There are few words that polarize people as much as abortion. But how do the people who provide that care feel? For this month’s Group Chat we hear a conversation between two care providers.
Here’s a conversation between L, a Wisconsin doctor who provides abortions and K, a harm reduction worker who serves high-risk populations. We’re using only their first initials to protect them from facing any kind of repercussions or harm.
This conversation has been edited for length and clarity.
L: So, tell me about your family.
K: My family has always been led by a very strong sense of agency. I was taught at a very young age by my family how important agency is. My mom was a teen mom, so she got pregnant at 16. When her school found out she got pregnant, she was actually kicked out of high school and was forced to go to a night school just for pregnant people.
L: How do you feel like that has impacted the work that you do?
K: It informs the work I do every day because I want people to be able to live the life that they feel like they deserve to live. People deserve to have their agency and their autonomy respected. People deserve to be able to decide for themselves what is best for them. I bet you see that as well, being a doctor.
L: The biggest thing that I think about is that no other procedure is this heavily regulated, even though it's more dangerous to remain pregnant than it is to have termination. As a physician, you can kind of just you can do whatever you want most of the time with minimal government involvement — except for abortion care. There are many other, higher-risk procedures that are done with far less government supervision that I feel don't get the attention that they need.
K: I say that all the time — that reproductive health care is just health care. What's something that people don't know about abortion, abortion care or access to abortion that may surprise them?
L: I think the biggest thing that surprised people is that we're actually really nice to them. I think they think that we're really mean and that we're really bad doctors and that we do this because we can't do anything else, but that's not the case. They often expect people to be really cold or expect to be judged for their decision. But it doesn't matter, as long as no one's making them do this and they feel good about the decision that they're making and it's something they're OK moving forward with. So I just don't ask. It's not my business.
It's very easy for a wanted pregnancy to turn into the termination when people don't have resources that they need, and that's something that I think is lost on a lot of people. It's not in isolation that people want to have terminations. I think that many people want to grow their families, but a lot of the time they are just in a set of circumstances that aren't conducive to that. We're a band-aid on a larger problem that they're experiencing.
K: I resonate with that completely. We're not just talking about singular, siloed decisions. We're talking about the outcomes of our entire lives and working with people who are experiencing ongoing, regular barriers to their basic needs — or even just like above basic needs, because people deserve to live quality lives. And so, if it comes down to having to jeopardize quality of life over what people perceive to be morally wrong, I think that is something that we need to unpack and deconstruct as a society.
Because, why are we OK with a low quality of life in our community? And why are we OK seeing people not have their housing needs, their food need met? Why are we OK with the kids in our community having lead poisoning? Why are we OK with pharmacies closing? With the labor and delivery units closing, the cath labs closing? If we say we really care about life, why don't we care about quality of life?
L: And I think, I don't know, I'm somebody who has ever had a lot of feelings about abortion. I don't know that I understand a lot of the emotion behind it, because even before I started providing this care it was just another thing — just another medical procedure. There's all kinds of reasons why you empty somebody's uterus. It can be because they were pregnant and they've had a demise. It can be because they're heavily bleeding after a demise. It can be because they have extra parts of their uterus in there and you need to change the shape of their uterus just help them get pregnant.
There are all kinds of reasons why we do this, and it's just so similar to every other thing that we do that it just kind of feels like another thing I'm doing that day, another way to help people.
K: I love seeing you're end of it because as someone who works with people in the community, meeting them like where they're at, that ability to get your needs met is a big deal.
Often in my case, I'm working with people who have severe, persistent mental illness, who are unhoused, who are survivors of sex trafficking. I'm working with some really high risk people in the sense that they are chronically unable to access their needs. It's the fact that we can't provide for everyone in our community that leaves people in high risk situations.
Seeing that same decision from both ends of the spectrum is so fascinating for me, because you're so right — that it's absolutely just another medical procedure. For me on my end, it is just another life decision. But that ability to make a decision for yourself totally changes the outcome of your life.
L: People are often like, "well, your choice was to get on birth control or not," and like, getting an IUD placed often costs more than twice as much as a single visit to have an abortion if you didn't have any insurance — if you can't get on Medicaid because you make "too much" money, which is really not very much at all, and you can't afford insurance and you're a person who's kind of in the middle — which is a lot of people in this country.
I think people's views on abortion are reflective of how we think about other people and how we are in connection with other people. I think it can be really easy to think that your situation applies to every other person, which it just doesn't. None of our situations apply to every other person. Every single person deserves to be able to make a decision for themselves about how they are going to conduct their life, including whether or not they are going to have a pregnancy that continues.
K: Speaking to this, I want to flesh out the idea of choice, because while it's true that people deserve to have their choices honored, we also have to recognize that under our current conditions, choice is a very complicated thing. It's so muddy. People don't really just get to choose, you know — whether that's choosing your access to birth control or insurance, as you're saying. If you're uninsured, paying for an IUD is like $1,200 out of pocket.
L: It's a ridiculous amount of money. And you can still get pregnant if you are on birth control. There are still people who can access contraception who end up pregnant.
K: People are having to make choices out of certain conditions. If you don't get to choose your housing, if you don't get to choose your employment or your career path, if you don't get to choose your education, if you don't get to choose your transportation, if you don't get to choose your health care, if you don't get any of these choices, then when you are made to make a decision, is it truly a choice?
L: Absolutely.
K: I think it also requires us to adapt a perspective of community care. I think that's something that's a very challenging idea in a very individualistic society, in a very classist society where status and control have so much power and can yield such powerful outcomes. It's necessary that we we turn inward and we look to how we can provide care for each other.
L: There is this perception that it would be really weird if I can't empathize with the person sitting next to me. That's really not an appropriate thing, and we have a word for people who can't look at other people and empathize with them. But it's OK that I can't empathize with another choice that someone's making or a decision that someone's making? I kind of view that along the same spectrum.
Like, this person is part of my community because we're all human beings living on the planet together. We all have something to offer. We all have something that, without each other, we can't get this done. And we have to be able to think about the importance of everyone's contribution and that people are not expendable.
K: Community is not a commodity.
L: So, what brings you joy?
K: I find truly so much joy being in community, and I need to be able to find and create joyful moments being in my community. How am I creating conversation with the barista when I get to my coffee in the morning? How am I saying hello to the person who's standing across from me at the gas station, as we're pumping gas into our cars? Or like, how am I creating opportunities to truly be present to build connection and to ultimately build memories in my community? That brings me so much joy. What about you?
L: I think knowing that all the work I do is inherently resistance. Whatever choice I make that day, I am part of the solution — and it doesn't have to be anything huge. I don't need to tear it all down today, but every interaction matters. The time I spend with patients matters. The time that I spend making extra phone calls, the time I spend getting somebody on the phone with the clinic to get them access, or the time I spend making sure that they have childcare or paying for this abortion. That matters, and that doesn't go unnoticed.
It really brings me joy to know that like the small things matters, the choices matter, the intent matters. It's really easy to get bogged down with like all these different things that I have responsibilities for, all these different things are hard about my job. But it matters. And even when it feels like it doesn't, people remember and they remember the effort that you put in. And that makes me know that I am doing something good that day.
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