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Doris and I stood in front of the young woman in bed 312-A, who was fast asleep. She had high-cheekbones, unlined bronze skin, and long black hair that fanned over her pillow. She looked peaceful. If not for the IV running into her left hand, you might have thought she just settled in for a late afternoon nap.
We were in the middle of shift change; Doris the day nurse handing off her patients to me, the evening nurse.
“An emergency D&C. They brought her up from the recovery room an hour ago. The doctor ordered a continuous IV drip and antibiotics every six hours. He wants vitals every four but take them hourly,” Doris instructed.
In her late 50s, Doris was an old-fashioned nurse. The kind who wore a nursing cap and a starched white cotton uniform with her graduation pin attached to her collar. I was twenty-three and had been a registered nurse for just over two years. I didn’t own a cap, and I kept my pin in the bottom of my jewelry box. Forced to wear a white uniform, I asserted my originality through my hairstyle. At the time, I wore it shaved up the sides, ratted on top and highlighted with alternating strands of platinum, pink, and blue. Despite our differences, Doris and I got along well. She was the best nurse I’d ever worked with, and I was a willing pupil.
“Keep an eye out for post-op hemorrhage. And nothing by mouth in case they have to bring her back to surgery,” Doris said. She paused, pointed at the patient in the next bed and motioned for me to follow her into the hallway.
“I didn’t want the patient in 312-B to hear, but she was 10 weeks pregnant. She self-induced an abortion.”
I shuddered. “How?”
“The admission notes didn’t specify, but the doctor thinks she inserted some kind of a metal object into her cervix.” Doris shook her head. “Her mother and her auntie drove her here. They had a four-hour drive. It’s a miracle she made it.”
My stomach cramped. I reflexively touched my lower abdomen, hoping Doris wouldn’t notice. “Do you think she’ll be okay?”
“That girl should be in the ICU, but they don’t have any beds. And the private hospitals wouldn’t accept a transfer.” She shook her head. “This didn’t have to happen.”
I pictured the young woman sitting alone on a toilet with tears running down her face and her pants bunched around her ankles. In one hand, she held a metal hanger. I felt her tissue rip as she shoved it inside. A flash of searing pain and then blood.
Momentarily dizzy, I leaned against the wall.
Doris arched an eyebrow. “Are you feeling alright?”
“Fine.” I stood up straight. “Tell me about the patients in 314.”
This took place in the early 1982. The hospital where Doris and I worked relied on federal funds. It served an economically vulnerable population for a large rural and urban geographic area. For many of our patients we provide their only source of healthcare services. There are similar hospitals throughout the country. Abortion was legal then in all 50 states. As Doris said, what happened to the young woman in 312-A didn’t have to happen.
Why did it? Why would a young women feel compelled to self-induce an abortion when one could be legally and safely obtained? I will never know for sure, but I think the answer was related to the Hyde Amendment. Passed in 1976, and amended in 1993, the Hyde Amendment banned the use of federal funds for abortion services except in the cases of pregnancy resulting from rape or incest or those that pose a threat to the mother’s life.
I had always been politically active and as a nurse working in a public hospital, I was particularly sensitive to any laws related to my patients. I was aware of the Hyde Amendment. But awareness and understanding are two very different things. That night for the first time, I saw the impact of the Hyde Amendment on a real person. By limiting funding, the law had prevented the young woman in 312-A from access to a safe abortion. For her, the constitutional right granted by Roe v. Wade may as well not have existed at all.
As I began my duties, I could not stop thinking about the young woman in 312-A. As the white middle-class daughter of two teachers, I had never really considered, or even been aware of, the reality she faced. I felt ashamed of my naivety. A shame that was heightened by the fact that two weeks before I too had terminated an unwanted pregnancy.
I got pregnant on a weekend trip to Los Angeles with my boyfriend. We’d been dating for six months after having met at an Iggy Pop concert. Lanky, with dyed red hair and hazel eyes, my boyfriend was 21 and had recently dropped out of college. Our relationship was built on a love of David Bowie, punk rock, and pot.
In a hurry while packing for the weekend, I accidentally left my birth control pills on my bathroom counter. “We need to get condoms,” I told my boyfriend as soon as I realized my mistake.
But we didn’t.
We had sex anyway.
I knew better, but I convinced myself it would be okay. After all, it was just a couple of times.
When I found out I was pregnant, I was angry at myself for my carelessness. That night, I cried into my boyfriend’s chest. As we laid together in my bed, he wrapped his arms around me and rocked me to sleep.
In the morning, I made an appointment at Planned Parenthood. We were in complete agreement about what to do. Neither of us were remotely ready for parenthood. We barely knew how to parent ourselves.
The clinic was a short distance from my apartment. My boyfriend came with me to the pre-op appointment. He sat next to me on a yellow plastic chair holding my hand while I talked to a gray-haired counselor about the procedure. She had a box of Kleenex and a dish of butterscotch candies on her desk. They were the same kind that my grandmother had carried in purse and her pockets throughout my childhood.
When the counselor handed me the consent, I began to cry again. This time my tears were harder, more like chest heaving sobs than the soft ones I’d shed previously.
“Let it out,” the counselor said as she handed me a tissue.
I blew my nose and kept crying.
My boyfriend, who had been silent until then, spoke. “If you aren’t sure, you don’t have…”
Hearing the fear in his voice, I interrupted him. “I’m sure.”
Taking a deep breath, I grabbed two butterscotch candies out of the tray. I handed him one and then unwrapped the other. We sat for few seconds sucking the candy, letting the soothing sweetness fill our mouths. Then I signed the consent.
The procedure cost 200 dollars. My boyfriend paid half. It was a sum that was not meaningless to us, but easy to obtain. My only financial sacrifice was that I couldn’t buy a vintage crystal necklace I had been coveting.
On the morning of the procedure, I cried some more. My crying confused me. I was certain about my decision. I didn’t believe that life began at conception. But that day, my chest was heavy, and my heart felt as if it were cracking into pieces.
I was just at six weeks, so I didn’t need anesthesia. I chose to be awake. Although I was still angry at myself for my recklessness, I didn’t make that choice to punish myself, but because I hated the side effects of anesthesia. And, perhaps just as important, it was less expensive to go without.
My procedure went off without a hitch. Lying on the table with my legs spread and my yellow socked feet in stirrups, I tried unsuccessfully to think of the ocean. A masked male doctor sat in front of me. Next to me, a nurse in pink scrubs. Her eyes were big and blue and her lashes layered with mascara. A little clumped in the corner of one eye; I wanted to tell her about it but didn’t.
The whole thing took 10 minutes. It hurt. I cramped. I gritted my teeth. I took deep breaths and squeezed the hand of the blue-eyed nurse so hard I thought I might break it. They used a vacuum aspiration. True to its name, it sounded like a vacuum. For me, the noise was the worst part.
When I was discharged, my boyfriend was waiting for me in the lobby. I saw him before he saw me. Sitting in another plastic chair – blue this time. His left leg was shaking as he flipped through an old Sports Illustrated. Seeing me his hazel eyes flooded with relief. Was it relief that I was okay? Or relief that he no longer faced the threat of unwanted paternity? Probably both.
In one hand, I carried a large plastic bag. Inside of it: a box of Kotex, a sheet of post-operative instructions, six pain pills, a prescription for antibiotics, and an emergency number to call if I began to bleed heavily. I would go home that night with my boyfriend at my side, and sleep in my own soft bed. Making the decision to terminate my pregnancy had been both the hardest and easiest decision I had made in my young life. I was tired, sad, and cramping. But I was safe. I would not hemorrhage. I would not get septic. As I exited the clinic, I didn’t yet know how lucky I was.
The night that the young woman in 312-A was admitted turned out to be a busy one. Our patient beds were full and our staffing short. On the surgical floor, we had two registered nurses and three aids to take care of 52 patients: 26 post operative patients each. As I sprinted between patients, the sense of shame I’d felt earlier dulled. I was too busy to think about equality.
For six hours, the young woman’s vital signs stayed stable and her bleeding contained. She slept most of the night, waking only once to ask for an injection of pain medication. I began to think that Doris’s warning to check on her hourly might have been overly cautious. At 10 o’clock, I debated skipping the check until shift change. I’m glad I didn’t. Like I said, Doris was the best nurse I knew.
The young woman had bled through her pad and her blood pressure had dropped. “We need to take her back to surgery,” the attending physician told me when I called him.
It took 30 minutes. In those 30 minutes she soaked through three pads. I instructed the nursing assistant to put the crash cart by her door and sat by her side with my fingers on her wrist. I think I must have checked her blood pressure 10 times. I don’t remember breathing until the operating room technician took her downstairs.
She lived, but had to have a hysterectomy. As I recall, she spent five days in the ICU. By the time she was transferred back to the surgical floor, I was working on another unit. I never saw her again.
It has been over 40 years. I never regretted my choice. I wonder how she feels.
We were two young women who made the same decision within two weeks of each other. We lived in the same country and should have had the same options for reproductive care. Yet we may as well have lived a world apart. 200 dollars and a short car ride made all the difference for the rest of our lives.
For young women today everything, and nothing, has changed.
Andrea Leeb lives in Venice, California. She has an MFA from Bennington Writing Seminars. She has been published in several literary journals including the Potomac Review and The Readers Post Journal. In addition to writing, Andrea has worked as an attorney and as a registered nurse. She is currently working on a memoir.