This piece is published in collaboration with Echoing Ida, a Forward Together project.
Abortion providers are the backbone of reproductive health care. They are there for patients in emergencies, and often experience stigma simply for providing a procedure that is essential to economic and reproductive freedom. My doctor was there for me ten years ago, and with the mounting challenges and restrictions providers face every day, I am ever grateful.
First recognized in 1996 to commemorate the assassination of Dr. David Gunn, National Abortion Provider Appreciation Day honors and celebrates those in our community who put their lives on the line to ensure we receive safe abortion care. In time for this year’s appreciation day, Rewire interviewed Dr. Cheryl Chastine, an abortion provider at the South Wind Women’s Center in Wichita, Kansas.
A young provider, Dr. Chastine represents the future of abortion care; she infuses reproductive justice values and transgender patient care into her practice. She has given up a lot, personally and professionally, to provide care to her patients throughout the Midwest and the Great Plains region, but she refuses to back down due to threats or intimidation. Instead she fights back by providing the best possible care to her patients, who often travel long distances as additional political and economic hurdles are put in their way.
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Rewire: What inspired you to become a reproductive health-care provider?
Dr. Cheryl Chastine: I knew I needed to provide abortions when I realized that there were people who would not be able to access abortion care if I didn’t. As providers, we are the links between the abstract right to abortion and the reality of being able to actually have one. I became a doctor to provide respectful, compassionate care to people who might be afraid or ashamed. Working in reproductive health lets me do that.
Rewire: What is the one thing you want everyone to know about why you do the work you do?
CC: No one ever expects to need to access abortion care themselves. It’s impossible to predict how you’ll feel about an unplanned pregnancy until you find yourself in that situation. I trust the person who is pregnant as a moral decision maker—decisions about whether to give birth are never made lightly. I provide abortions because my patients need them, as they have been needed in every time period and in every society. Every patient whom I’ve provided with abortion care, I’ve done so because they asked me to.
Rewire: You provide abortion care at the South Wind Women’s Center in Kansas, a clinic in the same location where the late Dr. George Tiller, who was murdered by an anti-abortion extremist, practiced. The stigma toward abortion providers remains strong, both in society and in the medical community. What would you say to medical students who want to get more involved in this work but are concerned about their personal safety?
CC: None of us go to medical school in order to do what is easy. You can’t decide not to do what’s right under the logic that “someone else will do it.” If you allow fear to stop you from doing something you know is right, then that’s a victory for terrorism. And if you choose not to provide out of fear, you deprive yourself of the incredible rewards of being a provider of abortion care. You can help someone enormously, at a desperate time in their life, in just a few minutes. It’s hard to match that feeling.
Rewire: What can medical students do to navigate the system if they want to become abortion providers?
CC: If you’re in medical school, or in residency, Medical Students for Choice is a great place to start. They’ll connect you with a whole community, including fellow students, residents, and wonderful mentors. They can help you to access clinical experience with abortion through their Reproductive Health Externship, which offers established connections with providers as well as funding. Even if you don’t have a chapter, the national organization will be more than happy to work with you.
Rewire: In the past few years, many laws have been passed intended to interfere with the doctor-patient relationship and force providers to disseminate inaccurate information about abortion and health care. How has that affected your ability to care for your patients? And how has it affected your clinic’s ability to adequately meet the needs of its community members?
CC: Kansas requires a patient who needs an abortion to receive certain state-mandated information in writing, and then wait 24 hours before they can proceed. We don’t find that that information or that wait changes anyone’s mind. What it does is adds additional logistical barriers, because it forces patients to return for another visit, and often necessitates delaying care for a week or more. Patients already think about this decision carefully for days and weeks before their appointment. It’s insulting to patients’ judgment and morality to treat them as incapable of making their own decisions without state interference.
Rewire: Why has South Wind been called “ground zero of the abortion wars”?
CC: Abortion has been particularly controversial in Wichita for decades. Kansas is a religious state as well as a state where individualism, privacy, and wariness of regulation run deep. Lots of people in Wichita who might otherwise have been neutral on abortion were forced to take sides due to threats of picketing and boycotts if they worked with Dr. Tiller as they would with any other business. Now, as a relatively new clinic, South Wind has attracted particularly vociferous anti-choice efforts to close it, as well as particularly strong national support.
Rewire: What do you believe is the role of abortion providers in the broader movement to protect their patients’ rights?
CC: This is a tough one—many abortion providers already feel like targets. And while cardiologists are seen as experts on cardiology and neurosurgeons are seen as experts on neurosurgery, abortion providers are often not seen as experts in abortion; they’re treated by anti-choicers, and many in the “muddled middle” as suspect, biased, and incompetent, which of course couldn’t be further from the truth. I think any physician who has the bravery to provide high-quality abortion care in this political context is already putting themselves on the line in defense of their patients’ rights and humanity. To be an activist beyond that has to be a choice. Physicians for Reproductive Health does sponsor a program called the Leadership Training Academy, where providers and other pro-choice physicians receive instruction and support on advocating for patients who need abortion care through the political process and the media.
Rewire: How do you infuse the teachings of reproductive justice into your medical practice?
CC: The reproductive justice framework is absolutely central to my approach to patient care. I work to situate my approach to counseling each patient within the context of their particular social and economic circumstances. I want to help my patients to be able to have the children they want to have, when they want to have them, meaning my approach to the topic of abortion is nondirective. It’s very important to our counseling process that we ascertain whether the patient is choosing freely to have the abortion; we inquire specifically about coercion with regard to abortion and pregnancy. We work with several abortion funds to help our patients overcome financial obstacles. I discuss each patient’s goals for childbearing and tailor their contraceptive counseling accordingly. I also provide patient-centered, informed-consent hormone replacement therapy, and general medical care for transgender patients, which I consider a central part of my practice.
Rewire: What can people do to raise awareness and support reproductive health-care providers across the country, and help ensure that you and other providers are able to continue providing women with access to critically needed health-care services?
CC: There are lots of ways we need support that you can help provide. You can write to your elected officials and your newspaper, expressing support for the idea of abortion care as a decision best made by the person who might need the abortion, and therefore supporting minimizing external obstacles to accessing that care. Contact your local clinic or clinics, especially if they’re independent, and ask if you can support them—via volunteering, escorting, fundraising, or even by working with them for business services like catering or construction. Find out what other health care you can receive there and consider going there for your care. You can talk to your friends and family about abortion as a common, normal experience; bringing it into personal context helps create nuance and support more than any abstract ideological discussion.
This interview was conducted via email. It has been lightly edited for length and clarity.
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