A Distortion of Care
Abortion providers aren’t criminals, bodyguards, saviors, or travel agents
Twenty years ago, I was granted an intimate privilege at an incredibly difficult moment in the life of a stranger.
Early one morning I stood, masked and gowned, in the corner of an operating room and watched a physician perform an abortion on a woman I’d never seen before and would likely never see again.
The procedure — a dilation and curettage (D&C) — followed standard protocol: insertion and removal of gradually larger dilators into the patient’s cervix, entered at a cadence designed to allow access to the uterus. Once granted, the uterine lining was gently scraped clean by a serene doctor.
Patience and careful technique were involved, blood was certainly present (as per usual), and things went smoothly. There were no complications. The early stage pregnancy was safely (and legally) terminated and after the necessary stretch of hours in recovery, the patient exited the clinic and resumed, or so I like to imagine, the familiar hum of her life.
I, however, failed to match her stoicism.
Midway through the procedure, I passed out cold. Watching the body of a female human being respond as intended to a set of carefully orchestrated steps designed to alleviate a condition she could not manage undid me. Awed, I crumpled into a pile of clammy flesh and paper fabric.
I stood (and fell) in the room that day as part of my training with Planned Parenthood of Australia. I was, at the time, a social policy grad student keen to devote volunteer hours to patient support at a local clinic. The staff were equal parts happy to have me and decidedly no-nonsense about exposing me to what it was I was poised to support women through: surgical abortion.
Although today abortion is legal across all Australian states and territories, it wasn't then. Twenty years ago, surgical abortion was permitted in New South Wales only if a physician deemed the pregnancy a “serious risk” to the mother’s health. Medical abortions were not legal. A maze of legislation and case law, akin to the matrix of confusion now unfolding state by state in post-Roe America, ruled the day. And yet public opinion lined up in one clear direction. Then, as now, a majority of Australians favored a woman’s right to choose. In a 2021 poll, a remarkable 76% of Australians supported the right to abortion — a (comparatively high) number that hasn’t budged in demonstrable ways for the past seven years.
I had, at the time, called Australia home for a handful of years and had developed a keen appreciation for the straightforwardness of social responsibility I often saw at play. Kids deserved schools that really taught them. Patients deserved care they could afford. Citizens deserved services that were available. And guns were horrid, full stop. I absorbed a felt sense of this civic ethos and admired it. Though not always perfectly executed, it stunned my American familiarity with brokenness.
Australian institutions can be, by design and cultural instinct, notoriously no-nonsense so the ‘roll your sleeves up and learn’ approach that had me masked and gowned that day made sense — even to an outsider. I needed to see to understand, the logic went. Given my lack of medical training, I appreciated the toughening up. Blood in a safely controlled setting, after all, is just blood.
As a ‘patient advocate’, it was my job to put language to the process women naturally asked about once their GP referred them to the clinic. Sometimes it was me who answered the phone. Detailed questions around ‘how it all works’ frequently arose when women called to make their appointment, or to locate fresh ears to help them wade through all aspects of a tremendous decision.
I was to listen, educate, offer resources, and stay out of the way of values or belief structure. We were, after all, a surgery center. Our duty was to practice medicine and deliver patient care ethically and responsibly, sticking to the narrow lane the law permitted us but moving quickly all the same. I paid close attention to the professional dedication of the clinic’s director and medical staff. This gig wasn’t about opining or raging (though I did plenty of both), it was about serving. Help the patient, move on to the next one, and leave your fussing at the door.
The Supreme Court’s maddening abandonment of the right to an abortion guaranteed by Roe v. Wade represents an advance in American brokenness at a scale I never imagined possible. It has me feeling what so many are feeling — dejected, angry, terrified, and appalled.
It also has me thinking about the torturous game we play with reproductive health providers when we yank our laws around: We distort them into people they are not.
Abortion providers are not criminals. They are not terrorists out to cause harm. They are not devilish change agents, nor are they bodyguards capable of protecting every human creature who crosses their threshhold. And they are not travel agents.
Yet our messy lack of progress casts them as all of these things.
Abortion providers are doctors and nurses, administrators and counselors, grandmothers and daughters, teachers and healers, leaders and quiet citizens thrust into the heroic (or demonic) spotlight because the world around them is so twisted in knots about reproductive freedom. Instead of supporting these folks to do their job, we layer awe and scorn upon them.
We get in the damn way — like I did that morning.
I remember feeling so terribly embarrassed for passing out, and impressed by the stalwart level of presence the staff around me exhibited in the face of a patient’s profoundly vulnerable moment. These women were tough, I told myself, and I was not.
In fact, as I came to learn in the weeks and months that passed, yes the staff were tough and dedicated and caring and attentive and exhausted and and and. But these women were not superhuman, and they had no interest in being regarded that way, thank you very much. They were simply doing their job — they were seasoned and loyal care providers, both talented and imperfect.
It was me who heaped upon them, and the tools of their trade, all manner of warped stories my American upbringing attached to the mysterious world of abortion.
What that morning of folding like a house of cards in the OR taught me is that feeling strongly (in whatever direction) about reproductive freedom may charge you up, or knock you flat, but it doesn’t do much to help. It is a sideshow — a noisy place where everyone gathers, yet few belong.
The main stage — the exercising of reproductive freedom — is what matters, and it is much quieter. It is the clinic. It is the nurse. It is swallowing the pill. It is discussing the contraception. It is the ultrasound. It is holding a hand. It is feeling the grief. It is the recovery. It is facing the blood. It is showing up again and again. It is safely moving through a profoundly difficult moment with the help of a serene provider before returning to the familiar hum of life.
On that stage, providers are cast as they should be—and it is that show that must go on.
With thanks to Planned Parenthood.
