You're the Only One I've Told

The Stories Behind Abortion

Meera Shah

• Publisher: Chicago Review Press
• Year: 2020
• ISBN:
  9781641603669
• Edition: 1
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

"Moving, multifaceted, and deeply human...as eye-opening as it is compelling" —Cecile Richards, author of Make Trouble At a time where reproductive rights are at risk, these vital stories of diverse individuals serve as a reminder of the importance of empathy, finding community and motivating advocacy For a long time, when people asked Dr. Meera Shah, Chief medical officer of Planned Parenthood Hudson Peconic, what she did, she would tell them she was a doctor and leave it at that. But when she started to be direct about her work as an abortion provider an interesting thing started to happen: one by one, people would confide that they'd had an abortion themselves. The refrain was often the same: You're the only one I've told. This book collects these stories as they've been told to Shah to humanize abortion and to combat myths that persist in the discourse that surrounds it. A wide range of ages, races, socioeconomic factors, and experiences shows that abortion always occurs in a unique context. Today, a healthcare issue that's so precious and foundational to reproductive, social, and economic freedom for millions of people is exploited by politicians who lack understanding or compassion about the context in which abortion occurs. Stories have the power to break down stigmas and help us to empathize with those whose experiences are unlike our own. A portion of proceeds will be donated to promote reproductive health access.

1

Sara

(Pronouns: she/her/hers)

After nine months, living together had become a problem for Sara and her partner, Chris. Living in a 530 square foot apartment in Austin, Texas, would be hard on most couples, but for Sara, the apartment felt like it vibrated with stress and constant arguments.

On the fewer good days, it was filled with the laughter of Chris’s two children from a previous marriage—a boy and a girl, both under ten—or the sizzling sound of beef for Taco Tuesday. Other days it was the light, plucky notes from one of Chris’s ukuleles, borrowed from their usual perch on a wall in the living room. The apartment had never felt like Sara’s space, though. She had moved into someone else’s home, and she was struggling to adjust. Complicating things further was this new co-parenting role, the stress it put on both of them, and Sara’s realization that she didn’t always like the way Chris spoke to or disciplined his kids.

When Sara and Chris first met, as coworkers at an Austin-based education start-up, Sara had been in the process of restoring a vintage 1989 tow-behind travel trailer. “I was recently inspired by an HGTV small home bender,” she explained. She’d lived all over the country, skipping from San Francisco to New York to Atlanta to San Diego before finally landing deep in the heart of Texas. Meeting Chris and his kids had been further reason to set down roots.

She’d purchased her new home on wheels from a pair of aging hippies and was slowly restoring it on their property while she lived in an apartment nearby. Something about the stability of home with the flexibility to travel anywhere in the country appealed to her. It was the best of both worlds.

In her mid-thirties, Sara is the kind of woman who wears a lot of flannel and not much makeup. She has long, golden blonde hair she parts on the side and the kind of milky, just-scrubbed skin that’s reminiscent of high school photographs from the 1970s. She’s the kind of woman who might wear feather earrings or who will offer to read your tarot cards and insist that you have “great energy.” She reminds you of that cool camp counselor—the one who made the best s’mores, who knew all the risqué campfire songs, and who later, once the young campers had turned in, was the first to pass around a joint or two among her fellow counselors.

It took a few tries on Chris’s part, but eventually he got Sara to notice him. They danced at the company Christmas party, got drunk at an after-work happy hour, and eventually Sara went home with him one night when the kids were at their mother’s. They cuddled and kissed, enjoying the blissful beginning of their budding romance. A few days later, she thought to herself, OK, the honeymoon phase is over and shit, this is real life. Sara’s logical side took over. She wasn’t here to waste this man’s time—and she didn’t want to waste her own time either. She wanted to know if he wanted more kids. She wanted to know how he voted. She wanted to know if he saw himself getting married again. Her thinking was: If there were any deal breakers, they’d need to put it all in the open now rather than mess around and make things awkward at work. If only she could have seen into the future then, to know just how bad things might get.

When it became clear that this was not just some fleeting fling, Sara moved into Chris’s tiny house and set up her trailer in the yard. Chris and his ex-wife, Julie, shared custody 50/50, which meant Sara and Chris were on a constant carousel that alternated between days when it was just the two of them and days when the stress of parental duties loomed large. Home life could be chaotic as they rushed to prepare the kids for school or bed, slogged through homework and bath time, and dealt with kids who were coming into their own, pushing boundaries and testing the patience of their caregivers. The kids were also navigating two households, two sets of boundaries, different levels of patience. Sara was given a clear picture of the kind of father Chris would be and the exact parenting life that she would have with him. How many women can say that about their partner? She didn’t need to wonder. Here it was right here, all laid out for her. The trouble was she didn’t always like what she saw. “I thought he was a shit parent at times,” she told me. He lost his patience easily or let his own stress set the tone.

Sara had leaned into her instamom role, reading all the parenting books and cramming hard as if studying for a midterm. She read How to Talk So Kids Will Listen and Listen So Kids Will Talk cover to cover because she was determined to crack the code of parenting. She had never really been sure about becoming a mother to her own children, but playing the role of stepmom was helping her figure that out. She was determined to get it right. Chris had been learning on the go for the past decade and, as is often the case, was too caught up in the patterns he’d already established to take a step back and evaluate how things were going. The addition of Sara, with her suggestions and new perspective, was a wrench in the whole system.

It was like having two completely different relationships: Sara and Chris with the kids, then Sara and Chris without them. It was exhausting.

They fought about co-parenting and their differing approaches a lot. To make things worse, Sara and Chris didn’t have their own room. They didn’t even have a door. Instead, they slept on a lofted bed in the kitchen, built to make room for the baby grand piano that stood underneath—a family heirloom that Chris cared about deeply. It had been an ingenious feat of engineering on Chris’s part, built out of frugality and necessity, and hadn’t been a problem when he lived there on his own with the kids. But now, with Sara in the mix, the whole thing seemed slightly ridiculous. Sara was tired of fighting and of sleeping across from the fridge. She needed some space, fast. So she moved out.

As daily stress about her relationship as well as a big project at work grew, Sara started to feel sick to her stomach. The nausea was similar to what she typically experienced during other times of stress, so she brushed it off. She tried to work through it, but it was so persistent and insufferable that she eventually decided to see her primary care doctor. She got a prescription for an anti-nausea medication and Xanax. But they weren’t helping. Two weeks later, she returned to her doctor’s office because her fatigue and nausea were worsening and she realized the cruelty of bad timing: she was pregnant.

Sara had been on her period the last time she and Chris had had sex. She wasn’t aware that she could become pregnant if she had sex while on her period, a common misconception. I also see patients who bleed during their first trimester, which makes them think they aren’t pregnant when they are. Bleeding and cramping can happen even in a normal, healthy pregnancy.

When Sara heard the news, she felt numb. She sat frozen in the exam room until finally, the reality of her situation hit her. She was unsure about her relationship, she’d been increasingly unkind to her body over the course of the last few years, and she was living in Texas—one of the most conservative states in the country. She began to cry.

Sara will be the first to acknowledge that her relationship troubles weren’t one-sided. Often in search of an escape Sara would self-medicate with alcohol and weed, anything to unwind, relax, and check out for a little while. But it had become a bit of a problem. She wasn’t in her twenties anymore and couldn’t laugh off the destructive behavior as being young and carefree. Now thirty-two, she realized how harmful it was, not only to her but to the mass of cells quickly multiplying in her uterus. Her body seemed to agree.

The morning sickness was unbearable. Everything made her nauseated. She couldn’t go more than a couple hours without throwing up. Her long, shiny hair grew slick with sweat as she kept it piled out of the way on the top of her head. She was weak and shaky; it felt as if her entire body was trying to turn her inside-out.

Her new apartment wasn’t making things any easier, either. The slipshod renovation had included a particularly toxic kind of enamel spray over the tile work in the bathroom—she’d had to sign a consent form about it—plus a coat of fresh paint and the accompanying fumes. It was all just too much to handle while pregnant. She kept the windows open all the time—in February. Luckily, Texas winters can be pretty forgiving.

She wasn’t even sure she wanted to be with Chris, let alone have a baby with him. She’d had a glimpse of the kind of father he’d be, and while at times she didn’t like his parenting style, she couldn’t deny that he was deeply devoted to his children. He’d fought hard for that 50/50 custody, and he’d do the same again if things didn’t work out with her. It would keep her tethered to Texas, and to him. Having a baby with him right now, having any baby right now, was a bad idea. She wanted to have her mind made up about their relationship before she brought a baby into the picture. Sara was grateful to have options. And despite their challenges, and the awful timing of it all, Chris supported her.

“This is your decision and I’ll support you no matter what,” he told her. She was grateful for his self-awareness, articulating to her that he understood why she might not want to have a child with someone who was a “jerk parent.” But he was working on it. “He got divorced early on in the girls’ lives and so he approached parenting from a survival perspective. He didn’t have much financial or familial support,” Sara told me. And though she’d moved out, they were still talking, still trying to make their way through everything as best they could. They cared about each other deeply and were doing the hard work at trying.

When Sara asked about terminating the pregnancy, her doctor wasn’t able to provide her with much information. This was Texas after all, a state with some of the most stringent antiabortion legislation in the country. Sara’s doctor, a woman in her thirties, wasn’t even sure what the current laws were and how they might affect or limit her options. She also wasn’t sure who or where the local abortion caregivers were. This is not uncommon. Primary care physicians are often not equipped to counsel people about their options or provide a referral if they are seeking an abortion.¹ Dr. Jessica Beaman and Dr. Dean Schillinger coauthored an opinion piece in the New England Journal of Medicine arguing that primary care doctors must be more involved in abortion care.² Some primary care doctors just don’t know the laws, but I have had patients tell me that they’ve seen doctors who’ve given them false information about abortion. Recently, a patient told me she saw her regular gynecologist for a checkup after she had an abortion at our health center. Her gynecologist told her that she would never be able to have children again because abortion causes infertility, which is not medically accurate information. My patient was devastated—she was fifteen. And so was I. Patients deserve accurate information from their doctor. Anything else is unethical. Sara was fortunate to have seen a doctor who shared her perspective and provided unbiased care.

Sara and I had met once through friends a few years back. She remembered that I was a doctor who provides abortion care and had briefly worked in Texas. She got my number from a friend and gave me a call. We talked about how she was feeling and what the process of getting an abortion in Texas would involve.

A few days later, it was clear that an abortion was the right thing for her to do. When she told her parents, they were immediately supportive of her decision, even though sex and reproductive rights weren’t necessarily topics that had been discussed in her family while growing up in the suburbs of St. Louis. On Sundays she went to a Presbyterian church and during the week attended an all-girls Catholic high school. Still, being in support of reproductive health was something she’d felt from an early age, thanks in no small part to her “badass” breadwinner mom, one of the only female researchers at a pharmaceutical lab in St. Louis. And though they may not have had any outright conversations on the topic, they didn’t need to. Sara’s mom worked hard to excel at her career, inverting the stereotypical gender dynamic and allowing Sara’s dad to stay at home. As if by osmosis, her mother’s ambition, her ideals, and the sense that a woman should be in charge of her own body was imbued in Sara. Without discussing it outright, she knew that her mom supported abortion access and that therefore so did she.

One day when Sara was in the third grade, this newly formed belief was suddenly put to the test. While at her friend Kerry’s house, instead of playing Skip-It or dreaming up new recipes for their Easy-Bake Oven, they sat in the formal living room, drinking Capri Suns and debating abortion. Sara said she was pro-choice, while Kerry was not. They got so mad at each other, and the debate became so heated, that Kerry wound up dragging Sara through the room by her ponytail and out the front door, where Kerry promptly locked Sara out of the house. A political science professor at Boise State University discovered that the stronger the parent’s political belief, the more likely the child is going to inherit that belief.³

The abortion debate in Texas has always been a fierce one. What would it be like getting an abortion here? Would there be protesters? Questions swirled in Sara’s mind, and the fear of what awaited her—not the procedure necessarily, but the people who might try to stop her—made her uneasy.

The governor of Texas, Greg Abbott, has made repeated attempts to target abortion access for Texans since he took office in 2015. My colleagues working in Texas have fought hard to stop his restrictions and have often won. Sara felt the stress and stigma from these policies. Even before becoming law, attempts at restrictions affect patient care in a very tangible way: they make people afraid of trying to receive care and confused about limitations on what care they might be able to access, which delays care or prevents them from seeking it altogether. In 2016, the governor approved a rule that would require any health centers performing abortions to cremate or bury fetal tissue. This law was later blocked by a federal judge. In 2017, Governor Abbott signed a law banning second-trimester abortions, which a federal judge also blocked from moving forward. And later that same year, the governor signed a bill to limit insurance coverage for abortions, with no exception for rape or incest. The antiabortion climate felt real and scary for Sara. “I didn’t know how all this would affect my abortion experience,” she said to me.

This is not just the case in Texas. In New York, I have patients tell me that they are pregnant and not ready to become a parent or don’t ever want to become a parent but genuinely have no idea if abortion is even legal in the United States. We must do a better job of making sure patients know what their options are. The antiabortion movement has done an incredibly effective job of disseminating false information about abortion care, so a simple Google search can leave people confused. In 2019, Google Ads announced a new policy that requires advertisers wanting to run ads using keywords related to abortion to first be certified as a place that provides abortion to distinguish them from places that do not.⁴ While this was seen as a win, actual websites can still be difficult to discern as real or fake.

Sara had booked the appointment at Whole Woman’s Health Alliance in Austin, a health center that provides abortion care, and her mother was on her way down from Missouri to take care of her and guide her through the whole process. While Chris knew about the abortion and had been supportive of Sara, she didn’t want him to come with her. “I wanted a woman to come with me; I wanted my mom,” she said. Sara couldn’t have been more grateful to have her mom there for the procedure.

Whole Woman’s Health Alliance had just reopened their health center in Austin after being shut down by laws that are explicitly written to target health centers that provide abortion care. These laws impose arbitrary criteria that make it difficult for them to remain open. In this case, these laws required that physicians who provide abortion services have admitting privileges at local hospitals (which some hospitals are not willing to give to those providing abortion) and that health centers meet the requirements of ambulatory surgical centers (wide hallways, deeper or wider sinks, and more). Neither of these requirements are based on medical evidence or make patients safer. Abortion already has an excellent safety record. Unfortunately, laws like these are successful at closing down health centers that provide abortion care. Texas once had forty-two health centers providing abortion care, but after these laws went into effect, the number dropped to nineteen.

Whole Woman’s Health challenged th...

Table of contents

• Cover
• Title Page
• Dedication
• Copyright
• Contents
• Introduction
• 1. Sara
• 2. Rose
• 3. Paige
• 4. Alex
• 5. Mary
• 6. Luna
• 7. Vandalia
• 8. Desiree
• 9. Gwen
• 10. Kham
• 11. Mateo
• 12. Charlotte
• 13. Maya
• 14. Hannah
• 15. Noor
• 16. Jane
• 17. Sally
• Call to Action
• Acknowledgments
• Notes