All language subtitles for Our.Bodies.Our.Doctors.2019.1080p.WEB.h264-COALESCENCE

- [Sarah] Mr. Chief Justice,
and may it please, the court,

we are not here to
advocate abortion.

We do not ask this court to
rule that abortion is good

or desirable in any
particular situation.

We are here to advocate
that the decision

as to whether or not
a particular woman

will continue to carry or
will terminate a pregnancy

is a decision that should
be made by that individual.

- [Justice Burger]
But any doctor,

I suppose, who may refuse her?

- [Sarah] Certainly,
your honor, he may,

he may refuse any kind of
medical procedure whatsoever.

Here, it's the question
of whether or not

the state by the statute will
force the woman to continue.

The woman should be
given that freedom

just as the doctor has
the freedom to decide

what procedures
he will carry out

and what he will
refuse to his patient.

(tense music)

- I'm sort of a typical doctor

who's just kind of
out in the world.

But then I also go and do
abortions in difficult places.

I think most people
who go into healthcare

have the same goals.

Everyone wants to
take care of patients.

Good morning!

But there's a lot that
goes in between that goal

and the reality of
what can be done.

(music slowly fades)

(distant traffic)
(birds singing)

(traffic rushes past)

(pump creaks)

(phone rings)

- Hello, South Wind
Women's Center.

This is Katie. How
can I help you?

Okay. I can help you do that.

To start off with,

can I get your name
first and last?

Okay. Can I get
your date of birth?

We are always working our best

to be in compliance with
the law because that is how

we remain open to
provide care to patients.

Okay. So we've got
all that figured out.

Now I'm gonna read
you some information.

This is called 72 hour
consent statement.

This has to be read to
you at least 72 hours

before you wanna be seen
per Oklahoma state law.

It's gonna take me a
couple minutes to read to,

so just bear with me, okay?

"The state of Oklahoma requires
we offer you a book called

'A Woman's Right to Know'.

You don't have to
read this book.

We just have to offer it to you.

A link to this book can
be found on our website.

And we also have copies
available in our office.

We can send you a copy of this
book by mail if you choose.

The state of Oklahoma
requires we provide you

with the following information.

This is just extra things
that the state makes us do

that adds five minutes
onto their appointment,

and, you know,

distracts them from listening
to the important things.

I want them to know, you know,

what to expect during
the appointment.

And, you know, I want them
to have the presence of mind

to be able to ask the questions

that they are wondering about.

And so, I don't want
their mind dulled

by this political speech
that I have to give to them.

At no cost, (indistinct) from me

that medical systems benefits
(rapid speech) that may occur

and that the man involved
in the pregnancy is liable,

so assists in the
support of your child

even has to pay
for your abortion.

They cloak all of these laws
in language that implies

that they're
medically necessary,

that they're about
women's health,

when actually they
interfere with our ability

to provide safe
healthcare to people.

I mean, we particularly
see that in this state

in that we have a 72
hour waiting period.

We cannot see anybody
sooner than 72 hours

after that statement
has been read.

And that means that since
we only have a doctor in

a few days a week, that can
push people out another week,

which if you're getting
close to a gestation change

that can change the
procedure you have done,

that can mean you have to go

to a different state
to have it done right.

To inform you that may
be an ultrasound images

of the heart in your fetus.

The booklet also needs
you to know the facility

offers these
services at no cost.

These materials from
provided by state board,

medicalized insurance
supervision,

and script details
about pregnancy

and lists agencies that offer
alternatives to abortion.

Okay. That part's done.

So now we'll just go over
the rest of the details

for your appointment, okay?

(gentle music)

(indistinct speech)

Are you for an appointment?

- Yes.
- Okay.

Can I get a photo ID?

- Sure.
(gentle music)

- Dr. George Tiller,
who was my former boss,

he became one of the
very few providers of

late termination of pregnancy

and the anti-choice
folks hounded him.

After he was assassinated,

it was either pack up and
find a different line of work

or dig in and not
let these extremists,

these terrorists,
tell us what to do.

I did not want them
to have the last word.

- You have a seat on the bed,

doctor will be with you shortly.

(door closes)

- In two days we can see
sometimes 70 patients.

Primarily they're from
the Oklahoma City area,

the Metro, that's about 50%.

Then from there, it's
all over Oklahoma.

We do see patients from Texas.

(gentle music)

- Even though it's
challenging here politically,

it doesn't mean we
can't do the work

that we want to
do or need to do.

It just might take a
little more creativity,

a little more money,
because you know,

like for example, having
to fly physicians in.

(laughs)

- I talked my way past 40
people at the TSA pre-check line

so I could make it on my plane.

- I believe in you doctor.
- Amazing.

I go to Oklahoma City in Wichita

because there aren't
doctors that perform,

particularly second
trimester abortions,

in those cities or states.

Hi, I'm Dr. Chiavarini.
It's good to meet you.

Have you you've paid cash
for the NuvaRing before?

- Mm-hmm.
- Yeah,

it's pretty expensive, huh?
- Yeah,

it's really expensive.
- Yeah.

So do you, what
county do you live in?

- Oklahoma City county.

- Oh, okay.

Did you wanna see the
ultrasound or not?

- It's.
- It's up to you.

Some people do and some people
don't. So we just always ask.

It's not something that,
you know, it's really your,

some people are really curious
and some people are like,

"I don't wanna
see anything," so.

- Yeah.
- Okay.

I grew up in the south,

so saw a lot of the
way that women were not

necessarily respected
that I think informed me

to be invested in making sure
that women were taken care of.

No surprises.
- Okay.

The good news is you're
super, super early.

So, that makes this procedure
very straightforward.

It's very, very quick.

And the recovery
should be really fast.

Basically, tomorrow should feel
like you're on your period.

- Okay.
- So,

I don't know if you
have to work soon or?

- I do tomorrow.

- Okay.
(chuckles)

Yeah, I mean,

you should be able to
get up in the morning

and take some ibuprofen
and it'll be like working

when you're on your period.

- Okay.

- [Molly] We have a
doctor in two days a week.

- Yeah.
- We have 60,

70 patients on the books that
you have to see in two days.

So we know it's
gonna be a long day.

I mean, the thing
is just, you know,

there's not a lot of clinics
in part of the country.

- Looking adorable.
- Thank you.

Any last minute questions?

- Nn-nnh
- Okay.

- All right.
(indistinct chatter)

- Okay.

The first thing I'm going to do

is I'm just gonna feel
your cervix, okay?

So you're just gonna feel
me touch on the outside.

A little bit of cold goop here.

So you'll feel some pressure.

We talk to women a lot about
owning their own decisions

and that they have
nothing to feel sorry for.

And especially the women
who have a lot of guilt

and they feel like
they don't have

the support of their
families or they're being

very judged by their families.

It's okay.
- Are you nervous?

Oh, that's normal!
- It's okay, sweetie.

- You know, if you
weren't nervous,

you'd be crazy and weird.

- Right.
- Everybody's nervous

before this.

Okay, the next
thing I'm gonna do

is I'm gonna put a speculum in

just like when you
have a pap smear, okay?

You're doing so great.

Think women come in feeling like

that if they're grieving or
they're sad that that means

that they're doing
something wrong.

We talk about that a lot.

I tell them,

"Look just 'cause you're
sad about something

doesn't mean it's the
wrong thing to do."

- Okay.
- Okay sweetie.

The next thing I'm gonna
do is stretch your cervix.

So you may feel cramps.

- Phase two.
- Okay?

So the best thing that
you can do is take

big old, deep breaths.
- Deep breaths.

Okay?
- In through your nose.

- [Dr. Chiavarini] You
can't get out of a pregnancy

without pain and tears,
regardless of how it ends up.

And sometimes it's
tears of relief.

But more than often than not,

it's tears of sadness and grief.

- [Katie] Down like
it's supposed to do.

So we're gonna breathe
through in through your nose.

Out through your mouth.
- You are a rock rockstar.

Good job.
- Keep breathing.

- [Katie] You got this.

Deep breath in
through your nose.

- [Dr. Chiavarini] We take
a break for just a second,

and then we got about five more
seconds and you'll be done.

Okay?
- You doing okay?

- You doing okay?
- But you're gonna be like,

"Oh, that one, shit!"

(laughing)

- [Katie] What
would you be doing

if you weren't
here with us today?

- [Patient] Probably sleeping.

- Asleep!
- Sleeping!

Oh, that sounds awesome.
- Cool!

- Okay. Five more seconds.

- (indistinct) Asleep.

- You got this girl? You got it?

- Absolutely!
- Keep breathing.

In through your nose.

- [Katie] She's a rock
star. She's got this.

- Big old breaths.

- [Katie] Deep breath in
your through your nose.

- Big old breaths.
- Out through your nose.

You're doing excellent, babe.

- Good job!
- Almost there.

(instrument clacks)

- All right, you are done!
- Congratulations.

- [Patient] That's it?

- That should feel much better.

- [Nurse] Just I've
told everyone to
massage their uterus.

- [Dr. Chiavarini]
Oh yeah. It helps.

That's the worst it
was gonna feel it.

It's gonna...

- Yeah.
- You'll be fine from now on.

You'll probably just feel
like you're on your period.

- Okay.
- You just said

you said you have to
work tomorrow, right?

- Mm-hmm.
- Yeah.

You won't feel, you'll feel
so much better tomorrow.

- Okay.
- Just take some ibuprofen.

- Okay.
- You doing all right?

- [Patient] Yeah.
I'm good, thank you.

- Okay, all right.

I'm gonna get you
cleaned up. Okay?

You okay?

- Uh-huh.

- Women and people come
from all walks of life.

They all have their own
stories and their backgrounds

when they walk in here.

(door clicks shut)

We do try to meet
them where they're at.

So when someone is even
downright hateful, sometimes we,

I don't take it personally.

I know you don't because

- Yeah.
- There's something else

going on, I know
that it's not us.

(gentle music)
- Thank you so much.

You're so awesome.

- You're welcome.

So basically you're
just gonna have

some cramping for
the next few days,

but we're sending you
home with the ibuprofen

and that will help
tremendously as well as that

uterine massage that I
showed you in the OR.

(gentle music)
(indistinct chatter)

- The thing that is
unique about abortion care

is that because it's
not an easy thing to do

you have to be pretty
dedicated to the work.

(distant chatter)

The people that came
into abortion care

a generation or so ago came
into it out of feminism

and watching so many women
suffer under illegal abortion.

And I know that there was a
fear among older providers

that there wouldn't
be so much commitment

to providing abortion
services because

my generation is the
post Rowe generation

and we didn't see these
kinds of things happening.

(distant chatter)

- This photograph is
actually my mugshot

taken by the Chicago police
on, as you see, May 4th, 1972.

(gentle guitar music)

The bust was
actually on May 3rd.

Seven Janes were taken.

And abortion, when it is
illegal, is felony homicide.

Those were the charges.

We, the women who worked in
it, called it The Service.

In my own case,

I actually discovered The
Service in the summer of 1970

through asking a medical
student, who was a pal of mine,

"I may need. Do you know?"

And he said, "Everybody
here," meaning

the University of Illinois
Medical School at Chicago,

"everybody here says,

call this number
and ask for Jane."

That was pretty striking to me.

I thought, "Oh really?"

The women who worked in it used
that as sort of a code name,

"Call this number and ask
for Jane," that was the line.

In the main,

the medical industry was
not the least bit interested

in assisting women
in those ways.

And of course, as we know,

the medical industry was
not particularly interested

in assisting women in
many ways. (chuckles)

(gentle piano music)

And it was in those years that
we saw the rise of the book,

"Our Bodies, Ourselves,"

which began as a
newsprint pamphlet of,

I don't know, maybe
a dozen pages.

It was like contraband.

Everybody, we thought,
"Oh my God, look at this!

Look what they're doing."

And that came out of those years

because the medical industry

was not serving
the needs of women.

(gentle music)

- The values of "Our
Bodies, Ourselves,"

and empowering women with
information about their bodies.

It changes the role of the
doctors away from paternalism

to partnering with women to
achieve their health goals.

Women, when they present
to the healthcare system,

they're now armed
with more information.

They're now aware of what
the possibilities are.

And so the very
paternalistic approach to,

"I'm the doctor and I
know what's best for you."

That's shifted greatly.

(gentle music)

- I certainly believe that
it's good that Roe v Wade

made abortion legal
in the United States.

However, if you read the text,

you see that it's the doctors
who have the power of choice,

not the women.

- [Sarah] If the right of
privacy is to mean anything,

it is the right
of the individual,

whether married or single,

to make determinations
for themself.

It seems to me that
you cannot say,

this is a woman of
this particular doctor

and this particular woman.

It is-
- Well,

doesn't it follow
from that then,

that a woman can come into
a doctor's office and say,

"I want an abortion."

- [Sarah] And he can say, "I'm
sorry, I don't perform them."

(gentle music)

- I do feel like the
Roe decision was still

too much associated with

patriarchal and parochial
notions that pervade healthcare,

placing a woman's reproductive
capabilities under, again,

the receivership of men,

just in the capacity of
being medical providers.

There's not an innate
right to self-determination

and bodily autonomy.

It is a woman's entitled
to access abortion care

if other people are
complicit with her decision.

- Because we were illegal,

it was extremely important
for every woman or girl

who came to us to understand
when you make this decision,

you are accepting responsibility
for breaking a law

and literally taking your
life into your own hands.

And that was what we wanted.

We wanted ourselves and
other women and girls

to take our lives
into our own hands

and not give them over to
either the medical industry,

or to the police or
to organized religion.

But to be able to say,
"This is who I am.

I have given this
serious thought,

this is what I need to do.

I can outline the reasons for
you, but I don't have to."

At the same time
that we were doing

abortion work underground,

we were learning about many
medical/political practices

that were unacceptable to us.

And certainly I think
would be unacceptable

to many, many people now.

(gentle guitar music)

- [Willie] Our healthcare
and medical system has been

no better than the country
in which it resides.

For example,

there's no denying what happened

with the Tuskegee
Syphilis Trial.

- [Narrator] This is not the
story of syphilis, the disease.

It is the story of public
health organization

who stamp out syphilis.

- A group of people in
the public health service

decided that they
want to figure out

what was the natural medical
course of untreated syphilis.

So there were black veterans
who contracted syphilis

and rather than being treated,

they were allowed to
be studied which was

unethical and tragic
given that penicillin

had already been identified

as an effective
cure for syphilis.

(somber music)

It's that history that's
undeniable that's there.

So people in the
anti-abortion movement

have exploited the
doubt and the suspicion

that communities of color
have about the medical system.

♪ We shall overcome

(somber music)
- The conspiracy theory

of black genocide, for example,

the latest iteration was
around 2006 with billboards

in Atlanta and other
major urban areas

that framed abortion
as black genocide

exploiting the epidemiology
that notes that

the highest rates of abortion

occur for African
American women.

The majority of the healthcare
providers in this country

are white people.

So to allege racism and
genocide has a chilling effect,

even on people who are
committed to providing the care.

(haunting tones)

(car whooshes along)

- Most physicians, you're
honored, you are respected.

There's a lot of authority.

That is not afforded
to abortion providers.

You don't talk about, I
am an abortion doctor.

You're an abortionist.

You don't, there are words that
are meant to be disparaging

used to describe people
who do abortions.

So yeah, this is our
friendly protestor, Sarah.

She's here every day
and, actually Mona
the clinic manager,

just a couple weeks ago went
down and was talking to her

and was like,
(reverse alarm beeps)

"Do you even know what
happens in an abortion clinic?

Like have you any idea?"

And was like, "Why
don't you just come in?

And like, if a patient agrees,

you can even listen to
a counseling session.

We are not evil."

[Interviewer] Was she
not interested in?

- [Sarah] No, not interested.

- [Receptionist] Go
ahead and come through

the door on the right.

(chattering)

- [Woman] It's a
two year fellowship

that is both researching.

- Thanks.

I'd grown up with parents
who were very pro-choice and,

you know, had talked about
planned parenthood and abortion,

and that was fine and you know,

wasn't something restricted
in my family at all.

So that felt like a very
natural thing for me to do.

Tomorrow, but I don't think
that's gonna be able to happen.

And so I signed up to
volunteer one day a week

at Planned Parenthood and
then ended up getting hired

to be a medical assistant
and that was when I met Deb.

- Right.
- Sounds good.

- She's in two.

I'm Deb, hi, the doctor.

We are here to end your
pregnancy today, correct?

- Yes.
- Do you have any

questions about that?

- No.
- Okay.

I'm gonna start by listening
to your heart and lungs.

- I just loved how
she interacted with
me and with patients

and just had this
really great presence.

That, coupled with the whole
message and the culture

and everything about family
planning just clicked.

It was really like, I
found what I wanted to do.

- So you're gonna
feel me touch you here

and then a cold speculum,
a lot of pressure.

(monitor beeps)

So you may feel
a little tugging.

If it's too much,
you let me know.

- [Patient] Okay.

- So that cramping will ease
up in the next few minutes.

Okay and little pressure
as the speculum comes out.

And any cramping you're having

will ease up in the
next five to 10 minutes.

So I am gonna go to the lab
and make sure we're done. Okay?

And I'll be right back.
- Okay.

- What we look for
are different things

at different gestational ages.

So at seven weeks, we're
looking for the pregnancy sac.

So everyone talks about
their amniotic fluid,

but there's actually
an amniotic sac

within the chorionic sac,

and the chorionic sac is
the true pregnancy sac.

Everything else we
see is uterine lining,

also called decidua, and we're
also looking for the decidua,

the uterine lining that sits
right over the pregnancy sac.

And so that also helps us
know we have what we need,

but I know from ultrasound
she's seven weeks pregnant.

My pregnancy sac is seven
to seven and a half weeks,

which is exactly what
her ultrasound showed.

(knocks on door)

How's the cramping?

- [Patient] It hurts.
It's not like it'll go.

- Would you like an Naproxen?

- Yeah.
- Okay.

I'll get you one of those.

So one of my favorite
facts is the uterus

is the strongest involuntary
muscle in your body.

- Yeah.
- And you are feeling

it's full effects.
- Yeah.

- So while it's not comfortable,

it actually means
your uterus is doing

exactly what we
want it to be doing,

okay.
- Okay.

- So the way a uterus stops
bleeding is by contracting.

- Okay.
- And that's what

uterus is doing.
- Okay.

- So that's great.

Everything looks great.
- Okay.

- Okay. Do you
have any questions?

- No.
- Okay.

So we are at the
other end of the phone

if you think of any.

Okay?
- Okay.

- And you're gonna see your
doctor and get that implant.

- Yes.
- Okay.

So between now and then no
sex or condom each time.

Okay?
- Okay.

I don't even plan on it.

It's led me to this.

- Yes. But often we don't
plan and there it goes.

- I know, all right.
- Okay.

All right.

(indistinct speech)
(gentle guitar music)

As an abortion provider,
one can get very isolated.

And so one of my favorite
things about coming here

is having colleagues.

- [Sarah] I'm gonna go
in and see this one, and-

- She's the one
you're also hoping to-

- Yeah, I only have six
dilators in there, so.

- Yeah.
- I'm thinking that's

not probably gonna happen.

- Sarah is truly, one of my
favorite people in the world.

Friday, so.

Last week when she
had a complication,

the first thing she did on
the way home is call me.

I had a difficult
patient on Tuesday,

the first thing
I do is call her.

- Well, I mean, one thing about

the family planning
community is that I think

it is really tight
knit and we do

really rely on each
other for support because

we can be isolated from the
rest of, not just medicine,

but even obstetrics and
gynecology sometimes,

we're considered other.

And so, yeah, we have a really
strong sense of community

and we're incredibly
supportive of one another.

And so, you know,

that's a benefit of being
in a marginalized group.

(gentle music)

(distant chatter)

- So my name is Rachel Hoffman.

I'm a medical student
and I am co-chair of

Medical Students
For Choice at UDub.

We wanna welcome you all again,
to introduce the panelists.

We have Dr. Sarah
Prager, who is an OB-GYN

and Dr. Deb Oyer, who
is in family medicine.

- Medical Students For Choice
really does what it does

by establishing a strong
community within which

we can all feel safe.

And that is so important for
all of us to gain the courage

to overcome the stigma
that we will face

on an almost daily basis
in the medical community

and the community at large.

- There is a pretty big
spectrum in terms of

how much, if at all,

medical schools have
abortion on their curriculum.

I know there are many
residents who start

OB-GYN residency programs

without having any
exposure to abortion.

I will admit,

I don't know the particulars
of each and every site

where you all can be
sent to do your clerkship

and whether or not abortion
care is a part of that.

I would say the minority
of rotations in OB-GYN

are going to specifically offer
exposure to abortion care.

- What you really wanna learn
from your core clerkship

is how to talk to a woman
about an unplanned pregnancy.

And then you will also see
miscarriage management,

which quite frankly, surgically,

is really not considerably
different than an abortion.

It's the emotion in the
conversation beforehand.

You know, if every time
someone comes in pregnant,

the office says to them,

"Oh, congratulations, isn't
this great," that's not okay.

- How many of you are
planning after your training

to be practicing
in a rural area?

- I think if I were practicing
in a more rural place,

seeing more news stories,

I don't know if I'd feel
safe providing abortions.

- So I spent five years as a,

the leader of an
abortion providing clinic

in rural central Pennsylvania.

We had some pickets
at the clinic,

but they were
generally respectful.

And remember,

picketing is a constitutionally
protected activity,

not in and of itself scary.

And then I went to
Portland, Oregon.

(chuckling)
Oh my God.

I was threatened.

My house was picketed
by those people

who said abortion providers
should be murdered.

It is a more confusing picture
than you might believe.

- Since you helped train
students to provide abortions.

Have you found
that some students

are really passionate about it,

but are too scared to
actually do it afterwards?

'Cause we've all heard, you
know, the horrific news stories.

- I in no way would
ever negate the fact

that there has been violence

and probably will
be violence again

in abortion clinics and
towards abortion providers.

But I also want to put into
perspective a little bit,

the safety issue when we
talk about abortion care.

And who knows which what
type or types of physicians

are at most risk from homicide?

It's actually emergency
medicine physicians

and psychiatrists.

To put it in perspective.

There are a lot less safe things
you could do as a physician

than be an abortion provider.

- Like cross the street.

(laughing)

(distant traffic)

(traffic hums past)

(cycle clatters)

(phone rings)

- Good afternoon, Downtown
Women's Center. This is Tristan.

We've been here over 30 years.

We're a small clinic
like you would go

to see just your regular
doctor if you had a cough.

(gentle music)

We work very closely with Oregon
Health Sciences University

and their fellows and residents.

- Here at OHSU,

We've developed a
very close connection

with the clinics in town.

- So I'm the physician that's

gonna be doing your
procedure today.

Do you like me to
kind of tell you

what I'm doing with each step
or do you prefer me not to?

- I think if you're talking,
that's probably good.

- Okay.

- We have our medical
students and residents,

and fellows and faculty
working in those settings.

- I'm gonna have you
lay all the way back.

It's super important to all
of us and all of our doctors

that we train the next doctors.

(door squeaks, closes)

- I come here periodically

to train family
practice residents.

We think it's really important
to prepare our residents,

to be able to take care of
women who need abortion care,

who need help with
miscarriage management#

when they have early
pregnancy losses,

and who can help women get

whatever kind of contraceptive
choice they want.

Oh, let's go just
through the instruments.

We talked a little bit about,

these are called manual vacuum
aspirators or MBAs for short.

There's this really
fun model where we use

a papaya as a pretend uterus.

And so you're gonna feel
firm, firm, firm, firm, firm,

and then a give because then
the relatively larger space,

potential space of
inside the uterus.

And that has a really
characteristic feel as well.

Not very many of
my residents go out

and actually become abortion
providers, but many,

if not most of them are able
to manage early pregnancy loss.

And then you take your aspirator
and you get this ready.

Whoa.

I'm gonna insert the
flexible cannula in there.

You get the seeds
coming through.

I love bringing residents here

so they get to see what a
feminist clinic is like.

And it's a very
patient centered place.

- Uh-huh.

Yeah, so there would be a
couple of different options.

You could either do
an in clinic procedure

here with a doctor where
you come in for about

two and a half to three
hours and just everything

would happen for
you at that visit.

Not everybody's terrified or
ashamed to have an abortion,

but everybody goes
through something.

Okay, so you can come back,
talk to somebody and kind of.

Some women just wanna come
in and be like, "Are we done?

How long do I have to be here?"

Other women stay much longer

and really need our
help a little bit more.

- So once you're in position,

the actual procedure takes
about six to seven minutes.

- Okay.

- The doctor will start
with a quick pelvic exam.

So just locating how your
uterus is oriented in your body

and where your cervix is.

And then he'll
place the speculum,

which you've
probably seen before.

- It was a pelvic exam, right.

- So, yeah,
- (indistinct) thing.

- After the pelvic exam,

then in order to see
the cervix, you know,

you have to kind
of open the walls

of the vagina a
little bit, so, this.

- I have had the experience
of people coming in here

really conflicted about
caring versus terminating

and like really on
the fence truly.

And I try and do the
pro-con thing of each side.

Sometimes I've even
told them, you know,

take 24 hours with
each decision.

- All right. I
think I'm gonna go.

Everything okay here?

- Yes.

The patients have left.
Everybody did well.

- Great.
- And we'll see you soon?

- [Amanda] Yeah. Next week.

- [Pamela] Thank you.

- Around the time when Roe
versus Wade was decided,

abortion care was
provided primarily

in big medical
centers and hospitals,

they were simple
and straightforward
and the hospitals

were prepared to
provide that care.

But, a number of
political factors led to

a shift out of hospitals,
into freestanding clinics.

- In the absence of the
access to healthcare,

the freestanding
clinic movement,

it was what put abortion
within the reach of women

when they needed it.

(gentle music)

- Is this the one who
had the miscarriage?

- Yeah.

- Health centers based
on a feminist model

expressing the values
of empowering women,

it changes the very
paternalistic approach to

"I'm the doctor and I
know what's best for you."

- My first time at a feminist
women's health center,

when they were interviewing me,

they told me the feminist
healthcare model at that point

was the doc was
just a technician.

So the women came in-

- Hired hands.
- Hired hands, exactly!

We were literally come in,
wield the cannula and leave.

I can see why doctors
were seen as not an ally.

(car horn sounds)

(distant siren wails)

- When the women's health
movement was getting started

there was a lot of
anger at physicians,

all of whom pretty
much were men.

The husbands and the doctors

seemed to own our
reproductive organs.

(gentle music)

So we were really pushing
back against that.

We wanted to take control
of that part of our lives.

(slide carriage clicks)

What we came up with was taking
control of our own bodies

through cervical
self-examination.

(slide carriage clicks)

And you need very little
to do a cervical self-exam.

You just need one speculum,
a flashlight, and a mirror.

(slide carriage clicks)

Always we'd do this in a group

so we could support each other.

(slide carriage clicks)

And one of the rules in
the group was always that

the woman looks at
her own cervix first,

and that's a profound change

from what happens
in an exam room.

(slide carriage clicks)

Can you see the baby
being delivered?

But there's one person missing.

You can't see the mother.

And so there was a lot
of advocacy for women to

be allowed to be more active
and present during childbirth.

(slide carriage clicks)

So the self-help ideas to
find out from each other

what's right and what's not
right about the medical care

that we're being given.

(paper crackles)

- The transition to freestanding
clinics was, in many ways,

a big step forward in the way
abortion care was provided.

The advantage is

they're completely
dedicated to abortion care

and they're able to provide
care much more cost effectively.

So simple first trimester
surgical abortions

can be done very
safely in clinics

and been where the majority
of abortions have been

provided in this
country for a long time.

However, it also had some
downstream consequences.

Abortion providers
began to be viewed

as outside the
mainstream of medicine.

They're kind of viewed
as rogue physicians.

In addition,

those clinics were just
obvious targets for terrorism.

(somber music)

- In the early '90s, there
was so much violence going on.

We were literally terrified
to come to work some days.

- These activists, I prefer
to refer them as terrorists,

but they had put my
name on a hit list,

a deadly dozen list
they called it.

This deadly dozen
list was issued

on the heels of two
assassinations of physicians.

And both of those people had
had a very similar in format

wanted poster put out on them.

In the middle of all this,

a bunch of protesters
came out to my home,

which frightened me.

And so I was worried for
the welfare of my children.

We had to go through what to
do in case of hostile fire.

What do they do?
Where do you go?

Something you don't really
wanna talk to your kids about.

We sued these people, and
the jury in their wisdom,

decided that indeed, this
constituted a true threat

and we were awarded at the time,

the largest civil judgment
ever in the history of Oregon.

(solemn music)
(crowd singing, talking)

(indistinct chatter)

This anti-abortion activism
comes out from a weird coalition

of the Roman Catholic Church
and the evangelical Christians,

which before historically, had
been at each other's throats.

And now in this issue,
they can get together.

And the Catholic
Church has the money

and the evangelicals
have the foot soldiers.

- That's shifted
a little bit now.

So now we're still
incredibly vigilant.

We have security,

patients have to push a doorbell
and announce who they are

to get into the clinic.

We just need to be
proactive to make sure that

people feel safe, but not so
safe that they're wondering

why is all of this stuff
here in the first place?

(solemn music)
- None of us who work at

Downtown Women's are at Lovejoy
Park in the parking lot.

(people chatting)

We don't want anything
to happen to our car.

We don't want people to know
what our license plate is.

You know, it's probably
fine. It's probably safe.

But we take those small
precautions because

we just don't wanna risk it.

Are you all ready?

- Yep.
- All right.

I'm just gonna check
and make sure we have

everything all set
before we get started.

It was never a question of
is the work worth doing?

It was more of an how
is this going to impact

maybe my career
choices in the future?

And also how is it
gonna impact my family?

One there. And one here.

Are there gonna be
protestors on my lawn?

Are people not going
to want to come see me

for other OB-GYN issues because
I'm an abortion provider?

Does that feel
okay on your hips?

- Mm-hmm.
- Okay.

- My medical school
class was the first

to have more women than men.

That shift was happening,
not just within OB-GYN,

but within medicine in general,

the older guys were men and
the younger docs were women.

And most of us applying
into OB-GYN were women.

And so it just seemed like

that was the direction
things were headed.

- Okay, so a little bit
of gel on the outside,

and you're gonna feel my touch.

Lots of pressure. And then a
hand on your stomach as well.

- I think that having
women providers

speaking out on behalf
of their women patients,

potentially there's
more weight to our words

and to our actions
when it comes to

advocating for women's
reproductive justice.

(indistinct chatter)
- Can I have another waffle?

- You want another waffle?

(indistinct chatter)

- What time's your flight?

- 10:40.

(zipper sounds)

It used to be that if you were

training in residency in OB-GYN,

it was not a requirement that
you had abortion training.

It's better now as a whole.

CREOG, which is the

Council for Residency
Education and OB-GYN

has very clear guidelines
for abortion training.

Now your program has to offer it

and you can opt out if
you choose not to do it,

but it's supposed to be part
of your regular schedule.

(door closes)

Medical Students for
Choice played a role.

They were increasingly in
positions of leadership

and had clout and increasing
the numbers of women

who were in leadership roles.

(car door clunks)

But I think it just
depends on where you are,

whether or not that's a
reality, geographically.

(gentle music)
(distant traffic sounds)

(indistinct chatter)

(phone rings)

- Hello, South Wind
Woman's Center.

This is Katie. How
can I help you?

(door clicks shut)

- Hey
- Hi.

You wanna have a seat up here?

Great. I'm Dr. Chiavarini.

It's nice to meet you.
- You too.

- It's required that
OB-GYN residents

train in abortion care.

That requirement really
comes into conflict

with what we find in state law.

The anti-choice folks in
this part of the country,

they've been able to push
through the legislatures

these laws that ban
medical professionals

from gaining that
adequate training at home.

For example, if you're part
of a public institution,

and that's where our
teaching hospitals are,

then you cannot be associated
with abortion care.

And so it's a matter of
sending residents out of state,

and that's a hardship
to be expected to go to

another state, another
city to do a training

is I think asking
a lot of people.

- At the medical school
in Oklahoma City,

when they have patients
who have severe anomalies

and they request termination
of the pregnancy,

increasingly they
send them to us.

You know, it's not like round.

- Yeah.

- They want to always
keep us at arms length.

It's like, you don't really
want us until you need us.

- We're lucky, especially
here in Portland,

because the community is
fairly small and we know

most of the docs who work
at the other hospitals.

And so you know that if
you have an emergency

and need to send a patient
to their emergency room,

that they're gonna
be getting good care,

but it's not always like that

everywhere else in the country.

- [Katie] It will be soon.

I can go check for you
in just a minute. Okay?

- We had a patient that was
from about three hours away,

she had a failed
medication abortion,

meaning that not everything

completely passed
through her uterus

and she did not want to stay
here for any intervention.

- I think she was maybe
just worried and overwhelmed

or who knows what was going
on, but she just suddenly,

when we were in the middle
of our treatment plan,

decided that she
just wanted to leave

and go to the emergency room.

- [Receptionist] It's up to her.

- But I want to write
up something that

the interventions
that we made today.

And then I'll get Andrea
to sign it if that's okay?

- There's a lot
of concern about,

if you have to send your
patient to another doctor

who isn't supportive
of that woman's choice,

then what kind of
care is she gonna get

when she goes to the
emergency room and you know,

how are they going to
judge you as the provider?

- She's gonna show up at this ER

and they're gonna be like,

"Oh, of course she
has no records.

Like they probably just
like sent her out the door."

You have to be perfect because
if you have a complication,

then suddenly you're horrible

even though everyone
has complications.

And she would've literally
been fine and been able to

walk out probably half
an hour to an hour later.

- Yeah.
- And with some prescriptions

and would've been fine.

But she decided that she
would be in better hands

going to the emergency room.

And we were trying to write up

a summary of what happened today

so that she would get
better care in the ER,

and be able to give
them that information.

But she wasn't willing to
wait for that information.

So she just left
without any information

about what had been
done for her today.

- Okay. Yeah.

Let me go get Aria. Okay?

- I mean, I don't know
how she's gonna present.

I don't know. She's
not from Oklahoma City.

We have a hospital

right down the street
here that's Baptist.

We have a couple of
Catholic hospitals

and then we have the state
University of Oklahoma Hospital

that's not religiously
affiliated yet,

but they just got merged
with a Catholic University

so are a Catholic
organization, so,

we'll see what
happens with that, so.

(gentle music)

- [Andrea] Yeah?

- I was just curious
about sort of residency,

but kind of going back to the
whole Catholic hospital thing.

Like, should you just
completely avoid any program

that's based in a religious
organization entirely?

- Yes.
- 0h, wow!

(laughing)

- Okay, there is
this growing issue of

Catholic hospital
systems merging with

secular hospital systems
and then taking over

some of the directives in terms
of what can and can't happen

in those previously
secular hospitals.

And usually those
mergers are happening,

not for philosophical reasons,
but for financial reasons,

but there are huge changes
that can actually happen

in terms of the care that
women are able to receive.

(bells chime)
(choral music)

- People do not
realize how integrated

the Catholic healthcare system
is becoming through mergers.

Oftentimes they're
walking into a hospital

that may have a name that
doesn't sound Catholic at all

and yet the doctors
are not allowed

to offer a full
range of options.

- If you come into the
hospital, for example,

with a miscarriage,

the pregnancy is separating
from the uterine wall,

but there is still a heartbeat,

in a Catholic hospital that
pregnancy cannot be ended

until the heartbeat is gone.

In spite of the fact that that
pregnancy is going to end,

it is no longer really
a viable pregnancy

and the woman's
life is in danger.

- Nobody even thinks if they
are having a miscarriage,

"If I go to Saint
whatever's Catholic hospital

and I'm having a miscarriage,

I'm bleeding to a
dangerous amount,

but I still have an
embryo with a heartbeat,

are they not gonna
actually treat me

because that would
be an abortion?"

Nobody is gonna be thinking
about that in that moment.

The Catholic Church's
point of view is,

well, if patients, they
know what we are all about,

and if they wanted
access to these services

like contraception,
or postpartum tubals,
or abortion care,

or end of life
care or LGBTQ care,

they just go someplace else.

But that's not
actually logistically
possible in many places

unless a patient wanted to
drive, sometimes out of state.

(soft music)

- I actually did my residency
at a Catholic hospital.

I chose it because their mission

was to take care of the
poor and the elderly

and that was very
important to me.

There were crosses
on every wall.

At eight o'clock, if you
were in the hospital on call,

prayers came over the PA system,

but there were no
rules about abortion

other than it could not
happen in the hospital.

So we could go to
another clinic to train

to become an abortion provider.

At the end of my first
year our contract changed

and said we could not
do abortions anywhere.

You know, I was a year
into my residency.

I had two more years.
Was I gonna fight this?

I also, at that point,

determined I was
pregnant and thought,

what I'm gonna fight for
is my maternity leave.

Since I left working for
the Catholic hospital

and over the 25 ensuing years,

the ethical directives
have really taken over.

- So this is a list
of rules, basically,

that you're supposed to apply
when taking care of patients

in a Catholic healthcare system

and the Bishop of whatever
area can determine the degree

to which the ERDs
should be enforced.

And then individual
hospitals sometimes even vary

how they interpret the
Bishop's interpretation.

The language is a
little bit tricky

around ectopic pregnancy.

An ectopic pregnancy is a
pregnancy that is located

outside of the uterus.

They are not viable
and this can be

catastrophically dangerous.

But to the letter of the
law within Catholic ERDs,

you are ending a fetal
life, which is not allowed,

and that is held to the
same value or higher value

than a woman's life.

(engine ticks over)

- [Deb] When I first
came to Seattle,

there was Swedish and
there was Providence

and they were totally separate.

- For financial reasons,

Swedish needed to merge
with another hospital

and Providence was
the hospital system

with which they merged.

There was a lot of
outcry and concern

that these ethical and
religious directives

would hold sway over
all of the physicians

that work at
Providence hospital.

And my understanding is that

there was a lot of
language that, you know,

don't worry about it.

There isn't going to be
any influence on that.

But there clearly is

because inpatient
abortions with live fetuses

could no longer happen.

So the operating room at
Swedish was no longer a place

where abortions for a live fetus

could happen at any
gestational age.

- Now, most women do not need

their abortions in the hospital,

but when a woman needs an
abortion in the hospital,

she needs one in the hospital.

We can have someone who has
say severe heart disease

or severe asthma who just
needs more monitoring

than we are capable of doing
in an outpatient setting.

So when Swedish got rid of
doing any inpatient procedures,

we lost that ability
for patients.

- If there is no longer an
ability to do those procedures

in a safe place, we are
really actually harming women.

(traffic rushes past)

- Physicians who really
wanted to provide

they get out into the
real world and realize,

oh, they have a contract
that happens to be signed

through an entity that
abides by the Catholic rules.

And all of a sudden they
have to sign a clause

that says they won't
provide abortion care.

- Even doctors who have
authority need to have a job.

And Washington's a great example

when 49% of the hospital beds
(gentle music)

are affiliated with the Catholic
church, it's kind of hard,

actually, it's impossible
in fact, in many counties,

to have a job at a hospital

that is not affiliated
with the Catholic church.

(indistinct chatter)

(machine beeps)
- Everything, all right.

- Do you have any last minute
questions for me at all?

- I don't think so.
- No, okay.

- So this is the mask.
It goes over your nose.

- Okay.
- Okay?

- You're gonna hear
the machine turn on

and it's gonna be about 30
seconds of suctioning, okay?

So just some cramping
during this, all right?

- Let the nitrous help you and
then blow it out. Good job.

- As much as abortion
is a procedure

that should be considered
normal and is safe

and shouldn't be stigmatized,

it is a procedure that
occurs when something

undesired has happened
and you're, you know,

and you're trying
to reconcile it.

It's not like getting
plastic surgery, it's,

this is an unwanted event
that you're dealing with.

- Hang in there, sweetie,
it's almost over.

You're doing great.

- I think you wanna
acknowledge that, but,

at the same time, if you
linger too much on that,

people will use that as a reason
why abortion shouldn't be,

why abortion's a
negative, you know?

It's because, just 'cause the
circumstances are negatives

it doesn't mean the
procedure itself is.

- Easing up for you now.
- I'm gonna take

that speculum out, just
relieve some of that pressure.

All right. And we're all done.

Everything went really well.

- Good job.

- Okay. How are you
feeling right now?

A lot of cramps. Yeah.

This is kind of the worst
of it right now. Yeah.

It'll get a lot better even
in the next few minutes here.

Okay.

We'll just kinda have you hang
out here for a little bit.

All right.

A lot of times
people say, you know,

"Why do women get
abortions or do you ever,

when you ask women why
they get abortions,

like what do they say?"

And I say, you know, "Honestly,

for the majority
procedures I do,

I have no idea why
they get an abortion.

'Cause I don't ask."

- Feel like going next
door. You can walk?

(indistinct)
Not very far.

A more comfortable bed
with a heating pad.

- That's right, if someone
sees me and they're uncertain,

then obviously I wanna
talk to them about it.

But as a provider, you know,

you have to ask
yourself who in the room

knows what's best for
that woman's situation?

You know, is it
me? Or is it her?

Some people will appeal
to the pro of abortion

by saying that these are women

who are in these
horrible circumstances

or these are pregnancies are
in these terrible circumstances

and you can make an argument
that that's a really,

that that argument is ultimately

working against
where you wanna go.

'Cause then you're making
distinctions between

what's a meaningful
abortion and what's not.

- There absolutely is this idea

that there's a good
abortion or bad abortion.

Just like there's
an idea that there's

a good patient or a bad patient
in many other situations.

You know, this diabetic
patient takes her insulin.

She's a good diabetic.

This diabetic patient
doesn't take her insulin.

She's a bad diabetic.

But what are we
actually talking about

when we're talking about that?

We're making it about ourselves.

If I'm talking about this
patient is good or bad,

that's my judgment.

It's my job to come in
and educate a patient

on risks and benefits
and to facilitate

the healthcare that she needs.

- So what are your thoughts?

- I mean, I think it's probably

just her first period
after her miscarriage.

(indistinct speech)
- Okay.

For me, what's hard is
when younger girls come in,

and their mothers bring them in

and either they agree
or they don't agree

with what their parents think
their decision should be.

And so that's always hard.

I've been a teenage
mother and I'm a parent.

And so I can
understand both aspects

of how the teenager may feel
and how the parent may feel.

Either way, I
still believe like,

that girl should be able
to make the decision

that she wants to
make even if inside

my gut feeling feels like

they should listen
to their parent.

(traffic hums past)

- When I started here,
staff were very cultured to,

we rip out pictures of babies

out of the magazines
in the lobby.

We don't show baby wipes.

We tear those off.

And I watched this thinking,

"That's odd. The women that
come in here are mothers.

Like what are we hiding from?"

So is it possible, like
we get you a hotel,

we could put you there.

Sister could go
home, get her baby.

And then come back to the hotel
and stay with you tonight?

Being a woman who worked here
through her two pregnancies,

nine months pregnant doing
ultrasounds, having patients go,

"They let you work here?"

I'm like, "Yeah, they
let me work here. Yes!"

And I'm getting you at
about like 19 weeks.

- 19 weeks.
- Yep.

That's pretty much
right, you know,

from like your last ultrasound.

In the past 18 years
that I've come here,

one of the things that
I've watched change

for actually the better is
that we're not shameful.

And so I am just about
done with the ultrasound.

Did you want to be
able to visualize it?

You absolutely
don't have to look.

- I will.
- You wanna look, okay.

This is your
pregnancy right here.

And it kind of goes
through right here.

- I see it.
- Do you see it?

- Yeah.
- Okay.

Do you have questions?

- Yeah.
- Okay.

So I'm gonna take it off.

Last year's the first year
we sent out Christmas cards,

we put our faces out there.

It was like, this is what we do!

Oh yeah, she could do that too.

It's just the idea
that she needs

somebody tonight with
her in that room.

So that's kind of
where she's at.

- Okay.

So the reason that it needs
to be a two day procedure

is because we need to
be able to have time

to dilate your cervix
in order to make this

procedure safe for you.

So what they'll do today
is insert a few dilators.

You'll go back to your hotel,

which I'll take care of as
soon as we're done in this room

and get you that information.

- [Patient] Okay.

- And then you'll come back
tomorrow to our Renton office

and then that's when they'll
remove those dilators

and then they'll remove your
pregnancy at the same time.

Did you have any
questions about that?

- [Patient] So that's not
gonna be removed today?

- Not today. No.

We just need to be
able to have time

to dilate your
cervix so that we can

remove the pregnancy tomorrow.
- Okay.

- And then you hit, Okay.

And now you hit Document.

There can be a lot of judgment
that surrounds LGBTQ care.

So we do hormone therapy,
transgender care.

We provide just a safe place
for the entire community

to be able to come and have a
free conversation regarding,

you know, any aspect of sex,

whether it's vaginal sex,
whether it's anal sex.

We want all of our
clients, patients,

to come through this
door and be able to say,

"Hey, this is what's
going on with me.

I've had this type of partner."

(crowd shouts)

(gentle music)
- There's a strong bond

and relationship between
LGBTQ people and women who are

seeking control of their
fertility by abortion.

The more visceral aspects
of anti-abortion sentiment

is related to the
insistence on the

primary roles for men and women

and LGBT expressions of
human sexuality challenge

patriarchal notions of what

the appropriate
roles are in society.

And similarly women,

as they explore
their fuller humanity

by actualizing all
of their potential

and take control
of their sexuality,

means it is now uncoupled
from an aspect of sexuality

that has to relate to
men or a particular man.

(gentle music)

Right around the time
that I had my call

to add abortion care to my,

the scope of practice
that I pursued.

It was also when I began to
do a deeper dive in feminism.

I'm not just being a good guy
when I pursue feminist goals.

I'm in pursuit of
a fuller humanity,

because if I have
to subordinate women

to have to feel like a man

then I'm losing an
aspect of my humanity.

(gentle music)
My consciousness raising

occurred with me
affiliating with

the organization of Sister Song.

And as I was transitioning

more fully into my
identity as a feminist,

I was introduced to the concept
of reproductive justice.

(gentle music)

- Well, the beauty of the
reproductive justice framework

is that it is the
isolation of abortion

from other social
justice issues.

And so it allows us to have the
conversation about abortion,

at the same time, we're
talking about white supremacy,

or economic injustice
or welfare rights,

or HIV aids or housing
or police brutality,

all the other things that
go on in our community.

- Reproductive justice
allows for a framework

that is inclusive of
issues that would be

seemingly remote
from one another.

It's not about are
you for adoption?

Are you for abortion? Are
you for birth justice?

Are you for LGBTQ rights?

A reproductive justice framework

allows for the intersectionality
of these issues.

- And so I think that is
our best ally right now

that we have an intersectional
inclusive framework

that allows us to have
conversations with people

who are uncomfortable, maybe,

only focusing on
abortion 'cause you know,

reproductive justice is
the right to have a child

and not have a child
and to parent our kids.

(gentle music)
(distant traffic sounds)

(indistinct chatter)

- I really wanna talk a
little bit today about

what an abortion looks
like and you know,

what it looks like in reality
and how it's portrayed,

and how it ultimately
sort of affects

being an abortion provider.

Have you guys both
seen abortions?

- Yeah.
- Okay.

And how far along did
you, how far along,

what's the latest gestational
age you saw a procedure till?

- Saw it around first
to second trimester.

- First.
- 14.

- It's 15 weeks.
- 15 weeks, okay.

What you think of the 15 week
procedure when you saw it?

- It was at the time I was
supporting the procedure

and we were using
ultrasound to assist.

So I think it was
a little bit more

eye opening for me at the time.

I did feel some
sadness for sure.

- Yeah.
- And to experience that

for the first time was,

was an interesting growth
moment I think for me.

- I actually remember
the first time I did a,

like a pretty late, you know,
a 20 week plus abortion.

I remember that
in that procedure,

all of a sudden the head comes
out and I remember, you know,

physically jumping back
like "Ugh!" you know,

because it was a really
disturbing thing to look at.

And since then I've done
enough that I try to sort of

block that reaction, but I, I,

it's a reaction that if
you've talked to people

that do abortion,
almost everyone had

the first time they
had that moment.

And yet that's a reality
of the procedure. Right?

And we don't talk about it

and it's because we
don't talk about it

here's this void of
information, you know?

And, when that void exists,

people can fill it with
whatever they want.

- A group called the Center
for Medical Progress,

a pro-life concern,
has been investigating

Planned Parenthood
for three years.

- Do you guys remember the

fetal tissue
controversy last year?

- Selling the body
parts of aborted babies.

- Some of it was obviously fake.

When they cut the
video, they made it,

they tried to make it
seem like people were

selling tissue when really

they were just talking
about the transport costs.

But some of it was actually

just putting out
facts about abortion,

but because no one had
heard about it before,

it was all of a
sudden, "Oh my God!

Like you remove the. This
is how you do an abortion?

And it, that's what
it looks like?"

A year ago I had a patient,
it was a late abortion,

and she understood
how it was being done,

but she wanted to see
the fetus at the end.

You know, I was kind of like,

"I don't know if
you wanna see this."

And I was honestly,
I didn't feel like,

I didn't want her to see
it personally, you know?

But I also recognize
that that was her choice,

and this was something
that came from her body

and there's a process to
her abortion, you know,

not the procedure,
but her abortion,

her, the experience
that she's undergoing

that she wants to
find a closure in

and it might involve
seeing the removed fetus.

- If we don't talk about
it, the stigma continues.

- Right.
- And I have felt

for a very long time when
I lecture on abortion

or even talk about it to
a non-medical audience,

I feel like I need to talk
about what really happens,

because, if you're
gonna be pro-choice,

you need to know what
actually happens.

And I don't feel like
everyone needs to know about

every medical procedure,

but there's so much
negative about what happens.

- Hi.
- Hi, I'm Deb Oyer,

the doctor, this is Seb Patel,

the other doctor.
- Hi.

- Nice to meet you.
- Nice to meet you.

- How was your night?

- Last night?
- Mm-hmm.

- It was okay.
- Okay.

- Yeah, I just threw up a lot

and then I had a lot of cramps.

- Okay. The medicine sometimes
can make that happen.

All right, let's get this
show on the road then.

- Okay, just a light press here

and we'll put the speculum
in here, lots of pressure.

- Surgery can be
disturbing. It can be messy.

It can be hard to watch.

Abortion becomes more
psychologically messy

because of this other
potential being.

Eight weeks and below we see
just the gestational sac,

and that's easy for most people.

Beyond that, we do start seeing
recognizable fetal parts,

and there are people who are

comfortable with
that theoretically,

but still have some sort of
aversion, a gut reaction,

to seeing a more
developed fetus.

For other people it's just like,

"Oh my God, that is so cool."

For those of us who've
studied embryology

to actually see it
in different stages.

Perfect.

We'll take some pap.

We all have our
different issues we bring

to everything in life.

And if somebody struggles
with ending a potential life,

I'm gonna sit down
and hear them out.

But you are ethically
required to be able to

talk to your patient
about abortion,

to be truthful about
abortion with them

and use scientific facts,

not those that the
other side would give.

And to also, if you're not
going to do their abortion,

to refer in such a way that
you're not putting them down.

So not, you know,

"I'm gonna send you
to see Dr. Prager

because I don't
believe in this."

- Right-
- But I'm gonna send you

to see Dr. Prager, because
this is her specialty,

just as I'm gonna send
you to see Dr. So-and-so,

who's the cardiologist 'cause
that's their specialty.

- All right,
speculum's coming out.

There you go. You're all done.

(indistinct chatter)

- Everything went really well.
And your IUD is in as well.

Okay?
(indistinct)

So as soon as Seb
gets you cleaned up,

we'll push you back up the table
and let you rest for while.

- All right.
- Okay?

- Thank you so much.
- You are very, very welcome.

We go up to 26 weeks,

through 21 weeks as
a two day procedure.

And then from 22 weeks to
26 as a three day procedure.

People end up being that
far along for a few reasons,

figuring out you're pregnant,
getting it together.

And often they'll
spend some time

trying to get money together

before they even go
in to see anybody.

(gentle music)

- Unfortunately,

oftentimes the women
who are the most needy,

those that have the most
profound social issues

or financial challenges
are the least able

to get abortion services

because of the distance
they have to travel

or the time they have to take,

or the health insurance loops

that they have to jump through.

And as a consequence,

they end up in the second
trimester or even later,

and they have to
then have an abortion

that's much more complicated
and carries greater risk.

(gentle music)

I think it's ironic that
the anti-choice movement

has in fact effectively
pushed abortions into

later in pregnancy.

(indistinct chatter)

When I look at the
patients that come to me

for pregnancy care and you know,

maybe I'm lucky enough
to deliver their babies,

they're very thankful
and appreciative.

- Yeah!
- Good job!

- Welcome baby.
- Congratulations.

- Congratulations.
- Thank you.

(baby cries)

- Later, take a deep breath.

There you go.
You're doing great.

But honestly I
think the gratitude

of patients in abortion
care is even more profound.

- I'm Dr. Sarah Prager.

How are you?
- Good.

- Good. This is Dr. Seb Patel,

- Hi!
- Hello.

- We're gonna be working
together today, okay?

I can't fix all of the other
stuff that potentially led to

that being a situation that
she is having to now manage.

I can't fix the
fact that, you know,

she no longer has her
same insurance and so

she wasn't able to pick up her
pack of birth control pills

and that's why she got pregnant.

or she's now in the second
trimester because it took her

10 weeks to raise the money
to be able to get here.

You know, any number of things.

So I can't fix that, but I
can fix her immediate problem.

All right. So we're all done.

That's it.

I've heard many times from
colleagues or other people,

"You know, nobody
likes to do abortions,

but somebody's gotta do them.

It's a necessary evil."

And I actually completely
disagree with that.

I enjoy incorporating
abortion care into my life.

I think we make
assumptions also about

how this has to be a
really private thing.

And I'm gonna tell
it a brief story

just to show that not
everybody feels that way.

I was at SeaTac airport
getting a muffin

(laughing)

and the woman behind the
counter looks at me, she said,

"I know you!" in this volume
voice, "You did my abortion!"

Lots of people in line,

other people she works
with standing right there.

And I'm like, "Yes, I did."
(laughing)

- More than anything else,

I hope that you walk
out of here today,

knowing what a huge
difference all of you make

in giving your patients access

to the family planning
care they need,

no matter what
specialty you choose.

(gentle music)
- Most of those people

will not end up being
abortion providers,

but they will be
people who have learned

how to talk to patients
about abortion,

and we need those people,

at least as much as we
need abortion providers.

Because when there's a hospital
that's becoming Catholic,

you need the cardiologist,
you need the anesthesiologist.

You need everybody
to stand up and say,

our ethical directives are
to take care of our patients.

- You're just gonna
feel some cold goop.

Sorry about that.

- My grandmother is an 86
year old Catholic woman

who goes to mass every day.

She doesn't know
that I work here.

I don't think that she
would be exactly pleased,

but at the same time,

I don't think that she would
be entirely disappointed either

because I'm doing
something that I think is

just so incredibly important.

- [Sarah] How you
doing? You feeling okay?

Right now about one
in every three women

has an abortion at some
point in the United States.

As long as women are
getting pregnant,

abortion is gonna
need to be around.

(gentle music)

- Now we're at a juncture where

we have a government that's
trying to outlaw abortion,

stigmatize it, defund it,

and to do so is not gonna mean

that abortion need
is gonna go away.

(gentle music)

(indistinct chatter)

We should be maladjusted to
the norms that undermine women.

And we should be nonconformist
with laws and policies

that are not rooted in justice.

(music ends)