“You will see me on the news.” Stella* said this with complete seriousness, the gravity of her statement not hitting me at once.
“What do you mean?” I asked cautiously.
“I’ll throw myself down the stairs. I’ll do what it takes. I need to get rid of this baby.”
Stella presented at my clinic at 28 weeks in her pregnancy. She had no insurance, had become pregnant as a result of rape, and because she had still been getting her periods until about one month prior, had no idea that she was past the legal abortion limit in Pennsylvania. She said this to me from behind sunglasses, her hands tensely gipping the chair’s armrests. I can only imagine the thoughts going through her head. I talked to her about the possibility of going to Kansas (Dr. Tiller’s clinic was still an option at that time) or Nebraska, but she didn’t have the money for a first trimester abortion in her home state, much less the finances to travel across the country. As I was explaining what her options were, including adoption and trying to fundraise to travel to another state, she got up and left. She didn’t slam the door. She collected her things and without looking at me, closed the door and walked out of the clinic.
I didn’t see her on the news. Despite the calls I made to her apartment, her place of work, her partner, I have no idea what happened to this woman. What I do know is that her desperation and anxiety were palpable, and I felt powerless to help her, to empower her to make the right decision for herself regarding her pregnancy.
In the wake of the tragedy of Dr. Gosnell’s clinic, where both women and viable babies were murdered, we have to have an open conversation about abortion restrictions. It is possible that my patient above ended up at Dr. Gosnell’s clinic; I have no way of knowing. What I do know is that women who do seek later abortions, no matter how uncomfortable they make us, deserve nothing less than access to compassionate, respectful, quality medical care. If we don’t want these women to be hurt or worse, killed by amateur doctors willing to break the law, we need to give them legal options to terminate their pregnancies.
Sometimes in the pro-choice movement, myself included, we get distracted by philosophical disagreements or hypothetical situations. We lose the stories of individual women seeking our services and focus on the what-ifs instead of the realities. What happened in my clinic that day was certainly not a common occurrence, but years later, I still think of this woman. What happened to her? What is my responsibility to her? What is the movement’s responsibility to her? The only answer that makes sense to me, that corresponds to my value of reproductive justice, is to demand better access to safe abortion, as late in the pregnancy as necessary.
What does this look like in practice? This means that even if we don’t personally agree with a woman’s reasons for abortion, if that’s what she needs, we help her access those services. Even if we wouldn’t have an abortion in her situation, we provide her with safe, affordable, medically sound treatment anyway. The job of the pro-choice movement, of abortion providers, is not to condemn or judge women for their reproductive health decisions. Our job is to support them, as best we can, and make sure that they can access the services they need. I only wish I could’ve done this for Stella.
* Name changed.
Abortion Gang 
I had a patient EXACTLY like Stella this week–she wanted her b/f to beat it out of her. Given his temperament he just might. But, as tragic and heartbreaking as these cases are, I respectfully disagree. I think that there are legal limits to terminating a pregnancy and sometimes you have to live with limits. My patient initially was desperate and angry but the more we talked the more resigned she got, and the more possible was her future. For instance, she had a primitive idea of what adoption was like which we updated. She got signed up for medicaid. We made an appointment with an ob/gyn. I urged her to talk to her parents and gave her the MomDadIMpregnant handouts.
I certainly wish a different fate for her, but she had a hand in her fate (in this case she took a pregnancy test in August which was negative and then not another one until December). I wish we could spare 19 year olds from their own mistakes but we cannot. Sometimes you have to play the hand that’s dealt you, and not change the rules of the game. This may sound harsh but snipping the spinal cords of neonates seems harsher. Y/our compassion may have no limits, but life does.
Thanks for this, Steph. I agree – we need to talk more about women’s stories, and less about the abstract. People like Dr. Gosnell exist because women who are desperate will do whatever it takes to seek a remedy. Our job as advocates for women’s health is to support women, as you have said, regardless of what their decision may be.
Thanks for your thoughtful replies, Serena and Peg.
I agree with you, Peg – but I also think that there is a humane, ethical way to perform later abortions. Dr. Tiller did them, Dr. Carhart does them. In my opinion, that is the framework in which we need to be operating. Snipping spinal cords is not an option. Compassionate later abortions are.