Getting An Abortion in Texas -The Toast

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Some, but generally not most, of the people in this story have had their roles reduced or removed, because I want this story to be about bodies, the state and medicine, rather than my messy personal life. I use the term “women” in several places to mean “people who can get pregnant/people who seek abortions” for the grammatical simplicity; though the majority of people seeking abortions are women, I don’t want to overlook the fact that some people who get pregnant are not women.

It was January 29, 2013 at 11 p.m. when the pain started. A dull throbbing ache in my left lower abdomen that could have been indigestion or cramping. It was uncomfortable, but not unbearable, and I thought the best thing to do was go to sleep. I had flown into Austin the day before, I was tired and in a new place and the next day was my birthday; I wanted to be well-rested. But every time I lay down–right side, left side, front, back–I would come up gasping for air in seconds, unable to breathe for no apparent reason. Sitting upright was fine. I sat upright until 1 a.m. trying to understand what was happening to me. Finally I got online, and looked up hospitals that would take my out-of-state health insurance. The friend I was staying with drove me to the hospital. I remember noticing how warm it was outside for January. I remember wondering how much this was going to cost.

No one likes hospitals. I was cranky and exhausted and frustrated and when the emergency room nurse asked me for my birthday to fill out the preliminary paperwork, I burst into tears. “Today, today is my birthday,” I said, and she said, “I’m sure everything is going to be fine.” She weighed me, I told her what medications I was on and for how long (birth control, six years; Relpax as needed for migraines; two years). We were sent to an exam room. We waited. A nurse came and took my blood and urine samples, she wished me a happy birthday. I wished I would pass out, if only to be able to sleep.

A doctor came in–young, white, pretty; her eyeshadow matched her scrubs–and she asked my friend to step into the hall. She looked at me, without sympathy, and said, “You’re pregnant.” I really wished I would pass out.

Someone once said to me that the difference between the North and the South is that in the North, it’s fine if your daughter has sex, as long as she doesn’t get pregnant. In the South, you’d better not catch your daughter having sex, but if she gets pregnant, that’s just what happens: it’s not ideal, but everyone gets along as well as they can. I was a Yankee girl, six weeks out of college, 14 weeks pregnant in a state where I didn’t know what laws and what morality dictated the next few minutes of conversation with this doctor, barely older than me, who had chosen to work in a Catholic hospital.

I asked her to let my friend back in the room. She said a technician would come back for an ultrasound.

I don’t know how to tell you about the mixture of resignation and panic that started to overwhelm me. I had just graduated from college with nearly $20,000 in debt. I had no job. I had only started flossing a month ago. There was no moment where I “weighed my options,” because never for a moment was having a baby a feasible option for me. My immediate instinct was to try to remember how much money was in my bank account. I did not take the decision lightly, but nor did it feel like a choice. Before the technician came in, I had made up my mind.

What the doctor actually meant by “a technician will come back for the ultrasound” was “a strange man will come back, take you into an even colder room, and insert a camera into your vagina while another nurse ostensibly watches but really plays Words with Friends on her phone.” He didn’t say anything, and I shook the whole time, from cold and because I didn’t know if this was medically necessary. To this day, I don’t know if the medical procedure I was given was for legitimate medical reasons, or if it was state-sanctioned, state-required rape. Does it matter? Do I want to know? Will finding out the specifics of what laws, religious doctrines and politics were in play that night help me feel better?

The technician wouldn’t turn the monitor towards me and I was afraid to look until they were wheeling me out. When I finally glimpsed it, I saw nothing, nothing resembling the collection of traitorous cells that had apparently been growing inside of me since Thanksgiving. I did not know what to think. I had been awake for 17 hours.

We waited longer this time for the doctor to come back, I lost track of what time it actually was. It remains unclear to me if you are allowed to use cell phones in hospitals or not; mine was dead anyway. I’m a Millennial, I don’t wear a watch.

The doctor came back and said several things very rapidly. She said You Have an Ectopic Pregnancy Attached to Your Left Fallopian Tube and We Are Going to Have to Remove It Either By Giving You a Pill to Force it to Rupture Or Surgery Because It Has Already Ruptured And I Am Pretty Sure It Has Already Ruptured Because The Reason You Can’t Go to Sleep Is that Your Stomach is Full of Blood and It’s Starting to Irritate Your Lungs And Do You Have Any Abdominal Pain Yeah Uh-Huh That’s What That Is So I Will Come Back Soon With the Other OB/GYNs and We Will Decide What to Do Okay But You Are Stable Right Now Okay You Aren’t In Danger Right Now Okay and I burst into tears again because now I didn’t have to try to get an abortion in Texas.

At least I could have. At least, in Austin, the capital of Texas, there were clinics I could’ve gone to, there were Planned Parenthoods and there were abortion funds I could have applied for, combined with my own savings. At least SB1/HB2–the notorious omnibus anti-abortion law that State Senator Wendy Davis filibustered in July–had not yet passed the Texas legislature, putting more financial and practical barriers between women and their right to choose. At least I wasn’t past 24* weeks; at least I was in a city. There are 36 reported abortion-performing facilities in Texas (down from 42 in 2011)–92% of Texas counties don’t have an abortion provider at all.

It is likely that 30 or more clinics will be forced to close in the next year under the provisions of HB2. The law requires doctors working at clinics to have admitting privileges to a hospital within 30 miles of the clinic. Given that the Catholic Church operates many of the hospitals in rural Texas and often refuses to give admitting privileges to doctors working at practices that offer abortions (and that due to a lack of qualified doctors to perform abortions, traveling/visiting physicians are often not allowed local admitting privileges), this provision alone could close a dozen clinics. HB2 also requires that clinics adhere to the standards of surgical centers.  5 clinics in Texas meet this standard currently: They are all in major cities.**

If 30 clinics close, Texas will have a health crisis in short order. These facilities provide low-cost gynecological exams, birth control, domestic abuse resources, rape counseling, STI/STD testing, emergency contraception, breast exams, LBGT education and support services and, yes, in some places men’s sexual health services. Texas already ranks 5th nationwide in teen births (#3 in teen pregnancies) and 1st in recurring teen pregnancy. Over 14% of all babies born to teen moms under the age of 15 in the United States occur in Texas. STD/STI rates will skyrocket; breast and ovarian cancers will go undetected. HB2 also requires that anyone seeking chemical abortions–RU-486–take the pill under the supervision of a doctor rather than being able to obtain the pill and go home, which means that a person must visit the clinic multiple days, up to 4 in total. If you can’t afford to stay the nights in a hotel–take the time off work, or travel to the clinic every day for 3 days–you’re out of luck.

The scale of this bullshit is the size of Texas: it took me weeks to get my head around the sheer size of the state. 26.06 million people live in Texas (the population of Uganda), and you would have to combine the area of New England, New York, Ohio and North Carolina to equal its size. People in Texas seeking abortions already travel an average of 43 miles to a provider: when HB2 goes into effect, some women in Texas will be over 500 miles away from the closest Texas abortion provider.*** Those who can get to a clinic will not be able to get abortions after 20 weeks, and there is no exception for rape or incest. Women in El Paso will be closer to a clinic in New Mexico than one in their home state. It is likely that the entire Rio Grande Valley (an area the size of Connecticut) will be without a provider if the two clinics there now are forced to close. All three facilities in Fort Worth will close. The sole abortion providers of Waco, Killeen and Lubbock will also close–the next nearest clinics will be over 100 miles away.

What happened to me? Four different OB/GYNs came in, put their hands in my vagina, and then nodded a lot at each other and then left. A nurse said, “It’s lucky you found out you were pregnant today, because I bet you would have had some drinks for your birthday!” and I thought, What a cunt. She put catheters in both of my arms and I was given a painkiller, the name of which I immediately forgot, and all the doctors who saw me after seemed deeply disappointed that I didn’t know, like it was my job to remember which drugs the other doctors had given me.

I’d been awake for 19 hours. I signed a waiver for one thing, and for another, my signature getting progressively weirder. I told my friend to sue the hospital if I died because no one seemed able to retain the fact that I was allergic to amoxicillin. A male nurse made a racist joke about Mexicans to me while taking my blood pressure. They told me I would go into surgery at 6 a.m. I started to look forward to it once I realized they would put me under and I would finally get some sleep

They wheeled my bed into surgery prep and a flurry of activity started all around me. Six nurses and an anesthesiologist started asking me questions I’d already answered and I started sobbing. One nurse, thinking that my tears were born of something much simpler than a sleep-deprived 22-year-old being a pawn of the medical-political-industrial complex, touched my arm and reassured me, “Don’t worry, it will be all ladies in the operating room.” That’s when the anesthesia took hold, just as I had time to say, “I LOVE ladies!”

I came to with a nurse sitting next to me; loopy and happy to find myself alive, I immediately asked him if my surgical hair net “looked good.” They put me in a recovery room. I slept intermittently. I woke up to find my friend looking deeply uncomfortable and concerned. “They took your tube,” he said slowly. I had been out of surgery for over five hours and no one had told me this. No nurse feeding me ice chips; no surgeon had checked on me. But the pretty OB/GYN had told my friend; reassuring him that despite the removal of one of my reproductive organs, I would still be able to bear his sons.

 It took another two hours before a medical professional told me this piece of critical information. The more the painkillers faded, the more I felt claustrophobic and unwilling to stay any longer. The less I wanted to answer any more questions or feel like I was getting part of the truth. I was alive, I was out of danger. I told my nurse (who kept complimenting my friend for having a girlfriend who “looked like a little doll” and was “so smart” for having a degree in political science) that I wanted to leave, I insisted on the paperwork being brought to me. My hand shook; she filled out most of it for me, watching my blood pressure spike with each question.




“22 today.”

“Maiden name?”

“Not married.”

“Sign,” she said. When I looked at the form, there was no signature line that said, “Patient.”

I signed the form on the “Mother” line, and gave the Catholic Church permission to bury my fallopian tube and unviable fetus somewhere in Texas. They wouldn’t let me leave without signing this release, it was the last document I was given.

They did ask me if I wanted to take it home, but I didn’t think the TSA would allow that.

I tell this story now, a lot, in varying detail, emphasizing different things to different groups. To women my age, I try to convey to them: this could happen to you, the period you get on the pill isn’t real, don’t be reassured by it, know your body, take care of yourself. Men, I try to explain how fucked up it is to never know your own body, to be lied to by authority figures about how it works and what it can do and what it should do. I try to explain what it feels like to have your biology regulated by the state, to have your value as a person reduced to your fertility and sexuality.

But a lot of people don’t want to hear it. A lot of women give me a look, a look I know, that says, “You brought this on yourself.” I get that it’s easier to not see yourself in me. You’re the girl who takes her pill on time every night, you know your body, you’ve never had a pregnancy scare. Me fucking neither, until I did.****

And they don’t care how good you are, we are all implicated in the regulation of bodies, regardless of how far you are able to retreat from the state of Texas at this very moment.

I live in Austin now. I moved here right before Senator Wendy Davis’ filibuster of the first iteration of HB2. I sat on the balcony in the Texas Capitol and cried as she talked about her ectopic pregnancy, and getting help from Planned Parenthood. Thousands of Texans rely on Planned Parenthood for basic healthcare–primarily because Texas has the highest rate of uninsured people of any state in the country (22.5% in 2012, compared to 15% nationally). I’m lucky–if I hadn’t had insurance I would be dead right now, there is no chance I would have gone to a hospital that night. Even with my insurance, the all-told cost of not dying that night was about $62,000.

My insurance covered only the hospital bill ($30,800.56) and not the surgery, the private OBY/GYN practice that worked out of the hospital, or the painkiller prescriptions I took for a week after.

I moved to Austin and I occupied the Capitol rotunda; I chanted “Whose house? Our house!” and “Shame!” so that the legislature could hear the people’s rage from inside the chamber. I collected and returned tampons confiscated by DPS. I register voters; I’m going to start volunteering for Lilith Fund. When my friends from the North ask me why I moved here (“Really? Texas?”), I usually make a joke, but mostly, I needed to live in a place where people have never taken choice for granted. I need to fight in a place where it matters. Comfort is nice, but it won’t protect you.

*24 weeks is the generally accepted medical point at which the fetus is considered to be able to survive outside the womb, the standard set by Roe v. Wade.

 **Austin, San Antonio, Houston and Dallas.

***The ACLU and Whole Women’s Health filed litigation challenging the chemical abortion regulations and admitting privileges provision. While Judge Yeakel of US District Court found that the admitting privileges requirement imposed an undue burden on those seeking abortions, he ruled narrowly that the chemical abortion regulations did not. The 5th Circuit Court of Appeals– one of the most conservative courts in the country– reversed Yeakel on Halloween. Since the reversal, the Texas Tribune has confirmed that 9 facilities have discontinued abortion services, forcing them to call patients with already scheduled abortions and cancel (The Washington Times says 12 clinics have/will close in the next week). The 20 week ban went into effect October 29, 20. The surgical center requirements do not take effect until September 2014 but some clinics have already announced plans to close. On November 4, the plaintiffs (Texas ACLU et al.) filed an appeal with the Supreme Court asking for an injunction to prevent any more facilities from closing because their doctors cannot get admitting privileges. Among the clinics that closed last week was El Paso’s, the residents of which are now 600 miles away from the nearest Texas clinic.

****I was going through the screening process to participate in a sleep study in May, and had to tell the doctor the whole story. He was horrified; he told me that he would give expert testimony if I wanted to sue my birth control manufacturer, so low are the odds of ovulating while on the pill.

Sarah Fitz is a queer Yankee curmudgeon living in Austin, Texas. She tweets @businessgoth_ and has a growing collection of mesh clothing and political theory books.

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