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Notes from the Field: Normalizing Abortion in a New Era

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lindaI saw a number of women in our clinics for abortions in the past few days. A 22-year old got squeezed into my regular schedule with a note by the medical assistant that just read, “Needs a sonogram to see how far she is.” It turns out, she had just has a positive pregnancy test the night before and was still a bit shell-shocked. The ultrasound showed a tiny pregnancy, not even 6 weeks, and I gave her my usual offer of “We’re here for you, whatever you decide.” She left the office with RHAP’s Early Abortion Options handout, and she came back to the clinic two hours later asking for the abortion pill. We talked through the process, I answered her questions, she swallowed the mifepristone and took the misoprostol tablets with her. She was just really relieved to be able to get back to her usual life.

The next day, we took a walk-in from our urgent care doctor. The patient was 14 and had a positive pregnancy text. She definitely did not want to be pregnant and did not want any kind of procedure. She decided to take the abortion pill and stay with her auntie the next day for her cramping and bleeding. That same day, we had a 35-year-old mother of six who had been told she had polycystic ovary syndrome and probably wouldn’t get pregnant again. However, she did become pregnant again and wasn’t happy about the prospect of one more. She’s still thinking about what she will do. Finally, a 19-year-old came in for the abortion pill after hearing about our clinic from a cousin.

None of these patient visits were particularly charged with angst or difficult- they were all just a part of the medical care that we offer day in and day out. But in my heart, I keep worrying that this basic, everyday care will be taken away from us, and from our clients. These women’s lives will be different, and probably not in the way they want them to be — perhaps for some women more drastically than others. But overall, not having this kind of care available will prevent women from having the futures they want.

It has been my dream to mainstream abortion care everywhere, making it part of normal and routine health care. Mifepristone makes abortion so amenable to primary care, and it’s really ideal when women can go to their neighborhood health centers (where they get all of their other health care) and take the medicines they need to get back for themselves the futures they want. We recently had a community training in medication abortion, teaching providers how to do medication abortion without mifepristone (the FDA approved abortion pill). I hope that it won’t come to this, but I do think it’s very important for us to all learn the alternative protocols and be prepared, especially as we face the challenges ahead.

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