While this article addresses pregnancy as a women’s health issue, we at The Daily acknowledge that the term “women” does not encompass all people who can and do get pregnant — nor can all women get pregnant. The full range of reproductive health options should be accessible to people of all genders.
Read the first article in the series here.
At the time of her abortion, Anne was 18 and had just started her freshman year at a school deep in the Midwest. She was already touring prospective law schools. She knew she wanted to be a lawyer for immigrants; her story would be about helping others. “I want a career,” she remembers thinking, not a baby. “I want to be a lawyer. I want to do things.”
In her dorm, Anne — whose name and other identifying details were changed for this story — met a typical, regrettable first-boyfriend-of-college. At first, she was attracted to how smart he was. But they argued constantly, and she knew their relationship would never last.
“The condom broke,” she said. “He wanted to keep it.”
It was already a rocky relationship, and when she told him she was pregnant, the arguing only got worse. Whenever Anne tried to tell him that the baby would have no quality of life with their scant emotional, mental, and financial resources, he would simply answer, “We’re Catholic. We don’t do that.”
In this sentiment appeared the age-old cognitive dissonance of young men who oppose abortion: He was the one who had gotten her pregnant and tried to shame her into keeping it, but she knew for a fact that if she had gone through with it, “he could have easily walked away.”
“I would’ve been by myself,” she said.
He told her to drop out of school to raise their family while he continued with his life unchanged, and when she said she didn’t want to, he responded, “Well, it’s not your choice.” He fought with her constantly while telling her he would never leave her. “I want you to leave, actually,” Anne remembered thinking.
She knew her deeply Catholic family would agree that it was not her choice to make. “My family is very Mexican, so, very religious,” she said.
The norm for the women in her family was to get married and have children young. “They already gave me crap for wanting a career over wanting a family,” she said. But she couldn’t fathom marrying the boy who had gotten her pregnant.
Anne weighed her options. She didn’t have a way to get to an abortion clinic near her school because there weren’t any; there were only four abortion clinics in the entire state.
But Anne’s parents knew how career-focused she was. She knew they would happily send her on a trip to tour a law school, one like Vanderbilt University Law School in Tennessee.
And what else was in Nashville? The Vanderbilt Center for Women's Health One Hundred Oaks.
So she made her decision to have the abortion there, asked her parents to book the flight, and began to save up money for the procedure, which ended up costing upward of $1000.
“I didn’t really eat much,” in the month before the procedure, Anne recalled. “I tried to save as much as possible to try to pay for it on my own,” even stealing food from the dorm cafeteria.
At one point, she tried to tell her best friend, another Catholic girl who lived in the same dorm. But the friend reacted poorly and stopped talking to Anne as a result, a devastating experience. “That’s why I don’t really ever talk about it,” she told me.
She was completely on her own.
“There was no one who was like, ‘Everything’s gonna work out. You’re gonna be OK.’”
Anne became very depressed.
And so she traveled alone nearly 700 miles to Nashville, a city she remembers as cold, cloudy, and unforgiving.
She arrived on a Monday. She went into the clinic on Tuesday or Wednesday for the ultrasound and state-mandated “in-person counseling.” Because Tennessee has mandatory waiting periods, she had to come back on Saturday for the procedure.
Protesters outside told her she was an abomination and a murderer each time.
She was 13 weeks along at that point and was told the gestational ban began at 15 or 16 weeks. She recalled the male doctor chastising her: “You waited until the last minute.”
They showed her the ultrasound. She remembered feeling overwhelming sadness looking down at the tiny figure in the photograph before handing it back.
The nurse sat her in the stirrups and spoke to her in Spanish, comforting her. It was a vacuum aspiration procedure. The nurse held her hand. “It felt awful.” She heard the vacuum start.
It felt like someone was pushing down on her stomach with excruciating pressure. After the procedure, the doctor walked out of the room in silence. Anne waited in the room. The nurse brought her Sprite for the nausea. “To this day, I still can’t drink that fucking soda.” She threw up on her way back to the hotel and bled for a week.
When she got back to school, “I just did homework and shut down, honestly.” She didn’t have coping mechanisms or anyone to turn to and talk about what happened.
“I felt like a terrible, awful human being,” Anne said. She didn’t regret the abortion, but she couldn’t continue on pretending that she was all right. “I felt like I was worthless. I felt so, so alone and so overwhelmed.”
Anne left the university at the end of her freshman year.
Few people know that the rationale behind the Supreme Court’s 1973 decision to protect abortion, known as Roe v. Wade, included a frank discussion of maternal mortality. The fact was (and remains): The inherently non-zero odds of a woman dying during pregnancy or labor were too high for the Court to feel comfortable allowing the state to force someone to go through with a pregnancy.
“Roe v. Wade was initially argued [with the idea] that for every pregnancy, a woman takes a risk with her life,” Thomas Easterling, a physician and high-risk obstetric specialist at UW Medical Center, said. Easterling retired late last year after working with women with medically-complicated pregnancies at the UW since 1985.
“There’s a maternal mortality [ratio] that is measurable that you probably can’t get below: six to eight per 100,000,” Easterling said.
In reality, the American maternal mortality rate is much higher than this supposed lower limit, at 19 maternal deaths per 100,000 births in 2017, the worst of any developed nation in the world. For Indigenous women, this rate is about 33, and for black women, it’s 43, according to the Centers for Disease Control and Prevention. (For reference, Syria’s maternal mortality ratio was 31 in 2017, six years after the start of the nation’s brutal civil war. In the Gaza Strip and the West Bank — also active war zones — it was 27.)
Last spring, nine states across the American South and Midwest — Utah, Missouri, Kentucky, Ohio, Arkansas, Louisiana, Mississippi, Alabama, and Georgia — passed bans placing extreme limitations on abortion. (Alabama tried to effectively ban all abortions in its jurisdiction, which was overturned at the end of October.) With this context, and because one in four women will have an abortion before the age of 45, I asked the women of the U-District community to talk to me about their abortions. I wanted to know what their experiences were, and what they thought about states limiting access to abortion in a country with such high rates of pregnancy-related deaths.
And Anne probably wouldn’t have died if she had carried her baby to term. But her life as she knew it would have been over.
According to Patricia Atwater, director of health promotion at Hall Health who spends her scant free time as a program manager at the Northwest Abortion Access Fund (NWAAF), much of Anne’s story is characteristic of many abortions. Having to cut back on food to save up money, travel long distances, and keep it all a secret to avoid stigma are all unfortunately common for many people needing abortions. Also typical, however, is Anne’s resilience.
“Pretty much every time I work with somebody [getting an abortion], they have a story where I’m just in awe of their strength and the contradiction between their experience and the narrative that we’re being presented about what abortion is,” Atwater said.
There are 70 organizations affiliated with the National Network of Abortion Funds like NWAAF. These organizations work across the United States to help people in need of abortions overcome financial and logistical issues.
Even in Seattle, which Atwater likes to refer to as a “destination abortion city” because of its prevalence of second-trimester abortion providers, there are some severe issues of access.
“We do not have any legislated restrictions on abortion on the books in Washington state. So most states have some combination of waiting periods, informed consent, parental notification, caps on gestational age so you can only seek an abortion up to a certain time in the pregnancy — we have none of those things,” Atwater said. “But we do have access issues. And they can make it very difficult … and very challenging and emotionally exhausting to seek abortion care.”
She told me the story of one woman who had recently come to see her, who had both a developmental and a physical disability, as well as some addiction issues.
The woman had Medicare, federal health insurance for disabled people and elderly people that is subject to the Hyde Amendment, which prohibits federal dollars from being spent on abortion except in cases of rape, incest, or endangerment to the mother’s life. The woman was already 24 weeks pregnant.
So while NWAAF decided to try to enroll the woman in Washington state’s pregnancy medical coverage program, “it was hurdle after hurdle after hurdle,” Atwater said. “This is a $4300 procedure … and this is a person who — she told me she had two dollars in her bank account.”
But the NWAAF was committed to getting the woman, who lived on Whidbey Island, to her appointment. “We were like, how are we going to get her to her appointment? Where is she going to stay? Her appointment was in Tacoma. We ended up putting her on an airport shuttle to Sea-Tac and then putting her in a Lyft to Tacoma.”
Like Anne, they had to get creative with their transportation options for the woman.
“We’re really harming ourselves in so many ways by not treating people with compassion,” Atwater said. “People shouldn’t have to be going through these things on their own.”
But not everyone has access to a fund like NWAAF; Tennessee only has one abortion fund registered with the national network.
When Anne left Tennessee, a part of her knew she had to get as far away from her trauma as possible. She headed to the west coast to stay in southern California, where she lived for over a year.
She took some time to heal from the shame and depression. And when she was ready, she decided to give school another try, this time at the UW.
When she came in and talked to me, Anne knew why she was there.
Before her abortion, she had never really thought about how important it was. She has a matter-of-fact way about her. Even while she talked about some of the most traumatic days of her life, she carried herself with a lightness about her. She cried, too.
She had seen the news, and with a strong conviction, she came to me to tell me her story and why it is vital that abortion remain legal.
You could count on one hand the number of people who knew about Anne’s abortion until she reached out to me for this story: The nurse, the doctor, and the receptionist at the clinic of her abortion, and her friend and her boyfriend at the time.
Anne hadn’t told a single soul since her friend and boyfriend at the time shunned her, but before our interview, she opened up to her current boyfriend. She said that talking to him about the experience is what healed her the most, because he reminded her that she wouldn’t be doing the immigration and asylum work she does now if she had had the baby.
But, like most things she does, she didn’t speak up for herself alone. She opened up a Pandora’s box of shame, guilt, fear, and painful memories, hoping this story would give others the strength to speak about their own stories, too.
She asked herself, “What if I didn’t have that chance?” She hoped that if more women came forward with their stories, it would show legislators what a vital resource abortion access is.
According to The Cut, the same year Anne got her abortion, 33-year-old Purvi Patel was sentenced to two decades in prison after Patel self-aborted with pills she obtained online in Indiana in the spring. That winter, self-described “warrior for the babies” Robert L. Dear Jr., shot 12 people at a Colorado Springs Planned Parenthood, killing three. The following month, a 31-year-old woman in Tennessee named Anna Yocca was charged with first-degree attempted murder for trying to self-abort with a coat hanger.
Do you have a story you think should be told?
Reach Investigations Editor Manisha Jha at firstname.lastname@example.org. Twitter: @manishajha_