We Need To Talk About The Invisible Cost Of Abortion Clinic Violence

Even in the most progressive parts of the country, women are paying an emotional price for health care access.

A few weeks ago, I went to my friendly local Planned Parenthood to have my IUD removed and a new one put in. It was an appointment I’d been dreading, because while I love low-cost long-term birth control, my experience of having that first IUD inserted was -- and I don’t use this word lightly -- traumatic.

It’s important to note that lots of people feel next to nothing when they have an IUD put in. Most report a little nip as the doctor slips the inserter through their cervix, then some mild cramping, and then on with their day -- off to have shameless, fear-free sex with a willing partner and not have babies as a result.

That was not the case for me. For me, having an IUD put in was absolutely excruciating. Annual gynecological exams have never been comfortable for me, thanks to a pelvic pain condition that can make penetration of any kind hurt. But the IUD insertion was a whole new world of pain.

There’s something about cervical pain that, for those of us who have never given birth -- and maybe for those who have -- registers as frightening. Even when I know why it’s happening, even when I know it’s not a sign of danger or of grievous harm, it terrifies me. The pain, which is somehow at once sharp and also dull, is so deep and so far inside my body, and I can’t get to it -- I can’t put my hands on it to stop it.

I didn’t want to go through this procedure alone... But here’s the thing: you can’t have someone there with you at Planned Parenthood. For security reasons.

When I had my first IUD put in, I cried out and squirmed and tears spilled out of me, even as I assured the understandably taken aback OB, who suggested stopping, that she should continue. My dad, who had come with me on the off chance that I wouldn’t be able to drive myself home, which of course I couldn’t, said he could hear me screaming through the wall as he sat in the waiting room. After it was done, when the doctor was out and I was left on the table panting and cramping and residually terrified, she joked, “Thank god you’re my last patient -- you’d have scared everyone out of my waiting room.” 

Like I said, I don’t use the word “traumatic” lightly.

Five years and zero accidental pregnancies later, it was time to get that IUD, which one of my friends nicknamed Robocop, replaced. Despite the pain I experienced, I’ve become an IUD evangelist. For those who can afford the upfront cost or can get it covered by health insurance, the IUD is by far the best combination of reliability and cost efficiency -- no small matter when you’re talking about birth control. In my case, the pain was bad, but it was worth it. But the worth-it-ness didn’t diminish the pain, and didn’t calm my fear of going through that pain again. I kept thinking about how awful that day five years ago had been, and I spent the 10 days preceding my Planned Parenthood appointment with a ball of dread throbbing in my lower stomach.

I didn’t know if I’d be granted the paracervical block, a localized anesthetic injection that I’d requested. I didn’t know if it would help. One thing I did know was that I didn’t want to go through this procedure alone. It had helped to have my dad nearby the last time, though I remember wishing that I could have held someone’s hand and had them tell me they loved me and that it would be over soon when it felt like I was breaking in two. So, I asked one of my best friends to be there with me, and she agreed.

But here’s the thing: you can’t have someone there with you at Planned Parenthood. For security reasons.

It doesn’t matter if you’re getting an abortion or receiving a positive HIV diagnosis, or just getting your IUD changed out: you can’t have anyone in the room with you. Or even in the waiting room. If someone wants to come with you to support you, they have to sit in a separate holding room with all the other husbands and mothers and boyfriends and sisters and friends. For security reasons.

Everyone passes through the metal detector and has their bags rifled through, but only patients can pass through that holding room and on into the waiting room. And once you’re there, you wait -- in my case, crying with nerves -- alone. The nurses and OBs are lovely, caring, patient, helpful people, some of whom are risking their safety to do the work they do, and they do that work very well. But no matter how caring and lovely and patient they are, they're still not your husband, or your mother, or your boyfriend, or your sister, or your friend. They surely don’t want it to be this way, but this is how it is: When you’re at Planned Parenthood, you’re on your own. For security reasons.

Of course, in my panic at my impending uterine incursion, I’d forgotten about this. I’ve been to that Planned Parenthood half a dozen times before, but I’d forgotten about the holding room. As I sat in the waiting room, frantically texting my friend who was stuck on the other side of the wall -- and after I asked the lovely, caring, patient, helpful women behind the desk if maybe they would make an exception for me -- I thought about the "why." Why was I texting my friend through a wall instead of holding her hand and making feeble jokes about vaginas to distract myself?

Clinic violence is the why. The long list of cruel and creative ways that anti-women, anti-sex, anti-choice terrorists have sought to interfere, to intimidate, to harm and hurt and frighten abortion providers and their patients, is why there’s a metal detector, why there’s a separate waiting room, why there’s a wall.

This is what clinic violence does. Clinic violence puts walls between people in need and the people who love and support them.

Clinic violence and harassment take many forms, as I wrote after last November's Planned Parenthood shooting in Colorado Springs:

Extremists have [thrown] butyric acid into clinics, glued clinic locks shut, locked themselves into clinic property using items such as bicycle locks or chains, drilled holes into clinic roofs so that the clinic floods, invaded clinics, vandalized clinics, made threatening phone calls, tried to persuade patients to go to fake clinics, put spikes in driveways, talked outside clinics about bomb-making chemicals, laid down on sidewalks, jumped on cars, camped out in front of clinics for multiple-day stretches, and sent decoy patients into clinics to disrupt business.

And then, of course, there are the bombings, the arson attacks, and the assassinations of abortion providers. In 2015, there were at least four incidents of arson and, over Thanksgiving weekend, that shooting at the clinic in Colorado Springs killed three people and injured nine.

Given the risks, clinics are right to do what they can to protect their workers and their patients, to implement security measures like bullet-proof glass, security guards, and metal detectors. And, in the case of my Planned Parenthood, a separate waiting room that prevents providers from coming into contact with anyone but the patient. You can’t run the risk that someone’s husband, mother, boyfriend, sister, or friend is there to harm the nurses or the doctors or the patients.

This is what clinic violence does. Clinic violence puts walls between people in need and the people who love and support them. It leaves you holding your sweaty phone and taking shallow, shaky breaths -- instead of holding your friend’s hand and cracking vag jokes. It leaves the people who have just had abortions curled up in hospital chairs alone with their own thoughts while their loved ones wait downstairs, wondering how they’re doing. It leaves teenagers alone with their feet in the stirrups for the first time and grandmothers alone with the mammogram machine pressing into them. This is what clinic violence does. 

I did get the paracervical block, but it didn’t help much, because the injection of the anesthesia was itself enormously painful for me. It was still a traumatic experience. I still screamed, and they still heard me in the waiting room. Tears still spilled out of me, and I couldn’t stop crying for about half an hour after Robocop 1 was relieved of its duty and Robocop 2 had taken its place. The OB was still taken aback at how much pain I was in, and rushed to clear away the bloodied instruments in an attempt to make me feel better. I still desperately wanted to hold someone’s hand, and have them tell me that they loved me and that it would be over soon.

The point of clinic violence and harassment is intimidation. The goal is to make doctors and nurses afraid to practice, and patients afraid to receive healthcare. In some cases, as David Cohen and Krysten Connon note in their book "Living In The Cross Hairs: The Untold Stories Of Anti-Abortion Terrorism," it frightens doctors and nurses away from abortion provision altogether, and it has surely kept would-be patients from braving the “protesters” and the risks of entering a clinic.

But even for those who make the choice to go into the clinic, the intimidation persists. Even for people who live in relatively abortion-friendly places, like New York City, clinic violence in less tolerant places takes its toll and extracts an emotional tax. It’s in the metal detectors and the uniformed guards and in the walls between you and the people who love you. I was safe in that clinic, and I knew that. But I was scared, and in pain, and the fear and pain were made far worse by the fact that I was alone. I was safe, and I was treated -- but I still paid the price for living in a country where my healthcare is demonized, criminalized, and under attack. I had to pay an emotional toll for my safe and legal treatment. Which is, after all, the whole point.



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