Planned Parenthood: An Insider Tells All

In response to certain states’ (including my home state’s) recent decision to drastically cut funding to Planned Parenthoods, I thought I’d share an interview I did with a friend of mine, Sarah McKetta, whose favorite job, post-college, was working for Planned Parenthood.

Kathleen Hale: So initially after college, you (and like, a trillion other recent graduates) went off to work for Teach for America (TFA). As far as I know, you snuck out in the middle of the night during training—in the middle of some trust fall exercise—and then went off to work as a reproductive health specialist instead. What was it about Planned Parenthood (PP) that made it a better fit?

Sarah McKetta: [laughs] TFA really stressed me out. I didn’t think they were terribly good employers and they were super disorganized. If I wanted to teach public school, I could teach public school; I don’t need to do it through these people.

I felt like Planned Parenthood was really in line with my politics; plus, they never kept me overtime, and the jobs were very concrete. Somebody asked me recently, “oh my gosh, wasn’t that so hard working around women who are getting abortions?” No, it was totally fine. I feel like I’m not qualified to make anyone’s decision for them, and when people came to me and weren’t sure what they wanted to do, I felt like, okay, well you need to think about that and figure it out. I can give you resources but I cannot make this decision for you. Whereas being a teacher is a lot more responsibility.

KH: So at Planned Parenthood, you were a more unbiased resource, then, say, a presumptuous teacher who was trying to enforce certain ideas.

SM: Yeah, at Planned Parenthood I felt like I was a resource and I was someone people could talk to, and I had these certain skills and I knew what I was talking about, and so the whole thing was all true—and they could take all this information and do whatever they wanted with it, and that was great. You don’t have worry about classroom management in the clinic. People come there because they want a certain thing and you can either give it to them or you can’t.

Most women were really relieved that there was somebody there who could just talk to them about this procedure and provide them with information. There isn’t much frank, accurate information on abortion out there. Its only really there for people who know to read scientific literature or know where to find that information. It’s presented as a disastrous, horrible thing that’s shrouded in secrecy. It’s the most common outpatient procedure in the United States. Four in every ten women gets an abortion. Its super common. And yeah, its totally emotional and totally upsetting and a lot of people don’t want to do it—and that’s fine. They don’t have to. It’s a totally personal decision.

KH: Aside from it lining up with your politics, would you say you liked the job?

SM: It was a relaxing job and a very fulfilling job. I went into it feeling like I had certain political stance, but I didn’t fully understand what I was standing up for. I was afraid I’d start doing this line of work, see things, and become anti-choice, but I didn’t feel that way at all.

KH: Were you ever a part of the actual abortion procedure?

SM: So, I’d been [working as a reproductive health specialist] for a year, and I’d learned how to draw blood and learned how to give shots. At that point, I was really involved in abortion education, which is this really wonderful process where you sit down with somebody and you explain to them “here’s what’s going to happen today”—and you answer all their questions about what to expect and what they’re going to go through. You’re just there to be a counselor, and I was really good at it and it was really fulfilling. But also I’d get a sore throat from talking all day. I spent 40 hours a week talking about to people about abortion.

So then I talked to my boss and I said, you know, “I love working in this particular field. I like this more than working at the front desk, I like this more than drawing blood, I like this more than giving shots. Is there something else I can do in this capacity that doesn’t involve talking all day?” So they trained me to be an assistant, which is basically where, when the doctor asks for a scalpel, I give them the scalpel. I’m not a nurse—I’m not qualified to monitor someone’s oxygen levels or give someone an IV—but I’d make sure the patient was comfortable and that the doctor had the tools they needed. Just be an extra pair of hands in the room during the abortion procedure. I went into my first training, and the doctor started injecting a local painkiller into the patient and I fainted. I was on the ground. I hit my head on some machine. It turned out I was that squeamish about… [laughs]

KH: [laughs] abortions?

SM: Yeah, and they were really hesitant to keep training me but I said, “I want to keep working in this area, and I think I can do something useful around here.” There was one type of work that no one wanted to do, and there was one person in our clinic who was assigned to do it 40 hours a week because she was the only person who had the stomach for it, and they thought for sure I would not be a good fit because I was actually a fainter and I’m squeamish. But they said “lets give it a shot.” My boss was so wonderful and flexible and so willing to work with my particular need to branch out.

Anyway, after that, my department was really like a laboratory. After a woman has an abortion, the doctor uses a low-level suction device to clean out the uterus and remove all the contents. A lot of people ask what happens afterward, where does that suction go? Well, a pathologist has to go through the contents and make sure that we got everything, the same way a pathologist will look at a mole after its removed to make sure all the cancer was taken out. That was my job. To check.

KH: Wow. So that’s like the most important part of the job because if you haven’t gotten everything…

SM: Yeah. If there’s tissue left over, you can get a really bad infection. Back when abortions were illegal, there was a high rate of maternal death during abortion because illegal procedures were often unsanitary, or the uterus would become perforated because of lack of attention to detail, or because of the tools used to perform it.

KH: How do you know you’ve gotten everything?

SM: How you know is you take the material and soak it in water and examine it over a light box so you can see what you’re looking at. You’re dressed head to toe in protective equipment. I looked like an astronaut. Very sterile environment. You have information about the patient—not personal information, but information about how far along she is in the pregnancy was supposed to be, and you’re looking to confirm that. You get an idea based on the patients’ information about what you should be looking for and at a certain age everything looks like an egg yoke, and you make sure it’s the right size, and then you give them the go ahead to send the patient home.

KH: Otherwise, you bring the patient back in and you get the rest of it. That rarely happens, but it happens, which is why the lab part of what you did is imperative.

SM: Right.

KH: I know that you said that when you signed up for Teach for America you signed up for a philosophy. You’d think that by signing up for Planned Parenthood, you’d be signing up for a liberal philosophy—but it sounds like working at PP was kind of less political than TFA, in a way.

SM: Yes, very little philosophy. Our only philosophy was that we believed that women had the right to choose and we supported women’s healthcare. A lot of the women we worked with had been trained as medical assistants and weren’t looking for work in an abortion clinic, they just needed a job. We ran a family planning clinic and this termination clinic, and we had different staff and different doctors, and some of the staff worked for both. We got bills from different accounts, and our paychecks came out of different places depending on which type of work we did that day. Some women I worked with wanted nothing to do with termination. They only wanted to talk about birth control, contraceptives, and pap smears—and everyone was supportive of that. (Until I came along, only one person wanted to do pathology.) Everyone who wanted to work for this organization cared about women and wanted to help them, but within that domain, there’s plenty of variability. It’s a political organization, but in Texas the rules are different for non-profits than they are nationally. We could not endorse any political candidates even though we were under the umbrella of the national organization, which can. The day Obama won, we wore his “HOPE” t-shirts under our scrubs so the patients couldn’t see them, because we were not allowed to present a political attitude. That was not the place for politics, it was the place for facts, science and helping women. Only, it turns out that just wanting to help women at all is incredibly political. Who knew?

KH: Remember when we were hitting on those guys and I told them where you worked and they walked out on us?

SM: Yes. They were appalled.

KH: Could you tell me a little about the protesters?

SM: They usually came on Saturdays, which is hilarious because we didn’t perform abortions on Saturdays. Half of these women were coming in for pregnancy tests and birth control. There was usually three or four protesters, and sometimes just one. One time they came on “Talk Like a Pirate Day” and they all talked like pirates—like, “Don’t get an ab-arrgh-shun!” Occasionally, there’d be more people, or we’d have some protesters who would get aggressive with patients and we would have to call the police. We were just a doctor’s office. Can you imagine someone protesting outside your gynecologist’s office?

KH: So, most of the patients were not coming in for abortion.

SM: Most people come because we have subsidized, low-cost women’s health services. A lot of people who just came out from college and aren’t on health insurance.

And even when they were coming for abortions…I mean, when I look at the political rampage about abortion, it’s so divorced from the actual process. Women don’t come to the abortion clinic because they’re thinking about getting an abortion, they come because they’re getting the abortion. You don’t go to a nail salon because you think you might one day possibly want to get a manicure—and yeah, that analogy is totally flippant, but they’ve made up their minds. They don’t come to us to discuss the possibility, they call us to discuss the possibility. When they come, they’ve made up their minds: they don’t want to be pregnant.

KH: So all those laws geared toward making women change their minds…

SM: Legislative barriers and protests mostly just make women feel grumpy and annoyed. What could be two hours in the clinic turns into eight hours in the clinic. We’d tell women, here’s your appointment time, it’s at whatever time in the morning, bring a book, wear comfortable clothes, because you’ll spend most of your time in the waiting room while we fill out lots paper work. It’s a fifteen-minute procedure, but the process takes around eight hours.

The way it actually plays out politically is so different than the experience these women have. A lot of these women are low income and their decision to get an abortion isn’t political—it’s almost always circumstantial and totally personal. A lot of people get pregnant because they don’t get proper sex education and they don’t have access to cheap birth control. I know so many people whose birth control prescription expired and they couldn’t get to a doctor, but, you know, shit happens, and if they can’t afford birth control they really can’t afford a baby, even with state support. Or the condom broke, what are you going to do? You could be a mother but you have a whole life ahead of you. And we have plenty of teenagers who came in and were pregnant and were psyched to have a baby. Great, have a baby. You should be able to choose.

Sarah McKetta graduated from Harvard in 2008. She is currently a graduate student at Harvard School of Public Health, after which point she plans to go to medical school.

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