I’ve had one abortion, three miscarriages, one ectopic pregnancy, and two live births. To GOP politicians, including and most notably the president of the United States, that means I’m worthy of one high-priced condominium in hell, three episodes of unfettered compassion, one state-mandated and medically impossible surgery, and, even though they’re the so-called party of “family values,” two joyful reminders that I live in a country that refuses to mandate paid family leave, equal pay, universal childcare, universal pre-K, and a seat at the political table.
But it also means I’ve been forced to procure necessary reproductive health care from a variety of establishments and via a number of doctors. I’ve seen two separate OB-GYNs for the birth of both my sons. I’ve seen Planned Parenthood medical providers for pap smears, birth control, and one scary breast cancer exam. I’ve seen a third OB-GYN for medication to save me from certain death after an ectopic pregnancy diagnosis, and a fourth OB-GYN who volunteered her time at a local Planned Parenthood for my abortion.
My reproductive health-care chart resembles a 200-piece puzzle; discombobulated and impossible to put together unless you have someone (with a generous Adderall prescription) fixated on and knowledgeable of all the moving parts.
A reported one in four women—not to mention a number of trans men and non-binary people—will have an abortion in their lifetime. And of the pregnant people who choose and/or need an abortion, 59 percent already have at least one child at home. Abortion, like ectopic pregnancies, miscarriages, still births, and live births, exists on a spectrum of common and often unpredictable reproductive outcomes. So why is abortion care separated from the rest?
The answer, of course, lies in the explicit tactics of the anti-abortion movement. For those looking to curtail the right to an abortion(s)—or at least make it more difficult to access—separating abortion care from the field of reproductive health care makes it easier for anti-abortion advocates to argue that the person who terminates a pregnancy and the person who carries a pregnancy to term are two completely different people. In reality, they are often one in the same.
And at least one health-care center in Memphis, Tennessee, has found a way to offer care that mirrors this reality.
CHOICES Center for Reproductive Health—an all-encompassing health-care center founded in 1974 shortly after Roe v Wade was passed and local feminists realized a need in the community for abortion services—is the first nonprofit to perform abortion care and birth services under the same roof. Yes, it may be hard to believe and, thanks to anti-abortion stigma, to envision a pregnant person preparing to give birth and a pregnant person having an abortion sitting side by side in the same waiting room, but Katy Leopard, assistant director at CHOICES, tells The Daily Beast that it makes sense to their patients. “That’s the way they experience their reproductive lives.”
Born out of a necessity in the heart of the South, the center—which cares for 5,000 patients annually, 2,300 of whom seek abortion services—is proof that the best kind of health care is the kind that centers patients and the various health outcomes they experience in their lifetimes.
“When we realized that the fertility clinics in our community wouldn’t see you if you weren’t married to someone of the opposite sex, we said, ‘That’s not right’ and realized we could do basic fertility stuff,” Leopard says. “We could do sperm washing. We could do inseminations. We could do basic timing your cycle, don’t wear this kind of underwear kind of stuff. And we would see anybody, and that started us down the path of, ‘Who in our community is not getting good health care and can we provide competent care?’ And stigma wasn’t an issue for us.”
CHOICES is slated to open up a new health-care center in April, 2020, which will house six exam rooms (“where we can see all of our wellness patients, all of our trans patients, all of our clinic care”) and two procedure rooms where surgical abortions will occur. “Our medical abortions—‘the pill’—we will do in the regular exam rooms,” Leopard explains, before going on to detail future plans for doctors to perform vasectomies, colonoscopies, and other out-patient services.
The second floor of the new center “will be the birthing center,” Leopard says. ”So we will have administrative offices on one side of the upstairs, and the other side of the upstairs are our birthing suites and midwifery offices. So that almost triples our capacity to see patients.”
Though CHOICES staff has yet to occupy their new facility, a few years ago the board hired two midwives who, in the span of only two years, have attended over 100 births.
“We’ve had one or two patients who have come in for abortion care who, in their patient education session, it has become evident that they’re not sure it’s what they want to do,” Leopard tells me. “So our educators have said, ‘You’ve got some time, here’s how long you have, get some information, and we have some midwives if you are interested in talking about what [pregnancy, birth, and parenthood] can be like’ who can give you some information.’ And two of them said yes and went down to talk to the midwives and ended up deciding to keep their pregnancies.
“And we had one young woman in her teens who, with her mom, came to see our midwives and it was very clear that she didn't want to be a mother,” she continues. “And the midwives said, ‘You know, you have other options. Would you like us to make an appointment to go down to talk to our patient educator?’ And she ended up terminating her pregnancy.
“We’ve seen patients ‘cross the line’ and live out what we know is the truth: that it’s your choice at any given time and it’s wonderful to have all the options all the choices under one roof.”
As for the visual of a person seeking abortion services and a person preparing to give birth seeking care side-by-side, Leopard says market research has been positive. “People indicated that they did not care at all if [labor and delivery care] was done in the same space that abortions were provided. They were very happy to access care however they could, and in fact many people were even more supportive of the idea that it was all together.”
“They’re in the grocery store together,” she continues. “They’re in the mall. It’s not like they don’t know. And it’s that perpetuation of the stigma that ‘you should feel ashamed’ and ‘you should feel bad’ and not all abortion patients do.”
In a country where states with the most abortion restrictions also have the worst maternal and infant mortality rates; where people who can’t access abortion care due to medically unnecessary barriers are more likely to live in poverty, more likely to experience mental health hardship, and the children they already provide for are more likely to suffer, CHOICES offers a safe space for inclusive, comprehensive health care—a sign of not only what is to come as health-care providers and clinics navigate the very real possibility of a post-Roe v Wade United States but a current reminder of what abortion has and always will be: a common, safe, normal outcome of reproductive experiences that many of us will either choose or find ourselves needing to undergo for the betterment of our health, wellness, and pursuit of life, liberty, and happiness.