The XX Factor

News Flash: First-Trimester Abortions Aren’t Heart Surgery

Supporters of Planned Parenthood on Feb. 3, 2012, in Seattle.

Photo by Stephen Brashear/Getty Images

In recent years, Republicans have been hugely effective in drowning abortion clinics in so much red tape that they have to shut down. But women still need abortions and will move heaven and earth to get them. Molly Redden of Mother Jones traveled across the country visiting clinics to see how new regulations have impacted clinics’ ability to provide care and how they’ve changed the experience of obtaining an abortion. “The onslaught of new abortion restrictions has been so successful, so strategically designed, and so well coordinated,” Redden writes, that the fight for abortion access “in many places has essentially been lost.”

The travel and work-loss burdens that add hundreds or thousands of dollars in costs have been well-documented. But what is less reported—until Redden’s piece—is how the new regulations make getting an abortion as pointlessly frightening as possible. Texas and 24 other states have passed laws requiring that abortions only be performed in “ambulatory surgical centers.” On paper, it doesn’t sound so bad; in practice, it would be comical if it weren’t so cruel.

First-trimester abortions typically should be done in a normal doctor’s office, in the same room you might get something like a cervical biopsy. But this is what clinics have to look like in these 25 states:

[Planned Parenthood director of government relations Kelly] Hart clicks through the door of an operating theater. It’s about the size of a starter apartment, and it’s slightly cozier than a meat locker. Planned Parenthood wanted to decorate the barren white walls with art. But ASC rules about dust control caused staff to reconsider. Above us, a set of cryptic-looking nozzles, for pumping nitrous oxide and compressed air, jut out from the ceiling like high-tech stalactites. “It’s frightening, isn’t it?” Hart says. “And there’s just no reason for that.” None of them have hoses attached; the doctors don’t need what they pump. At the nurses’ station, a row of blinking orange lights alerts us that the supplies are low.

“Women wait for their turn in a reception area” in normal clinics, Redden writes, “and they wear their own clothes. But in surgical centers like this one, all the patients are naked beneath their hospital gowns.” In normal clinics, nurses wear scrubs but are emotionally available to patients, ready to hold hands and smile at them. Under the new regulations, “nurses disappear beneath bonnets and booties and surgical masks.”

Anti-choicers claim these regulations are for safety, but abortion was already 40 times safer than a colonoscopy. The real purpose of these regulations is to make the patient believe that what she is undergoing is major surgery. The intended message is that abortion is dangerous and traumatic, especially compared with childbirth. 

First-trimester abortion is easy. Early term pregnancies often abort on all on their own. For a vacuum-aspiration abortion, you’re in the stirrups for 10 to 15 minutes, usually with a local anesthetic. There is no cutting involved. For a medication abortion, you take a pill and go home, ready to expel what is going to look like a heavy period. You may need an aspirin. This is not heart surgery, but the regulations are clearly meant to make you think otherwise—and to be afraid. 

Here’s a crystallization of the sadism of these laws: Michigan has a new rule that requires not just that you acknowledge reading an anti-abortion pamphlet 24 hours before getting an abortion, but that you print it out to “prove” that you did with a time stamp. “At least once a week, a woman appears at the clinic who read the documents the day before but couldn’t print them until the morning of her procedure (poor women, especially, suffer because they use their phones as computers),” Redden writes. If they can’t stop you, anti-choicers will punish you with bureaucratic perversity that Kafka in his fictional hellscapes would have deemed overkill.