By Kate Rounds
Buffalo Womenservices, a women’s health center that provides family planning, mental health, and abortion services, has added a birthing center, making it the nation’s first facility offering care for abortion and birth under one roof.
The move was unsettling for both antiabortion activists, who want to stigmatize abortion services, and traditional medical practitioners and insurers, who are uncomfortable with out-of-hospital births. But Womenservices’ owner, ob/gyn Katharine Morrison, would like to see more practices follow suit. She says, “Women are artificially divided into good, obedient patients who go to the hospital, and bad patients who do not want to continue their pregnancies. But they are the same patient. Abortion and birth coexist in one woman’s life. What connects those who are against both abortion and birthing centers is the belief that the mother is unimportant, that the only thing that matters is the present contents of the uterus.”
In fact, more than half of abortions in the U.S. are performed on women who are already mothers, according to a 2011 study. So why is the notion of a combined birthing center and abortion clinic considered so radical? “Abortion has been segregated from hospital care and from routine gyn care,” Morrison says. “The women who seek abortions are not seen as those who have or will have children. Birth and abortion have been painted as polar opposites rather than part of many women’s reproductive lives, just as women are always divided into Madonna and whore. I don’t see birth and abortion as separate.”
Morrison, who had been doing hospital births since her residency in 1984, had an epiphany in 2007 when she observed a home birth with a midwife. “It opened my eyes to how badly women were treated in the hospital,” she says. “In the hospital they are subject to unscientific and dangerous rules. I set out to change that.”
Morrison is referring to the alarming maternal mortality rate, which has doubled in the United States since 1987, fueled in part by what she calls a “criminal” rise in cesarean sections (from 5 percent in 1970 to 33 percent today). “C-sections are ten times more dangerous than vaginal births,” Morrison says.
Why so many c-sections? For doctors, Morrison says, “there is no consequence to doing c-sections. They’re quicker. Doctors make up any reason to get back to the office to do Pap smears, which pay the bills. It takes a lot more time to do a vaginal birth.”
Witnessing a home birth, Morrison says, “just transformed my experience. It was so different from what happens to women in the hospital. As a feminist, I realized this was the right way to do things, and I couldn’t stop.”
Morrison applies the same principles to abortion services that she does to birthing services. “Respect, dignity, and real options are the cornerstones of abortion care,” Morrison says. “Women are best suited to know if continuing or ending a pregnancy is right. Legalizing abortion meant that women didn’t have to grovel, lie, or pretend illness in order to win approval to terminate a pregnancy.”
In setting up the birthing center in partnership with nurse-midwife Eileen Stewart, Morrison was one step ahead of the game. As a women’s health clinic, Buffalo Womenservices already had what is known as a Certificate of Need (CON), a permit that allows the establishment, construction, or renovation of health-care facilities. Obtaining a CON can be a major barrier to starting a new stand-alone birthing center, but in this case Morrison was able to petition the New York State Department of Health for an extension of services.
At the center, women get emotional care as well. “Women receive a lot of education and support through the pregnancy,” Morrison says. “They grow in abilities and confidence as they go into labor and birth.”
Morrison is all too aware of the volatile political climate in which she works. Soon after she started working at Buffalo Womenservices in 1998, Barnett Slepian, a physician who performed abortions at the center, was gunned down by anti-abortion zealot James Kopp, who is currently serving a life sentence for the murder.
Morrison says she thought of Slepian “as a teacher and a mentor. He was an ethical and courageous person, who wouldn’t be intimidated, but he and his family paid a terrible price, and we can’t forget that.”
Is she afraid for her own life?
“I’ve had a lot of threats,” she says. “But to be honest, I’ve taken more guff about collaboration with a home-birth midwife than I did professionally for doing abortions. Ob/gyns and doctors and administrations fear pregnancy and childbirth and want women to be obedient and do what’s done in hospitals.”
Now that she’s seen this new model of comprehensive care in action, Morrison is eager to spread the word: “I’m champing at the bit to go on the road and tell people.”