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Staying Alive

A Day in the Life of a NYC Abortion Clinic: ‘We Just Keep Working. And We Keep Doing What We Have to Do’

"We’ll rise up to it. But it’s hard."

12:12 PM EDT on June 24, 2022

In 1971, shortly after New York legalized abortion but before Roe v. Wade, Merle Hoffman founded Choices Women's Medical Center in Queens, one of the first abortion clinics in the country.

On Friday, in a 6-3 ruling, the Supreme Court overturned Roe. But as Hoffman shared in this diary she wrote for Hell Gate describing a day in the life of the clinic, Choices, like many clinics in New York City, is prepared to offer abortions to people from around the country, and working with a network of abortion funds to do so. "We just keep working. And we keep doing what we have to do," she writes. "If we have to expand, we expand. Whatever we have to do, we'll do."

Hoffman, who is in her 70s, has come under some sharp critique in recent months, after she and two other activists, one of whom is affiliated with a small, ultra-left organization that has been described as a "cult of personality," started a group called Rise Up 4 Abortion Rights. Critics in the reproductive justice and abortion rights movement have charged that the group does little to build a movement that helps people obtain abortions, and that its messaging, reliant as it is on outdated images like coat hangers, is counterproductive. It's more than valid criticism. But Hoffman, who has seen friends and colleagues murdered for providing abortions, brushes it aside. "I am not just going to sit back and let them rip my rights away," she writes.

Hoffman provided Hell Gate an hour-by-hour snapshot of a day in the life of Choices this week. This is the first in a series on how NYC activists are responding to the fall of Roe v. Wade.


7:30 a.m. I wake up and immediately check to see if there are any texts or messages from the clinic, as we start seeing patients at 7 a.m. If there's an emergency, I'm called. No urgent messages today, so I scan loads of different newspapers, national and international. Lately, because of the looming Supreme Court decision, they're running a lot of individual stories from women who are caught in Kafkaesque situations. All of these stories are heartbreaking, but you know, I've had 51 years of personal stories. That's what motivated me and inspired me to devote my life to this work, but the bottom line is that the opposition—fundamentalists, the conservative Supreme Court—doesn't care. You can tell as many stories as you want, but then Amy Coney Barrett will just say, just go through the nine months, take the baby and drop it off somewhere, like at a "fire station."

11 a.m. I go to the clinic and go into my office. The clinic is already busy and working with abortion patients as well as patients seeking pre-natal and other gynecological care. I check with my clinical administrator who is upstairs in the surgical suite about how everything is going.

12:15 p.m. I have a call with the FBI Counterterrorism Task Force along with a clinic escort leader and my chief administrative officer. They inform us that they are sending counterterrorism officers in squad cars to monitor Choices in preparation for the Supreme Court decision coming down. They're concerned that the constant potential of violence from the protesters around Choices will escalate.

It's not the first time that the FBI has gotten involved with the clinic. During the Clinton years, there was a lot of violence, bombing, and murders. In fact, a friend of mine, Dr. George Tiller, was shot in the head in Kansas and killed in his church, and I was personally threatened to the degree that Janet Reno sent armed guards to protect me and Choices for three months. During that time, the clinic was also being threatened by eviction.

Everybody thinks that New York is very progressive. We legalized abortion in 1970, which was three years before Roe. We see ourselves, and we like to see ourselves, as a beacon of progressive equitable values. But maybe two, three times a week, and every Saturday, we have very loud, boisterous, harassing protesters out here. They've been coming around as long as I've been here, and in any other facility that we've had. And they scream at women, "You're killing your babies." And if the patients are Black, they say that you're desecrating the legacy of Martin Luther King, Jr. We have clinic escorts here, to take patients in so they don't feel so attacked.

I've seen this harassment for decades. They used to pray for my soul. But now there's no prayers. Sometimes they'll do a prayer vigil, but most of the time, it's screaming, and it's harassing, and holding really horrible visual images that are factually untrue.

1:10 p.m. In my office, I start reading about digital security threats, because the antis have been unleashed. We're getting alerts from the National Abortion Federation to make sure you're careful with your IT.

We've been hacked here a few times. I reach out to our IT, and ask them about our firewalls, and whether or not we need to add more protection.

1:20 p.m. I also read that two abortion funds ran out of money early this month. Indigenous Women Rising, as well as the Utah Abortion Fund, which is out of funds and will reopen again July 1.

I've recently been attacked by mainstream abortion rights organizations about my political strategy with Rise Up 4 Abortion Rights. Their argument is the main thing we have to do is fund abortion funds. They say, Roe is falling, and we have to give money to abortion funds, because that's the only thing we can do. We can't fight this, we have to just give money.

The problem is, you can't fund everyone who needs to have an abortion. Some are in prisons, some are in abusive relationships. Abortion funds are important because many people will need that. And we have to have funds to help individual women. But you don't sit down and say, well, we'll just have to get abortions on our own. I just can’t do that.

1:30 p.m. Another patient from Texas arrives. She is 14 weeks pregnant with twins and will be coming back tomorrow morning. She needed help paying, so we arranged to have the New York Abortion Access Fund subsidize her care.

There is a great deal of administrative time to coordinate all of that. And multiply that by many more people who will be coming to New York. It's already happening—in 2018 and 2019, we would see about five to eight abortion patients each month who came from outside of New York City, including from other parts of the state. In May, we had 17 patients who traveled from outside of the state alone. It's definitely going to be a challenge. We’ll rise up to it. But it’s hard.

You know, I'm very, very angry today. This morning, I read that story in the Washington Post about the Texas 18-year-old who was forced to have twins. I had to take a deep, deep breath. Sometimes, after all these years, that rage comes up and I have to work to put it down because it's not effective.

I think about another patient who came from Texas last week. She flew in very early on a Friday morning, with a return ticket to Texas that same night. And she was convinced she was less than 12 weeks pregnant. We do the sonogram, and it turns out she's between 14 and 15 weeks.

The counselor had to tell her that we couldn't complete the abortion in one day, because this is a two-day procedure at that stage of pregnancy. She told us, "I can't stay over because I have a flight booked for tonight. I have no food, I have no money and I have no place to stay." So we called the Brigid Alliance, one of the abortion funds that has been very active and very helpful. And in the end, she had a place to stay and she had money, and she had food. And they also changed her plane ticket. And she came back the next day to have her abortion, and then she went home, not pregnant and back to the life she had.

2:30 p.m. I email back and forth with the other two co-initiators of Rise Up 4 Abortion Rights, which we started in January. I've seen, and heard on the street, the criticism of our work and the attacks on Sunsara Taylor over her involvement in the Revolutionary Communist Party—that it's a cult, and so everything that Rise Up 4 Abortions Rights does is suspect.

And I have a problem with communism, I do. And I've struggled with Sunsara about this. But the transcendent necessity, the prime directive is to save this law, to save lives, and not to just roll over. And I've been attacked about, Oh, you don't like abortion funds. I mean, that's ridiculous. I've been using them for 10, 11 years. I've been doing the work. The real point is that all of us have to work together—attacking another pro-choice political group for their different vision and philosophy is just destructive.

I am not just going to sit back and let them rip my rights away and just say, let me figure out how to deal with this now. No way. I don't want this to happen. And I'm not going down without a fight.

3 p.m. I have a Zoom meeting with the management staff of the OB/GYN department at Montefiore Hospital, where we discuss the looming possibility of the influx of patients to Choices, which would likely lead to an uptick in hospital admissions. Abortion is very safe—these could be for later pregnancies beyond our clinic’s gestational limit, or for patients who have contraindications to having an outpatient abortion. We are developing a program where Montefiore would be able to send fellows and attending physicians to Choices to assist with our patients. The talks are in the intermediate stage, but we want to help train the next generation of abortion providers.

4 p.m. We saw about 30 patients today, and that includes medication abortions and surgical abortions. If we had 20 more patients today, we could have accommodated them. But if we had more than that, we’d probably have to have another provider.

When the SCOTUS decision comes down, as far as our staff are concerned, we just keep working. And we keep doing what we have to do. If we have to expand, we expand. Whatever we have to do, we'll do, and we'll do the best we can.

But it's such a loss, that the only analogy I can give is the death of my mother. It feels like somebody is on life support, and it's any day now. You are prepared and you are ready. But they're still there. But when they're not, your whole world changes. You are never truly ready for that.

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