Because of this experience and hearing of similar experiences from my classmates, I felt a strong desire to work in women’s health.

I have been an OB/GYN in the Knoxville community for over 30 years. I would like to share my personal history with abortion and explain why I am an abortion provider today.

I grew up in a low-income family in Gatlinburg, although we never knew we were poor. My father worked as a cook, and my mother waited tables. Although no one in my family had gone to college (my father was not allowed to finish high school due to his family’s need for money), my parents encouraged my sisters and me to get an education. When I was 16, I became pregnant. Although my boyfriend and I used protection, condoms have a high rate of failure, and birth control pills were not available to unmarried young women. When I found out I was pregnant, I was very frightened due to my desire to continue my education and the limited choices available to women in Tennessee.

This was before Roe vs. Wade, and although abortion was legal in California and New York City, I could not afford to go to those places. I discussed my choices with family members and my boyfriend and elected to have an illegal first-trimester abortion in Knoxville. Even though I was lucky enough to not suffer any serious complications, as many poor young women did during those times, it was still a very painful and frightening experience done by a local gynecologist but without any counseling or explanations.

Because of this experience and hearing of similar experiences from my classmates, I felt a strong desire to work in women’s health. I met and married my husband of 36 years just before attending medical school at UT Memphis and went on to complete a residency in OB/GYN. My husband and I had discussed having children following our education but were dismayed to find out that our very effective method of birth control had failed just before I started medical school. We then made the decision to terminate the pregnancy. This time the abortion was done legally and was a much more humane and less painful experience than the first one. Several years later, after I finished medical school and my husband finished his Ph.D., we had two wonderful daughters.

In my 30-year career, I have referred all of my patients who were pregnant and who wanted to terminate the pregnancy to Dr. Morris Campbell, an excellent local OB/GYN working at the Knoxville Center for Reproductive Health. I chose not to do abortions in my own office because the counseling and pre-abortion services available at an abortion clinic could not be matched in a private office setting. I never had a patient who had a bad experience with having an abortion done at KCRH. I also never had a patient have a complication from a procedure done by Dr. Campbell.

Tragically, Dr. Campbell died of a hemorrhagic stroke in 2012. I elected to start providing abortions following his death. Tennessee had recently passed several laws that restricted abortion providers, including a law requiring that doctors performing abortions had to have active hospital privileges at a local hospital. I think many people in the lay community and perhaps some of our legislators did not realize what having active hospital privileges actually entails. In order for a physician to have active hospital privileges, the hospital requires surgeries be performed in their facility. For the OB/GYN specialty, this includes hysterectomies, Cesarean Sections, and other types of pelvic surgery. Fortunately, due to the very low complication rate from abortions, abortion providers encounter complications very rarely and therefore almost never need to perform these surgeries in the hospital setting. The hospitals cannot credential physicians not performing procedures in their faculty and actually require a certain number of surgeries to be performed in order to maintain active privileges.

For this reason, to have active hospital privileges, a provider must have a private practice in which they see patients who need various surgeries. In other words, in addition to working in an abortion clinic, the provider must maintain an active private practice at the same time. Financially and logistically, this is very difficult. Most OB/GYNs are part of a group practice or work for hospitals with fixed office and employee costs. Contrary to the beliefs of some state legislators, abortion providers in the Knoxville community actually make less money by providing this service than they would if they spent all of their time in private practice. It is also difficult for me to arrange to travel outside of Knoxville, since most of the doctors who would be happy to cover the clinics when I am out of town have not continued to perform major surgeries in the hospital setting and therefore do not have active hospital privileges. Doctors outside of Knoxville do not meet the requirements either, since the law stipulates that active privileges must be with local hospitals.

Requiring clinics to meet ambulatory surgery requirements is also unnecessary for the safety of patients having abortions. Many minor gynecologic surgeries are routinely done in physicians’ offices. The multiple and expensive requirements for ambulatory surgery facilities are not required in most states, and in these states the complication rate for abortion procedures is very low. Multiple medical studies are available to demonstrate this outcome.

In looking back to my personal and professional history, and in light of the multitude of difficult decisions that women must make in their reproductive years, I am happy to have lived in a time when women were treated with the respect to make their own reproductive choices. Birth control is not 100 percent effective, and families have a multitude of difficult decisions facing them daily. Please leave the decision of whether to continue a pregnancy up to the woman, her family, and her physician.

Susan, East Tennessee