The National Institutes of Health is hosting a series of regional meetings across the nation to gather input and ideas from scientists and communities about their research priorities to promote women’s health. The University of California, San Francisco, is hosting one of these meetings next week, during its conference: Moving Into the Future – New Dimensions and Strategies for Women’s Health Research for the National Institutes of Health
On Wednesday, May 27th, there is to be a public hearing which provides the opportunity for “individuals representing organizations with an interest in research areas related to women’s health to provide written and/or oral testimony.”
I am very excited to report, that I, along with Exhale Talkline Volunteer, Danielle Thomas, will both be presenting oral testimony about the need for research t0 promote wellbeing after an abortion. Another Talkline Volunteer, Elsa Valmidiano, submitted written testimony. All of our testimonies will become a part of public record.
I am happy to provide you with the full text of my written testimony:
In a recent New York Times interview about health care, President Obama said: “Consumers have gotten more active in their own treatments in a way that’s very useful. And I think that should continue to be encouraged. To the extent that we can provide consumers with more information about their own well-being, that, I think, can be helpful. ”
My name is Aspen Baker and I am here to testify and advocate for research to better understand what women, and their loved ones, need after an abortion in order to support their own emotional well-being.
I am the founder and Executive Director of Exhale (www.4exhale.org), an Oakland, California-based national nonprofit organization which provides direct emotional support services to women and their loved ones after an abortion.
Our service is nonjudgmental and without political affiliation. Our mission is to create a social climate in which each person’s unique experience with abortion is respected, supported, and free from stigma. We call that mission “pro-voice.”
Exhale is a nationally renowned, award-winning, multilingual organization. We have been featured in Glamour magazine, The New York Times magazine, and on National Public Radio and CNN, among many others. We are currently partnering with the Advancing New Standards in Reproductive Health program at UCSF to study women’s emotions after an abortion, a research project that is the first of its kind.
In my testimony today, I will:
• share my own personal experience with abortion, which led me to found Exhale;
• describe the work of Exhale and what we have learned from women regarding their own well-being after an abortion;
• describe the social and political landscape in which abortions take place today, and how Americans’ view of emotional health has changed;
• explain how past research on abortion and mental health falls short;
• and explain what new research is necessary for women’s health and well-being today.
Personal Experience Led to the Founding of Exhale and a Nonjudgmental Talkline
Ten years ago in August, I had an abortion. I was 23 years old, I had just graduated from college, and I made what was for me the very difficult decision to end my pregnancy. After the abortion, I remember feeling relieved that the angst-ridden decision-making process had finally come to an end, as well as the unfamiliar medical procedure, which I had been dreading, to say the least.
I also remember feeling totally surprised that nowhere in the chain of medical services did anyone talk to me about what I might expect to feel afterward, or what I could do to take care of myself emotionally. No one offered me any resources to contact afterward for counseling, should I need to. My abortion, while a simple medical procedure, was personally, a very emotional one, and I wanted support in acknowledging and processing those feelings.
When I looked for resources myself, I found instead politically and emotionally charged services that claimed to support me if I felt traumatized, or if I felt liberated. Nowhere did I find sound, helpful information grounded in credible research into women’s real experiences after abortion.
Today’s Social and Political Landscape, and New Beliefs About Emotional Health
What I didn’t know then, but what I know now, is that I was not alone – either in my abortion experience, or in my search for information about my own emotional well-being.
According to the Guttmacher Institute, abortion remains one of the most commonly performed medical procedures in the United States, and approximately one in three women will have one in her lifetime.
In 2005, 1.21 million abortions were performed, down from 1.31 million abortions in 2000. In 2005, 208,430 women obtained abortions in California, a rate of 27.1 abortions per 1,000 women of reproductive age. The rate declined 13% since 2000, when it was 31.2 abortions per 1,000 women 15-44. Abortions in California represent 17.3 of all abortions in the United States. In short, abortion is incredibly common.
And yet, as we all know, abortion is so much more than a simple medical procedure. It is at the center of a major political and moral debate that has been raging for decades. The debate raises important questions about our ideals and our values around human rights, women’s health, and fetal life. Human dignity is also at stake in this debate, as opposing sides attack each other on emotional, political, and social grounds. In fact, as we all know, the conflict over abortion can be so intense that it is commonly referred to as a war.
But while this “war” around abortion has raged, American life has changed dramatically. Research shows we’ve increased our emotional intelligence, our emotional IQ. We have gained a respect, understanding, and a vocabulary for feelings about a whole range of life events, and we see the importance of being able to identify, share, and process those feelings. We want to know how to be physically and emotionally well, through good times and bad, and we expect our health care providers to be able to give us the information, resources, and support that helps us experience well-being. We also take a much more active role in our own health, as President Obama said in his interview.
But when it comes to abortion, no research exists to help us do that. We need new scientific research to better understand what women, and their loved ones, need after an abortion in order to support their own emotional well-being, and help them take a leadership role in their own care.
What Women and Health Care Providers Are Telling Exhale
I founded Exhale in 2000, and in 2002, we launched the nation’s first post-abortion talkline, here in the Bay Area, that is neither religion-based nor politically affiliated. My co-founders and I envisioned Exhale as a safe space for every woman who has had an abortion, and her loved ones, across the range of experiences, beliefs, and political persuasions. At Exhale, we believe that after an abortion, whether you are pro-life or pro-choice, you deserve to have your own unique experience seen and heard, and to get what you need for your long-term emotional well-being. This is the “pro-voice” message.
Exhale’s national, multilingual talkline is operated by trained peer counselors who have undergone extensive training in our empowerment-based model. The number one way people learn about our service is through direct referral from abortion providers throughout the nation. The second – and the fastest growing – way people learn about our service is through the Internet. They find Exhale after searching for “abortion counseling,” “after abortion support,” and “women after abortion,” among many other terms.
We know that after an abortion, many women go online to search for ways to share, connect, and communicate about their personal experience with others who can relate to them and support them in a nonjudgmental and respectful way. We believe this is a positive trend that can produce even more support for women if they also find, in addition to nonjudgmental services like Exhale, sound and helpful information that is the result of good research.
Since its launch in 2002, Exhale’s post-abortion talkline has received more than 18,000 calls. We reach more than 35,000 women every year through our outreach and education efforts. We have trained more than 100 Bay Area women to be volunteer counselors on our talkline, and we recently received an award for “Excellence in Nonprofit Volunteer Management” from the Volunteer Center of the Bay Area.
Because of Exhale, women now have more access to nonjudgmental emotional support after an abortion than ever before. At a clinic, they are now more likely to speak to a staff person who is trained to discuss emotions around abortion, and they are more likely to receive a referral to the Exhale talkline or other nonjudgmental resources. Previously unheard of resources are now available to them: They can read other women’s stories online in our zine and in several mainstream media publications thanks to our outreach; they can send or receive a post-abortion e-card that recognizes their unique experience; and they can engage in pro-voice advocacy by sharing their personal abortion stories in a public forum, like a blog or web video channel hosted by a nonjudgmental resource.
Exhale’s efforts over the past seven years have made a significant difference in the lives and emotional well-being of women who have had abortions, and their loved ones. They are able to take a leadership role in their own well-being. But there’s more to be done.
We need you, the National Institutes of Health, to join us in our mission to understand, acknowledge, and support the emotional needs of women post-abortion. We need research that helps us better understand women’s emotional experiences, and that provides women with the helpful information they need to support their own well-being, and their own mental and reproductive health.
Why Past Research Is Not Enough
Since the 1970s, research regarding women’s emotions around abortion has focused on whether abortion, on its own, has negative consequences for women’s mental health, and it was meant to serve one side of the political debate or the other.
Famously, the Surgeon General under President Regan determined that despite the popular claim that abortion has negative consequences on women’s psychological health, the data behind that claim was insufficient. Most recently, in 2008, the American Psychological Association completed another review of existing literature, and concluded there is no evidence of negative mental health effects from abortion. They found that the research that did show negative emotional impact had severe methodological flaws that made the data unreliable. Further scientific inquiry into women’s mental health after an abortion has found other predictors for poor mental health outcomes, including pre-existing mental health conditions, a lack of social support, a lack of self-esteem, and the heated public controversy around abortion, just to name a few.
It is safe to say that there is scientific agreement that abortion, on its own, rarely causes severe negative outcomes for a woman’s mental health.
But what else about women’s emotional well-being after an abortion has been determined by science, beyond the fact that abortion, on its own, does not damage women’s mental health? At a time when the emotional experience of any life event is publicly accepted as important and relevant to our overall health and wellness, there remains a great deal to be studied and researched about abortion.
Today, more than ever, there is a great need for sound, thorough research into women’s emotional well-being after an abortion: The abortion procedure is so common, the families and communities impacted are so diverse, the debate around abortion is so loud, and the overwhelming stigma – which, according to NIH’s own definition, “threatens psychological and physical well-being, and helps to perpetuate health inequalities within societies” – is so harmful that it is time for the National Institutes of Health to proactively address the emotional needs of women who have abortions, by using its support and resources to undertake and share sound, thorough research into women’s real experiences.
This research would:
• Assess the psychological and emotional needs of women after an abortion.
• Evaluate the effects of different post-abortion emotional support models on a woman’s well-being.
• Examine men’s emotional experience with abortion.
• Understand the characteristics of healthy coping after an abortion in diverse communities.
• Explore the connection between the social experience and the emotional experience of abortion.
Why This Research Matters
It is critical that the National Institutes of Health address emotional and mental health as part of its strategies to promote women’s health and wellness. And when an issue is as common and as contentious as abortion, it is even more critical: not only can research promote long-term emotional well-being, it can also dispel politically and emotionally charged claims that distract from emotional well-being.
Benefits of this research include the following:
• Provide medical and emotional care providers with the information we need to support patients’ emotional resiliency and well-being in the long term.
• Provide intimate partners, family members, and communities with information about how to be a source of comfort and support for their loved ones and each other.
• Provide women with the tools and information to make well-informed decisions about our health, including pregnancy and abortion, and strategies to promote our own emotional well-being.
• Provide information to women and health care providers about appropriate interventions and responses when a woman does have negative emotional consequences after an abortion.
As a woman who has had an abortion, as the co-founder of an organization that now serves thousands of women and men each year, and as a peer counselor who has listened to many women share their stories and their feelings after an abortion, I know that Exhale has already met a need, just by providing safe, nonjudgmental emotional support for women and men after an abortion.
But I also know that we need to do more. We need to provide women and men with the kind of helpful, well-researched information that supports their well-being after an abortion. We need sound, detailed research that addresses the broad range of experiences and feelings people have around abortion, immediately afterward and far into the future. We need research that reflects the real experiences of people like the women and men who call Exhale to share their stories, receive emotional support, and achieve emotional well-being.
Today, I call on the National Institutes of Health to join us in this work. I ask the NIH to take a leadership role, as only it can, in providing the research and information that will help today’s health care providers and patients achieve emotional well-being after abortion.
Pro-Voice Ambassador Danielle Thomas
Danielle volunteers in many capacities for Exhale, her main role is as a talkline counselor. Currently she is a Program Associate, specializing in family financial stability, at United Way of the Bay Area (UWBA). Danielle focuses on partnering and building relationships with Bay Area nonprofits that help the community thrive. Prior to UWBA, Danielle was a Patient Advocate at Whole Woman’s Health, a clinic specializing in abortion. Through this work she was exposed to both the medical and emotional sides of abortion. Danielle has long held a passion for women’s reproductive health and since her work with Exhale, has developed a strong passion for evolving the abortion conversation.
In her written testimony, Danielle writes:
“I’m so glad this service exists” is a statement I hear frequently as a counselor on the Exhale talkline. Many times women have no support or safe space to speak about their abortion experience. Exhale provides that support and space, and I continually bear witness to the positive impact the counseling model has on the emotional health of our callers.
A prevalent emotion in my calls is one of surprise. Women are surprised that the feelings they’re having are experienced by others, that abortion happens a lot and that people still aren’t talking about it. These simple facts are surprises because as a society we still haven’t made it okay to talk about abortion in a safe and understanding way. These women, and the people in their lives, desperately want to connect with others who’ve had similar experiences. Women with abortion experiences long for a place where they can be understood and accepted.
The Exhale talkline allows callers to share their story free from judgment and stigma, and the more shifts I have, the more I realize this environment isn’t available anywhere else. The lack of availability of this thinking and space coupled with the impact I see drives me to dedicate myself to Exhale and its mission more and more. This environment and the “pro-voice” spirit are true catalysts for change.
Pro-Voice Ambassador Elsa Valmidiano:
(Elsa, at right, doing outreach for Exhale)
Elsa is a poet and Los Angeles native. She currently resides in Oakland volunteering at various feminist and pro-choice organizations throughout the Bay Area. In 2008, Elsa received Exhale’s Rachel Falls Compassion Award which is given annually to a talkline counselor who best embodies the spirit and values of Rachel Falls: exuberance, strength, empathy, commitment, vision and compassion.
In her testimony, Elsa writes:
In 1997, I had an abortion. Openly making that statement is ironic to me because for several years I could not talk about it and kept it a secret.
When I became pregnant, I was 19-years-old and in an abusive relationship. My parents were strict, conservative, devout Filipino Catholics. They had no idea I was even in a relationship at the time. Sex and relationships were never discussed in my household but I learned that the very idea of being pregnant and unmarried was an absolute shame and disappointment, not just upon a daughter, but on an entire family. A small part of me wanted that baby at 19, but I could not live with the shame and disappointment for the rest of my life.
It was very easy to hide these things from my parents because I was away at college. Having grown up in a tight-knit Filipino community, I also did not feel comfortable sharing my abortion with my friends back home for fear of being criticized, judged, and outted. In the end, I felt my relationship, pregnancy, and abortion were absolutely outside the realm of what anybody would accept and understand about me. The result was that I suffered from the emotional scars of my abortion because there were no safe spaces available for me to openly talk about it. Because I could not talk about it, I felt I could not completely heal.
When I moved to the Bay Area, I sought volunteer opportunities and was thrilled when I found Exhale. Finally, I thought, here is a non-judgmental organization that provides a wonderful service with valuable information and referrals. Exhale is a service I wish had existed for me in 1997.
Volunteer Experience as an After-Abortion Counselor
On the talkline, there are so many reasons why women have abortions. Some cannot financially afford raising a child, whereas others feel they are not ready for motherhood due to school, their career, or they do not have the support of a partner to raise a child. While these are just some of the reasons, under whatever circumstance that compels a woman to terminate her pregnancy, most women whom I’ve encountered on the talkline feel that they do not have the emotional support to see them through after the procedure. While abortion can be a difficult decision for any woman to make, it can even be more difficult to deal with one’s emotions following an abortion.
After listening to more than one hundred women on the talkline and looking back at my own personal experience with abortion, I never want anyone to face the isolation and loneliness that haunted me for many years. For me, being a counselor for Exhale is a great honor where I can provide a safe space to callers marking a healing process, as well as a validation process, for many. For those that feel relief and empowerment in contrast to sadness and guilt following an abortion, every woman deserves validation for whatever emotion she is feeling.
By listening to people’s abortion stories, we learn there is no one type of woman that has an abortion. Abortion exists on an individual case-by-case basis where reasons and circumstances cannot be lumped into one. Oftentimes, when I have encountered people at school or in the workplace who talk about abortion, they presumptuously think that it happens to other people, but not me. By listening to people’s abortion stories, we break down stereotypes and we bring it down to each and every person’s unique experience where we are not just like everybody else.
Exhale invites pro-voice supporters to join Pro-Voice Ambassadors (like the ones pictured below) to show up for the hearing and demonstrate your support for our research priorities. Together, we can make sure every woman who has had an abortion gets the best information she needs to support her own emotional wellbeing.