In 1973, Jane Roe needed an abortion. She couldn’t access one in her state (Texas, where abortion was illegal except to save the mother’s life) and so Roe carried to term and gave her child up for adoption. Then, she sued Texas.
Roe v. Wade made it to the Supreme Court, which 42 years ago today ruled 7-2 that a fetus is not a person: The decision to abort belongs to a pregnant woman alone. This landmark decision affirmed that every woman in the U.S. has the same right to an abortion during the first two trimesters of pregnancy “as she has to any other minor surgery,” TIME wrote of the decision in 1973.
Today, that right is under attack. As the legal battle over abortion plays out on the national stage, we often lose sight of what this procedure looks like on the ground. Individuals across the country are working tirelessly behind the scenes to ensure that women who need abortions can access them. We spoke with five of these workers — a doula, a counselor, a clinic escort, a doctor, and a practical support volunteer — about what they do, why they do it, and their takes on the future of women’s reproductive rights in America. Whatever your stance — pro-life or pro-choice — you’ll want to hear what these five women have to say. Read on for their stories.
Randi is a counselor at Planned Parenthood.
When I started social work school, in my first-year internship field placement, I decided I wanted to give reproductive rights a try. I got really lucky and was placed at Planned Parenthood in Manhattan. I’ve been here ever since, and that was 14 years ago. I’m really passionate about working with women and working in health care. [This is] both together: working for reproductive rights, with women, on the front lines of clinical services. It’s always been rewarding.
Patients go through a series of steps when they’re here, depending on what service they’re here for. My role is to help facilitate their service throughout the day. Their counseling session includes reviewing all of their options: parenting, adoption, and their option to choose to have an abortion. It includes discussing all of their birth-control methods — we encourage women to review all of their options and hopefully leave our center with an effective method that is right for them. We review all of their options if they do decide to choose to terminate their pregnancy — whether that’s a procedure in the clinic or a medication abortion. That includes what support system they have, making sure they’re in a safe relationship, [education about] sexually transmitted infections, safe sex — all of that gets included.
I’m the senior director of social services, so I oversee all of the social workers and the counselors for Planned Parenthood of New York City. But, I actually spend four days out of my five per week directly counseling patients as well. We have patients who do have very difficult situations, whether they’re currently looking for a place to stay, or they’re in a difficult relationship, or they’ve disclosed a history of sexual assault or abuse. Those are the patients that are often referred to me. I can help them with the service they’re in the clinic for that day, but I also help them navigate everything else, even referring them to appropriate places — for mental health counseling, or for rape crisis or domestic violence counseling, or even to help with housing. It’s this cross between helping them through what is often an unplanned pregnancy and helping them navigate other things that are going on, which they might not have a chance to talk about with anybody else.
Having a counseling session never means that a patient’s decision is going to be questioned, or that it’s a time where they have to defend themselves. It’s always just an opportunity to get education, to get more information, to discuss options, and just to make sure that the patient is making the right decision for them. This decision is very personal… I think being nonjudgmental and supportive are the two most important things that most women really appreciate. Planned Parenthood and lots of other organizations are available every day to help women when they need it.
Dierdre is a practical support volunteer at ACCESS.
I had been a clinic escort for a number of years, but when I moved to California I realized there wasn’t the need for clinic escorts… I wanted to find something else I could do, to sort of put my money where my mouth is. It’s always been super important to me to be active in reproductive rights and reproductive justice, [more] than just sending a check now and then.
I met a women who worked in reproductive health and research, and she was talking about ACCESS, so I called them and said I wanted to volunteer. I’m still volunteering there, and it’s been at least six years. What I’m involved in is practical support… A lot of the women whom ACCESS serves are women from other parts of California who are too far along to get an abortion at the clinic nearest to them. In California, there’s only one hospital in the entire state north of Los Angeles that takes Medi-Cal and performs second-trimester procedures. For a lot of women from other parts of the state…it takes them so long to save up the money for the procedure that they’re chasing the price. By the time they have the money saved up, San Francisco is the only place they can come. I should also mention that a second-tri procedure is a two-day procedure. You go in the first day and they dilate the cervix, and then you come back the next day for them to complete the procedure. These women need a place to stay overnight, so that’s what I do. I host them in my home, on my futon.
It’s just incredibly gratifying because it’s very tangible — something concrete that I can do to make a difference in one person’s life. It’s not vague or amorphous at all. I am giving these women a place to sleep when they are often in a lot of discomfort. It’s not a comfortable thing, to have your cervix dilated. I’ve had women be in so much discomfort that they come in, take their painkillers, and go right to sleep. I had one poor woman who did not react well to the pain and the painkillers, and she spent half the night throwing up in my bathroom. I felt so bad for her. For the most part, we sit on the couch, and I learn a little bit about them and their lives, and they learn a little bit about mine… What I do is a drop in the bucket, but at the same time it’s everything.
Kathleen Morrell, MD, MPH
Dr. Morell is a board-certified OB/GYN and Reproductive Health Advocacy Fellow at Physicians for Reproductive Health.
I was raised Irish-Catholic. I went to Catholic schools my whole life, including college. But, my house was much more focused on the social justice aspect of Christianity and Catholicism. I’m not a practicing Catholic anymore, but those social justice things are very instilled in me. I grew up in an incredibly small, poor, conservative town…it became clear to me that other young women didn’t have strong female role models like I did. I remember very vividly a conversation I had with my mother… I was talking about how my doctor was a family medicine doc and he had a lot of female physician assistants in his office — and I said to [my mother], “I want to be a physician’s assistant,” because those were the female role models I saw. She looked at me and said “You know, you could just be a doctor.”
So, I went to medical school…and did a summer of research in New York and exposed myself to abortion care. I wanted to know if I could handle it. Even though you intellectually want to be involved in it, it doesn’t mean that you can actually physically handle it. I was able to expose myself [to it], and it all worked and clicked. It’s almost like when people talk about how they love delivering babies because it’s an incredibly powerful time in someone’s life, and they’ll never forget it and they always remember who the person was that did it. I kind of feel the same way about abortion care. I am playing an incredibly important role in that one day.
I would say that the number-one myth [about abortion] is that it is not safe. That it will affect [women’s] ability to have children in the future. One in three [women] are going to have an abortion in their lifetime, and if one in three women started to become infertile because of their abortions, we’d have a huge drop in population! The math doesn’t add up. It’s a huge myth that is clearly perpetuated, because my patients will repeat it to me all the time.
One of the things that is always striking to me is how different each patient is. I hear politicians make sweeping statements about abortions and I’m like, “You have no idea what you’re talking about, because I’ve seen every single type of woman in my office, with every single type of problem, with every single type of reaction.” No woman reacts the same way. I just see women. I think my number-one worry is that it’s going to take women dying for people to realize what restricting access state-by-state is doing.
Sarah is an abortion doula with The Doula Project.
I did social work for a long time, and when I moved out of that field, I was still looking for a way to do work that felt necessary. I was looking for a way to get more involved with the reproductive rights movement. Those two things met really well in doula work.
The training that we go through as doulas is pretty exhaustive. It’s around 40 hours and The Doula Project itself does that training. We also do birth work, so we use a lot of similar techniques that birth doulas use…physical support, emotional support, verbal support if that’s what the client is looking for. We [learn to] ask what our clients need in the moment [and to] support them in the best way that we can.
Basically, my job is to love people unconditionally in 5-10 minute increments, which is about how long a first-trimester procedure takes. Depending on the clinic that we’re in, we will go into the room with the patient, we’ll help them get settled, get comfortable. Depending how long it takes the doctor to come into the room, we might be making small talk with them. Sometimes, people don’t want to talk at all, which is totally fine. People usually don’t want to talk about their emotions, if they have any, around the procedure, which is also obviously fine. Then, the doctor comes in, the procedure happens, [and] we’re right next to the patient during the procedure, again offering physical support if the client wants that, or verbal support… Then, they go into the recovery room, and that’s pretty much the end of our relationship with that person. We don’t have to solve anyone’s problems — we just have to be very loving and in the moment, which I think is a great job to have.
For a lot of people, the procedure is not a big deal. But…some people are going in with some really conflicted and painful emotions. Sometimes, they wanted a pregnancy, but they just don’t have the resources to continue… A few times, especially with people who are very religious or just really conflicted with the decision, I think it’s been really helpful for them to have someone say “You’re not a bad person, you’re making the right decision, and I care about you.” One of the great things I learned from one of our founders [is that] when people ask her, “Do you think God will forgive me?” she responds, “Well, do you believe in a forgiving God?”
I think care is a basic right, and being loved is a real, universal human need. That certainly applies to the birth work that we do, too. Having someone there whose sole role is to support you [while you’re] undergoing this experience…their only function is to be there for you, [and that’s] really powerful for people. A lot of the people we work with don’t necessarily have that unconditional support anywhere else in their lives.
By Hayley MacMillen