Some of these things might seem so outrageous you'd wonder how anyplace could operate doing these things. And you might marvel that women don't just turn around and walk out when they see some of these things. All I can say to that is that I've seen the documentation myself. These kinds of things do, indeed, happen. The mantra of "safe and legal" has led to a false sense of security. Many women dismiss their fears about the clinic or the doctor because they assume that somebody must be overseeing the place, or it wouldn't be operating openly. This is not necessarily the case.
In the order you're most likely to notice them:
1. The person who answers the phone when you call for an appointment verifies your pregnancy and tells you how many weeks pregnant you are.
You can't make diagnoses over the phone, for one thing. And even professional pregnancy tests, much less the ones you buy in the grocery store, can give false positives. For another thing, even with an examination, a practiced doctor can be several weeks off in his estimate of how far a pregnancy has progressed. In facilities that pay the doctor on a sliding scale according to how advanced the pregnancy is, the final determination of his pay is typically made after the abortion, by comparing a fetal foot to a chart. If that kind of accuracy is necessary to determine how much to pay the doctor, how can they do your informed consent and counseling based on a guess made over the phone?
2. The prolifers outside are handing out copies of lawsuits against the facility or the doctor.
3. You are asked for payment in full up front, before any examination or counseling has been done.
As I said in #1, nobody can really verify how far advanced the pregnancy is without an ultrasound -- unless, of course, the abortion is over and they're measuring a fetal foot. How can they answer your questions about risks, the fetus, and the procedure if they don't know how far advanced your pregnancy actually is?
4. You get vague, reassuring answers to your questions.
This might not mean quackery; it might just mean paternalism. But either way, you're being deprived of your right to make an informed decision. Any discussion of risks that doesn't cover failed abortion, hemorrhage, infection, and post-abortal syndrome (the uterus filling with clots immediately after the abortion) at a minimum is trying to gloss over risks and just sell the abortion. If questions about emergencies don't bring out what hospital you'd be taken to and what ambulance service they'd call, odds are nobody will know what to do if there is an emergency. And if you ask questions about the fetus and get answers that don't jibe with what you've seen on pregnancy websites such as BabyCenter, Parents, or What to Expect, they're not being honest with you. How can you trust them with your life if they won't give you truthful answers to simple questions?
5. You hear other patients moaning and/or screaming.
Obviously this place isn't using adequate pain management. Where else might they be skimping?
6. The facility appears dirty and/or disorganized.
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| Combination patient bathroom and "sterilization room" at Krishna Rajanna's Affordable Medicine Clinic |
Abortion is a surgical procedure with inherent risks. If they're not keeping the waiting room, counseling area, rest rooms, and hallways clean and sanitary, they're probably not keeping the scrub room, procedure rooms, and other critical areas clean and sanitary either.
7. They can't describe the qualifications of the staff that are attending to you.
Some places might have a doctor on staff -- on paper. That doesn't mean that the person doing your abortion has ever had any medical training at all. And in places where the doctor is such a quack the staff don't trust him, they might start doing medical procedures themselves because it seems safer that way. If the person about to do your abortion can't answer, "Where did you go to medical school?" as fast as you'd answer, "Where did you go to high school?" he or she might not have gone to medical school at all. The time to find out is before that person sticks sharp instruments into your body. Also, don't take it for granted that the person about to administer anesthesia knows what he or she is doing. Abortion clinics have been caught letting a "hand holder," a receptionist, and a janitor administer anesthesia. If the person standing at your head about to administer drugs can't say that he or she is an anesthesiologist or CRNA -- and say where he or she went to school, you might wind up being yet another anesthesia coma or death. Don't assume that just because the place is operating openly the staff are actually qualified.
8. They don't monitor you in the recovery room.
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| Lou Ann Herron: Pleas for help brushed off |
They at the very least should be putting a pulse oximeter on your finger and checking your vital signs every ten to fifteen minutes. There should also be a nurse in the room. Ask for the person's qualifications. If you're not being monitored and you're not sure the recovery room is overseen by a nurse, be ready to call 911 to get help for yourself if you start to become alarmed at your symptoms. Women have died right in the recovery room because their pleas for help were ignored or handled by somebody who didn't know what to do.
10. When you call for follow-up, you can't get through to a human being that will listen to you and take you seriously.
Especially in facilities that rely on "circuit riders," there might not be anybody on staff who has a clue how to deal with complications. The phone might ring to an answering machine. If you are concerned about your symptoms and you can't reach a person, or you feel like you're being brushed off, seek care elsewhere regardless of what papers they asked you to sign before your abortion. When in doubt, go to the emergency room and bring any paperwork you have from the facility. Delays while trying to reach somebody who can and will direct you to proper aftercare can lead to disaster or death.
Watch the companion video on YouTube.
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