My Abortion was a Painful, Kafkaesque Nightmare

One year later, I'm still glad I got it (and still pissed at the mistreatment of chronically ill folk)

Hello friends,

I’m posting this from my hotel room at the AWP conference, the biggest (as far as I know?) conference for writers and writing programs in the US. I’ve been here for a day and a half and I’m leaving in about three hours, so it’s been a very quick trip. It’s terribly timing to be publishing something like this when a good portion of my readers are otherwise extremely occupied, but today is the day that it is and I can’t control the timing of that.

It is the anniversary of my abortion. I had a lot of feelings about getting it at the time, and now, looking back, I don’t have as many. But I do have a lot of love for the person I was who was having all those feelings in February and March 2022. I suppose the feeling that I’m left with now is a quiet rage, the same rage that I feel every time I need to interact with our broken medical system, the system that took a decade to diagnose my genetic condition and which has and continues to belittle much of my experience.

The essay below is a very slightly modified version of the one that was published originally in The Doe, a publication that no longer exists. But I want this piece of writing to exist somewhere for other chronically ill and disabled folk who might need to deal with this particular situation.

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My Abortion Was a Painful, Kafkaesque Nightmare; I’m Still Glad I Got It

In March of 2022, just three months before the Supreme Court overturned the constitutional right to abortion, I discovered I was pregnant. My partner and I do want a child, but after many (many) tearful (and difficult) conversations with him, my mom, and one of my closest friends, I decided I wanted an abortion. I was in the middle of a long-term creative project that means a great deal to me, and I struggle with anxiety and depression as it is; the idea of trying to finish the project while also carrying the pregnancy to term made me worry that I’d end up resenting the resulting child or my own creative work, and I didn’t want either outcome.

I wasn’t concerned about access. I live in a blue city in a relatively blue state; there are several Planned Parenthood sites within short driving distance of my apartment; and although my insurance didn’t cover the procedure, I was lucky enough to have the savings with which to pay for it out of pocket. While it wouldn’t be easy emotionally, I naively thought that scheduling and receiving the reproductive care I was seeking would be relatively painless.

Boy, was I wrong.

There are a few things you need to know about me that are relevant to these events. I have been chronically ill since I was a kid, with migraines beginning at around age six, and other forms of pain coming on over time. As many chronically ill people know, figuring out what’s going on with you can take years, sometimes decades. After much trial and error, many tests and unhelpful results, and doctors upon doctors who doubted or dismissed my experience, blamed my pain on my mental illness, or implied that it was imaginary, I’ve been left with no small amount of medical trauma. As a result, I feel extremely on edge whenever I need to interact with healthcare services, which is unfortunately fairly frequently. A couple of years ago, I finally learned that I have a genetic condition that cannot be cured and which has been contributing to my pain for my entire life. On the way to getting this diagnosis, I was also inadvertently diagnosed with some other things that I never sought out, including moderate sleep apnea for which I have a BiPAP machine that I almost never use anymore.

(Yes, I should use it. I know. It’s hard, sometimes, to be chronically ill in the correct way; if I don’t follow doctors’ orders, I am immediately somehow at fault, even if following those orders might mean exchanging one kind of discomfort for another rather than actually fixing anything.)

When I showed up to my first Planned Parenthood appointment in order to talk to a nurse about the abortion process and my options, I found out that the organization’s call center—which throughout this process was the only way I could contact them—had scheduled me for a pregnancy test, which I didn’t need. The nurse apologized for the screwup, I peed in a cup, and I asked my questions. While she tried to be kind, she was also unwilling to give me straight answers. I didn’t need guarantees; what I did need, though, was reassurance that in the majority of cases, people have no trouble getting pregnant following an abortion, because despite knowing better, the myth that the procedure could cause infertility was rattling around my brain. Instead, the nurse gave me vague responses about how many factors would come into the future possibility of pregnancy like my age and any potential health conditions.

It was clear to me what was going on: the nurse hedged because if she gave me anything like a guarantee I could potentially sue her or the clinic for providing false information. Even worse, if I was an anti-abortion activist, I could be recording her so as to later blast PP in the press or on social media for promising something she couldn’t.

In other words, in what I would come to learn was a regular part of how PP staff—in my experience, at least—operated, the clinic’s safety came first.

Look, I get it. For years, anti-abortion activists seeking to ban this particular aspect of reproductive healthcare have used tactics ranging from outright violence to the indirect violence of criminalizing any harm that comes to a fetus and strategic data collection in order to scare abortion providers and pregnant people. It makes sense that Planned Parenthood, facing these kinds of threats, needs to cover its own collective ass. The trouble comes when this takes priority over patient need, which is what happened when I finally got my abortion.

The week after my first rather pointless appointment, I was scheduled to get a surgical abortion with twilight sedation on a Tuesday. Monday afternoon, I received a call from the PP call center and was asked some basic medical history questions including whether I had any blood circulation issues. I have POTS (post orthostatic tachycardia syndrome) which for me means I frequently get headrushes when I get up, and I mentioned this because it’s related to circulation. The phone rep, who didn’t know what it was, had to talk to her manager about it. After a brief hold, she told me that I’d need a letter from my primary care physician giving me approval for the procedure, and that I wouldn’t be able to get the abortion the following day after all.

I started crying. Now that I’d made my decision, I wanted to be done with it already, and while my symptoms had been mild at first, by this point I was so constantly nauseous that I could barely move or eat, let alone work, and was spending most of my time on the couch watching Scooby Doo and moaning. After some back and forth during which I tried to explain that I’d had two operations in the last couple of years with more serious anesthesia, I was eventually transferred to a manager who told me that I could keep my appointment and that the clinic would contact my doctor while I was there and receive verbal approval from her.

Tuesday morning, I was at the clinic early. When I talked to the receptionists, it quickly became clear that the call center had once again screwed up. Verbal approval wasn’t a thing; I’d need to get that from my PCP in writing. I’d contacted her the previous night and I called her office as soon as it opened that morning. All I could do now was sit in the waiting room, hoping for the best.

The TV was on loud, set to Bravo, which was showing back-to-back episodes of Friends. They weren’t sequential, but they did share a theme: each and every episode’s plotline involved a pregnancy or a baby. It was almost funny. Here we were, a bunch of pregnant people lucky enough to have access to a clinic that had no anti-abortion protesters downstairs, only to receive pro-baby propaganda from reruns of network TV in Planned Parenthood’s own waiting room.

Finally, at 10am, a nurse told me that they wouldn’t be able to treat me that day since they hadn’t heard from my PCP. I started crying again. The nurse told me to come back at the crack of dawn on Thursday.

Thirty-six hours of nauseous misery later, I was back at the clinic, two copies of the signed doctor’s note in my bag. The TV was on the same channel, and though I didn’t recognize that morning’s sitcom, the episodes I glanced at while waiting to be called in were once again about babies and pregnancies.

I was exhausted, nausea made worse by breathing my own dehydrated mouth smell in my mask (I had needed to fast since the night before), but I was also feeling relieved. By the end of the day, I would no longer be pregnant. When the nurse called my name, I jumped to follow her, nervous and eager to get the process going. I filled out more consent forms, checked off boxes on a more extensive medical history, changed into a paper gown, texted my partner, and tried to calm down.

“I see you have sleep apnea,” a nurse said, going over my forms. I told her it was very mild, that I didn’t even use my BiPAP machine. Her eyebrows scrunched above her mask. “I need to check something, hang on a second.” My lips started to quiver. Something was wrong. Again. I would need to leave. Again. I’d be nauseous and pregnant for who knew how much longer.

“Okay, so here’s the thing,” she told me when she came back in. My face was hot and I could feel something beyond the sadness and frustration rising in me. She explained that my sleep apnea made me a high-risk patient, and because of that, only a CRNA, a Certified Registered Nurse Anesthetist, could administer twilight sleep. The CRNA had been in yesterday and wouldn’t be back for another two weeks.

“But wait,” I said, trying to control what I now recognized as rage. “My doctor knows about my conditions. She still gave her approval for the abortion with anesthetic. She clearly doesn’t think I’m high risk.” Over and over again, I said some variation of this. The nurse just shook her head and explained repeatedly that it didn’t matter, that if they’d known I had sleep apnea they would have told me about this before.

So why didn’t they know? Because they’d never asked. Because they never told me what conditions would make me ineligible to receive anesthesia from anyone other than a CRNA. They never told me that this was even a possibility, and it had never occurred to me because I’d been under full anesthesia for surgery on my elbow the prior year, and my wisdom teeth removal the year before that. Now it felt like I was being punished—not for getting an abortion, but for being chronically ill and for telling the truth about my conditions. I think now that I should have lied.

I did have another option, of course, which was to go through the abortion without anesthetic. It was either that, or wait two weeks. The nausea was awful, and every day put me further behind on my freelance and creative work. I was furious and frustrated. “What happened to ‘my body, my choice’?” I asked the nurse. I wanted my body asleep when my choice was put into practice, but I couldn’t wait two weeks. I wanted to get it over with. And while my medical conditions make my pain threshold quite low, my pain tolerance is very high, because I live in a state of pain all the time. I decided to stay at the clinic and get the procedure without anesthesia so I could go home. What was some more pain?

Except, of course, when I was wheeled into the operating room, the MD giving me the procedure said it wouldn’t hurt. He gave me a little pep talk while the nurses were maneuvering my legs into the humiliating gynecological position, and when I realized he was a doctor, I became incensed all over again. Why on earth couldn’t he give me the anesthetic? Because he couldn’t. A tautology. Because it wasn’t protocol. Because PP’s safety from legal retribution was more important than my body, my choice. So there I lay, splayed open, waiting for a man to remove a clump of cells from inside my uterus.

As soon as he told me there would be some pressure, I knew he’d lied about the pain. Doctors always lie about the pain. It hurt. It hurt a lot. It hurt over and over again as an instrument scraped tissue from my uterus and out through my cervix. It probably hurt worse because I was already so angry, so clenched up, feeling so betrayed by Planned Parenthood, which had always been held up as the paragon of reproductive healthcare. The nurse in the room tried to get me to hold her hand, and I’m pretty sure I said “Fuck no” aloud and yanked my hand away.

And then it was over. The nurses on the other side of the operation, the ones who gave more or less drugged-up patients heated blankets and Tylenol, were much warmer than the others had been. Maybe they needed better bedside manner on this end of things in order to support patients’ intense emotions or the post-anesthesia weepies. They noticed I was mad as well as in pain, and I told them the story, crying again. They brought over a regional manager who squatted down in front of the big easy chair I’d been put into and listened to me attentively. She was kind. They all tried to be kind. I know that. Other than (theoretically) talking to the call center that had given me an incorrect appointment first and misinformation second there was nothing this regional manager could do.

For the first few days after the abortion, I repeated this story frequently. Most of the people I told were horrified because they, too, had thought that Planned Parenthood was the best, most trustworthy place you could go. For many people, it probably is. But if you have certain health conditions—it’s unclear to me still how anyone is supposed to know which—it might be more complicated than that.  

What haunts me is the knowledge that despite all this, I was so lucky and privilege to go through it as I did. Not only because of the access I have, but because I am in my thirties and have been dealing with the medical establishment for years. I know how to stand up for myself in these settings (even if I hate doing it) and while I don’t suppress my anger as well as I’d like to, which doesn’t do me any favors, I know how to ask for clarification and follow-up steps. I kept thinking about someone a little like me who is much younger, more scared, or who has more guilt than I did. What if that person wouldn’t come back to get the abortion after being turned away the first time?

As for me, I’m so glad I returned, so relieved that I’m not a parent yet as I write this, relieved that I can try again in the future, when I’m ready.