Today it snowed, hard and heavy. February in Maine. I’m feeling haggard and gray, caught in the grind of unrelenting work. My pre-dawn run today was along the frozen Kennebec River. The Coast Guard is sending an icebreaker upstream to prevent ice jams and flooding. It’s Tuesday, so I drove an hour and a half to Bangor, considered “northern Maine” to everyone south of the city, but actually only halfway up the state. Women who were pregnant – and did not want to be – also drove in from all four cardinal directions. Like airline magazine diagrams showing flight paths converging on cities, I traced patients’ journeys on a mental map. Some had had abortions before; many were moms of two or three kids already. Most were trying to manage jobs outside of the house while their children were doing part- or full-time homeschooling over zoom. Three women placed the transvaginal probe themselves; the rest wanted me to do it. Today, no one wanted to see or watch their ultrasound, but everyone wanted to know about their dating and the number of gestations.
They all caught my heart. The 26-year-old woman who cried through her abortion, thick, black eyeliner streaking down her temples. Four kids already, the youngest just 6 months old. Her bearded husband stood through the entire procedure, holding her gold clutch purse against his red flannel shirt. Afterwards, in a tumble of awkwardness, he stuttered some of their story – he, a truck driver. She, going back to school. How much they love their four kids. Afterwards, I grasped his shoulder and held her hand, looking into their eyes. “You are good parents,” I said. “I know you are making this choice out of love and concern for the kids you have.”
The 31-year-old woman who disclosed her recent recovery from ten years of an eating disorder that started after a rape. Under pressure from her partner to keep this pregnancy, she was clear about needing to heal herself before taking care of another, yet so conflicted that this was her fourth visit. Finally at peace with her decision, she was calm and grateful after her abortion.
Two couples with tears and smiles. A completely nonplussed state worker who talked about her art and her dog the whole time. The teenager from far, far northern Maine whose grandmother rented a car for the day because the family didn’t have a vehicle that could make the trip.
Another woman, raised in a conservative religious family, disclosed a significant trauma history. With a lifetime of misinformation and myths about abortion, she was terrified about the procedure, yet here she was. “Will I die from this? Will you cut open my pelvis?” she asked. We talked about how she could feel empowered and safe during the procedure. I had her raise her fingers whenever she was ready for me to do the next step: wave – insert speculum, breath. Wave – wipe the cervix, breathe. Wave, cervical block. Wave for each dilator… At every step, she anxiously asked terrified questions about dying, then breathed and waved, and we moved forward little by little. At the moment I started the aspiration, she started sobbing and cried “You are the first people who have not judged me or shamed me or made me feel bad! You all are wonderful! Thank you so much!” The courage of this woman to seek and go through with the abortion she knew was the right decision for her -despite significant family/cultural judgment, a lifetime of shaming, and fears of death- humbles me.
I learned to say “cervix” and “thank you” in a patient’s native dialect. Before returning to the room from the lab, I asked Siri how to say, “You are so strong.” The patient’s face lit up in surprised pleasure when I affirmed her with words she could understand.
Abortions with pills, swallowed in person, taken home, or mailed out after tele-visits, same-day procedures with manual or electric vacuums – different means to the same end, per patient preference. How lucky we are to have options.
Now, the snow has stopped falling and the plows are out. The clinic has closed, and we have all headed home. I’m thinking about all those women who were pregnant this morning and didn’t want to be reversing their travels and spreading back out across the state. I’m picturing them arriving at their homes, greeting their kids and dogs, appreciating the snowfall, ready for the rest of their lives.
Theirs are not my stories to tell. In abortion care, I am just a passing character in a woman’s journey, a skilled technician offering a medical procedure and a kind word at what can be a stressful time. I bear witness and hold space. And yet these stories sustain me. Don’t get me wrong; I’m always grateful to be a physician – to don an N-95 and face shield for an end-of-life discussion with a patient dying from COVID, to celebrate someone’s improved a1c, to deliver wanted babies – but none of it fills me with quite as much astonishment about ordinary people’s strength as abortion care does. Sometimes I feel like I am drowning at work: a frozen EMR, an avalanche of complicated patients in 20-minute appointments, a flood of paperwork whose tide only seems to be rising. Abortion days arrive like a coast guard cutter on a frozen river, creating a path forward for me. Spring, it seems, might actually come.
About the Author
Julia McDonald (She/They) is a queer artist, writer, and physician from central Maine. They spent most of 2021 working in east Africa. You can follow them on IG (@drjuliamcdonald) and blog (https://drjuliamcdonald.wordpress.com)
Supporting Reproductive Rights
This is a critical time in our fight to preserve access to abortion and reproductive healthcare. We believe that every action counts. Here are three things you can do.
- Fight stigmatization by sharing your story and/or supporting people who have shared their stories. Supportive comments and likes make a big difference to the people who have chosen to share their personal experiences.
- Reach out to your representatives on the federal, state, and local levels and tell them that you want them to pass legislation that protects reproductive rights including abortion access.
- Donate to organizations committed to protecting access to safe and legal abortions. This writer recommended Sister Song for the work they are doing for reproductive justice.
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