27, getting her PhD and then going back to her own country to join her boyfriend.  this woman, whom i'll call angela, lives with a roommate from her country who is very religious and although she claimed to support angela no matter what she chose, did have a clear preference that angela continue the pregnancy.  angela, though, was clear.  she kept saying that she did not want to continue the pregnancy, felt that she had a responsibility to herself to complete her studies so that she might find a job in her country that would allow her to find employment in her country.  her mother and boyfriend both wanted her to come home immediately and get married.

because angela was not even one week late on her period, i did talk her into going home telling her that she could return in a week after she had talked more to her boyfriend so that she would be sure that abortion was what she feels is best.  i do not know what she will ultimately choose.  but i do know that sending her home was the right thing on that day.  for someone so far from home, without enough time to talk to her loved ones, acting too quickly might result in her regretting her choice.  by taking her time, i feel that whatever she chooses, it will be the right decision.

Clarity

After you are done talking to a woman, which as you know if you're a frequent reader of this blog, can be pretty profound, you have to write up a counseling note, which is usually quite a bland affair. I invariably start out, "So and so is clear about her decision and...." and that is true as far as it goes for most women. But this woman, I will call Anjie, was clarity personified. She said, "There are women in the waiting room crying. Am I a monster because I am not?" There are some people who are guilty for not feeling guilty but I hadn't really talked to one of them recently.

I think there are a few things going on here: Anjie was very focused on her goals in life--she was finishing college and had already gotten a placement doing meaningful work. She loved her boyfriend but she didn't necessarily see herself with him far into the future. And she had never experienced pregnancy. I do see a difference in recent moms who are entranced by the joys of motherhood. (Older moms have a different take on it-- a sort of "yes, but..." attitude.)

But what made Anjie really unique was that she was conscious that there were strong forces that were trying to make her feel bad. She was actively rejecting the slogans and conventional wisdom of the anti-abortion folks that have seeped into our cultural consciousness.

The other amazing thing is that she said, "I am the last in my crowd to have an abortion. Now it is 100%." Many of you will see this as a sign of depravity among college students. But the remarkable thing is that all those friends had been open about their experience and were willing to share their experience to help out a friend. She felt taken care of, connected, and what I can only describe as NORMAL. This is amazing for how rare it is. But the truth is that abortion, like having a baby, losing a parent, having sex for the first time, getting married, etc. is a rite of passage. Not everyone will do all of those things, but it is one of the milestones in life that people go through so why not talk about it openly? We are all in agreement that it is better to prevent a pregnancy, but when that fails, having some honest friends is a really good thing.
--Bon

men and abortion

note to all readers of this blog:  i apologize that we have neglected this blog and allowed it to be hijacked.  i promise to do more to try to fix it soon.  in the meantime, i have read about a new website for men whose partners are considering or have chosen abortion.  you can access it at www.menandabortion.com.  an article about it follows.

lou

http://www.knoxnews.com/kns/national/article/0,1406,KNS_350_4655250,00.html