abortionclinicdays

All Five Feelings

It is axiomatic in the counseling world that there are just five basic feelings: anger, fear, shame, sadness, happiness. I had a patient who covered all her bases-- especially the first four. She came in with major attitude-- slamming about, throwing things, refusing blood work, leaving the clinic, arguing with her mother. My staff just wordlessly handed me her chart: It said: "Abortion is disgusting!" 

So, I sat down with her. She was angry at everyone and everything: she couldn't believe this was happening to her. She was also sad: the more we talked about it, the more she could connect with that feeling. She was scared: she didn't know what to expect. She had always been against abortion for herself (though not for others) and felt ashamed that she was in a clinic.

Miraculously, listening to her attentively, without judgment, and respectfully seemed to do the trick. At one point she said, "I don't really have anyone to talk to about this." She was right in her concern about how she would process this afterwards. (Me too.) But, she felt she had no choice--she had two small children, one an infant, no means of support, had some mental health problems, and partner not present. Gradually we mapped out some ways that she could shift from an impossible view of herself to a more self forgiving, compassionate place. It turned out that she couldn't square her personal identity as a mother with having an abortion, even though she was doing it largely FOR her children. In this instance, the workbook A Guide to Emotional and Spiritual Resolution After an Abortion was a good resource for what was sure to be an ongoing process.

Tough stuff. I often urge women, as I did this woman, to give themselves credit for struggling with all these big issues, in the face of all sorts of negative messages from our culture and often people close to them.

She finally said, "I think I'm feeling better." Then we did her ultrasound which was actually very reassuring to her. She was our patient of the day. When I saw her in recovery, she gave me a thumbs up and smiled. It probably wouldn't qualify as "happy" but I'm gonna take it-- five for five!

--Bon

Obvious Child

I know we're usually ultra serious about abortion in this blog, but I wanted to let people know about a romantic comedy that features abortion in a positive yet humorous light. It's called Obvious Child (and the Paul Simon song by the same name is featured) and it's about a young woman (Donna) who is dumped and in the consolation drunk hooks up with a guy and gets pregnant. Sort of like Knocked Up except the guy is basically a good soul.

Donna is not too conflicted about her decision--she doesn't even remember the guy's name-- and chalks it up to temporary stupidity. That allows for a certain light hearted inevitability. She confers with her girlfriend and asks, "Will it hurt?" She replies, "Not as much as the break up."

Unlike Juno (which I loved in spite of this scene) the abortion clinic is neutral, and the actual abortion is just her nodding off. The "recovery" has women not meeting each others' eyes (ah the stigma shows up) and I guess that happens, although in my experience recovery rooms are fairly friendly.

So check out Gillian Robespierre's Obvious Child and tell your friends. It deserves a wide audience. (in case the link doesn't work http://pandagon.net/index.php/site/a_rom_com_about_abortion/)

--bon

Your abortion stories

Even though we do not typically respond within the comments section of this blog, Bon, Lu and I do read comments to see what readers have questions about and what kind of stories would be meaningful to our readers. I want to thank those of you who have written in with your own abortion stories. Nothing better illustrates the richness and complexity of a pregnancy decision than hearing from women who've been there. The women's positive abortion stories help us as counselors identify the qualities that help encourage resilience and healthy coping before and after an abortion.

We often share your stories with our own patients. Hearing that someone else has walked that path with strength and grace--and that they're not afraid to tell their story--our patients describe as the most precious gift they can receive from the women in their community. The abortion stories women provide that describe isolation, suffering or painful rumination--those teach us something too. We should be listening to these women to understand the qualities that contribute to their suffering so that no woman has to describe her pregnancy or abortion experience in this way.

So how can you help the women you love to have positive memories of their abortions? I would love to hear from readers about the factors that made a difference in their abortions being positive or negative memories. Some suggestions I've gotten from women include:

Listen closely and let me express all the feelings I'm having, even the ambivalent ones.
Don't tell me what to do, unless I ask you for that feedback.
Tell me your own abortion story.
Don't assume that be cause I am pro-choice, this experience will be clearcut or simple for me.
Don't assume that describing myself as "against abortion" means I don't want to have one.
Help me with practical things--childcare, a ride to the clinic, make my favorite dinner for when I get back home, clean the house, cover my shift at work on the day of my appointment.
When you make promises to help with this stuff--FOLLOW THROUGH!
Don't promise to "help me with the baby" unless you can identify specific things you are willing to help with. If I choose this path, once again, FOLLOW THROUGH!
Remind me what a good job I'm doing taking care of my family already.
Help me find accurate information about abortion care.
If I ask you to respect my privacy and not tell other people about my pregnancy, please do so.
Love me no matter what.

What are the factors that made your own abortions positive experiences? Were there things that impacted your experience negatively? What else would you add to this list?

Nell

The Fund

The past two weeks at our clinic have really been something else. I just wanted to take a moment and sing the praises of our local networks of abortion funds and amazing volunteers. An abortion fund offers help for women who are unable to pay for the cost of their abortions. Our local fund has been an amazing resource and increasingly, they've been able to step up to ensure that patients' entire experience is positive and respectful. With the economy going south, jobs in our region disappearing, health insurance scarce and gas prices soaring, it's more and more difficult for our patients to arrange the practical details of getting in for medical care. Due to the number of clinics in our part of the country, some women have travel time of up to four or five hours—if they have a car, that is.

As a staff, we wind up trying to arrange all manner of logistics so patients will have access to abortion care—waiving fees for lab work or sonograms when patients can't find enough money, picking patients up at the bus station, slipping their boyfriends or grandmas a little money for gas out of our own pockets. The local abortion fund, while initially intended to pay for medical care, has agreed to help with everything from bus fare to babysitters. Donating money to any cause can feel a little abstract sometimes. In addition to helping women pay for the abortion itself, here is a list of expenses the fund helped with this week:

2 tanks of gas—one to pick up Jules a few counties over and one to drop off Alanna. Jules' partner was in prison for domestic violence; in his absence, his family had been harassing her, blaming her for his incarceration. She was so fearful of them that she had our volunteer meet her at a local restaurant to ensure their safety. Alanna was staying at a shelter for homeless women with her teenage son that was run by the local church. The workers at the shelter said that they would not *prevent* her from having an abortion, but they would not assist her in any way.

2 hotel rooms—One was for Jules who needed two appointments and worried about her safety if she went home and one was for Mandy, a teenager from a small town four hours away. She and her boyfriend came into the clinic with just days left before they would be over the number of weeks the clinic sets as a cutoff. In our counseling session, I explained that she would need a two-day appointment, and suggested that they find a place to stay nearby. She began to sob. If she and her boyfriend pooled all their money from their summer jobs, they would have just enough for the abortion. She asked if I knew of a safe place where they could sleep in their car or a 24 hour diner where they could wait overnight. None of our volunteers had an open couch that night, so I made a few phone calls and got a discounted rate for them at a local hotel, which the fund agreed to cover.

1 bus ticket—For Alyssa, who has been coming to us for her well-woman care since she was a teenager. She had run out of money one month, failed to get her birth control on time and was too embarrassed to call us and ask for some sample packs. In our counseling session, she confessed that she had exactly the amount of money needed for her abortion (borrowed from a friend) and had no plan for how to get home after her surgery.

When I think about the difference the abortion fund made in these women's experience, it makes me so proud. What would it have been like for Alanna to have to beg the workers at the shelter for a ride? Some folks might say that this is squandering resources—that Mandy could have slept over in her car. (Maybe so. If you really need access to abortion services, sometimes you gotta do what you gotta do.) But the fund gives us another option. There was a whole community of pro-choice women and men who wanted this to be an okay experience for her. It let us transform that day from a scary experience in a unknown city into one where she and her boyfriend felt safe, valued and listened to. Isn't that what's at the heart of humane, feminist healthcare in the first place?

Nell

Some Women

There have been a few women lately whose stories have stuck with me, so I wanted to share them here.

Lindsey (as always not her real name) is 37, has some serious medical conditions, and, as she put it, "just missed having kids" because she was taking care of elderly parents, in business, busy. She and her husband of 25 or so years were still in love and met with me on an off day so that we would have time to talk about what was troubling her. She talked about her life for about an hour and how upset she was that she was pregnant. There was nothing that I heard that was encouraging about having a child; she was happy with her life mostly, but she was also doing some spiritual work and wanted to be sure having a child wasn't "supposed to be" her new path. That is such a  hard thing for so many: figuring out what meaning life has for us. She scheduled for the following week and I genuinely thought that she was fairly resolved. When she and her husband returned, I talked to them for over an hour again, and still she was not completely "there." But, as  her husband pointed out, she had not taken one step toward having the baby either (prenatal vitamins etc.) She didn't say anything different, but just couldn't go forward. I encouraged them to leave, to take a walk, anything to break the deadlock. What seemed like hours later, I was holding her hand during the abortion and she finally said, in a very small voice, "Am I bad person?"  "Can I have an abortion and still be a good person?" is a question that lurks in many women's minds.

Melanie was a difficult patient for  me, which was good, if you see what I mean. Her voice tone was, well, whiny, and it really seemed that she was not taking responsibility for her decision. Her partner was, like Lindsey's, kind and patient and devoted and he was clear that this was the wrong time for them to be pregnant. They were both quite deeply religious. I listened to her carefully and very directly told her that she  did not sound resolved at all, and that if she went through with the abortion, she could regret her decision and jeopardize her own emotional stability as well as her relationship. (She kept saying, "Well, maybe I should just get it over with." I sent her off with the Pregnancy Options Workbook, and with a new workbook called "A Guide to Emotional and Spiritual Resolution After an Abortion," which I felt she would need sooner or later.

When she came back the following week I couldn't believe it was the same person. First of all, her voice was in a normal register and she just looked "centered." She had filled out her workbook and was brimming with an energy she did not have before. She was still anxious about the procedure and she too gripped my hand tightly during the abortion. She too was having problems with the idea of having an abortion and still being a good person. When she asked "what do you do with it?" I suggested that she could enclose a  note, and both the remains and the note would get incinerated and 'return to the universe'. Her partner went outside and brought back a rose and we included that too. I let her smell the rose, which was so fragrant, and I hope that is her memory of her abortion instead of all the negative thoughts she had about herself the first time I talked to her.

Finally, LaShonda got to me because she was sobbing. She too was religious and struggling with what was "right." She had 4 kids and 3 of them were the result of marital rape. She had been abused so severely that she lost the use of a limb. We are talking about Sybil kind of abuse here, the kind that you read about and can't quite get your mind around. And she  needed to talk about it. And I listened intently, trying not to hear the horror of it, but to that thread of strength and hope that somehow kept her going to get out of those situations. She nearly died so many times, and no one helped her but her young child who was also abused in a very sick way. The irony for her was that she was with a wonderful caring man now--why  keep the rapist's child and not the one created out of love? But she also knew that she was spent physically and every other way and it was time for her to heal herself and her children. As with Lindsay and Melanie, she gripped me fiercely during the abortion, and said, "I never told anyone these things before." She will stay with me for a very long while.

A fellow counselor from another clinic told me that she often writes a patient's name on a little piece of paper and puts it in her pocket. She often finds it in the laundry or mixed up with her shopping list, but it is her way of getting  some closure on emotionally significant sessions.

Dear readers, thank you for being my ritual for closure tonight.

--Bon

"Choosing Us" by Alison Piepmier

I've been meaning to add a link to this story by Alison Piepmeier for quite a while. Even though close to 40% of American women will have an abortion during their childbearing years, it's one of the few things that we don't talk about freely. Is there anything else happens to 40% of us that we don't talk about?

We talk about sex and finances and relationships/partnerships and illness and parenting and all messy details of our lives. Why not about this?

I think this is a beautiful, brave essay. What would the world look like if we could all tell our stories so freely?

Nell

Choosing Us

Annie's story

Last week, Annie appeared at our door without an appointment, begging the guard to let her in.  After much discussion with the guard, and a counselor coming to the door to learn more, Annie was admitted for a counseling session and sonogram.  Annie told us she was 18 weeks pregnant, needed to have an abortion immediately, but had only a few dollars.  At 18 weeks, the cost for an abortion is more than $1000, is a 3 day process, and our state law requires a mandatory 24 hour delay.

I sat down with Annie to hear more of her story.  She told me that she did not want to be pregnant, that her boyfriend had thrown her out, she had nowhere to live and did not earn enough to even pay her rent and utilities.  So we set her up to have a sonogram to determine exactly how far into her pregnancy Annie really was.  The sono revealed that she was exactly as she said, 18 weeks, meaning that we had only one week to complete the process according to the protocols of our particular facility.  Annie told me that she wanted an abortion more than anything in her life, that she was the only person in her whole family who was not addicted to drugs and she wanted to make something of her life.  She said she was determined that she would not be like them.  She stated that no one in her family had ever had a job, no one had ever even gotten a driver's license and she wanted a different life. She had plans and had been dreaming of a different life for the past 8 years.  In fact, as she entered the clinic she immediately asked, "Do you have that five year birth control?"  I assured her that we did indeed have Mirena, that she could have it at her check up appointment and we'd take care of the necessary paperwork in the meantime.  "And", she asked, "is is possible to get a second one put in after the first five years, because I figure it will take me 10 years to get a degree, get my life on track and have a good enough job to have a baby."  Again, I assured her that she could get another Mirena inserted after the first one plus there is a 10 year IUD that we could talk about.

While Annie and I were talking, getting her medical history, and getting her consent forms signed, two other staff persons were working to find funding for her abortion since she did not even have enough money to feed herself, let alone pay for the abortion, not so uncommon these days.  By the time she left the clinic, just about everything was in place for her to return the following day for the first steps of her abortion.  Before I left for home, I thanked everyone who had worked so hard to get all that Annie needed with so little lead time.

When I arrived the next morning, the first thing I asked was, "Where's Annie?"  "Oh," another counselor reported, "Annie called and canceled.  She said that when she called her mom to tell her that she was having an abortion, her mom told her she'd never speak to her again if she had the abortion."  I was shocked.  Annie had seemed so sure, so convinced that she wanted her life to take a different path than her family.

Concerned, I called her later in the day.  "Annie", I said, "how are you?"  "Oh, Miss Lu", she said, "when my mom told me she'd try to get off crack if I had the baby and that she would never speak to me again if I had an abortion, I just had to change my mind.  Maybe this baby will help my mom to get clean. I hope you're not mad at me."  I assured her that we understood, that she was choosing what she thought was best for her.  I wished her health, happiness and success.  And I meant it.

Lu

I can't believe it happened to me!

No woman ever imagines that she will someday need an abortion.  Either because she is consistantly using birth control, or because she has a history of infertility, or because she has not gotten pregnant despite using no birth control in the past, or because her knowledge of how conception occurs is faulty, but one way or another, no one ever seems to think unintended pregnancy will happen to her.  But, of course, it does happen.  In fact, 50% of US pregnancies are unintended. 

As a counselor, I talk to many women who have chosen abortion but are still shocked that they got pregnant.  Even those using no birth control sometimes cannot believe that they are indeed pregnant. Diane was one of those women who first tried to deny to herself that she was pregnant, then hoped that her period would somehow come even though she had by then taken numerous pregnancy tests confirming the pregnancy.  Eventually, she acknowledged that she was pregnant, and decided to have the baby and put it up for adoption.  As time went on, though, she began to have doubts that she could actually go through with the adoption, and knew that she had no resources that would allow her to raise a child responsibly.  Which brings us to the point where I spoke with her.  Diane described how and why she had made the decision to have an abortion.  She described herself as "sure of her choice" but still feeling sad and lost.  "Sad" I understood but I wanted her to tell me what she meant by "lost".  Diane said that she felt adrift, was finding it difficult to reconcile her past thoughts about abortion with what she had chosen.  She said that she "never believed in abortion" yet here she was.  Eventually, as she continued to explore exactly what she was feeling, she concluded that what was lost was her own innocence.  Diane stated that life was simpler when it seemed black and white.  She concluded that she was not so much sad about having an abortion, but rather sad because never again could she imagine herself living in childlike innocence that abortion is always wrong and having the baby always right.

Many of us who have never had to face unintended pregnancy can still relate to Diane's situation.  For most of us, whether at age 18 or age 35, at some point each of us will find ourselves having to accept that life is not as simple as we would wish, that difficult choices do have to be made, but also that we can allow the sadness, accept that life is not always as we'd wish, but then move on to healing.

Lu

ps While we are sympathetic to those of you having problems with our spam blocker, we cannot seem to set it to keep out the porn spam and yet allow all of you to comment.  Sorry

homeless

Being on the front lines as we are, and talking to real women every day, counselors get to meet with and hear the stories of women and families who have been directly affected by the mortgage crisis, the closing of businesses and factories, the downturn in the economy. For them, these are not just stories in the news.  Historically, one of the major reasons women give for choosing an abortion is financial insecurity.  Now, more than ever in my many years of doing this work, I am talking to women who are essentially homeless.  I mean women who are actually living in shelters alone or with their children, or women who stay with friends a few weeks here, a few days there, hoping that they can find a job that will allow them to move out on their own before they, too, are forced into the shelters or the streets.

Myra, whom I remember from last month, was staying temporarily with her sister, but could not remain there much longer because there was no room for her.  Her boyfriend was sleeping on a friend's couch but that too could only be for a short while longer.  Her children were boarded out with family members.  Little more than sixty days earlier, her boyfriend had a good job and they rented a nice house.  When his employer suddenly closed the business, in very short order they lost their house, then their car.  Although they were both looking for work when she came for her abortion, they had not been able to find anything that would pay enough for them to again cover rent, utilities and support their kids.  Needless to say, abortion was her only option.

There have been several other similar stories in just a few months time.  Yesterday I saw a woman who lost not only her house but her kids when her husband was murdered.  She went into shock and then became so depressed her children were put into foster care.  She is again on track, but still living in a shelter.  Having found a responsible job, and now able to fend in the world again, she is on the verge of getting into an apartment, which will allow her to get her kids back.  But if she had another baby right now, she said she feared that she might not get her other kids out of "the system".  That had to be her priority, she said.

Another woman, Linda,  who lives in a rural county said that the only employer who had jobs for college educated people had recently lost their grant to operate so she had been out of work for nearly six months, is in the middle of a divorce, and cannot even sell her house because there are no buyers in her area since there is nothing to attract people to move into the area.  So although she had never imagined herself choosing abortion in the past, suddenly saw no way out since her own future is so unclear.

Our experiences with women make the stories from the newspapers and tv so much more real.  We can see how frightening it is for women to not be able to care for their kids because of economic factors.  It tears them apart, they worry every day about those kids, miss them and plot how to get them back living under the same roof.  But as the number of foreclosures increases, sadly I expect that we will see ever more women who have exhausted their welcome with friends and family and who are forced to live in the shelters.  The only option for them is abortion.

Louisa, whom I spoke with recently, told me that she works two full time jobs in order to be able to pay her rent, utilities and car payment.  She said she was looking to move to a less expensive apartment because even with the two jobs, she was just barely making ends meet.  Louisa was very sad and weepy as she told me how she would love to have a baby and wondered if the time would ever be right financially.  Her boy friend does not make enough money to live on his own so he still lives with his mom whom he helps to support.  None of them has enough room for anyone else; none makes enough to live differently and none sees any hope for things to be different.

Lest you think that all of our work is sad and depressing, it is not so!  A sizable number of women who choose abortion are actually hopeful that the future will be better for them.  They are going to school, have just gotten a promotion or are content with the family they now have.  While there may be some sadness for them, they still see life getting better.  But I want to point out to readers what may be a mini-trend in our patients' lives, so I am calling it out.  Telling their stories to us, the women we see are not just statistics.  They are real!

lu

I just kept talking and talking......

Sometimes the safety and privacy of a counseling room presents women with the opportunity to talk about things that they rarely discuss in medical settings. Whether due to lack of time, lack of trained staff or a perspective that emotional or psychological well-being are just “not a part of gynecological  or obstetrical healthcare,” it's rare for women to have the opportunity to reflect on their sexual and reproductive lives with their medical providers.  Recently, I've had the some amazing conversations with women that have led me to think about resiliency and survival in our sexual/reproductive lives.

Rayanna was quiet and almost bashful when I asked her questions about how she had come to choose to have her abortion with us today. She had given birth six times, indicating that three of the children did not live with her currently. She and her partner were caring for three of the youngest children. She was taking good care of these three, she explained, but any more, that would push them beyond their financial and emotional means. “I'm slowing it all down,” she said, 'seven pregnancies—that's too many.”  Her current pregnancy was a result of a failed tubal ligation surgery.  Complication with surgical sterilization are rare, but they do happen and sometimes you just don't know the surgery's failed until you find yourself pregnant.

Rayanna had indicated that her family did not support her having the abortion and I asked her about their relationship. “Most of them are in Mississippi,” she answered, “so I don't have to see them that often.” Her mother, however, figured large in her pregnancy history. “She does think that I'm going to hell for this,” she answered, “but I have a hard time hearing that from her. Back in Mississippi where I grew up, you know in small towns—in my family—there was a lot of incest there. Everyone just made like that was what happens. Like you go to hell for having an abortion, but not for what she's done” (referring to her mother).  Rayanna went on to describe her extended family and how the uncles were given free reign over younger female family members. “It happened to so many of us, it was almost like it wasn't any big thing. No one talked about it and when I told my mom what was happening, she didn't do anything, didn't stop it.”

As a result of the incest, Rayanna had been sexually active for most of her life—but not on her own terms, not with her consent. When Rayanna became a teenager, she said she longed for affection and attention.  But, not yet understanding how to get what she needed,  she became sexually active with partners she described as “no good, beating on me, cheating on me and never there when I needed them.”  She got pregnant twice as a teen and her mother forbid her to have an abortion. Bewildered, she went along with this and the two infants were adopted by a relative. A third pregnancy two years later came as a result of a rape. Again, her mother forbid her to have an abortion and the child was adopted by a family friend. She had borne three children by the age of 20—again, not on her own terms.

When Rayanna moved away from home, she met her current partner. “It was like moving from the projects to Beverly Hills,” she explained, describing their relationship, and they had three children together. All her other children had been boys; this time she had two daughters. Something happened to her, she said, when the girls were born. She could recognize herself in them and before she knew it, she started talking about the abuse. “I just started talking and talking,” she said, “and no one could shut me up. I talked to my mother about what it felt like when she didn't listen to me. I talked to my relatives  about what happened to me. I made sure everyone knew what those uncles had done and that all the children were aware.” This was not received well by older family members, she said, who were angry with her for stirring up “old trouble.” “Why would they think it would just stop?” she said, “They think because they're old men now that's gonna stop them? You do it to one child, you're gonna do it to another.”

Rayanna brought it into the light. Generations of incest, silence and abuse ended that day. Her children would be safe—she would see to that.  It meant sacrificing her relationship with her extended family and straining her relationship with her mother, but it was a worthy price to pay.  I didn't know what to say, other than to thank Rayanna for what she had done. “I feel like I'm sitting here with a woman of such amazing strength,” I said. “Do you realize what a big deal it was for you to speak up about that? You did it, you're keeping your family safe.”  It was a hard road, but she was staking claim to her life, her safety, her sexuality, her fertility--this time on her terms.

“I'm slowing it down,” she said. “I had three babies born and given away before I was even sure what babies were good for. Maybe if my mother had listened to me when I tried to tell her about the abuse the first time and gotten me some help, maybe then I wouldn't have needed to have all those boyfriends who treated me bad.  Maybe I wouldn't have got pregnant and maybe no rape.  But that was then. I talk about it all now and no one's going to do that to my kids.  It took years of counseling to understand what all happened and now, I'm slowing it all down. I've got my three kids and we're working on communicating better and better and I just can't handle any more kids today. That's why I'm here. I'm slowing it all back down.”

Nell

Note:  Nell (not her real name) has graciously accepted our invitation to join us on abortionclinicdays.com.   We are thrilled and honored to have her authentic voice and wisdom.