“How does it feel to provide abortions while you are pregnant?” a team member at the abortion clinic where I work asked me one day. “Does it feel … weird?”

I responded half truthfully: “No.”

Many of my patients are going through incredible emotional struggles. So I had wondered at first if my visible pregnancy might cause them further distress, and prepared myself for negative reactions. Instead, everyone congratulates me, and patients often want to know every detail of my pregnancy. Despite our different circumstances, talking about my baby allows my patients and me new opportunities to connect and bond.

Being pregnant does not change my ethical understanding of abortion, but it does give me a new perspective. The bigger my belly becomes, the more I realize how our differing circumstances shape our choices.

Multiple people have told me that providing abortions while nurturing my own baby inside me must present a moral conflict. Those people don’t understand that my baby has nothing to do with my patients. The people who come to me for abortions cannot become parents at this time for their own perfectly valid reasons. Their situations are different from mine.

Most people in the United States who have abortions already have one or more children. They have experienced the joy of parenting, but are not ready or do not want to become parents again. I am a parent who is currently pregnant. I know firsthand how much energy and time pregnancy and parenthood require. Forcing the responsibility of supporting a life onto someone who does not want to be pregnant or become a parent is unhealthy for both the parent and the child. Rather than being “anti-family,” people who seek abortions are protecting their current and future families, whatever that looks like.

 

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Racist systems, structures, and restrictions can force people to parent or not parent, regardless of their actual preferences. Based on financial status, race, and access to resources and support, there are inequities in accessing pregnancy care at all stages: prenatal care, birth care, post-birth care, and abortion care.

But biased access does not have to be our reality. Increasing access to contraception and abortion will improve outcomes in all communities. People should be able to choose when or whether to expand their families without concern for financial costs. Currently, federal money is barred from funding abortion care, which means people on Medicaid and other people who receive health insurance through the government, like military personnel, have to pay for abortion care out of pocket. Meanwhile, insurance fully covers prenatal care. This policy eliminates choice and disproportionately hurts people with low incomes, and Black and brown people. It worsens existing inequities.

Many of my patients receive insurance through Medicaid, and without insurance coverage of abortion they often struggle to pay for it. This can mean delaying the procedure until they have enough money, or forgoing anesthesia to make the procedure less expensive. In some cases, it even means continuing an unwanted pregnancy and giving birth.

We can resolve this by eliminating the Hyde Amendment, an annual legislative rider that bars federal funding for abortion. We can pass legislation like the Pregnant Workers Fairness Act so that people who do choose to become pregnant have the protections they need in the workplace to continue earning wages while staying safe and healthy.

I’m grateful to provide my patients with abortion care while I am pregnant. Everyone, regardless of whether they choose an abortion or to continue their pregnancy, deserves equal access to necessary health care that affirms their life decisions.