Our Bodies, Ourselves (69 page)
Read Our Bodies, Ourselves Online
Authors: Boston Women's Health Book Collective
Be gentle with yourself. Whatever route you decide to follow, you may grieve for the path you did not take. Grief is normal. It does not mean that you have made the wrong decision but rather means that you are feeling a loss. Reach out to others who have made similar decisions for discussion and support.
Abortion
U
nless we can freely decide whether to continue a pregnancy, it is impossible for us to control our lives, to enjoy our sexuality, and to participate fully in society.
While there are more contraceptive options now than ever before, no birth control method is 100 percent effective, and access to reproductive health information and services is unevenly distributed, geographically and economically, both in the United States and worldwide. In addition, gender inequality, coercion, and violence mean we are sometimes unable to choose or control when we have sex.
Almost half (49 percent) of all U.S. pregnancies are unintended.
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No woman should have to remain pregnant or become
a mother against her will. Each woman must be able to decide whether or not to continue a pregnancy based on what she believes is best (see
Chapter 12
, “Unexpected Pregnancy”). Our ability to make these personal decisions should not be restricted by the government, religious institutions, or any individual. Unfortunately, abortion rights opponents in the United States have succeeded in placing many obstacles in the way of women who seek abortions.
Abortion is one of the most common medical procedures in the United States. About one in four pregnancies, excluding miscarriages, end in abortion.
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U.S. abortion rates have declined from a high of 29.3 per 1,000 women aged fifteen to forty-four in 1981 to 19.6 per 1,000 women in 2008.
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Approximately 1.21 million legal abortions were performed in the United States in 2008.
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On the basis of current abortion rates, about one in three women in the United States will have an abortion by age forty-five. There are many misconceptions about who has an abortion. The following statistics demonstrate that women who have abortions cannot be put in a single category.
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⢠Women between the ages of twenty and twenty-four obtain 33 percent of all abortions; women ages twenty-five to twenty-nine obtain 24 percent; teenagers obtain 18 percent and women thirty-five and older obtain 11 percent.
⢠Non-Hispanic white women account for 36 percent of abortions; African-American women, 30 percent; Hispanic women, 25 percent; and women of other races, 9 percent.
⢠Thirty-seven percent of women obtaining abortions identify as Protestant, and 28 percent identify as Catholic.
⢠Poor and low-income women account for more than half of all abortions; 42 percent of women obtaining abortions have incomes below the federal poverty level (in 2010, this was $10,830 for a single woman with no children).
⢠About 61 percent of abortions are obtained by women who have one or more children.
The most common reasons women give for having an abortion include concern for or responsibility to other individuals; inability to afford a(nother) child; interference with work, school, or the ability to care for dependents; difficulties with husbands or partners; and not wanting to be a single parent.
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Although abortion has been legal in all states since 1973, accessibility depends on which state you live in, how far away you are from a provider, how much money you have or what your insurance will cover, and how far along you are in your pregnancy. Eighty-seven percent of U.S. counties have no abortion provider.
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Most abortions are provided by freestanding clinics. Some specialize in abortion exclusively, while others provide a range of reproductive health care services.
Fewer than 5 percent of abortions are performed in hospitals. Over the past twenty years, the number of hospitals providing abortions has decreasedâfrom 1,405 in 1982 to only 610 in 2008.
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While only a small number of abortions are performed in hospitals, the impact of the decrease is greatest on women in rural areas, low-income
women who depend on hospitals for health care, and women whose health requires hospital services. It also reduces the opportunities for training new health care providers to perform abortions.
FREQUENTLY ASKED QUESTIONS
Women and the public in general are exposed to a great deal of misinformation about abortion. In some cases, abortion rights opponents have intentionally spread myths. What follows are the facts.
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Is having an abortion safe?
Having an abortion is safe, and very few women experience complications. Having an abortion poses fewer risks to a woman than going through pregnancy and birth.
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Will having an abortion affect my ability to get pregnant in the future?
Uncomplicated abortion poses virtually no risk to a woman's future reproductive health, as shown by numerous studies. Very rarely, serious pelvic infection can cause damage to the fallopian tubes, which can increase the risk of ectopic pregnancy or fertility problems. You can decrease this risk by seeking prompt treatment if symptoms of infection occur.
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Does having an abortion increase my risk of breast cancer?
No. In 2003, the National Cancer Institute convened a workshop of more than a hundred experts from around the world to evaluate the research. These experts concluded that “induced abortion is not associated with an increase in breast cancer risk.”
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Do women who have had an abortion suffer from post-traumatic stress disorder, “post-abortion syndrome” (PAS), or “post-abortion stress syndrome” (PASS)?
No. In spite of claims by abortion rights opponents that women who have abortions are at risk of PAS or PASS, no such syndrome is recognized by any mainstream professional organization.
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In fact, studies have shown that women most frequently report relief, positive emotions, and decreased stress after an abortion.
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Some women also feel sadness and loss after an abortion, as well as anger, confusion, shame, and guilt, even when they know they've made the best decision. Abortion is not associated with long-term psychological distress.
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The resources below can help you find an abortion provider and/or help with funding an abortion.
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Planned Parenthood
, plannedparenthood.org, enables you to search by zip code or state for Planned Parenthood clinics that provide abortions, including those that provide abortions after the first trimester. You can also call Planned Parenthood at 1-800-230-PLAN.
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The National Abortion Federation
(NAF) Hotline provides referrals to member clinics in the United States, Canada, and Mexico City: 1-877-257-0012. For information about abortion and other resources, including financial assistance, call NAF's other hotline number: 1-800-772-9100. You can also visit NAF online: prochoice.org.
WHAT YOU NEED TO KNOW
The following list includes some of the questions you may want to ask when you call for an appointment.
Medical Issues
⢠What abortion methods are available to me? What are the differences in terms of numbers of visits, costs, and restrictions?
⢠Is there anything about my physical condition or in my medical history that could interfere with my getting an abortion at your facility? Is there an upper weight limit for your abortion care? Will you perform an abortion if I'm HIV-positive?
⢠What pain relief and other medications are available? What is the difference in cost?
⢠Will the clinic be responsible for routine follow-up care? For treating complications? What type of backup services are available in case of emergency?
⢠I need a Pap test or chlamydia testing. Can I get these done when I come in for the abortion?
⢠Will birth control be available if I want it?
Financial Issues
⢠How much does the abortion cost? Must the fee be paid all at once? Is everything included, or will there be additional charges? At what point in the pregnancy will the fees increase?
⢠Will Medicaid or health care insurance cover any of the cost?
⢠Does your clinic have funds to pay for my abortion?
⢠Do you know of any other resources that may help with funding?
⢠If calling Planned Parenthood: Do I qualify for any financial support for the abortion?
⢠Can you bill my insurance company directly?
State Laws
⢠Are there age requirements? Do I have to tell my parents, get their consent, and/or bring proof of age? Will my parent or guardian need to visit the clinic? (For more information, see “Parental Consent and Notification
Laws Affecting Teens”
)
⢠Is there a mandatory waiting period between the counseling and when I can have my abortion? Can I have the counseling over the phone, or do I have to come to the clinic?
Clinical Procedures
⢠How long should I expect to be at the clinic? Will everything be done in one visit?
⢠Can I bring someone else with me? Can she or he stay with me throughout the counseling and the procedure? If not, why?
⢠Will there be a counselor or nurse with me before, during, and after the abortion?
⢠How will my privacy be protected before, during, and after the procedure? Will my medical records be protected?
⢠Will there be someone in training performing my abortion?
⢠Will there be staff people who speak my native language? If not, will an interpreter be provided?
⢠Can you accommodate any special needs I have (for example, wheelchair accessibility)?
⢠Will there be protestors? If so, does your clinic have escorts who will accompany me into the clinic? How will I recognize them?
⢠Do you have counselors who can provide follow-up counseling after the abortion? Do you have names of private therapists you can give me who work with women before and after abortions?
The National Abortion Federation offers free brochures you can download, including “Unsure About Your Pregnancy? A Guide to Making the Right Decision for You” and “Making Your Choice: A Woman's Guide to Medical Abortion.” These brochures, which are available in several languages, can be found at the National Abortion Federation (prochoice.org), under Publications.
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The National Network of Abortion Funds
, fundabortionnow.org, maintains local funds in most states that can provide referrals, offer help with funding, or help identify sources of funding.
When looking for a clinic or provider, watch out for “crisis pregnancy centers,” often listed as “abortion alternatives.” These centers often draw women in by offering free pregnancy testing or ultrasounds and advertise themselves as counseling and referral agencies. In reality they are run by groups opposed to abortion. They are not staffed by trained health care providers, and they try to dissuade women from having abortions by giving misleading and inaccurate information. For example, they may tell you that the pregnancy is further along than it really is or that abortions are dangerous and cause breast cancer and/or infertility (they don't; see
“Frequently Asked Questions,”
, for more information). Such centers are often located close to clinics that do provide abortions and have similar names.
Also steer clear of websites that claim to sell pills for abortion. While one type of abortion, medication abortion, uses pills to induce abortion, there are unfortunately many websites that will send fake pills or charge your credit card and send nothing. Contact the resources above to get honest information about medication abortion.
It's natural to feel anxiety and anticipation before your appointment, as you might before any medical procedure. Try to go about your normal activities and get a good night's sleep. It's important to avoid excessive alcohol, street drugs, and strong sleeping pills before the abortion.
Most abortions performed in the clinic are done while you are awake, with drugs that help you relax and ease the pain of cramping. If you are having heavier intravenous (IV) sedation or
general anesthesia, you will probably be advised to avoid food after midnight, though clear liquids may be allowed.
© Ali Price
IF I HAD LISTENED
A'YEN TRAN
If I had listened to the subway ads for postabortion trauma counseling or the men at the clinic brandishing rosaries and yelling racist pleas not to “kill your black/Hispanic/Oriental baby,” things would be different. I would not hold a degree, and I would not be building a career. My child's father would have been a man who sexually, emotionally, and mentally abused me. Worst of all, my child would not have the financial and emotional support necessary for a healthy life.
When I was nineteen, I got pregnant for the first time. On the recommendation of a friend, I opted for a medical abortion. I was left to go through the process alone, which made the experience difficult. While my side effects were unusually strong, I was grateful and relieved to have been able to have an abortion.
Several years later, in college, I got pregnant again. The pregnancy may have been from a condom breaking or from carelessness in not applying the condom before the first moment of penetration. This time I had a surgical abortion. The doctor was kind and caring, and her assistant held my hand and told me what was happening.
I told my friends that I was having an abortion, and they offered ample emotional support. I didn't feel alienated, because I was part of a vocally pro-choice community. Now I coordinate a group of abortion clinic escorts to deflect the harassment of antichoice protesters.
If I had listened to the antichoice protesters, I would not be able to pursue my life goals. Currently, the World Health Organization conservatively estimates about 47,000 women die every year due to lack of access to safe abortion services. I want to change that. The world I envision is filled with happy, healthy, nourished babies and parents.