Outlawed Feed Drop! Tension of Opposites

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i'm jane marie and this is the dream today you're going to hear an episode of a show i've been working on for the last year all about abortion First, I need to remind you, you can listen to this episode with zero ads.

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Anyway, I've been working on this show for the last year.

We have a whole season out and the new season, the second season just launched this week.

It's called Outlawed.

And it's hosted by two doctors out of North Carolina.

And it's all about trying to get you the real facts and information so so that you are armed with them.

If you ever have to get in a discussion or an argument or, you know, write an email to somebody expressing your opinions, no matter what side you're on.

We just wanted to get the facts out there.

I'm Bev Gray.

I'm an OBGYN and a complex family planner, which means that I am an expert in providing early pregnancy care, and that includes miscarriage care, abortion care, treatment of ectopic pregnancies.

Also provide contraception for people who have a lot of medical illnesses that may have complex medical needs.

So that's like kind of the work thing.

I also do like a lot of just general OBGYN.

I work on labor and delivery and help deliver babies and bring life into the world and see patients in the office.

So it's a wide variety of things that I do.

Okay, Jonas?

Yeah, I'm Jonas Swartz.

I'm also an OBGYN OBGYN and a complex family planner.

And so from a clinical standpoint, I do a lot of the same things that Bev does, but I do more research than Bev does.

And so the clinical stuff that I do takes up less of my week.

And in my research, I'm interested in health disparities and in particular in access to care during pregnancy, access to contraception, and access to abortion.

And I particularly study how public insurance programs like Medicaid may change people's access to those services.

And then when they don't have access to those services, what does that mean for their lives?

Yeah.

So I was explaining to my friend and colleague that people who were providing abortion care were seeing dramatic changes very quickly, especially people who lived in states where there was a trigger ban in place, which meant after Dobbs, immediately they had a strict ban on abortion care in their state.

And so things were happening quickly.

It was hard for us to keep track of what was happening in North Carolina, much less what was happening in the Southeast.

And it felt sort of like this urgent moment to start listening to people's story.

And Dobbs is the decision that overturned Roe v.

Wade for people like me and other ding-dong listeners out there.

And it put the decision back to the states, right?

So it let individual states decide whether or not abortion could be legal.

And so we were like, you know, people would come up to us and they were like, you guys guys are pretty good at explaining these things.

And so we were like, well, maybe we could tell more people about it.

And so this seemed like a format that we could do that.

And we had no idea, you know, we're idiots too, right?

And so we think, oh, yeah, we'll just make a podcast, no big deal.

But like, we had no idea how you turn audio into a format that A, people would want to listen to, right, from a sound quality standpoint, but then B, how you structure a story so that

it makes sense to listeners who maybe are interested enough to

click on the feed or whatever.

Yeah.

Well, you guys taught me way more than I could have taught you.

I didn't know how little I knew about abortion before we made this show.

And it was very little.

Like I thought I was, you know, a well-informed feminist,

pro-choice kind of person.

But

getting like your specific experience and your understanding of the intricacies of the laws in various states

and your personal run-ins with these laws in North Carolina and just the access you also have to like

really important people in the abortion fight was really fascinating for me.

I felt like it was very enriching.

And continues to be so.

Yeah, it does.

There's still so many stories we haven't told.

And I think one of the great things is for the most part, we can ask most anyone to talk to us about this and they say yes.

And I think people are afraid to have these conversations with people that they know and love because they're afraid of it's such a contentious topic.

People don't necessarily want to have conversations, but if they have the tools to have these conversations and the knowledge to have these conversations, they can be really fruitful.

One of our goals is to help myth-bust some of these very common and pervasive myths that are out there about abortion care.

And, you know, like the whole idea of abortion after birth.

Like, I feel like we did a really good job of talking about that issue in the first season and really understanding that

people that are making decisions to have abortion later in pregnancy are doing so because they have new information about their health, their pregnancy.

And that, you know, I think this idea that people are making flippant decisions about their health care is just not the reality.

That's not, those aren't the patients that I've ever cared for.

Yeah.

There's so much internalized stigma about abortion, too.

And so even when you're thinking about talking with people who are an audience who you are unsure of their views, oftentimes, you know, abortion is this topic that maybe people feel is taboo and won't bring up with them.

But the reality is that the majority of people in the United States support access to abortion care and are of similar minds about it.

And a large group of people may feel uncomfortable talking about that, but they are of similar minds.

And I think part of our goal in the show is that we think that talking about it is important, right?

Like you need that sort of public expression of support to move forward.

I mean, I think of that

Saturday Night Live skid with Cecily Strong where she talks about how, you know, she's dressed up as a clown talking about abortion and she talks about how the she's calling women clowns and saying that the clowns won't talk about their abortion at all until they're at a dinner party late in life.

And then, you know, it turns out that many people in the room have had an abortion.

And I think that that is a pretty common - we know that abortion is common.

And so that is actually a pretty common experience, but it's an experience that we hide or people hide from each other and then don't talk about it.

And then that enables these, you know, heinous laws because there isn't this expression of public support.

And so I hope that we can at least help people feel a little more comfortable approaching those conversations with someone.

So here is an episode of our show.

It's called Outlawed.

You can find it everywhere.

We just launched the second season this week.

So go subscribe, et cetera.

Bev, have you heard that?

Are we recording?

Sure.

We've been recording for like two minutes and we've not accomplished anything.

Have you seen that Pete Buttigieg clip of him talking about, I think on Fox News, about

the quote-unquote late-term abortion idea where he sort of takes the interviewer to task on the idea of a late-term abortion?

Yeah.

Yeah.

So just to be clear,

just to be clear, you're saying that you would be okay with a woman well into the third trimester deciding to abort a pregnancy.

Look, these hypotheticals are usually set up in order to provoke a stronger.

No, no, but

it's not hypothetical.

There are 6,000 women a year who get abortions in the third trimester.

That's right, representing less than 1% of cases.

I know what it says.

Let ourselves pregnancy.

Let's take ourselves in.

So let's put ourselves in the shoes of a woman in that situation.

If it's that late in your pregnancy, that means almost by definition, you've been expecting to carry it to term.

We're talking about women who have perhaps chosen a name, women who have purchased a crib, families that then get the most devastating medical news of their lifetime.

Something about the health or the life of the mother that forces them to make an impossible, unthinkable choice.

And the bottom line is, as horrible as that choice is,

that woman, woman, that family may seek spiritual guidance, they may seek medical guidance, but that decision is not going to be made any better, medically or morally, because the government is dictating how that decision should be made.

All right.

So I think what I love about his discussion is that he's very...

clearly able to contend against this misinformation that's out there about abortions later in pregnancy and is able to clearly convey in language that's understandable to people why

there are a small number of people that need to make a very thoughtful decision about their health care.

And it's important for them to have the freedom to do so.

Aaron Powell, yeah.

And I like that he does focus on the numbers.

It should be noted that the numbers may not be accurate, right?

There are some states that don't report abortions to the CDC or to other sources and that those happen to be places where some later abortions take place.

There also has been a shift in abortions since the Dobbs decision with some states removing gestational age limit restrictions that were present before.

And so

because people can't access care where they are, they may need to access care later in pregnancy in other places, right?

We know that one of the effects of abortion bans is that they push people to have abortions later in pregnancy.

Even so, These are so few abortions compared to the majority of abortions that occur, right?

We know that 90% of abortions are occurring in the first trimester, and the number of abortions that occur beyond the first trimester goes down as you increase in gestational age.

So when you are restricting abortion later in pregnancy or talking about abortion later in pregnancy,

in order to restrict that abortion, you are making it much harder for 97, 98% of people to have the abortions that they need earlier in pregnancy.

And it's also insinuating that people, no matter where they're at in their pregnancy, are not making thoughtful decisions and that you need

to oversee their decision-making when these folks are making very thoughtful decisions.

And, you know, some of the cases that we've seen, you know, patients are wanting to be compassionate for themselves,

for their families, for the pregnancy that they're carrying, especially if there's, you know, a really

difficult diagnosis that they're dealing with or new information about their pregnancy that they're they're grappling with

and the assertion that they're not being thoughtful, that they're not being compassionate, that they're being unethical.

It's just that's not the reality of what we see when we care for folks like this.

Aaron Powell, the other power of this misinformation is that it takes something that feels easier to put in your head and object to, right?

Like you can think of a picture of what a baby looks like later in pregnancy.

And the more people equate that picture with abortion, the harder it is for them to support abortion.

But that just isn't the reality of what most abortions are.

Yet,

it is a very powerful talking point for anti-abortion groups because they can point to that and say, oh, well, look what's happening.

You don't want to prevent that.

And it's really just beside the point.

I mean, that's Mayor Pete's point.

Yeah, so I'm excited to hear this conversation.

Dr.

Jenny Vivicencio is really an expert in

so many things, but advocacy, understanding and contextualizing abortion care.

It's part of her mission, as you'll hear, to destigmatize the idea of quote-unquote late-term abortion.

And we're hopeful that this can help you gain understanding about this very hot button that people like to bring up.

and give you some perspective about what happens in real people's lives.

My name is Jenny Via Vicencio.

My pronouns are she, her, a, yeah, and I am a first-generation OBGYN and complex family planning specialist.

I provide all trimester abortion care.

What that means is that I sometimes spend my nights delivering babies all night long and sometimes I spend my days offering and providing abortion care for folks.

I think the myths that are coming out of

those people that want to ban abortion, there's lots of them that are out there that we're hearing about after birth abortion and all of these, this rhetoric that's happening is a really deep and purposeful misunderstanding of complex medicine.

So we are not out there taking newborns and killing them.

We are not offering abortion care to people rolling in at 40 weeks who thought they were going to have a baby and suddenly decide that they don't want to.

That's just not a reality.

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It definitely is a little nerve-wracking and at times scary to be talking out loud about this.

I know that when I

decided that I was going to provide abortion throughout pregnancy, as well as start talking about it, I had a conversation with my husband, I had a conversation with my family, because it absolutely, based on history, increases your risk of things happening.

I already live where I don't get mail at my house.

I am,

you know, have a P.O.

box.

I take different routes to work and back doing things to protect myself from harassment, but this increases that risk.

But this is the work that I am called to do.

I do this work out of a moral duty to my patients and to my community.

And I have never been able to not talk about what I do.

And I think one thing that's really important is to know about me is that I actually grew up extremely conservative and I was anti-choice well into my my early 20s.

I am first generation Latina and I grew up very Catholic and very, very conservative.

Very called by a lot of the social justice values of Catholicism.

Holding people's hands, washing their feet, you know, showing up for them no matter what they need.

It's actually, my values are exactly the same now.

I just express them differently.

But as part of that Catholicism, I got involved in the pro-life movement and it was a huge part of my identity.

I mean a huge part.

So youth groups, we volunteered for crisis pregnancy centers, we would write letters to people, we put kits together for people who would continue their pregnancies.

It also looked like a lot of

talking and evangelism really.

I, in high school, my senior year in high school, I actually wrote a essay and read it to my entire high school.

I was in Catholics, all-girl Catholic school, but I wrote an essay entitled, A Woman's Choice Ends When She Chooses to Have Sex and I read that to my entire high school.

So what I thought I was doing as part of being part of the pro-life movement and that's I say it in that way because that's the way I identified,

I was told that abortion was detrimental to women.

They said it was dangerous.

They said that it would hurt them from a mental health perspective.

All of the myths that we hear now.

It's they're not reinventing any wheels.

It's exactly the same.

And obviously they said that it was killing babies and it was destroying families and that if these women just knew better, they just knew better, they wouldn't ever have an abortion.

And as someone who cared very deeply about justice and about my community,

I felt called

to rally against something that was so horrible.

I think also the religious aspect, the faith on top of it, and being told that it was a sin.

I mean, the first time that I ever heard about abortion was in second grade in CCD.

Those of you who are Catholic will know what I'm talking about.

And they were talking about the different types of sins, venial and mortal sins.

And the example of a mortal sin was an abortion.

In second grade, that's the first time I heard about it.

And so it had been this like through line in terms of like, that is a bad thing.

And this felt, I was guided towards this.

It felt like a way for me to be helping.

The other piece that was kind of layered on top of that is that I was part of the kind of purity movement.

I had a promise ring.

I had took a virginity pledge.

I actually had a boyfriend from 13 to 19.

He became my fiancé.

At 18, we got engaged.

We did not have sex.

That was a very big part of my identity as well.

And that really

the rejection of sexuality really kind of overlaid and intensified the dedication to being pro-life.

It was very easy for me in

the position that I was in to think, just don't have sex.

Whether it's a rejection of sexuality or a centering of sexuality, I think it's almost both, right?

It's like putting it front and center, but making sure that it's front and center so that you can punch it away all of the time, right?

You're not allowed to look at it, you're not allowed to talk about it, you're not allowed to engage with it, but you better keep it front and center so that you make sure that you don't never touch it or engage with it.

And so I think it's almost both.

And ultimately, that was one of the reasons why I left the church.

There were a couple of different reasons in my early 20s, but including some of the

controversy and very, very clear, obvious sexual abuse that was happening in the Catholic Church, that was very hard for me.

But as I was coming into my womanhood, I was having a really hard time with that.

what for me felt like a virgin horror dichotomy type thing that was happening.

And so that was one of the reasons that I actually left.

And I didn't really think about abortion for several years.

I kind of just like put it aside.

And then I went to med school.

In med school, I met my first atheist, and they didn't have horns growing out of their head.

And so, you know,

I also was politically kind of evolving a little bit.

And I just didn't really think about abortion for a while, which was so weird for me because it had been such a huge part of my life for so long.

I mean, like, every day it was like old signs that say honk if you love life and all of those sorts of things.

Certainly, the type of pro-life activism I was involved in was less hateful than some that you see.

It was much more,

we love you, love your baby-type stuff, which in of itself is hateful, but it was less

hellfire and brimstone and more, come over here, I will hold you, which felt good to me.

It felt in line with what I thought I was doing.

I,

in residency,

had evolved a fair amount both personally and professionally.

But what really kind of fixed my mind on taking care of folks and providing abortion care was I was taking care of a patient.

I was on the night shift.

I was a second-year resident, which is still a baby doctor.

And this very young woman was having an abortion, an induction abortion for a lethal fetal anomaly.

So there was no chance for her pregnancy to continue.

And my attending told me, who's like my supervisor, told me, I don't do abortions, I don't believe in them, so don't call me.

I'll sign the papers in the morning.

And so

I was completely alone, and my patient was abandoned with someone who had never participated in this before.

I was comfortable at this point participating, and fortunately, everything went well.

But

this young woman asked if she could hold her baby.

And I was very nervous because

the baby really did not look anything like you would expect it to because it was so anomalous.

So I did the best that I could to wrap it up.

And it was three in the morning and the whole room was dark and her family was there.

And I handed it to her.

And this young woman who had just chosen to enter pregnancy looks down and she goes, look at how beautiful my daughter is.

And it really was in that moment at like that 3 a.m.

call that I decided that

this was how I actually enacted the justice that I had been so dedicated to my entire life, was showing up for people like her and making sure that she was never abandoned again and anyone like her was never abandoned again.

And ever since then, I've dedicated my life to providing comprehensive care and making sure that I am not in the position of othering or in judging.

I'm only in the position of receiving people as they are and caring for them to the best of my ability.

What ultimately did it for me was I realized how much I was othering people.

For me and my experience with religion, it was very much like, I am different than you because I follow all of these rules.

And that started to be really exhausting and really, really tough just on a like basic personal level.

And I was obviously not able to meet up, you know, meet those standards all of the time, which felt really crappy.

And so I started thinking, like, do I have to live this way?

And exploring my actual values, things like justice and community and compassion, rather than them under the veil of my religion.

And I realized that I could be expressing those values in a much more articulate, in a much more authentic way if I were receiving people and not othering them.

You know, I had a couple of personal experiences.

I know the first time that I had sex, I ended up needing Plan B.

And this was, I was still kind of in the throes of religion and I had to go to a family planning clinic.

This was before it was over the counter.

And I remember passing through all of these protesters and they were screaming horrible things at me.

And I remember thinking in my head, I'm one of you.

I believe what you do.

I'm just here for you know plan B.

I'm not here for an abortion.

It was my fiancé making all of these sort of excuses and not even really being mad at them, right?

Just trying to almost be on their side of the line.

And then when I got into the clinic, I sat down and I looked at everybody else and I couldn't do the othering that I was used to doing.

I couldn't tell who was there for an abortion or contraception or plan B like me, right?

And I wish in my like 19-year-old brain that had been the thing that triggered it.

It took a lot longer after that, but it definitely is something that sticks with me where I was like,

now that I'm in this position and other people are looking at me that way, this feels really bad.

And

it really made me think about not wanting to continue to do that.

And as I mentioned before, my values when I was 15 as a super hardcore pro-life Catholic, when I was 22, super hardcore pro-life Catholic, and now as an all-trimester abortion provider, my values are exactly the same values.

They have not changed.

I just articulate them and express them in what feels like a much more authentic way now.

I provide abortion care up to 34 weeks in pregnancy and I think that there's probably

less than 10 of us that provide that level of care routinely.

There are certainly more that may do it at the hospital, kind of a one-off, but as a routine care, there's not many people at all.

I would say folks that are providing later abortion, it's probably less than 30.

So what's interesting is that the term later abortion, which is typically what we like to use, or abortion later in pregnancy, is a really relative term.

It means very different things to very different people.

Typically, what we mean is later in the second trimester or into the third trimester, but I've had patients that think that a 14-week abortion is a late abortion.

And I think that it's really important that we acknowledge that everyone has a different relationship with this term, late.

That's very connected to the stigma that exists as it relates to abortion care.

When I talk about later abortion, I'm typically talking about 26 weeks and above.

And those are the folks that are the most marginalized in abortion care.

They only have a handful of places that they can go in the entire country to be able to get abortion care.

And I think that they are some of the most stigmatized, among the most stigmatized, folks that are seeking abortion care.

There's a lot of misinformation out there about later abortion.

And I understand that.

I think that people worry about and think about the moral and ethical guardrails around abortion care just generally.

And so part of my job is to talk about it openly and to let people know that the folks that need abortion care later in pregnancy are doing so within the constructs of the moral and ethical guard roles that we all have.

And for me, it was all about talking to these patients, being with them, holding them, seeing how thoughtful and

careful they are.

They also recognize that it's different and that doesn't mean that it's wrong.

I also, for me, recognize the potential of that pregnancy and also deeply respect that the person who is the steward of that pregnancy, that potential life, is telling me that that is not going to end well if they have to continue it.

I take care of people all the time that are excited about their pregnancies and know that they need an abortion.

And so it's very important for me to be doing work like this and to be showing up for patients so at least they have somebody who is giving them the option, even if they don't end up having an abortion.

It's a very common question to ask why someone might need an abortion later in pregnancy, maybe after 24 weeks.

And the way that I usually break that down, and I'll give some examples in a moment, but the way I usually break that down is either they received new information in their pregnancy.

So that means they received a health diagnosis either for themselves or for the fetus.

They had a new circumstance in their life.

Their financial situation changed.

Their family situation changed drastically that impacted how they were viewing their pregnancy.

Or they had a late diagnosis of pregnancy.

We don't acknowledge how oftentimes people are not finding out that they're pregnant until later on in their pregnancy.

Jenny brings up a couple of important points.

And I think one of the things I take from what she's talking about is that the types of decisions that people are making about their pregnancy are similar later in pregnancy to those decisions in the first trimester when people are making in the first trimester, right?

They have a variety of reasons.

They may get new information,

but they need to have the freedom to make the decision in that moment.

Right.

And we care for patients all the time that are receiving new information about their pregnancy.

And she talks about some of those patients, the ones who maybe get new

ultrasound information about a devastating diagnosis, something new that changes how they want to continue this pregnancy.

Aaron Powell, Jr.: And I think one of the most problematic things that anti-abortion groups and anti-abortion politicians do is they mix two different things.

So one type of care is abortion care, and that's ending a pregnancy before birth, right?

Another type of care is palliative care that may occur after delivery, which is not an abortion.

Can you talk about like how people come to that decision and what exactly that means?

Right.

So, you know, patients may receive new information about a lethal birth defect,

and some decide to seek abortion care, but others decide to continue the pregnancy and have a birth experience.

But once they give birth, offer palliative care or comfort care to their child.

And that aligns more with their values.

And I think it is not our place to direct people into what option they should choose, but rather to support them and what their values are

to help them have the experience that makes the most sense for them and their families.

And so when a patient decides to continue the pregnancy and give birth,

we offer them comfort care or what's called palliative care.

And Jenny will talk a little bit more about this in her discussion, but that's very similar to end-of-life care that we think about when people are facing futile diagnoses in their health care.

Aaron Trevor Bowie, right?

And it's not abortion, right?

No one is intervening to take the life of that baby, right?

It's that they're not offering painful

or heroic measures that may or may not prolong life.

And

it's really harmful.

that those two things are mixed that someone would call that abortion care because it's just not abortion.

Right.

And the visual imagery of someone killing a baby after birth, I mean, that really is

inflammatory and makes people think that there's something happening outside of those ethical guardrails, but that's not the case at all.

And these cases are

heartbreaking and tragic for families.

And they should have the freedom to choose what's right for their families in those moments.

And, you know, I talk to patients all the time that have a variety of feelings and emotional reactions to either seeking abortion care or having palliative care.

But we always talk about how, you know, you're making a decision to be compassionate for your child so that your child won't suffer.

And Lisa talked about that in the Texas episode as well, about sort of envisioning that life for her child, which was with a great deal of suffering, and that that was why she decided to have an abortion.

Yeah,

I also think just to say it, I mean, we do offer people intervention sometimes, right?

I mean, there are some conditions that can be treated or that can try, and some families, you don't want to do everything, so it's not right for everyone to do palliative care, but all three of those options need to be on the table.

And the reality is that there are very few places where the idea of an abortion after 24 weeks, say,

is an option that people can pursue.

Trevor Burrus, Jr.: Right.

And if you look at the numbers out of Texas after their strict bans went into place, their infant mortality numbers went up by about 10,000, which equates to the number of these infants born with these lethal birth effects.

And so some patients are being forced into that decision of continuing a pregnancy

only to know that there's nothing that can be done for their child.

And in terms of the deaths after birth that they are talking about, what they are co-opting are deeply, deeply painful and difficult situations where people are having babies that are not able to survive and are opting for palliative and comfort care.

There are many scenarios in which families are choosing not to do intense, crazy intervention to try to get a couple more days for their child that they deeply love.

We are familiar with this concept much later in life when we talk about whether or not we want a, you know, full resuscitation for our grandmother who is 89 years old.

We want to do CPR where we crack her chest and put chest tubes in her and intubate her.

We're a little bit more comfortable with those conversations as Americans.

Those are very similar conversations in the extremes of life.

And the way that people who want to ban abortion are co-opting that and saying that it is murder or that we are doing it routinely is

horrifying and disgusting and completely outside of what's actually happening.

And so the way that I respond to that is not saying it doesn't happen.

I say it's not happening at all the way that you are saying that it's happening and you are doing a deep disservice to the people who need that health care.

I was consulted in the ER at one of the hospitals that I work at, and it was a very young woman who was having a serious mental health crisis.

And she was in,

she was about 22 weeks pregnant.

And she had

been boarding in the ED for three weeks, so literally living in the emergency room.

And the reason is they could not find psychiatric placement for her because she is pregnant.

And so they asked me to come down and do some level of prenatal care for her.

And what I do when I'm initiating prenatal care, if it's the first time that I'm meeting someone

and they are kind of finding out about their pregnancy, I talk about pregnancy options.

How are you feeling about this?

How are you, do you want to continue the pregnancy?

Have you thought about those things?

In a very neutral way.

And initially, she expressed she was not interested in abortion, and so we just kind of continued to move on.

And then right in the middle of the conversation, she goes, you know what?

I want a baby, but I don't think it's a good idea.

I think the reason I can't get the help that I need is because I'm pregnant and I don't have a support system and I need to get well before I, I mean, she had this incredible insight for someone who was in the throes of really serious mental health crisis.

And

I said, I don't know what this looks like.

You know, you are under.

There's lots going on with you, but if you want me to, I will try to investigate it for you.

She said, please.

And I did that, and I actually got admonished by multiple people for discussing abortion with her.

And they felt like she had already

expressed that she was excited about her pregnancy.

And so there was no reason to ever talk about abortion with her.

And I think that that just demonstrates how little we actually understand about how people have abortions.

People have a hard time holding two things that are seemingly opposing.

It's called, in psychology, it's called the tension of opposites.

I was a neuroscience major in undergrad, so I love this stuff.

They have a hard time, but if you allow them to give them space to hold two things at the same time that seem opposing, they're actually very, very capable of it.

The example that I give that has nothing to do with abortion is that

my parents live with me now.

They moved from Miami and they live in my home with me and my husband.

I move them in because they are not well.

My father has dementia and my mother is not well either.

And as a first-gen Latina, it's a huge part of our culture.

We have intergenerational households and we take care of our parents.

And so I'm deeply honored to be able to participate in that and to honor my cultural heritage and to take care of my parents.

And it's kind of ruined my life, right?

Like it's,

that's a hyperbole, but it's really, really hard.

And so I could tend to just the part of me that is proud and honored and fulfilled that I can do this, but I would be leaving a part out, the part that is struggling, and that would be eating away.

I also could just focus on the part that was struggling, but that polarization

doesn't work when you're trying to actually live in the real world.

And so now I just allow myself to hold those two things at the same time.

Yeah, it's really, really hard.

I'm really, really struggling.

Some days I wish this wasn't the case, and I'm really happy that I can do it.

And I think with abortion, for most people,

it sits in that space.

I wish I I didn't have to have an abortion.

I wish abortion wasn't allowed.

I wish abortion wasn't this thing.

And

I think people should be able to have an abortion when they need one.

And I am not interested in making people choose between those two things.

I think that those are very, very, you're able to hold those two things at the exact same time.

That's what my mother does.

She holds, I'm worried about your soul.

I think abortion is a sin.

And I'm really proud of you for showing up for people and using your skills to take care of them.

And I don't try to ask her to choose between those two things.

I think it's more healthy for her to manage that conflict on her own.

You're so smart, she did a good job.

Thank you.

I did tell her during the throes of, I did tell my mother during the throes of some of our arguments, she was like, This is not how I raised you.

And I said, This is exactly how you raised me.

And so she didn't like that very much, but it is true.

My mom and dad are both pretty Catholic, and initially it was very, very challenging.

I went to med school to be a trauma surgeon, and then I thought maybe I was going to be a cancer doctor.

And my parents were really excited.

And then I called my mom and I said, I think I'm going to go to Family Planning Fellowship.

And she said, what does that mean?

Are you going to help people get pregnant?

She thought it was infertility.

And I said, no, I'm going to do abortion care.

And she said, kind of just started doing what my mom does, which is like, are you sure?

Didn't you want to do this?

Didn't you want to do that?

And there was like a tension in the air.

But I was in my mid-20s at this point.

And I was sort of like, get on board, right?

Like there was no, I was not giving her any space to feel anything.

And we actually didn't talk about it for about eight months.

I was pissed at her.

I think she was pissed at me.

But it didn't feel good to not talk about things.

As I said, I can't not talk about things.

And so I started trying to explore where her feelings around abortion actually were.

I knew that she abortion was a sin.

She had told me that before.

But she

ended up over time, over about five years, slowly with having multiple conversations telling me about her own reproductive history.

I hadn't realized that I was,

she had to conceive me with infertility treatment.

She had a really hard time getting pregnant.

And

actually, she...

had my sister and then she had an unplanned pregnancy which I had no idea about right after my sister and my father said I don't think we can afford afford this.

I think we need to have an abortion.

And my mom said she thought about it for about 30 seconds and said, no, I can't do that.

And she ended up having a devastating late second trimester miscarriage.

And to this day, she believes that God punished her for considering having an abortion.

I knew none of these things about my mother.

And hearing that helped me understand the context in which she was viewing abortion.

Her lived experience and her religion, her faith, her values, all of those things were coloring the way that she was was viewing it.

And it was like a lightning bolt to me.

And I was like, of course, you would feel differently about this.

And then I will never forget this moment.

I was standing in the C group of Southwest Airlines.

So, you know, waiting forever to get on in that catacol.

And I'm on the phone with her.

And we were talking about something else.

I was going to a conference, and she goes, you know, I went with my friend to get an abortion one time.

And I said, what?

And she goes, yeah, when we were 15, it was illegal, and she really needed one.

and she asked me to go with her.

And so we walked there together and I begged her the whole time, I begged her not to do it, that I told her that I would help her, that, but, you know, we were both 15 and she knew that that was not going to happen.

And so I stood there and I held her hand while she had the abortion.

And now I'm sobbing in the C group of Southwest Airlines, waiting to get on this plane because...

I now understand my mother to be a person who can hold someone's hand while they're doing something that she disagrees with, but show up for them.

And I realized that that's what she was trying to do for me, right?

She was showing up for me in her way, and even though she disagrees with it.

And now we're in a really beautiful place where she prays for me and my patients, and not in a like you're going to hell way, but in a like, I want you to be safe and I want you to be held.

She still thinks abortion is a sin.

Every once in a while, she worries about my soul.

And I thank her for that.

I thank her for worrying about me.

But she's also deeply proud of me.

And when I actually went to tell her that I was going to do all trimester care, I thought it was going to be another situation.

And she goes, yeah, no, I totally get that.

I hear that.

So she had moved as well.

And so, yeah, I think having those conversations were really important.

It happened over time and it was not like a linear process, but understanding her as a person and where she was coming from was critical to

realizing that we actually have a lot of shared values and that we can differ on some things.

I mean, she lives with me now.

She walks around the neighborhood and her Planned Parenthood shirt with her walker.

Like, I mean, she's like in a totally different place now, but

it's been our journey.

Opinions expressed on this podcast are our own.

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