In honor of 40 years of legal abortion in the US: we are abortion clinic workers, ask us anything.

Its interesting to see this comment, as at mass recently (I'm Catholic), a letter was read by our bishop calling for a day of voluntary fasting/abstaining from meat/other sacrifice to mark the the same, and the 50 million elective terminations since then (from his letter, I'm sure this info is on the internet)

I'm staunchly prolife, and in fact went to a "protest" once because my aunt and members of her church were going. Honestly, it was kind of a strange experience because I am a private person, but basically the group stuck to themselves and prayed. There was no hatred of the people providing abortions or of the people getting them (and I assure you, no intention to shame, embarrass, or harrass anyone). Only sympathy for all involved, and sadness. And if anything, a desire to be a visible reminder that abortion is a serious matter.

I work in healthcare - I'm in residency - and ethical issues are not uncommon for me. In the minority/disenfranchised population I serve, seeing parities of 3-4 by 18 or 20 is not a surprise, and as a med student the youngest delivery I can remember was 12 or 13. These women dont have support, don't speak English, and frankly don't have lives I can relate to in any way. So when I see similar patients with multiple terminated pregnancies, I the only feeling I have is the same empathy I have for any other patient (keeping in mind I have rough days where I'm sick of my patients) and thankfulness for my own circumstances. At the same time, I wish that we as a society had more to provide than abortion.

I'm writing this because I'm not a religious zealot, a redneck, or anything else. I'm a well informed individual who happens to be a doctor, be Catholic, has "lived vicariously" through my patients and sees a lot of suffering from a lot of different situations.
I feel my beliefs are firmly grounded, and my core belief is that there is an inherent dignity we possess by virtue of being human. I feel like I'm more pro-human than pro-life, because I'm opposed to war (the recent ones we've had), the death penalty, deportation of undocumented aliens, mistreatment of the poor/disabled/etc, and also opposed to abortion. I'm opposed to abortion as firmly as some people support it. Any person capable of rational thought, who hasn't taken a moment to ask "Am I on the right side" regarding abortion should take a moment to really challenge themselves to consider the stakes (terminating life, vs the harm done to patients who keep an unwanted child who is an addition to whatever resources are available, and other considerations). Whenever I interact with a pro-choice person I respect, I find myself challenging my beliefs again, because I want to do right by our society. I think this is a responsibility for any person with any opinion on any controversial subject.

Any person capable of rational thought, who hasn't taken a moment to ask "Am I on the right side" regarding abortion should take a moment to really challenge themselves to consider the stakes (terminating life, vs the harm done to patients who keep an unwanted child who is an addition to whatever resources are available, and other considerations).

I do this all the time, and I think a lot of other people who do the sort of work I do do so as well. I'm also religious, and deeply believe in inherent worth and dignity in every person, but I don't personally believe that personhood begins at conception and believe that the woman's rights are greater than the rights of any potential people found in her uterus. It's not always so simple feeling though, I think we all struggle sometimes and I think that a lot of the strength of my convictions comes from considering my position again and again.

Also, I'm glad to have reasonable people on your side too, and I'll take a pro-lifer who is also anti-war over one who isn't all day every day.

-K

Have you ever had someone taking the position of "The only moral abortion is my abortion"? For example, someone that has had an abortion at your clinic but then shows up at a later date at the picket lines?

Yep, we get those pretty commonly. Not so much with the then showing up to protest, but it's really common to have a woman spend a lot of her time with me telling me about how different her abortion is from everyone else who is there that day's abortion.

-K

No question, just thank you for what you do.

You're welcome! It's a rough job sometimes, but I love it a lot and am thankful every single second I get to spend doing it.

-K

I'm a male, and am thinking of submitting an application to be a clinic escort. Am I needed, and would being a guy be a hindrance/problem?

Edit: Thanks to the mysterious stranger who gifted me reddit gold. I don't deserve it, I only have good intentions that haven't been met with action yet. Thanks to this thread for having so much helpful information and getting people like me energized to stop the talk and walk the walk.

I can't tell you how to sign up- I personally went to the site of Planned Parenthood organization that operates the clinics in my area (ranging about 20 miles across). Their volunteer section has an application for clinic help, and clinic escort is an option to check off.

absolutely! in fact, male clinic escorts are a HUGE help. having both male and female escorts is a visibility issue -- it tells protesters that it's not just "those crazy dyke feminists" who care about this. and honestly, whenever i have a guy come out to volunteer, it automatically cuts down on the aggression targeted at me and other women. sad but true. :/ -c

Is there any situation in which you would counsel a woman to not get an abortion?

Sure. If she doesn't want to have an abortion, if someone is pressuring her and she really wants to continue the pregnancy, anything like that. My job really is just to be someone to listen to her and support her decisions.

-K

Why do most people you encounter decide to get abortions?

A lot of reasons, really, I don't think there's a typical story. Many of them are already mothers, struggling to care for their existing children. Others are very young and not at all ready to begin a family. Some have been raped, some are in abusive relationships. Really, it's all sorts of things.

-K

What's the most common misconception about abortions?

That clinics are dirty and that we hate babies. Neither is true.

-K

Does your facility have a children's area in the lobby/waiting area?

my facility does not allow minors in the building unless the minor is a patient. since we see women who are having abortions due to fetal anomaly or whose fetuses have already died in utero it would be pretty insensitive. -C

Same. - K

Have you ever been attacked by anti-abortion supporters?

No. They pretty much just yell.

-K

What do they yell? I've always wondered but been too scared to get close enough to find out.

Edit: Thanks for the replies, and in all honesty, the protesters are doing more damage than the people they yell at.

A variety of things, depends on the person and the day. We've got a couple who really like to yell "Mommy, I love you. Daddy, protect me" which is...awful. C may have better answers on this, I only have to deal with it for a couple of minutes at a time.

-K

Have you ever responded to it or is it your job to ignore it? And I'd like to know what C has to say too.

you would not believe some of the shit i hear on a regular basis. they call me demon, witch, dyke, slut, whore, murderer, nazi, auschwitz guard, babykiller, babyeater, on and on. two weeks ago a woman told me that i was worse than the guy who shot all those kids at sandy hook.

some things they yell at patients/partners: "name your baby before you throw it away." "be a real man and don't let her kill your baby." "she's a pretty girl, if you have the baby it could be a model and you can make a lot of money off of it." "if you kill your baby god will give you cancer." "don't go in there, they'll sacrifice your baby to satan." and of course, the old standbys of "you're going to hell," "you're a whore," "you're a murderer," etc.

general yelling: "they sell the babies to pepsi and they make pepsi with baby kidneys." "did you know they have a cookbook and they eat the babies after they kill them." a priest once told me that he could see the "devil's tentacles in [my] soul" and it was everything i could do not to tell him that i was unaware i was in a japanese animated porno.

i treat them like they're ghosts. and i'm not scared of ghosts. -C

i treat them like they're ghosts. and i ain't afraid of no ghosts. -C

FTFY

A+++ :D -C

Why can't abortions be done in hospitals so the nutters have no clue who is getting what procedure?

That'd be super, wouldn't it? But the vast majority of hospitals won't allow abortions to be performed their regularly exactly because of those people.

-K

Okay well this is a personal AMA for me because I have a very important question for you, what is there that can be done for women who cannot afford the cost of abortion and has no insurance or anything?

I am 18 and my girlfriend is pregnant (19) and we basically have no money and I can't get a job because I dropped out and I am getting my GED, she is trying to get jobs but simply nobody is hiring. We are getting desperate and have nobody to turn to.

Would explaining this to somebody at a clinic even make a difference?

there is a lot that can be done. some clinics (planned parenthood, especially) operate on a sliding scale, so they'll adjust their rates for you based on your income. another little-known resource is abortion funds. www.fundabortionnow.org is a comprehensive list (with contact information) of all the abortion funds in the US, with a few that operate internationally. and really it doesn't hurt to explain things to somebody at a clinic. contrary to what the anti-choicers say, nobody goes into abortion care to make money. we go into it because we want to help people. good luck. PM if you want to talk more. -C

Hope you guys are still answering questions, but how exactly does an abortion work? Is it different if the women are in different stages of pregnancy? Thanks for answering in advance!

It is different depending on what point in the pregnancy it happens at. At my clinic we do procedures until around 22 weeks, so I'll try to give a breakdown of the basics.

Medication abortion: different states have different laws, but the basics are a woman early in pregnancy (under 9 weeks some places, under 7 weeks others) can take a combination of medications that cause her body to pass the pregnancy.

Surgical abortion: It's really a very simple procedure. It starts out like a pap smear, speculum and all that, then the cervix is gently stretched open, and then the pregnancy* is removed. In my experience, under about 15-16 weeks the pregnancy can fairly easily be removed with only suction, past that forceps are generally necessary. Dilation is done with metal dilators, which come in varying sizes, though women who are past 17 weeks in the pregnancy typically need to have dilators called lamineria inserted some time before the procedure so their cervices can dilate gently. That's the basics.

*Note, I say pregnancy because I mean the whole deal, gestational sack and all, not just fetus.

-K

Does it hurt? How much does an early abortion cost?

Strong cramps, back to back. Some women describe it as similar to braxton-hicks contractions. And I think the nation wide average cost of a first trimester procedure is around $470, likely a bit higher if you're sedated.

-K

Have you ever had any emotional reactions to your work or a particular patient?

All the time. The women I see are getting through so much that it can be overwhelming. Counseling women who are pregnant as the result of rape or incest is always very emotionally difficult, as is counseling women in domestic violence situations, very young women, and women with fetal anomalies. It's heavy emotional labor.

-K

[deleted]

Other than being on the receiving end, no. We had a large period of intensive training before we were permitted to begin working with patients though.

-K

constantly. the women who are rape or abuse victims are hard, the really young ones are harder. i had a twelve year-old patient once, i went home and bawled. i've seen mentally retarded women who were raped. the women who were so excited to have a baby only to find out that their fetus is anencephalic, or that their fetus has died in utero, are pretty tough, too. -C

Obviously, we won't answer questions that identify us, our clinics, or our patients, but we'll get as close to anything as we can without that.

You can message the mods to verify confidentially.

i submitted verification 3:02am GMT-6. -c

How difficult is it to leave what you do at work actually at work? I mean, do people accost you on your personal time for where you work? My state only has one abortion clinic and it is constantly being protested, so I always wonder how the workers function when they're off the clock.

Thank you so much for what you do, you deserve more thanks than we could ever give.

It can be really difficult, no matter what I do I'm pretty much always the abortion lady, but I'm okay with that. What is really hard is that some seemingly ordinary conversations you probably have in your day to day life become really awkward and difficult for me. You ever have someone you don't know well at all ask you where you work or what you do for a living as part of casual conversation? Yeah, deciding how to respond to that is real difficult.

-K

How do you usually respond?

I used to lie, now I mostly tell the truth (unless I'm somewhere where it seems particularly unsafe to do so).

-K

Ok I am Pro-Choice and go to a Catholic School. They like to throw alot of stats at us and such. I'm fairly confident most of the stuff they feed us is bs, but i would like to hear your answers.

1) How do the Doctors that perform abortions feel about their work in your opinion? 2) They showed us a video called Eclipse of Reason in which they show a 3rd trimester abortion where basically the doc gets in there with some pliers and pulls the fetus out in chunks, how have late abortions changed? And have you ever seen this film. 3) Also have you or the clinic ever been threatened? 4) Last what kind of area is the clinic located in, in the sense of racial demographic and relative income?

1) How do the Doctors that perform abortions feel about their work in your opinion?

Our doctors are very dedicated to their work, and really do it out of a deep sense of compassion for women in difficult situations. They tend to be very cautious about who they tell about their work, but largely because they and their families are regularly threatened by those opposed to what we do.

2) They showed us a video called Eclipse of Reason in which they show a 3rd trimester abortion where basically the doc gets in there with some pliers and pulls the fetus out in chunks, how have late abortions changed? And have you ever seen this film.

I've never seen that, but a couple things here. 1) Abortions are not performed in the third trimester basically ever, around 20-22 weeks is the typical cut off, with very limited options for up to 24 or 26 weeks. 2) While it is true that fetuses are not removed whole (in part because procedures where fetuses can be removed whole have been illegal in the US since 2003), they are not alive during this process. Abortions done with only suction also often result in non-intact fetuses because fetuses, well, lack structural integrity.

3) Also have you or the clinic ever been threatened?

I haven't been explicitly threatened, but I spend my walk in to work being called a murderer regularly. The clinic has in fact been threatened, but that's all been a bit less intense in recent years than it was in say, the 90s.

4) Last what kind of area is the clinic located in, in the sense of racial demographic and relative income?

It's pretty blended really.

-K

If you didn't see the answer to this already, he answered #2 in another question.

he

She. Most people who work in an abortion clinics are women.

-K

what is your opinion on the only abortion clinic in Mississippi being shut down?

It's fucked up, and will affect poor women much more than women with economic means. I'd be unsurprised if closing that clinic resulted in hospitals seeing a lot of women with the same sort of horrible complications we saw pre-Roe. Though, I was under the impression that they'd managed to stop that clinic from being closed?

-K

Whats your favorite type of ice cream?

Ben and Jerry's Imagine Whirled Peace.

-K

Is there a demographic that has a higher than average rate of abortions that totally surprised you when you started doing this?

I'm surprised by very little anymore, but I was at first very struck by the number of openly religious women who have abortions.

-K

Do you know what the general statistic is for what proportion of women have had abortions? (I recently heard in a presentation it was above 15-20%)

Do you ever get return visits? And if so, do you look to counsel that person on being safer with their sex life?

Thank you for your work, counseling efforts, and spreading information!

Do you know what the general statistic is for what proportion of women have had abortions? (I recently heard in a presentation it was above 15-20%)

1 in 3 women will have an abortion by the time she is 40.

Do you ever get return visits? And if so, do you look to counsel that person on being safer with their sex life?

Yes and we talk to all of our patients about birth control and practicing safer sex.

-K

Have you ever done an abortion that has made you question the ethics of the procedure?

I'm not a physician, so no. However the first few times witnessing procedures certainly involved some reflection on the ethics of the procedure. Even in reflection though my beliefs about the legality of abortion never wavered.

-K

Coincidentally I watched the documentary called "12th and Delaware" last night about an abortion clinic in Florida that dealt with pro-life protestors every day and they'd try to convince patients to go to their "family planning centre" across the street instead of getting the abortion. They were really shady and would tell the women that they'd help them financially and would throw out these bullshit statistics. it was insane.

Have you had to deal with protestors or backlash from your community in general because of what you do? Also, has you or anyone you've worked with had to deal with violence against them?

We've got one of those about 10 mins from our clinic, it uses a very similar name to our clinic hoping that people will get confused.

We have protesters most days we have clinic, but the community we're located in is actually pretty supportive as are all the communities I'm part of. Some of our doctors have received threats, or will have protesters outside of their homes, but there's thankfully been no violence in recent memory.

-K

Why do you think abortion is controversial in the US, while its pretty much accepted in the rest of the western world?

because Americans have been missing the memo about the separation of church and state for the past 100+ years. -C

Daaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaamn. C speaks the TRUTH.

I know, she is amazing.

-K

oh you! stahp! -C

I have a few.

• Are you required or requested to do sonograms and show the woman contemplating abortion? Does it make a difference in their subsequent decision?

• By the time a woman comes to you, has she pretty much decided on an abortion?

• Do you have any female friends who pro-life? How do you get along?

• What sort of limits on abortions would you not be opposed to?

• Is "partial birth" abortion a real thing, I mean, as the anti-abortion activists talk about it?

• Are either of you mothers or have you had an abortion?

• What percentage of women, in your experience, have post-abortion counseling? What does it deal with most often? How long does it typically take?

Just so you know, I'm pro-choice, but as a small "L" libertarian I'm against using tax money to fund abortions as so many taxpayers are vehemently against it on moral grounds; freedom of conscience is freedom of conscience. I've donated to Planned Parenthood in the past. I'm also against underage girls getting abortions without parent/guardian notification - it's a medical procedure, after all, and not without occasional complications.

Are you required or requested to do sonograms and show the woman contemplating abortion? Does it make a difference in their subsequent decision?

It's medically necessary to do one beforehand, but we're not required to show them the ultrasound if they don't want to see it. Women who do see the ultrasound typically do have the abortion all the same though.

By the time a woman comes to you, has she pretty much decided on an abortion?

Most of them have, but some are very ambivalent and really need some time to think. We have a whole bunch of resources and workbooks for women who are ambivalent, and will spend however much time she needs talking through her feelings. Some women also come in just to discuss their options, as we also work with organizations that facilitate adoptions and support women who choose to parent it winds up being a convenient place to go talk if you aren't sure.

Do you have any female friends who pro-life? How do you get along?

There are people I know and relatives who are, but any friends I had who were pro-life have since cut me out of their lives. Which I feel is unfortunate because I was very willing to overlook our difference of opinion to sustain those relationships.

What sort of limits on abortions would you not be opposed to?

I don't have a really clear answer to this, though there certainly is a point where I would become strongly uncomfortable with an abortion being performed. I'm not at all opposed to that actual doctors are required to be the ones providing them.

Is "partial birth" abortion a real thing, I mean, as the anti-abortion activists talk about it?

No. The procedure that the "partial birth abortion ban" made illegal is properly termed intact dilation and extraction. The procedure is certainly not pretty, but it is in many situations actually safer than dilation and evacuation procedures as the fewer times you have to enter the uterus with an instrument, the better. IDX was often used in situations where a fetal anomaly was present, allowing parents who were suffering the loss of a wanted pregnancy to have a whole fetus to bury if they chose to, as the law stands fetuses are not allowed to be removed intact and so families lose that option.

Are either of you mothers or have you had an abortion?

I am not, and by some stroke of luck have not.

What percentage of women, in your experience, have post-abortion counseling? What does it deal with most often? How long does it typically take?

Very few women return to the clinic for post-abortion counseling. When they do, it's typically to do with something a protester or anti-choice family member said to her about the abortion and takes roughly an hour to work through. I don't know at what rates women use other counseling sources (hotlines, regular therapists) or what they talk about there.

-K

do you get mostly referrals to the clinic or how do people find your clinic usually?

My clinic has been around for a very long time, so a lot of people in the area just sort of know it's there. A lot of people also find us through google and because their friends and family tell them about us.

-K

If someone wants to do what K does -- options counseling, abortion counseling, patient support, etc -- what paths should they take? Eg, university courses, training...

How did you get into this?

Depends on what capacity you want to do that work in, but a background in women's health is always helpful. Courses in public health, and the parts of women's studies more related to reproduction can be very helpful as well. Pro-choice activist work also can open doors to clinic work, some ladies I work with started by doing volunteer escorting at our clinic and then got hired when there was an opening.

How I got in to it in specific is sort of complicated, my background is in politics and I had done some activist work locally before applying to my current position. I was very involved in feminist/pro-choice politics in my city beforehand, and had begun searching for work that would get me closer to the lived experiences of women rather than just the politics.

-K

Do you ever feel bad after a procedure? Has anyone ever made you feel guilty for what you do?

Sad, yes. Bad? No. And people have certainly tried, but it doesn't work. My two minutes hate every Saturday morning has given me a pretty thick skin.

-K

What advice would you give me to console a woman who has recently had an abortion?

tell her it's okay to feel whatever she feels. so many women are told they should feel this way or that way after an abortion, and that's bullshit. tell her you're there for her and you care about her, that you're there to listen or help if she needs anything. then follow through on it if/when she turns to you. that's all i can offer, but in my experience it's been more than enough. -C

Retired ObGyn here. My residency at a public hospital in a large city overlapped pre- and post-Roe. We saw a couple of women each week with horrible complications from back-alley abortions - infection, perforated uterus, bowel injuries, etc. They disappeared almost overnight post-Roe. We can expect them to reappear and proliferate in Mississippi.

Abortion may be emotionally and ethically complicated, but we live in a complicated, real world, where many choices are not black and white. Not that logic has an impact on fanatics, but the best way of preventing abortions is readily available contraception.

Thanks for the AMA and for the work you do. Be strong.

Thanks for your voice. It's so important that we don't forget the reality of illegal abortion: women dying horrible deaths from terrible complications.

-K

How common is the so-called 'partial birth abortion' in reality?

IDX procedures comprised roughly 0.17% of abortions in the US before the passage of the "partial birth abortion ban" in 2003.

-K

Have you ever had people act negatively when you tell them what your job is?

I saw in one answer you said you had some friends cut you out of their lives. How often have you had to deal with things like this?

Also, how often do you have to deal with protestors?

I think it's awesome you're doing an AMA!

Have you ever had people act negatively when you tell them what your job is?

Mostly I get weird looks and maybe disapproving looks, but there have clearly been some people who had worse responses.

I saw in one answer you said you had some friends cut you out of their lives. How often have you had to deal with things like this?

Not often, it's mostly just a couple of people I was close with in high school and college who have since decided that I'm not allowed to be part of their lives. It pretty much all happened at once when I first started talking about it and has been over ever since.

Also, how often do you have to deal with protestors?

At very least every Saturday, usually at least a couple other times during the week if not every day.

I think it's awesome you're doing an AMA!

Thanks!

-K

Firstly, I want to thank you very much for doing this AMA. I volunteered in a feminist clinic (that provided abortions) for several months and it was a great experience.

On to my long question: I am staunchly pro-choice, but the fact that even Planned Parenthood refers to abortion solely as a "women's health issue" rubs me the wrong way. I am a cis female (so I accept any criticism/backlash with my question or how I present it from non-cis folk), but I have several friends who do not identify as female who can get pregnant. Have you ever had someone come in who does not identify as female who is seeking an abortion, and how does your clinic treat non-cis individuals in general? (I'm not saying "do you treat them well or do you treat them poorly" but rather what's your approach to non-cis individuals who come in for "women's health"-related reasons?)

^{[edited for further political correctness]}

to my knowledge this has never been an issue that has come up at my facility, but as it becomes more common we have been discussing what our protocol would be in the event that a non-female pregnant person were to want an abortion. we have also been talking about in the future expanding our services to be a better resource for trans* people, but we don't have the space or the funds right now, which is really unfortunate.

tl;dr it hasn't happened yet, but we're trying to make sure we have a good plan before it does. -C

Thank you for what you do and you and your colleagues bravery in the face of the insanity that you guys deal with.

Is there a situation where you've been temped to throw in the towel and what got you out of it?

You know, everyone has days where they go "why the hell do I do this job" but...I don't think I've ever been really tempted to leave.

-K

What think your family about your work?

It makes my parents a little nervous, because of the protesters and all. But, despite being generally very conservative, my parents are generally supportive. My extended family ranges from totally supportive to disapproves but ignores it and doesn't know because I'm not willing to tell them.

-K

What is an abortion on a 22 week baby like? How often are late term abortions performed?

Later abortions are significantly rarer than earlier abortions, with the vast majority occurring before 12 weeks. 22 week procedures are uncommon, but, basically the woman has dilators inserted the day before the procedure is completed, when she returns she is sedated, the dilators are removed, the cervix is dilated any further that is needed, the umbilical cord is compressed (causing instant fetal death), and the pregnancy is removed through a combination of suction and forceps.

-K

Has the fetus at 22 weeks ever not passed away and was actually born alive?

No, we're very careful to make sure that fetal death occurs before any attempts are made at removal.

-K

Aside from religious issues, why else do people oppose abortions. I do not understand why you would want to tell others what they can or cannot do because you believe in some religion.

As a lifelong supporter of abortion rights, I can't say that I'm the right person to answer this question.

-K

Have you had anyone quit because of an ethical problem with abortion?

No.

-K

My girlfriend and I went to an abortion clinic to get an ultrasound done to make sure she wasn't pregnant. Turns out she wasn't. It was just the Plan B pill causing havoc on her body.

But as a person who worked in the medical field, I was VERY surprised at how professional, clean and kind everyone was at the clinic. Im actually kind of ashamed that I assumed it would be disgusting and full of dirty looks.

I just wanted to thank you for everything you do. Very awesome of you.

so many people assume that the facility will be dirty or the staff will be judgmental or that the doctor is a med-school flunkie who barely got a license to practice when nothing could be further from the truth. the anti-choice movement's smear campaign has been pretty successful, unfortunately. it breaks my heart every time a patient asks me "is the doctor good?"

I'd argue that abortion facilities are even more fastidious than other medical facilities simply because so many people want to shut us down.