Abortion: Uneasy Day At the Clinic

Patients' Views

Michelle slumps in her chair in the counseling room and answers the questions in a soft monotone.

Two children already ... First abortion in 1995 ... And, she reveals, the father of the baby she's about to abort is not her husband. He's in Africa. Her boyfriend will come by later to take her home.

"Do you have any doubts? Any questions about what will happen today?" asks the counselor, Meg Curtis, who has already explained what the doctor will do.

"No," says Michelle, about seven weeks pregnant, without hesitation.

On this day at the surgical unit of Planned Parenthood of Southeastern Pennsylvania, in central Philadelphia, 21 people will have abortions. Another two dozen pregnant women will come in to view a video and to "start the clock" on their state-mandated 24-hour waiting period. Most will come back for abortions. Some will never be heard from again.

Amid the cacophony of the highly emotional, politicized debate over abortion in America, the 1.2 million women annually who undergo the procedure are usually silent. Few want it known that they've chosen to end a pregnancy. But they each have a story to tell.

With the promise of anonymity for the patients, the Philadelphia clinic allowed this reporter to spend a day there, tour the facilities, observe counseling sessions, and speak with anyone who was willing to talk. Patients' names have been changed for this article.

Upon descending the stairs into the basement of the Philadelphia Planned Parenthood, where the abortion clinic is located, one is greeted by a sea of women - black, white, young, not-so-young, some with men along for support, or mothers, or just friends.

Many have that tell-tale look, the loose-clothing and swollen bosom that hint at pregnancy. There's a matter-of-factness to the proceedings, as women one by one are called for counseling, then to undergo "the procedure," as staff members say.

By now, most of the shock and anguish, if any, at discovering an unwanted pregnancy has subsided. The moment for getting it over with has arrived. Sometimes, says clinic manager Paula Monastersky, a woman will just get up and leave. Occasionally, a woman will even be undressed and on the table, moments away from the doctor's instruments, and she'll change her mind. On this day, nothing like that happens.

Quiet decision

Sarah, a 40-something woman with two children, and her husband have driven here an hour from Delaware for an abortion. They had been careless and gotten pregnant, she says with some embarrassment, and she just didn't feel mentally she could manage a third child. Money wasn't an issue, and tests had shown the baby was healthy, she says, but "I feel I'm at the maximum. I'm trying to do right by the kids I already have."

Her biggest concern was being "found out," which is why she and her husband chose not to use a clinic closer to home. In her town, pro-life sentiment is strong, and she didn't want to face questions, or worse. To avoid any eavesdropping, she made sure she never used the cordless phone when setting up her abortion.

But at the same time, she's willing to speak to a reporter, she says, because "I feel strongly about Roe v. Wade" - the Supreme Court ruling that legalized abortion 25 years ago today. "In my life, I feel fortunate to have a safe and caring environment to go to."

DeNeese, by contrast, has never heard of Roe v. Wade. She's not even in high school yet. At age 14, five months after losing her virginity, she's now almost 14 weeks pregnant - the maximum length of pregnancy that this clinic will handle.

"I didn't realize I was this far along," says DeNeese, a petite girl with large brown eyes and close-cropped hair.

The father of her baby is her steady boyfriend, and when she got pregnant, there was no discussion of keeping the baby. "I just told him I'm having an abortion," she says. "I don't think I ever wanna have kids."

In Pennsylvania, parental permission is required for abortion patients under age 17. And DeNeese has full parental support. With her stepmother at her side, DeNeese listens to counselor Jessica Huertas like a schoolgirl who's been sent to the principal's office. DeNeese leans over the table, her chin resting on her hand, her eyes rolling as Ms. Huertas delivers a mini-tutorial on how she must continue to use condoms even after she gets a Depo-Provera shot that will keep her from getting pregnant for three months.

No one suggests that DeNeese might want to try sexual abstinence. "We have to be realistic," says Ms. Monastersky, the clinic director, later in the day. "This girl is going back to her boyfriend and he's going to say, 'Oh baby, I love you....' and well, you know."

Tough lessons

Some women come out of the abortion experience swearing they'll never have sex again, but usually they do, sooner or later. And they need to know how to protect themselves, say the clinic counselors.

"Some of these young ones don't know anything about their bodies; some don't know how they got pregnant," says Huertas. "Then we get a 13-year-old with gonorrhea and all she knows is she's taking pink pills for something. Sometimes abortion is the least of the issues someone is dealing with."

Lee Tripp, an affable man wearing a casual jacket and a broad smile, strolls through the clinic midmorning. He's here to start performing abortions.

Dr. Tripp has been working here part time for seven years, and for the past year has also worked at a clinic in West Chester, Pa., a conservative suburb of Philadelphia. It's the West Chester clinic that's been giving him problems.

Twice, he says, protesters he recognizes from West Chester have come and protested in front of his house, trying to incite the neighbors to call him a murderer and a baby-killer.

"The neighbors just shouted right back," says Tripp. But he and his wife, who have four children, are starting to have second thoughts about his working at West Chester.

Tripp has a bulletproof vest that he wears only when he sees unusual protesters at West Chester. Monastersky, the manager of the Philadelphia clinic, wishes Tripp would use the vest more often. "It's not doing him any good in the trunk of his car," she grumbles.

At the Philadelphia clinic, a regular crowd of about 200 people comes to protest the third Saturday of every month, but the faces are familiar and the staff isn't too worried.

Still, after an anti-abortion gunman killed two women at two clinics in Brookline, Mass., in 1994, Philadelphia Planned Parenthood reworked its security. The windows in the basement clinic and the glass doors to the building are now bullet-resistant, as is a new enclosure for the main-floor receptionist. People entering the abortion clinic must be buzzed in, and if there's an invasion of protesters through the front door, the receptionist can push a panic button to lock the door into the clinic.

Monastersky, who's been working in abortion clinics for most of the past 25 years, comes to her work with a combination of fearlessness and practicality; her home phone number is unlisted. Tripp is more cautious. When a local television station calls on this day requesting an on-camera interview, he declines.

Though violence at clinics has declined dramatically in the past few years, he knows he is still vulnerable. It comes as no surprise that the number of doctors willing to perform abortions is declining steadily.

Over the years, Monastersky has seen it all - from the avowedly pro-life people who are willing to make exceptions when their own circumstances get complicated to the women who are showing up several times a year and clearly using abortion as birth control, a practice that makes Monastersky wince with disapproval.

"Abortions come in waves," she says. "After prom time, after New Year's, at the end of the summer when people are saying good-bye to go off to college. It's weird, but it's true."

On this day, Monastersky is moved by a young woman named Keesha who's come in for an abortion that her community has helped fund. Keesha is barely out of her teens, lives with her aunt, and already has two little boys. The neighbors have scraped together most of the $295 needed to cover the procedure, and the clinic will forgo the rest.

In her counseling session, Keesha explains that she's going back to school and it isn't a good time in her life to have another baby. The man who got her pregnant is out on the streets, and she expects to see him again, but he doesn't know she's here today.

"He thinks he got me knocked up and I'll have his baby," she says. "But I ain't worried about what he'll do when he finds out."

A couple's challenge

Like many women, some men, too, mourn the loss of their aborted babies. One couple, immigrants named Christina and Gabriel, are here today for her fourth abortion, and they're both clearly having difficulties. During our interview, Christina is reserved. But her fiance, Gabriel, welcomes the chance to talk.

"It was difficult to come here, she's going through a lot of pain," says Gabriel, who stood by her during the operation and said the decision to abort was mutual. "Our relationship was shaky, and I hope this will bring us together."

They already have a one-year-old child, at home with Gabriel's mother, who lives with them. She's very religious, says Gabriel, and doesn't know they're here.

"It was taking a life, and it's selfish on our part to take it away," Gabriel concludes. "Maybe this child could have grown up to be somebody special."

By the time Christina and Gabriel go home, it's late in the day. The last few patients are in the recovery room, drinking ginger ale and making sure there are no complications. The clinic director wanders back to check up on DeNeese, who's so young and such an innocent - at least by appearance - that Monastersky wants to give her a big motherly hug.

DeNeese's abortion was difficult, since she was so far along in the pregnancy. She's now on the floor, on all-fours with a blanket over her, Monastersky reports. That was the best way she could find to get comfortable. More than any lecture, her experience may lead her to give abstinence a try.

* Tomorrow, a place for unwed mothers. Part 1 (yesterday) explored the search for common ground on this divisive issue.