The Washington PostDemocracy Dies in Darkness

New spa-like abortion clinic is part of a trend to de-stigmatize the procedure

March 30, 2015 at 7:00 a.m. EDT
Carafem is a new abortion-pill clinic in Montgomery County that promises a "spa-like" experience for women with a open and unabashed approach to pregnancy termination. Pictured are Melissa S. Grant, the Maryland clinic’s vice president of health services, and Christopher Purdy, president and chief executive. (Sarah L. Voisin/The Washington Post)

With its natural wood floors and plush upholstery, Carafem aims to feel more like a spa than a medical clinic. But the slick ads set to go up in Metro stations across the Washington region leave nothing to doubt: “Abortion. Yeah, we do that.”

The Maryland clinic, opening this week in Montgomery County’s tony Friendship Heights area, specializes in the abortion pill. The advertising reflects its unabashed approach — and a new push to de-stigmatize the nation’s most controversial medical procedure by talking about it openly and unapologetically.

Plagued by political setbacks in recent years, abortion rights activists are seeking to normalize abortion, to put a human face on the women getting the procedure and, in some cases, even putting a positive spin on it.

In Los Angeles County, groups recently sent women door-to-door in conservative neighborhoods to talk about their abortion experiences in the hope of changing minds. A number of Democratic lawmakers have publicly acknowledged having undergone the procedure. And new online projects solicit personal testimonials, including from women who have no regrets about terminating their pregnancies.

At Carafem, staff members plan to greet clients with warm teas, comfortable robes and a matter-of-fact attitude.

“We don’t want to talk in hushed tones,” said Carafem President Christopher Purdy. “We use the A-word.”

The campaign comes as the abortion rights movement is struggling politically. Since 2010, states have enacted more than 200 laws restricting the procedure, and dozens of clinics have closed their doors. Groups on both sides agree that antiabortion activists have the momentum, with a simpler message — “abortion kills” — and a gut-level emotional appeal.

Even Americans who support abortion rights are often deeply conflicted about the procedure. Although a majority of Americans say abortion should be available in most cases, polls show roughly half of those surveyed also think abortion is morally wrong.

“Most people in this country do not think abortion is a good thing on its face, even if they deeply believe it should be legal,” said Lanae Erickson Hatalsky, director of social policy and politics for Third Way, a center-left think tank.

Hatalsky praised the efforts to de-stigmatize the procedure, saying the approach is attracting a passionate new crop of young activists to the movement. Telling personal stories, she said, echoes a strategy successfully employed by the gay rights movement, helping it change public opinion by coaxing people to come out of the closet to their friends, neighbors and colleagues.

‘Gray’ areas

Groups such as Planned Parenthood are trying to walk a fine line, appealing to these young activists while also remaining palatable to the majority of Americans who are conflicted, a group that Third Way refers to as “abortion grays.”

“We still do a lot of work with people who are less supportive of abortion, and one way we need to communicate is in a more empathetic framework that kind of says, ‘Look, these are really complicated personal issues,’ ” Planned Parenthood spokesman Eric Ferrero said.

But “we also need to be unapologetic and bold,” Ferrero said, to connect with young people, who he said have flocked to the 100-year-old organization.

Since 2011, the number of college chapters has risen from 70 to 250.

Some of these younger activists have grown weary of what they see among their leaders as an overly apologetic attitude about abortion.That has led to some in-your-face tactics. Last year, Emily Letts, a 26-year-old actress and clinic counselor, made waves after posting a YouTube video of her surgical abortion, filmed from the waist up.

“Not everyone is sad about their abortion,” said Letts, who has attained celebrity status in the abortion rights movement. “We need to hear the full range of stories, and the positive stories are not being conveyed appropriately.”

Her three-minute video went viral and was one of two winners in the first-ever “Abortion Stigma-Busting Video Competition” sponsored by the Abortion Care Network, a Washington group devoted to “normalizing the abortion experience.”

Some mainstream abortion rights supporters have also turned to jaw-dropping tactics. Ohio state Rep. Teresa Fedor (D), in an emotional speech last week on the Ohio House floor during debate over a proposal to ban abortion once a fetal heartbeat is detected, revealed her decision to terminate a pregnancy that resulted from rape.

"You don't respect my reason. My rape. My abortion. And I guarantee you there are other women who should stand up with me and be courageous enough to speak that voice," Fedor said in a video posted on the Toledo Blade's Web site. "I've sat here too long."

Fedor is among an estimated 1 in 3 American women who will have an abortion by the time they turn 45, according to a 2011 study by the Guttmacher Institute, a reproductive rights think tank. Those statistics demand a more matter-of-fact approach, the feminist poet Katha Pollitt argues in a new book, "Pro: Reclaiming Abortion Rights."

“We need to talk about ending a pregnancy as a common, even normal, event in the reproductive lives of women,” Pollitt writes, adding that the decision to abort can be “just as moral as the decision to have a child — indeed, sometimes more moral” because “part of caring for children is knowing when it’s not a good idea to bring them into the world.”

Marjorie Dannenfelser, president of the Susan B. Anthony List, an antiabortion lobbying group, predicts the approach will fail. Even people who support abortion rights “don’t necessarily see it as something to celebrate,” she said. “They want to think about [abortion] as a necessary evil.”

Carol Tobias, president of National Right to Life, a prominent antiabortion group, agreed. Tobias said she thinks people will be “disgusted” by Carafem, the spa-like abortion clinic.

“Abortion is not pleasant,” she said, “and trying to put pretty wrappings around the procedure isn’t going to make any difference.”

Less stigma overseas

Purdy said he got the idea for Carafem two years ago after more than a decade with DKT International, a nonprofit group that promotes family planning and HIV prevention in developing countries. Overseas, he said, getting an abortion is often as simple as visiting a pharmacy. In the United States, however, some states strictly regulate the abortion pill, citing concerns about its safety, making it virtually impossible to get in some rural areas.

“I was flabbergasted,” Purdy said, to find “that it was easier to get an abortion in Ethi­o­pia compared with the United States.”

Because Carafem will offer only the abortion pill, not vacuum aspiration or other surgical procedures, prospective clients must be no more than 10 weeks pregnant. (Roughly two-thirds of all abortions occur in the first eight weeks of pregnancy, according to Guttmacher.)

After receiving counseling and some basic tests, Carafem clients will take an initial pill at the clinic. Purdy’s team expects to get them in and out quickly, within about 60 minutes. They will be sent home with a second set of pills to take the next day. The second dose induces the abortion, which resembles a miscarriage, typically within six hours.

By offering only pharmaceutical abortions, Purdy says, he can avoid purchasing expensive surgical equipment and can keep prices low for clients. The average pharmaceutical abortion cost about $500 in the United States in 2011, Guttmacher figures show; Purdy plans to charge around $400.

Another striking aspect of the project is the design: The clinic will have wood floors and a natural wood tone on the walls that recalls high-end salons such as Aveda. Appointments, offered evenings and weekends, can be booked online or via a 24-hour hotline.

“It was important for us to try to present an upgraded, almost spa-like feel,” said Melissa S. Grant, vice president of health services for the clinic.

If the project is successful, Purdy says, he hopes to expand his model to other states.

“It’s fresh, it’s modern, it’s clean, it’s caring,” he said. “That’s the brand we’re trying to create.”

Scott Clement contributed to this report.