Friday, December 18, 2015

This Is the Way to Do It

I've been saying for years that the way to make abortion really safe is to put clinics in hospitals or large office buildings where they can be essentially anonymous, instead of in stand-alone clinics that scream "bomb me!"

But of course the motherfucking freakazoid misogynists who make it impossible for women to get abortions have no interest in making them safe.

The pervasive stigma associated with ending a pregnancy influences patients’ assumptions about what will happen once they walk through the doors of an abortion clinic. They may imagine that abortion is a frightening or dangerous procedure. They might be intimidated by the tight security measures in place to protect abortion providers against violence and harassment. They could encounter aggressive protesters on the sidewalk. And, thanks to the highly publicized flood of restrictions on abortion over the past several years, they may wonder whether these clinics are even allowed to continue offering the procedure in the first place.

Cockrill understands why the Arkansas woman had that reaction. “She entered a space that had an armed guard outside, people milling around outside, bars on the window. And she had to pay cash,” she recounted. “It was a quality health care provider that was taking precautions because of the environment of stigma around abortion — but from a patient’s perspective, it can actually reinforce this sensibility that they’re doing something illicit and wrong.”

When Cockrill asked that interview subject what she would have preferred for her abortion experience, she said she wished it had been more like a spa.

That interview took place more than five years before Carafem, a health clinic in the D.C. metro area that’s recently made headlines for touting its spa-like atmosphere, first opened to the public. But it was a prescient commentary about what women are looking for in an abortion provider.

Carafem president Christopher Purdy, who has a background in global health, decided to launch the new clinic after observing that the abortion pill is more accessible in many foreign countries than it is in the United States. Purdy and his team were interested in eliminating some of the barriers that make it difficult for U.S. women to obtain an abortion.

One of those barriers, they decided, can be the environment that patients first walk into and their subsequent expectations about how they’re going to be treated.

You can’t get a pedicure or a facial at Carafem — but you can sit back on a purple couch and take the abortion pill in an environment that feels much warmer than a traditional doctor’s office. The clinic offers the full range of birth control options as well as medication-induced abortion up to 10 weeks of pregnancy.

“It was important to us to have natural wood finishes, natural light, nicer finishes, spaces that look really clean,” Melissa S. Grant, the vice president of health services for the clinic, explained during a tour of Carafem’s facilities. “We want to challenge the social myth that abortion clinics are scary, that they’re these sad places where no one would ever want to work, that you can walk in and tell immediately it’s an abortion clinic. This health center doesn’t feel that way.”

Carafem, which has been serving patients for about eight months, is tucked away in a large office building in an affluent neighborhood on the outskirts of the nation’s capital. The organization’s name is just a tiny line in the expansive directory in the lobby, which makes riding the elevator up to the health center feel a bit more anonymous than walking into a standalone Planned Parenthood clinic.

One thing that helps Carafem feel indulgent is the high level of convenience and ease it extends to people interested in its services. You can call, text, or chat a staff member at any time to book an appointment, and they can be flexible enough to fit you in the very next day. Appointments typically don’t last longer than an hour.

There’s a lofty goal behind Carafem’s careful attention to these details: “It’s our hope that when a patient enters this facility, she’ll feel at peace and at ease because she doesn’t feel like she’s hiding this secret,” said Carin Postal, the organization’s communications director.


Grant conceded that abortion providers in the United States have been fighting to stay open for years amid mounting attacks and restrictions. Still, she said she remains hopeful about continuing to break down patients’ barriers to abortion access — starting with stigma.

Carafem’s health center is filled with subtle reminders about the societal shift that Grant and her colleagues are pursuing. For instance, there aren’t any photographs of tearful or anxious women, a departure from the most common images used to represent the experience of unintended pregnancy. The women at Carafem are smiling.

“The visit itself is one of empowerment, and we want to reflect that,” Grant said.

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