This Common Secret: My Journey as an Abortion Doctor (3 page)

He called for nurses to come hold me down.

The claustrophobia grew and grew, the pain kept coming, and I writhed and fought as nurses grabbed my arms and shoulders. I heard myself scream. Tears ran past my ears and into my hair. Then they injected something into my arm, and I faded away from the nightmare.

When I woke, my face was stuck to a Naugahyde couch. I was in a very small room, alone. I struggled up groggily and went to the door. Locked. Panic rose up again, but all I could do was sit and cry until someone let me out.

“If you have problems, go to an emergency room,” was the sum total of advice I was given as I went out the door.

Something terrible had been done to me. I felt abused and violated and beaten. I did not feel that I had made a bad choice, that I had done a bad thing. But I knew something bad had been done to me. All I wanted, then, was to escape.

I remember sitting on the dark staircase in our house that weekend and calling my mother, telling her what had happened. “I wish I could be with you,” she kept saying. I could hear her voice tremble over the phone, almost two thousand miles away. I wished I had talked to her earlier. I wished I had allowed her to support and comfort me.

After David and I were married and had moved to California, I became pregnant again. He was still playing sax, and I was waitressing, but this time was different. As much as I hadn’t felt attached to the earlier pregnancy, this time I felt an immediate connection. I knew I wanted this baby.

My problem, and it grew more and more worrisome as the pregnancy advanced, was that I was terrified of doctors and clinics and hospitals. My abortion experience had scarred me. I simply couldn’t relinquish control over my body to someone who might treat me as badly as I had been treated in Portland. The thought of being in a sterile hospital room with my feet in stirrups and no one I loved nearby was horrifying.

Friends talked about the possibility of having a home birth with a midwife. As soon as it sank in that this was a real alternative, I jumped on it. The connection I made with our midwife, Nan, was immediate and wonderful.

The pregnancy and the birth were both completely normal. In stark contrast to my abortion experience, during Sonja’s birth I was surrounded by people I loved and who loved me. I was in my own bed, in my own home, the tiny apartment we rented. And I knew exactly what was happening, both because of my own research and because my questions were honored and answered.

Desperate Measures
Used to End Unwanted Pregnancies:

N
ow, three years after Sonja’s home birth, I was considering the possibility of entering a medical career, a profession that held real terror for me, as well as fascination and challenge. It would mean I could attend home births as a physician and educate women about alternatives. It would mean that I could support Sonja.

Since the breakup of my marriage, providing for Sonja had become a major preoccupation and necessity. I knew that public assistance was a temporary boost, but I didn’t want that to become my permanent solution.

In the end, what tipped the scales was the realization that if I actually pulled this off, I could make sure my patients were treated differently than I had been—with respect and decency. The memory of my own abortion troubled me, but it also hardened my resolve. I refused to let one bad doctor dictate a decision over my life direction.

By the beginning of July going to college was sounding like a challenge I wanted to accept. I made a trip to the University of Wisconsin at River Falls and went to the financial aid office to see what the possibilities might be. I was greeted by encouraging, knowledgeable people who helped me through the landscape of forms and formalities needed to apply for college and for student loans.

I enrolled in August. I hadn’t declared any long-term intention, but I was at least going to get started. Sonja and I gave up our wall tent and moved two hours south, into a trailer house next to the river just blocks from campus. Our first morning I set her in a red Radio Flyer wagon piled high with books and extra clothes and snacks. I dropped her off at the day care on campus and began college full-time.

My declared major was sociology. I still didn’t know if I could handle the hard sciences. I hadn’t studied physics or chemistry in high school. How dare I have the audacity to think I could even
be
a doctor?

The first quarter was all it took to boost my confidence. I took chemistry and math, along with biology, psychology, and English, and came out with a 4.0 GPA. By the end of the first year I was on a roll and loving every bit of it. I went to summer school to do the equivalent of a year’s worth of physics and continued with excellent grades and increasing optimism.

Sonja went with me everywhere. In warm weather I pulled her around campus in the red wagon. During the winter months she burrowed into a nest of blankets in a box mounted on a sled. She came with me to biology lab and counted fruit flies through the dissecting scope. She loved the poster of the human skeleton and learned the names of all the bones with me. When she fell off the porch and broke her arm, she walked beside me into the emergency room holding her arm.

“I think it’s the radius,” she told the doctor, and she was right.

The second winter we lived in a drafty farmhouse outside of town. It had no running water, and our electricity was limited to one extension cord that ran in the door from a junction box outside, but it was rent-free. The owners wanted someone there to keep vandals out. Every evening Sonja would sit on the couch, cuddled up in a sleeping bag and cutting out paper snowflakes, while I built a fire in the wood stove. I would stoke that stove for hours, using the wood my father and sister had hauled down from home, 120 miles away. Even at that, it was all I could do to get the heat up to fifty degrees. By the end of winter, every inch of wall space was covered in paper snowflakes.

But I was happy being a student. Chemistry, biology, physics, all the course work I had feared—from photosynthesis to physics in everyday life, I kept having ah-hah! moments. I aced course after course.

I was happy, too, because I’d met a man named Randy. Actually, I’d known Randy slightly back in high school. He had been a senior when I was a freshman, and I remembered him for his successful crusade to abolish the student dress code. We met again when I was home visiting and working at the local food co-op. He was working as a heavy equipment operator.

We started spending weekends together whenever possible. I loved Randy’s genuine honesty, his dependability, and his solid commitment to people and the causes he believed in. He was the only person I trusted with my true medical aspirations.

Most important, Randy fell head over heels in love with Sonja. The feeling was mutual. Almost from the start, Sonja started calling Randy “Randad.”

It wasn’t until I’d finished two years of school, and was fueled with newfound confidence, that I felt able to articulate my ultimate goal to my family and friends: I was going to be a doctor.

My mother was encouraging and proud and promised to do all she could to help. There was no money to help with expenses, but she could pitch in with child care. My father was skeptical but knew enough not to say it out loud. Maybe he was worried about where he’d have to haul wood to next. I could feel the sideways looks of aunts, uncles, and cousins, very few of whom had gone past high school.

Higher education had never been a part of our extended family expectations. Mom would have loved to go to college and law school, but the times and circumstances did not allow it. Dad had only finished eighth grade, but he had enrolled in machinist school on the GI bill after serving in World War II. He had earned a GED many years later, along with some of his brothers. Dad and all five of his brothers served in the war.

After three years I earned my bachelor of science degree in biology and was accepted into medical school. Another move for Sonja, but this time we joined a married couple with two kids. The husband was in the same program I was, and the wife was in nursing school. We shared childcare responsibilities, along with meals and bedtime stories. And, as Sonja pointed out, you just had to turn up the thermostat to make it warmer.

Most weekends we drove down to be with Randy. I studied nonstop, but Randy and Sonja had their standard routine. They’d make a trip to the dump, buy groceries, do chores, then head off on the round of family visits to grandmas and aunts and uncles. Randy built Sonja a sandbox in the yard, where she played for hours.

It didn’t take long in medical school to see that even though women were allowed in, it was a system run by and for men. Most of the lecturers and attending physicians were men. All the deans and department heads were men.

There were times when it was all I could do to keep my mouth shut. Other times I was not able to contain myself and took actions that almost got me expelled. One incident that put me toe to toe with the medical school hierarchy still makes me shudder.

It was the first morning of a third-year medical student rotation in obstetrics and gynecology. We met in a lecture hall for a discussion of pelvic anatomy with the attending physician. He told us that the best way to learn pelvic anatomy was to do an exam on a relaxed pelvis and that a woman under general anesthesia was ideal. We were led to the operating room suite and were told we would all be performing pelvic exams on five or six women and then discussing our findings.

It dawned on me that these were women admitted for a variety of operations or procedures. A gallbladder surgery, perhaps, or breast lumpectomy or knee surgery. I suspected that the patients hadn’t been told they would be undergoing pelvic exams by eight or ten medical students while under general anesthesia.

My suspicion was confirmed. I was absolutely appalled and walked up to confront the attending physician.

“So we’re all doing pelvic exams on this patient?” I asked.

“Yes.”

“Without her permission?”

He stared at me.

“We’re all really supposed to do this?”

“Quit asking questions,” he said. “Scrub in and get with the program.”

I refused, turned around, and went directly to the department head.

“I can’t believe we are expected to do this,” I said. “It is a terrible violation.”

“These women have come to a teaching hospital,” he replied. “They understand that medical students are present and need to learn. They’ll never know it anyway.”

“Are you proud of this teaching institution?”

“Of course,” he replied.

“Then you’ll have no problem when I go to the local paper and discuss this teaching practice.”

I knew very well that this could mean the end of my medical education, but if this was what it meant to become a doctor, I had no desire to go any further. After a heated discussion, the department head agreed to put a halt to pelvic exams on anesthetized women, and I agreed not to go to the papers with the story.

In spite of the fact that almost half of the women in this country have an abortion at some time in their reproductive lives, abortion was not acknowledged, discussed, or described during my ob-gyn rotation. When I asked to be taught the procedure, I was met with total resistance. It was simply not a program option. This refusal only made me more determined.

Shouldn’t a physician be able to at least intelligently discuss all the options for women with unplanned pregnancies?

I was finally able to arrange, on my own, an elective reproductive health rotation at another institution. There I was able to learn about the various methods of abortion and observe procedures.

Memories of my own abortion kept creeping in, memories too painful to talk about, but I had been in enough medical situations by then to realize that my experience was not the norm. I was anxious to see how procedures were done in a legitimate, well-run clinic.

The first abortion I saw during that rotation was for a woman who was halfway through her pregnancy. The fetus had an abnormality incompatible with life. It had started out as a very planned and wanted pregnancy. When the abnormality was diagnosed through an ultrasound, the woman chose to end the pregnancy instead of going full-term, delivering the baby, and having it die immediately.

Most abortions done at this stage are for similar reasons, or to save the life of the mother, but knowing the circumstances did not soften the visual reality of a twenty-one-week fetus. Seeing an arm being pulled through the vaginal canal was shocking. One of the nurses in the room escorted me out when the color left my face.

Not only was it a visceral shock; this was something I had to think deeply about.

I had been about eight weeks pregnant when I had my abortion. I knew from my embryology classes in the first year of medical school that an eight-week embryo is about the size of my thumbnail. It cannot feel pain or think or have any sense of being. I have never regretted that abortion.

Confronting a twenty-one-week fetus is very different. It still cannot feel pain or think or have any sense of being, but the reality is, this cannot be called “tissue.” It was not something I could be comfortable with. From that moment, I chose to limit my abortion practice to the first trimester: fourteen weeks or less.

Over the next six weeks I met eight to ten women in the clinic almost every day, women who had come to end pregnancies for a variety of reasons. For some it was financially motivated. Others had educations to finish or careers they had just started. Some were in abusive relationships and did not want that connection to the man. There were women with chronic illnesses whose lives would be in jeopardy if the pregnancy continued. And there were women carrying fetuses with genetic abnormalities or anomalies incompatible with life. Many had been using a form of birth control that failed.