Not all abortion care is created equal. Within the pro-choice/pro-abortion community, we know some doctors, some clinics, some methods, are better than others. But when you are strongly pro-choice/pro-abortion and/or work in the field of abortion provision and support… it’s understood that you don’t publicly critique your local abortion care. It is generally assumed that if I support abortion, and want to fight for access to abortion in my community, that of course, I am grateful and deferential to my local abortion clinic(s) and providers, and support them at all costs. After all, they are under a tremendous amount of economic, social, and political pressure, the last thing they need is criticism and critique from within their movement of supporters. Abortion criticism is the trope of anti-abortion activists, not pro-choice ones! So how can I believe in abortion access and also believe most of my local clinics and providers are doing a lackluster, or outright awful, job? How can we demand accountability from our local abortion providers and not play into anti-abortion propaganda?
There needs to be room within the abortion rights and access movement for feedback for local providers. It is absolutely our job to hold the providers in our movement accountable for their care, even and especially when that care is awful. This feedback and accountability do not make us a weaker movement, it makes us a stronger one.
It is hard to do this in a movement already under attack. The pro-life/anti-abortion community has always been highly organized, singular in their beliefs and goals, and able to mobilize a national conversation at an impressive capacity. The pro-choice/pro-abortion movement overwhelmingly plays defense to this messaging, rather than crafting it’s own compelling public messaging in part because our messaging is much more complex. Not only do we think abortion should exist, but also that it should be accessible, affordable, legal, without stigma, etc. Providers and staff in the movement are burnt out and stretched thin from their demanding work, and activists so bogged down dealing with anti-abortion messaging, very little time, energy, or critical thought is spent on how people accessing abortion care are actually feeling about the care they receive, and if our clinics and providers are providing the highest quality care they could be. We’re so grateful for the open clinics and available doctors, that our scarcity complex has made it difficult to challenge them.
I am not a supporter of abortion at all costs. Some costs are not worth supporting. We have allowed our movement to be so co-opted politically that we have forgotten to deeply support the people this is supposed to be all about: the people having the abortions. Supporting them, wholly and deeply, should include demanding not just that they can have an abortion but that they can have the best one. This includes staff and providers who are respectful, compassionate, skilled, and invested in providing excellent care. This means being knowledgeable about different people’s bodies, histories, traumas, preferences and is equipped to handle these competently. This means practicing from a space of evidence, innovation, and informed choice, and making non-judgemental space for clients to choose aspects of care outside “typical” offerings. This means building more time, space, energy, and funding into the care model to allow for these focuses. Are we so used to fighting for scraps in the movement that we have forgotten to demand a higher level of care and attention for the people actually accessing the care? And then — what good are we as abortion advocates if we are not advocating for the abortion clients?
Advocating for high-quality care is not new to me. As a full-spectrum doula and midwife, I don’t just help my clients have a birth. I help them have the best birth we can. I don’t just advocate people should get basic miscarriage management but that they should actually come through the experience more whole and connected and empowered than they went into it. It’s no different in abortion care: I don’t settle for sub-standard care for myself, my clients, friends, or loved-ones. And I won’t stay quiet when my local abortion providers need accountability. Demanding improvements in abortion care makes a strong and resilient movement community. It improves experiences for people seeking abortions and shows critical thought and awareness. It makes a stronger movement. It refocuses the whole point of the movement on the people we’re supposed to be advocating for in the first place and puts their needs and values and care first.
Some abortion providers and abortion clinics are awful. Saying so does not put me in the camp of anti-choice zealots. It’s just the truth, and all us pro-abortion folks know it. Stop covering up for providers and clinics in your beloved movement who are providing substandard care. Demanding better makes you a better advocate. We are big enough people to hold in complexity that we support abortion care and access AND have standards we believe that should meet AND know that some places don’t meet those standards AND know to oppose these substandard places could limit abortion access. It’s a complex space in the abortion community, but we need to start talking about it openly for the sake of the movement and, more importantly, for the sake of the people seeking quality abortion care.