Women share personal stories about abortion at Planned Parenthood Abortion Storytellers
Women share personal stories during a Planned Parenthood Arizona abortion storytelling event on July 25, 2022, one month after Roe was overturned.
Michael Chow, Arizona Republic
Jennifer Kirshner will never forget one of the first women she supported through an abortion.
The woman was about 12 weeks pregnant. When she arrived at Planned Parenthood, she said she didn’t want any sedation.
She had a couple of kids at home, she said. She had to go back to work. An Uber was picking her up after the procedure. She didn’t have the time for sedation. She needed an abortion, and then she needed to get on with her life.
“She was just a hoot,” Kirshner said. “She was extraordinary.”
Kirshner was new to her volunteer role as an abortion doula at Planned Parenthood. She got to know the woman before her procedure and held her hand through the pain.
They only spent about an hour together, but Kirshner felt an immense connection. If they had met in another context, she would have wanted to stay in touch.
“I drove home just welled up with emotion,” Kirshner said. “Tremendous emotion.”
When she signed up to be a doula, Kirshner didn’t know what to expect. And as her first shifts unfolded, she realized she had been right to go in with no preconceived notions.
“Nothing can prepare you for the beauty, sometimes the joy, the relief, the pain, the anguish, the sorrow, everything that sort of just emanates from that,” Kirshner said. “From that room, from that space.”
Kirshner is normally a little squeamish. Doesn’t like to look when her kids get a cut. But when she’s in the room with surgeons and nurses and blood and fluids, focused solely on comforting a patient, the unease falls away.
“You’re just there,” she said, “in that moment.”
Helping through the pain and politics
Though abortion doulas volunteer in a health care setting, their work carries with it fraught politics, the abortion debate almost inescapable. A doula will try to keep the noise out.
Since the Supreme Court overturned Roe v Wade in June 2022, Americans have been met with an unceasing barrage of headlines, advertisements, billboards, posts and conversations about whether abortion should be legal, and in what circumstances.
In Arizona, where the issue is on the ballot in November, access to abortion has been rife with uncertainty. For months, it was unclear what would take precedence: A territorial-era total ban on abortion or a more recent law permitting the procedure up to 15 weeks.
The territorial ban was repealed earlier this year, making abortion up to 15 weeks law. It is available thereafter only if proceeding with the pregnancy would endanger the mother’s life or cause substantial and irreversible impairment, a restriction that has placed women who experience medical complications later in pregnancy at risk.
If approved by voters, Proposition 139 would establish a fundamental right to abortion, making it legal up to viability, about 23 or 24 weeks, and thereafter if a health care provider determines the mother’s life or physical or mental health would be in danger if the pregnancy continued.
The language of the amendment could also see the eventual overturning of other restrictions in Arizona, such as the mandatory ultrasound and 24-hour waiting period prior to having an abortion.
As the debate rages, clinics across Arizona continue to provide abortions — and some patients will have a doula by their side.
‘It was like Superman’
Kirshner signed up to be an abortion clinic escort, ferrying patients to and from their cars and their appointments, in the thick of COVID-19.
She felt a pull toward action in a world that felt increasingly uncertain, where long-established rights suddenly teetered on the brink.
Kirshner, who is 54, grew up in Phoenix in a family of activists. Her parents were always involved in various causes, and as a toddler, she marched with her mom at the state Capitol in the early 1970s. In the same decade, her mom volunteered for Planned Parenthood, and some years later, when Kirshner was a teenager, she went there for birth control. Her sister is currently on the organization’s board in Missouri.
“Planned Parenthood just sort of runs in our blood,” she said.
She wanted to do something, and Kirshner felt she could help most in a role where she could really connect with people.
“I’ll go knock on doors and I’ll get the word out,” she said. “But I’m not a fundraiser. You know, you just learn your strengths.”
She escorted patients in and out of clinics for a while, doing her best to comfort and calm them in the brief period of contact. Then she saw one of her fellow volunteers going inside after her escort shift and asked what she was doing.
The volunteer, Kirshner learned, was also an abortion doula.
“She was Clark Kent on the outside,” Kirshner said. “But then she went in and it was like Superman.”
What a doula does
Doulas have long been a presence in pregnancy care, offering emotional and educational support as women carry and give birth.
An abortion doula does much the same thing, but instead of supporting parents-to-be, they support someone through the process of ending a pregnancy.
When Kirshner arrives for her twice-monthly shifts at Planned Parenthood, she drops her bag, finds out who’s who, and heads straight out to the patients waiting for procedures, their minds quietly whirring with questions and worries and desires of their own.
Kirshner introduces herself and lets them know that she is there to help in any way she can. Some women are immediately open to having a doula. Others are more hesitant, cautious about opening up, or unsure what it is, exactly, that a doula does.
What that is, exactly, changes from patient to patient, from day to day. “No minute is ever the same,” Kirshner said.
She might sit with a woman who wants answers to questions, or the distraction of conversation, or the silent solidarity of swiping through dog pictures, or a sympathetic ear. A patient might have practical needs, which doulas try to meet through a cabinet stocked with ginger ale and graham crackers, heating pads and blankets, squishy balls and coloring books.
The doulas are there to guide patients through the process: answer questions beforehand; be there during the abortion, if the patient wishes; help them dress and wheel them back out to the recovery room once the procedure is complete. They supply warmth, try to make the environment feel less clinical and more comfortable.
As she goes about these tasks, Kirshner draws on her counselor training and her knowledge of trauma.
She will guide patients through breathing exercises and encourage them to stay hydrated. If a patient is particularly anxious, uptight or scared, she will ask for permission to touch their hand, urge them to stop and notice the physical sensation, just for a moment.
“It’s just kind of anchoring into that connection, that safety,” she said.
It’s about finding aspects of the experience the patient can control, Kirshner said. Going in for an abortion — or any medical procedure — can feel frightening, beyond what a patient can manage. But they can choose to sip water, to breathe slowly and deliberately, and offer a signal to their body: you are safe.
The patient isn’t always the focus. Sometimes they bring along a partner who needs support too.
“At this point, the patient has gone to their appointment. They’ve been to the space. They may have had an opportunity to ask questions, had their questions answered,” Kirshner said. More often than not, they have a sense of autonomy and agency over what is happening, residual anxiety notwithstanding.
Partners, on the other hand, can be a little deer-in-the-headlights, a situation where a doula comes in very handy, Kirshner said.
“If we can kind of support the partner, the partner can better support the patient.”
Perhaps above all, she offers unconditional acceptance for the patient’s decision to end their pregnancy. “They’re making the right decision for themselves at that time,” Kirshner said.
Questions, relief and sometimes grief
There’s no rhyme or reason to who wants the support of a doula.
Sometimes, the younger women are more timid, less sure of themselves, Kirshner said. But on a recent day, a 19-year-old — “a sweet, tiny little whisper of a thing” — upended those expectations.
“This one was like, ‘let me talk’,” Kirshner said. “You know, just the anxiety. She wanted to talk. She wanted to sort of process through things.”
Another patient, in her early 30s, took on a doula role herself as she waited in the recovery room.
“She was sort of talking to other patients and just checking in. You know, ‘I just had it done and you’re going to be okay’.”
Lots of women come in with questions. Is it going to hurt? How much? Will I be able to get pregnant again? When can I have sex again?
Relief emerges in a thousand different shades: that it’s over, that they won’t be nauseous in the mornings anymore, that it didn’t hurt as much as they thought it would. Relief that the suction did not, in fact, sound like a vacuum cleaner. Relief that they will not be giving birth to a child.
And then there’s grief. Having an abortion is not an emotional or difficult experience for everybody. But it is for some.
“There was a patient who really had, I think, some internal dissonance about the decision, but realized that this was the right decision for her at that time,” Kirshner said.
The woman was early on in her pregnancy. She felt strongly that she wanted to see the fetal tissue that was removed from her uterus, known as the product of conception, and to have it cremated, along with a service.
“That was highly emotional because she had an emotional attachment, as early along as she was,” Kirshner said. “This was a difficult decision for her. And so that was very heavy.”
Kirshner has looked after women having their third or fourth abortion, which, she said, is their prerogative: the right decision for them at the time.
Sitting with a patient through the abortion procedure offers a more intimate connection than that forged with the medical staff, Kirshner said. She sees herself as a patient advocate, there to cater to all non-medical needs.
“I’m here for you,” she tells patients, “so that the nurses and the doctors can be there for the rest of you. So I’m here for your emotions. I’m here for your hand. I’m here for your tears. I’m here for your laughter.”
She is also on the lookout for risk. She had a patient who shared that her partner was picking her up, but he didn’t know she was having an abortion, instead assuming she was receiving routine health care like a pap smear.
Kirshner flagged the issue with nurses, who conducted a safety assessment, as per protocol. They made various adjustments to the patient’s care, ensuring she didn’t leave with anything tangible that signaled she had an abortion, such as the post-procedure self-care bags put together by the doulas.
A need to feel cared for and respected
Kirshner talks to her patients about all sorts of things: kids, pets, partners, questions, fears. But one topic isn’t so common.
“You know, it’s interesting,” she said. “Politics hasn’t come up.”
Occasionally, a patient will express frustration with existing laws, especially if they have had to travel. If someone has come from, say, Yuma or Texas, Kirshner said, and they’re further along in their pregnancy, meaning they have to take medication and wait for its effects prior to the procedure, anxiety and anger can build.
But most of the time, the politics around abortion goes unmentioned.
Most patients are aware of the uncertainty of the past couple of years. Most know abortion is on the ballot in Arizona. The fact the issue is controversial has not escaped those who find themselves in the Planned Parenthood waiting room.
But by the time they get there, Kirshner said, they are looking forward, not back. She sees it as part of her role to not let politics seep into the space, adding more anxiety to what is already a difficult moment for many.
“I think it’s trying to quiet the noise, you know?” she said. “All the stigma, all the judgment, even from patients walking in the door, from what they see from protestors that are standing outside.”
The way Kirshner sees it, if they leave carrying all the stigma and anxiety they might have walked in with, it will only complicate their recovery. “That’s only going to continue to infect how that person moves forward and how they feel about themselves,” she said.
She wants that noise to ebb once patients are inside, for them to feel cared for and respected.
“To feel,” she said, “that they’re where they should be at that time.”
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Publish date : 2024-10-11 02:13:00
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