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What Donald Trump's Abortion Comments Got Wrong, According To An OB-GYN

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Last week, the nation was shocked when a presidential candidate, Donald Trump, said that women should be “punished” for their abortions. For deciding to end a pregnancy. Punished? As a physician who performs abortions, I have something to say to you, Mr. Trump: My patients are punished enough.

As an OB-GYN, I love that I get to provide care through all stages of my patients’ lives, from their teenage years until menopause. Abortion is part of my patients’ lives, too. When I learned that nearly 90 percent of counties in the U.S. have no abortion provider, and that just 14 percent of the 97 percent of OBs in the U.S. who have seen a patient seeking an abortion are willing, equipped, or able to provide one, I felt a responsibility to become an abortion provider. After four years of medical school and four years of residency, I completed a two-year fellowship of in-depth training in providing all methods of abortion and contraception safely and effectively. And doing this work is how I learned the many ways women are already punished for taking control of their own lives.

My patients are punished before they ever know they may need me, by unjust laws and deeply-rooted health and economic inequities that make it impossible for them to raise families on their own terms. More than 60 percent of women who have an abortion are already mothers, and they are well aware of what it takes to raise a child. They know what it means for their children’s health when they do not have paid maternity leave, or quality schools, or a safe neighborhood — or sometimes even a safe home. My patients know exactly how hard it is to get themselves, and their children, to the doctor when they don’t have paid sick days or affordable childcare.

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My patients are punished before they make their first appointment with me, by the persistent stigma surrounding abortion.  No matter the circumstances, there are patients I treat who feel they cannot tell even their closest friends or family members about their decision to end a pregnancy. This is our culture punishing women, and the end result is the fact that very few of my patients know that three in 10 women have an abortion by the time they’re 45, or that 95 percent of women who have an abortion feel it was the right decision.

My patients are punished when they pull into our driveway, by hostile lines of protesters who presume to know more than my patients do about what is best for them.  

These laws are a form of humiliation — not just for my patients, but for me and all who provide abortions. These laws are designed to make it seem as if we are not competent to provide care to our patients and worse, they violate the most sacred relationship in medicine.

My patients are punished again after they walk through our doors, by laws that restrict insurance coverage of abortion. Far too many of my patients are struggling — truly struggling — to make ends meet, and we know that the time it takes to amass the hundreds of dollars needed to pay for an abortion procedure is time spent delaying access to care.

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My patients are punished because our current laws make safe and legal providers of abortion too few and far between. There are the more obvious and well-documented ways in which Texas laws have forced dozens of abortion providers and dozens more birth control clinics to close their doors forever, but the political and regulatory climate across the country makes it hard, if not impossible, for willing and skilled providers to offer abortion care to their patients as part of their own practice.

Because I am an abortion provider in this country, every day I have to do things I know are not in my patients’ best interests.

My patients are also punished by state laws that tell me how to practice medicine. It is a punch in the gut every time the law forces me to provide information that is dubious, or perform a procedure that may not be medically necessary, or have an intimate conversation with a patient in a room that is bigger, colder and brighter than medically appropriate. Targeted Regulation of Abortion Providers (known as “TRAP”) laws impose irrational requirements related to the size, design and staffing of health centers providing abortion services. According to the Guttmacher Institute, today, 24 states have such laws in place.

These laws are a form of humiliation — not just for my patients, but for me and all who provide abortions. These laws are designed to make it seem as if we are not competent to provide care to our patients and worse, they violate the most sacred relationship in medicine, between a doctor and a patient, when they force us to do things that are contrary to what our training and experience has taught us.  

Even if a patient does not want to look at the sonogram from the ultrasound I am forced to perform upon her, I am forced to display the screen so she can see it. I have to play the heartbeat for her. I can’t force her to look or hear, but it’s against the law if I don’t do these things — I would risk fines, imprisonment, and worst of all, as someone who feels a calling to provide abortion care, the loss of my medical license.  

Put simply, because I am an abortion provider in this country, every day I have to do things I know are not in my patients’ best interests.

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Now many of my patients are additionally punished by the words of a candidate vying for the position of president of the United States of America; a man who has had the privilege to be able to provide for his family in ways my patients can only dream of.

My patients are mothers who drop their kids off at school, travel for hours to come to me, and then drive back home that evening to keep their families running. My patients are women who are not ready to have another child.  Or women who thought they were done having children.

On the same day as his original comments were made, Trump’s team did their best to course-correct his words issuing a statement that doctors, not women, ought to be punished, for women are “victims” if they have chosen abortion.  

Victims?

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As every media outlet and social media news feed repeated his heartless comments, I thought about the women who come to our clinic.

My patients are mothers who drop their kids off at school, travel for hours to come to me, and then drive back home that evening to keep their families running. My patients are women who are not ready to have another child.  Or women who thought they were done having children.

If you were an abortion provider, you would see what I see every time a patient sits in my exam room chair, looks me in the eye, and tells me she is certain about her decision; you would see the astounding strength and resilience of women.  

My patients are young women who venture all the way across town because they don’t feel ready to be a parent.  My patients are new mothers suffering from postpartum depression. My patients just learned they are carrying a pregnancy that won’t survive outside the womb. My patients are women who were misinformed about their birth control options.  

My patients are making a deeply personal decision that is their right, despite the restrictions that have been imposed on them.

Mr. Trump, if you were an abortion provider, you would see what I see every time a patient sits in my exam room chair, looks me in the eye, and tells me she is certain about her decision; you would see the astounding strength and resilience of women.  

If my patients can overcome the punishment already doled out to them by people like Donald Trump and the anti-abortion advocates who’d like nothing more than to take their rights away, then so can I.