Jane Smith, MD, is a pseudonym for the abortion provider and member of Physicians for Reproductive Choice and Health who wrote this post.
On May 31, 2009, Dr. George Tiller was fatally shot in the foyer of the Reformation Lutheran Church in Wichita, Kansas. For many Americans, this story was likely a news brief that came and went. But not for me.
I am an abortion provider.
My colleagues and I comprise a small, close knit community of abortion providers and advocates across the nation. As we mourned Dr. Tiller's loss, we also struggled to understand what his death meant for our own lives. Reading tributes to Dr. Tiller and his career, I was humbled. I was also embarrassed by my own silence. Outside my chosen professional community, I've kept my work a secret.
I thought about sending a card
to the Tiller family or making a donation in his name. Then I realized
the best gift I could give to honor his life is to "come out" to
friends and family, to identify myself and the work I do with pride.
So I did. I emailed or called more than a hundred friends, family members,
and acquaintances and told them that I am an abortion provider.
I was tired of the awkward silences (awkward in my mind, at least) when people asked about my job. "Women's health" or "family planning" often sufficed, but when pressed, I usually switched the subject. There were a thousand reasons I didn't want to identify as an abortion provider. I wondered, will she never speak to me again? Will our kids get picked on? Will play dates cease? Will our family members stop calling? Worse yet, could we become the targets of harassment and violence? Yet when I revealed this part of my job, none of these concerns became reality. Many of my confidants expressed their support for my work. Some opened up about their own abortions.
By remaining silent about abortion, I contributed to the marginalization of abortion and, more important, the women who have had abortions. These women are our neighbors and teachers; members of our churches, synagogues, and mosques; sisters, mothers, and daughters. All of us know women who have had abortions (one in three women will have had an abortion by the age of 45). If you are not aware of any, it is only because they choose not to share their stories. It is also because we don't ask or provide safe spaces in which to tell.
I didn't "come out" to
change anyone's political views on abortion. I wanted to share a side
of my life that I find hard to discuss under ordinary circumstances.
And I would be lying if I did not admit that I hoped my letters and
calls would open up thoughtful conversations about the meaning of pregnancy,
unwanted pregnancy, parenting, and yes, abortion. Conversations that
went beyond overly simplistic stereotypes and hurtful words.
Telling the truth about what I do was incredibly rewarding. I suspect some of my friends and family are struggling with the news that I provide abortions, but the responses I heard have all been positive. This is an important start for me, and I have farther to go - I am using a pseudonym for this post because I am not yet ready to be widely known as an abortion provider. I share the story of my progress so far in hopes that it will encourage other providers to reveal their secret. If each of us had the "coming out" conversation with a hundred friends and colleagues, thousands of conversations would begin about the need for abortion and the rewards of offering women this service.
I never planned to be an abortion provider. There is nothing glamorous or lucrative about this career path. As a family doctor, I provide a breadth of care across the life cycle; offering abortions in my own practice has been the most satisfying part of my career. There are days when working in our current health care "system" does not seem worthwhile, but I can honestly say that providing women the full range of reproductive health care sustains my passion and gets me to work every day.
Women come to me asking for abortions for so many reasons: partners leaving them, condoms breaking, not having insurance to pay for the most effective contraceptives, ambivalence about pregnancy and parenting-I could go on. Most recently, the economy has been a major driving force. Many of the women and men I care for are losing their jobs and struggling to care for the children they already have.
Some stories I find more compelling than others. All stories are rich and highly personal; they challenge and push me every day to continually uphold one of the core ethical principals in medicine: "respect [patient] autonomy." This is the nature of my work, which reflects the nature of being human in an increasingly complex world. I cannot claim to understand women's choices all the time - whether they decide to become parents, end the pregnancy, or make an adoption plan - but I trust that they are doing what is best for them and their families at that certain place and that certain time in their lives.
In Dr. Tiller's own words:
"Abortion is not a cerebral or a reproductive issue. Abortion is a
matter of the heart. For until one understands the heart of a woman,
nothing else about abortion makes any sense at all."
By telling the truth about my professional life, I hope I've helped my friends and family understand my own heart, and my patients' hearts, a little better.

























