This as-told-to essay is part of a short series exploring abortion access in Illinois, which is preparing to become an abortion ‘island’ as surrounding states have banned or have signaled that they will ban abortions in the wake of the end of Roe v Wade. This piece is based on a conversation with Hanz Dismer, education and research coordinator at Hope Clinic for Women in Granite City, IL.
With the pandemic, we’ve seen this increase in people having mental health crises. So some of my day is spent just comforting people, helping people calm down. I try to be the friendly person who is there to advocate for patients and to help make the process understandable and hopefully less anxiety-inducing.
Since Roe v. Wade fell, people are definitely in more of a crisis because most of the patients we are seeing are traveling hundreds of miles. On the day the decision ending Roe came down, the most common question I got asked was, “Do you see people out of state?” A lot of people were under the assumption, or were fearful that, “Oh, I’m not in that state, therefore I can’t get care.” We also had a lot of patients that were asking us if we were going to cancel their appointment, because a lot of folks have had appointments canceled at other clinics. For a lot of people across the Midwest and South, we are now the nearest clinic.
The other day, I saw somebody from Texas who was under six weeks pregnant and that’s happened multiple times. There’s a lot of stress that comes with having people travel 900 miles to take a pill to induce an abortion, or to have a five-minute procedure to no longer be pregnant.
Many people say that they’re relieved when they get here. Like, “This was stressful, but I’m just glad I’m here.” Or, “Yeah, it sucks that I had to drive five hours, but at least I’m here. At least I can get my appointment.” Through my counseling work with folks who’ve had abortions and as well as research, we know that the vast majority of people who have abortions feel a sense of relief. That doesn’t mean that other feelings don’t come up and that other feelings aren’t valid, but pregnancy is a stressful time for most people.
Even before the end of Roe and the start of the pandemic, we knew that a lot of our patients didn’t have a mental healthcare provider. They may not have a primary care provider. They may not have been to the doctor in years. So many people in this country are uninsured, or even if they are insured, it’s hard to get to healthcare providers. And so many folks only go for pregnancy-related care or when something is seriously wrong.
So that is where holistic care comes in. We may tell people: “Hey, you have this condition. It’s not being treated. What barriers are in the way for you to get this treated? And how can we help alleviate some of those barriers?” Whether it’s a referral or whether it’s talking to you about how you can apply for your state’s Medicaid program, or a variety of things, just in an effort to limit some of those health disparities, identify them and work to get people the care that they need and deserve.
One of the things patients say to us the most is, “I wasn’t expecting you to be so nice.” There’s this idea that’s out there of what an abortion clinic is like and what workers are like, that is pervasive, that we’re mean scary people who hate babies. That’s so not true. There’s a real villainization of abortion clinics.
In addition to supporting patients, and connecting them to resources, I also run our post-abortion counseling program. We’ll do follow-ups with anybody we identify at the clinic that might be a little bit higher risk for having difficulty coping. I give these patients a phone call to check in and see if there are any other resources or support they need. The majority of folks say, “I’m doing a lot better than I thought I was.” “Life’s getting back to normal.” or “Yeah, the day or two after it was a little hard, but I feel so much better. I feel relieved.”
In the past few weeks, we’re starting to see some emboldening of our regular protesters. We have protesters that line our sidewalks virtually all the time. Normally they have signs. They yell pretty vile things. Recently they have gotten this video of an ultrasound that goes progressively through pregnancy. We have two competing ultrasound vans outside of our clinic. They both show up, sometimes at the same time, to try to lure people into their vans to do ultrasounds. One of them has been here since the ‘80s. And what’s notable is they’re anti-abortion fake clinics. They’re crisis pregnancy center vans and neither one of them to my knowledge are licensed by the state to do ultrasounds. One of them is run by someone who claims to be a former nurse. And the other one is run by somebody who claims that the ultrasound is a religious tool to convince people not to have abortions.
They’re using Hope Clinic purple on the side of the van. It says, “real hope.” They recently put up signs that cover the windows that are just pictures of aborted fetuses. They don’t get a lot of folks. Every once in a while someone will go in but it might be one or two people a day.
They use a lot of manipulation tactics and hostility. One of the protestors that harasses staff has had a long history in the anti-abortion movement and at the clinic. He routinely yells extremely racist things at patients, as well as staff members. He will literally stand outside of the clinic and he’s yelled at me before, “You had this many Black people walk in and these many white people walk in,” tallying people based on race outside of the clinic, which is deeply disturbing to say the least.
Staff members write incident reports when they hear these things so we can have just a documentation trail of the type of harassment that our staff are experiencing and that the patients we serve are experiencing. Also, our staff who are staff of color, specifically Black staff members, experience heightened levels of harassment from the protesters.
Dealing with this increase in hate is extremely stressful for our staff. It feels like everybody’s against you. We have wonderful allies in our communities, and we know that the majority of Missourians are pro-choice, but those aren’t the loudest voices in so many cases.
Of course, we want to make sure that all of our employees leave feeling fulfilled and feeling like they have a decent work life balance, but it can be really difficult when not a lot of people want to work in abortion care because of the unfortunate occupational hazards we’re subjected to: From protestors and intimidation and violence and stress, let alone all of the nuances of being a healthcare provider operating as a very progressive business in a not so progressive community.
Sometimes it does feel isolating because we’re in the middle of one of the reddest parts of Illinois, and right across the street from Missouri, which is not friendly to our work.
I’ve felt myself being more frustrated than usual. But the biggest thing that has helped me through this is the team and is knowing that we are a group of people who are in this together. We’re going to figure this out. I’ve been having debrief sessions with coworkers. A lot of what I do is, “Okay, something really stressful just happened. Why don’t you come to my office? We’re just going to talk about it.”
Taking care of each other I have found to be the most important thing, whether that’s just debriefing, whether that is bringing somebody a little stuffed animal or something, just a little token of something like, “Hey, I support you. I love you. You’re doing a great job. Keep in there.”