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the Body Politic
Vol. 7, No. 9 - September 1997, Page 8
Copyright © 1997 by the Body Politic Inc.

Limits to Access

by an abortion provider -- Anytown, USA

I worked with a woman last week which yet again made me recognize how many "barriers" there are to access to abortion care and how many "false assumptions" I continue to have, regardless of the number of women I see for abortion care.

An Hispanic woman came in with her husband and two year old son for the state mandated twenty-four hour counseling session with the physician prior to her abortion. Her husband was her translator as she could not speak English and we currently do not have a Spanish speaking staff person (much less a Spanish speaking doctor available to do the counseling).

The clinic forms are in Spanish so we gave them to the woman and her husband to fill out. It took the woman a considerable length of time to complete the forms. Afterward we took her, her husband and her son into see the doctor for the state counseling session.

This lasted only a few minutes before the doctor came out of the room saying the husband did not speak enough English to translate -- and they needed a sitter for the child (the child was healthy, active and verbal). The doctor left the clinic as this was his last patient so I called another doctor who is older and more philosophical about the state informed consent law. He came into the clinic and did the session -- and was OK with it. He felt that both the woman and the husband understood the information that was given to them.

Now just think of the number of times this woman could have been STOPPED from receiving the abortion care she was seeking. She had no transportation, no child care, could not speak English, could not read ...
One of our trained counselors worked with the couple for a lengthy period making sure the woman understood everything -- and was comfortable with her decision. The appointment for the abortion was scheduled for the end of the week.

I believed from working with this couple that this woman very much wanted to have the abortion. But I still felt a bit uncomfortable that perhaps everything had not been said to her that she needed to know in terms of what to expect during the procedure and how to take care of herself afterwards (much less how she felt about her decision). I asked a friend whose mother was from Chili to come in and "check in" with the woman on the day of the procedure. I wanted to be sure we had covered all the bases.

The woman arrived with her husband to have the procedure and she was all dressed up -- panty hose et al. I had my friend talk with the woman and request that she sign the clinic's informed consent forms which were in Spanish. These forms had been given to the woman on her first visit. Everything seemed to be going well until we got to the part about her having read and understood the consent forms. I saw my friend ask the woman delicately a couple of times and I saw that the woman floundered a bit. And then my friend said, "Shall I read these forms to you?" The woman said yes.

It turns out that not only could the woman not speak English, she could NOT read Spanish -- she was illiterate. I was very proud of my friend because she handled this difficult moment so smoothly. I nearly fell out of my chair when I realized what the problem was because we had made the assumption that although she could not read English, she most certainly could read Spanish.

We progressed from there and the woman had her termination and did just fine. After her recovery, she and her husband were sitting by the front door. She was re-dressed, panty hose et al. And I noticed they weren't leaving too quickly, so I came out to see if everything was OK. Since she was still cramping a bit I asked her husband if he wanted to go and get the car and bring it to the front door, and I would walk her out. He said, "We don't have a car." (Of course, I immediately felt like an idiot for being caught with another assumption). So I asked them how they got to the clinic. He said they took a cab but they had no money for one to go home. I asked where they lived -- in a small town across the river -- close enough for a $8.00 cab ride but not on the public bus route.

I started to say "What are you going to do?" but stopped myself because I saw them walking home (five or ten miles) in 95 degree heat, and this image of this proud, strong young woman who had just undergone surgery, walking along in those panty hose in 95 degree heat just struck me. I went in and got $10 out of my purse and called a cab.

Now just think of the number of times this woman could have been STOPPED from receiving the abortion care she was seeking. She had no transportation, no child care, could not speak English, could not read -- and that does not even address the fee we charged her to perform the abortion.

There are many good reasons to have a baby, but lack of transportation, the inability to speak English or to read, are NOT good reasons to be denied an abortion and to be forced to bear a child.

When will people begin to understand that abortion is NOT READILY AVAILABLE TO ALL?? Our affluence makes us blind and ignorant.

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