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The first abortion I ever did was on a young woman in her late twenties. She was about 10 weeks along and was sure about her decision to end her pregnancy, as sure as my prenatal patients are about their decision to keep theirs.
Her story sticks out to me, perhaps more than some of the other more sensational stories that tend to make headlines and provoke heated debate among politicians.
She wasn’t “too young” for pregnancy. She didn’t face “tremendous obstacles,” financial or geographic, to obtain an abortion. She didn’t become pregnant through a non-consensual encounter, specifically rape or incest, as we often read and hear.
She simply didn’t want to be pregnant anymore. She knew her life and her body better than anyone else ever could, and thus made the decision that brought her to our clinic.
This story is not meant to trivialize those patients who are young, so young, or forced to overcome unthinkable obstacles under unimaginable circumstances in order to obtain an abortion. These patients are at risk and deserve the very best resources and care that we have to offer. It’s critical, however, that we understand the facts about who accesses abortion in our country, as too often, racist and sexist stereotypes replace what we know to be true in the national discussion on abortion and pregnancy.
According to the Guttmacher Institute, a policy and research organization with a specific focus on sexual and reproductive health, 1 in 4 women will have an abortion by the age of 45, and the majority of these patients are over 18 years old, already have one child, are using a form of contraception and are from poor or low-income backgrounds.
Put simply, the average patient could be any one of us — perhaps a young professional, perhaps already a parent, perhaps someone who never saw herself with children, perhaps in a happy relationship, perhaps single. She could be your sibling or friend or colleague. She could be you or someone you love.
We are now in the wake of the Dobbs decision in June, living in a reality that is unprecedented in my lifetime and in the lifetimes of most of my colleagues and patients. It is a reality in which abortion, a service that has always been part of the continuum of reproductive health care, is criminalized, a reality that is sure to lead to dire health outcomes across all of our communities, particularly those that are already the most marginalized and vulnerable.
And this is especially striking, even unbelievable — in the most literal sense of the word — when one considers that the majority of Americans support legal access to abortion, including 74% of North Carolinians.
Harkening back to this reality then: how did we get here? How is it that politicians, who by and large are not physicians or other medical professionals, have been able to craft such restrictive policy that it at its core, devalues the lives of pregnant people in service to their own brand of ideological extremism? How has the individual become so powerless in such a merciless health care system?
What we are seeing is a fundamental lack of understanding, intense stigmatization and willful ignorance on the part of our lawmakers who are operating in a climate of misogyny, racism and political posturing, most of which has no basis in medical science. Let us all take a moment to recall the Ohio State House of Representatives’ frighteningly memorable bill in 2019 that stated that physicians should “take all possible steps to preserve the life of the unborn child,” including the medically impossible “(reimplantation of) an ectopic pregnancy into the woman’s uterus,” a notion that is just one in a sea of ill-informed assertions made by unwitting politicians.
From my years of medical training and experience, I can testify to the importance of ensuring legal and dignified access to abortion. It is an extraordinarily safe procedure, one that gives the reins of reproductive justice and freedom to individual patients, and empowers them to make their own decisions and determine their own futures.
Just like with any medical treatment or procedure, my patients come to me having made a thoughtful and thorough decision that is the best one for their lives and circumstances, and that includes abortion. Who are our legislators to say otherwise?
Chelsea Daniels, M.D., is a family medicine physician and abortion provider with UNC Family Medicine in Chapel Hill.
