41 Things You Should Know About Abortions And The Doctors Who Perform Them



sexedweek

Health

“I’m in a constant battle to help women and it can get
exhausting sometimes, but the good days outweigh the bad ones.”

Posted on April 19, 2017, 15:01 GMT

Forty-four years ago,
the US Supreme Court affirmed a woman’s legal right to have an abortion in the
Roe v. Wade decision. Today, abortion access is still
being fought over in many states — but while you hear all the
time from activists on both sides, the doctors who perform
these procedures are often left out of the
conversation.

Drew Angerer / Getty Images / Via gettyimages.com

BuzzFeed Health reached out to abortion providers across
the country to find out what they wish people understood
about the job, the procedure, and the women they treat.

We heard from physicians who practice in conservative
Southern states, liberal coastal cities, the rural
Midwest, and in between. The following is a selection of
perspectives and anecdotes from 11 physicians (some of
whom asked to remain anonymous) that illustrate their
day-to-day and the current landscape of abortion care in
the US.

[Editor’s note: This article is meant to be informational
and educational, but it does not speak on behalf of all
providers or all patients. Although all quotes are from
physicians, this is not meant to replace advice from a
medical professional. If you are seeking an abortion or have
any questions about abortion, talk to your doctor or a
health educator.]

1. Abortions are just one part of the
job. These are OB-GYNs, family physicians, maternal-fetal
medicine specialists, medical directors, and more.

“The majority of my practice is full-scope OB-GYN care, so I
provide abortions but I also work in infertility, obstetrics,
gynecological surgery such as hysterectomies, family
planning, abnormal uterine bleeding, and I also work at a
local country jail providing gynecological care for
incarcerated women. People only think I terminate pregnancies
but I deliver babies too, and I love that part of my job.”

—Dr. Rachna Vanjani, OB-GYN, San Francisco, California,
fellow, Physicians for Reproductive Health

“I get to care for women during these monumental times
throughout all the stages of their lives. That may mean
providing prenatal care, helping a woman through a
miscarriage or stillbirth, helping women who choose adoption,
providing care during menopause, or safely terminating
pregnancies — and for me, it’s a great honor.”

—Dr. Lisa Perriera, OB-GYN, Philadelphia Women’s Center,
Pennsylvania, fellow, Physicians for Reproductive Health

Dola Sun for BuzzFeed News

2. Abortion providers don’t feel like
they’re on the fringes of the medical community.

“Because of the stigma around the word abortion, there’s this
idea that an abortionist is some unprofessional on the
fringes of the medical community, but that’s not true at all
— I very much tie my identity to professionalism and the
tenets of medical ethics and that’s what drew me to this
field in the first place.”

—Anonymous OB-GYN, New Mexico, fellow, Physicians for
Reproductive Health

3. Most pursued training in abortion
care because they wanted to help women.

“I perform a simple medical procedure all day and walk out of
work knowing I impacted the lives of 15 to 20 women. In most
cases, I took away the biggest worry or obstacle in their
lives at that moment so they could follow their dreams or
finish their education, get a better job, and have the family
they want in future. In that sense, I feel like I get to save
women’s lives every day.”

—Dr. Sara Imershein, OB-GYN, clinics in
the DC area

4. Patients should expect to be treated
with kindness and compassion when they come in for this
procedure.

“I remember the first patient I ever had took my hand during
the procedure and said thank you for being there and being so
kind and it just broke my heart and still makes me tear up
that she was so shocked at our kindness and thought maybe she
didn’t deserve that or shouldn’t expect it.

“My patients are the reason why I go to work every day. I
know that many of them have experienced so much hostility and
judgment and they are very grateful to have a compassionate
provider. So if I can do that, if only for a short period of
time, it means the so much.”

—Anonymous OB-GYN, Oregon

5. They don’t see their role as judging
you or your decision — they just want to give you safe,
professional care.

“My patients should never feel like they need to justify
their decision to me — if it helps them to talk through
it, I am always happy to listen — because I will never judge
their reasoning and all I want is for them to be as healthy
and safe as possible, regardless of the circumstances.”

—Dr. Raegan McDonald-Mosley, chief medical officer,
Planned Parenthood Federation of America, OB-GYN,
Maryland

6. Legal abortions are safe and
do not affect your ability to get
pregnant in the future.

“Abortion is much more common and safe than anybody
unfamiliar with the procedure realizes. Medical and surgical
abortions do not have any impact on future fertility, and the
body goes completely back to normal. It’s a simple medical
procedure that doctors have been doing for a long time and
it’s very low-risk.”

—Dr. Imershein, Washington, DC

“Abortions are very safe and most are done in a doctor’s
office exam room. Any patient can go to a hospital, but they
really only need to if they are high-risk or they have a
medical condition that requires extra care or monitoring.”

—Anonymous OB-GYN, Michigan

7. In fact, childbirth is riskier than an early (legal)
abortion.

“This is one of the safest medical procedures a woman can
have. There’s a higher risk of something going wrong when you
continue a pregnancy than there is when you get an abortion,
especially if the abortion is done early in the first
trimester.”

—Anonymous OB-GYN, Oregon

8. The vast
majority of abortions occur in the first
trimester.

“There’s this perception about abortions among the public and
in the media that abortions are always done later in a
pregnancy, but that’s not true — most abortions in the
US happen before 21 weeks, and the majority of those happen
in the first trimester.”

—Anonymous OB-GYN, Oregon

9. The phrase “partial-birth abortion”
isn’t actually a medical term used to describe
abortions.

“There are a lot of misconceptions about second-trimester
abortions and when they are performed. Most happen well
before 23 or 24 weeks, because at that point we’re getting
into the third trimester and the fetus is reaching viability
[the point at which it can survive on its own outside the
womb, which varies] and most states prohibit abortions this
late anyway. But even though second-trimester abortions are
done later in the pregnancy, the phrases ‘late-term
abortion’ or ‘partial-birth abortion’ you hear are not
medical terms we use to describe abortion. They often
describe a fetus being removed from the womb in the final
days of a pregnancy, which is essentially a cesarean
section.”

—Dr. Perriera, Pennsylvania

10. Surgical abortions aren’t
technically surgeries — they require no incisions or sutures
— and they usually last around 10 to 15 minutes.

“Surgical abortions should really be called procedural
because there’s really no surgery involved — there is no
knife involved and no cutting or scraping or sewing incisions
back together — all we do is go through a natural
orifice in the body and remove the lining of the uterus and
everything attached to it, either by using suction or
sometimes forceps. And we usually do the procedure in a
doctor’s office, not in a surgical center or operating room.”

—Dr. Imershein, Washington, DC

11. They want people to understand what
actually happens during an abortion. (Some readers may
find these details graphic.)

“The abortion is usually the fastest part of the whole
appointment. If it’s early enough in gestation, we can do
medical abortion — it’s a two-step pill process. First
you take mifepristone, then 24 hours later you take
misoprostol — these expel the pregnancy from the uterus and
you bleed like you do in a miscarriage.

“First-trimester surgical abortions only take about 2 to 7
minutes and second-trimester abortions take around 10 to 15
minutes. We lightly sedate the patient and insert a speculum,
then we numb the cervix with a shot of lidocaine before we
dilate it a few millimeters using a tapered metal rod. Then
we place a small tube that’s thinner than a drinking straw
through the opening in the cervix, and it’s attached to a
suction machine so it draws the uterine lining and pregnancy
into the tube and out of the body.

“If it’s a second-trimester pregnancy, we dilate the cervix a
few centimeters so sometimes we might need to put synthetic
dilators in the day before to help the cervix soften
overnight. We typically give the patient more anesthesia and
we usually have to use forceps in addition to suction to
remove the fetus from the uterus. I think it’s important to
explain the procedure very clearly, because demystifying what
happens can dispel many of the myths and false information.”

—Dr. Deborah Oyer, family physician, medical director of
Cedar River Clinics, Seattle, Washington

12. How a patient feels after the
procedure varies from person to person.

“After the procedure, some women really grieve the loss of a
pregnancy and they’ll ask for an ultrasound picture to take
home, but many women also feel very relieved and like a huge
weight has been lifted off their shoulders. And whatever a
woman feels after the procedure, she is allowed to feel
that.”

—Dr. Perriera, Pennsylvania

Dola Sun for BuzzFeed News

13. They don’t see their job as
convincing anyone to have an abortion; they simply give them
the information they need to make a decision.

“There’s this huge misconception that I make decisions for
other people — but I don’t decide anything for anyone. I
provide counseling, and support so that they can make the
right decision for themselves. As a medical professional,
it’s my legal, ethical, and moral obligation to give a
patient all the information they need to make informed,
competent decisions.”

—Dr. Sarah Wallett, medical director, Planned Parenthood
Greater Memphis Region and OB-GYN, Memphis, Tennessee

14. They want to make certain that a
patient is 100% sure of their decision and that they made it
on their own.

“We don’t perform abortions for woman who seem unsure — we
never want a patient to feel like someone talked them into
it. If I ever sense that a patient isn’t comfortable with
their decision, I’ll stop and make sure they’re ready. So
yes, that means some women change their minds at the very
last minute. I’ve even stopped a procedure right as I was
putting a patient under anesthesia. And if that’s the right
decision for them, we always respect it.”

—Dr. Imershein, Washington, DC

15. They don’t all work at Planned
Parenthood.

“Abortion care is often synonymous with Planned Parenthood,
but that’s not the case. Actually, the majority of abortions
are done by independent providers at either private or public
clinics. And it’s not as if it’s ‘Planned Parenthood versus
independent providers’ or one is better than the other — they
are just different, usually in terms of which services they
provide.”

—Dr. Oyer, Washington

16. They provide abortions to all
different kinds of women, for all different reasons.

“I may perform 20 abortions in one day and every single woman
will have a different reason why she’s there. For example, on
a typical Saturday I saw these patients: One woman had her
GRE book on her lap and was studying during every free minute
of her appointment, and she said she got an abortion so she
could go to grad school; one woman really wanted a baby but
there was a severe fetal anomaly and the pregnancy wasn’t
viable; one woman had been trying to get pregnant with her
husband for two years, then she was raped by her boss and
didn’t know if the baby was his and was very traumatized, so
she chose to get an abortion. There is no one reason why a
woman gets an abortion, but every reason is valid.”

—Dr. Vanjani, San Francisco

17. That includes women who identify as
“pro-life” or who are very religious.

“I practice in Memphis, where there’s a church on practically
every corner and my patients are from the Mississippi Delta
region. So most of the women I provide abortions to are
religious. Sometimes I think those religious patients feel
even more stigma and feel more alone than other patients
because society teaches us that religious people just don’t
agree with or have abortions. But that’s not true.”

—Dr. Wallett, Planned Parenthood, Tennessee

18. Sometimes they care for women
dealing with substance abuse who’ve been using during their
pregnancy.

“We have a large population of substance abuse patients who
are dependent on illegal drugs [such as heroin] or alcohol,
and many are either afraid or know that they’ve caused harm
to the pregnancy because of their drug use. They often feel
like they need to terminate the pregnancy so they can get
sober, because otherwise they’d keep using and harm the baby
even more.”

—Anonymous OB-GYN, Michigan

19. Other times that’s mothers who — for
whatever reason — cannot have another child at this
time.

“We see all different kinds of women, but a lot of them are
mothers who know how challenging and expensive raising a
child can be. They often decide to get an abortion so they
can allocate their resources and care and time toward the
children they already have.”

—Dr. McDonald-Mosley, Planned Parenthood, Maryland

20. And other times patients are ending
a desired pregnancy because something went wrong.

“Many of my patients deeply desire to carry their pregnancy
to term and to go home with a healthy newborn but
complications occur that make the prognosis for the mother
and/or the fetus very dire. In those circumstances, some
families choose to end the pregnancy, and often to minimize
suffering for a baby that will be born very sick with no or
minimal chance of survival. For these patients, the decision
to end a pregnancy is very difficult and made from a place of
love and compassion. The rhetoric on both the pro- and
anti-choice sides often overlooks these patients.”

—Anonymous maternal-fetal medicine physician, Utah

21. Those cases can be hard on the
doctors, too.

“When a woman or a family hears bad news about a desired
pregnancy, it shakes them to their core. The information I
need to convey is sometimes the worst news they have ever, or
will ever, hear. A woman that goes to the doctor and receives
terrible news about a pregnancy is not the same woman that
comes home.”

—Anonymous maternal-fetal medicine physician, Utah

22. You probably know someone who’s had
an abortion.

“One in three women has had an abortion in America, so
statistically, you know someone — she might be your mother or
your sister, your aunt, your daughter, your neighbor, your
co-worker — there’s this societal sense that any women who
have had abortion are the ‘other’ but she is us, she is all
of us.”

—Anonymous OB-GYN, New Mexico

“Every woman thinks she’s the only woman she knows who’s had
an abortion, but it’s actually very common. We only think
it’s rare because it’s taboo to talk about.”

—Dr. Oyer, Washington

Dola Sun for BuzzFeed News

23. False information about abortions
can cause unnecessary paranoia and delay care.

“By the time we see patients, they might believe that the
procedure will impair them for life or it’ll cause them to
get breast cancer or they’ll never be able to have a baby
again. It’s very difficult for us as doctors because we only
get to see these patients for an hour or two, yet we still
have to gain their trust in that time, enough to dispel all
of the myths and erase the fear that they’ve caused
[patients].”

—Anonymous OB-GYN, Michigan

24. Nobody thinks they’re going to need
an abortion — just like no one expects an unplanned
pregnancy.

“Nobody thinks it’ll happen to them, just like nobody expects
an unplanned pregnancy. You truly don’t think you’ll need an
abortion until you need one.”

—Dr. Perriera, Pennsylvania

25. In the providers’ experience, most
women who get abortions have carefully thought about their
decision for a long time before their first
appointment.

“People think because the legislature mandates a waiting
period that women haven’t thought carefully about their
decision to get an abortion by the time they come into the
clinic. But they have thought about it extensively,
from the moment their period was late or they saw a positive
pregnancy test or the day they called to make an appointment.
Most people know pretty immediately if it’s the wrong time in
their life to be pregnant.”

—Dr. Imershein, Washington, DC

26. Talking about abortion can help
de-stigmatize it, but not every woman wants to talk
about her abortion — and that’s okay.

“We want women to feel comfortable enough to talk about their
abortions because its real and it happens every day. The
silence around abortion can be harmful and increase the
stigma, and we need to stop it.”

—Dr. Perriera, Pennsylvania

“A lot of people will say women should talk about their
abortions to fight the stigma, but that also might be too
much to ask for some women — especially if they have to
parade their stories in front of men who don’t understand at
all. Abortion, just like any health issue or medical
procedure, is still a private matter and we should respect
that. There is no one way to de-stigmatize abortions.”

—Anonymous OB-GYN, Michigan

27. Some doctors are open about what
they do, some aren’t.

“There’s a spectrum of being ‘out’ as an abortion provider.
Some of us are very public about it and some people keep it
private, but it really depends on the context — their comfort
level, where they live, their family’s beliefs, the threat of
harassment around them.

“I’m very open about my work and what I do, despite the
risks. One of my favorite stories is about this time I was at
a farmers market and I struck up a conversation with this
big, burly bearded man covered in tattoos. He asked me about
my job and I told him, then there was a nervous pause.
Suddenly, his face just lit up and he told me he used to
volunteer as a patient escort at a clinic in rural
Pennsylvania, and we ended up having this amazing
conversation. You can never expect how people will react, but
in my experience it’s often positive.”

—Dr. McDonald-Mosley, Planned Parenthood, Maryland

28. The threats and harassment can be
scary, but it doesn’t stop them from doing their jobs.

“People have made postcards with my face and address on them
in an attempt to discredit me as a physician or put me in
danger. It can get scary, but I really worry more for my
partner and my kids. I can’t live in fear every day as a
provider.”

—Dr. Perriera, Pennsylvania

“There were fliers in the neighborhood saying I was a
murderer, so I had to explain to my kids pretty young that if
a pregnant woman isn’t ready to have a baby, I help her get
‘un-pregnant.’ But otherwise, it doesn’t bother me.”

—Dr. Imershein, Washington, DC

29. The protesters outside the clinics
don’t make women change their minds, they just make them feel
more guilt and self-blame.

“The protesting doesn’t change anyone’s mind, it just makes
patients feel terrible and internalize the stigma. I don’t
think the protesters realize that they are forcing these
women to suffer a trauma, and sometimes they’ll come into the
clinic so upset and they’ll think they deserved it. Nobody
deserves that. It’s so terrible and unkind. I often try to
listen and understand the anti-choice rhetoric because I’d
love to engage in a productive dialogue, but I don’t feel
like I’m being met halfway. And when they harass or
disrespect my patients, that’s just not okay.”

—Dr. Perriera, Pennsylvania

Dola Sun for BuzzFeed News

30. Abortions are not federally funded.
Most women pay out of pocket or use their insurance.

“Either the patient pays for an abortion or their insurance
pays for all or part of it. The
Hyde Amendment makes it illegal to use federal funds for
abortion services except to save a woman’s life. We can offer
low-income women grants from
national funds, for example through the
National Abortion Federation — otherwise, it’s really up
to the state and insurance companies.
Some states will fund ‘medically necessary abortions’
under Medicaid, but there are usually restrictions. In most
cases, the patient pays out of pocket,”

—Anonymous OB-GYN, Michigan

31. Some abortion providers also care
for undocumented immigrants and people who cross the border
to get health care.

“We get to practice global health domestically in border
cities, such as San Diego and El Centro, where our clinics
are truly steps away from Mexico. At Planned Parenthood, we
don’t ask our patients if they are citizens or not — we
just provide care to anyone comes through our door. But if we
do take care of undocumented immigrants, they pay for
services out of pocket, often in cash. And we’ll sometimes
have patients come across the border from Mexico just for the
day to get an abortion, and go back at night. Regardless of
immigration status, we believe women should have access to
quality health care.”

—Dr. Sierra Washington, medical director and chief medical
officer, Planned Parenthood Pacific Southwest, OB-GYN in San
Diego, California

32. State restrictions often act as a
barrier to getting safe and timely care.

“Most restrictions are rooted in making abortion
inaccessible, not science or medical literature. And it’s
very frustrating because they influence what I do — Tennessee
state law requires state-mandated counseling and a 48-hour
waiting period, so two in-person visits — but I know these
extra steps aren’t medically necessary. All they do is make
the process seem more scary and confusing, or make it harder
for women to get the care they need, when they need it.”

—Dr. Wallett, Planned Parenthood, Tennessee

“The state you practice in can definitely dictate the kind of
care you provide to women. I’m very lucky to practice in
Maryland where there aren’t many restrictions or
non-evidence-based barriers to care — there’s no wait period,
we can waive parental consent, and it’s a safe and calm
environment. I don’t ever really have to turn women away who
desperately want an abortion.”

—Dr. McDonald-Mosley, Planned Parenthood, Maryland

33. Doctors can’t diagnose many fetal
anomalies until later in the pregnancy, which is why many
doctors oppose 20-week bans.

“When biology and nature do not work as planned, it is
imperative that patients have options available to them,
including pregnancy termination. The ways in which a normal
pregnancy can go awry are so numerous and varied that even my
colleagues and I can’t predict them all, and we are experts!
If we can’t predict every complication that can arise,
politicians and lawmakers certainly cannot do so.”

—Anonymous maternal-fetal medicine physician, Utah

34. It can be stressful to feel like
their job is in constant threat or that the way they care for
their patients might change because of new
legislation.

“It’s funny because they always say ‘keep politics out of the
exam room,’ but politics are constantly threatening how I do
my job and practice medicine. It’s so stressful to think that
on a monthly or yearly basis, the way I provide care is
threatened.”

—Dr. Vanjani, San Francisco

“It always feels like I’m fighting to defend a procedure that
is shown over and over again in the medical literature to be
safe and effective and positive for women and families. I’m
in a constant battle to help women and it can get exhausting
sometimes, but the good days outweigh the bad ones.”

—Dr. Wallett, Planned Parenthood, Tennessee

Dola Sun for BuzzFeed News

35. They think the concept that people
will use abortions as birth control is pretty
ridiculous.

“Anti-choice individuals will say that people will get
abortions over and over again and it’ll just let them be
irresponsible. Never once in my career of being an abortion
provider have I ever felt that to be true. I think it’s
ridiculous and it’s just a way to stigmatize abortion. Even
if abortion is made more accessible, it’s still a difficult
thing to go through and no one would want to do it all the
time.”

—Dr. Vanjani, San Francisco

36. Many patients choose to go on some
form of birth control after their abortion; some even get an
IUD during their procedure.

“After a patient gets an abortion, it’s a great time to talk
about contraception because we already know she doesn’t want
to be pregnant at that time. I’d say over 95% of the
women I provide abortions to end up choosing some form of
contraception afterward.”

—Dr. Vanjani, San Francisco

“Many of my patients decide they want to prevent pregnancy
for several years so they choose to get either a hormonal or
copper IUD, and we’ll implant this right after we perform the
abortion, while the cervix is still dilated and we have the
speculum inside you. We just do it all in one procedure.”

—Dr. Oyer, Washington

37. It’s not as simple as being either
pro–abortion rights or anti–abortion rights; there’s a huge
gray area in the middle.

“Abortion has become so polarized in US, and people think
that there’s only pro-abortion and anti-abortion sides, so
the gray area of abortion gets completely lost. It’s honestly
a very complex thing, and the reality is that nobody
wants to have an abortion — nobody wakes up and
thinks, Hey I think I’d really like to get an abortion
today
.

“So it’s very frustrating when people oversimplify it and
think women and doctors are either good or horrible people,
and it’s either right or wrong. The reasons why someone
chooses to get an abortion are so complex. As a provider, I’m
just here to respect women and help them regardless of the
circumstances or how I feel.”

—Dr. Washington, Planned Parenthood, San Diego

38. In their eyes, the best way to
decrease the abortion rate is to increase access to
effective, reliable contraception.

“If more women are able to access highly effective forms of
birth control, there will be fewer unplanned pregnancies and
fewer abortions — it’s pretty simple. Unfortunately, many
states have restrictions not just on abortion but all
reproductive health care, which isn’t good for health
outcomes.”

—Anonymous OB-GYN, Oregon

39. Being an abortion provider can be
incredibly rewarding, especially in the long-term.

“Abortion providers have some of the lowest rates of
physician burnout. Medicine can be very frustrating because
we try really hard to fix things that are often out of our
own control, and some problems like type I diabetes or heart
disease we can never fully ‘fix,’ but in this specific aspect
of women’s health care, we can do this simple, safe procedure
that has the potential to change a woman’s life — and that’s
pretty beautiful.”

—Anonymous OB-GYN, New Mexico

40. They are all physicians. But, now,
many of them are activists, too.

“Many of us went into the job to take care of women and came
out being activists even though some of us are total nerdy
introverts and would be happy being quiet. But we see all the
setbacks and you feel compelled to stand up and make a
difference and defend access to care; and these days I only
feel more and more encouraged to speak up.”

—Dr. McDonald-Mosley, Planned Parenthood, Maryland

41. Abortion won’t stop happening if it
becomes illegal.

“No matter how bad the stigma, the protesters, or the
barriers, women still come in. There are even women who come
in after hearing all these misconceptions who think the
procedure is scary or they’ll never get pregnant again — and
despite all that, they still show up. It just shows how
important this procedure is to women and their lives, that
they’re willing to take all of that on. The women who really
want abortions will get abortions.”

—Anonymous OB-GYN, New Mexico

“The more restrictions on abortions, the more likely it is
for women to resort to illegal and unsafe practices to
terminate a pregnancy — abortion has always existed,
even when it was illegal, and it will always exist in the
future.”

—Dr. Perriera, Pennsylvania

Lixia Guo / BuzzFeed News



Source link