The Land of Os

Part Three

Our doctor did not live in the area. No one in this small town would have anything to do with the clinic – except, or course, the employees and the women in need.
Each week a worker met the doctor at the airport and returned him to the clinic. Most of the time he arrived to hear people screaming “Murderer, butcher, baby killer.” He was also met with applause from those seeking an abortion. The emotions were in all directions on procedure day.

After the introduction I asked Kaylene to place her feet in the stirrups and lay down. Then she needed to slide her buttocks to the very edge of the table.

At this point the confidence, with which some women strike that infamous position privately like they were born in the pose, was simply not there.
It was amazing though, how many women, who obviously had participated in sexual activities at least once, were suddenly too embarrassed to keep their legs open.

Kaylene had been informed, as all women were, it was important to their own safety to keep the legs apart so the physician would have a clear view of the cervix. Still, particularly with this very young woman, shyness made it necessary for me to give her an occasional reminder.

FEAR was the hardest barrier to break through for women. Fear of pain, fear of permanent physical damage, fear of harassment, fear someone would find out, and the fear many of the women shared-that they would burn in hell forever for having an abortion. Still they were there.

I reminded Kaylene to begin to use her oxygen to help with the pain and to help relax her muscles. My background as a health consultant and counselor, and specifically my education in stress management , was a very big help during the procedures.

What made it very difficult was when the management combined the positions of advocate and physician’s assistant into one position. I was one of the lucky ones chosen to do this! Both positions, I felt, were very important to each woman, but the clinic had financial problems so they were forced to make this change.

The physician told Kaylene he was going to do a uterine size check in order to verify her weeks of pregnancy. Often a sonogram is done and blood and urine pregnancy tests. The uterine size check is the physician’s way of verifying, again, the weeks of pregnancy. That is very important because as the weeks go by the procedure becomes more difficult.

He then inserted a plastic speculum for a clear view of the cervix. We only used plastic ones at the clinic as they are much lighter and warmer than the metal ones normally used in many other clinics.

All instruments were sterilized, and needles, syringes and speculums were used just once. The rooms were carefully cleaned between each procedure.

Kaylene was maintaining a decorum of control as she was taking in long and deep breaths of oxygen. The majority of women I saw were amazed at the empowering effects just knowing they can truly help themselves so much by just being mindful of their own oxygen intake.

I believe diverting the attention to the breathing techniques also helped to
keep the mind calmer.

The next step was the optional injection to the cervix; lidocaine, a numbing agent. Probably 95% of the women opted to use the injection, and prior to the abortion they had other options to choose pain medications. The choices were valium, codeine or natural herbal relaxants.

I watched the physician attach a tenaculum to the cervix. Since the uterus is a floating muscle it needs to be held stationery during an abortion. The thought crossed my mind that I had learned so much about so many things in such a brief time. Forty seven years old, the mothers of three children and I finally learned my cervix has an “os”. “The cervix is the land of os,”
I thought.

As the physician attached the canula to the tubing of the aspirator machine, I explained he would be inserting it and then the actual abortion would begin as the machine was switched on.

This particular abortion was difficult for me, partly because of Kaylene’s age, and partly because this was the first time I had experienced the fusion of advocate and physician’s assistant into one position. It was difficult, but nothing is impossible when you make up your mind to do it. Particularly,
for me, when another human’s well-being is at stake.

As I turned the machine on I saw Kaylene begin to tense. “Keep that oxygen coming,” I reminded her. “A deep breath in through the nose, and a long exhalation blowing out through the mouth. You can do it”, I assured her.

The physician was breathing to with us. He was exhausted by the number of abortions he was performing each week and the distances he was forced to travel to do so.

Later he commented to me that he had never seen so many abortions go so smoothly as those where the women were using the breathing techniques. I was glad for that as it is a very trying time for each woman.

In order to do a complete vacuum aspiration, the physician must actually feel the contents of the uterus as it passes through the tubing. This is important to be sure the abortion is complete, as any remaining tissue could cause a uterine infection.

After each procedure the in clinic lab always checked to make sure the abortion had been complete.

Kaylene began to breathe quickly again and I breathed slowly and loudly and she picked up the reminder and calmed down again.

It took only two minutes to complete the abortion as she was only six weeks along. She had been at the clinic for six hours. It was imperative for the women’s safety to take health histories, hear an explanation of what was to happen, and have a time period between taking the pre-medication and the procedure. Usually abortion days were twelve hours or longer, with rarely a break.

The physician assured Kaylene. “Everything went fine. The lab will confirm that the abortion was complete. It’s Important you have a quiet weekend if possible. Take care of yourself now.”

Though the physician was a firm believer in the rights of women, and the empowering of women, he personally felt his demeanor of gentle assurance would assist each woman to begin to heal. The majority of women appreciated his warmth. So many times they said, “My own
doctor’s bedside manor is cold and unappreciative of who I am.”

It was over. The room smelled of sweat and the air was permeated with the trace smells of alcohol and disinfectant. Kaylene was okay. She knew it was over physically. She handled the trauma as good as the majority of the six hundred women I dealt with during the time I worked at the clinic.
Rarely did any of the clients “freak out” or “cry and wail” as so many people would have you believe.

The women who come into the clinic have already made up their minds.
Most women were totally relieved the pregnancy was over and read to begin their lives again.

There were only two women whom I wanted to scold and turn down, but again, I am not to be anyone’s judge. The first was having an affair, and the second was in for her fourth abortion – simply using it as birth control.

I learned along the way I would never participate in an abortion when the woman was further along than twelve weeks. A late pregnancy abortion is, in my mind, wrong. I know there are women who still seek them at a late point, but I find it hard to understand WHY they waited so long.

I was sent out of town one week and participated in a 24 week abortion. My heart still aches from seeing a small hand in the tissue. I can still see the physician using something similar to tongs to pull out “parts”. This
scenario made me reevaluate my standing. I still came to the conclusion it is only the choice of the woman who seeks the abortion, and I would still support a woman’s right to choose.

My position with the clinic ended because my husband was concerned with my safety. He really felt I was in danger, and I honored his thoughts. Two weeks after I quit , the clinic was burned to the ground for the second time.

I was grateful I hadn’t been infected by blood, grateful I hadn’t been shot, and yes, grateful I was no longer working there. I had completed my mission to support women, and gain understanding in the process.

I learned several years after I’d quit the physician had made a mistake in an abortion in another town and the woman had died. Thousands performed safely, but one error took that woman’s life.

To this day I think it was right for me to be there to advocate for those women who were determined to end their pregnancy. THEY had worth
in this life. It was THEIR decision.

In all the time I was there, not one person “outside” offered anything except consistent verbal abuse, accusations, and screaming at the clients. Empty words but nothing to back them up in the way of “help” for these women.

I keep reading my Bible. I hope and pray that God in His infinite wisdom knows my heart and reasons within it that led me to enter The Land of Os.

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