One Friday in the new, post-Roe America: How losing abortion access changes us all

Jessica Dieseldorff, a nurse practitioner at Planned Parenthood Mar Monte
Jessica Dieseldorff, senior program manager, abortion services, at Planned Parenthood Mar Monte.
(Via Jessica Dieseldorff)

Soon, the Santa Cruz area’s Planned Parenthood’s offices will see 250 to 500 more patients per week, out-of-state refugees pushed west by Friday’s Supreme Court decision to reverse Roe v. Wade. But those are only the ones who have the money and connections to get to us. Jessica Dieseldorff, a nurse practitioner at Planned Parenthood Mar Monte in Watsonville, writes about our new reality, both for those coming to California and for those of us here.

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It’s a normal Friday.

Except for one thing.

It’s a terrible Friday. The Supreme Court has just overturned 50 years of court precedent and eliminated the constitutional right to abortion.

I’m in my office at Planned Parenthood Mar Monte, where we serve over 220,000 patients per year in 35 health centers in California and northern Nevada.

My first abortion patient today starts feeling the sedative, and tells us about her dream family, how she wants to see her 6-month-old get to kindergarten before they welcome a little sister or brother.

Five minutes later, at the end of her abortion, she says, “You know how you feel vibes from some people and they click with you? I liked your vibes, what’s your sign?”

We laugh together as she warns my medical assistant to watch out for Geminis — they have a kind side and an angry side.

It’s a terrible Friday.

A patient just like mine shows up at a clinic in Louisiana.

I try to imagine how the staff turn this patient away. I know it won’t be just a closed door and a sign. I imagine medical assistants and managers and nurses in the waiting room and at the front desk explaining over and over, calling and leaving messages, bringing patients back to private rooms to cry and talk and try to understand and discuss options.

I see people giving up.

I see people deciding what they will forgo to take the next steps. Will they eat less? Take out a high-interest payday loan? Sell something precious? Postpone rent and bills? I see them looking at their $500 in cash, which is no longer enough. I see their dreams and their power being ripped away from them.

It’s a normal Friday.

I sit by the exam table and speak with my patient through the Farsi phone interpreter. I fall into the rhythm of shorter sentences and longer pauses. It feels luxurious to take the time to confirm and set expectations for each patient.

Would you like me to explain what I am doing? Would you like to hear the ocean sounds from the white-noise machine? Would you like to hold someone’s hand? What else do I need to know to take the best care of you? In Oakland, in Fresno, in Reno, in Watsonville, it’s health care as usual.

It’s a terrible Friday.

A patient just like mine shows up at a clinic in Kentucky. In Texas. In Alabama. In Arizona.

As the day goes on, they have ignored the phone messages telling them not to come. They’ve hoped and shown up.

It’s not just one patient.

One by one, lives are becoming so much harder. Someone else decides about your body, your life. It’s confusing and alienating when health care as usual is suddenly illegal, suddenly wrong and so very far out of reach.

It’s a normal Friday.

As the day goes on, my patients and colleagues and I stop focusing on “it,” on what has happened. We talk about what to eat for lunch (clam chowder? Tacos? Pasta?) and the Bay Area traffic that will be awaiting us when we leave. It’s not that we’re trying to make it normal, it just is normal.

Our normal Monday will mean continuing to hire, train, grow, plan, organize and serve more patients who can no longer get what they need in their home state.

We imagine seeing 250 to 500 more patients per week. But those are only the ones who have the money and connections to get to us.

We are learning new ways of working, scheduling, and following up. We’ve been practicing for a few months with some who have been fleeing Texas’ restrictive laws and coming to us. We’ve been coordinating with providers and patients.

Here in California, a low-income person can enroll in pregnancy MediCal at our front desk and receive coverage right away, to end their pregnancy or continue their pregnancy. If you’re from Texas, it’s harder to get connected to financial help. This patient navigation will be part of the new normal.

On this normal Friday, my next patient tells me the point of Disneyland for an adult: seeing the joy on your daughter’s face. And the pineapple ice cream with fruit. She gets dressed and goes home.

One by one, we return patients to their lives. I sit outside at the parking lot picnic table under the tree, remove my mask, rub the sore ridge on my nose, eat my sandwich.

It’s a terrible Friday.

Patients just like mine sit in passenger seats, at kitchen tables, in bedrooms and parking lots across the country. Forced to stay pregnant. Turned away, disappointed, devastated. Told over and over: The law says that your dreams and hopes and plans and ideas about caring for your body are illegal.

It’s a normal Friday.

My teen patient mumbles through her mask: “When can I text my mom?” Her stomach hurts and her back hurts and we try to help her get more comfortable on the table. She doesn’t share a story. She’s brave, and then she gets dressed and goes home.

It’s a terrible Friday.

It’s not a surprise. It hurts. It’s unbelievable. It’s unfair.

It was a great Friday.

I tell my very last patient, “Great work!” “You too,” she says.

We run the final lab report, wipe down tables, remove the last IV. I walk the last patient to her ride. Her friend sits cross-legged on the grassy patch at the front of the clinic, jumps to her feet, hugs her.

They get into the back seat of her mom’s station wagon. Back to their lives.

Jessica Dieseldorff, senior program manager, abortion services, has worked as a nurse practitioner at Planned Parenthood Mar Monte for 24 years. She holds bachelor’s and master’s degrees in humanities from Johns Hopkins University and received her master of science in nursing degree from Vanderbilt University. She lives in Live Oak.

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