This Common Secret: My Journey as an Abortion Doctor Read online

  I would first discuss the entire approach with the patient. Then I had her come to the clinic after hours. I would insert laminaria into the cervix and send her home, with instructions to come to the emergency room at the hospital the following morning at six AM, when I would be on call. The laminaria would cause the cervix to open a small amount, and bleeding would begin. Basically, it starts a miscarriage. When the patient came to the emergency room the next morning with vaginal bleeding, cramping, and a positive pregnancy test, a therapeutic D & C, using vacuum aspiration, was the treatment of choice. I could take her into the operating room and complete the abortion, never charting the use of the laminaria.

  Much as it grated to have to operate in this surreptitious, underground fashion, I was not about to let down women who needed me. And I felt an unexpected connection with Dr. Hartzell and scores of other practitioners throughout the world who had done what they felt was right in circumstances less than ideal.

  Time in Grantsburg wasn’t all work related. I had many relatives and friends nearby whom I could visit, and I arranged to keep a horse at a friend’s stable. Riding had always been my solace in difficult times and an everyday joy whenever I had the opportunity.

  When I was on call but nothing was happening at the hospital, I’d escape for a quick ride, not even changing out of my scrubs. Several times an ambulance call came in while I was out riding bareback. The hospital would radio me, and a police squad car would meet me at the trail. One of the officers, a high school friend, would ride the horse back to the stable, while I hopped into the squad car and raced off to meet the ambulance.

  Summer passed, and I stayed on in Grantsburg. All along, my mother was my confidant. She was the one I had called after my abortion in Portland. She knew about my training in abortions. I had vented my frustrations to her about the Grantsburg hospital. She was one of the few who knew about my underground activities and who completely understood the phenomenon of community blindness.

  The next winter I heard about a march being planned—the March for Women’s Lives. When I told Mom about it, she said, “Let’s go. Let’s all go, even Sonja.”

  In early April of 1989, we headed for Washington, DC, three generations of women. We arrived two days early and stayed in a single, cheap room twenty minutes from downtown.

  We were too nervous to try the subway system at first, so we walked to the march headquarters at the National Organization for Women (NOW) office and volunteered to do whatever we could to help. We stuffed envelopes and made signs and put together clipboards for gathering signatures. Mostly, we talked.

  There were women working in that room from every layer and corner of America. Lawyers and store clerks. Factory workers, nurses, the unemployed. Elderly women, young women, mothers, and grandmothers. Women who had hitchhiked across the country. A busload of students from a Catholic college. Hour after hour we talked about our reasons for coming. We shared the life events that had inspired us to action. I felt caught up in the energy of a solidarity I had never before known.

  Even though it was cold and drizzling rain on the morning of April 5, solid masses of people kept emerging from the Metro stations, carrying signs, calling out slogans, united in their demands for women’s rights. We joined with tens of thousands, all jostling toward the Washington Monument. From there we marched down Pennsylvania Avenue. All the while, the three of us circulated, taking down names of marchers on clipboards, documenting the event. People stretched for miles down the route. The official count was six hundred thousand.

  At the end of the march, during the music and speeches, my attention was riveted on a particular speaker, Molly Yard, who was then president of NOW. Everyone has gifts, she was saying. Everyone has some special gift, talent, or energy. All of us can do more than we are doing right now. We all need to be brave, to put ourselves on the line for this cause. We know what it is we can do, and we know how to do it. We just need to start.

  For a long time I stood there, thinking. I don’t remember the rest of the speech, or any of the others for that matter. Her call to action had sunk in. I knew I had more I could do.

  Two weeks after returning home I began making inquiries. I called one of the St. Paul clinics that provided abortions. When I told the director that I was a doctor, that I wanted to help in clinics that provided abortions, and that I was trained in the vacuum aspiration procedure, I don’t think she really believed me. Doctors who were trained and willing to work in the clinics were very few and very far between.

  Within days I was sitting in a meeting with clinic directors who had traveled to meet me from Fargo, North Dakota, Appleton and Milwaukee, Wisconsin, and Minneapolis and St. Paul, Minnesota. For more than an hour they grilled me with technical questions. They wanted detailed descriptions of procedures, explanations of possible complications and how I would treat them, follow-up concerns, my philosophy. At the end of our meeting they were satisfied I knew what I was talking about.

  Then they began explaining the hardships I would face if I decided to begin the work on a regular basis. They told me about the emotional toll, the stresses my family would face, and the difficulties presented by protestors. I heard their words, nodded my head, and reassured them that I was fully aware of all that and I was still prepared to work in their clinics as an abortion provider.

  I nodded my head, spoke the words, and told myself I was prepared. I didn’t have a clue.

  Crimes Committed by Abortion Protesters

  in the United States and Canada, 1977-2005:

  » 7 murders

  » 17 attempted murders

  » 52 bombings

  » 180 arsons

  » 89 invasions

  » 1,211 incidents of vandalism

  » 1,341 trespasses

  » 100 acid attacks

  » 655 anthrax threats

  » 146 cases of assault and battery

  » 375 death threats

  » 3 kidnappings

  » 96 burglaries

  » 480 cases of stalking

  One in five clinics experiences blockades, invasions, arsons, bombings, chemical attacks, stalking, gunfire, physical assaults, threats of bombs, death, or arson.

  —FEMINIST MAJORITY FOUNDATION

  chapter five

  On June 22, 1989, I flew to Milwaukee from Minneapolis, was picked up at the airport by clinic staff, and came to work at one of several clinics owned and operated by Susan Hill’s National Women’s Health Organization.

  I was the only doctor that day, feeling those first-day jitters. I’d done hundreds of abortions, but never as the sole physician in a facility. It felt like the most important and dramatic moment of my professional life. I was utterly focused on the day ahead, my mind full of thoughts, images of patients, the approach I wanted to take as I began establishing my style.

  My escort dropped me off and went to park. A group of protesters circled the front door, a dozen or more. When I walked toward them, they assumed I was a patient coming for an abortion.

  “Mommy, don’t kill your baby. Let us help you. You’ll die in there!” they shouted. “You’ll bleed to death. You’ll never get pregnant again. Mommy, Mommy don’t kill me!”

  Their shouts barely registered. I was concentrating hard on the work waiting for me. I shouldered through them without breaking stride and found more welcoming staff inside. They showed me where to find the scrubs and where to change my clothes, and gave me a quick tour of the clinic. They were warm and friendly, obviously appreciative, but I am sure more than a little anxious about this new doctor.

  I shared that anxious undercurrent. There were fourteen patients on the schedule. Today I would have no supporting doctor to turn to for advice. The responsibility was all mine.

  The head nurse welcomed me with a cup of coffee, and we sat down to talk through the patient flow details. I liked what I heard about counseling approaches, established protocols, and patient priorities. Out in the hall I saw one of the clinical assistants gently escorting a pa
tient into a room for an ultrasound. The staff member spoke softly and directly to the patient, obviously treating her with respect and compassion. As I began to negotiate the charts, I felt myself relax. My sense of comfort increased when I actually started seeing patients.

  The time passed quickly. I met patient after patient, established a rapport with each one, earned their trust. It felt so good to finally be in a clinic, providing the service I knew was vital to the physical and emotional health of women. Time and again I flashed back to my own abortion. I carried those memories into every meeting. It reinforced my confidence and commitment to hear the concerns women shared. It was even more reassuring to see patients in the recovery room. There the women were comfortable, healthy, and relieved, and in a palpable way they seemed empowered.

  It’s been nearly twenty years since that first day in Milwaukee, but one woman remains sharp in my memory. She was well dressed, articulate, composed. Every hair was in place. Perfect makeup. When we talked before the abortion, she was straightforward and unemotional. She revealed no inner turmoil and answered my questions briefly, but with obvious determination. I tried to get her to engage with me on a more personal level, but she remained businesslike and direct. No hand wringing or outpouring of emotions.

  During the procedure she remained completely still and calm. She showed no sign of fear or anxiety. She made no sound, asked no questions. I talked as I worked, explaining what I was doing and telling her to please speak up if she was uncomfortable.

  When the abortion was finished, I rolled back from the bed on my stool and began picking up instruments. When the nurse began checking her blood pressure, the patient lifted her head and caught my eye.

  “We’re through?” she asked in a hushed voice.

  I nodded.

  She let her head down again and spoke to the ceiling in a slightly louder voice. “Does this mean I am not pregnant anymore?” There was a new tone in her voice. She sounded like she was ready to explode.

  “Yes, it does,” I almost whispered back.

  “YEEAAAAAAAYYY! YES! YES! YES!” The shriek of primal relief echoed in the room. I jerked away in surprise, almost tipping backward on my stool.

  Her arms shot up in triumph, like an athlete after a game-winning point. I had thought she was immune to emotion. All of this had been carefully pent up—all the tension, the weight of her situation, all of it locked behind her impeccable facade. Until now.

  Now she wore a smile that wouldn’t fade. She released a flood of concerns she was free of, some of them planted by the words of the protesters out front. She and I talked about the insensitive actions and outright lies spewed by the protesters. We talked about how hard it had been for her to walk through their gauntlet, and how difficult it would be for women who weren’t as strong as she was. Young women, for instance. Women with no one to turn to for support, women who didn’t know the facts about abortion.

  Later that first day, when I left the clinic, I saw the protesters differently. They were no longer just a nuisance. They were a force that had a negative impact on my patients, planting unnecessary fear and guilt in women at this vulnerable crossroads, as they weighed whether to end an unwanted pregnancy. Their rhetoric and self-righteous pleading were misleading and alarming. I knew, looking at them, that the last thing they cared about was the safety and well-being of the women I had seen that day.

  Within a month I added another clinic, flying to Appleton, Wisconsin, to work for Maggie Cage, a woman full of commitment and understanding who was also a tough, battle-hardened warrior. I used all my vacation days, my usual day off, and all my Saturdays to provide abortions in Appleton and Milwaukee. The atmosphere and attitudes of the staff were exactly what I had been hoping for.

  My contract as a general practitioner in Grantsburg was up for renewal in October. I had been there just fifteen months. I relished the joy of delivering babies for women I’d grown up with and taking care of friends and relatives in the emergency room, the clinic, or the nursing home. But it often cut too close to the bone. Every time one of the elders died, part of me died with them. Taking care of chronically sick people who had abused their bodies for decades did not bring me much satisfaction.

  Juxtaposed against the new energy I felt, and the sense of performing meaningful work on behalf of women, there was no contest. I did not renew my contract. Instead I offered my skills as an abortion provider to three additional clinics, one in Fargo, North Dakota, one in Duluth, Minnesota, and one in St. Paul.

  These clinics were owned or managed by women who understood that no one should be turned away because of financial constraints. They understood that patients needed clear, accurate information and care that was emotionally supportive as well as physically safe.

  Susan Hill owned the clinic in Fargo as well as the one in Milwaukee. I started traveling there regularly. In Duluth the clinic was run by a strong, feminist woman with a great staff. The clinic in St. Paul was part of a large nonprofit organization. The manager was my main point of contact, and she was as dedicated and kind as anyone I’ve ever worked with. She was an excellent liaison between the umbrella administration and the clinic staff, and put patient care issues first.

  As the weeks passed, what grew more powerful in me was the fundamental commitment to patients and to the cause of keeping reproductive rights safe and legal. I was free of the conservative, oppressive bosses who lived in denial and demanded allegiance to the financial bottom line over full treatment. Free of edicts to spend no more than ten minutes with a teenager experiencing her first pelvic exam and wanting birth control advice.

  “Give them a Pap, hand them birth control pills, and move on,” I’d been instructed in Grantsburg. Now I was free of off-site administrators with no community knowledge telling me to stop seeing “welfare patients” because they didn’t bring in any money. More to the point, I was finally free of secretive, furtive abortions.

  Work was invigorating and gratifying, but there was a price to pay. My schedule was exhausting. And it played havoc with my family life. I felt as if I were constantly in a state of jet lag, rotating between airports and clinics and vehicles.

  “Sue,” Randy said one weekend. “It’s your mom’s birthday next week. Let’s find a day to go see your folks. Your dad isn’t doing so well, and Sonja always loves seeing them.”

  “I know,” I said, “but tomorrow I fly to Appleton and don’t get back until late Tuesday. Wednesday I drive to Duluth and won’t be home until late.”

  “What about Thursday night?” he asked.

  “Nope. I go to Milwaukee this week, so I fly out Thursday morning and don’t get back until Friday night, and I’ve agreed to work on Saturday in St. Paul.”

  “Sunday?”

  “Please, I need one day at home,” I said. “You and Sonja go if you want, but I have to have one day staying put.”

  If Randy was disappointed, he hid it well. He was totally supportive of my work and the choices I’d made, but I know there were many times he had to swallow hard and walk away. Sonja had her own busy schedule, full of swim team practices and homework and friends, but she missed the trips to see family.

  My professional life was hitting sonic speed, heady and rewarding, but I was suffering from tunnel vision.

  Part of my work preoccupation came from the fact that I still had so much to learn. One of the counselors in Appleton was a clinic veteran named Dottie. She taught me valuable lessons about how to talk with patients and how to really hear what they are saying. Dottie always made it clear that we did abortions for the woman, not for her partner or husband or mother. For the woman. It was her choice, and she needed to completely own that. Dottie taught me that no matter how good the counseling was before the abortion, there would be times when issues wouldn’t come to the surface until the woman was actually undressed and facing the beginning of the procedure. I learned to ask every patient if she was absolutely sure of her decision.

  “Is anyone pushing you or telling you that
you have to do this?” I’d ask.

  Any hesitation whatsoever and I stopped and asked her to get dressed again, and we talked more. It wasn’t uncommon for me to send her away to reconsider her options. My biggest fear has always been to do an abortion on someone who will later come to regret it.

  In the early years, when issues of this nature came up, the staff and administration always allowed the time and resources to support a woman’s choice and to help her reach a point of resolution. The patient took first priority. That supportive, nurturing environment within the clinic made it possible for me to endure the increasing efforts of the anti-abortion zealots and to overcome the hate they directed at me.

  By the summer of 1990 the protestors had figured out that I was one of the doctors. When I approached a clinic entrance, tried to get out of an airport, or walked from my car to a clinic entrance, they went into a frenzy.

  “Murderer!” they screamed. “Baby killer!”

  I dreaded seeing them—every time. How could they hold up a Bible while screaming through clenched teeth? When in a public place and being singled out, I cringed at the looks people gave me. I hated the thought that anyone witnessing this spectacle would believe I actually did kill babies. My stomach would knot and churn.

  Sometimes I was close enough to see the hateful, twisted facial expressions of the protesters. It was horrifying. Their voices were shrill and loud and unstoppable. I was engulfed in a tornado of frenzied emotion, out of control and very dangerous. I fought the urge to panic, to flee, but I never reacted outwardly, never responded to their taunts, never made eye contact. When they tried to block my way, I’d shove past, hurry on.

  “Baby killer! Their blood is on your hands, Susan!”