Today was quite an interesting day. I had my MS class this morning, and it was actually enjoyable. The same statistician that I really liked last summer gave the first half of the class, and one of the statisticians I had worked with over the summer for my research gave the other half.
Last week, one of my classmates had invited all of the CCLCM students to visit Preterm, which is an abortion clinic about ten minutes away from CCF in Shaker Square. There is a student group for choice at Case, and a bunch of Case students went today, along with about half a dozen of us from CCLCM. Visiting an abortion clinic was both a disturbing and informative experience, and it's probably something that every medical student nationwide ought to do.
The clinic staff began by giving us an orientation to the clinic and what services are provided there. (They provide counseling services and birth control as well as abortions.) We were also given statistics about abortions, abortion access, and political efforts to keep abortion legal versus outlaw it. One thing I hadn't realized is that Ohio has a pretty extreme, staunchly anti-choice state legislature. One representative apparently introduced a bill that would outlaw all abortions, even if it was necessary to save the life of the woman. They also passed around a pro-choice petition for people to sign. I am not registered to vote in Ohio, so it wasn't an issue for me to decide if I even wanted to support pro-choice legislation, but I'm not sure I would have signed regardless. That is mainly because I felt the orientation was a bit overly proselytistic and defensive. But I suppose it's understandable that it would be, considering that the clinic employees have rude protesters outside their place of work shouting nasty things at them and their clients every day.
The more interesting part was when the staff demonstrated how the abortions were done. I didn't know very much about abortion procedures before visiting the clinic, and the surgery procedure in particular was nothing like what I expected. Most women get abortions during their first trimester using vacuum aspiration. The abortion is performed by first dilating their cervix, and then inserting the vacuum cannula and suctioning the embryo out of there. It only takes a few minutes to do the suctioning from start to finish, and no further surgery is required. They had models of a woman's cervix and manual vacuum pumps that were basically like giant syringes so that we could see what it was like to perform the procedure ourselves. It was surprisingly easy to do once I got the hang of using the vacuum pump.
Alternatively, the patient can be given a medical abortion using drugs that interfere with progesterone activity and prostaglandins, which stimulate uterine contraction. (Progesterone is the hormone that maintains the uterine lining during pregnancy.) She takes one pill at the clinic and then a second one at home the following day. This method of abortion actually has a higher rate of complication versus the first method.
If the woman is past her first trimester, other methods like dilation and evacuation (D & E) have to be used. These are the infamous "partial birth" abortions, where the woman's cervix is dilated, and then the fetus is partially delivered, disassembled and pulled out of the uterus piece by piece. The physician described the procedure to us, and it was pretty graphic and gruesome. He explained that although Congress tried to outlaw D & E a few years ago, it is still performed in this country. The main difference is that they apparently used to do it on a living fetus, and now they are required to kill the fetus first before removing it from the woman's uterus.
I can't agree with what I view as Preterm's completely amoral stance about abortion. As a person who is devoting my life to "doing no harm," I do consider abortion to be a "necessary evil," and I do not agree that abortion is just another form of birth control. Unplanned pregnancies are tragic, and so are the abortions themselves. If that makes me "judgmental," then I suppose I am guilty as charged.