When people ask what I do for a living, there’s always an awkward pause as I consider the situation. I’ve answered, vaguely, that I work in a doctor’s office; cheerily, that I work in women’s health care; and, bluntly, that I work at an abortion clinic. It is unfortunate that abortion has been so stigmatized that introducing it into everyday conversation can elicit emotional and political responses. But, more important than my minor discomfort in discussing my workplace is the fact that the charged atmosphere that surrounds abortion care doesn’t stop at our clinic doors — it enters with every patient and can affect how she perceives the entire experience.
Women have approximately 13 menstrual cycles each year, and the average American woman menstruates for over 30 years, so there are literally hundreds of chances to get pregnant.1 Our bodies are designed to become pregnant. So, it is not surprising that many women experience an unintended pregnancy during their lifetime. In fact, abortion is the most common outpatient surgical procedure in the United States: one-third of U.S. women will have an abortion in their lifetime.2 It is also one of the safest: 11 times safer than carrying a pregnancy to term and nearly twice as safe as getting a penicillin injection.3
Yet, I am often struck that these statistics are rarely shared with women seeking abortion care, women who would find consolation and empowerment in how common the procedure is. I’m not suggesting that getting an abortion is a casual decision, only that most women will have at least some cause to consider the procedure, however briefly. Women who call for an appointment often ask how common it is, and more than a few believe they’re the only ones who need an abortion. When they arrive, they’re often astonished to find other patients waiting.
Abortion care, and the women who need it, is portrayed in our society, as a “bad” procedure that only “bad” women choose. The national conversation often focuses on the morality of the procedure (in the anti-choice camp) and on keeping it legal and accessible (in the pro-choice side). But, access to legal abortion care is just one front in this debate. Even if abortion care were widely accessible throughout the U.S. (its not), women would still be stigmatized for needing, and getting, the procedure.
Abortion is treated like a cancer diagnosis was, decades ago. Forty or fifty years ago, it was fairly common for doctors not to inform cancer patients of their diagnosis, believing that it would only dishearten and shame them. Likewise, while abortion is safe, legal, and very common, it is not considered acceptable or polite to publicly acknowledge terminating an unexpected, unwanted, or unhealthy pregnancy. To do so risks making other people very uncomfortable. As one patient said, “Even today, I feel like ‘damaged goods’ just for talking about my experience, which I do to lessen the stigma that, I promise you, anyone who has made that choice feels.”4
Complications can occur with any pregnancy experience, and I certainly don’t want to downplay the emotional pain that some patients experience. But, the vast majority of women who terminate a pregnancy, have an uncomfortable few weeks followed by years of occasionally remembering the pregnancy, the way that you think about relationships that didn’t work out.
Contrast that with the way abortion is typically portrayed in the media. On movies and TV, abortion is an option that women either don’t consider when they have an unexpected pregnancy, or one they reject at the last moment. The image of women running out of the clinic in relief presents abortion care as a bad, seedy option.
I know this has an impact on women, because they feel degraded just by having to call an abortion clinic. I’ve had patients schedule without ever saying the word “abortion.” Some are astonished that we are in a safe area, expecting the clinic to be in a questionable neighborhood. It’s normal to be nervous before anysurgery, but patients often dread their visits to us and fear we will be unfriendly or neglectful while they are in our care. But it’s very unlikely that our staff would push their way past surly Catholic school students (who picket us to earn community service hours) every day, just for the joy of judging other women. A few years ago, I didn’t know anything about birth control. A few years from now, I could have a fetal anomaly. The only thing that separates me from most of my patients is a little luck and time.
The stigma of abortion isolates women, when often they need look no further than their family or friends to get support from others who’ve been in the same situation. Fortunately, several advocacy groups are working to de-stigmatize this medical procedure and talk about it more openly. Exhale is an after-abortion talk-line where women and their families can just vent and have their voices heard, regardless of politics (www.exhaleprovoice.org). Backline is another talk-line offering pre- and post-abortion counseling; it is also the vendor for Abortion Diaries, a documentary that examines women’s personal experiences (www.yourbackline.org). Advocates for Youth’s “1 in 3 Campaign” collects women’s stories about abortion, in written and video form, and displays them anonymously (http://www.1in3campaign.org).
While no one is pressuring women to share their stories, I know that most of our clients want to vent after this stressful experience. At my clinic, we keep a patient journal that women read and contribute to while waiting for surgery — and the emotion it contains is palpable.
One of my favorite parts of working at the clinic (besides getting to supplement my somewhat scanty sex education) is the chance to work with a team of awesome women. The clinic that I work at employs a diverse group of women, and a few men, of varying races, religions, and world views. Everyone, however, has a strong interest in helping women through a difficult situation.
Often clients ask us if it is depressing to work here, or want to know how difficult it is to deal with the protesters outside. I can honestly say that I’ve never experienced the loyalty and tight-knit community at any other office that I have here, and that’s probably due to the nature of our work. I imagine my work experience is like working in a fire station: constantly dealing with emergency situations, helping people in a time of need, and getting to know yourself and other people really well in the process.
I still remember one of our patients, getting options counseling, then standing up, shaking her head, and announcing: “It’s not easy being a lady sometimes.” Her remark perfectly expresses both the difficulty and reality of this choice for many women. For millennia, unplanned pregnancy and abortion have been a part of women’s experience and I cannot imagine a future where women don’t have agency over their bodies and their futures. What must change is whether we can trust and honor women enough to give them the information and support they need during any pregnancy.
This article was written by: Jessica Shines
Jessica Shines is a women’s health advocate that has worked in abortion care for several years after graduating with a degree in Africana Women’s Studies. She lives in the Chicago area and is planning to travel more and write about women’s issues from an international perspective.
1. U.S. Department of Health and Human Services, Office on Women’s Health, Menstruation and the Menstrual Cycle Fact Sheet, Retrieved July 3, 2013 from http://www.womenshealth.gov/publications/our-publications/fact-sheet/menstruation.cfm#f.
2. The Guttmacher Institute Website, Facts on Induced Abortion in the United States, Retrieved June 17, 2013 from http://www.guttmacher.org/pubs/fb_induced_abortion.html.
3. The Guttmacher Institute Website, Facts on Induced Abortion in the United States, Retrieved June 17, 2013 from http://www.guttmacher.org/pubs/fb_induced_abortion.html.
4. “5 Women, 5 Takes on the Abortion Debate,” Retrieved on July 3, 2013 fromhttp://www.refinery29.com/2013/07/49223/abortion-debate-stories?page=2