0:00

M Hi.

0:08

I'm Chelsea Clinton, and this is in fact

0:11

a podcast about why public health matters

0:13

even when we're not in a pandemic. Today,

0:16

we look at what happens when healthcare gets

0:18

politicized. We've seen a lot of

0:20

that over the last year, with the conversation around

0:22

mask wearing, social distancing, and getting

0:25

vaccinated becoming more fraught by the day,

0:27

and we'll dive into all of that on the season

0:29

of the podcast. But long

0:31

before COVID, there was already a political

0:33

battle happening around one of the most personal health decisions

0:36

there is whether when and

0:38

how to become a parent, which

0:40

brings us to reproductive rights into planned

0:42

parenthood. You've probably heard of

0:44

Planned Parenthood there in the headlines a lot,

0:47

often unfortunately because of another

0:49

attempt to defund the organization. But

0:51

on this episode, I want to go beyond the headlines.

0:54

I want to talk about the healthcare provider that one

0:56

in five women in the United States has been to

0:58

at some point in her life. It offers

1:00

everything from breast exams to HIV screenings,

1:03

to save in legal abortion, and provide

1:05

sex education to millions of people every

1:07

year. I also want to talk about

1:10

the lessons we can learn from the fight to protect reproductive

1:12

rights and how we can apply those lessons to other

1:14

public health issues like confronting a pandemic.

1:17

So today I'll be talking with Dr Kleen mc

1:19

nicholas, chief medical officer of Plan Parenthood

1:21

in the St. Louis region in southwest Missouri.

1:24

Also here from author, actor and director

1:26

Ambrea Tamblin about her personal story. But

1:29

first I'm talking with Planned parent and president

1:31

Alexis McGill Johnson. Alexis

1:35

officially took the helm of the organization in June. She

1:38

has been an activist for years, working on issues

1:40

of social, racial and reproductive justice.

1:43

I'm so glad to sit down with her for a

1:45

conversation about the moment we're in and where

1:47

we're headed. So,

1:49

Alexis, thank you so much for being with us today,

1:52

and I think it would be just helpful

1:55

to start with how you first got involved

1:57

with Plan Parenthood. I actually

1:59

was not reproductive justice

2:01

or reproductive rights activists for the great

2:04

majority of my life. And I found

2:06

myself one day in New York City walking down

2:08

towards Spring Street, which is right in the middle

2:11

of Cash neighborhood, and so ho and

2:13

I looked up and I saw this billboard that

2:15

had this adorable little black girl's face on

2:17

it, and I just instinctively looked up to figure out

2:19

what she was trying to sell. You know. I got

2:21

closer and I saw the words, and

2:24

the words said the most dangerous

2:26

place for an African American is

2:28

in the womb, and it just piste

2:31

me off. I just could not get

2:34

the notion that black women's

2:36

sexual reproductive health choices were,

2:38

you know, essentially damned if we do, damned if we don't.

2:41

And I got so angry about it. I couldn't

2:43

stop talking about it. And I ended up at a

2:45

dinner party with Cecil Richards, who's

2:47

the former president of Flint Parenthood,

2:50

and I just kept pestering her about this billboard,

2:53

and I said, you need to do something about this.

2:55

This is on your watch. You need to do something about this.

2:57

And she's like, um, you need to do

2:59

something this and she recruited

3:02

me in that conversation into the

3:04

movement. Can you talk a little bit

3:06

about how you're taking that moment

3:08

of outrage that you clearly still feel from

3:10

all those years ago and soho and helping

3:12

people understand that reproductive

3:15

rights are racial justice issue.

3:18

Yeah, absolutely. I mean, look, racism is

3:20

a public health crisis. When people talk

3:22

about systemic racism, what they're talking about

3:24

is the intersection of a lot

3:26

of systems that marginalize people

3:28

of color, that create disparate

3:30

impact, but also disparate access to

3:33

experiences in healthcare. So it

3:35

could be everything from the transportation

3:37

system to you know, where hospitals

3:40

are located, to quality

3:42

of care that is provided. All

3:44

of these ways ladder up to

3:47

separate and unequal systems of healthcare.

3:50

And there are areas in this country, as you

3:52

know, where your healthcare is literally determined

3:54

by your zip code. I think that

3:56

what this year or this last year

3:58

has demonstrated very clearly under

4:00

COVID is that the people

4:02

who were most impacted, the people who were defined

4:05

as essential workers, the people who

4:07

even right now are struggling to get

4:09

in a line to get a vaccine, are

4:12

more likely to be people of color,

4:14

low income communities. And that

4:16

to me is the work the

4:19

kind of safety net, of the safety net for

4:21

communities that really don't have access

4:23

to quality healthcare. And I think

4:25

one of the most galling things

4:27

that we've seen over the last year how

4:30

in some states politicians have exploited

4:33

this moment to try to further restrict

4:35

access to the reproductive

4:38

healthcare that every woman in our country

4:40

should have access to. Can

4:42

you just talk a bit about how you've

4:44

responded to that as an organization, but

4:47

also how you've supported your providers

4:49

and your patients, for whom this isn't

4:51

just political rhetoric, it's it

4:53

is deeply personal. COVID

4:56

gave us a real peak behind

4:59

the curtain to at a world

5:01

without ROW would look like we saw

5:03

it at the beginning of the pandemic. Politicians

5:06

across the country, particularly those hostile

5:08

to sexual and reproductive health, we're using

5:10

the pandemic as a cover to limit access

5:12

to abortion. And what we saw

5:15

was not people not seeking access to abortion

5:19

and sexual reproductive healthcare. We saw people,

5:21

in fact, getting in their cars and driving fifteen

5:23

hours from Texas to Colorado because

5:26

they were seeking what they needed to live

5:28

full and free lives. We

5:30

know that without ROW,

5:33

roughly twenty five million women are going

5:35

to be in states with restrictions

5:37

who might not have access, and so

5:39

the work that we've had to do as

5:41

an organization with our partners has

5:43

had to think about what does the infrastructure look

5:45

like how do we support the travel,

5:48

help do we support through telehealth? Where

5:50

will the fights be as we move into

5:52

our contentious state legislative season

5:54

to ensure that the majority of people

5:57

who support access to sexual rebuctive healthcare

5:59

aren't ordered by a vocal minority.

6:02

I do want to talk about stigma because one

6:05

of the ways that we have found

6:07

to be effective in combating stigma

6:10

is through sharing stories. So are there any

6:12

stories you would like to share of planned

6:15

parenthood patients over the time that maybe have really

6:18

stayed with you. Yeah. I mean

6:20

back when we were flying, I remember

6:23

getting stuck at the Washington d

6:25

C. Airport. You know, when it rains, you can

6:27

be stuck on a tarmac for hours and hours

6:29

waiting to take off. And I

6:31

happened to be sitting next to this woman

6:34

who was walking me through all of

6:36

what was happening because she happened to be an aerospace

6:38

engineer. I probably chatted her up for a

6:40

good two hours, and finally she turned to me

6:42

and she's like, well, what do you do? And

6:44

I said, you know, I'm probad of the planned

6:46

parenthood and she was like, oh

6:49

my god, that's amazing. And

6:52

then we kind of went on. We took off

6:54

thirty minutes later. I said, thank you so much

6:56

for explaining what was happening

6:58

in the air. I can't wait to tell my daughter's about you

7:00

and how exciting a career in aerospace

7:03

engineering could be. And she said, well,

7:05

thank you, because if it hadn't been for the abortion

7:07

I had at twenty two, I would not be an

7:10

aerospace engineer. And

7:12

it was a moment of just her

7:15

normalizing and experience she had

7:17

in college, an experience that she knew

7:19

a choice she need she need to make in order to

7:22

become the person that she wanted to be.

7:24

Those are the stories that I hear often through

7:26

plant parenthood, or when I talk about the work

7:29

and I talk about the mission Alexa's. I

7:31

think part of the work you

7:33

have to do is in some ways the

7:35

outcome of us not having

7:38

age appropriate, consistent sexual

7:41

and reproductive health education in schools.

7:44

Education is probably the number one thing that people

7:46

come to pland parenthood for around

7:48

understanding their bodies and sexual

7:50

education. I think we also find

7:52

that parents are grappling without

7:55

the access in science based

7:57

curriculum around sexual reproductive

8:00

healthcare in our education system

8:02

is apparent myself of young girls. It

8:04

has been really important in addition

8:07

to reinforcing the needs for

8:09

sex education, to also reinforce

8:11

the core value of freedom

8:14

and what self determination means

8:16

and what bodily autonomy really means.

8:18

My ten year old asked to to dye

8:20

our hair a couple of years ago, and

8:23

you know, in a school, wearing uniforms,

8:25

and wanted to differentiate herself. And I was completely

8:28

like, no, We're not dying

8:30

our hair. That's not happening. And her

8:32

response was, but you always tell

8:34

me my body is my own, My hair is my body,

8:37

It is my own. And I couldn't

8:39

argue with that, right, I mean, because those

8:41

are the values and the lessons that we are trying

8:43

to build, and that's what we were trying to inculcate

8:46

through you know, the sex education work that we

8:48

offer throughout the Federation, as well as the kinds

8:50

of policies that we have championing across the country.

8:53

So did she dye her hair? She did

8:56

magenta magenta. I

9:00

wanted to paint the walls

9:03

of my childhood bedroom

9:05

alternating shades of

9:07

pink and purple. I had this image, Alexis

9:10

that I was going to have like a kind of pink to purple

9:12

rainbow, and my mother just

9:14

said, no, I mean it

9:17

was it was definitive. There was no space

9:19

for any compromise. And I

9:22

wish that I had gone the hair

9:24

route because I think she probably

9:26

would have supported that. So

9:30

please tell your daughter, I have some you

9:32

know, decades belated envy.

9:38

We'll be right back to stay with us. I

9:51

think one of the challenges

9:53

I would imagine at this moment Alexis is

9:55

that while there is hope

9:59

kind of embedded in the new administration

10:01

of President Biden vice President Harris

10:03

for more robust

10:05

public health and health care access

10:08

and hopefully the protection of

10:11

access to safe and legal abortion

10:14

actually being expanded, we also

10:16

now are confronting a conservative

10:18

majority on the Supreme Court and

10:21

a number of governors who

10:23

right now are working to restrict

10:25

access to safe, legal

10:28

abortion. How do you talk

10:31

about the mix of hope

10:33

and yet also caution and the

10:35

need to be able to push towards expanding

10:38

health care access while also preventing

10:41

the dismantling of health

10:43

care access, including through prim parentet

10:45

How do you balance that In talking with

10:47

with supporters, First of

10:49

all, the the the amount of damage that was

10:51

done over the last four years,

10:54

the harms that we have to undo over the last

10:56

ten years. We do have a tremendous

10:58

amount of work to get to a

11:01

HIDE repeal, and alexis I'm

11:03

so sorry to interrupt, but before we go on, could

11:05

you just remind folks about what the High Amendment

11:07

is. The High Amendment is a policy

11:09

that bars people who depend on medicaid

11:12

from accessing abortion, and so

11:14

it is typically attached to budget

11:16

bills as a way to energize

11:20

anti abortion constituencies, and

11:23

the impact of it is that

11:25

disproportionately low income people, people

11:28

of color, people who are more likely to be

11:30

systematically barred from healthcare, transgender

11:33

communities, non binary people, young people, they

11:36

are not able to use their

11:38

health insurance to access safe and legal

11:40

abortion. So HIDE, I think,

11:42

as a as a moral issue as

11:45

much as a lived experience issue,

11:47

is very critical for us to take

11:49

on along with the Biden Harris administration,

11:52

to make sure that we find a way to repeal

11:54

it in this moment where we

11:56

have more people paying attention to public health than

11:58

probably ever before because of the COVID

12:01

nineteen pandemic. What's the one

12:03

thing that you wish people understood

12:06

about reproductive and sexual health?

12:08

Than about planned parenthood. I

12:10

want people to see and understand that planned parenthood

12:13

is a critical part of the public health

12:15

infrastructure. That by being

12:17

part of a public health infrastructure, it

12:19

means we are fighting for health care for all and

12:22

we are there literally as a safety

12:25

net. Plan parenthood for

12:27

me, is about fighting for freedom.

12:29

That when you are able to control your own body,

12:32

it gives you the capacity to

12:34

imagine where you want your future to

12:36

be and who you want to be in that future. Many

12:40

years ago, I was on a panel in which

12:42

I said I wish that my grandmother

12:44

had been able to go to planned parenthood. Now

12:46

that got manipulated

12:50

by the anti choice activists to claim

12:52

that I wish that my grandmother had aborted

12:55

my mother, and that I clearly

12:57

was so self loathing that I wish I'd never

13:00

inborn. And of course

13:02

what I meant was that for my grandmother, who had

13:04

had to start working to support

13:06

herself before her fourteenth birthday, when

13:08

she got her first period, there was no one there to help

13:11

explain what was happening to her

13:13

body. When she later

13:15

shared with me how boys

13:18

had touched her in ways that made her feel very

13:20

uncomfortable and unsafe when she was in high

13:22

school, because she was a really vulnerable

13:25

young woman, um living in someone else's

13:28

home, helping to take care of their children, to just be

13:30

able to support herself and have the chance to kind

13:32

of pursue her own education. What,

13:35

of course I meant was I wish there had been somewhere

13:37

safe for her to go to ask questions

13:39

about what was happening to her body,

13:42

to feel like she had agency over

13:45

what was happening to her body, to have the

13:47

tools to say no to

13:49

people who are making her feel uncomfortable

13:52

and unsafe, because that

13:54

is fundamentally what I think every

13:56

person should have in our country. And

13:58

I'm incredibly grateful that Planned

14:00

Parenthood exists, and incredibly grateful

14:03

to you, Alexis, for your leadership and for

14:05

your time today. Thank you so very

14:07

much, Thank you so much for sharing that with

14:09

me, and thank you for having me. Alexis

14:13

McGill Johnson is the President and CEO

14:15

of Planned Parenthood Federation of America.

14:25

On any given day, there's a lot of debate about

14:27

reproductive rights happening in Congress, state

14:29

legislatures, and across the courts, but

14:32

the most profound conversations about this issue

14:34

are taking place at clinics across the country between

14:36

healthcare providers and their patients. These

14:39

conversations aren't about scoring political

14:41

points, about science, medicine

14:43

and public health and the day to day reality

14:46

of people's lives. And I think about some of

14:48

what I've experienced when I was a kid and people would

14:50

yell at me about my parents positions on choice, or

14:52

these days when people yell at me on Twitter, I

14:54

think about just how much all of that

14:56

pales in comparison to what doctors like Clean

14:59

McNicholas experien It's every day she

15:01

worked her planned parenthood of Missouri, the

15:03

state where politicians have worked really hard

15:05

to limit access to abortion care, and

15:08

yet every day she provides healthcare,

15:10

including abortion, to patients who are making the decisions

15:13

they know are right for them and their families. I'm

15:15

incredibly grateful that she could be with us to talk

15:17

about her important work. So

15:20

Dr McNicholas, thank you so much

15:23

for being with us today. Thank you so

15:25

much, Chelsea. If you're bringing this

15:27

topic to your listeners, and

15:30

so Dr mc nicholas, could you just describe

15:33

what you do in your job for anyone who might

15:35

be listening who has only

15:38

heard of planned parenthood when

15:40

it's uttered as a curse instead

15:42

of as a place where anyone can

15:44

go to access any care that

15:47

they might need. Just can you tell

15:49

us a little bit about about your job. One

15:51

of the great things about planned Parenthood is the

15:53

diversity of services

15:55

that it provides. Yes, it

15:57

most certainly provides abortion care, and it's

16:00

to do that, but it also provides a

16:02

breath of different sexual reproductive

16:04

health access and services, things

16:07

like breast exams in annual

16:09

wellness exams, prevention of

16:12

HIV through services

16:14

like PREP. Many affiliates also

16:16

provide services to transgender communities,

16:19

affirming gender through hormone therapy.

16:22

There are so many things that planned Parenthood

16:24

provides to the community that go beyond

16:27

abortion. But I think true to our

16:29

core, we recognize that abortion

16:31

is healthcare. It is part of

16:34

the reality that pregnant capable

16:36

folks across their lifespan will

16:39

encounter in some way, shape or form.

16:41

And if I have learned one thing over my time

16:43

as an O, B, G, I, N, it is that everybody

16:46

has an opinion about abortion until

16:48

they face the possibility of needing one.

16:51

And it's at that point that they really

16:53

think about what do they believe right

16:56

what do they deserve access to in

16:58

a way that talking points and

17:00

political pundance can't really inform.

17:03

Can you just talk about what it's

17:06

like to be a doctor working

17:08

at a state where the political leadership

17:10

clearly has very different values and a

17:13

very different approach. You know, Missouri

17:15

is one example of many states across

17:17

this country where we have just

17:19

one clinic left that provides

17:22

abortion. And although we talk

17:24

about the promise of ROW, and for many

17:26

people, even those who support abortion

17:28

access, they don't actually understand

17:31

what it means to have the

17:33

reality of ROW be actualized.

17:35

Right If you can't pay for your abortion, if

17:38

you can't figure out how to have your children cared

17:40

for while you travel hundreds of miles,

17:42

and in Missouri that means multiple times,

17:45

then ROW means nothing to you. And

17:47

that's the reality for so many people

17:49

across this country, not just in Missouri. I

17:52

have to tell you, and I started my ob du in

17:54

residency, although I knew that abortion

17:56

would be part of the care that I provided, I

17:59

really envisioned my career as

18:01

a O B G, I N who practiced

18:04

a broad spectrum of

18:06

of services and that abortion was just

18:08

one of those things. But I

18:10

never really envisioned myself in

18:12

the space I am now. It really was

18:15

through experience with politicians

18:18

in Missouri that I came to

18:20

this space, and I came to this space

18:23

as I realized with bill

18:25

after bill, regulation after regulation,

18:27

committee hearing after committee hearing, that

18:30

the voices being heard had nothing to

18:32

do with medicine, had nothing to do

18:35

with the people who are accessing

18:37

the care, who need the care, And it really

18:39

felt like an insult to my medical

18:41

degree and that of my colleagues that

18:44

we spend this time and in this

18:46

country money to get educated,

18:49

to be able to give of ourselves and that talent

18:51

to help the community be more healthy.

18:54

Yet it is a completely separate

18:57

system with largely

18:59

no medical background, with no

19:01

public health degree or education

19:04

that is driving public health policy.

19:06

And so for me that became an inflection

19:09

point. It became important for me to then step

19:11

into the arena of public policy

19:13

and to be a voice for people who need this

19:16

care. You know, we don't ask

19:18

people having colonoscopies to go to the

19:20

capital and talk about why they deserve access

19:23

to a colonoscopy, But somehow

19:25

we've gotten to this point where we are

19:27

asking and demanding and in some

19:29

ways feel like we need people to talk

19:32

about their abortion to justify

19:35

access for that very basic

19:37

and routine health care for your patients.

19:40

Do they see these choices that

19:42

they're considering, or if

19:45

they do decide to terminate

19:48

pregnancy, do they see any

19:50

aspect of that experience as political

19:53

or is it mainly the politicians who

19:55

see it as a political issue. You

19:57

know, the interesting thing is those who are affected

19:59

the most by these regulations in laws

20:02

are those who are already disproportionately

20:05

marginalized, who are already facing

20:07

so many barriers in their life. And the

20:09

truth is, once they decide

20:11

that pregnancy and parenting

20:13

are expanding their family is not right for them

20:16

today, they jump

20:18

through hoop after hoop and they attempt

20:20

to do whatever they can to be able to access

20:22

that care. You know, folks

20:25

who access abortion span

20:27

the spectrum. There are religious folks,

20:30

there are black and brown and white folks.

20:32

There are young folks and older folks. There

20:35

are Republicans and Democrats

20:37

and independence all who have abortions.

20:40

And I will say this for folks

20:42

who are not accustomed to being

20:44

marginalized, who are not accustomed

20:46

to being told what they can

20:48

and cannot have and how they have it, the

20:51

level of indignation

20:54

and anger they have when they

20:56

find out that no, they can't have their procedure

20:58

today, they have to come back another day and know

21:01

your insurance won't pay for it. That

21:03

is something that unfortunately now we have

21:05

to fix in the voting booth. And did

21:07

you think about this when you were voting

21:10

last time? Again, it goes back to having

21:12

that personal experience, having

21:14

empathy, having thought about what this

21:16

could mean for you if you ever were

21:19

in that situation. Do

21:22

you see echoes of

21:24

the debates in Missouri or

21:26

around the country around how to navigate

21:29

COVID nineteen to what you have

21:31

navigated yourself as a doctor and as

21:34

an abortion provider. You

21:36

know, it's such a great question. My

21:38

wife is an I see you doctor, and so

21:40

she has been on the front lines of the COVID

21:42

pandemic since it started. And

21:45

one of the things that very early on became

21:48

clear to me is that the

21:50

politicization of COVID in

21:52

the pandemic response and now vaccine

21:55

distribution, the groundwork for that

21:57

response was laid and facilitated

22:00

by what we allowed to happen

22:02

in the reproductive health policy world. We

22:04

allowed legislators and regulators

22:07

to go unchecked, nobody

22:10

questioning the truthfulness

22:12

of the things they were saying and the laws that they were

22:14

passing and the rules that they were enforcing,

22:16

And so they desensitized an entire

22:19

community of people around

22:21

public health, and that laid the groundwork

22:23

for where we are today. So it's

22:26

not surprising to me and to my colleagues

22:28

with one regulation, with one politician,

22:31

with one sentence sort of dissuading

22:33

people about the truth and the reality

22:36

of a public health crisis. It

22:38

didn't happen overnight, you know, It's been happening

22:40

since nine three. They

22:43

have been feeding these lies

22:45

and helping folks to

22:47

slowly get to a point where they don't trust

22:50

medicine and science. And although

22:53

it was ignored for a long time because

22:55

it was just abortion, just abortion,

22:57

just abortion, and nobody wanted to be involved

22:59

in a controversial discussion. The

23:02

consequences, though, are now an

23:04

entire health care system that is on its

23:06

knees because we allowed

23:10

constant lying and changing the narrative

23:12

around public health. I think that is

23:14

such a powerful and important point.

23:17

We live in, you know, a first world country

23:19

where our state and our federal government

23:22

should be helping to protect our public

23:24

health. But they're not, and that's

23:26

no different than when somebody is seeking pregnancy

23:29

care. We're

23:33

taking a quick break. Stay with us.

23:44

Could you just reflect on the different first

23:47

conversations you have with patients

23:49

who come to you to maybe

23:52

share a decision they've already made as they're

23:54

trying to decide whether or not having

23:57

an abortion is the right decision for them.

23:59

What those conversations

24:01

like, you know, I'm thinking actually

24:03

of a patient we just saw who chose

24:06

to terminate her pregnancy for a number

24:08

of reasons, but was incredibly

24:11

sad about the judgment and the shame

24:13

that she felt from who she thought

24:15

should be her support system.

24:18

As abortion providers, as

24:20

folks who interact with people going through

24:22

this process, I think actually the science

24:24

and the medicine is quite easy. The procedure

24:27

is not difficult. The thing we

24:29

spend the most time with and the thing

24:31

we developed the most in our training, is

24:33

the ability to sit with patients and provide

24:36

that space. Most of them just need

24:39

a empathetic and compassionate

24:41

ear and someone to reaffirm

24:43

that choosing to end up pregnancy

24:46

doesn't make them a bad mom. One of

24:48

the things I often say to people as they're

24:50

leaving the procedure room or leaving

24:52

the clinic is be kind to yourself. And

24:55

unfortunately, you know, the stigma around abortion

24:58

doesn't allow people to put those

25:00

things in the front of their their head. You

25:02

know, it's folks who have

25:05

overcome substance use disorders,

25:07

who are finally on the right path,

25:10

who have been cleaned for maybe a

25:12

week, maybe three months, maybe three

25:14

years, but who see this pregnancy

25:16

as a real threat to the success

25:18

of their sobriety and their ability to

25:21

parent the kids they have. I think

25:23

of another woman who, just days

25:25

before finding out she was pregnant, was also

25:27

diagnosed with metastatic melanoma,

25:30

and she shared how this

25:33

procedure will allow her to then

25:36

get treatment and maybe be around

25:38

to care for her one year old in five years.

25:40

I mean, these are the stories we hear day in and day

25:43

out, and I want to be clear, there is no good

25:45

abortion or bad abortion. Every abortion

25:48

is the right decision for the people who make

25:50

it. And it's pretty rare that people

25:52

come in not having that

25:54

decision made already, not already knowing.

25:57

But what is less common

26:00

and is people feeling comfortable

26:02

and confident in that decision because

26:04

of the world around them, and what

26:07

we do is just provide that reassurance

26:09

to people that they are good people. Good

26:11

people have abortions, And

26:14

I think, Colleen, it's especially important

26:17

that, as you said, that this is

26:19

not uncommon, and that many

26:22

of the women who make this choice are

26:25

making this choice for the children that

26:27

they already have. If we

26:29

are going to have

26:32

an opinion, I hope that it certainly

26:34

comes from a place of empathy,

26:36

but also informed by

26:38

the reality represented by

26:41

the thousands of women that you've cared for and

26:43

the many, many, many thousands

26:45

millions of women for whom this has been

26:47

part of their lives. The

26:50

reality is is there are many ways where

26:52

we could address some of these issues

26:55

right. Drivers of the

26:57

need for abortion include things

26:59

like economic make in financial insecurity.

27:01

Yet we struggle as a community to

27:03

believe and to execute on a livable

27:06

wage, being able to carry

27:08

a pregnancy safely, and

27:11

to maintain your health throughout that requires

27:13

health insurance. But we can't

27:15

quite get to a place where we believe everybody

27:18

deserves access to basic

27:20

health care to keep them healthy.

27:22

If you live in a place where

27:25

your housing is transitional, the

27:27

thought of expanding

27:29

your family seems inconceivable.

27:32

So there are ways that policymakers could

27:34

do something to help reduce folks

27:37

need for abortion care. Abortion

27:39

won't ever go away, but gosh,

27:42

if we could fix some issues around housing,

27:44

insecurity and equal pay

27:46

a livable wage, and by gosh,

27:48

I'm not sure that fifteen is even

27:51

a livable wage, and we can't quite get

27:53

there. So there are many things that we

27:55

could do to address some of

27:57

the need for abortion. But

27:59

you know, the hypocrisy of those who

28:01

really want to do away with abortion is

28:04

that they're also not willing to entertain any of those

28:06

things. Could you just reflect

28:09

kind of on how the work

28:11

you do comes with the consequence

28:13

of greater risk for you and

28:15

your loved ones, how

28:18

you live with that risk, how you

28:20

manage it honestly, but don't let it overwhelm

28:23

you or undermine your work. You

28:25

know. How how we manage that risk is

28:28

different for everybody. And what I will

28:30

say though, at the core, is that

28:32

if at some point folks feel

28:35

like the risk is not manageable,

28:37

it is appropriate for them to step back.

28:39

You know, sometimes for those of us

28:41

in the movement, we are so committed

28:44

to access into the work

28:46

that sometimes we lose sight

28:48

of the fact that we are real people and we have real

28:50

kids. I have a ten year old little

28:53

guy, and and certainly we are

28:55

always reassessing that risk. We

28:57

take some very basic precautions. We have

28:59

cameras in security systems, and certainly

29:02

our organizations, Planned Parenthood, the National

29:04

Abortion Federation have teams of

29:06

security folks who are keeping an eye on

29:08

us, and we're appreciative that. But

29:11

you know, honestly, I wake up every

29:13

day knowing that I'm doing the right thing,

29:15

that I have in my core a

29:17

true belief that this work is important

29:21

and that risk is worth assuming,

29:23

to continue to live by my values, and

29:26

to know that at the end of the day,

29:28

I am on the right side of history. Every

29:31

person should be able to make what are

29:33

the right and best decisions for themselves

29:35

and their families. And I hope that every

29:38

person is lucky enough

29:40

to have healthcare providers

29:43

like Dr McNicholas in their

29:45

own lives. So thank you so much for

29:47

your time today. Thank you. Dr

29:51

Killeen McNicholas is the chief medical officer

29:53

of Planned Parenthood of the St. Louis Region in southwest

29:56

Missouri. It's

30:00

one thing to talk about the decision to end a pregnancy

30:02

and the abstract it's another thing to actually

30:04

make that decision. So for

30:06

today's episode, I reached out to my friend Amber

30:08

Tamblin. In addition to be an author,

30:11

actor, and director, she's also

30:13

a fierce advocate for every woman's right

30:15

to make her own health care decisions. She's

30:18

been incredibly brave and generous

30:20

in talking about her personal experiences

30:23

as someone who has had an abortion, as someone who's

30:25

had a miscarriage, and as someone who

30:27

is now a mom. I'm just so honored

30:30

Amber could join us to talk about all of this

30:32

and more so for

30:34

this episode about choice, We've

30:36

talked to the president of Planned Parenthood

30:39

Plan Parenthood, doctor, and I'm

30:41

so thankful to have this chance to talk with

30:43

you because you just have been so open about

30:46

your personal story, and I hope you could share

30:48

that with us today.

30:50

Yeah, of course, So I think before I

30:52

tell you the end of the story, I have to tell you

30:54

the beginning in the middle of the story, because those

30:57

two things really inform the

30:59

choice that I may, which was to terminate

31:01

a pregnancy and to have an abortion. I'm

31:03

thirty seven now and I've been acting

31:06

since i was ten years old. Between

31:08

the age of ten and about

31:10

twenty five or twenty six, I

31:13

had gone from being on a soap opera as

31:15

a child. When other kids were going

31:18

to school and then after school they were

31:20

going to get to go to McDonald's or get to go hang out

31:22

at a friend's house. I was going across

31:24

town to the ABC Studio lot to

31:26

go shoot a TV show. And

31:28

around my mid twenties, I really

31:31

had quite a deep existential

31:33

crisis and had to examine

31:37

all the ways in which I felt very

31:39

detached from my choices

31:41

in my life and my ability to choose

31:44

whether or not I wanted to be an actress. You know,

31:46

people would always interview me and say

31:48

how old were you when you do you wanted to be an actress?

31:51

And I used to just answer that question like a robot

31:53

and say, well, it all started when I was doing

31:55

a school play. YadA, YadA, YadA. But around

31:57

my mid twenties I really started to really

32:00

lies that when you're a child,

32:02

you don't really make that choice. Parents

32:05

make that choice for you, Adults around you

32:07

make that choice for you. I've done

32:09

it for so long I hadn't had a moment to

32:11

stop and think, do I want to

32:13

do this? Is this the life that I want?

32:16

Around my mid twenties, I also was

32:18

struggling a bit with some addiction

32:21

issues with drinking a fair amount.

32:24

I couldn't do auditions anymore. I

32:26

was really bad at them, and then when I failed,

32:28

I went into spirals

32:30

of deep, dark depression. So

32:33

right around this time I had just gotten married

32:35

and a few months after I found out I was pregnant.

32:38

It paralyzed me. It

32:40

was not the feeling I wanted to feel. It

32:43

was not the way that I wanted that experience

32:46

to happen. My greatest

32:48

fear in the world was that if I had not

32:50

done some of the work on myself, if

32:52

I had not severed that

32:55

old version of a

32:57

young girl who was just an object for

33:00

a living for twenty years, who

33:02

knew she had so much more to offer

33:04

the world, but that the world didn't know that yet,

33:07

what kind of parent would I become? What kind

33:09

of mother would I be to bringing

33:11

a young child into the world? Would I harbor

33:14

resentment against that child because

33:16

that child was going to inevitably have the childhood

33:19

I didn't get to have. How would I feel in

33:21

this sort of crucial moment

33:24

between these two lives. If suddenly

33:26

this other life that I was hoping to have one

33:29

as a director and a writer and a

33:31

producer and and an actor,

33:33

like to be able to do all of those things together, maybe

33:36

I wasn't gonna be able to have any of those things with

33:38

a child, because oftentimes, and

33:40

everything I had ever seen from women in my family

33:43

was that women harbored the burden of

33:45

child care and raising children.

33:48

How is that going to change my life? So I made

33:50

that decision, and it was very difficult

33:53

for my husband. I was

33:55

sad because I loved him and I had just gotten

33:57

married, and in my head, I thought, this

33:59

is what you're supposed to do, right. I have money

34:01

in the bank, I own a house, I

34:04

have an incredible husband. What's wrong

34:06

with me? What the hell is wrong with

34:08

me? Why is this what I want? I

34:11

know that I made the right choice in

34:13

that moment, at that time in my life, and I also

34:15

know that now that I am a mother, and

34:17

I feel like I'm a pretty incredible mother

34:20

for a lot of reasons, and a lot

34:22

of those reasons have to do with those choices

34:24

that I make. Thank you

34:27

for sharing the beginning and

34:29

in the middle of your story, as well

34:31

as the choices that you've made

34:34

and for doing so so bravely.

34:37

When did you decide to share the

34:39

story of terminating

34:41

a pregnancy, and also why

34:43

you knew that was the right choice for you

34:45

to make at that moment in time. I'm

34:48

a storyteller through my body, so I'm

34:50

very connected to my body

34:53

and how it speaks and what it says. And

34:56

I remember that the sort of a

34:58

few weeks after we

35:00

had found out that I was pregnant, I remember

35:04

hearing my body so loudly

35:06

saying, this is not the time,

35:09

This is not good for you. And

35:11

if it's not good for you, it will not be good

35:13

for that child. So I made the choice.

35:16

So we talked about it, and I made the choice. So

35:18

I shared that story in my last

35:20

book that I wrote, which was called Era of Ignition,

35:23

Coming of Age in a Time of Rage and Revolution,

35:26

which sort of has looked at the last four

35:28

years of American life and

35:30

what it's been like for women and this sort of condensed,

35:33

palpable change that has taken place all

35:35

throughout the country. So I share it

35:37

in the very opening pages of that book,

35:39

mostly because I didn't want to bury

35:41

it inside, like a treasure to be found.

35:44

I wanted it to feel normal and

35:47

real and for people to understand

35:49

that that was, in that moment

35:51

freeing for me. And what

35:53

it allowed me to do when that happened

35:56

is that it allowed me to say, I have chosen

35:59

life. Actually I chose my life. I

36:01

chose my life, which is not something I

36:03

had ever really done before, because, as I

36:05

said, I was always used to just being

36:07

an object for a living. So for me, I

36:10

did choose life in that moment, and

36:12

I wanted that to be expressed in the writing

36:14

of that book. I wanted people to know that

36:17

every woman has a different story and a different

36:19

experience with terminating a pregnancy.

36:21

For some women, it is an absolute

36:24

relief, It is a sense of freedom,

36:26

it is a sense of choosing themselves. For

36:28

other women, it's extremely painful.

36:31

I know I have several friends that have experienced

36:33

that, having determinated a wanted pregnancy,

36:35

that they didn't want to have to terminate the

36:38

pain that that brings you,

36:40

and I think ember one of the many misconceptions

36:42

around women who make the choice

36:44

determinated pregnancy is how most of the

36:46

women are already mothers or

36:48

will become mothers and

36:51

I'm curious if, after the air of

36:53

ignition and you sharing your story publicly,

36:55

did you have people who reached out to you to share

36:57

their stories or who shared that you helped

37:01

them tell their stories to their kids maybe

37:03

or to others in their lives. Yes,

37:06

I did. I'm not speaking out of turn with this because

37:08

I asked her if it was okay if I shared it. But my

37:10

mother actually told me that before I

37:12

was born, she had terminated a pregnancy

37:15

because she had no money. She was completely

37:17

broke and terrified. She

37:20

and my father weren't even married yet. My dad was

37:22

like a struggling artist at that point, so

37:24

my mom shared that with me. I think

37:26

I was quite surprised by

37:29

the outpouring of

37:31

people reaching out, commenting of stories

37:34

written about it. Talked about being pregnant

37:36

with fetuses that were incompatible with

37:38

life, which basically means there's no possibility

37:41

that fetus will turn into a child

37:43

and live, and making that choice, and the pain

37:45

of that choice. I talked to other women

37:48

who talked about, you know, even though they had not been

37:50

child actors or had my experience, had

37:52

their own similar experiences of feeling

37:55

robbed of their life and unready and

37:57

terrified for what kind of parents they might

37:59

become. So I was really quite taken

38:02

aback in a great way and humbled

38:04

to read so many stories.

38:07

We're living now in this year where

38:11

we're on track to see the highest

38:13

number of abortion restrictions enacted

38:16

by state legislatures and signed by their governors

38:19

across the country since Ruby Wade

38:21

first of effect decades ago. How

38:24

do you feel knowing that is happening,

38:27

and what do you think those

38:29

of us who believe it's really important

38:31

that women be able to make the best choices for themselves

38:33

and their families can be doing to try

38:36

to support women who are living in

38:38

states where that isn't what their legislators

38:40

and governors believe. There is a

38:43

stomach fear of the power that

38:45

women can wield naturally, and

38:48

I think that's why we're seeing so many of

38:50

these laws. These laws are also deeply

38:53

classist and racist. Yes, wealthy

38:55

white women have always had choices, that

38:57

is correct, and so they are not accounting for

39:00

the millions of women, low income women,

39:02

and women who do not have access to childcare,

39:05

let alone the ability to terminate

39:07

a pregnancy, and they think that is enough

39:10

to stop women for making that choice.

39:12

But if we've learned anything from

39:15

history, no amount of laws

39:17

are going to stop women from

39:19

choosing the right choice for their body.

39:22

I think if it got worse and worse, women

39:24

are going to continue to fight harder

39:26

and go further underground with their choices

39:29

the way that they had to before. Roe v. Wade.

39:32

I think it's a reminder to all of us

39:34

too that we have to continue

39:36

fighting. That we can't look just to presidential

39:39

elections as the thing we fight

39:41

for in that particular year, because

39:43

that's the fancy thing we want to fight for in

39:45

the moment. We have to remember that the

39:47

fight is happening around us all the time.

39:49

It's happening with voter registration right now

39:51

and so many different states. It

39:54

has always been happening against women's

39:56

bodies, the weaponizing of

39:58

us, of our choices, of our health care, all

40:01

of it has always been here. So this

40:03

fight is not something that's new. These

40:06

types of laws are not something that's

40:08

new. I think about perseverance

40:11

a lot. We can't think of this

40:13

as something that is going to go away for

40:15

a while and that we can just rest and

40:18

rest on our laurels and come back later and

40:20

fight again. It needs to be talked

40:22

about at all times, it needs to be

40:24

destigmatized at all times. The

40:26

more you can hear those personal stories,

40:29

the more the Megan McCain's out

40:31

there, who you know I'm friendly with, but

40:33

who believes ardently, ardently

40:36

pro life, Even though I cannot

40:38

imagine Megan in a situation

40:40

in which she had a fetus incompatible

40:43

with life, what choice she would make in that

40:45

moment until it's happened to you,

40:47

You don't know until you've been that woman.

40:50

You can't say what a woman should or should

40:52

not do until you've had that experience.

40:55

You just have no right. Amber,

40:58

Thank you so much for everything.

41:01

Thank you for everything. Such a pleasure.

41:03

Thanks for having me. Chelsea

41:09

amber Tambland's most recent book is Era of

41:11

Ignition, Coming of Age during a

41:13

time of rage and revolution. When

41:16

a deeply personal health issue becomes politicized,

41:19

the result is often disastrous,

41:21

disastrous for patience, and disastrous

41:24

for public health or at large. And as we heard

41:26

today, the consequence is almost always

41:28

fall hardest on people living in poverty,

41:31

people of color. And I

41:33

don't know about you, but I find it really

41:35

frustrating, especially during a pandemic,

41:38

to hear that yet another room full of mostly

41:40

white, mostly male politicians

41:43

has voted to make it even harder for

41:45

women to get the health care they need. Thankfully,

41:48

though, there are many ways

41:50

to channel that frustration into action. For

41:52

starters, we can support organizations

41:55

like Planned Parenthood and other organizations

41:58

doing the work to help protect payations

42:00

and protect reproductive rights. And

42:02

we know that we can't stop there. We need to

42:04

make our voices heard by registering to vote

42:06

and turning out for every election.

42:09

I know that with an ondes lot of laws like the one that

42:11

we've seen this year, it can be easy to

42:14

get discouraged. But thankfully,

42:16

the majority of people in this country support

42:18

reproductive rights and believe that a portion should

42:21

remain safe and legal. So

42:23

we have to keep speaking out, we have to keep

42:25

showing up, and we have to keep having conversations

42:27

like these about why it's so important

42:30

to protect access to reproductive healthcare for

42:32

everyone. Thanks for listening,

42:35

and we'll see you next week. In

42:38

Fact is brought to you by iHeart Radio.

42:41

Were produced by Erica Goodmanson, Lauren

42:43

Peterson, Cathy Russo, Julie

42:45

Subrian, and Justin Wright, with help

42:47

from the Hidden Light team of Barry Lurry,

42:50

Sarah Horowitz, Nikki Huggett,

42:52

Emily Young, and hum Abite, with

42:54

additional support from Lindsay Hoffman. Original

42:57

music is by Justin Wright. If

42:59

you liked this aisode, in fact, please

43:01

make sure to subscribe so you never miss an episode,

43:04

and tell your family and friends to do the same. If

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you really want to help us out, leave us a review on

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43:11

for listening, and see you next week.