'We Must Take Action': An Abortion Doctor in the South on the Future Under Trump

My Christian mind remembered the words of Job as his trials unfolded: "That which I have feared greatly has come upon me." My cultural bluesy, soulful music-loving brain remembered the opening line from an Amy Winehouse song: "What kind of fuckery is this?"

In choosing this Winehouse lyric, I am aware that it contains a word that some people might take offense to, finding it profane even. But let me redirect your sensibilities; there is a difference between words that are uncomfortable to hear and things that are profane, like the unthinkable reality of untold numbers of people at risk for compromise by the policies of the incoming administration. Winehouse's term is impolite, but the reversal of laws to make abortion unsafe once again is profane. I hope that you don't find yourself more concerned about colorful language than you do about the prospects of pernicious governmental policies on the horizon.

Many of us are struggling with feelings of devastation and uncertainty right now. We don't know what policies will change. We don't know what rights will remain. We don't know how much care will cost. We don't know how access to care will be affected. We do know that Trump has promised to appoint Supreme Court justices who will overturn Roe v. Wade, that he has no issue with women having to "go to a different state" for reproductive health care, and that many of his cabinet picks are extremely and vocally anti-choice.

The burden of the unknown affects some of us more than others. We have already seen that legislative attacks on abortion access target low-income women, women of color, young women, and immigrant women. This is something I see firsthand as a doctor working and Alabama and Mississippi, the latter of which only has one clinic remaining in the entire state. I see women who have to travel for hours to reach a clinic, sometimes sleeping in their cars due to waiting period laws that require an interval between an initial consultation and a procedure. I see women who struggle to scrape together the funds to afford a procedure due to harmful policies like the Hyde Amendment, which restricts public funding of abortion. Perhaps worst of all, I see women face painful stigma and hostility for simply seeking to exercise control over their own bodies.

What does it mean when a woman does not have access to abortion care? Research can answer this question most soundly: One in four low-income women is forced to carry an unintended pregnancy to term due to federal restrictions on Medicaid coverage. This will only worsen if more restrictive policies are passed or the Affordable Care Act is dismantled. A woman's health insurance should meet all of her health care needs, and we know that the public supports this value. America's most vulnerable communities, like some of the patients that I see every day, will suffer if additional anti-choice policies are pushed through under president-elect Trump.

When we take a step back from talking about access to abortion and think about financial coverage of care, I know that our need to preserve the Affordable Care Act is larger than ever. It has been critical for access to care for all, but especially for women: They are no longer discriminated against because of gender or preexisting conditions, and expanded contraceptive coverage has been a game changer. America's teen pregnancy rates have plummeted, thanks quite possibly to expanded access to contraception, most notably long acting reversible contraception like IUDs and implants, which are more effective than condoms or the birth control pill.

All of this is very heavy. But it takes the dark to see the light, and now we get to what I'm truly here to tell you: In spite of all that we don't know, we can be reassured by and find hope in the humanity behind the reproductive health care community.

I'd like to share a story that perfectly illustrates the moment we've found ourselves in: Long ago, during a meeting of doctors facing clinical cutbacks in an underserved area where I worked, I saw someone write on a blackboard, with chalk (that's how long ago it was), "Opportunity is nowhere" and then asked us to space and punctuate the phrase to give it meaning. One person placed a period at the end of the sentence, and it read "Opportunity is nowhere." The next person placed a period behind the W and one behind the E at the end: "Opportunity is now. Here."

I know that most of us don't see it now, but we have been presented with the biggest opportunity to build sustainable, unconquerable support for reproductive rights. Yes, we are being threatened, but now is our chance to fight. Know you are surrounded by some of the fiercest of advocates I've ever known: Providers of comprehensive reproductive health care will continue to advocate for your health and safety no matter what. Over the course of the last 50 years, we've made such striding progress; we must stay vigilant against policies that would pose a threat to your bodies. We hear your concerns, we share these concerns, and we are alongside you for the long haul to stand up for you and your family's wellbeing.

Whether you are seeking access to contraception, prenatal care, or compassionate abortion care, your providers will do everything in their power to get you the care you need in a timely, affordable, and safe manner. Your medical providers will continue to fight for your right to decide if and when you choose to start a family. You should always consider clinics that provide comprehensive reproductive health care as a safe space for those of all beliefs and backgrounds.

You should be hopeful in knowing that the election results are not at all connected to the way people feel about reproductive health. Women of all faiths, races, and sexualities support and seek access to contraception and abortion care. These views and needs will not change in light of who is elected; women will always seek out abortion, and it is up to us to decide whether or not it will be a dangerous or a safe procedure. Our elected officials must honor and respect the fact that the majority of people support access to safe and legal reproductive healthcare and ensure that we keep American women and their families safe. This election was not a referendum on reproductive health.

I urge you to turn you fears into action. Call your elected officials, donate to organizations that are gearing up for the fight ahead, and be a loud voice for the health and dignity for women. Be dejected but not defeated. The difference? Effort. We cannot surmount failure without trying. Experience is not what happens to you—it's what you do with what happens to you.

For the women who are not only filled with fear, but whose future depends on our coming together and ensuring that comprehensive reproductive health care remains protected in our country for everyone, we must take action. And now is our time.