The Abortion Clinic: What Goes On
Tommy and Paula pulled up in their pickup truck at the one-story flagstone building in the northern reaches of Phoenix. It was shortly before 7:30 on a Wednesday morning. As they hesitantly made their way up the short stretch of sidewalk leading to the door of the Family Planning Institute, a group of picketers moved toward them. "We want to show you some literature," one woman said, thrusting forward a brochure showing a bloody fetus. "Do you know what a 6-week-old fetus looks like?" demanded a second picketer, pushing a tiny, pink, plastic baby at her face. "Leave her alone," muttered Tommy, shouldering a path through the thicket of signs that read "Human Garbage" and "Real Women Don't Kill Babies."
Inside, Tommy, 26, waited while Paula, 25, registered along with the five other women scheduled for the day's first abortions. But when he emerged from the office 10 minutes later, the gauntlet re-formed. Words were exchanged. Tommy scuffled with two of the men. It wasn't long before three policemen arrived at the coffee shop across the street where he had retreated to wait for Paula. The cops arrested him for threatening behavior and put him in a patrol car.
In the clinic Paula was called from the group counseling session being conducted by Gretchen, 26, one of four nurses on duty. A few minutes later she returned. "Tommy's been arrested," she told the group. "This is all we need."
Later Tommy tried to explain. "They got in my face again when I came out," he said, after paying $412 bail. "One lady, she kept calling me a murderer. We felt bad enough about doing this. We have a 1-year-old son. Paula just quit her job. We have no insurance. We have no money at all. We just couldn't have another baby right now."
As the abortion debate intensifies, confrontations like this have become routine at the 1,500 clinics and doctors' offices where 80 percent of the estimated 1.5 million abortions in the U.S. are performed each year. Last year abortion and planned parenthood clinics were targets of 100 violent incidents, including bombings and arson. The Family Planning clinic in Phoenix—which averages 72 abortions each week—has received two bomb threats, and its telephone lines have been cut. "Periodically we feel we are under siege," admits Constance Bennett, 39, a psychiatric nurse who a year ago took over as director of Family Planning clinics in Phoenix, Tempe and Las Vegas.
Outside the Phoenix branch, prolifer Peggy Green has picketed every Wednesday and Saturday for a year. Preparing again to hoist her sign one morning, she explains, "The only way laws get changed in this country is when people take to the streets. And we're doing it because life in the womb is sacred."
But the picketers are no deterrent to Family Planning staff members who work daily with women unwilling to bear children. "Until we can provide every woman with reliable birth control, abortion should be a legal and safe alternative," says Gretchen. In the counseling sessions, which are mandatory at Family Planning clinics, she listens as the women discuss the pressures that led them to decide on abortion.
"My husband and I have two boys at home," says Molly, 28. "They're 2 and 5, and we planned both of them, but we don't want more kids. I hated being pregnant, and I just can't handle it again, emotionally or physically."
Louisa, an Hispanic woman, speaks next. "I'm separated from my husband. I have a new boyfriend. This was a mistake, but I can't even tell him I'm pregnant. He told me if I ever had an abortion he'd kill me."
The counseling room falls silent as Daphne stares at a spot on the floor. "I'm 24, unmarried, and I have a 7-year-old girl," she says. "I was raped when I was 16. I knew the guy. I come from a real small town in western Pennsylvania. Abortion wasn't an option. I'm glad I kept her, but I know what you give up when you have a baby. After the age of 17, I never had a date. Excitement for me was taking my baby to the grocery store. I don't want to have an abortion, but it wouldn't be fair to my daughter or to me to have another child."
Similar stories are told at each of the clinics. At Tempe one morning, Annette Thierbach, 37, explains, "I'm single, and I already have a child. I got pregnant for the first time when I was stationed as the first woman at the Coast Guard base in Portsmouth, Va. They told me then that if I had an abortion, I could keep my job. I wanted the baby. They called me a whore and a slut, and the Coast Guard discharged me. Then they promoted the father and sent him to Hawaii. I sued the Coast Guard. I won, too. Now, though, I can't afford another child, and I couldn't bear to give it up for adoption." Thierbach is angry about the picketers outside. "Half of them are men," she says. "They've never carried a baby for nine months. How can they tell us what to do?"
There are few rules at Family Planning, but those that exist are strictly enforced. Women who come to the clinics must submit to a pregnancy test. Neither men nor women friends are allowed to accompany patients into the counseling or procedure rooms. Women under 18 must have notified a parent of the planned abortion. Sometimes parental concurrence is not the problem. One night recently, says Bennett, a teenager blurted out in a counseling group that her mother was forcing her to have the abortion. The girl was taken out of the group, and mother and daughter were advised to discuss other alternatives, such as adoption, with a staff psychologist.
On this morning Gretchen leads Molly, the first of her group, down the hall to the procedure room. "I'm going to be with you the whole time," she says. Despite the 10 mg of Valium that is administered to each woman, Molly still flinches as the doctor inserts a speculum and injects a shot of Carbocaine, a local anesthetic, into her cervix. Then he inserts a plastic suction tube. In a moment the hum of the aspirator begins. "Hold my hand tight," Gretchen instructs. What looks like menstrual fluid is suctioned into a glass bottle. "That's it," announces the doctor. Several seconds later Molly raises herself onto her elbows, shaky and perspiring. "I'm sorry," she stammers, "but, could I see?" "Sure you can," says the doctor, removing the filter to reveal a thumbnail-size patch of tissue. "That's what there is at this stage. You were early, just eight or nine weeks." Molly looks relieved.
Even though abortion is legal in Arizona through the 20th week of pregnancy, Family Planning will generally perform only first trimester abortions—up to 12 weeks. The policy is set by its doctors. "The doctors on our staff are only comfortable doing procedures between seven and 12 weeks," explains Bennett.
At up to seven weeks, an abortion a simple medical procedure a menstrual extraction, for which Family Planning charges $135. "It's easy because it doesn't require dilating the cervix," explains Jackie, 32, a nurse who has worked at the clinic for four years. "It's a vacuum aspiration in which the tube suctions out the pregnancy." Abortions of fetuses between eight and 12 weeks are more complicated because the cervix has to be manually dilated. The clinics charge $185 for these abortions, which account for 60 percent of their procedures. "The doctors always see the women beforehand to ascertain the size of the fetus," says Jackie. "The examination is reliable. If they're over the limit, we turn them away, but we'll recommend a local gynecologist or clinic that will help them. Those places will usually charge between $650 and $2,000, although most of the women I see will have a hard time coming up with that kind of money."
One by one the women are led into recovery, a sunlit room presided over by Lynne, 37, an obstetrical nurse. She is an eight-year veteran at Family Planning. Though complications are rare, it is Lynne's job to monitor bleeding, cramping and vital signs. "That hurt like hell," moans one patient. "Have some juice and cookies," Lynne suggests. "They'll raise your blood sugar. You'll feel better in about five minutes." On a couch across the room, Paula begins to cry softly. Lynne bends down and comforts her. Afterward she explains: "No one says abortion is an easy thing. Women react differently. Most are just relieved. But the ones who take it the hardest are usually mothers who have small children."
Forty-five minutes later most of the group is dressed. All have been given some form of birth control, the telephone number of the on-call nurse in case of emergency and an appointment to return in two weeks. "It's important to come back," Lynne stresses to each woman. "We need to check for possible infection and to see that your cervix has healed properly." Two thirds of them, however, will never be heard from again. "We'll call the number they've listed, and it will be nonexistent," says Lynne. "One time I reached a construction trailer."
For all their expertise, the Family Planning staff is confounded by "repeaters," women who appear at the clinic for as many as five or six abortions. Though these women are not turned away, neither are they welcomed. "I get really angry," says Jackie. "It makes us wonder what we're doing here. We sit down again and again, lecture them and try to find them a better form of birth control."
Though they are committed to their work, the Family Planning staff have found that the simple fact of working in a clinic can be socially troublesome. One receptionist will not tell her parents—who live in another state—where she is employed. Jackie, recently engaged, has found the issue coming between her and her fiancé. "He's very much opposed to abortion," she says. "Even though he's gotten more understanding, he still thinks I shouldn't be in this environment."
The staffs of both the Phoenix and Tempe clinics have seen strangers copying down the license plate numbers of cars in the parking lot. Photographs of staff members have been snapped entering and leaving work, and their cars have been followed. The doctors, fearful of retaliation against themselves or their families, decline to be identified in print. "It's a very difficult situation," admits Constance Bennett, who has brought in a psychologist to help her employees cope with the stress. The psychologist refuses to discuss her role.
Family Planning's troubles mounted last year when the Chicago-based Pro-Life Action League, one of the most militant of the anti-abortion groups, listed the Tempe clinic among 12 that it was determined to shut down. The league's founder, Joseph M. Scheidler, had already counted his organization responsible for at least 18 closed clinics. Shortly thereafter a local right-to-life organization, Project Jericho, stepped up its harassment. Bennett was forced to hire people to escort patients the 100 yards from their cars to the clinic. On Good Friday of last year 250 protesters, some dressed as witches in black robes, marched in a ring around the building. Musicians blared Onward Christian Soldiers while the group erected white crosses all over a dirt lot next to the clinic.
Finally, last September Bennett obtained an injunction preventing picketers from trying to intimidate staff and patients. Since then, on Tuesdays and Fridays, days on which abortions are performed, the Tempe police stand guard in the parking lot enforcing the injunction.
Jim Mooney, 45, the paid director of the Aid to Women Center and Project Jericho, is unsympathetic to those who frequent the clinic. "The people who are really being harassed are the ones inside the mother's womb," he says. A longtime opponent of abortion, married and the father of three children, Mooney took up the cause full-time in November 1983, when he decided to give up his mail-order clothing business to join the picketers he passed each day outside the Tempe clinic. A year later two local businessmen donated $40,000 to Project Jericho. Mooney used the money to rent an office adjacent to the clinic. He attached a sign to the door reading, Aid to Women Center. Though it is identical in design to the green-and-white Family Planning sign next door, Mooney denies that he is attempting to confuse women seeking an abortion. "We give pregnancy tests and counsel women on alternatives to killing their babies," he says. Mooney claims proudly that his office has "saved" 70 babies since January. "We totally agree that women have a choice," he says, "as long as they guarantee the same choice to the unborn." Still, Mooney admits, "we may have made some mistakes."
Last spring a woman who had driven three hours for a scheduled abortion at Family Planning says she was escorted into the Aid to Women office, given a urine test, taken into a small room and shown the antiabortion film The Silent Scream. She tried to leave, only to find that the door had been locked behind her. "She began screaming, and they finally let her out," says Bennett. "She ran over to our clinic completely hysterical." Though Mooney maintains the door locked accidentally, the city of Tempe is bringing a charge of unlawful imprisonment against Mooney.
Since that incident there has been an uneasy lull in the struggle between Family Planning and Project Jericho. "I don't trust that they're giving up," says Bennett. "But they're not as overtly aggressive at the moment." For a time Bennett was convinced that her staff would be sufficiently intimidated to quit. "There are a lot of nice jobs around," she says. "But instead of giving up, our people seemed to get angrier and more adamant about women's rights."
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