The Supreme Court decision ending the constitutional right to abortion has highlighted the inhumanity of attempting to legislate and restrict potentially life-saving care. As a Latina abortion physician, I see this every day. Each day brings another harrowing story of someone denied the abortion they need.
People who want to ban abortion want you to believe that this conversation can be reduced to an arbitrary number: a number of weeks after which abortion becomes illegal. But the complexities of our lives — particularly of pregnancies — can’t be captured in black and white. Existing in the gray area are people’s hopes, dreams, families, dignity and health. They are things that politicians should never attempt to control.
This black and white conversation can’t hold every step that has brought someone seeking abortion care to me. I’ve witnessed all kinds of barriers that stand in the way of someone getting an abortion once they’ve made the decision to do so. Many of my patients face countless hurdles: inability to take time off from work, coordinating childcare, and abortion restrictions that force them to travel hundreds or even thousands of miles. Some patients are scraping enough money together to pay for everyday living expenses, never mind an unexpected cost like abortion that often isn’t covered by health insurance. I’ve encountered patients who have decided not to pay their utility or credit card bills that month because they knew the longer they waited, the more expensive their abortion would become.
In our San Francisco clinic, I have seen far too many young girls who come to us later in pregnancy because they were raped while crossing the border into the U.S. Some as young as 11 years old, whose small pelvises aren’t ready to have a baby. They arrive scared, alone and unsure who to trust. Those are the hardest days for me. They’ve had their innocence taken away and had to fight so hard just to make it to their appointment. The last thing they need is to worry that on top of every other horror they’ve faced, it’s too late for them to get the abortion care they need.
Black and white can’t account for the times when life doesn’t go as planned. Someone might get a diagnosis that means their baby can’t survive or discover a medical condition that puts their own life at risk. Someone might feel they could take on a pregnancy, and then find themselves in a different situation financially, physically, psychologically or emotionally. They could lose a job, a partner or a safe place to live. Only the person who is pregnant can decide what their life can handle. My role is to support people as they make the right decision for them based on their judgment about what they need to stay healthy and whole.
Black and white has no room for me as a mother, guided by my Catholic faith, to provide abortion care. What some people see in the doctrine of the church, a rigid doctrine that clearly influences the recent abortion bans, does not align with how so many Catholics live our lives. I’ve seen patients who’ve made the very conscious decision to end their pregnancy make the sign of the cross or grasp a rosary as they drift off under anesthesia. I’ll often provide an abortion and then share a moment of prayer to mark the moment. This isn’t rare. It happens on a daily basis.
My Catholic faith guides me to care for my patients, to meet them where they are, and support them in their journey to determine for themselves whether or not they can handle a pregnancy. This is essential for Black and Latinx patients who face the most barriers and don’t have the same access to high-quality health care. I can see a weight lift from my Latinx patients’ shoulders when they realize they have a Spanish-speaking physician taking care of them.
Those moments fuel my commitment to spending as much time as I can in the clinic providing abortion care. The people who have abortions are our friends, neighbors and families; they’re the people who form our communities. We need to end stigma and allow individuals the dignity they deserve by being able to make their own medical decisions. We also need to ensure they can access the quality health care that every person in this country has a right to.
When people are turned away because of an arbitrary limit imposed by politicians, they face a heavy burden in trying to find the care they need. They have the additional stress of having to travel to another state, get time off from their job, and make sure someone can take care of the children they may already have. They lose the trust and comfort of the relationship formed with a clinician who has been guiding them through their pregnancy. It makes them feel like pawns in a cruel or indifferent system rather than a partner in determining their medical care and future. They could be forced to continue a pregnancy they’ve decided they shouldn’t have. That was true when the arbitrary Roe standard was in place, and it remains true to this day.
The tragic fallout of the Dobbs decision has shown the public that the government has no place in deciding how and when someone can end their own pregnancy. Every pregnancy is different. There is no list in black and white words on a paper that can encompass the broad spectrum of individuals and scenarios where abortion care is necessary. There is no good law that tells us which abortions are acceptable, and no situation in which physicians like me or my patients should be treated like criminals for recognizing that.
In the face of persistent attacks from people who want to ban abortion in all its forms, we must fight for a world in which no politicians stand in the way of people’s ability to make their own decisions about their pregnancies.
