December 1, 2015 — In an interview with Rolling Stone, Cheryl Chastine, "a Chicago-based family physician who provides abortion care," discussed "why she decided to specialize in abortions [and] the maddening trend of dismissing abortion providers' medical expertise as political bias," among other issues.
Chastine outlined her career path, noting that her work with Medical Students for Choice at the University of Kentucky "made a new connection for [her]: for abortion to remain a meaningful option, we need doctors who are trained and willing to do them." She explained, "With providers at the time aging and retiring, I realized, there would be people who would need abortions and not be able to have them, unless I stepped up."
Noting how common and safe the procedure is, Chastine said "it's amazing and appalling how marginalized it is in most areas." She outlined how her medical school education "didn't cover it," how she had to independently seek out abortion training during her residency, and how "even as an OB-GYN, the default assumption is that you won't provide abortions."
Chastine initially practiced family medicine in the Chicago area while traveling to perform abortions, but antiabortion-rights harassment eventually led her to leave her family medicine practice and "bec[o]me a full-time provider of abortion care." Currently, she travels to provide abortion care "to communities whose providers have retired and not been replaced, or have been forced out of doing the work, or have been murdered."
Discussing laws designed to target access to abortion, Chastine called mandatory delays "[t]he most degrading to the patient." She said the patients she sees have "already carefully considered their decision," and such laws are "really designed to increase the chances that the patient will be unable to access the abortion at all, because they won't be able to arrange the time off work, or they won't find childcare, or they won't have transportation, or a family member will get sick."
She also talked about how "abortion stigma and violence" have created a situation in which "there's not only a shortage of doctors who have the necessary training, but a mismatch between where trained providers live and where services are most needed." She said that because of the various obstacles to abortion training, and the continuing stigma around the procedure, "the only people who become providers are ones who start off ideologically committed to abortion care" and "those physicians are hesitant to then make their homes providing abortions in actively hostile environments."
Chastine touched on how she discusses her work with others, noting that while she is "proud as hell to do what [she] do[es]," she always has to weigh whether to disclose her profession for fear of antiabortion-rights harassment. "It's absurd and appalling that I have to think about that," she said, adding, "But I make those sorts of calculations every day."
During the interview, Chastine also discussed how abortion-rights opponents have "convince[d] the general public that abortion providers are not to be regarded as experts on abortion." According to Chastine, "This is simply bizarre and without precedent in the medical world." She said, "It's infuriating that my judgment is considered irrelevant by politicians and activists who know absolutely nothing about the provision of abortion care."
She added, "Underlying the anti-choice legislative approach to abortion care is the presumption that abortion providers aren't interested in providing safe care, but rather want to provide the lowest standard of care that we can get away with. That's no more true for us than it is for any area of medicine." She said, "We should be regarding anti-choicers' perspective on abortion safety as the suspect one, since they find all abortion care unacceptable regardless of its safety."
Planned Parenthood Videos
Chastine dismisses the misleading videos targeting Planned Parenthood's fetal tissue donation program, noting, "Given the huge number of medical professionals who have worked through Planned Parenthood, and the huge number of patients they care for, it is beyond belief to suggest that" the activity alleged in the videos "would go unchallenged and undocumented." She added that patients regularly make unsolicited offers to donate fetal tissue because "they find it comforting to think that someone else may be helped as a result of their abortion experience."
Chastine called out the subsequent political attacks on Planned Parenthood. "Even for those of us who don't work for Planned Parenthood, the message is clear to us that we're next," she said, adding, "If Planned Parenthood is forbidden to receive Medicaid reimbursement, then the rest of us who provide abortion care can also expect to lose our Medicaid practices." She noted, "The main losers in that scenario are [low-income] Americans."
Meanwhile, Chastine said the videos have not "significantly affected ... the flow of patients or the concerns they raise." According to Chastine, "that really shows just how irrelevant all this grandstanding is to the actual people who find themselves in need of abortion care."
Supreme Court Case on Texas' HB 2
Touching on the Supreme Court's decision to hear a lawsuit challenging parts of Texas' omnibus antiabortion-rights law (HB 2), Chastine said if the high court "rules against providers in Whole Woman's Health v. Cole, then every hostile state will implement the most stringent requirements allowed by the decision, then pass more laws targeting the few clinics that survive."
She added, "The [state] legislatures are going to keep moving the goalposts until either the Supreme Court stops them, or every abortion provider is shut down." Chastine contended that "[i]f abortion access vanishes again in most of the United States," more clinics will be built on state borders to circumvent restrictive laws, there will be an increase in self-induced abortions, and the "burdens of [unintended] childbearing and unsafe abortion will fall heaviest on [low-income], rural, black and Latino/a people" (Grimes, Rolling Stone, 11/24).