Sarah* entered my clinic with her head down and tears in her eyes. She told me she was ashamed that she had to see me again and continued, “I know I should have started that birth control prescription you gave me last time.” Unprompted, she went on to explain that she had thought the volatile and violent relationship with her husband was finally over, but when he called her over the holidays and asked to see her again, she reluctantly agreed. “I did it for my children,” she said. He promised her he had changed: stopped drinking, started working, got his temper under control. She started crying; she told me it was only two weeks before she had another black eye. And then she missed her period.
I was the only person who knew she was pregnant. “Will anyone be able to find out if I had an abortion?” she asked. While I went on to reassure her about the confidentiality of medical records, I realized she needed more than my words. As her physician and now sole confidant, I was in a very privileged position. I could offer her the support she so deserved when no one else could. I reached across and hugged her; she sobbed harder. While my heart ached with her palpable sadness, I found solace in knowing I could help her in a profound way: by performing her abortion.
While my patient undoubtedly felt that she was in an unlucky situation that day, she was, in many ways, far luckier than some. We were fortunate to be in the state of Hawaii where the state legislature has not imposed undue restrictions on abortion access. Had she been in South Dakota, she would have had to wait three days between seeing me for a pre-abortion counseling visit and undergoing the procedure. In South Carolina, she might have had to pay out of pocket for her abortion, if she had an insurance plan that is prohibited from covering it. In any number of states, she would have had to walk through a crowd of protesters screaming “baby killer” at her as she entered the clinic.
Access to health care, including abortion, is a basic human right that should be affordable and accessible for all. A 2014 United Nations report reaffirmed that “access to safe and legal abortion improves women’s health and wellbeing” and concluded “provisions should be made for the availability of and access to safe abortion for all women who need it.” Unfortunately, we are moving backwards in this regard in many parts of the U.S., as states have passed increasingly onerous laws to restrict access to this basic health care service. This is illustrated by the fact that more abortion restrictions were enacted in U.S. states from 2011 to 2013 than in the entire preceding decade. Compound this with the fact that the number of abortion providers has decreased in the past two decades, and the question becomes not “Why do I provide abortion care?” but “Why wouldn’t I provide abortion care?”
Why wouldn’t I help a woman and her family during their most vulnerable time? Why wouldn’t I perform a safe and simple medical procedure? Why wouldn’t I encourage and train other doctors to do the same? I refuse to be deterred by those who wish to deny women their basic human rights, those who propose medically unnecessary abortion restrictions, those who judge, stigmatize, and harass women seeking an abortion and the providers who offer this care.
No woman ever wants to be in a position where abortion is the only answer, but many times it is. Every time that I help a woman have an abortion, I am humbled by the selfless and thoughtful reasons she has chosen that path for herself.
Sarah cried with relief later that day when I completed her abortion. She no longer felt bound to her abusive partner. She thanked me for my help. I was in awe of her strength and courage in making this humane decision and reclaiming her life. And I was ready for the next patient.
*Not her real name. Identifying details have been changed to protect the patient’s confidentiality.
Kate Whitehouse, DO, is a practicing obstetrician/gynecologist, researcher, and family planning specialist in Honolulu, Hawaii. She is a Physicians for Reproductive Health Leadership Training Academy Fellow.
March 10 is the National Day of Appreciation for Abortion Providers, observed every year on the anniversary of the day in 1993 when Dr. David Gunn was murdered by an anti-choice extremist. Every year, Physicians for Reproductive Health honors the courageous medical practitioners who provide this much-needed service and fight the stigma surrounding this safe, legal medical care. You can find out more at www.prh.org/why.
