abortionclinicdays

Where is the Juno of the Abortion World?

Jezebel wrote a post today on one young woman's blogging through her abortion experience. Frank and unabashed, she started the blog as a response to the lack of personal pro-choice blogs available. For years I've been saying that when I write a book, it'll be called the Oh Shit! Pregnancy Guide, and would include early pregnancy information for women who haven't made up their minds yet about the decision to adopt, have an abortion or parent, but are still puking their poor guts out and wondering why they're running to the bathroom every fifteen minutes to pee. (The Pregnancy Options Workbook is one of the only books to do a pretty good job of this--without the profanity, of course.)

The author seems to have beaten me to the punch with her writing project: What to Expect When You're Aborting. So far, she's written about her pregnancy test, her nausea, gathering information about what to do next and considering a surgical vs. medication abortion.

As a counselor, this is the kind of site that keeps me honest. I like to think our clinic is a pretty welcoming place but what kind of first impression does it really make? How do we balance patients' emotional needs and personal comfort with our medical obligations and protocols? How do we keep patients (and ourselves) safe while not looking like a military bunker? How do I provide the "mandatory" counseling while still affirming that the idea of mandatory counseling is pretty condescending? I really appreciate that she's taken on this project and wish her well.

-Nell

PS-Just a warning, there is no commenting on her site and I'm going to turn comments off on ours for this post if they get cruel or unproductive. Not sure if your comments fit this criteria? Consider the following guidelines Lifehacker or Jezebel have outlined for their own sites.

PPS-There is, of course, always a chance that the site is not authentic. This would not be the first time that there was something disingenuous said about abortion on the web. That said, I do hope anyone going through an abortion is surrounded by people who'll love and care for them. I guess we'll have to follow along on the journey...

Why do this work?

Dr. Henry Morgentaler, Holocaust survivor and one of Canada's most prominent abortion rights advocates, was recently awarded the Order of Canada, the country's highest civilian honor this July. Dr. Morgentaler endured more than 20 years of legal battles to ensure the rights of Canadian women to obtain safe, legal abortions and opened six clinics across Canada. This has drawn a great deal of attention to abortion services in Canada and the politics and controversy surrounding them.

Below is a piece by Dr. Garson Romalis, delivered on Jan. 25, at the University of Toronto Law School's Symposium marking the 20th Anniversary of landmark court case R. vs. Mortentaler, reposted in its entirety.

Dr. Romalis has survived two attempts on his life as a result of his commitment to providing women with safe abortions. His memories of the (politely named) septic obstetrics ward are an important reminder of how commonplace attempts to end pregnancies were prior to legalization, as well as the devastating consequences of an unsafe abortion. 

-Nell

I am honoured to be speaking today, and honored to call Henry Morgentaler my friend.

I have been an abortion provider since 1972. Why do I do abortions, and why do I continue to do abortions, despite two murder attempts?

The first time I started to think about abortion was in 1960, when I was in secondyear medical school. I was assigned the case of a young woman who had died of a septic abortion. She had aborted herself using slippery elm bark.

I had never heard of slippery elm. A buddy and I went down to skid row, and without too much difficulty, purchased some slippery elm bark to use as a visual aid in our presentation. Slippery elm is not sterile, and frequently contains spores of the bacteria that cause gas gangrene. It is called slippery elm because, when it gets wet, it feels slippery. This makes it easier to slide slender pieces through the cervix where they absorb water, expand, dilate the cervix, produce infection and induce abortion. The young woman in our case developed an overwhelming infection. At autopsy she had multiple abscesses throughout her body, in her brain, lungs, liver and abdomen.

I have never forgotten that case.

After I graduated from University of British Columbia medical school in 1962, I went to Chicago, where I served my internship and Ob/Gyn residency at Cook County Hospital. At that time, Cook County had about 3,000 beds, and served a mainly indigent population. If you were really sick, or really poor, or both, Cook County was where you went.

The first month of my internship was spent on Ward 41, the septic obstetrics ward. Yes, it's hard to believe now, but in those days, they had one ward dedicated exclusively to septic complications of pregnancy.

About 90% of the patients were there with complications of septic abortion. The ward had about 40 beds, in addition to extra beds which lined the halls. Each day we admitted between 10-30 septic abortion patients. We had about one death a month, usually from septic shock associated with hemorrhage.

I will never forget the 17-year-old girl lying on a stretcher with 6 feet of small bowel protruding from her vagina. She survived.

I will never forget the jaundiced woman in liver and kidney failure, in septic shock, with very severe anemia, whose life we were unable to save.

Today, in Canada and the U.S., septic shock from illegal abortion is virtually never seen. Like smallpox, it is a "disappeared disease."

I had originally been drawn to obstetrics and gynecology because I loved delivering babies. Abortion was illegal when I trained, so I did not learn how to do abortions in my residency, although I had more than my share of experience looking after illegal abortion complications.

In 1972, a couple of years after the law on abortion was liberalized, I began the practise of obstetrics and gynecology, and joined a three-man group in Vancouver. My practice partners and I believed strongly that a woman should be able to decide for herself if and when to have a baby. We were frequently asked to look after women who needed termination of pregnancy. Although I had done virtually no terminations in my training, I soon learned how. I also learned just how much demand there was for abortion services.

Providing abortion services can be quite stressful. Usually, an unplanned, unwanted pregnancy is the worst trouble the patient has ever been in in her entire life.

I remember one 18-year-old patient who desperately wanted an abortion, but felt she could not confide in her mother, who was a nurse in another Vancouver area hospital. She impressed on me how important it was that her termination remain a secret from her family. In those years, parental consent was required if the patient was less than 19 years old. I obtained the required second opinion from a colleague, and performed an abortion on her.

About two weeks, later I received a phone call from her mother. She asked me directly "Did you do an abortion on my daughter?" Visions of legal suit passed through my mind as I tried to think of how to answer her question. I decided to answer directly and truthfully. I answered with trepidation, "Yes, I did" and started to make mental preparations to call my lawyer. The mother replied: "Thank you, Doctor. Thank God there are people like you around."

Like many of my colleagues, I had been the subject of antiabortion picketing, particularly in the 1980s. I did not like having my office and home picketed, or nails thrown into my driveway, but viewed these picketers as a nuisance, exercising their right of free speech. Being in Canada, I felt I did not have to worry about my physical security.

I had been a medical doctor for 32 years when I was shot at 7:10 a.m., Nov. 8, 1994. For over half my life, I had been providing obstetrical and gynecological care, including abortions. It is still hard for me to understand how someone could think I should be killed for helping women get safe abortions.

I had a very severe gun shot wound to my left thigh. My thigh bone was fractured, large blood vessels severed, and a large amount of my thigh muscles destroyed. I almost died several times from blood loss and multiple other complications. After about two years of physical and emotional rehabilitation, with a great deal of support from my family and the medical community, I was able to resume work on a part-time basis. I was no longer able to deliver babies or perform major gynecological surgery. I had to take security measures, but I continued to work as a gynecologist, including providing abortion services. My life had changed, but my views on choice remained unchanged, and I was continuing to enjoy practicing medicine. I told people that I was shot in the thigh, not in my sense of humour.

Six years after the shooting, on July 11, 2000, shortly after entering the clinic where I had my private office, a young man approached me. There was nothing unusual about his appearance until he suddenly got a vicious look on his face, stabbed me in the left flank area and then ran away.

This could have been a lethal injury, but fortunately no vital organs were seriously involved, and after six days of hospital observation I was able to return home. The physical implications were minor, but the security implications were major. After two murder attempts, all my security advisors concurred that I was at increased risk for another attack.

My family and I had to have some serious discussions about my future. The National Abortion Federation provided me with a very experienced personal security consultant. He moved into our home and lived with us for three days, talked with us, assessed my personality, visited the places that I worked in and gave me security advice. In those three days, he got to know me well. After he finished his evaluation, when I was dropping him off at the airport, his departing words to me were "Gary, you have to go back to work."

About two months after the stabbing, I returned to the practise of medicine, but with added security measures. Since the year 2000, I have restricted my practise exclusively to abortion provision.

These acts of terrorist violence have affected virtually every aspect of my and my family's life. Our lives have changed forever. I must live with security measures that I never dreamed about when I was learning how to deliver babies.

Let me tell you about an abortion patient I looked after recently. She was 18 years old, and 18-19 weeks pregnant. She came from a very strict, religious family. She was an only daughter, and had several brothers. She was East Indian Hindu and her boyfriend was East Indian Muslim, which did not please her parents. She told me if her parents found out she was pregnant she would be disowned and kicked out of the family home. She also told me that her brothers would murder her boyfriend, and I believed her. About an hour after her operation I and my nurse saw her and her boyfriend walking out of the clinic hand in hand, and I said to my nurse, "Look at that. We saved two lives today."

I love my work. I get enormous personal and professional satisfaction out of helping people, and that includes providing safe, comfortable, abortions. The people that I work with are extraordinary, and we all feel that we are doing important work, making a real difference in peoples' lives.

I can take an anxious woman, who is in the biggest trouble she has ever experiences in her life, and by performing a five-minute operation, in comfort and dignity, I can give her back her life.

After an abortion operation, patients frequently say "Thank You Doctor." But abortion is the only operation I know of where they also sometimes say "Thank you for what you do."

I want to tell you one last story that I think epitomizes the satisfaction I get from my privileged work. Some years ago I spoke to a class of University of British Columbia medical students. As I left the classroom, a student followed me out. She said: "Dr. Romalis, you won't remember me, but you did an abortion on me in 1992. I am a second year medical student now, and if it weren't for you I wouldn't be here now."

Military Families

I don't know if other clinics are noticing this as well, but we've seen lots more servicemen and women over the past year. I don't want to use this post to make any overly-simplistic arguments like Iraq War = more deployments and hardships for military families = more abortions, but I do want to mention some of the challenges that military families face when choosing abortion.

Maricela had been a teen mom and struggled for years to achieve some degree of self-sufficiency for she and her son. She worked a minimum wage job at a big box store. She met a boyfriend there and he challenged her to explore more options for her life. "There's not much out there for a single Latina mom with no education," she said, "and so I enlisted." She waited for basic training and a few weeks after getting her assignment, found out she was pregnant. "I'm sure that I can't have a baby now," she explained, "I have to get some training so that afterwards I can take care of my son. This is our only hope." Her mother had agreed to care for her son while she was gone. The challenge now was the pregnancy test at her preliminary medical exam. (Many pregnancy tests will give a false positive reading in the weeks after an abortion, because they test for hormones that are still in the body.) "If I come up as pregnant, I don't get to go. It's this or the Walmart." I offered to have her records faxed to any clinician she wanted, but she was reluctant. "I don't really want them to know that I just had an abortion, but I guess if it comes to that I'll have to. I guess we can just hope for a negative test, eh?"

Lana's story was much more serious. She had a string of abusive boyfriends and finally found the guy she said was "the one." Just one little problem--he was due to be sent to Afghanistan just three months after they started dating. Lana was in school to be a vet tech and had huge student loan bills. When her roommate moved out, her rent doubled and bills piled up. She worked at her regular job, but this wasn't making a dent. A friend worked as an exotic dancer and suggested that she give it a try. "I looked for something else, really there was nothing. I was going to be evicted." She didn't tell her boyfriend. "I was so ashamed. He's in a war zone, why would I bother him with my problems. Everyone kept telling me--don't worry him, he doesn't need to know about this. All his family kept saying was don't you break his heart, you better be faithful." Lana was raped by a man at the club, but didn't report the incident. "I felt like, who was going to believe me--I was a stripper." Now pregnant from the rape, there was nothing she would have liked more than to tell her boyfriend, not just about the pregnancy, but about the dancing, the money issues, her mounting debt, all the stress she was under. "Everyone kept saying, he needs you to be strong, don't you worry him. I don't know what he'd think of me. I was such a nice girl and now I'm a stripper. How could I tell him?" I reinforced that no one should ever be raped and being in the sex industry doesn't change that, but she had a hard time hearing me. "I'm supposed to be the loyal girlfriend at home pining away, not having an abortion from some guy who forced me." I encouraged her to get some counseling and gave her a referral to a sexual assault agency in her area, but with all that shame around the rape, I'm doubtful she followed up.

Cheyenne was positive that she didn't want to be pregnant while her husband was deployed, but military insurance will ONLY cover abortion services when the life of the mother is at risk. (Yep, check it out. No coverage if you're raped, if you have a significant fetal abnormality. No coverage for counseling, even.) "Hasn't our family sacrificed enough already? I have a thyroid disorder, depression and PTSD. My husband is in Iraq. I had to move in with my mother and I've hardly bought groceries this month because I've been trying to save up for a f***ing abortion," she said. "How much more 'at risk' does my life have to be?" That, I told her, was a damn good question.

-Nell

Coming Out as an Abortion Provider

I finally met my partner's grandparents a few weeks ago. They are a plane ride away, so it's pretty rare that the whole family is together. We had discussed first impressions and what to expect from them. Active in their local church, Elks Club and Rotary, as well as the local Republican party, I wasn't sure how they would react to my work. It was a pretty long walk back to the hotel, so we decided to tell them that I worked as a counselor at an ob/gyn office until we'd all had the opportunity to get to know each other better.

After dinner with Grandma, Grandpa and family friends, one of the women there asked me what I do. I explained that I worked with pregnant women and that it was work that I really loved. I talked a little bit about how most of the women that I work with don't get great support at home through their pregnancies, have pretty tough lives and deserve good care. I mentioned how hard it is for women to express any mixed feelings about motherhood, when our culture often sends the message that it's supposed to be one of the most magical times in your life. I added that many women have had difficult experiences with pregnancy, partner issues or miscarriage, and it's hard to know who to talk to about this.

"Do you see many dead babies where you're at?" Nana's friend blurted out. My partner's jaw fell open and we shot each other a look and sat in silence for a moment.

"I mean...well, you see..." she quickly started apologizing, "when I...I was twenty-five I was pregnant. It was a stillbirth. The baby died and it was...awful. I still think about it. I think it's really important that women have someone with them for something like that. I'm really glad the women at your office can talk to you."

My partner recovered faster than I did, "Nell does work like that, she's done all kinds of pregnancy work, including grief work. I'm sorry, I was reacting to the language. We're pretty sensitive to stuff like this because, well..." We locked eyes and I gave a nod, "She also does abortion counseling with women." I braced myself for what was going to come next.

"Well..." Nana started, "Good for you. How about that, Ed?" She nodded at Grandpa, who gave a 'humph' in agreement. "You know, I think our family doctor used to do them," she said. "When my mother was pregnant--I had eight siblings--dad used to tease her about her visits. He'd say, 'make sure he knows what you're going for.' It was the depression," she added, "Women had to take care of their families."

I assured her friend that I was not shocked by the language, just unsure how to respond to her question. We went on to have a great conversation about pregnancy, abortion, miscarriage, postpartum depression, stillbirth, adoption, parenting. Nana and Grandpa had been foster parents for years, it turned out. We talked about the families they'd helped over the years and about her friend's stillbirth and later single parenthood to a daughter. It was such a weight off my shoulders and I left with deep respect for everyone who was there.

I think that many of us in the abortion care field get so used to the violence and vitriol spewed out by our protesters that we forget most folks don't feel that way and that women are anxious to tell their own stories about pregnancy, abortion, adoption or mothering. We fear a bad reaction, so we keep our work to ourselves and no one hears the real stories about what we do. This was one small, very meaningful lesson for me in speaking up.

-Nell

A Pagan Perspective on Abortion

A friend of mine is Wiccan and she commented that we've covered many spiritual perspectives at abortionclinicdays, but haven't had a post that spoke to her sense of faith and right action. She forwarded me this post by Anne at Blog o' Gnosis, which I'm going to repost in its entirety.

Abortion: Holding Life and Death

What with the persistent attacks on women’s right to abortion and birth control in this country, I feel I must start clarifying my own position in the (falsely dichotomized) pro-life vs. pro-choice debate. I am both pro-life and pro-choice. I do believe life begins at conception, AND I do not believe it is a sin or a death to end that life before the fetus is born.

Because nobody is ever listened to these days without having to stand on their credentials, here are mine: 3 live births, 2 abortions, 1 miscarriage. 2 children adopted as teenagers. 4 children successfully raised to adulthood, one still an adolescent. Have attended births, deaths, fertility rituals, infertility rituals. Have friends who were adopted out as infants, friends who gave up infants, friends who adopted children. Have taught the kids of abusive and/or addicted mothers. Have counseled addicts and women who are unable to support themselves to have abortions.

Ursula LeGuin has a wonderful article (”The Princess”, an address to NARAL in 1982 collected in Dancing at the Edge of the World) where she writes, in response to the ridiculous claims of the Christian Right that every pregnancy must continue to birth, that as a young woman she got pregnant accidentally. Because she was in no position to raise a child, because she chose abortion and finished her schooling, she then went on to create a stable relationship and have three very wanted children. But if she’d had to raise that one, none of the other would have happened. So with the abortion, it is still a net gain of 2 babies. Following the Right’s crude mathematical logic, this should be cause to celebrate, right?

I don’t have the patience to write so craftily in response to this right-wing assault as she has. I am plain furious that our government keeps narrowing the birth control and abortion options for women both in this country and abroad. I hate that they think this is good for social ills of any kind. And I am furious that reasonable-minded people are letting this happen. I don’t like the fact that the Left keeps letting itself get out-flanked on the issue, and I don’t like that by saying I’m pro-choice I’m not supposed to admit that life begins at conception. As a Pagan, there is no contradiction here. Our religion teaches us to hold both death and life simultaneously.

I have trained for many years to sense energy, to feel what is going on both inside my body and in the spiritual realms around me. Each time I have gotten pregnant, it took very little time for me to make contact with the spirit of my unborn child. For me, that connection was so instantaneous, so deep and intimate, that the thought of bearing a child and then giving it up once it was born was not an option for me. That would have been far more devastating than having an abortion.

Each time I had an abortion, it was because I knew I did not have the time and energy to raise that child to my own childraising standards. That is a knowledge borne out of the experience of many, many hard years of mothering. I was completely clear that aborting the pregnancy was the best thing to do. Where I part company with the pro-lifers is here: it is not murder to abort a fetus. The child at that point is a spirit, not a body. It resides only occasionally in its little, developing fetus body. Mostly, it hovers in and around the mother, feeling what we feel, remembering where it’s been before, riding the changes in its consciousness and ours in a completely non-judgmental way.

When it is time to abort the fetus, I have felt the spirit around me strongly. I have said good-bye in a tender, loving, deeply grieving way. The fetus is expelled, and the spirit just drifts away. It does not die, it is not harmed. I know this to be true. It goes back to the spirit world to wait for its next opportunity to come through, hopefully richer for the experience of our having been so close for a short time. That is what happens, yet even with this outlook abortion is deeply traumatic for women, something to be avoided if at all possible. It is not an easy process, even when we want it.

In a term pregnancy, usually the child’s spirit fully enters its body at birth. So from a spiritual perspective I can see why pro-choice folks rally round the credo that life begins at birth. But for me, acknowledging that life is there at conception allows me to take the pro-choice argument a step further: it is a woman’s birthright, this ability to judge which spirits pass through our wombs into life, and which pass through into death. That is part of the deal, part of the package of being born a woman.

We have that power, and we need to claim it, learn how to use it wisely, and guard it ferociously. We need to teach our daughters about their birthright, and be comfortable ourselves talking to them about birth control and our own deepest experiences with our fertility. If we give up the right to choose when we want to have children, either by apathy or by struggle, we will be giving up power over our own bodies AND an important part of our spiritual power. Women are the gates, and the gatekeepers, between the born and the unborn. We hold life in one hand and death in another, and that is how we are meant to be. This cannot be neatly parsed into the ridiculous boxing match of pro-life vs. pro-choice. Abortion should be legal, and extremely rare. We achieve this through realistic sex education (I’m not talking about abstinence-only here) and by providing free or low-cost birth control and abortion services to all women of childbearing age. End of story. Now, just how do we go about making this the law of the land?

Illegal abortion in Brazil

Ipas, the international women's health organization produced this short spot to encourage discussion about illegal abortion in Brazil.

For a more thorough discussion of the issues raised, here is Amber Levinson's recent commentary, Crime and Punishment: Illegal Abortion in Brazil, and a 2005 article from Women's E-News: Brazil Begins to Talk Openly About Abortion.

The Brazilian organization Catholic Women for the Right to Decide and the International Women's Health Coalition also provide information about reproductive justice throughout Latin America.

Nell

True Freedom of Choice

Now is the time for women to take action and require FULL DISCLOSURE from reproductive healthcare providers.  These days more and more physicians and pharmacists are opting out of providing certain services to women, and only to women! No men have been denied any healthcare they are seeking!  In order that we not waste our money, our time, and subject ourselves to humiliation or worse, we hereby demand that pharmacists, nurses and physicians make known up front exactly what their belief system will preclude them from offering us.  We demand a level playing field. 

Beginning now, all healthcare workers must display the following sign prominently in their office so that we will know whether we want to take our business elsewhere.  A colleague has suggested the following:

NOTICE TO PATIENTS

I follow my own religious beliefs ahead of your medical needs.  Therefore, I will not support, offer, or approve any of the following checked off below.

__ I do not subscribe to a woman's right to make her own decisions about her reproductive healthcare.

__I do not believe that a woman has the right to choose her method of contraception and therefore will not sell prescription birth control.

__I do not believe in Emergency Contraception, even if you have been raped, and will therefore not give you Plan B to prevent pregnancy.

__ I do not believe in abortion and therefore will not provide an abortion nor will I offer a referral for an abortion elsewhere.

When this sign is posted in all healthcare institutions from doctor's offices to clinics to emergency rooms to pharmacies, then women will have true freedom of choice.  Women will know before they make an appointment, spend money and time whether their healthcare provider offers the services they are seeking.  We are informed of the contents of our food, our haircare products, our drinks.  Why not which healthcare needs we will be denied before the humiliation!

Please spread this list far and wide!  Women unite! Begin asking before you make an appointment if your doctor or clinic will provide you with all of the healthcare services you need.  If not, take your business elsewhere!

Lu