A few days before the Supreme Court overturned Roe v. Wade last month, a woman who described herself as an anti-abortion activist showed up in the waiting room of Dr. Marissa Lapedis, a family-medicine doctor who performs the procedure in Atlanta.
But she wasn’t there to protest—she had an appointment.
“She talked about being in marches, and said she had spent a lot of time volunteering in crisis pregnancy centers—you know, showing patients the ultrasound image and explaining what happens,” Lapedis, a fellow with the group Physicians for Reproductive Health, told The Daily Beast. “She said she had been anti-abortion her whole life, and that her whole family was like her—and yet she was so appreciative of the care she received from us. She literally was like, ‘I’m so grateful that I’m able to make this choice for myself.’”
Lapedis’ experience is remarkable in part because she resides in a state with a looming ban on the procedure after six weeks—though the law has so far been held up in court.
“You sometimes have anti people who are like, ‘Promise me no one’s going to find out, my boss cannot know,’ [because] they work in the Republican legislature or something. Which has happened—but this patient was so appreciative.”
Abortion providers across the country are reeling from the fall of Roe, and some face the prospect of legal reprisal from law enforcement in their own state or even other states where patients need help. Almost inevitably, they are reflecting on the many patients they’ve seen who came in for a service they claimed to fervently oppose—and in some cases actively protested against.
“All of us who do abortions see patients quite regularly who tell us, ‘I’m not pro-choice, but I just can’t continue this pregnancy,’” said Dr. Sarah Prager, a professor of obstetrics and gynecology at the University of Washington. “We’ve even seen people coming into the clinic off the protester lines to get their abortion, then return to protesting outside the clinic.” And to be clear, she added, “These are not people who turn anti-choice after having an abortion, but who simply access this essential service when they need it in spite of their personal beliefs about abortion in general.”
According to Prager, the phenomenon is so common that abortion providers have a name for it: the Me Exception.
“We in the movement often say people believe abortion should be legal in cases of rape, incest and ‘me,’ meaning whatever reason is relevant for that person,” she said. And yet, she noted, of the many surveys describing how Americans view abortion, virtually none reflect that reality.
“Anti-choice people have no incentive to be honest about whether or not they’ve had an abortion, and we as physicians would never leak a story about a patient,” she continued. Doing so is prohibited under the Health Insurance Portability and Accountability Act, or HIPAA, the federal law that protects confidential health information.
Still, health professionals are permitted to discuss cases in general terms, and when asked about patients with anti-choice views this past week, abortion providers had no shortage of sometimes incredible tales about activists deeming themselves an exception to the rule.
Dr. Portia Jones, a family-medicine physician in Washington, recalled the time a woman “whose sister-in-law was the president of a big right-to-life organization” had asked to be “snuck in the back door” of the clinic where she was working in Philadelphia. Then there was “the picketer who brought her daughter in for a procedure and was back on the picket line the next week,” she recalled. On another occasion, a woman came in “and declared to a full waiting room that they were all sinners and should leave immediately,” she said.
“When I drew her aside, I found out she was there for an abortion, too,” Jones told The Daily Beast.
Jones and other abortion providers attributed many such instances to a sense of exceptionalism on the part of patients who decide their situation entitles them to do what they believe other women should—legally—be unable to. “I’ve done a lot of options counseling with patients who had to do some pretty creative moral jujitsu to justify their behavior to themselves,” she added. “But our role is to give people information, to create a space for them where they can make decisions, and to support them in that process.”
While 13 states with so-called trigger laws are poised to be the first to effectively prohibit almost all abortions, roughly two dozen states in total have laws on the books that could be used to sharply restrict the procedure, according to an analysis by the Guttmacher Institute, a research organization that supports abortion rights. The laws are, of course, the product of decades of far-right organizing against reproductive rights, with actions ranging from peaceful protest to the election of anti-choice officials to violent attacks.
But providers said the hypocrisy among the rank and file powering the so-called pro-life movement was glaring.
“I’d say about a third of my patients would reveal in their counseling or during the procedure, you know, ‘I want you to know I’m pro-life, but you understand why this has to be,’” said Dr. Nicholas Gideonse, recalling his work as an abortion provider in rural Oregon. “I think in almost all of those cases, they were making that choice in order to be the best parent that they could be.”
There were certainly those pro-life patients who “stridently insisted that their circumstances were particular and special,” Gideonse added. But there were cases, too, of pro-life patients who came to him seeking compassion.
“I’m remembering a soft-spoken younger woman who felt that I, because I had delivered her other unplanned pregnancy, understood how pro-life she really was and that for this reason I was the person who could perform the procedure she needed now,” he said.
Rather than a one-off, stories about anti-choice activists literally coming off the protest line to seek care were rife. That phenomenon may fade in states where clinics are shutting in the face of legal threats, but providers were confident hardcore activists will continue to seek their care.
Several years ago, Dr. Meera Shah, chief medical officer of Planned Parenthood Hudson Peconic in New York, provided abortion care to one of the protesters regularly outside of her clinic.
“I treated her with compassion and kindness just like I do everyone, knowing that people come to us with their own lived experiences,” she said. “I don’t know what this person was exposed to, or what her community is like—it may be unsafe for folks to express an alternative view [about] abortion in their communities or their families. But I do know that nobody anticipates this. Nobody thinks they’re going to be in that situation. You can have these fixed beliefs around something that you think will never impact you, and then when you’re in the moment, your thoughts around it can change, and that’s very much the case with abortion. We see it all the time.”
In her book, You’re the Only One I’ve Ever Told, Shah explored the everyday reality of abortion care that mainstream political dialogue mostly fails to capture.
“I think that the anti-abortion movement comes at it with very strong preconceived notions,” she said. “Their lived experience has taught them that abortion is bad, so they just run with that. But what they fail to do is keep an open mind and express empathy for those who are going through it. And that’s what got us here.”