Beth shook her head, unable to speak.
The nurse sat down on the edge of Beth’s bed. “I didn’t mean to eavesdrop,” she said, “but it’s pretty hard when the door’s wide open.” She hesitated. “This isn’t my usual floor, you know. I work on the ortho floor, but I’m covering for a colleague who needed a personal day. So I’m not sure what the protocol is here.”
Beth wiped her eyes. “What do you mean?”
“Well, in ortho, if I found out my patient is an intravenous drug user or has some other history she didn’t disclose to the doctors, I’d tell my supervisor. It could be a matter of life or death. What I’m trying to say is that you really do need to tell me the truth.” She looked at Beth. “So,” she said, “which is it?”
Beth blinked at her. She felt the walls pressing in.
“You told me you didn’t know you were pregnant. But I just heard you tell your father you went to an abortion clinic.”
Beth flushed. “I want my father …”
“If you had a surgical abortion and it didn’t go right and that’s what’s caused the bleeding, your health could be in danger. Beth, you could die.”
Beth wiped her eyes with the corner of the hospital johnny. “I did go to the clinic,” she admitted. “But they said they couldn’t help me unless I went to a judge. So I filled out all the forms and got a hearing scheduled and then I got a call saying the judge couldn’t see me for two weeks.” She looked up at Jayla. “I couldn’t wait that long and then go back to the clinic. It would be too late.”
Beth started to cry so hard she couldn’t catch her breath. “I didn’t have a choice,” she sobbed, curling into herself, making a shell of her own body. “You get that, right?”
Jayla stroked her back. “Okay,” she said. “Okay. Deep breaths.”
If only they had used a condom.
If only she wasn’t under eighteen.
If only the judge had shown up when he was supposed to.
If only she had lived in Boston or New York, where there wasn’t just one clinic, but many.
If only it hadn’t been so damn hard to fix this on her own.
If only she’d kept the baby.
The thought crawled into her mind like a spider. She would still have faced her father’s anger. She would still have been a whore, in his eyes. For all she knew, he would have thrown her out.
For all she knew, he still might.
That made her cry even harder, which was why she did not hear Jayla slip into the hallway, take out her cellphone, and call her husband. “Nathan,” the nurse said, “I need your help.”
—
JANINE SAT ON THE EXAMINATION table, panicking. It was one thing to come into the Center using a fake ID, and register for an abortion, and sit through a counseling session. But it was another thing entirely to dodge the state-mandated ultrasound. Somehow, she needed to get the evidence she had come here for. Just last month in another state, a pro-life girl had gone into a clinic undercover, like Janine, and had told a counselor that she was thirteen and her boyfriend was twenty-five and she wanted an abortion. The counselor had said, on tape, I didn’t hear that. The damning audio had made the rounds of the Internet, and had even aired on Hannity on Fox News.
Janine heard the quick knock and slipped her phone into her dress pocket, hitting the record button on the voice memo just as the door swung open. The social worker smiled. “Hello there,” she said. “I’m Graciela. So we’re going to do your ultrasound, right?”
Janine felt herself break into a sweat. She needed to get this woman talking. “Wait!” she blurted out. “I have allergies!”
“To latex?”
Janine swallowed. “To, like, everything. I forgot to write it down.”
Graciela made a note in her file and then turned on the ultrasound machine. It hummed alive, as if they were all an orchestra and this was the note they must become attuned to. “What if I don’t want an ultrasound?” Janine asked.
“I’m afraid you don’t have a choice. The state says I have to do one today, and ask you if you’d like to see it. You can say no, if you want.” Graciela paused, her hand holding the wand. “You seem a little nervous.”
In any other situation, Janine would have thought, This woman is kind. But although Graciela might still be a lovely human being, it didn’t change the fact that she had made the choice to work at an abortion factory. It wasn’t like you could get prenatal care here, if you wanted it. The last undercover spy that Allen had sent into the clinic had worn glasses with a tiny camera in the bridge of the nose, and she had video of this very woman saying no, they did not offer pregnancy care, but could refer her to a place that did. They really shouldn’t call themselves a reproductive healthcare center if they weren’t willing to help women reproduce.
Once, she had been in a clinic like this, not as a spy but as a patient. Did she have an ultrasound there? Why couldn’t she remember?
It was not until Graciela handed her a Kleenex that she realized she was crying. “Are you nervous? That I can fix,” the social worker said. “But if you’re crying because you don’t know if you’ve made the right decision … that I can’t help you with.”
Janine thought of the voice recording in her pocket, closed her eyes, and prayed for something to happen—anything—that might incriminate Graciela, before Janine was incriminated herself.
—
FIFTEEN WEEKS WAS THE TRICKIEST. When Louie had a patient come in fifteen weeks pregnant, he knew he was in for a challenge. The fetus’s bones would have just started to calcify, so it would have to be disarticulated. The way Louie explained it was that the uterus was like an ice cream cone. Imagine you had an Oreo at the top and needed to get it through the bottom of the cone; of course you had to break it into parts. In Mississippi, there was an additional wrinkle: by law, you could not use forceps while a fetus still had a heartbeat. This law was passed by nonscientists who believed that fetuses at sixteen weeks could feel pain—which they could not. But as a result of political posturing, Louie had to amend his procedure, adding extra steps that might cause more risk to the patient, instead of doing what was best for her.
That meant Louie would start with an ultrasound. Cytotec caused sustained uterine contractions, which meant that most of the fetuses would be asystolic due to the constant squeezing. But if that wasn’t the case—if there still was a heartbeat visible on the ultrasound—it was up to Louie to use suction to bring the umbilical cord down and transect it to end cardiac activity.
Louie told the patient none of this.
He looked at Joy Perry, who was his primary concern for the next quarter of an hour. Like all his fifteen-and sixteen-week patients, she was the first and last procedure of the day. She had come early for the Cytotec—eight hundred micrograms in pill form—which were inserted by him, vaginally, to make the cervix pliable.
Now she was lying back, her pale hair in a ponytail that spilled over the edge of the procedure table, like the tassels on his grandmama’s brocade curtains. He met her gaze through the valley of her bent knees. “This is going to take about seven minutes,” Louie said. “We’re gonna get you through.”
He glanced at Harriet, his nurse du jour. He’d worked with Harriet long enough to have a shorthand with her, but truth be told, Louie flew to seven different clinics throughout the South and Plains states and he was used to working with a rotating panel of RNs and nurse practitioners. They were all exceptional, standing by the side of the women on his procedure table; providing him with a syringe of lidocaine when he needed it and a gentle whisper of support when his patient did. A flick of Louie’s eyes to the right, and Harriet took Joy’s hand in her own and squeezed.
He touched her knee.