Alone

This past summer, I was interning at a large, urban community hospital that also provided abortion care. As a future abortion provider, my purpose for this month-long excursion was to see and experience abortion care from the perspective of a provider. I knew, on paper, how the procedure went and I knew how the counseling was supposed to go, but I had never witnessed either. It was a truly incredible experience and one from which many future blog posts will most likely be about. However, I would like to focus this posting on something unrelated to my experience, but more of a disturbing incidence that occurred overnight with one of our patients. It’s an episode that deeply disturbs me and only further drives me to seek equality for women seeking that completely legal procedure known as abortion.

In the state I interned, parental notification laws for minors seeking abortions were on the books. A 15 year old girl, let’s call her Leila, had come in seeking a second trimester procedure one afternoon. She was not in a position to tell her parents of her current unwanted pregnancy and chose the judicial bypass course instead. The judge deemed her competent to make the decision to terminate her pregnancy, and thus she showed up alone to her appointment. Upon ultrasound examination, it was determined that the gestational age of the fetus was 15 weeks and 6 days. In this particular hospital, it was standard practice to insert laminarias in a women’s cervix if she was over 14 weeks gestational age. The woman would then go home, allowing the laminarias to slowly dilate her cervix over night, and then return to the hospital the next day to complete her second trimester abortion. However, there was one problem with this system. Leila couldn’t go home. Her parents would ask questions, wonder why she had to go to the hospital the next day, wonder why she was so uncomfortable, etc. After all Leila had already been through enough to conceal this secret from her parents, and going home clearly wasn’t the best option.

So Leila called a trusted friend, who knew her situation, and asked her to pretend she was spending the night at her house if her parents called looking for her. Leila then called her own parents and told them she would be staying at her friend’s house for the night. Instead Leila would be staying in the hospital overnight…alone.

When the resident tried to find a room for Leila (and there were plenty open), nobody would take her. Nobody. The Obstetric department didn’t want a young girl aborting in their ward and the surgery team refused to have Leila stay on their end of the hospital. After the resident pleaded and negotiated with the Ob department, they finally agreed to take Leila, but it was clear they were not happy about it.

Leila settled in to her room in the Ob ward…alone. Nobody was there to stay with her and nobody came to check in on her. Yes, let me repeat that, the nurses never once came to check in on Leila. When the resident came to see her the next morning, Leila has spontaneously aborted the fetus in the middle of the night and it remained in her vaginal canal until the resident found it there the next morning. Fortunately, Leila was ok medically. Although abortions are extremely safe, they still come with risks (ie. hemorrhage, infection).

I am so enraged with I think of this story. There is no other situation where nurses and physicians would refuse to provide a hospital bed and care for a patient. There would be outrage if hospital staff refused to provide care for a patient recovering from an appendectomy, for a 55 year old woman pregnant with triplets, or maybe for a 85 year old man recovering from a penile implant.

I can’t imagine being Leila-absolutely alone, knowing that the hospital staff does not want you there because of what you are there for, not knowing what is happening to your body and afraid to ask anyone for help. What a horrible and traumatic experience. I hope I never hear of another Leila or personally witness it in whatever hospital I end up doing my training. Although, the skeptic in me thinks that is highly unlikely.

The stigma behind abortion is alive and well. Which is why we segregate it. You get abortions there , not here! Leila had made a choice, a choice she was legally allowed to make, and yet she was punished for it and her health was in danger because of it. It will take a long time to destigmatize abortion, but the time to start is now. No woman should have to go through what Leila went through…and this was in the Northeast! Imagine what it could have been like somewhere else.