To Push Back Against Mounting Restrictions, We Must Be Honest About Abortion Care

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Commentary Abortion

To Push Back Against Mounting Restrictions, We Must Be Honest About Abortion Care

Pratima Gupta

As a provider, I will celebrate the anniversary of Roe v. Wade by discussing abortion in order to highlight just how unnecessary—and potentially dangerous—the anti-choice restrictions sweeping the country truly are for women and their families.

Read more stories commemorating the 42nd anniversary of Roe v. Wade here.

Mindy Kaling, creator and star of the Mindy Project, recently generated controversy by saying that abortion was too serious of a topic to address on her sitcom, a comedy about a South Asian OB-GYN who is also named Mindy. I share with the fictional Dr. Mindy a nationality and a profession, but that’s where the similarities end: I will celebrate the anniversary of Roe v. Wade by discussing abortion, in order to highlight just how unnecessary—and potentially dangerous—the anti-choice restrictions sweeping the country truly are for women and their families.

I agree that abortion is a serious issue, in that the decision to become a parent is a serious one. But considering how critical it is for people to be able to make their own choices about what is best for them and their families, we must be honest about what abortion truly entails to push back against the limitations forcing reproductive health care out of reach.

I’ve watched as, one by one, our country elects legislators who vow to use their power to restrict abortion access. It used to be that lawmakers who were trying to interfere with reproductive rights would use morality as their basis, trying to apply their religious standards to the rest of us. Their tactics have shifted; now, they make all kinds of false assertions about protecting women and families. As an abortion provider, though, I know the procedure is extremely safe. In fact, an abortion has a lower complication rate than a colonoscopy, for which I refer all my patients older than 50. I work with those patients to determine the course of treatment that is best for them; the situation is the same for those seeking abortions.

Roe is gone. The chaos is just beginning.

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I am infuriated by the spiteful policies imposed on abortion providers that are designed to force us to close our doors, such as requiring ambulatory surgical center standards or hospital admitting privileges. These bills upset me not only because they decrease access, but also because they ignore the very real fact that abortion providers are already providing high-quality follow-up care. Legislators continue to assert they’re trying to keep patients safe, while falsely implying that the services I provide are inherently dangerous and limiting options for people in need.

Prior to performing an abortion, I review all pregnancy options, including continuation of the pregnancy and adoption, with each patient. In addition, I allow family or friends to be present for this process so that everyone’s questions can be answered in a medically accurate and comprehensive manner. While complications are rare, I elucidate the different possibilities and how we might respond to each situation to ensure the continued health of my patient. Yet around the nation, bills are also being pushed that include mandated scripts with medically inaccurate information. I am so upset that politicians think they should mess with the relationship and unique trust that a patient has placed in a doctor. Rather than empowering women to make a strong decision with the support of their medical provider, these abortion counseling mandates serve to discourage women from seeking abortion services by lying to them and scaring them.

These lawmakers seem to believe that our patients themselves need legislation to inform them about their different options. In reality, though, they are often media-savvy and ready to make their own decisions—and if they aren’t, I and my expert colleagues are the ones who should be advising them, not someone in a statehouse. A few days ago, a woman I’ll call “Kelly”—with a delicate nose piercing, wavy blond hair, and skinny jeans—came to me as a new patient. I provide Pap tests, prenatal care, and abortions all in the same setting, because all of those services are normal procedures that should require the same kinds of dignity and individual attention. Kelly, who had recently obtained insurance through her job, was excited and nervous about getting her first gynecological exam in many years. Her period had been late, but she’d thought nothing of it, because school and work had frequently caused irregular cycles. When she learned she was pregnant, she was shocked and resolute about her decision to terminate it.

When I counseled her about her pregnancy options, she was relieved that she would not have to navigate yet another system for services. As I performed an abdominal ultrasound on “Kelly” in preparation for her procedure, she asked, “Dr. Gupta, do I have to see the photos? I really don’t want to.” Kelly, like many of my patients, was an experienced consumer of health media, and she had seen reports of legislation requiring providers to force patients to view ultrasound images, or perform vaginal ultrasounds, or read aloud state-approved scripts—all non-medically necessary attempts to limit Kelly’s right and access to safe abortion.

Fortunately for both me and Kelly, that is not the case in California, where I practice. In fact, the state is one of the few places where there have actually been proactive advances in reproductive health. Certified nurse midwives, physicians assistants, and nurse practitioners (collectively known as advance practice clinicians) can now train in and offer first-term surgical abortions; minors can ensure confidentiality while seeking reproductive health services; and a provision requiring insurance coverage of all FDA-approved contraceptive methods with no cost-sharing was recently passed. California is truly a model of safe abortion care and increasing reproductive health-care access for the rest of the country. That being said, not all Californians can even access abortion care easily, for there is an undue burden placed on women living in rural and low-income areas. The anniversary of Roe v. Wade is a good reminder to all reproductive health advocates that we must continue to collaborate to ensure medically accurate, readily available care for women and their families.

In addition, the anniversary should also be a reminder to us that we are dangerously close to reversing the right to privacy enshrined in Roe. I am also an educator of OB-GYN residents and medical students, and most of them are in their twenties and never saw an OB-GYN hospital ward before Roe. In fact, during a recent lecture I gave, they had to look up “septic abortion” on their smartphones; not a single individual had ever encountered a patient with post-abortion sepsis. This is yet another example reinforcing how safe abortion is now. Women aren’t dying from abortion like they did in the bad, old days before Roe v. Wade.

While some people may roll their eyes at the supposed entitlement of this generation, I prefer to say many are enlightened and invigorated by the mothers, sisters, wives, and daughters who lost their lives through personal sacrifice. That history is also why I continue to help families and provide abortions—and that I will continue to do my job to the best of my ability despite mounting restrictions.