The War on Women is Coming From Within..( are you sure “your national family planning clinic” really is there for you?)
I have finally healed to the point where I can share my story. In fact, I must share my story. If I don’t, then the most well known “national family planning clinics” (I will refer to as QQ to avoid backlash) will have stripped me of my voice, which is central to who I am. I will not allow that to happen to me or to any of you .
I am a woman with a Masters degree. I have been gainfully employed since I was 15 years old. I am a mother of two. I have been an activist since I was 8 years old; loudly standing up for the rights of others. It’s who I am. It’s in my blood. I have always stood for the rights of women. I have always supported QQ and women’s right to choose. I have made it my life career to work for the underserved and misunderstood populations of our society. This year, I turned to QQ for help.
I first went to QQ when I was 16 years old. My friends and I were sexually responsible; we supported each other as we went to QQ for birth control pills, condoms and STD testing as we were becoming sexually active. I made a conscious decision as to when I would have sex for the first time with my long term boyfriend. I got on the pill prior to that and used condoms every time. I was so grateful that QQ was there for me and my friends. I continued by support of QQ throughout my years and continued to refer people to them. Having health insurance, I stopped going to them but I believed they were always there for me.
Ironically (but nothing really is a coincidence), I interviewed for a leadership position at QQ earlier in the year. QQ was concerned about how they could re-engage the women who used to use their services, but who are now older. I think, because of my experience and my story, this will be nearly impossible for them; all women know substandard care when we see it.
Flash forward. I am 39 years old. I was in a long term relationship. We used condoms. I got pregnant. I did not want more children. I called QQ. I was anxious but knew I would be able to pay for an abortion. Additionally, I was only a week late so I discovered it early.
I think the best way to share my story about what happened to me is to share the letter that I subsequently wrote to the CEO, VP and Medical Director of QQ in my state. I have omitted various details about locations.
Dear M CEO, M VP and Dr. Medical Director,
I must regretfully write to you to inform you of an incident of substandard care that I and 17 others received at QQ on XXX, 2011. It is my hope that you will find this to be an outlier in terms of standards of care within your clinics and that you will make every effort to make amends to the women who were impacted in this event.
I have been a devoted supporter of QQ through all of my reproductive years. It is because of my dedication to your mission, that I met with all three of you to discuss possible employment earlier this year. It is because of the positive interaction that I had with each of you that I believe you would be concerned about this incident. Due to unfortunate circumstances, I needed the services of QQ at this time in my life. I am absolutely grateful that I maintain the right to seek abortion services in my state, after recent legislation. I want to share my struggle in obtaining those services.
On Monday, I called QQ to make an appointment. I was left on hold for up to 40 minutes a time. I never reached a person. I became frustrated so I left my place of business and drove to the admin location to make the appointment in person. I quickly learned there was no longer a clinic at that location. I encountered two women who emerged from the admin offices and they asked if I needed help. I told them of my struggles with the phone line and they directed me to drive to the XXX St office. I drove about 20 minutes to the XXX St office and was able to make my appointment. The front office worker was very sensitive to my privacy needs.
On Friday XXX, I went to my scheduled appointment at the XXX office. I had elected to receive the medication abortion, so I received my pills on this date. I made a note on the comment card that the ultrasound tech had loudly discussed my circumstances in the hall, which I felt compromised my confidentiality. Everyone else was pleasant.
On Friday, XXX, I came back to the XXX office for my follow-up visit. Apparently I would require surgical abortion as the entire sac had not passed. This was scheduled for 7:30 am on Sunday. At this time the PA and the ultrasound tech were caring and friendly. The lab tech was friendly but was texting on his cell phone as the Dr. discussed my ultrasound results with me.
On Sunday, I arrived at my appointment before 7:30 am, however the door was not opened until 7:30. I was the first patient signed in. The waiting room quickly filled to capacity. I was called back approx 8:20, where I had an ultrasound and lab work. At 8:45 am I was taken back to a room (later referred to by staff as the “holding area”). I was told the Dr. did not come in until 11 am so I was to wait for over 3.5 hours. The “holding area” became so full that it was standing room only. There were a total of 18 women in this area who were expected to wait at least 2 hours. The room was very cold and I had notified the nurse. She agreed that it was cold but no blankets were offered. I asked why we were scheduled so early and she said that the Dr. needed to have everyone prepared so he could come in and serve everyone immediately. I began to become very suspicious at this time. The nurse called back 2 patients at a time and gave us each a prepared cup with 2 phenergan and 4 ibuprofen. An IV line was administered. We were told to go back in to the holding area. At about 10:30 a RN named XXX came into the holding area and loudly announced “My name is nurse XXX. I have been here 10 years. The doctor will be in soon and then he will get you all done one after the other like boom, boom, boom. You need to go to the bathroom because the doctor will be able to tell if you don’t.” The women looked at each other and one specific comment was made that we were being treated like cattle. 11:00 came and went and there was no Dr. At approx. 12:15 I overheard Nurse XXX calling the doctor and left a message saying “we have a waiting room full of ladies here. Please call us back.” At about 12:30 I asked a tech if he can find out why they had not called Dr. Medical Director. At approx. 12:45 I overheard the center manager, XXX, telling Nurse XXX that Dr. Medical Director would be in in about 40 minutes. Nurse XXX came to the holding area and said “Dr. Medical Director will be here in about 40 minutes. Then it will go fast.” She kept directing a male tech to complete the “prep”. He came into the holding area several times and in front of everyone, called names and loudly asked the women if they had gone to the bathroom and if they put a pad in. One woman asked if we would get a refund for waiting so long and Nurse XXX said “no.”
Dr. Medical Director arrived at approx 2:00. 3 women were called back into rooms. I was the first patent scheduled so I asked why I was not called back. A tech told me that there would be a total of 7 women before me because they had different needs and that’s how the charts were ordered. I asked to leave the facility. At that point I was convinced that I was obtaining substandard and inhumane treatment. The tech said the doors were locked and I could not get out. I asked her to take me out of the facility. She told me she was taking me out, and then directed me into the lab where the center manager, XXX, was standing. She ordered me to sit down and asked how she could help me. I said I wanted to leave the facility, that I do not feel comfortable with the care I was receiving and that I would go to my own ob/gyn. She said there are other people ahead of me and I need to wait. I again stated I wanted to leave the facility and she said I could not. I repeated “You are telling me I cannot leave this facility?” She said that there were procedures. I asked what the procedures are. She said I need to see a nurse. I asked to see a nurse. She said they are busy. She took me to the post-op area and told me to sit down. A nurse came to talk to me and again asked what my issue was. I told her that as a healthcare professional myself, I understand that doctors sometimes run late. I also understand about quality of care and patient rights. I told her that I and 17 other women have been made to wait in a freezing cold room for over 7 hours with no information or choices. I told her I am not confident in the care I was receiving, although I do believe that Dr. Medical Director would be concerned had she known the depth of this incident. She left the area and then returned and explained that there were 7 women before me and the Dr. thinks I need to wait. I refused and asked to leave. She left again and then agreed to put me next in line. She was apologetic and asked if we could just move on past this incident. She stated I was probably so upset because I never thought I would be in this position in my life. This was minimizing to my experience.
At approximately 3:00 (after waiting 7.5 hours) I received my procedure by Dr. Medical Director who was apologetic. I do not think she has been informed of the magnitude of yesterday’s events.
As a fellow healthcare administrator, we strive to provide not only quality care but trauma informed care. This incident reminded me of the critical nature of providing trauma informed care. Choosing abortion is a tremendously traumatic decision for women. Going to the clinic alone is traumatic, there were at least 20 protestors harassing us and our support partners outside of the clinic. Several women began to share their stories- how one got quickly pregnant after delivering a premature baby, how several had small children and were struggling, how one woman experienced failure of birth control and emergency contraception. You have no way of knowing which women have a history of trauma and violence (certainly statistics say that most of us have) . We never expected to be recipients of violence in a healthcare setting. We were treated like assembly line cattle without regard for dignity or respect. I felt that I was intimidated and coerced. I was certainly held against my will. At the minimum our privacy rights were violated. We all knew that we were receiving abortions. We learned who was deaf, who was far along, who needed an IUD, who had language barriers. Abortion itself is traumatic on the body. Certainly yesterday’s events were the most traumatic of all. After fighting for our rights for so long, it was heartbreaking to learn that our needs and our bodies did not matter.
I ask that you issue an apology and compensation to the affected women. I recommend that you launch an investigation into this location, its personnel and its procedures.
I appreciate your time and attention to this matter. I would prefer a written response to this letter.
The CEO responded to my email stating:
Dear Ms. XXX: M XXX, Dr. Medical Director and I met late yesterday to discuss the information in your message. Dr. Medical Director will be following up directly. I am sorry you had this experience. CEO XXX
Dr. Medical Director responded as well stating:
Dear Ms. XXX,
Thank you for taking the time to share your concerns about the service you received at our XXX Health Center on XXX 2011. M CEO, M VP, and I reviewed and discussed your statement. We strive to provide outstanding clinical care and excellent customer service at our health centers and the experience you described did not meet our standards. We extend our sincerest apologies and will take appropriate corrective action. I’d like to specifically address your concern about not being allowed to leave the health center. Please understand that for your own safety our protocols require your IV line to be removed prior to exiting our health center.
Your observations are very much appreciated and will aid our ongoing efforts to ensure that we are providing patient-centered service at our health centers. I am available if you would like to schedule some time to discuss this further via telephone.
Additionally, I have tried to contact the national VP of QQ to share this story, hoping she would care. Her assistant told me that I needed to contact the media for personal stories. REALLY? Do you really want me going to the media? OK…I took your advice.
After these responses, I still felt the need to share my story. We do not deserve inhumane and disrespectful treatment. We do not need to be further victimized at the hands of our trusted healthcare providers. We do not deserve to be punished for making the most difficult decision of our lives. I do not care if you went to college, if you are deaf, an immigrant, a teenager, a stripper or a soccer mom. You do not deserve to be traumatized or disregarded. I thought we were past back-alley abortions. It was utterly disappointing to discover that an organization that I passionately supported ,supported me the least.
All I want to say to you is that if you find yourself in a similar situation that I am in, please be aware of your rights and do not accept care that does not feel right to you. Trust your instinct. Leave. Scream. Call 911. Just believe that we deserve better.
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