Welcome to Bustle's Abortion AMA column, where reproductive rights advocate and Romper editor Danielle Campoamor will speak to experts and medical professionals to answer people's questions about abortion in a way that is educational, unvarnished, and judgement free. Ask us anything.
During the period when I found out I was unexpectedly pregnant and in need of an abortion, I was privileged to live in a state with few restrictions to access. Still, there were numerous steps required to prove that I was ending a pregnancy on my own terms. From signing a document that stated I was of sound mind and making the choice to terminate without any outside influences to being separated from my then-partner prior to my procedure in order to, again, tell a counselor that I was not being coerced to end a pregnancy in any way, I was asked to make it clear that I wasn't being forced into getting an abortion. At the time I found these steps tedious and patronizing; I knew what I wanted and was looking forward to having the procedure so I could no longer be pregnant. I didn't recognize how fortunate I was. Specifically, I didn't realize that not everyone is in a relationship where they have full autonomy over their body when faced with an unplanned pregnancy.
If you are pregnant and in a toxic relationship where you believe your partner will pressure you to make a certain decision, it's important to know that you're under no legal or ethical obligation to disclose your pregnancy or subsequent choices with them. "If you're in a toxic relationship there's no such thing as a healthy conversation," Rachel A. Sussman, LCSW, a licensed New York City therapist providing marriage counseling, relationship counseling for couples, and family therapy, tells Bustle. "So if you feel you're in a toxic relationship and you've become pregnant, you don't have to ask anyone for permission [to have an abortion or continue with the pregnancy], or even give anyone any information. That does not need to be a conversation you even have."
Some signs of a toxic relationship, according to Sussman, include being in a relationship with someone who is controlling, makes you feel anxious and depressed, and leaves you feeling insecure about the future. Other signs of a toxic and potentially abusive relationship, according to The National Domestic Violence Hotline, include: a partner telling you that you can never do anything right, growing jealous when you're away with friends, discouraging you from seeing friends or family members, controlling your finances, telling you that you're a bad parent, insulting, demeaning, or shaming you, and pressuring you to have sex when you don't want to. If you believe you are in a toxic, unhealthy, or abusive relationship, seek help immediately. You can call the National Domestic Violence Hotline at 1-800-799-7233.
An abortion clinic is also a safe space for you to discuss your thoughts and feelings about your unplanned pregnancy, no matter what they may be. "One of the things that unites abortion clinics in this country is that we have a commitment to honoring the choices women make about their bodies," Sanithia Williams, M.D., an OB-GYN in California and Fellow with Physicians for Reproductive Health, tells Bustle. "So even though we provide abortions, we don't have a vested interest in a woman having an abortion. Our goal is not for women to have abortions when they come through our doors. Instead, our goal is to support them through that choice if it's something they have decided for themselves."
There are numerous ways you can alert someone at an abortion clinic — whether it be a provider, counselor, or staff member — that you're unsure about moving forward with an abortion and/or are feeling pressured by someone else to end a pregnancy. "Every clinic is slightly different, but in most clinics there is some kind of counseling process, and that’s obviously a very clear space for you to have those types of conversations," Williams says. "But any time throughout the process, if you're ever unsure or you ever want to talk and/or you feel like there's someone pushing you toward an abortion and that's not what you want, you should feel free to be able to say that in an abortion clinic. The people who work there want to support you in making the decision that's specifically right for you."
According to Williams, it's standard practice for a clinic to separate a pregnant person from the person they came into the clinic with, so that they have the opportunity to speak with a counselor or physician alone and without having to ask their support person to leave. "It's built into the process for the pregnant person to be by themselves," she says, "so that also creates a space that hopefully people are more able to talk about any difficulties they've encountered in making the decision, or any coercion that they may be feeling."
There are also signs counselors, abortion providers, and clinic staff members are trained to look for in potential patients, so that they can also help facilitate any potentially necessary conversations about a patient's thought process, choice, and any outside influences that may be impeding them from coming to their decision on their own terms. "It can be as simple as people who show a lot of uncertainty about the decision," Williams says. "For some people coming to the decision to have an abortion is more challenging, so that doesn’t always mean there’s some type of coercion happening, but it can be a sign that providers and/or staff need to talk with the patient a little bit more to find out if there’s something else going on."
This care and attention is invaluable to a woman struggling with her choice, but the majority of pregnant people who walk into a health care clinic seeking abortion services are very sure of their decision. According to a 2017 study published in Contraception, an international reproductive health journal, the "level of uncertainty in abortion decision making is comparable to or lower than other health decisions." The study called into question anti-abortion laws like mandatory waiting periods, mandatory counseling, and ultrasound viewing, meant to force women to think about their choice to end an abortion for an extended period of time. (Currently, according to the Guttmacher Institute, 33 states require a patient receive mandatory counseling before having an abortion, 27 require patients to wait a specified amount of time before ending a pregnancy, and 15 states that require a patient be informed they cannot be coerced into obtaining an abortion.) For many individuals across the country, these unnecessary laws are actually coercive in nature, and make it much harder for pregnant people to seek out abortion services or even accurate information about their reproductive health options.
"[The choice to terminate a pregnancy] can be challenging and complex for a lot of people, but I think [mandatory waiting periods and counseling sessions] infantilize women and pregnant people by assuming they haven't thought about these things themselves before they even walk through the clinic door," Williams says. "People are very much able to know and recognize and understand what a pregnancy means for them, their bodies, and their families. And most people don't really need to have too much of a conversation about that. They are the experts on themselves, so by the time they make it to an abortion clinic, nine times out of 10 they know what is best for them."
It's perfectly alright if you're that one out of 10, though, and if you're feeling pressured to make a specific choice, reach out for help, either at your nearby abortion clinic or via a reliable abortion hotline, like the National Abortion Federation Hotline that you can either contact online or by dialing 1-800-772-9100.
If you are feeling pressured to obtain an abortion — or continue with an unwanted pregnancy — it's important to know that no one has the legal right to force you to have a procedure you do not want to have, and there are people who can help you get the support and help you need. There are also steps you can take to distance yourself from any individuals who might be coercive instead of understanding. "Building a support system is key," Sussman says. "And through the support system you can get love, support, but also validation that it's your choice and the choice you made is the right choice for you. That support system can be family, friends, colleagues, or professionals."
Having full autonomy over your body means having the freedom to make any health care decision that's best for you... regardless of what that decision ultimately is.
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