An Abortion Provider on Infertility: ‘Not Despite, Because’

abortion-provider-infertility-ivf-reproductive-justice
A rally for abortion rights in Philadelphia in 2019. (Joe Piette / Flickr)

I spent six years trying to get pregnant. I am also an abortion provider. 

It was a long six years—after three attempts at intrauterine insemination, eight rounds of in vitro fertilization (IVF), multiple early pregnancy losses, countless hormone injections, four painful egg retrievals, and an unsuccessful clinical trial of laparoscopic ovarian surgery in an attempt to increase the viability of my eggs, I was eventually able, with the help of an egg donor, to carry a pregnancy to term. I now have a wild and wonderful, energetic and empathetic 5-year-old, and am grateful every day for the privilege allowing me to finally bring him into my family. 

So how, people ask, could I perform abortion care while struggling for so many years to become pregnant? How could I help people end their pregnancies while I was experiencing the anguish of infertility and subjecting myself to seemingly endless medical procedures to get pregnant? 

This question has always seemed strange to me. As someone who believes in and advocates for reproductive justice—a framework developed by Black women to address the intersections of race, gender, class, ability, nationality and sexuality—I am also a firm believer in its basic tenets. Among these are the right to have children, to not have children, and to parent children in safe and sustainable communities. So how can I have experienced the hardship of infertility while also continuing to support and provide abortion care? The better question is: How could I not

My right to choose assisted reproductive technology (ART) methods in pursuit of my choice to parent is no different than a person’s right to choose not to parent. If you advocate for one, it should be clear that you must also support the other—it’s about making decisions for our bodies, our families and our values. 

The majority of people who have abortions are already parents. They know the sacrifices—financial, practical and emotional—that come with carrying and raising children, and only they are able to decide how another pregnancy would impact their lives and families. Anti-abortion rhetoric denies a pregnant person’s autonomy and vision for their future. Having experienced my own reproductive struggles and having faced the judgmental scrutiny about my own choices, I can relate to the frustration of being doubted or even shamed for personal healthcare decisions. 

The number of times I was told I was being “selfish” for not pursuing adoption— which was also not an easy decision—further convinced me that judgements about reproduction and family-making are not limited to any one specific choice. As a professional who started this journey intending to parent alone, the disapproval was often palpable. It is amazing how many people will openly tell you how unprepared they believe you are to parent. It felt terrible for me. I cannot imagine what that experience is like for a young, single pregnant person carrying even more age-based judgement around their decisions to parent or not to parent. 

What I’ve learned from being both an abortion provider and a person struggling with infertility is simple: The time has more than come for the world to respect our decisions about our families and our futures, regardless of what they might be. 

My experience forced me to consider the infinite range of individual circumstances that contribute to people’s healthcare decisions. It forced me to consider the privilege that allowed me to undergo round after round of IVF, and remember that many do not share that privilege, which often puts access to many types of reproductive healthcare—including abortion and ART—out of reach. To that end, just as we work to make abortion care more accessible, we should do the same for ART. 

What I’ve learned from being both an abortion provider and a person struggling with infertility is simple: The time has more than come for the world to respect our decisions about our families and our futures, regardless of what they might be. 

I was privileged to be able to take periodic breaks from my career while I was attempting pregnancy, but it was not because of some conflict between the work that I do and my desire to get pregnant. It was because depression is real and often times hormonally driven, and I was injecting hormones like … well, like getting pregnant depended on it. 

And here I find another point of connection between my personal experience with infertility and my work in abortion care. People struggling with infertility often feel alone and broken, misunderstood in the public sphere and forced to explain their choices to the world. Despite the fact that one in four women will have an abortion over their lifetime, my patients also often feel a sense of loneliness rooted in stigma and shame. 

Abortion providers come to this work with a constellation of experiences around pregnancy. Many have children of their own, many have had abortions themselves. My experience is not unique—abortion providers also struggle with infertility. These experiences allow us to be better providers of care. They remind us to trust our patients, and they compel us to fight stigma in all its forms while advocating for true reproductive freedom.

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About

Julie Jenkins is a sexual and reproductive health nurse practitioner, abortion provider and mother. She is the Reproductive Health Access Project’s APC cluster leader and is completing her doctorate at Johns Hopkins University School of Nursing. She was previously the lead plaintiff in Jenkins v. Lynch, an ACLU lawsuit seeking to overturn Maine’s physician-only law.