Saturday, September 19, 2015

Thoughts on unplanned pregnancy and standing with Planned Parenthood

A few weeks ago, I was in a meeting in Uganda with healthcare providers, who were sharing their experiences with women who had died from complications of unsafe abortions. A nurse midwife spoke up. "I had a woman come to me last year asking me if I could help her have an abortion. I told her I do not believe in abortion and that she must go somewhere else for this thing. I turned her away. A few days later, her family brought her to me as she was dying. I could do nothing for her and I watched as she bled to death. I have never forgotten her."

This story isn't a new one. This woman is one of many. Every year, ~70,000 women die from unsafe abortions worldwide and millions more suffer from debilitating complications. But this isn't a post about abortion. It's a post about unplanned pregnancy.

I work as a sexual and reproductive health advisor for an international NGO. I spend big gobs of my time talking and thinking about contraception and how to help women have babies when they want them and not otherwise. I'm passionate about this.

Because here's the thing about unwanted pregnancy: it is always a bad thing. Yes. I'm taking an unequivocal stance on this. Sure, I know you probably have a story about your friend's sister who got knocked up unexpectedly and it ended up dragging her off a ledge of drugs and violence and turning her into a better person. Or perhaps a cousin whose unwanted pregnancy with her husband ended up bringing them back from the brink of divorce. Or maybe it's you who had an unwanted pregnancy and you'd never go back and change your life because the turn it took as a result of your experience has formed a big chunk of who you are. I get that. Good things can come out of bad things. But first and foremost, it's a bad thing to be pregnant when you don't want to be.

It's a bad thing because no matter what happens, no matter what you choose, the outcome isn't ideal. It isn't ideal to have an abortion. It isn't ideal to give up a child for adoption. It isn't ideal to raise a child you didn't want to have. It simply isn't. And because having a child, or giving it up for adoption, or having an abortion are all big, life-changing decisions, it means that no matter what you choose, your life will never be the same.

A lot of people think that adoption is the ideal. Have an unwanted pregnancy? No problem - just give it to someone who wants it. If I had a dollar for every time I heard that there are more parents out there who want all these unwanted babies, I'd pay off my freaking student loans and live happily ever after on an island in the Bahamas. Having worked for an adoption agency, I can tell you first hand that adoption may seem glossy and beautiful, but that it is entrenched in the ugliness of poverty, privilege, racism, and capitalism in ways that you could never imagine.

You look at adoption and you see babies and happy adoptive parents. I look at adoption and I see the broken, poor women left in the wake - most of whom are uneducated, impoverished, and full of mental health issues. I see women overwhelmed with their violent, hopeless backgrounds, trying to get by. I see the woman I worked with who had given up six children for adoption because her stepfather kept sexually abusing her and getting her pregnant, which she put up with so he wouldn't beat her mother. No one ever tried to help her - they looked forward to the babies (money) she would bring them when she'd come back to the agency with another pregnancy. I see the woman from Philly who we dropped off at the homeless shelter with her four and two-year old children, two short weeks after she'd given birth because she literally had nowhere else to go. I repeat: we dropped her off at a homeless shelter with her two kids. THAT is what adoption looks like to me. It looks like capitalizing on human tragedy.**

You look at keeping and you might see your cousin and her beautiful little girl, but I look at keeping and I see the three-year old girl with a huge chunk taken out of her face, the result of a smack across the face with a cubic zirconia ring on her mother's middle finger. I see a hugely pregnant woman dragging her saline drip across a hospital room in an attempt to beat the shit out of her little son who was bored and misbehaving. I see children growing up in poverty with mothers who, while they do love them, have absolutely no clue how to raise a healthy child because they are exhausted and overwhelmed and poor and, sometimes children themselves. Some research:

Children whose conception was unintentional are also at greater risk than children who were conceived intentionally of experiencing negative physical- and mental-health outcomes and are more likely to drop out of high school and to engage in delinquent behavior during their teenage years. 

Are my experiences simply the worst case scenarios? Probably not. The majority of unwanted pregnancies are experienced by poor, minority women. How about some research to go with my personal anecdotes:

"women who experience unintended pregnancies have a higher incidence of mental-health problems, have less stable romantic relationships, experience higher rates of physical abuse"

I could only stomach the adoption job for a year and trust me, a year was enough. I will never forget what I saw there.

I also worked for Planned Parenthood for a few years. I worked on a research study, looking at the efficacy of a new type of emergency contraception. I talked to women and their partners who came in to get the morning after pill. I listened to their stories. I gave them pills that prevented the thickening of their uterine walls, thereby preventing implantation of an egg. I watched the relief on their faces as they came back for follow-up and were declared "not pregnant." I saw a lot of the good work Planned Parenthood did first hand. I watched my coworkers call women back to tell them that they had cervical cancer. I watched them provide low-cost contraception to poor women and, if those women couldn't afford it, they'd provide it to them for free. I saw all types of women come in and out of the clinic, but all of them needed help and Planned Parenthood never turned anyone away.

I also went to Planned Parenthood myself. I went when I didn't have health insurance and needed birth control. I went to Planned Parenthood to get Gardasil, the vaccination that prevents cervical cancer. I wanted it, but without health insurance, I couldn't afford it. Planned Parenthood helped me to get all three vaccinations for about $50. Planned Parenthood took care of me when I didn't have other options and they gave me some of the best medical care I've received.

I watched the videos that were put out talking about fetal tissue donation, both edited and "unedited."
I felt Dr. Nucatola's flippant way of talking about fetal tissue donation was awful, unprofessional, and tragic, though it is clear, even in the edited version of this video, how she's being manipulated and pushed by her "colleagues." It doesn't impact in the least how I feel about Planned Parenthood. I support fetal tissue donation unequivocally and I wasn't bothered that Planned Parenthood was providing this lifesaving service to research facilities. As a researcher, I know first-hand how important this type of tissue can be for medical advancement. If you have questions about this, I suggest doing some research into it. Or, for a beautiful story about it - here.

I support women's right to safe abortions.*** That doesn't mean that I think it's the right choice for every woman who has an unwanted pregnancy - that's each individual woman's prerogative to decide. I support their right to have abortions because I understand, probably better than most, that they need it as a choice and if they don't have it as a safe choice, they will choose it anyway and will suffer and die from their injuries. I also support women's right to put their children up for adoption and to keep their children. I support women who have unwanted pregnancies because they need support. I work very hard to try to make it so that they have access to contraception and emergency contraception all over the world. I also work to address underlying issues of gender inequality, violence, and sexism that prevent women from getting the choices and support they desperately need. I support women regardless because it's not my job to judge them for their lives or choices - it's my job to try to help them.

I support Planned Parenthood because Planned Parenthood also supports women regardless of their lives or choices. I support them because they continue to stand up for poor women. They were a support when I needed them. And I'm confident that, wherever you stand on the issue of unwanted pregnancy, if you needed them, they'd support you too.

**Note: that does not mean that I think ALL adoption is capitalizing on human tragedy - let's keep some sense of nuance here, people

***Note: Planned Parenthood does NOT USE FEDERAL FUNDING for abortions. I want to point that out in the context of the bill that passed in the House to defund them. What are you defunding? You're defunding the cervical cancer screening, vaccinations, the STI testing and treatment, the low-cost or free contraception for poor women. You're defunding poor women - the very women who are at the greatest risk of having an unwanted pregnancy.

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