Sharing secrets with my grandmother

“I feel bad …” Amy whispered, then paused.

I’m a family medicine resident, and I was doing my gynecology rotation, which involved spending a few days at a Planned Parenthood facility. This was my first day. I’d been assigned a patient to shadow: a young woman named Amy, who was here to have a first-trimester abortion.

I’m a fan of Planned Parenthood’s work providing high quality, affordable contraceptive and gynecological care. In college, when I lost my health insurance, I’d gone to Planned Parenthood for birth control. Now, as a doctor in training, I was curious to see how the clinic worked from the inside.

I’d found Amy sitting with a young man in the waiting room. She was twenty-seven, with large, expressive eyes.

After she’d had an ultrasound, we crossed the hall to the laboratory. Amy squeezed her eyes shut and giggled nervously as the nurse found her vein and filled a tube with her blood. Then we went to the counselor’s office, where Amy was asked a myriad of questions.

She had been pregnant once before and had a 4-year-old son. She and her current partner had been together for three years and had been using an intrauterine device (IUD) for birth control. Unfortunately, this had been expelled, resulting in Amy’s current pregnancy.

During this lengthy interview, my mind wandered back to a conversation with my grandmother a few months prior. I’d been sitting at her kitchen table, stirring a cup of herbal tea.

“Where do they have you working now?” she asked as she handed me a bowl of honey and a spoon with her gnarled, arthritic hands.

“Obstetrics. I’m delivering babies,” I replied, spooning honey into my tea.

“That’s nice. You know, when I had your aunt and your mother, back in the Soviet Union, there was none of these fancy pain-medicine shots they put in your back nowadays.”

“I know, babushka, I know,” I said, rolling my eyes. I’d heard this so many times.

Sipping my tea, I wondered aloud: “So you had my aunt, and then my mom eight years later. Why did you wait so long to have another baby?”

“We couldn’t afford it,” she replied simply, settling down across from me with her teacup.

I thought she would leave it at that, but after a moment she said, “I did get pregnant once. When your aunt was about a year and a half old.”

I replaced my teacup in the saucer, surprised. This was news. I’d thought I knew everything about my grandma.

“What happened?” I asked.

“I had an abortion,” she said matter-of-factly, spreading raspberry jam on a roll. “We were poor. All three of us lived in one room in a communal apartment, sharing the bathroom and kitchen with three other families. Your grandfather and I earned pennies at the factory. I worked the day shift, and he worked nights, so we could take turns staying home with your aunt. We couldn’t afford day care. We would all have starved if I went through with the pregnancy and had to stop working.”

“So what did you do?”

“Well, abortions were illegal — Stalin wanted to increase the population. But I heard there was a woman in my neighborhood who knew what to do.” She absentmindedly took a bite out of the roll and looked off into the distance.

“Go on.”

“I went to her house, and she put a catheter into my womb. Then I went home. I was worried, because for hours nothing happened. I just walked around with a catheter between my legs. Finally, the blood started to come. And that was that.”

I pictured my grandmother lying on a couch in a dim room as an older woman inserted a nonsterile catheter through her cervix. As much as I respected this woman for helping other women in need, I also felt horrified: My grandmother could have died of an infection or had some awful complication. I had heard of things like that happening in the US in the days when abortions were illegal.

“Why haven’t you ever told me about this?” I asked.

“It never came up,” she shrugged. “I haven’t thought about it in a long time.”

“Okay, we’re all finished here.” The Planned Parenthood counselor’s voice brought me back to the present.

A nurse whisked us away to another waiting area, thronged with women of various ages, races, ethnicities, shapes and sizes.

I tried to picture my grandma here and wondered if she would have preferred this place to a stranger’s living room.

Before long, the charge nurse called Amy’s name, then led us to his office.

“You’ve been medically cleared for a manual vacuum-aspiration procedure,” he told Amy. He gave her an ibuprofen tablet. “Take this; it will help with cramping during the procedure.”

When the charge nurse stepped out of the room, I asked Amy a few questions. She told me about her job, her family and her boyfriend, the young man in the waiting room.

“He’s going to take me back to my job,” she said. “It’s not far, so I’m not missing too much work.”

Whenever Amy mentioned her boyfriend, she looked uncomfortable. The counselor had asked her if her partner was abusive or threatening, and she’d firmly responded, “No.” But I wondered if there was more.

“You seem nervous,” I observed.

“I feel bad …” she whispered, then paused. Her eyes were bright with tears. Before she could say more, the charge nurse returned and led us into the procedure room, where another nurse, a physician and a doula were waiting.

What does Amy mean? I wondered. Does she feel bad about her pregnancy? Does she regret choosing to get a termination?

The nurse got Amy a cool compress for her forehead, and the doula held her hand and distracted her with conversation as the family-medicine physician quickly performed the procedure, then inserted an IUD. The whole thing took no more than five minutes, and Amy did not seem terribly uncomfortable.

Soon Amy was reclining in a soft recovery-room chair, warm packs soothing her back and abdomen. She looked relieved.

“What did you mean before, that you feel bad?” I asked.

“I think he’s mad,” she said vaguely, her eyes growing sad.

“Your boyfriend?”

She nodded. “I think he wanted the baby, to keep me around.”

“What do you mean?”

“We haven’t been doing so well,” she said. “He’s an actor; he’s always off performing. He gets a lot of attention from other women, but he’s very jealous whenever I talk to any man. We’ve been fighting a lot.”

“Ah,” I said. Understanding began to dawn. “Are you thinking of leaving him?”

“Yes, and I have my son to think about. I can’t have another baby right now,” she said firmly.

Ah. I got it. Amy was already a single mom to her son. She didn’t want to be in the same situation with a second child.

My heart filled, thinking about this decision she’d had to make. I felt honored that she’d confided in me. And I wondered how my grandma had felt, making this decision a half-century earlier. Looking ahead, I hoped that I would be able to help women like them in my future practice.

I squeezed Amy’s hand.

“Thank you for letting me shadow you,” I said, then stood to go.

Amy smiled and waved goodbye.

Leaving the room, I glanced back one last time. Amy’s eyes were closed. She seemed at peace.

I thought I’d go home and call my grandma.

Maria Gervits is a family-medicine resident. This piece was originally published in Pulse — voices from the heart of medicine, and is reprinted with permission.

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  • Patient Kit

    Thank you for sharing your grandmother’s story. It’s a good reminder that we often have no idea what other people have been through. Every human being — strangers, acquaintances, coworkers, neighbors, close friends and relatives — has a story and has been through things that we don’t know about. We should keep this in mind when talking to each other, especially about sensitive issues like abortion and rape. And, of course, like you and your grandmother, we should make time and the effort to talk to each other.

    I’ll never forget, years ago, when I was young and doing some pro-choice political work, one of my neighbors came up to me on the street and thanked me for the work I was doing. He was a man my father’s age whom I’d known my whole life. Out of the blue, he told me that his mom had died many years ago from complications of a botched illegal abortion. We never know what people have been through – until they tell us.

  • http://www.ronsmithmd.com/ Ron Smith

    Hi, Maria.

    I was driving home from my daughter’s house just last night. My wife and I ended up in separate cars there to watch the two granddaugthers while the two grandsons went to T-ball practice. Of course Nana and Gr had a great time and both the girls ended up falling asleep and laying on me as they watched Frozen. Even the little one that is just 6 months old seemed to stare at the TV as she lay in my arms.

    Later as we were headed home, I realized that my wife of 36 years was in her care ahead of me, that the darkness had done something to my perception. Perhaps it had always been doing this, and just now I had realized it.

    It was as if for a second, I was consciously unaware of this woman I love with all my heart in the car ahead. Quickly I had to arrest thoughts of some tragic think like her having a car accident. Had she been further down the road ahead of me where I couldn’t even see the car, her presence would have been even further out of my mind, and the possibly accident scenario not even a thought.

    For mankind, it is the dark and hidden places like that which seem to change our perspective. Surely had I come upon her having been involved in an accident the occurrence of which the darkness obscured from me, I would have been beyond myself if Stacy had been hurt or even killed.

    It is amazing what nighttime and darkness does to our mind. Things we would otherwise be terribly upset over as well as things we blow so out of proportion are both consequences to the unclear conclusions the dark brings. The former though often gives way to the later which often skews our actions this way or that.

    The dark, hidden places are the most dangerous places of all.

    Warmest regards,

    Ron Smith, MD
    www (adot) ronsmithmd (adot) com

  • Suzi Q 38

    Nice story, but I think that this is too much information.
    Some of the stuff granny went though is really none of my business.

    • Patient Kit

      I assumed, perhaps wrongly, that Dr Gervits had her grandmother’s permission to write publicly about her story, including her abortion. I certainly hope her grandma was ok with this.

    • Judgeforyourself37

      Suzi Q 38, as a very old retired RN, who remembers full well, that prior to Roe v Wade, only the wealthiest of women could afford a safe abortion, we must never, ever return to those days. Unfortunately, some politicians, today, would like to take us back there and we must do all we can to vote them out and not let that happen. That young doctor’s grandmother was a wise lady to have shared her story so that her grand daughter would gain some insight and be a better physician for her newly gained information.
      Making abortion illegal never has stopped abortions, it only stops the safe abortions. Thank heaven for Planned Parenthood and any doctor who still will perform this needed, STILL LEGAL, procedure.
      No one knows what another person is enduring, unless that person shares their story

      • Suzi Q 38

        My comment was not about Roe vs. Wade or who could afford an abortion or not.
        It was about my interest that the author’s grandmother had so many stories to tell, yet chose this deeply personal one.
        Everyone is different.

  • SarahJ89

    Thank you for sharing your grandmother’s story. It is important for people to know specifically how illegal abortions are performed and were performed only decades ago. Most of my female friends had illegal abortions, several nearly died and one did die. They were messy, bloody and dangerous affairs. My friends would travel to NYC by bus, go to the home of a stranger, hand over $200 (a lot of money in the early 70′s) to have a catheter inserted in their uterus. They would return to our rural state by bus, pull the catheter out after four days and then endure the infection that resulted.

    Since abortion was illegal there was no way to get medical help. We were all young and scared, although over time we kind of got used to young woman nearly dying before our eyes. But the mother and anyone with her faced legal retribution. When things got really bad for one young woman her friends simply left. The one who died turned to a friendly psychiatrist for help. The psychiatrist took her to a hospital which turned them away. She died while the psychiatrist tried to get her to another hospital. The psychiatrist was hauled into court. I can’t recall if she lost her license.

    My sister-in-law was lucky. She got pregnant by a rich guy whose family paid for her to go to Japan. Imagine being in your early twenties and having to go to Japan from the east coast of the US to have a simple medical procedure. But she’d seen the NYC lay version.

    My own mother was a woman who never, ever should have had children. She had two abortions, both in the 1940′s. One was done by a doctor. Who was not happy to discover belatedly that she’d lied about how far along she was. The other was done on someone’s dining room table in Texas. Ironically, on Mother’s Day.

    I was lucky. When my birth control failed abortion was legal in NY state. I consider safe, legal abortion a gift from God, frankly. There’s no way we should turn back the clock and it’s important to tell these stories so people will actually know what we’re talking about.

  • Linda Jansen

    Thanks for this story. I work as an escort at Planned Parenthood. Yes, we are needed to buffer patients from the ignorance of protestors who call out increasingly vile things to them as they try to access healthcare. Support Planned Parenthood and other women’s clinics however you can, as Dr. Gervits is doing.