Rachael's Story

I knew about abortion since I was a young child, probably even before elementary school. My mother had two abortions, one after I was born and one after my younger sister was born. The first one she had because my father didn't want the child. The second she had because of a problem with her uterus that would have caused her to die if she had carried the child to term. My earliest understanding of abortion was that sometimes people can't take care of babies, so they have an operation and the baby goes away. This made sense to me as a child. I understood, somehow, that my mother felt as if she had no other choice. I never questioned it, and in fact, as I grew older, I felt very strongly that women should have the freedom to choose whether to bear a child.

The year I was sixteen, I took out a copy of Our Bodies, Ourselves from the town library. I immediately devoured all the information I could out of the book. I was particularly interested in the chapters on reproduction, pregnancy and abortion. At that time, I remember thinking that as a woman I could never be too informed on these subjects. You never really know if you will become pregnant unexpectedly, right? Every birth control method had a failure rate. How did I know I wouldn't be the 1% failure rate of the pill? I had to know my options.

In the first days of reading Our Bodies, Ourselves, I became entranced with the idea of home birth. At age sixteen, I decided that I would have a home birth. Its been almost ten years since I made that choice. I have never wavered from the resolution that I would not give birth in a hospital, and although I haven't given birth yet, I know I never will.

In the nine or so years since my first copy of Our Bodies, Ourselves, I developed a passion for midwifery and childbirth that was, in my experience, unparalleled. I read every book about childbirth I could get my hands on, from Spiritual Midwifery to (ugh) What to Expect When You're Expecting. I focused primarily on the midwifery side of the childbirth experience. I bought books that were out of print, I bought books I feared would go out of print. I took every book on childbirth out from my local library. I watched home birth videos.

Choosing home birth was a statement of my concern about the standard of care in hospitals and birthing centers. Despite the proximity to emergency care for possible complications during childbirth, there is significant evidence that routine procedures in hospitals actually cause the complications. Episiotomies (cutting the skin between vagina and anus to widen the pelvic area for the baby's head, most often done to guard against tearing) can lead to worse tears in the perineum; just like a swatch of fabric that has a tear in it, skin will rip easier where there is a weakness. Labor stimulating drugs can cause a woman to labor too quickly or cause contractions to come on too strong, not allowing the laboring woman to adjust to the sensations of labor gradually, which in turn can lead to a panicked woman and/or fetal distress. The comfort of a laboring woman cannot be underestimated. When a woman is going through an intense life changing event such as having a baby, having familiar surroundings can help give the woman the focus that she needs to give birth safely.

In January of 1998, in my women's spirituality group, I met a woman who was five months pregnant with her first child. After going to an OB-GYN throughout her early pregnancy, she had recently reached the decision to have her child at home. Knowing my passion for home birth, the women in my group made sure to introduce us and explain to Melissa that I wanted to study midwifery. Melissa and I didn't really bond that night, or even talk much for that matter.

Two weeks later, I ran into her and we immediately began a conversation about why we thought home birth was right for us. We talked of complications due to labor inducing drugs, such as Pitocin. We talked about episiotomies, and the importance of laboring in a place you feel comfortable. Toward the end of the conversation, she asked me to come to her birth. Needless to say, I was thrilled. And even more remarkable, Melissa and I hardly knew each other. From then on, I went with her to her prenatal exams with the midwife. Her midwife was a woman named Nancy. Nancy is in her early forties and very hippieish. She and I discovered early on that she and my mother had gone to high school together. Nancy had an apprentice, but she liked teaching me how to check the baby's position and heartbeat. Nancy, Melissa and I became friends.

Melissa's birth was one of the happiest days of my life. As I knew she would, she had a perfect labor. No complications. She was amazing and powerful throughout the experience. When Ryan was crowning, Nancy made room for me next to her so that I could see everything. Ryan was born March 23, 1998 at a little after 6:30pm. One of the important things I took with me from the experience was the respect Melissa's caregivers gave her during the experience.

I became pregnant on July 14, 2001. I had just moved from Connecticut to North Carolina to live with my boyfriend, David, in April. I knew my period was late around two weeks later. I couldn't remember when I had menstruated last, so I waited to get a pregnancy test. And waited. I began to get morning sickness, except it was really in the afternoon. David and I decided to make an impromptu weekend trek to Connecticut to visit my parents during the weekend of August 18th. The afternoon we left I was so nauseous I didn't think I'd be able to make the drive without throwing up every five minutes. "If this is pregnancy," I thought, "I'm not sure I could do nine months of this.

During a trip to the grocery store that weekend, I picked up a home pregnancy test. I did the test Saturday afternoon, with my best friend Shannon, her boyfriend and my mother home. David was out on a fishing trip. As I was waiting for the test line to show, my mother grabbed the test out of my hands. After a few seconds, the began to make a familiar moaning noise she makes when something isn't good. I grabbed the test back and saw that both lines were there. Meaning I was pregnant. Sadness hit me suddenly.

I followed my mother into the other room and talked with her. I remember feeling very sad, like tears might come at any moment. David and I had discussed abortion, and made a preliminary decision that we would get an abortion if I discovered I was pregnant. I went through all of the pros and cons of having a child. Our relationship was so new, we were still working on building a strong foundation. From all of my reading I knew that having a baby would change our relationship drastically. On one hand, our relationship was already very strong; the best relationship I have ever been in. I am 24, he is 29. We are certainly not so young to have a baby. Other people have babies before they get married. But I had lost my job soon after I became pregnant. David had graduated college in May and was working on becoming a Professional Engineer. His salary was enough for us to squeak by on, but not enough to support me and a child, as we still had a considerable amount of credit card debt and school loans to pay off. I discussed all of this with my Mom, who seemed very sad for me. I knew she would support me in whatever decision David and I made, however.

During the twelve hour ride back to Raleigh, David and I discussed our options more. At this point, I was beginning to become attached to the baby; I wondered if it was a boy or a girl, I felt that protection instinct about the child inside me. I had wanted children for a long time, before I was involved with David I had considered being a single parent. But he was resigned to getting an abortion. I understood his reasoning. It was very logical and responsible. We ultimately decided to get an abortion.

I waited a couple of weeks before making the appointment, mostly because I am new to the area and was unsure which clinic to choose. In the end, I called two different clinics. At the first clinic, the Raleigh Women's Health Organization, a woman answered the phone. She sounded cranky and bored. When I said I wanted to make an appointment she asked me, "Pap smear or termination?" I asked her to explain the procedure they used and what I would need to do. She gave me prices, told me they used the vacuum aspirator procedure (your cervix is dilated and a machine like a vacuum sucks out the contents), as well as telling me that if I weighed over 200 pounds, it was extra. I wondered what the extra charge was for, but was too uncomfortable to ask.

The second clinic seemed more promising. It was called A Woman's Choice and had a pretty ad in the yellow pages. When I called there, the girl who answered the phone was very patient with my questions. She explained the procedure, told me what I would need and explained the pricing to me. It was about $40 cheaper than the first clinic, so I made an appointment for three weeks in advance to give me time to come up with the money.

I got a job temping at the light company and borrowed $100 from my mother to pay the $310 it was going to cost. The money from David's salary would just barely cover our bills, there certainly wasn't another $300 kicking around.

I had a lot of ambivalence about the abortion in the three weeks I waited for my appointment. I became increasingly more sad about the idea. I had dreams about my baby almost every night. For me, it was hard not to become attached to the baby inside me. If I had been single, I would have had the child on my own, but since I am in a relationship, I felt that the decision needed to be made my both of us. It wasn't so much that I didn't want to have an abortion, it was more that I never thought I would have to do it. It was facing the reality of actually doing it that was the hard part.

The day came and I woke up earlier than normal. We got ready to go and brought things with us to do on the four hour wait we expected. We got to the clinic a couple of minutes before the scheduled appointment time and already the waiting room was full. There were women of all colors and backgrounds there. Most of the women were with a girl friend or mother. There were only two women there that had boyfriends with them, me and another girl.

When we got to the clinic, we each stood in line for the bathroom so that we could do our pregnancy tests. Then they sent us back out to the waiting room for a few minutes. I was unsure whether I should go in the back to fill out paperwork or if I would do that later. After a few minutes, the thirteen women having abortions that day were taken back into a room where we watched a video about the procedure and filled out paperwork. The only time the nurses talked to me was when my paperwork was looked over, and only then to tell me that I was overdue for a pap smear.

After the video, we were taken into another room to wait for our ultrasounds. When it was my turn to go in the ultrasound room, the doctor seemed friendly and I was reassured about the staff momentarily. However, when my I got on the up on the table, I said hello. The doctor did not respond to me at all. During the ultrasound procedure, I asked some questions which he also did not respond to. After it was over and the picture had been printed, I asked how far along I was and if I could see the picture. The nurse and doctor looked at me like I was crazy but showed me the picture anyway. I was nine weeks pregnant, so the baby was just a little blob on the ultrasound photo. I just couldn't pass up an opportunity to see my baby that one time.

Once we were all finished with the ultrasounds, we were herded back into a room where we were given valium and motrin. At this point, the nurses gave us each a number according to when we came in. I was number eleven out of thirteen. When each of our numbers was called, it was time for our abortion. We were instructed to take off our pants and underwear and change into a hospital gown with the back open. I can't express how humiliating it felt for me to sit in a room of thirteen strangers in a hospital gown with no underwear on. Also, having never taken valium, I was apprehensive about the side effects. In about an hour, I felt high from the valium and was stumbling around every time I got up to use the bathroom, which was every five minutes.

At this point, I had been separated from David for about an hour. I was unable to go out into the waiting room to talk to him on account of the hospital gown. He was not allowed in the back part of the office, so if he was worried about me (which he was), he had no way of seeing or talking to me. It had always been my understanding that part of the abortion procedure was some sort of counseling session, either with or without your partner or support person. I received no such care and David was practically ignored by the clinic staff. The only time any of the staff spoke to him was when they collected the money and then I doubt it was more than a half dozen words.

Right before it was my turn to go into the exam room, one of the first girls to go in came out. She was dressed already and had a look of sheer anguish on her face. I could tell it was painful for her to sit down. I began talking to her and discovered that she had come to the clinic alone and planned to drive herself home. I asked her if there was someone to come pick her up, and she said that no one knew she was there. After a few minutes, I went in to get one of the nurses in the hope that maybe there was some pain medication she could be given. When the nurse came in, she was very curt and said that all they could give was another motrin. At that point my number was called so I left her to be comforted by one of the other women. I never found out how she was or if she was able to drive herself home. She was gone before I came out.

Ultimately, I waited in that room for two hours. Not a single staff member spoke to me the entire time I waited. By the time I reached the exam room, the valium had worn off. I asked for the optional nitrous oxide and got comfortable on the table, feet in the stirrups. I waited in there for an additional ten minutes, breathing in as much laughing gas as I could get into my system and staring up at the Space Jam poster on the ceiling.

Finally the doctor came in. He performed a bimanual pelvic exam on me to check the size and position of my uterus. Immediately after that he put the speculum in my vagina. This was painful and I involuntarily scooted my butt back up on the table. The doctor (and this was the only time he addressed me) said disdainfully, "It's just a speculum." The next step of the procedure is to put dilators of graduating sizes into my cervix to dilate it enough to put the vacuum aspirator into my uterus. Every step of this hurt like nothing I ever experienced and I began to sob loudly and uncontrollably. The nurse and the doctor ignored me and moved on with the procedure. The vacuum aspirator made me feel like my insides were being sucked out. I was still sobbing. All in all, the whole abortion procedure took about three minutes. It felt like three years.

Immediately afterward, I was helped up by the nurse, who had acquired my shoes from somewhere. Thankfully I was wearing clogs, so it was easy to put my shoes on. She placed a maxi pad between my legs and made me squeeze my thighs together to hold it there. I was then taken into the recovery room, given a recliner to sit in, some juice and a heating pad for my belly. We were required to stay at the clinic for an hour after the exam, so most of the women were not in a rush to get up. I sat there for about a half hour, then got up and went to put my clothes on. By that time, I was feeling fine. I had a little bit of cramping and a scant amount of bleeding. I knew I would be fine.

I filled out the final paperwork, including a signing a waiver that said the clinic was not responsible if I drove myself home. I was given a few sheets of paper that were supposed to explain the aftercare, but really only said that the clinic was not responsible for complications due to the abortion procedure; and if you had problems, you should contact your own physician. I thought, "Some of these women don't have any health insurance, what makes you think they have a physician??"

During the time I was in recovery, the nurses talked on their cell phones or gossiped to each other. They never made a move to comfort a woman who was crying or throwing up. After I finished my final paperwork, I was allowed to go out into the waiting room to see David. When I got out there, his face was practically white with worry. He asked me how I felt and I said, "Fine. Lets get out of here." We ended up leaving the clinic a half hour before the recovery time was up, but I just couldn't stay there any longer. Getting out of there felt like escape. I was relived to have the whole thing over with. We went out for a celebratory breakfast, and I know we both deserved it.

Approximately 43% of women have abortions before the age of 45. I know that everyone's experience could not have been as bad as mine, but there is a real problem with our standard of care for abortions in this country. Instead of treating women (and their partners) having abortions as a souls in need of compassion, the women having abortions the day I was there were treated as cattle. We were given numbers and herded around the clinic. Our feelings were not considered; not one person in the staff tried to console the girl crying and in pain after her abortion was done. We were not counseled, our partners were not counseled. We were not even respected as human beings. When I was lying on that table in pain, not a kind word was spoken to me. No one asked me if I might want to change my mind. No one talked to me about other options.

The abortion procedure itself was not even explained to us by a nurse, or even by a person. We watched a video - and mind you, last time I checked, videos can't answer questions. When it was time to leave, we were given about three sheets with aftercare instructions on them. On the sheets, it was clearly stated that if we had any complications after we went home, we were to go to our personal doctors or the hospital. What if some women don't have insurance, and therefore have no personal doctor??

My message is this: when you have an abortion, visit the clinic beforehand so you can get an idea of the standard of care at the facility. Will you be offered counseling or aftercare? Is there a number where you can reach the doctor who performed your abortion afterwards, in case the hospital or your personal physician had questions for him or her? Will the nurse in the examination room be available for support or hand holding during the abortion?

We do not have to accept less than excellent care during such a trying time. Unfortunately, once you are in the clinic, it can be hard to leave if you are not being treated as you deserve. Research your options well.

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