September 23, 2025 • 47 mins
Abortion later in pregnancy is often misunderstood and heavily targeted through both policy and stigma. Erika Christensen, co-founder of Patient Forward and later abortion patient and advocate, Jenn Chalifoux-Gene, later abortion patient and advocate, and Dr. Diana Greene Foster, demographer and Professor at the University of California San Francisco and lead of the Turnaway Study, sits down to share their personal stories and talk with us about why access to later abortion will always be needed.
Some people—including young people, people with chronic health conditions, and people who have been recently pregnant—are late to discover they are pregnant. That means those who make this discovery later in pregnancy in states with six-week abortion bans do not have access to abortion. Further into pregnancy, costs rise, available providers decrease, and barriers to care mount. Since Dobbs, ten states have enshrined viability measures into their constitutions, and 41 states still ban abortion at some point in pregnancy. The good news? Culture is shifting—more Americans agree that legislators should not be involved in pregnancy decisions, including in the third trimester. There are also more clinics and providers for abortion later in pregnancy than there were previously, and states are continuing to repeal viability limits.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Jennie (00:03):
Welcome to rePROs Fight Back, a podcast on all things
related to sexual andreproductive health, rights, and
justice.
[music intro] Hi, rePROs.
How's everybody doing?
I'm your host, Jennie Wetter,and my pronouns are she/her.
So I feel like almost everyweek before I sit down to record
the intro, I am like strugglingabout what to talk about.
(00:24):
I just feel like I'm not thatexciting and I don't have a ton
of things happening that I feellike y'all want to hear about.
So this week was no differentthan many other where I was
like, I don't know what I'mgoing to talk about.
And then I opened social mediaand saw something that brings me
joy every year.
And I am so excited, y'all.
(00:46):
This week is a really, reallyimportant week.
That's right.
It is Fat Bear Week.
I'm so excited.
If you have not experienced thejoy of Fat Bear Week, y'all,
you have to dive in.
It is just pure delight.
It is done by the KatmaiNational Park in Alaska and it
(01:11):
is about their brown bears.
And so every year brown bearsneed to eat all this food so
that they can hibernate, get fatfor hibernation.
So, Katmai started doing FatBear Week and created a
tournament for educationpurposes and it is just so much
fun.
So you go on, it starts the22nd, so you go vote for your
(01:39):
favorite bear.
There's a round robin every daywhere you go and pick I don't
(02:07):
remember how many it is everyday, like, three or four or
, like, two or four of yourfavorite bears um as the
tournament progresses and we'llhave crown our Fat Bear Week
champion at the end of the week.
And it is just so much fun andit brings me joy every year to
see cute bears, hear theirstories; there's always like a
delightful story of who thisbear is.
(02:29):
It's just so much fun.
I don't know.
It's one of those things thatbrings me joy every year.
So I hope that you go and checkout Fat Bear Week.
It is a lot of fun.
Okay.
Let's see.
The only other thing I reallywanted to talk about is this is
the last in our series thatwe've done six episodes on
(02:50):
abortion later in pregnancy.
And y'all, I am so, so gratefulto everybody at Patient
Forward, Bonyen and Garin andErica.
Thank you.
Thank you so much for every forhelping co-create this series
for thinking up the topics andfinding amazing guests.
It has just been such awonderful series and I am so
(03:13):
grateful to all of you for allof that you did to make this a
wonderful series, for being onthe podcast multiple times, for
helping find guests; like, thisseries would not have existed
without all of you.
So, thank you, Patient Forward.
I am so grateful for yourpartnership and being such great
collaborators so thank you somuch.
(03:33):
And y'all, I had so much fundoing this series.
So if you have ideas for otherthings you would like us to see
do in this format, to do a deepdive on different aspects of a
particular issue, let me knowand we'll see if we can make it
happen.
So yes, send me your ideas.
With that, let's turn to myinterview.
I am so grateful this week forhaving three wonderful guests.
(03:55):
We are talking about, again,abortion later in pregnancy, but
we're Thank you to PatientForward.
Thank you to Erika, Jenn, andDiana for this episode, and
(04:36):
let's turn to our conversation.
Hi, Erika, Jenn, and Dr.
Foster.
Thank you so much for beinghere.
It's a pleasure.
Thanks.
Jenn (04:45):
Thank you so much for having us.
Jennie (04:46):
Okay, before we get started, let's do introductions
so everybody can learn torecognize people's voices.
And I'm going to go the order Isee you on my screen, which
definitely will help our audiopeople, right?
Because they can't see you, butthat's okay.
So Jenn, would you like to goahead and introduce yourself
first?
Jenn (05:03):
Sure.
My name is Jenn Chalifoux.
I am an attorney in Colorado,and I am a later abortion
patient as in 2010.
So, I'll be speaking about thattoday.
Jennie (05:18):
Okay.
Dr.
Foster?
Diana (05:19):
My name is Diana Green Foster, and I'm a demographer
and a professor at theUniversity of California, San
Francisco.
And I led the Turnaway Study,which looks at what happened to
people who were too too late toget an abortion, too far along
in pregnancy compared to peoplewho are just under the limit.
And I have had the pleasure ofspeaking to Repros Fight Back
(05:44):
about it.
But here, this was such a greatopportunity to focus
specifically on later abortionswith other experts on later
abortion and talk about what weknow about later abortion in
this post-Dobbs era.
Jennie (05:59):
And then last, let's go to Erika, who has been very much
a partner in in this series ofsix.
I cannot believe this is ourlast one, but Erika, would you
like to go ahead and introduceyourself?
Erika (06:10):
Yeah, thank you so much, Jennie, and thank you again for
working with Patient Forward onthis series.
I think all of the episodeshave been amazing, and we just
thank you for being willing toplatform later abortion care in
this way.
It's really important.
I'm Erika.
My pronouns are she/her.
I'm co-founder of a strategyand advocacy organization called
(06:30):
Patient Forward.
We're the only nationalorganization focused primarily
on eliminating barriers toabortion care throughout
pregnancy.
And I'm also, like Jen, a laterabortion patient advocate.
Jennie (06:44):
Okay.
Like I said, this whole serieshas been focused on abortion
later in pregnancy.
And sadly, we were at the end,but I'm so grateful for Patient
Forward for all of their help inmaking this series happen.
It would not have happenedwithout y'all.
We wouldn't have had suchamazing guests.
But now that we're at the finalepisode, I thought it was a
(07:04):
good time to sit back for asecond and think: what is the
thing that you think is missingfrom the general narrative
around abortion later inpregnancy?
And I don't know who wants togo first.
Erika (07:16):
Oh, I do! Well, I mean, what's interesting is that I
think what is, to me, the reasonthat we wanted to do this
episode is that the central sortof intersection of later
abortion and later recognitionof pregnancy is so important.
It's so relevant that wethought that it deserved its own
(07:36):
episode and its own dedicatedtime because it is so sort of
systematically erased from theconversation in most instances.
So to me, that's the one I'llpick.
I could give you a bulletedlist, but I know Diana and Jen
will have good additions aswell.
But I'm going to start withjust later recognition.
(07:57):
I mean, I just think it's justso crucial and that's why I'm so
excited to talk about it today.
I
Diana (08:03):
I think that later abortion is really the target of
the most hateful languagearound abortion and so
misunderstood.
And the misunderstandings seemto trivialize people's decision
making in a way that's justridiculous.
(08:24):
And so, like Dr.
Shelley Sella says, if you canunderstand third trimester
abortion, you can understand allabortion, that there's
something, if you couldunderstand all abortion,
understand why someone could belate in seeking an abortion, you
will understand so much moreabout all of abortion and all of
the massive barriers that havebeen imposed on people to
(08:46):
getting an abortion,particularly affect later
patients and make everybodylater or nearly everybody later.
It slows people down.
So at the same time, we'remaking abortion, we're heaping
on stigma.
We're also making everybody belater.
It's, it's a crazy world.
Jenn (09:07):
I really agree with everything that's been said.
For me, I think there's areticence to fully embrace later
abortion seekers with the samerights protecting fervor that we
hear about earlier abortionseekers, particularly among our
own, you know, major reprorights organizations.
(09:31):
And I think there's a lot offocus on the reasons why
somebody is seeking an abortionwhen they're later, but there's
not a lot of focus on what drovethis later.
Why is it later now?
And what outside the personwho's seeking the abortion could
have driven the person thislate?
(09:52):
So, yeah, I think that thatreally needs to be talked about
more.
And I'm excited to talk aboutit today.
Jennie (09:58):
Me too.
I'm so excited to have all ofyou on to talk about this.
Let's maybe start with Diana.
since you were the leadresearcher on the Turnaway
Study, and you found that therewere two common pathways that
people experienced when theywere needing a later abortion.
Can you explain them and whylater abortion will always be
(10:18):
needed?
Diana (10:19):
Sure.
One thing that I think wasn'tfully recognized before the
Turnaway Study was that somepeople are late to discover
they're pregnant, and there's anassumption that somehow that's
because they're irresponsibleand instead what we find is that
(10:40):
people have a huge range ofexperiences with pregnancy and
some people have the benefit ofnot being nauseated and not
being tired and not having allthe symptoms of pregnancy.
For wanted pregnancies that's awonderful blessing to not
experience some of the negativeside effects but if you weren't
trying to become pregnant thenit's very possible for to spot
(11:03):
throughout your pregnancy andnot realize you're pregnant
until quite late.
And so I think that this lackof sympathy for late recognition
of pregnancy is a problem.
We also find that people whoare using contraceptives in the
month they conceived are muchmore likely to be late, which
(11:25):
makes sense because they weredoing everything they could to
avoid becoming pregnant.
And so they thought they werecovered.
And many people, manycontraceptives, contraceptive
methods, you don't get periods.
So there's nothing to miss.
So you can be late indiscovering that you're
pregnant.
So one major reason that peopleare late in seeking abortion is
(11:47):
that they were late to discoverthey are pregnant.
All these states with six-weekbans just completely make
abortion unavailable for thesefolks.
So in fact, if we're talking,if you look at people who had
abortions in the thirdtrimester, a third of them only
discovered they were pregnant ator beyond 20 weeks.
This is in the Turnaway studywhere we've removed people who,
(12:11):
not including people with fetaldiagnoses, which also happen
later in pregnancy, or maternalhealth problems, which also tend
to emerge throughout pregnancy,specifically in the later half
of pregnancy.
So late discovery of pregnancyis a major thing.
And the other is barriers togetting abortion slow people
(12:32):
down.
So trying to make abortion moredifficult to get.
There are laws that explicitlymandate waiting periods.
So that exactly slows peopledown by law.
And my colleagues here at UCSFAnswer have found that a 72-hour
waiting period doesn't slowpeople down by 72 hours.
(12:55):
It slows people down by morethan a week because getting all
the logistics to get somewhereand having an opening at the
clinic Our laws, the ones thatraise costs, that increase the
cost, those slow people downbecause people are waiting,
trying to raise money to pay foran abortion.
And anything that increases thedistance slows people down.
(13:17):
So all of these abortion bansthat make abortion, clinic-based
abortion illegal in certainstates will dramatically slow
people down.
And we've found that thefraction of people getting
second trimester abortions,pre-DOBs, from these states with
bans was 8%, and it's 17%post-dubs.
(13:37):
So, it's more than doubled.
So, abortion bans slow peopledown by making people travel
vast distances.
So, money, distance, both ofthose dramatically are a major
cause of people needing to havelater abortions.
Jennie (13:53):
Yeah, I think that's one of those things that people
think of a lot of those abortionbans, like waiting periods or
anything else that can slowpeople down in a vacuum or think
of them as like this one thingand not understanding how they
all interact together to pushcare further out of reach
because it's not just a waitingperiod it's clinics in your area
(14:16):
have closed and you have totravel further and that makes
the cost more expensive and nowyou can't get a medication
abortion because you got pushedfurther out so then now you need
a procedural abortion nowthat's more expensive and you
need to raise more money sothese all interrelate and push
care later and make people haveto wait longer to access the
care they need.
Exactly.
(14:36):
And then I guess the only otherbit is, you know, I think a lot
of people try to talk aboutmaking abortion care easier to
access, which is great, but thenmaking it seem like, well, then
we don't need to worry aboutabortion later in pregnancy.
So, do you maybe want to talk alittle bit about why that's
important and why we always needto make sure that it's
(14:57):
available?
Diana (14:59):
Yeah.
So if it were just aboutpolicies that slow people down
and that was the only reasonthen better access would help
everybody but that isn't theonly reason people have later
abortions they have it becausethey didn't realize they were
pregnant they have it becausesome they got some information
about their life or theirpregnancy that made them
(15:20):
reconsider carrying to term andso there won't be a point where
you can say okay everyonedeserving of an abortion could
get it if only we set the limitat some number of weeks It's
just that life is toocomplicated.
People's situations are tooindividual for policymakers to
(15:40):
decide some limit that wouldwork for everyone.
Instead, you know, limitsstigmatize the people who are
beyond it and act like they'renot important.
And just backing up for anylisteners who don't know about
the Turnaway Study; the TurnawayStudy looked at people who were
too far in pregnancy to get anabortion compared to people who
(16:01):
are just under a limit and didget it.
And when we follow people overtime, we see worse outcomes.
In every way those two groupsdiffer, it's to the detriment of
people who couldn't get theirabortion.
So greater poverty, worsephysical health, poor outcomes
for their existing children,less likely to have an intended
(16:22):
pregnancy later.
I could go on and on and Iwon't, but it's important for
everybody to be able to makethis decision.
And it's not like people whohave later abortions, somehow we
should just throw them away andnot care.
Their outcomes, their kids'outcomes, their lives matter
too.
Jennie (16:41):
Yeah, I highly recommend if you have not read the book
about the Turnaway Study to readthat.
We'll make sure to link to theepisode that we had Diana on the
podcast before to talk aboutthe Turnaway Study so you can
get a much more in-depthunderstanding of the entire
study and not just the littlebit we were able to talk about
today.
Jenn, you have personalexperience with later
(17:02):
recognition.
Can you share a bit about thatand how it related to your
decision-making timeline?
Jenn (17:10):
Yeah, definitely.
So a lot of what Diana justsaid is personally relatable for
me and I'll touch on it.
So I found out that I waspregnant when I was 18.
And when I found out that I waspregnant, I found out that I
was well into my secondtrimester already.
(17:30):
And so to kind of set the seen,I was struggling with an eating
disorder at the time.
I had come home from college ona medical leave so that I could
attend eating disordertreatment in my hometown, which
was in New York State.
And I was going through thetreatment and I was getting
(17:52):
better, but my period wasn'tcoming back.
And it's a very common symptom,not always, but very common
that people who have restrictiveeating disorders might lose
their period.
Amenorrhea is the medical termfor it.
And so, you know, I had a teamof doctors who were working with
me at the eating disorderfacility.
(18:13):
And none of us were concernedabout my period because it just
made sense for my symptoms atthe time.
And it was probably a couple ofmonths into my treatment.
By the time I was just talkingto my mom and mentioning that my
period hadn't come back and shevery casually kind of offhand
said, well, there's no chancethat you're pregnant, right?
(18:35):
And I was like, oh my God, no,I'm on birth control.
And I had been on birth controlfor over a year at that point.
But what she said stuck withme.
And maybe a week or so later, Itook a pregnancy test and it
was positive.
And a little while after that,I got a blood test and that
confirms that I was pregnant.
And it was the blood test thattipped off how far along I was
(18:58):
or an estimate, which wasn'teven, it turns out, accurate.
But what was accurate was thatI was told that I was well into
my second trimester at thatpoint.
When I look back, I had a lotof symptoms of pregnancy and
those symptoms were masked bythe eating disorder that I was
dealing with.
I had nausea, but we thoughtthat that was part of the
refeeding process.
I was gaining weight, but I wassupposed to gain weight because
(19:21):
I was recovering from my eatingdisorder.
And so for that reason, Imissed it.
And the doctors that I wasworking with missed it.
None of them asked me if I waspregnant.
It was my mom who asked me.
So that was how I missed it andhow I found out.
Of course, it wasn't as easyas, okay, I'm pregnant.
(19:43):
Now let me get an abortiontomorrow.
So that's what I thought it wasgoing to be.
And I was all ready to make anappointment with Planned
Parenthood.
And then they told me that Icouldn't do a medication
abortion because of how faralong I was.
Because I found out that I waspregnant when I was already in
my second trimester, that meantI had less time to do all of the
(20:05):
things that anybody who findsout they're pregnant has to do
in order to make a decisionabout what they want for
themselves and for thatpregnancy.
And then in order to gather theresources necessary to make
that decision.
And so I thought I had enoughmoney for my abortion on my own,
but now I wasn't looking at amedication abortion.
Now I was looking at anabortion in a clinic that would
(20:28):
likely take at least two days.
because I had to go in first toprep.
And that was going to be a lotmore expensive.
We're talking tens of thousandsof dollars without insurance.
And I realized I didn't haveenough money.
So then I had to take a fewdays to think about how am I
going to come up with the money?
Am I going to tell my parents?
I had to psych myself up tohave that conversation with
(20:49):
them.
And they were immediatelysupportive.
I did tell them.
They were incrediblysupportive.
And I am beyond blessed that mymother had an insurance plan
that I was on that covered mostof my abortion.
That is like almost unheard of.
That's not the case for so manyother people, right?
So many other people have totake the time to actually gather
tens of thousands of dollarsout of nowhere in a country
(21:11):
where most people don't haveenough money in their bank
account to get through nextmonth.
So I had to make thosedecisions.
Then there were all kinds ofappointments I had to go to.
I went to see my OBGYN.
I had to get an ultrasound.
I had to get an appointment ata clinic that would do my
abortion where I was living onLong Island.
There weren't any.
So I had to go into Manhattan.
I'm lucky enough to live inclose proximity at the time to a
(21:35):
major city that had an abortionclinic that does later
abortions.
Most people do not.
Then when I got to the abortionclinic for, it was actually a
hospital, for my first day forprep, they did an ultrasound
that day.
And they said, wait a minute,you're even farther along than
we thought.
It's going to be a three-dayprocedure.
(21:56):
You have to come in for twodays of prep.
And then we'll do, so we can'teven do it this week.
We have to schedule you foranother week.
And so I had to wait anotherweek.
And at that point, they told meif I had been even a week later
than I already was, I wouldhave had to go out of state to
get the abortion because at thetime, New York State had a
cutoff of 24 weeks.
I don't remember if I was 23 or24 weeks.
(22:18):
I don't remember how theyinterpreted that cutoff at the
time, but I know that I got itas late as I possibly could in
New York.
And that was even though Itried to get it as soon as I
possibly could.
The moment I found out that Iwas pregnant, It was, and I
don't have it written down, butto my recollection, it was over
a month between finding out thatI was pregnant and getting the
abortion.
(22:38):
And I found out that I waspregnant already in my second
trimester.
And so that's how my laterdiscovery of pregnancy because
of my eating disorder greatlyaffected my abortion timeline
and pushed me later.
And when I look back on thatstory, I think about all of the
ways that I am deeply privilegedto have had access to
(23:00):
insurance, to have lived inclose proximity to a clinic, to
have lived in a state thatallowed me to get an abortion up
to 24 weeks when I could havebeen living in a state that had
waiting periods or a state thatdidn't allow me to do that at
all.
I believe myself to be verygrateful.
I mean, I am very grateful andI believe myself to be very
privileged.
It took me a long time to getto that point because for a long
(23:22):
time after my pregnancy and myabortion, all I felt was
frustration and despair that Ihad gotten it so late.
Jennie (23:29):
Jenn, thank you so much for sharing your story I think
it's so important that peoplehear a full range of experiences
that people have because Ithink a story like yours is not
one you hear as often rightthere is so much focus on the
the fetal indication that youdon't hear the other stories as
(23:49):
loudly they don't break throughas much I think some of them are
shared but but they're not theones that are being like
heralded and that you hear inlike big loud like crashing like
This is why it's so important.
And these are all importantthat people are able to access
the care they need.
Jenn (24:06):
Yeah, I really agree.
For a long time after I got myabortion, the only time I heard
people mention later abortionwas either to just flat out
demonize it or to say, no, weneed later abortion because
people find out about fetalindications and we need a path
(24:26):
for them to be able to makedecisions about their pregnancy
and their fetus.
like, fully.
And I was not hearing, we needlater abortion because some
people just need an abortion andit's late.
And that was...
And that just drives stigma,right?
Yeah, I felt...
You feel alone.
I felt very, very stigmatized.
You know, I, for a very longtime, I was thinking, oh my God,
(24:47):
what's wrong with me?
Like, what is wrong with methat I needed an abortion for
some completely differentreason?
Like, why did it take so long?
I should have realized sooner.
And also, like...
a little emotional justthinking about it i always do
also the i mean the moststigmatizing part is feeling
(25:11):
like people people canunderstand later abortion when
it's for fetal indication Evenif this next part isn't spoken
aloud, the implication is thatif you're getting a later
abortion for another reason,it's too late for you.
Like you shouldn't get one.
We're not okay with that.
And that was the message that Iwas hearing and internalizing
(25:35):
for like 10 years after myabortion until I got connected
with Erica and Patient Forwardand until I found out about
Diana's research.
And all of that just changed mylife.
Jennie (25:46):
This whole idea that I feel like permeates like all of
thisanti-abortion stigma that we all wade through everyday, and the idea that there are "good abortions" and "bad abortions"
vs just your experience and the healthcare you need access to.
Erika (26:17):
Yeah, and I like, I just, sorry, this is Erika talking
now.
I guess I just want to reallyhighlight and not try to cover
that this is stigma that isperpetuated by people who get
paid to advocate for abortion.
Okay.
This is anti-abortion stigma.
And I just think that we arelike past time.
(26:40):
This is when we need to behaving these conversations now
that we're no longer sort ofunder the thumb of Roe.
Now is the time to askourselves and to really take
accountability, I think, topeople like Jenn and so many
thousands of other people whohave been made to feel this
shame and stigma by the peoplepaid to protect abortion.
(27:03):
It truly blows my mind.
Whenever I'm privileged enoughto hear Jenn or any later
abortion patient tell theirstories like this, it just
really kills me.
I just These are not the antis,but it is anti-abortion,
anti-abortion stigma perpetuatedby supposedly pro-abortion
(27:26):
people.
Because what our exceptions aresaying is that we need
exceptions to keep the, quote,wrong people from, quote,
"misusing abortion services."Who is that?
Who are those people?
Not Jenn, right?
I'm sorry.
I'm so fired up.
I'm so angry.
Every time I hear Jenn's story,I just get so angry all over
(27:47):
again.
Jenn, thank you for sharing.
It means you have changed theworld.
Here's the other thing.
Before Jenn telling her storylike this, I mean, it was so
few.
There are a couple other peoplein this whole country who would
be willing to talk about theirexperiences like this, and I
truly believe it has changed theworld.
(28:07):
I just am so grateful to you,Jenn, for for continuing to tell
your story and to represent themajority of later abortion
seekers.
The majority.
Jenn (28:21):
Thank you, Erika, for your anger on my behalf and really
on behalf of everyone else whoneeds a later abortion.
Yeah, I mean, I would watchdebates, political debates.
I would watch politicians thatI planned to vote for talk about
why we should have, you know,viability restrictions.
(28:42):
And depending on yourdefinition of viability, like I
might not have been able to getan abortion under a viability
standard, given the timeline ofmy pregnancy or people talking
about exceptions.
And my pregnancy would not havefallen under any of the major
exceptions that are sofrequently talked about for such
a long time.
And still, to this day, today,still, even now that we no
(29:07):
longer have Roe and we can makeour own framework, even still to
this day, I hear pro-choiceorganizations supporting
restrictions on later abortion.
And I take it personallybecause it feels like saying if
you need an abortion for any ofthe reasons that our movement
(29:30):
has accepted people need to needabortions if you just need an
abortion because you don't wantto be pregnant and you have
bodily autonomy and we love andsupport your bodily autonomy
that's great but if you need itafter a certain date We don't
care about your bodily autonomyanymore.
And it was like, well, but why?
Why doesn't my body and mydecision and my future and what
(29:53):
I want for myself, why doesn'tit matter as much as people who
didn't have an eating disorderso they found out earlier or
people who weren't on birthcontrol so they found out
earlier or people who just foundout earlier, period?
It's deeply stigmatizing andthat stigma can do serious
damage.
For a long time, I thought thatmy abortion had been traumatic.
I've done some work since.
And now I understand it was mypregnancy that was traumatic.
(30:15):
It was the fact of realizing Iwas pregnant so late.
And then all of the stigma thatI internalized that I used to
beat myself up.
It's just unacceptable for ourmovement to put people in that
position.
Erika (30:29):
No, that's important.
And just in case like maybe alittle bit of data is helpful to
back you up.
I think it's also would besurprising to a lot of people
how common later recognition ofpregnancy is.
is.
I think that there's this ideathat, you know, people just
(30:51):
immediately feel nauseous,pee on a stick, and you know
that that happens at like fiveweeks or something.
But we know that one in 13.5pregnancies are discovered after
12 weeks of all pregnancies.
That's a lot.
And that's after therecommended window for
medication abortion in theUnited States, which is how the
(31:11):
vast majority of people aregetting care right now.
And so you understand that itactually affects so many people.
I think we've been sort ofvictims of this small numbers
theory where, you know, thisdoesn't affect that many people,
therefore compromising on theirbacks isn't that big of a deal.
But in fact, it is a big deal.
The 1% of abortions happenafter 20 weeks is a fake stat
(31:35):
based on a deliberate misreadingof CDC data.
And we know that laterrecognition is incredibly common
So this not only affectsthousands and thousands of
people a year, but we know thatit tends to affect people that
are already living at themargins through no fault of
their own, who lack healthcare,housing, who are experiencing
(31:58):
food insecurity.
It's the same people, youngpeople.
I mean, Jen was young.
Young people areoverrepresented among later
abortion seekers and those whodiscover pregnancies later for
very obvious reasons.
I think I think that it's very,I mean, if you think about it
for just a moment, it becomes, Imean, honestly, sometimes I
think, how does anyone discovera pregnancy early?
(32:20):
Like when you look at the sortof systemic forces at play,
you're like, wow, in theseUnited States, people actually
can figure out they're pregnantearly and get to an abortion
early.
It seems miraculous that mostpeople in fact can, because the
structures that we've built makeit very easy for someone to be
in Jen's position.
(32:41):
or, you know, I haven't talkedabout this much, but I
discovered a pregnancy later.
I had a third trimesterabortion and soon after I was
pregnant again a month later andmy body was very out of whack.
And a couple months after that,I had a miscarriage in a Whole
Foods bathroom and it was verytraumatic.
(33:03):
I was in the Whole Foodsbathroom for hours.
My husband and partner atPatient Forward, Garin, had to
like buy me a very expensive,you know, like yoga outfit from
Whole Foods because Icompletely, I mean, I had a very
dramatic miscarriage in apublic bathroom.
And, you know, after that, wedecided to see a fertility
(33:24):
specialist because by then I hadhad a lot of losses and we were
actively trying to becomeparents.
And, you know, months later, Iwas in a fertility clinic and,
you know, they took our history,heard about all my complicated
pregnancies.
And then they said, okay, let'sQuick do a physical exam and
(33:44):
the doctor did an ultrasound andhe said, there's a baby in
there.
And we said, what?
The nurses all start cryingbecause they've heard our
history.
And they're like, oh my God.
And they're all saying, they'relike, well, we don't normally
get good news this quickly atthe fertility clinic, but
there's a baby in there and sheappears to be around 14 weeks.
(34:07):
So you really need to get intoa OB immediately.
And sure enough, and we wereshocked.
By the way, another commonalitybetween my story and Jen's is
that we were both activelyseeing, like having very active
medical care, like we wereregularly being seen by doctors.
After my miscarriage, I went tomy OB to be checked.
(34:29):
And they said, Oh, yeah, well,you just got to let it complete,
you know, because, you know,they just did sort of an oral
exam.
And that was it, there was nofollow up.
So no one noticed that I wasstill pregnant and likely lost a
twin.
You know, again, pregnancy canbe a hellscape.
You know, it's just sosquirrely.
(34:49):
And it just can't possibly becontained by the law.
I mean, it just is so, I mean,it's lunacy.
But in our case, we were verylucky because, again, we were
actively trying to be parents.
So we got into prenatal care asquick as we could, you know,
and that's now our kid.
You know, that's our child.
That's, you know, that's howshe came into this world.
(35:11):
And we were already doingabortion advocacy.
And so to experience laterrecognition like that just
really brought it home for us.
You this really could happen toanyone.
All of the sort of stigmatizingconventional wisdom that we all
hear is complete bullshit andwe have to stop perpetuating it.
And I think a way to fight thisdisinformation and stigma is by
(35:36):
hearing stories like Jen's andso many others who just really,
anyone hears Jen's story or Ican speak for myself.
I heard that story and said,well, that could have been me at
18 very easily.
And I think we can all identifywith these stories when we hear
them.
Jennie (35:52):
Okay. So that is, I feel like such a perfect place to
end, but we also have to get toErika's part, which is the
policy and advocacy part.
So Dr.
Foster talked about theresearch Jenn walked through and
Erika as well, personal reallife experiences.
Erika, do you want to talkabout how all that leads to
policy and the reality of doingadvocacy around abortion later
(36:15):
in pregnancy?
And also what are you seeingright now for the legally
landscape?
Is it getting better?
Is it getting worse?
What are we seeing?
Erika (36:25):
Well, there's good news and bad news, which I'll share.
And then, of course, I'm soeager to hear Jenn and Diana's
thoughts on this question, too.
But from my perspective, first,the good news, research shows a
monumental shift in culturechange.
That's good news.
A majority of peopleconsistently say now that they
do not want governmentinterference in pregnancy
(36:46):
decisions, including explicitlyin the third trimester.
So public opinion hasundoubtedly moved, and it's
moved towards supporting and notpunishing people throughout
their pregnancies.
Now, before people come for me,does that mean people are not
still uncomfortable aboutabortion later in pregnancy?
Sure.
(37:06):
But they're also realizing thatthey can both feel
uncomfortable about somethingand not want to meet that
discomfort with giving thegovernment tremendous power to
police pregnancies.
So that's good.
Morgan, Good news is that moreall-trimester clinics are
opening more than ever before,and they're led by young,
diverse clinicians who areoffering modern, trauma-informed
(37:30):
care.
This is great news.
More good news, I want tohighlight our colleagues in
Massachusetts.
For the first time in anystate, Massachusetts advocates
are loudly and boldly working torepeal the state's viability
limit and recognizing thatgovernment has no place in
pregnancy decisions.
(37:50):
And that is the first timewe've ever seen that.
Other states have repealedviability limits, but they've
done it quietly.
This is the first time we'veseen a whole campaign around
doing it.
And by the way, Massachusettsvoters are supporting it by 66
percent, according to thepolling.
So that is great.
Some less good news is thatwe're still overinvesting in
(38:10):
later abortion bans.
Since Dobbs, 10 states haveenshrined viability limits into
their constitutions andcollectively ballot measures
with viability limits have costupwards of $200 million
altogether, and we're expectingto see more of these bans on
state ballots next year.
Obviously, we do not think thatit's a good idea to spend
(38:31):
hundreds of millions of dollarson protecting the state's right
to criminalize people later inpregnancy.
It is a horrible trend sinceRoe.
That's been kind ofheartbreaking.
More bad news, 41 states dostill ban abortion at some point
in pregnancy.
Nearly half of those states arearound viability, usually
interpreted on theground around 24 weeks. So
there's still a long way to go,you know, before the field meets
(38:54):
people where they are in laterabortion, which is to say people
want full reproductive freedomthroughout pregnancy.
They don't like pregnant peoplebeing criminalized.
And we think it's time that ourpolicies meet people where they
are.
That's sort of the long and theshort of it.
But I'm eager to hear what Jenand Diana think as well.
Good news.
Good, good, bad policy news, Iguess, is the sort of broad, the
(39:16):
broad prompt.
Diana (39:17):
It's this is such an honor for me.
me to be on this podcast withJenn and Erika.
I have never met Jenn beforeand her story is such a perfect
capture of so much scientificdata.
I know that's not how shewanted to live her life is to
act out scientific data, but wehave found that young people are
(39:39):
much later to recognize they'repregnant because their periods
are irregular anyway, becausethey may not be familiar with
all the symptoms of pregnancy.
People with chronic healthconditions which she was
experiencing also are later todiscover they're pregnant
because often chronic healthconditions have the same
symptoms of pregnancy.
(39:59):
And Erika's story of havingbeen recently pregnant and that
explaining why she was late todiscover pregnancy, that's also
something we see because havingbeen pregnant and your body's
still recovering and feelingterrible, especially if you
deliver the child or...
Had a massive miscarriage inWhole Foods.
(40:21):
People's bodies experience lotsof symptoms for lots of
reasons, and it's not alwayspregnancy.
And so it's perfectlyreasonable that you could not
know you're pregnant.
You can also just not havesymptoms.
So this is, yeah, really anhonor to be with people who are
willing to share their personalexperiences.
(40:42):
And the science has their backscompletely.
Jennie (40:46):
I always like to end the podcast by not just talking
about like what's bad or what weneed to change, but how can the
audience get involved?
So what are some of the thingsthe audience can do to get
involved in this conversation orthis fight?
Erika (40:58):
I'll start.
I guess what we know, bothbecause we're people who notice
things, but also this is backedup by research, is that stories
go a long way in helping changehearts and minds.
And what we also know is thatsecondhand stories, like telling
someone's story that you heard,that you read in the news, can
(41:19):
can be as effective as hearingit from the person themselves.
There are organizations thathave spent a lot of money on
doing a lot of deep canvassingand that's one of their big
takeaways.
And I think if you're listeningto this podcast today, you now
know Jen, now you know me.
And so when your friend orfamily member or coworker says
(41:39):
something wrong and stigmatizingabout later abortion care, you
can say, well, you know,actually my friend Jen
experienced this when she was ateenager.
And she was going through ahard medical event and blip,
blop, bloop.
You know that story now.
You know us.
We're friends.
And so please use these storiesto help fight disinformation.
(41:59):
That's something you can do.
Jenn (42:01):
I just really agree.
I think for me, the more Ishare my story, the more
empowered I feel in my ownexperience and the less shame
and stigma I feel.
And the more I share my story,the more people come up to me
and say, oh my gosh, that's socrazy.
What happened to you?
And I'm I'm like, yeah, and ithappens to so many other people
who don't have the resourcesthat I had.
(42:23):
So I just want to echo, Ithink, sharing if you have a
later abortion story or a laterrecognition story and you feel
safe sharing that, absolutelyplease do if that's a place
where like if you're comfortablewith that, but also just
talking about it more ingeneral, pushing back on
(42:43):
misinformation in general whensomebody says something that
doesn't feel accurate or whensomeone one says something
stigmatizing, even if it feelsuncomfortable to push back,
doing so as long as you feelsafe is so important and can
help make people think, oh, Ididn't realize that the way I
was phrasing this isexclusionary.
I didn't realize the way I wasframing this leaves out people
(43:05):
who are having this experience.
Maybe I need to rethink how Italk about later abortion.
The more you share, the moreminds you can change and hearts
you can open.
Diana (43:15):
And I'll add, in addition to the share of stories and
humanizing the experience ratherthan letting it be some
ideological debate that this isactually a human experience that
is so shared and that peopledeserve compassion and humanity
is that there's so much to beoutraged about right now and
(43:40):
that's a problem for so manyreasons but one is that our
attention is constantly beingpulled by other things and there
I know that abortion funds haveseen a drop off in their
funding.
So especially funds that helplater abortions like the Bridget
Alliance are worthy recipientsof support so that if you can
(44:04):
keep that cause in mind whilewe're faced with such an
onslaught of important issues,that this is one that still
deserves attention andincreasingly deserves attention.
Jennie (44:16):
Okay.
I want to be respectful ofeveryone's time, especially
since since I know Diana has torun.
So Diana, Jenn, Erika, thankyou so much for being here
today.
It was so wonderful to get totalk to all of you.
Diana (44:27):
Yeah, thank you, Jennie and Jenn and Erika.
Really great to spend time withyou.
Thanks so much.
Erika (44:32):
100%.
Same, same.
Jenn (44:35):
Yes, thank you, everybody.
Jennie (44:37):
Okay, y'all.
I hope you enjoyed myconversation with Jenn, Erika,
and Diana.
I had so much fun talking tothem about abortion later in
pregnancy and later discovery.
It was just such a great seriesand I am so grateful to
everybody at Patient Forward forhelping make this happen.
So thank you again, and I willsee everybody next week.
If you have any questions,comments, or topics you would
(44:59):
like us to cover, always feelfree to shoot me an email.
You can reach me at jennie@reprosfightback.com, or you can
find us on social media.
We're at Repros Fight Back onFacebook and Twitter, or
@reprosfb on Instagram if youlove our podcast and want to
make sure more people find it.
Thanks, all.
Welcome to rePROs Fight Back, a podcast on all things
related to sexual andreproductive health, rights, and
justice.
[music intro] Hi, rePROs.
How's everybody doing?
I'm your host, Jennie Wetter,and my pronouns are she/her.
So I feel like almost everyweek before I sit down to record
the intro, I am like strugglingabout what to talk about.
(00:24):
I just feel like I'm not thatexciting and I don't have a ton
of things happening that I feellike y'all want to hear about.
So this week was no differentthan many other where I was
like, I don't know what I'mgoing to talk about.
And then I opened social mediaand saw something that brings me
joy every year.
And I am so excited, y'all.
(00:46):
This week is a really, reallyimportant week.
That's right.
It is Fat Bear Week.
I'm so excited.
If you have not experienced thejoy of Fat Bear Week, y'all,
you have to dive in.
It is just pure delight.
It is done by the KatmaiNational Park in Alaska and it
(01:11):
is about their brown bears.
And so every year brown bearsneed to eat all this food so
that they can hibernate, get fatfor hibernation.
So, Katmai started doing FatBear Week and created a
tournament for educationpurposes and it is just so much
fun.
So you go on, it starts the22nd, so you go vote for your
(01:39):
favorite bear.
There's a round robin every daywhere you go and pick I don't
(02:07):
remember how many it is everyday, like, three or four or
, like, two or four of yourfavorite bears um as the
tournament progresses and we'llhave crown our Fat Bear Week
champion at the end of the week.
And it is just so much fun andit brings me joy every year to
see cute bears, hear theirstories; there's always like a
delightful story of who thisbear is.
(02:29):
It's just so much fun.
I don't know.
It's one of those things thatbrings me joy every year.
So I hope that you go and checkout Fat Bear Week.
It is a lot of fun.
Okay.
Let's see.
The only other thing I reallywanted to talk about is this is
the last in our series thatwe've done six episodes on
(02:50):
abortion later in pregnancy.
And y'all, I am so, so gratefulto everybody at Patient
Forward, Bonyen and Garin andErica.
Thank you.
Thank you so much for every forhelping co-create this series
for thinking up the topics andfinding amazing guests.
It has just been such awonderful series and I am so
(03:13):
grateful to all of you for allof that you did to make this a
wonderful series, for being onthe podcast multiple times, for
helping find guests; like, thisseries would not have existed
without all of you.
So, thank you, Patient Forward.
I am so grateful for yourpartnership and being such great
collaborators so thank you somuch.
(03:33):
And y'all, I had so much fundoing this series.
So if you have ideas for otherthings you would like us to see
do in this format, to do a deepdive on different aspects of a
particular issue, let me knowand we'll see if we can make it
happen.
So yes, send me your ideas.
With that, let's turn to myinterview.
I am so grateful this week forhaving three wonderful guests.
(03:55):
We are talking about, again,abortion later in pregnancy, but
we're Thank you to PatientForward.
Thank you to Erika, Jenn, andDiana for this episode, and
(04:36):
let's turn to our conversation.
Hi, Erika, Jenn, and Dr.
Foster.
Thank you so much for beinghere.
It's a pleasure.
Thanks.
Jenn (04:45):
Thank you so much for having us.
Jennie (04:46):
Okay, before we get started, let's do introductions
so everybody can learn torecognize people's voices.
And I'm going to go the order Isee you on my screen, which
definitely will help our audiopeople, right?
Because they can't see you, butthat's okay.
So Jenn, would you like to goahead and introduce yourself
first?
Jenn (05:03):
Sure.
My name is Jenn Chalifoux.
I am an attorney in Colorado,and I am a later abortion
patient as in 2010.
So, I'll be speaking about thattoday.
Jennie (05:18):
Okay.
Dr.
Foster?
Diana (05:19):
My name is Diana Green Foster, and I'm a demographer
and a professor at theUniversity of California, San
Francisco.
And I led the Turnaway Study,which looks at what happened to
people who were too too late toget an abortion, too far along
in pregnancy compared to peoplewho are just under the limit.
And I have had the pleasure ofspeaking to Repros Fight Back
(05:44):
about it.
But here, this was such a greatopportunity to focus
specifically on later abortionswith other experts on later
abortion and talk about what weknow about later abortion in
this post-Dobbs era.
Jennie (05:59):
And then last, let's go to Erika, who has been very much
a partner in in this series ofsix.
I cannot believe this is ourlast one, but Erika, would you
like to go ahead and introduceyourself?
Erika (06:10):
Yeah, thank you so much, Jennie, and thank you again for
working with Patient Forward onthis series.
I think all of the episodeshave been amazing, and we just
thank you for being willing toplatform later abortion care in
this way.
It's really important.
I'm Erika.
My pronouns are she/her.
I'm co-founder of a strategyand advocacy organization called
(06:30):
Patient Forward.
We're the only nationalorganization focused primarily
on eliminating barriers toabortion care throughout
pregnancy.
And I'm also, like Jen, a laterabortion patient advocate.
Jennie (06:44):
Okay.
Like I said, this whole serieshas been focused on abortion
later in pregnancy.
And sadly, we were at the end,but I'm so grateful for Patient
Forward for all of their help inmaking this series happen.
It would not have happenedwithout y'all.
We wouldn't have had suchamazing guests.
But now that we're at the finalepisode, I thought it was a
(07:04):
good time to sit back for asecond and think: what is the
thing that you think is missingfrom the general narrative
around abortion later inpregnancy?
And I don't know who wants togo first.
Erika (07:16):
Oh, I do! Well, I mean, what's interesting is that I
think what is, to me, the reasonthat we wanted to do this
episode is that the central sortof intersection of later
abortion and later recognitionof pregnancy is so important.
It's so relevant that wethought that it deserved its own
(07:36):
episode and its own dedicatedtime because it is so sort of
systematically erased from theconversation in most instances.
So to me, that's the one I'llpick.
I could give you a bulletedlist, but I know Diana and Jen
will have good additions aswell.
But I'm going to start withjust later recognition.
(07:57):
I mean, I just think it's justso crucial and that's why I'm so
excited to talk about it today.
I
Diana (08:03):
I think that later abortion is really the target of
the most hateful languagearound abortion and so
misunderstood.
And the misunderstandings seemto trivialize people's decision
making in a way that's justridiculous.
(08:24):
And so, like Dr.
Shelley Sella says, if you canunderstand third trimester
abortion, you can understand allabortion, that there's
something, if you couldunderstand all abortion,
understand why someone could belate in seeking an abortion, you
will understand so much moreabout all of abortion and all of
the massive barriers that havebeen imposed on people to
(08:46):
getting an abortion,particularly affect later
patients and make everybodylater or nearly everybody later.
It slows people down.
So at the same time, we'remaking abortion, we're heaping
on stigma.
We're also making everybody belater.
It's, it's a crazy world.
Jenn (09:07):
I really agree with everything that's been said.
For me, I think there's areticence to fully embrace later
abortion seekers with the samerights protecting fervor that we
hear about earlier abortionseekers, particularly among our
own, you know, major reprorights organizations.
(09:31):
And I think there's a lot offocus on the reasons why
somebody is seeking an abortionwhen they're later, but there's
not a lot of focus on what drovethis later.
Why is it later now?
And what outside the personwho's seeking the abortion could
have driven the person thislate?
(09:52):
So, yeah, I think that thatreally needs to be talked about
more.
And I'm excited to talk aboutit today.
Jennie (09:58):
Me too.
I'm so excited to have all ofyou on to talk about this.
Let's maybe start with Diana.
since you were the leadresearcher on the Turnaway
Study, and you found that therewere two common pathways that
people experienced when theywere needing a later abortion.
Can you explain them and whylater abortion will always be
(10:18):
needed?
Diana (10:19):
Sure.
One thing that I think wasn'tfully recognized before the
Turnaway Study was that somepeople are late to discover
they're pregnant, and there's anassumption that somehow that's
because they're irresponsibleand instead what we find is that
(10:40):
people have a huge range ofexperiences with pregnancy and
some people have the benefit ofnot being nauseated and not
being tired and not having allthe symptoms of pregnancy.
For wanted pregnancies that's awonderful blessing to not
experience some of the negativeside effects but if you weren't
trying to become pregnant thenit's very possible for to spot
(11:03):
throughout your pregnancy andnot realize you're pregnant
until quite late.
And so I think that this lackof sympathy for late recognition
of pregnancy is a problem.
We also find that people whoare using contraceptives in the
month they conceived are muchmore likely to be late, which
(11:25):
makes sense because they weredoing everything they could to
avoid becoming pregnant.
And so they thought they werecovered.
And many people, manycontraceptives, contraceptive
methods, you don't get periods.
So there's nothing to miss.
So you can be late indiscovering that you're
pregnant.
So one major reason that peopleare late in seeking abortion is
(11:47):
that they were late to discoverthey are pregnant.
All these states with six-weekbans just completely make
abortion unavailable for thesefolks.
So in fact, if we're talking,if you look at people who had
abortions in the thirdtrimester, a third of them only
discovered they were pregnant ator beyond 20 weeks.
This is in the Turnaway studywhere we've removed people who,
(12:11):
not including people with fetaldiagnoses, which also happen
later in pregnancy, or maternalhealth problems, which also tend
to emerge throughout pregnancy,specifically in the later half
of pregnancy.
So late discovery of pregnancyis a major thing.
And the other is barriers togetting abortion slow people
(12:32):
down.
So trying to make abortion moredifficult to get.
There are laws that explicitlymandate waiting periods.
So that exactly slows peopledown by law.
And my colleagues here at UCSFAnswer have found that a 72-hour
waiting period doesn't slowpeople down by 72 hours.
(12:55):
It slows people down by morethan a week because getting all
the logistics to get somewhereand having an opening at the
clinic Our laws, the ones thatraise costs, that increase the
cost, those slow people downbecause people are waiting,
trying to raise money to pay foran abortion.
And anything that increases thedistance slows people down.
(13:17):
So all of these abortion bansthat make abortion, clinic-based
abortion illegal in certainstates will dramatically slow
people down.
And we've found that thefraction of people getting
second trimester abortions,pre-DOBs, from these states with
bans was 8%, and it's 17%post-dubs.
(13:37):
So, it's more than doubled.
So, abortion bans slow peopledown by making people travel
vast distances.
So, money, distance, both ofthose dramatically are a major
cause of people needing to havelater abortions.
Jennie (13:53):
Yeah, I think that's one of those things that people
think of a lot of those abortionbans, like waiting periods or
anything else that can slowpeople down in a vacuum or think
of them as like this one thingand not understanding how they
all interact together to pushcare further out of reach
because it's not just a waitingperiod it's clinics in your area
(14:16):
have closed and you have totravel further and that makes
the cost more expensive and nowyou can't get a medication
abortion because you got pushedfurther out so then now you need
a procedural abortion nowthat's more expensive and you
need to raise more money sothese all interrelate and push
care later and make people haveto wait longer to access the
care they need.
Exactly.
(14:36):
And then I guess the only otherbit is, you know, I think a lot
of people try to talk aboutmaking abortion care easier to
access, which is great, but thenmaking it seem like, well, then
we don't need to worry aboutabortion later in pregnancy.
So, do you maybe want to talk alittle bit about why that's
important and why we always needto make sure that it's
(14:57):
available?
Diana (14:59):
Yeah.
So if it were just aboutpolicies that slow people down
and that was the only reasonthen better access would help
everybody but that isn't theonly reason people have later
abortions they have it becausethey didn't realize they were
pregnant they have it becausesome they got some information
about their life or theirpregnancy that made them
(15:20):
reconsider carrying to term andso there won't be a point where
you can say okay everyonedeserving of an abortion could
get it if only we set the limitat some number of weeks It's
just that life is toocomplicated.
People's situations are tooindividual for policymakers to
(15:40):
decide some limit that wouldwork for everyone.
Instead, you know, limitsstigmatize the people who are
beyond it and act like they'renot important.
And just backing up for anylisteners who don't know about
the Turnaway Study; the TurnawayStudy looked at people who were
too far in pregnancy to get anabortion compared to people who
(16:01):
are just under a limit and didget it.
And when we follow people overtime, we see worse outcomes.
In every way those two groupsdiffer, it's to the detriment of
people who couldn't get theirabortion.
So greater poverty, worsephysical health, poor outcomes
for their existing children,less likely to have an intended
(16:22):
pregnancy later.
I could go on and on and Iwon't, but it's important for
everybody to be able to makethis decision.
And it's not like people whohave later abortions, somehow we
should just throw them away andnot care.
Their outcomes, their kids'outcomes, their lives matter
too.
Jennie (16:41):
Yeah, I highly recommend if you have not read the book
about the Turnaway Study to readthat.
We'll make sure to link to theepisode that we had Diana on the
podcast before to talk aboutthe Turnaway Study so you can
get a much more in-depthunderstanding of the entire
study and not just the littlebit we were able to talk about
today.
Jenn, you have personalexperience with later
(17:02):
recognition.
Can you share a bit about thatand how it related to your
decision-making timeline?
Jenn (17:10):
Yeah, definitely.
So a lot of what Diana justsaid is personally relatable for
me and I'll touch on it.
So I found out that I waspregnant when I was 18.
And when I found out that I waspregnant, I found out that I
was well into my secondtrimester already.
(17:30):
And so to kind of set the seen,I was struggling with an eating
disorder at the time.
I had come home from college ona medical leave so that I could
attend eating disordertreatment in my hometown, which
was in New York State.
And I was going through thetreatment and I was getting
(17:52):
better, but my period wasn'tcoming back.
And it's a very common symptom,not always, but very common
that people who have restrictiveeating disorders might lose
their period.
Amenorrhea is the medical termfor it.
And so, you know, I had a teamof doctors who were working with
me at the eating disorderfacility.
(18:13):
And none of us were concernedabout my period because it just
made sense for my symptoms atthe time.
And it was probably a couple ofmonths into my treatment.
By the time I was just talkingto my mom and mentioning that my
period hadn't come back and shevery casually kind of offhand
said, well, there's no chancethat you're pregnant, right?
(18:35):
And I was like, oh my God, no,I'm on birth control.
And I had been on birth controlfor over a year at that point.
But what she said stuck withme.
And maybe a week or so later, Itook a pregnancy test and it
was positive.
And a little while after that,I got a blood test and that
confirms that I was pregnant.
And it was the blood test thattipped off how far along I was
(18:58):
or an estimate, which wasn'teven, it turns out, accurate.
But what was accurate was thatI was told that I was well into
my second trimester at thatpoint.
When I look back, I had a lotof symptoms of pregnancy and
those symptoms were masked bythe eating disorder that I was
dealing with.
I had nausea, but we thoughtthat that was part of the
refeeding process.
I was gaining weight, but I wassupposed to gain weight because
(19:21):
I was recovering from my eatingdisorder.
And so for that reason, Imissed it.
And the doctors that I wasworking with missed it.
None of them asked me if I waspregnant.
It was my mom who asked me.
So that was how I missed it andhow I found out.
Of course, it wasn't as easyas, okay, I'm pregnant.
(19:43):
Now let me get an abortiontomorrow.
So that's what I thought it wasgoing to be.
And I was all ready to make anappointment with Planned
Parenthood.
And then they told me that Icouldn't do a medication
abortion because of how faralong I was.
Because I found out that I waspregnant when I was already in
my second trimester, that meantI had less time to do all of the
(20:05):
things that anybody who findsout they're pregnant has to do
in order to make a decisionabout what they want for
themselves and for thatpregnancy.
And then in order to gather theresources necessary to make
that decision.
And so I thought I had enoughmoney for my abortion on my own,
but now I wasn't looking at amedication abortion.
Now I was looking at anabortion in a clinic that would
(20:28):
likely take at least two days.
because I had to go in first toprep.
And that was going to be a lotmore expensive.
We're talking tens of thousandsof dollars without insurance.
And I realized I didn't haveenough money.
So then I had to take a fewdays to think about how am I
going to come up with the money?
Am I going to tell my parents?
I had to psych myself up tohave that conversation with
(20:49):
them.
And they were immediatelysupportive.
I did tell them.
They were incrediblysupportive.
And I am beyond blessed that mymother had an insurance plan
that I was on that covered mostof my abortion.
That is like almost unheard of.
That's not the case for so manyother people, right?
So many other people have totake the time to actually gather
tens of thousands of dollarsout of nowhere in a country
(21:11):
where most people don't haveenough money in their bank
account to get through nextmonth.
So I had to make thosedecisions.
Then there were all kinds ofappointments I had to go to.
I went to see my OBGYN.
I had to get an ultrasound.
I had to get an appointment ata clinic that would do my
abortion where I was living onLong Island.
There weren't any.
So I had to go into Manhattan.
I'm lucky enough to live inclose proximity at the time to a
(21:35):
major city that had an abortionclinic that does later
abortions.
Most people do not.
Then when I got to the abortionclinic for, it was actually a
hospital, for my first day forprep, they did an ultrasound
that day.
And they said, wait a minute,you're even farther along than
we thought.
It's going to be a three-dayprocedure.
(21:56):
You have to come in for twodays of prep.
And then we'll do, so we can'teven do it this week.
We have to schedule you foranother week.
And so I had to wait anotherweek.
And at that point, they told meif I had been even a week later
than I already was, I wouldhave had to go out of state to
get the abortion because at thetime, New York State had a
cutoff of 24 weeks.
I don't remember if I was 23 or24 weeks.
(22:18):
I don't remember how theyinterpreted that cutoff at the
time, but I know that I got itas late as I possibly could in
New York.
And that was even though Itried to get it as soon as I
possibly could.
The moment I found out that Iwas pregnant, It was, and I
don't have it written down, butto my recollection, it was over
a month between finding out thatI was pregnant and getting the
abortion.
(22:38):
And I found out that I waspregnant already in my second
trimester.
And so that's how my laterdiscovery of pregnancy because
of my eating disorder greatlyaffected my abortion timeline
and pushed me later.
And when I look back on thatstory, I think about all of the
ways that I am deeply privilegedto have had access to
(23:00):
insurance, to have lived inclose proximity to a clinic, to
have lived in a state thatallowed me to get an abortion up
to 24 weeks when I could havebeen living in a state that had
waiting periods or a state thatdidn't allow me to do that at
all.
I believe myself to be verygrateful.
I mean, I am very grateful andI believe myself to be very
privileged.
It took me a long time to getto that point because for a long
(23:22):
time after my pregnancy and myabortion, all I felt was
frustration and despair that Ihad gotten it so late.
Jennie (23:29):
Jenn, thank you so much for sharing your story I think
it's so important that peoplehear a full range of experiences
that people have because Ithink a story like yours is not
one you hear as often rightthere is so much focus on the
the fetal indication that youdon't hear the other stories as
(23:49):
loudly they don't break throughas much I think some of them are
shared but but they're not theones that are being like
heralded and that you hear inlike big loud like crashing like
This is why it's so important.
And these are all importantthat people are able to access
the care they need.
Jenn (24:06):
Yeah, I really agree.
For a long time after I got myabortion, the only time I heard
people mention later abortionwas either to just flat out
demonize it or to say, no, weneed later abortion because
people find out about fetalindications and we need a path
(24:26):
for them to be able to makedecisions about their pregnancy
and their fetus.
like, fully.
And I was not hearing, we needlater abortion because some
people just need an abortion andit's late.
And that was...
And that just drives stigma,right?
Yeah, I felt...
You feel alone.
I felt very, very stigmatized.
You know, I, for a very longtime, I was thinking, oh my God,
(24:47):
what's wrong with me?
Like, what is wrong with methat I needed an abortion for
some completely differentreason?
Like, why did it take so long?
I should have realized sooner.
And also, like...
a little emotional justthinking about it i always do
also the i mean the moststigmatizing part is feeling
(25:11):
like people people canunderstand later abortion when
it's for fetal indication Evenif this next part isn't spoken
aloud, the implication is thatif you're getting a later
abortion for another reason,it's too late for you.
Like you shouldn't get one.
We're not okay with that.
And that was the message that Iwas hearing and internalizing
(25:35):
for like 10 years after myabortion until I got connected
with Erica and Patient Forwardand until I found out about
Diana's research.
And all of that just changed mylife.
Jennie (25:46):
This whole idea that I feel like permeates like all of
thisanti-abortion stigma that we all wade through everyday, and the idea that there are "good abortions" and "bad abortions"
vs just your experience and the healthcare you need access to.
Erika (26:17):
Yeah, and I like, I just, sorry, this is Erika talking
now.
I guess I just want to reallyhighlight and not try to cover
that this is stigma that isperpetuated by people who get
paid to advocate for abortion.
Okay.
This is anti-abortion stigma.
And I just think that we arelike past time.
(26:40):
This is when we need to behaving these conversations now
that we're no longer sort ofunder the thumb of Roe.
Now is the time to askourselves and to really take
accountability, I think, topeople like Jenn and so many
thousands of other people whohave been made to feel this
shame and stigma by the peoplepaid to protect abortion.
(27:03):
It truly blows my mind.
Whenever I'm privileged enoughto hear Jenn or any later
abortion patient tell theirstories like this, it just
really kills me.
I just These are not the antis,but it is anti-abortion,
anti-abortion stigma perpetuatedby supposedly pro-abortion
(27:26):
people.
Because what our exceptions aresaying is that we need
exceptions to keep the, quote,wrong people from, quote,
"misusing abortion services."Who is that?
Who are those people?
Not Jenn, right?
I'm sorry.
I'm so fired up.
I'm so angry.
Every time I hear Jenn's story,I just get so angry all over
(27:47):
again.
Jenn, thank you for sharing.
It means you have changed theworld.
Here's the other thing.
Before Jenn telling her storylike this, I mean, it was so
few.
There are a couple other peoplein this whole country who would
be willing to talk about theirexperiences like this, and I
truly believe it has changed theworld.
(28:07):
I just am so grateful to you,Jenn, for for continuing to tell
your story and to represent themajority of later abortion
seekers.
The majority.
Jenn (28:21):
Thank you, Erika, for your anger on my behalf and really
on behalf of everyone else whoneeds a later abortion.
Yeah, I mean, I would watchdebates, political debates.
I would watch politicians thatI planned to vote for talk about
why we should have, you know,viability restrictions.
(28:42):
And depending on yourdefinition of viability, like I
might not have been able to getan abortion under a viability
standard, given the timeline ofmy pregnancy or people talking
about exceptions.
And my pregnancy would not havefallen under any of the major
exceptions that are sofrequently talked about for such
a long time.
And still, to this day, today,still, even now that we no
(29:07):
longer have Roe and we can makeour own framework, even still to
this day, I hear pro-choiceorganizations supporting
restrictions on later abortion.
And I take it personallybecause it feels like saying if
you need an abortion for any ofthe reasons that our movement
(29:30):
has accepted people need to needabortions if you just need an
abortion because you don't wantto be pregnant and you have
bodily autonomy and we love andsupport your bodily autonomy
that's great but if you need itafter a certain date We don't
care about your bodily autonomyanymore.
And it was like, well, but why?
Why doesn't my body and mydecision and my future and what
(29:53):
I want for myself, why doesn'tit matter as much as people who
didn't have an eating disorderso they found out earlier or
people who weren't on birthcontrol so they found out
earlier or people who just foundout earlier, period?
It's deeply stigmatizing andthat stigma can do serious
damage.
For a long time, I thought thatmy abortion had been traumatic.
I've done some work since.
And now I understand it was mypregnancy that was traumatic.
(30:15):
It was the fact of realizing Iwas pregnant so late.
And then all of the stigma thatI internalized that I used to
beat myself up.
It's just unacceptable for ourmovement to put people in that
position.
Erika (30:29):
No, that's important.
And just in case like maybe alittle bit of data is helpful to
back you up.
I think it's also would besurprising to a lot of people
how common later recognition ofpregnancy is.
is.
I think that there's this ideathat, you know, people just
(30:51):
immediately feel nauseous,pee on a stick, and you know
that that happens at like fiveweeks or something.
But we know that one in 13.5pregnancies are discovered after
12 weeks of all pregnancies.
That's a lot.
And that's after therecommended window for
medication abortion in theUnited States, which is how the
(31:11):
vast majority of people aregetting care right now.
And so you understand that itactually affects so many people.
I think we've been sort ofvictims of this small numbers
theory where, you know, thisdoesn't affect that many people,
therefore compromising on theirbacks isn't that big of a deal.
But in fact, it is a big deal.
The 1% of abortions happenafter 20 weeks is a fake stat
(31:35):
based on a deliberate misreadingof CDC data.
And we know that laterrecognition is incredibly common
So this not only affectsthousands and thousands of
people a year, but we know thatit tends to affect people that
are already living at themargins through no fault of
their own, who lack healthcare,housing, who are experiencing
(31:58):
food insecurity.
It's the same people, youngpeople.
I mean, Jen was young.
Young people areoverrepresented among later
abortion seekers and those whodiscover pregnancies later for
very obvious reasons.
I think I think that it's very,I mean, if you think about it
for just a moment, it becomes, Imean, honestly, sometimes I
think, how does anyone discovera pregnancy early?
(32:20):
Like when you look at the sortof systemic forces at play,
you're like, wow, in theseUnited States, people actually
can figure out they're pregnantearly and get to an abortion
early.
It seems miraculous that mostpeople in fact can, because the
structures that we've built makeit very easy for someone to be
in Jen's position.
(32:41):
or, you know, I haven't talkedabout this much, but I
discovered a pregnancy later.
I had a third trimesterabortion and soon after I was
pregnant again a month later andmy body was very out of whack.
And a couple months after that,I had a miscarriage in a Whole
Foods bathroom and it was verytraumatic.
(33:03):
I was in the Whole Foodsbathroom for hours.
My husband and partner atPatient Forward, Garin, had to
like buy me a very expensive,you know, like yoga outfit from
Whole Foods because Icompletely, I mean, I had a very
dramatic miscarriage in apublic bathroom.
And, you know, after that, wedecided to see a fertility
(33:24):
specialist because by then I hadhad a lot of losses and we were
actively trying to becomeparents.
And, you know, months later, Iwas in a fertility clinic and,
you know, they took our history,heard about all my complicated
pregnancies.
And then they said, okay, let'sQuick do a physical exam and
(33:44):
the doctor did an ultrasound andhe said, there's a baby in
there.
And we said, what?
The nurses all start cryingbecause they've heard our
history.
And they're like, oh my God.
And they're all saying, they'relike, well, we don't normally
get good news this quickly atthe fertility clinic, but
there's a baby in there and sheappears to be around 14 weeks.
(34:07):
So you really need to get intoa OB immediately.
And sure enough, and we wereshocked.
By the way, another commonalitybetween my story and Jen's is
that we were both activelyseeing, like having very active
medical care, like we wereregularly being seen by doctors.
After my miscarriage, I went tomy OB to be checked.
(34:29):
And they said, Oh, yeah, well,you just got to let it complete,
you know, because, you know,they just did sort of an oral
exam.
And that was it, there was nofollow up.
So no one noticed that I wasstill pregnant and likely lost a
twin.
You know, again, pregnancy canbe a hellscape.
You know, it's just sosquirrely.
(34:49):
And it just can't possibly becontained by the law.
I mean, it just is so, I mean,it's lunacy.
But in our case, we were verylucky because, again, we were
actively trying to be parents.
So we got into prenatal care asquick as we could, you know,
and that's now our kid.
You know, that's our child.
That's, you know, that's howshe came into this world.
(35:11):
And we were already doingabortion advocacy.
And so to experience laterrecognition like that just
really brought it home for us.
You this really could happen toanyone.
All of the sort of stigmatizingconventional wisdom that we all
hear is complete bullshit andwe have to stop perpetuating it.
And I think a way to fight thisdisinformation and stigma is by
(35:36):
hearing stories like Jen's andso many others who just really,
anyone hears Jen's story or Ican speak for myself.
I heard that story and said,well, that could have been me at
18 very easily.
And I think we can all identifywith these stories when we hear
them.
Jennie (35:52):
Okay. So that is, I feel like such a perfect place to
end, but we also have to get toErika's part, which is the
policy and advocacy part.
So Dr.
Foster talked about theresearch Jenn walked through and
Erika as well, personal reallife experiences.
Erika, do you want to talkabout how all that leads to
policy and the reality of doingadvocacy around abortion later
(36:15):
in pregnancy?
And also what are you seeingright now for the legally
landscape?
Is it getting better?
Is it getting worse?
What are we seeing?
Erika (36:25):
Well, there's good news and bad news, which I'll share.
And then, of course, I'm soeager to hear Jenn and Diana's
thoughts on this question, too.
But from my perspective, first,the good news, research shows a
monumental shift in culturechange.
That's good news.
A majority of peopleconsistently say now that they
do not want governmentinterference in pregnancy
(36:46):
decisions, including explicitlyin the third trimester.
So public opinion hasundoubtedly moved, and it's
moved towards supporting and notpunishing people throughout
their pregnancies.
Now, before people come for me,does that mean people are not
still uncomfortable aboutabortion later in pregnancy?
Sure.
(37:06):
But they're also realizing thatthey can both feel
uncomfortable about somethingand not want to meet that
discomfort with giving thegovernment tremendous power to
police pregnancies.
So that's good.
Morgan, Good news is that moreall-trimester clinics are
opening more than ever before,and they're led by young,
diverse clinicians who areoffering modern, trauma-informed
(37:30):
care.
This is great news.
More good news, I want tohighlight our colleagues in
Massachusetts.
For the first time in anystate, Massachusetts advocates
are loudly and boldly working torepeal the state's viability
limit and recognizing thatgovernment has no place in
pregnancy decisions.
(37:50):
And that is the first timewe've ever seen that.
Other states have repealedviability limits, but they've
done it quietly.
This is the first time we'veseen a whole campaign around
doing it.
And by the way, Massachusettsvoters are supporting it by 66
percent, according to thepolling.
So that is great.
Some less good news is thatwe're still overinvesting in
(38:10):
later abortion bans.
Since Dobbs, 10 states haveenshrined viability limits into
their constitutions andcollectively ballot measures
with viability limits have costupwards of $200 million
altogether, and we're expectingto see more of these bans on
state ballots next year.
Obviously, we do not think thatit's a good idea to spend
(38:31):
hundreds of millions of dollarson protecting the state's right
to criminalize people later inpregnancy.
It is a horrible trend sinceRoe.
That's been kind ofheartbreaking.
More bad news, 41 states dostill ban abortion at some point
in pregnancy.
Nearly half of those states arearound viability, usually
interpreted on theground around 24 weeks. So
there's still a long way to go,you know, before the field meets
(38:54):
people where they are in laterabortion, which is to say people
want full reproductive freedomthroughout pregnancy.
They don't like pregnant peoplebeing criminalized.
And we think it's time that ourpolicies meet people where they
are.
That's sort of the long and theshort of it.
But I'm eager to hear what Jenand Diana think as well.
Good news.
Good, good, bad policy news, Iguess, is the sort of broad, the
(39:16):
broad prompt.
Diana (39:17):
It's this is such an honor for me.
me to be on this podcast withJenn and Erika.
I have never met Jenn beforeand her story is such a perfect
capture of so much scientificdata.
I know that's not how shewanted to live her life is to
act out scientific data, but wehave found that young people are
(39:39):
much later to recognize they'repregnant because their periods
are irregular anyway, becausethey may not be familiar with
all the symptoms of pregnancy.
People with chronic healthconditions which she was
experiencing also are later todiscover they're pregnant
because often chronic healthconditions have the same
symptoms of pregnancy.
(39:59):
And Erika's story of havingbeen recently pregnant and that
explaining why she was late todiscover pregnancy, that's also
something we see because havingbeen pregnant and your body's
still recovering and feelingterrible, especially if you
deliver the child or...
Had a massive miscarriage inWhole Foods.
(40:21):
People's bodies experience lotsof symptoms for lots of
reasons, and it's not alwayspregnancy.
And so it's perfectlyreasonable that you could not
know you're pregnant.
You can also just not havesymptoms.
So this is, yeah, really anhonor to be with people who are
willing to share their personalexperiences.
(40:42):
And the science has their backscompletely.
Jennie (40:46):
I always like to end the podcast by not just talking
about like what's bad or what weneed to change, but how can the
audience get involved?
So what are some of the thingsthe audience can do to get
involved in this conversation orthis fight?
Erika (40:58):
I'll start.
I guess what we know, bothbecause we're people who notice
things, but also this is backedup by research, is that stories
go a long way in helping changehearts and minds.
And what we also know is thatsecondhand stories, like telling
someone's story that you heard,that you read in the news, can
(41:19):
can be as effective as hearingit from the person themselves.
There are organizations thathave spent a lot of money on
doing a lot of deep canvassingand that's one of their big
takeaways.
And I think if you're listeningto this podcast today, you now
know Jen, now you know me.
And so when your friend orfamily member or coworker says
(41:39):
something wrong and stigmatizingabout later abortion care, you
can say, well, you know,actually my friend Jen
experienced this when she was ateenager.
And she was going through ahard medical event and blip,
blop, bloop.
You know that story now.
You know us.
We're friends.
And so please use these storiesto help fight disinformation.
(41:59):
That's something you can do.
Jenn (42:01):
I just really agree.
I think for me, the more Ishare my story, the more
empowered I feel in my ownexperience and the less shame
and stigma I feel.
And the more I share my story,the more people come up to me
and say, oh my gosh, that's socrazy.
What happened to you?
And I'm I'm like, yeah, and ithappens to so many other people
who don't have the resourcesthat I had.
(42:23):
So I just want to echo, Ithink, sharing if you have a
later abortion story or a laterrecognition story and you feel
safe sharing that, absolutelyplease do if that's a place
where like if you're comfortablewith that, but also just
talking about it more ingeneral, pushing back on
(42:43):
misinformation in general whensomebody says something that
doesn't feel accurate or whensomeone one says something
stigmatizing, even if it feelsuncomfortable to push back,
doing so as long as you feelsafe is so important and can
help make people think, oh, Ididn't realize that the way I
was phrasing this isexclusionary.
I didn't realize the way I wasframing this leaves out people
(43:05):
who are having this experience.
Maybe I need to rethink how Italk about later abortion.
The more you share, the moreminds you can change and hearts
you can open.
Diana (43:15):
And I'll add, in addition to the share of stories and
humanizing the experience ratherthan letting it be some
ideological debate that this isactually a human experience that
is so shared and that peopledeserve compassion and humanity
is that there's so much to beoutraged about right now and
(43:40):
that's a problem for so manyreasons but one is that our
attention is constantly beingpulled by other things and there
I know that abortion funds haveseen a drop off in their
funding.
So especially funds that helplater abortions like the Bridget
Alliance are worthy recipientsof support so that if you can
(44:04):
keep that cause in mind whilewe're faced with such an
onslaught of important issues,that this is one that still
deserves attention andincreasingly deserves attention.
Jennie (44:16):
Okay.
I want to be respectful ofeveryone's time, especially
since since I know Diana has torun.
So Diana, Jenn, Erika, thankyou so much for being here
today.
It was so wonderful to get totalk to all of you.
Diana (44:27):
Yeah, thank you, Jennie and Jenn and Erika.
Really great to spend time withyou.
Thanks so much.
Erika (44:32):
100%.
Same, same.
Jenn (44:35):
Yes, thank you, everybody.
Jennie (44:37):
Okay, y'all.
I hope you enjoyed myconversation with Jenn, Erika,
and Diana.
I had so much fun talking tothem about abortion later in
pregnancy and later discovery.
It was just such a great seriesand I am so grateful to
everybody at Patient Forward forhelping make this happen.
So thank you again, and I willsee everybody next week.
If you have any questions,comments, or topics you would
(44:59):
like us to cover, always feelfree to shoot me an email.
You can reach me at jennie@reprosfightback.com, or you can
find us on social media.
We're at Repros Fight Back onFacebook and Twitter, or
@reprosfb on Instagram if youlove our podcast and want to
make sure more people find it.
Thanks, all.
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