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I’m a third-year medical student at the University of Alabama at Birmingham. I plan to become an obstetrician-gynecologist. I dream of delivering healthy babies, working with families and supporting midwifery. But as part of my practice, I also envision providing abortions to women who need them.
The road I took to get here isn’t your stereotypical one. My parents are small-town conservative Christians who believe that abortion is wrong. Growing up, I naturally shared their view. But I’ve also wanted to be a doctor since I was 4 years old, and in high school, I began to feel drawn to issues of women’s health. In college, I designed my own major to broaden my understanding of women’s health by including psychology, sociology and women’s studies courses.
I also served as a counselor for a volunteer organization that helps victims of rape. I sat in hospital rooms with young women who would look at me and say, “I can’t be pregnant. I just couldn’t carry his baby.” I could feel their desperation.
At the same time, I found myself shocked at how little many of my friends — women who were studying biology and planning to become doctors — knew about their own sexual health. They didn’t know about or couldn’t get the reproductive health care they needed because of barriers put up by their culture, their religion and their parents, whose sole contribution to sex ed was generally an unspoken “Thou shalt not!” One friend begged me to help her concoct a legitimate-sounding excuse — painful or irregular periods, say — for why she needed to be on birth control. No one could know the real reason: She was sexually active and didn’t want to get pregnant.
I began to feel as if I were leading a double life. At school, the choices I saw women struggling with were forcing me to question my old convictions. When I went home, I’d go to church with my parents but would find that my views contrasted starkly with those I heard in the sermons. It was a difficult time, because I felt that neither my family nor my church would welcome my questions or understand my struggle with my beliefs.
For the most part, I don’t talk to my parents about those beliefs. They already feel as though I’ve turned my back on much of what they taught me because my husband and I bought a house and lived together for a few months before we were married. “How could you do this to us?” they asked. Two and a half years later, that rift isn’t fully healed. I know that my views on reproductive rights would be another blow.
But ultimately, we have more in common than they might think. I agree that ending an unwanted pregnancy is a tragedy. When I advocate for reproductive rights, for choice, I don’t claim that abortion is morally acceptable. I think that it’s a very private, intensely personal decision. But I was stunned when one of my professors, a pathologist and a Planned Parenthood supporter, told me that years ago, entire wings of the university’s hospital were filled with women dying from infections caused by botched abortions. It’s clear that women who don’t want to be pregnant won’t be deterred by limited access to providers or to clinics. And I believe that it’s immoral to let them die rather than provide them with safe, competent care.
I still have a long way to go in my medical training. I’ve never witnessed an actual abortion procedure, though I have been trained, through my work in Medical Students for Choice, in manual vacuum aspiration, a very simple procedure used for both incomplete miscarriages and elective terminations in the first trimester. I plan to choose a residency program that provides further training — a place where I won’t worry that asking to be taught to perform an abortion could somehow limit my future options. At the start of medical school, I was very careful about how I presented my pro-choice views to the faculty for fear that I could jeopardize my grades or hurt my chances for recommendations or of being accepted into a program run by any of the professors. This experience of treading lightly is unique to medical students in more conservative parts of the country, where opposition to abortion is widespread — and it astounds many of my fellow Medical Students for Choice leaders from the Northeast and the West Coast.
As I continue my education, my views on abortion are still evolving. Take late-term abortions. When I first heard about them, I was horrified. I remember the flyer I saw at a pro-life event that described the procedure: It claimed that when the baby’s head emerges, the doctor jabs a pair of scissors into the back of its neck, severing the spinal cord. Even after I became pro-choice, this crossed a line for me. But later, I learned that this description was misleading and graphically politicized.
It wasn’t until I spent time in ultrasound rooms during a research job in graduate school that I began to see late-trimester abortions in a very different light. In one case, the patient’s baby had just been diagnosed with a lethal congenital anomaly. The high likelihood was that it wouldn’t survive after birth for more than a few minutes. As long as the baby remained in her mother’s womb, however, she would live. I asked the physician what this woman’s options were. The answer was, not many. She could choose to continue the pregnancy, but then she might be waiting for almost 20 more weeks to give birth to a baby that would never take more than a few breaths on its own. She was past the point where she could legally terminate the pregnancy in Alabama. If she could get an appointment in Atlanta within the next week, she might be able to have the procedure there. Beyond that, there were only a few physicians in the nation who would perform an abortion in such a case.
I could hardly wrap my mind around the agony that this woman and her husband must have been facing. They needed a caring and compassionate physician to help them through this dark moment, and if they chose not to continue the pregnancy, they also needed a physician who was both skilled enough and brave enough to provide them with the care they needed. They needed Dr. Tiller.
I can’t yet imagine doing precisely the kind of work that he did. When I think about my future practice, I think about a doctor I met at a conference who spoke candidly about the harassment his children endured at school because of what their father did. I wonder what seventh grade might be like for my children if I choose to provide abortions.
I’m not the only one with questions, of course. Once, after Medical Students for Choice co-hosted a panel discussion on reducing abortion by providing better education on reproductive health, some of my classmates approached close friends of mine. They were puzzled that a pro-choice group was talking about wanting to reduce abortions — and that it viewed ending unwanted pregnancies as a tragedy. Mostly, though, they were confused about what I was doing there. “I know she goes to church every Sunday and that she’s a good person,” one classmate asked. “Why would she be involved in a group like this?”
I know my answer to that question. Someday I hope my classmates will understand, too.
I am Dr. Tiller.
[Excerpted from the Washington Post with the author's permission]
[R.F. Love, "My Choice", Washington Post, Sunday, June 7, 2009]