After spending my first summer in college working in a bar in Brooklyn, I was set on doing an elective in the US at some point during my clinical years. It was a goal sitting at the back of my mind, stored away with an awareness of the paperwork and cost associated with doing anything in the States. At some point along the way, a friend told me that there was a non-profit which provided funding for Irish medical students to do a placement in an abortion clinic in north America.
At the beginning of my fourth year, I decided to apply for a reproductive health externship with Medical Students for Choice (MSFC). Via MSFC, I came across the Midwest Access Project (Map), another non-profit that provides training and exposure in the field of reproductive health. I applied to Map in April of this year, and in May I found out that I had a placement confirmed in Wisconsin.
Arriving in Sheboygan in mid-July, I realised this was going to be nothing like my previous experience in the US, which was limited to New York City. I went for a walk one Sunday evening, due to start placement the next morning. Within five blocks I came across two churches, one Catholic charity, a Christian bookstore and some kind of business called Great Marriages. When my host mentioned that one of his co-workers had moved his family out of Sheboygan because it had become “too liberal”, I struggled to understand.
[ Roe v Wade: As history shows, banning abortion simply makes it less safeOpens in new window ]
The overturning of Roe v Wade preceded my arrival by about two weeks, making abortion illegal in Wisconsin. This added another level of apprehension and curiosity to my expectations. As expected, Planned Parenthood Wisconsin (PPWI) is in a phase of serious transition. Posters remain on the wall from the period prior to the supreme court decision — Get Informed: Abortion Services are at Risk in Wisconsin. In terms of the day-to-day, family planning and sexual health services continue as normal. Pregnancy assessments, ultrasound dating, and options counselling are also running, to some extent. Interestingly, abortion remains legal in almost all of Wisconsin’s border states.
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The presenter said she had to pinch herself every morning when she remembered with delight that Roe was, in fact, ‘really gone’
Most referrals are to Chicago suburb Waukegan. Patients in the community are aware of the recent ruling. During birth control consultations they might ask: “We can still go to Illinois for an abortion if we need one, right?” And they are told that yes, in theory, they could — but the clinics in the border cities are absolutely slammed with referrals. The combination of appointment wait times and limits on terminations at certain gestational ages make abortion a lot less accessible to people in the midwest than would seem on paper. Many women in Ireland are in a similar position due to such restrictions, with travel to the UK for a termination of pregnancy still commonplace.
Observing patients being told the lengths they must go to access an abortion is heart-breaking. Most attend alone, unable to share their decision-making with partners or parents. The PPWI staff are incredible, providing as much information, options, and education as possible. I was also impressed by the resources in place in terms of funding available to patients to travel across the border and access contraceptives when they return. This was something I didn’t know I would find in a country where healthcare is so commercialised. However, at the end of the day, money for gas can only go so far in easing the pain of such a lonely journey.
There isn’t a huge protester presence in Wisconsin. Instead, there is an eerie atmosphere of celebration. On my first day, I turned on Cow Country Radio by chance and got a shock when the presenter said she had to pinch herself every morning when she remembered with delight that Roe was, in fact, “really gone”. There are, however, still people dedicating time to intimidating Planned Parenthood patients and staff. One day I was pulling out of my parking space in front of the clinic, and I spotted a man about 60 strolling up and down the street wearing a sandwich board. Thinking he was advertising or selling something, I looked closer to see that on the board there was a photograph of a cherub and the caption, Choose Life: It’s Awesome, and on the back, Science now shows that babies can be heard crying in-utero. I had been present during a particularly sad case of a teenage girl that day and I was torn midway between feeling sorry for him and running him over.
When I originally wrote my personal statement to MSFC, I highlighted how recently abortion became available in Ireland, how limited the access was, and probably slightly exaggerated the Catholic Church’s role in the everyday life of Irish people. I wrote about how I needed to go to the US to gain such exposure, because “we’re just not there yet” in Ireland. At the time, I never expected to arrive right after the supreme court decision in a state operating under a law written more than a century ago. It makes for quite an ironic story. This does not mean that reproductive rights in Ireland are adequate, as I believe there is still a long way to go. However, I am able to think fondly of home knowing that we have made such a positive change so recently, and where there is the hope for more progress.
- Isabel Waters is a medical student at Trinty College Dublin.