Lauren Haines is one of TBD’s nurse practitioners based on the East Coast. When she’s not working with TBD, she volunteers as an advocate/escort and works part-time as a registered nurse at a clinic delivering reproductive healthcare and pregnancy termination care. She sat down with us to tell us a little more about her experience with these roles and why she’s passionate about this.

AT: Thanks so much for taking the time to talk to us! So it sounds like you have been part of an organization that helps offer reproductive healthcare, specifically abortion care, and that you started there as a volunteer escort. What does being an escort at an abortion clinic mean?

LH: There is a volunteer organization locally that trains and provides escorts for a couple of the abortion clinics here in North Carolina. We get there before the patients come, and you have your vest to show who you are. The whole goal is to kind of shield the patients who are going into this abortion clinic from the protesters. Protesters are not allowed on the clinic property, but they stand right at the edges and on both sides of the driveway. As cars are driving through, they'll try and stop them to give them pamphlets and to talk to them about not proceeding with the termination. They are usually really nice at first but as the cars ignore them they typically start yelling at them and calling them murderers.

AT: That must be hard for those patients to hear as they’re coming in for a procedure.

LH: Yes, usually the cars will just drive past them, sometimes they stop and they take information. As volunteer escorts, we sort of help move the cars through, because some of the protesters will also wear vests like we have to pretend to be escorts, which can be confusing to patients. We help them park and then once they park, we kind of walk them down with a big umbrella to shield their face from the protesters. We do this just so they're not recognized, because sometimes the protesters will yell out to them specifically like “You with the Red Hat!”. It's just helpful to kind of block their appearance. As an escort, we don’t really engage with the protesters.

AT: That has to be so hard - what was the training like for this? Do you get training on what to do with protesters?

LH: I did an online training and then I did a shadowing day. After that I started escorting on my own. The goal of the training is pretty much how to stay safe and not engage with the protesters. I think there were some issues a while back where some escorts would engage with them or would have conversations with them and things would just escalate. Things could then become more dangerous for everybody. It’s been a lot more calm with this non-engagement approach.

AT: How did you end up getting into this kind of volunteering?

LH: I actually went on a date when I first moved to the area, and he mentioned how he did escorting one day a month. I thought it was so cool and something I’d love to be involved in - so I just googled how to be an abortion clinic escort. I found somebody to email and I filled out a survey. They messaged me a couple months later, and I got started!

AT: Are there things that have surprised you about this experience?

LH: I’m surprised every time. The first time I went, there were probably only 6 or 7 protesters, but I was surprised because somebody brought a loudspeaker, so his voice really travels. I was also surprised when some other guy brought a camera, not to record the patients - but to record himself talking. They just go on and on and on, mostly talking and preaching, even when no one is outside to hear them.

AT: So they do this all without an audience? What are the topics they talk about - is it mostly religious?

LH: That's the biggest thing that surprised me. I expected them to yell at the patients as they walked by, but I didn't expect them just to talk constantly for so long with no audience. They just have so much stamina, it’s actually impressive. It reminds me of a pastor preaching at a church service, you know? Even without an audience, they'll just go on and on. It is predominantly religious discussion but they also go on tangents about things completely unrelated - people who are trans, gay, COVID…they try to loop it back to abortion somehow.

AT: How do the patients react?

LH: In all different ways. Some of them are surprised. Usually the men or male partners of the patients are most surprised by the protesters. I love it when patients come with their moms, because I feel like some of these moms are feisty, like a mama bear, telling folks to “get away from my daughter!”. It’s often the person who goes with the patient who tends to engage with the protesters and stands up for their friend or relative or partner. The patients seem to be more quiet, since they’re often stressed out enough as it is.

AT: Is this kind of protest outside of clinics really common? As someone who lives in a more liberal area, I haven’t seen this much.

LH: Well I think it’s probably everywhere, but it’s a bit different since we’re located in the Bible Belt area. But we get protesters from everywhere - the liberal cities and also the more rural areas. I’ve had different experiences at different clinics and I’m not sure if that’s because of the current political climate. In my training years ago. I did a clinical rotation at a Planned Parenthood in Connecticut, where they did pill abortions and there were never protesters outside. It might be different for the clinics that do surgical abortions in Connecticut.

AT: Wow. Yeah, it sounds like part of it is probably cultural, local, what’s going on politically. I’m so glad you're actually doing that work, even if it's not that often. This reminds me of the scene in Sex Education where one of the characters goes into the abortion clinic and there are like two protesters outside. How many patients does your clinic typically see a day? They could be going there for other kinds of care right?

LH: My clinic provides STI testing and contraception as well, but mostly does abortion care. Typically there are maybe 10-20 patients a day. There are usually around 6-12 protesters on weekdays but that can jump up to about 30-50 on a Saturday.

AT: Wow, that's a lot of people to show up to protest. And not that many actual patients.

LH: That was surprising to me too. Protesters just stay outside, kind of yelling at the building. And usually when patients leave they hand out pamphlets and hold up signs about pill reversal, and that it’s not too late to change their mind even though they’ve already taken the first pill to start the process.

AT: From what I understand, pill reversals don’t really work right?

LH: They really are not safe or proven. I think that we’ve had one patient that did change her mind and ended up seeing a specialist (OB/GYN) and actually had a successful and healthy pregnancy. I’m sure that’s not the case for others.

AT: Sounds dangerous from a medical perspective and definitely not medically advisable. It also sounds like you work as a nurse there part-time right? In addition to volunteering? Can you tell us a little more about that?

LH: Yes, I saw a job posting for an as-needed nurse, just one or two shifts a month. I just wanted to help since I have the skill set, and I figured this was another way to help. I had a phone call and an in-person interview. I did a few in person training days as well. There is a lot to learn - just like in any new role or field in nursing. I’ve been doing this now for about 2 months.

AT: I’ll be that’s a whole new set of skills to learn. What's like your role and specifically as a nurse typically in this?

LH: Well there’s a lot of paperwork and charting, and making sure patients have all the consents filled out correctly. For the patients taking the pills, we go through their history, making sure that it’s safe and appropriate to receive the pill. I also help with preparing the medication while they’re there and the medication to take when they go home.

AT: What are the medications for abortions like?

LH: They’re different - one shuts down the pregnancy and stops the fetal growth. Then they take another medication home which they will take 24-48 hours later which will help to soften the cervix and expel the pregnancy.

AT: Do you do the patient teaching?

LH: There’s another person at the clinic who routinely does all the counseling and all the education. They talk about side effects, what to expect - and what happens if you throw up etc. I answer any remaining questions. The doctor and I walk down together to give them the pills, and then they can leave if they don’t have any other questions.

AT: What about for patients who have a surgical abortion?

LH: For surgical abortions, I help with medications before the procedures like antibiotics, pills that help soften the cervix, etc. We have a recovery room where I monitor them for half an hour after the procedure, take their vitals, and make sure there’s not too much bleeding. If they’re stable, we let them go home after about 30 minutes.

AT: Sounds like a lot to learn! Have you had experience specifically with this kind of work as an RN or nurse practitioner before?

LH: No, my main RN role was in the emergency department. I was never in OB or labor and delivery. I did work as a sexual assault nurse in the ER before, but nothing really to do with abortion.

AT: What got you interested in this line of work specifically?

LH: I think I've been interested in it ever since I did that clinical rotation at Planned Parenthood (which covered general women’s health, pregnancy care, and abortions as well). I feel like I had a lot of exposure to women’s health and reproductive care at that time. And I've also always been a strong advocate for people to be able to make their own decisions about their body.

AT: What are the folks like that tend to come in for these procedures? I feel like there’s a lot of common misconceptions about who actually gets procedures done

LH: Definitely. Even in the short time I’ve been there we've had, all races, ethnicities, age groups. People up into their mid to late 40’s are not uncommon. The physician I work with has had children as young as 11 and 12 that he has provided care for. It can be difficult for kids and teens in certain states, since they may need consent from a parent or guardian. They can also go to court to plead their case and they may be granted a temporary emancipation where they have the ability to get an abortion if desired.

AT: Are you serious? That has got to take some time and resources and cause a delay in care, right?

LH: Absolutely, and you need it for both the pill or the surgical abortion. And trying to figure out the logistics of that legal part can be hard for anyone, especially an adolescent.

AT: That sounds so tough to figure out - even as a healthcare provider I still struggle with navigating the healthcare system. The diversity you speak of is what has always been so interesting to me in my practice. My clinic will usually send people to specialists for terminations, but most of my patients who have ever asked about terminations have been older women with families. It’s not always this narrative of a teenager type of patient like on the TV shows.

LH: Yeah, we've had some people that have medical issues and that their doctors have recommended that they not proceed with a pregnancy because it's going to be too dangerous for the mom and high risk for the fetus. There's all sorts of different reasons that people have for choosing abortion, sometimes even folks in abusive relationships. We’ve also started seeing some of the influx too from other areas or states nearby that don’t have access to abortion care.

AT: Knowing that Roe v Wade is likely overturned, what do you see as happening for you or the clinic that you volunteer/work for? I know that in some states, they’ve put some legal safeguards in place and other states have laws that will effectively outlaw abortion if Roe V Wade is overturned.

LH: I have no clue. I don't think they're planning on restricting abortion access in our state within the next year or anytime soon. But honestly, who really knows. There aren’t clear safeguards for abortion care in North Carolina like some other states have.

AT: It sounds like people travel from other states to your clinic. Is there a good concentration of services in your area?

LH: There are only about 14 clinics in North Carolina, but they’re not very well spread out. Over 90% of counties in North Carolina don’t have any clinics. We regularly get people that are traveling up to 2 hours for care. Access is definitely a barrier here.

AT: What are some of the takeaways that you have - now, after working as a nurse and also volunteering as an escort in a clinic that providers abortions?

LH: I think the main one is just that everyone has different reasons to end a pregnancy. We have women who are in loving relationships who have been trying for a baby and want one so bad, but their health is in jeopardy or the fetus has an anomaly that isn’t compatible with life… And then they have to walk by these protesters yelling at them and calling them murderers. It’s traumatizing. We just need to show compassion.

AT: Thanks for sharing that with us and for all your work, the literal work and the volunteering and the advocacy. We’re lucky to have you!