Allison Fuster is a counselor by education, an advocate at heart, and a creative person through and through. An Atlanta native, Allison continues to work in the southeast as an advocate for and provider of mental health services.

Nina Pine: How did you become interested in reproductive health and working with patients around this issue?
Allison Fuster: When I graduated from college, I had no idea what in the world I was going to do for a living. I waited tables at first, but I got tired of that quickly. I realized that I liked interacting with people, and was looking to do that in a more fulfilling way. While looking for volunteer opportunities, I stumbled upon a job as a Patient Advocate at an abortion clinic. I didn’t know much about this work, but as a self-proclaimed feminist it seemed like a good fit for me. I fell in love with it immediately. I really liked being able to connect with someone during an intimate time. I found that people just wanted someone to listen to them and maybe selfishly I really liked being that person. I quickly learned about the many barriers people face when trying to obtain an abortion, and I became passionate about trying to help them navigate that.

NP: You mentioned that your patients wanted someone to listen to them. What did they want you to hear?
AF: At the facility where I worked, there was only one point during the appointment where the individual having the abortion was able to sit down one-on-one with someone privately and with the door closed. During this time we would review the consent form, associated risks, and what to expect before, during, and after the procedure. It was the one time that clients could sit in a closed room with another person’s full attention, where they weren’t in the waiting room where other people could overhear them.

During this time, I found they often wanted to talk about the families they already have, the circumstances that lead to their pregnancy, their relationships, and plans for the future. I realized that abortion is something that can make a person more aware of where they are in life. It can bring into awareness current family or relationship dynamics, or even their employment. It can open the door to things that are impacting their lives that they may not have otherwise considered. It’s not that way for everyone, but in my experience in sitting with patients, I think they just wanted to share a bit about who they are.

Unfortunately, with abortion access as limited as it is, especially in the South, clinics are really busy. In order to try to reduce time spent in waiting areas, staff is under pressure to move patients through their appointments quickly. I think that can make the experience feel impersonal, and perhaps that’s why people wanted to personalize it. They wanted to communicate that they are not just another person in the waiting room. They wanted the opportunity to say “this is me, this is my life, this is my name.”

NP: How have you seen abortion stigma impact patients you’ve worked with?

AF: One of the most blatant examples I saw would be when we received calls from patients who didn’t even want to say the word abortion. They would say “I’m pregnant, and I don’t want to be, is that something that you do here?” They would find creative ways to discuss it without actually saying it.

There are ways that even I, to this day, play into that stigma. For example, I collaborated with a local non-profit to host a fundraiser for low-income Southerners to receive their annual pap smears. Because the event was for wellness exams, I believed people would be open to it. That allowed me to be very comfortable with how I marketed and spoke about the event. I would like to think I would take the same approach to an event raising funds for abortions, but I’m not so sure. And that definitely has to do with the stigma associated with abortion.

When I was at the clinic and people asked me where I worked, my response would vary depending on the person. If it was a stranger, I would say “similar to a Planned Parenthood, that kind of thing” until I got a better feel of whether bringing up abortion was okay or not.

I also think about accessibility around this topic. I want to engage people in conversations around abortion as much as possible. Sometimes I think it’s best to tread lightly – partially out of fear that I will turn someone off by being too blunt, but also in the hopes of getting to a point of sincere discussion. Other times, I’m in a stigma-busting mood and want to jump right in. I think there are really interesting conversations to be had regarding safety, stigma, and how we communicate about abortion. As deeply as I want to be a fearless advocate for abortion access and abortion story telling, I can’t deny that I continue to struggle with how to share that information in a way that will be safe and accessible to someone else, especially someone with opposing values.

NP: Can you tell me a bit more about your experience of working around abortion in Atlanta?

AF: Earlier in our conversation, I alluded to the barriers people face when trying to obtain an abortion. Living in the South can definitely be one of those barriers. Being from Atlanta, I had never given much thought to having access to a clinic – there are roughly 10 abortion providers in town. But, travel outside the city, and options suddenly disappear. Working at an abortion clinic in Atlanta meant working with people all over the Southeast. Many surrounding states to Georgia have more restrictive abortion laws, leading patients to travel to Atlanta. Because abortion clinics in the South are primarily found in a few major cities, it wasn’t unusual to see folks who would have to travel more than three hours for their appointment.

In the South we have a few clinics and organisations that are very public and engaged in advocacy, such as the Feminist Women’s Center, but many are not. The threat of protesters and drawing attention of anti-choice organizations is very real here, and so I believe the culture in the South amongst a lot of these providers is to fly under the radar.

I guess one other thing that comes to mind is the relationship between abortion and mental health. Both mental health and abortion come with their own stigma, but I particularly struggle with talking about these two things together in the South. Just to be clear, I’m not implying that individuals who have abortions are in need of mental health care, but I also just want to put it out there that hey, that’s a possibility. Like with any life event or procedure, there’s a certain amount of processing that people go through, particularly if it’s a challenging experience. Since getting my degree in counseling I’ve been trying to build connections between the two, to be a provider who can reach clients who have had abortions and may need to process the experience. It’s challenging for me to approach organizations around this, as they’re hesitant to connect these two things. And that’s with reason, there are voices out there that would like to say that having an abortion directly causes mental health issues such as depression, and so I definitely understand the hesitancy, but I don’t think that means we can’t create a space for both of them.

I think that where I’m at with this right now is acknowledging that I’m a mental health provider, I’ve worked in an abortion clinic, and if someone is seeking therapy around this or any other issue, I want them to know my practice is a safe place to discuss that.

NP: What would you tell someone who has had an abortion?

AF: There’s no right or wrong way to feel. Your experience is unique, and to try not to place any judgment on how you’re feeling.

NP: Is there anything else you’d like to share?

AF: I am really grateful that you asked me to do this, sometimes I forget just how passionate I am about de-stigmatizing abortion and giving people a space to talk about it.