Taub, too, is an activist — one on the opposite front line of America’s reignited abortion wars.
For the next two days, the 36-year-old will perform two dozen abortions a day at Trust Women. She travels here at least once a month because the clinic can’t find enough local doctors to perform abortions in a state where the procedure is culturally shunned — and demand is surging.
Traditionally, most doctors have avoided politics. But to Taub this is work rooted in social justice and as urgent as ever, when the right to an abortion soon could virtually disappear in many states, even as 1 in 4 women terminates a pregnancy by the time she is 45, according to the Guttmacher Institute.
“Abortion is political,” Taub said in the genial, matter-of-fact tone that dominates her fast-paced conversation. “There’s no way to uncouple providing this care from the political aspect of it. Politics have a direct impact on the work that we do every day.”
The war over a woman’s right to an abortion will intensify Wednesday when the Supreme Court will hear a Mississippi case that could effectively gut the landmark 1973 Roe vs. Wade decision. While Roe allows a woman to terminate a pregnancy before 24 weeks, after which a fetus could survive outside the womb, the Mississippi plaintiffs want to ban abortions after 15 weeks.
If they succeed, abortion could become virtually illegal in as many as 26 states, advocates estimate. Providers and public officials are preparing for California and other states to become havens where tens of thousands of women might come to safely and legally terminate their pregnancies.
That shift could mean that California could soon need the services of out-of-state doctors, too — to deal with a surge in demand.
Such a reality would also send many women — at least those who can afford it — to travel hundreds of miles from their homes in search of care.
That’s already the case in Oklahoma, where Taub works.
Before a Texas law took effect in September that bans nearly all abortions after an embryonic heartbeat is detected — usually around six weeks — and makes no exceptions for rape, sexual abuse or incest, the Trust Women clinic scheduled 20 to 30 appointments per day. Now it’s booking 50. Its rotating roster of out-of-town physicians like Taub has swelled from four or five to 17.
The volume of calls to the clinic has doubled, and a majority of the inquiries are from Texas. So many Texas women have booked appointments in recent weeks that many Oklahoma patients must drive more than two hours to Trust Women’s clinic in Wichita, Kan.
If the clinic weren’t able to fly in doctors like Taub, clinic manager Kailey Voellinger said, “we would not be able to see patients.”
“It’s really difficult to find a provider that wants to work in a state or an environment that’s really hostile to their job,” Voellinger said. “People don’t want to get harassed when they go to the grocery store, right? People want to be able to just work and do their job and not be bothered.”
Taub, though, derives joy from how immediately her services impact a patient’s life.
“When you provide an abortion for someone, you are really changing their life in a really meaningful way,” she said. “They are in a situation that they know that they cannot be in, and you are able to go in and solve that problem.”
“When I see patients in a (Bay Area) clinic, it’s not the same way,” she said, as many of her California patients are seeing her for a variety of other reasons. Plus, she said, they are fortunate to live in a state where abortion is legal and easy to obtain.
But with that satisfaction comes risk. She, like many who provide abortion services in states that are politically and culturally hostile to the procedure, must act with discretion, from the choice of where she stays in town to how she travels in and out of the clinic. She rarely leaves the apartment the clinic rents for her. In the morning, she quickly dabs on makeup before throwing on leisure wear and driving to the clinic. After work, she does yoga, then eats takeout while watching episodes of “Shark Tank” as an escape from the emotional and physical intensity of the long days.
Until recently, her side work was unknown to even those close to her. Taub’s mother didn’t know she was traveling to less abortion-friendly parts of the country to perform the procedure until she read about it in The Chronicle in a September story about the Texas law.
“I didn’t want her worried about my safety,” Taub said. “And I knew that she would be concerned. I know that I am being as careful as I can be. I, you know, just didn’t want to worry her.”
Taub’s concerns aren’t theoretical. The Trust Women clinic has ties to some of the darkest moments in the abortion battle.
The first Trust Women clinic opened eight years ago in Kansas on the site of a facility run by Dr. George Tiller, a longtime abortion provider. Tiller was assassinated in 2009 by an antiabortion activist who shot the 67-year-old doctor in the head while he was serving as an usher inside his Wichita church. It was the second time he had been shot by an antiabortion zealot.
Five years ago, Trust Women opened the clinic in Oklahoma City, which clinic operators say was the largest major metropolitan city in the country without abortion services at the time.
Taub acknowledged that “safety is a concern for anyone working in any abortion clinic anywhere. But certainly, knowing that this clinic has a personal history of violence against providers does make me more nervous. It makes me more aware.”
Most of the time she is so busy treating patients that she can’t see the protesters when she’s inside the largely windowless building.
“But when I hear that there’s, you know, 20 people, 40 people outside, it definitely concerns me. I feel like it also sort of lights a fire in my belly,” Taub said. “The most important thing that we can do is to continue to provide this care, because if we stopped providing this care because we are afraid, that’s exactly what those who would wish ill upon us would want. It definitely is part of what motivates me to continue to do this work and continue to do it here.”
One of the women receiving care from Taub at Trust Women on a day in August was Maria, 24, who asked that her last name not be used because she doesn’t want her family to know about her abortion.
This is the second time Maria has terminated a pregnancy. The first was in 2015, when she was a senior in high school. Her deeply religious mother had erroneously told her that if she took contraceptives, she wouldn’t ever be able to have children.
She had an abortion then because she wanted to attend college — and went on to become the first person in her family to earn her degree. Now, she is working as a legal assistant for an immigration attorney and studying for the LSAT exam, in hopes of attending law school.
She was on birth control but got pregnant after she took a few months off for medical reasons. Her partner waited for her outside the clinic. He has been supportive, but she feared telling her family.
“I could never tell them that this is something that I had to do, or even consult with them to make the choice because I know that they would say, ‘No, it’s not even an option,’” Maria said.
- div">>By talking about her abortion, Jackie Speier inspired a generation of lawmakers to do the same
- div">>U.S. Supreme Court appears to waver a bit during hearing on Texas abortion law
Maria wasn’t deterred by the demonstrators outside. She knows that crowd well. Her mother was one of the protesters standing outside the gate when the clinic first opened.
But some women Taub treats can’t tune out the protesters.
Anna, who asked that her full name not be used, was so intimidated by the protesters that she drove past the clinic four times. She pulled over a few blocks away and called the clinic to ask if there was another way to get in.
“These two guys came up to my car and started yelling at me and telling me, ‘Hey, come talk to me. There are other ways,’” she said.
After what she had been through, she didn’t want to be near men.
Nine months earlier, the 40-year-old nursing assistant traveled to Maryland to take care of her brother, who eventually died from COVID-19 complications, and his two young sons. While she was there, she said she was sexually assaulted. Shortly after she returned to Oklahoma City, she realized she had been impregnated during the attack.
She said she couldn’t bring herself to tell friends or family, including her 15-year-old daughter. Her husband, to whom she had been married for 17 years, died five years ago. The only place she confided her thoughts was her journal.
Feeling alone, she went to a dark place. “I thought about getting a gun,” she said.
Her regular doctor wasn’t much help. She wouldn’t say the word “abortion” — she used the phrase “pregnancy bypass” — but eventually pointed Anna to the Trust Women clinic.
That all flashed through Anna’s mind as she drove by the clinic’s entrance again and again, trying to summon the courage to go inside.
“I thought about other people that have it worse,” she said. “I have this opportunity.”
She eventually pulled into the clinic parking lot. As she walked inside the building, she heard a protester saying, “You don’t know Jesus.”
“I think that if you really want to help a person with a situation, you shouldn’t announce it over a megaphone,” Anna said. “I’m pro-life too.”
Hours later, as she rested in the recovery room, clutching her journal, she asked whether the protesters were still outside. They weren’t. They had left for the day.
Taub doesn’t often hear stories like Anna’s, in part because she doesn’t ask patients why they’ve come to the clinic.
“It doesn’t matter to the care that I provide them,” Taub said. “I ask them about their medical history, and I ask them about their obstetric history — those are all things that are important to the care that I provide. But the reason that they came here, I trust that their reason is good. It’s not for me to judge that reason. And it does not make a difference to their care.”
Taub mirrors the welcoming, nonjudgmental attitude of the clinic and its workers. On the walls of the examining rooms and hallways are inspirational imagery and quotes. “Everyone loves someone who has had an abortion,” read one.
The clinic provides two types of abortions. In a medical abortion, the patient takes a combination of medications over a couple days that cause the lining of the uterus to shed. These are generally done up to 11 weeks after the first day of the patient’s last menstrual period. It requires no surgery or anesthesia, and the success rate is up to 97%, according to UCSF.
Surgical abortions, in which a tube is placed into the uterus to remove its contents, are performed for women who are more than five weeks pregnant. The success rate is 98%, according to UCSF.
Taub’s time with patients who receive an abortion using medication is brief, perhaps only a few minutes. Her blond curls tucked under her surgical cap, she looks each one directly in the eye and radiates just the right amount of warmth to quickly put them at ease.
Taub greeted one of them, a 25-year-old nurse named Nicole, who asked that her last name not be published, in a windowless examining room. She explained to Nicole, who drove for three hours to the clinic from her home in Dallas, how and when to take the medicine and what to expect.
“Most people will have bleeding and cramping within four to six hours after taking this medication, but it can take up to 24 hours,” Taub said. “If it’s been 24 hours and you haven’t had any bleeding or cramping or just some light spotting, give us a call. OK?”
Taub adopted a similarly calm, reassuring tone when she performed a medical abortion later that day. The patient, a 31-year-old woman who has delivered one child and aborted another pregnancy, sat on an examination table as Taub explained each step of the procedure.
As Beyoncé played softly in the background, the woman grimaced after Taub administered numbing medication to her cervix.
“I know this medicine does not feel good,” Taub reassured her. “But it does make the rest of the procedure more comfortable. And now you’re all done with the hard part. You’re doing great. You’re amazing,”
The procedure took about 11 minutes. Taub moved onto her next patient.
Until the Texas law took effect, roughly half of the abortions Taub performed at this clinic were medical abortions.
But like much of the abortion landscape these days, that is changing, too.
In June at Trust Women’s Oklahoma City clinic, there were a little over 100 medication abortion patients. Now, post-Texas law, the clinic is performing closer to 100 to 125 surgical procedures a month and 40 to 50 medication abortions, clinic manager Voellinger said.
Taub doesn’t know why the shift is occurring but has a guess. She thinks it might have something to do with the urgency women feel after the Texas law forced many to travel far from home to seek abortion care.
“I think it’s because people are nervous to take a pill at home when they’re so far away from the clinic,” Taub said. “And if something doesn’t work, they don’t know that they’re going to be able to get the help that they need.”
It is another way that recent — and possibly future — policy shifts and legal rulings will change how women receive reproductive care.
And soon, those changes could impact California.
Abortion rights activists predict that if the Supreme Court kills Roe and abortion becomes illegal in much of the country, that would force women in those states to travel in some cases hundreds of miles to terminate their pregnancies.
California is preparing to assume a leading national role in protecting a woman’s right to obtain an abortion.
California’s Planned Parenthood clinics saw a preview of what a post-Roe world would look like during the early days of the pandemic, when some states restricted abortion because they didn’t consider it an “essential” health services. Planned Parenthood said 7,000 women from out of state came to their California clinics for services in 2020.
If more states move to restrict abortion access, the number of out-of-state women of childbearing age who would find their nearest clinic in California would increase from 46,000 now to 1.4 million, many of them from Arizona, which advocates predict would be one of the 26 states to further limit the procedure, according to a report last month from the Guttmacher Institute.
“It will certainly have a large impact on states like California that have made a conscious decision to be a reproductive freedom state,” said Jodi Hicks, CEO and president of Planned Parenthood Affiliates of California.
In September, 30 organizations — including the ACLU, American College of Obstetricians and Gynecologists, NARAL Pro-Choice California, Black Women for Wellness Action Project and others — formed what they call the California Future of Abortion Council to examine the ways new abortion restrictions could affect the state.
California’s top political leaders, all of whom are Democrats, have backed their effort. Gov. Gavin Newsom said he wants California to “continue to be a beacon for those seeking essential services, particularly those who face greater barriers in our state or are coming from out-of-state to California to seek essential care they cannot receive in their own state.”
In December, the group will release a list of proposed policies and possible state legislation for the Legislature, which has a Democratic supermajority, to take up. Led by organizations such as Access Reproductive Justice, the panel is looking for ways to fund travel, lodging and child care to people coming to California to access abortion services.
Other questions have arisen, too. Like how to train providers in states where abortion could be virtually outlawed.
“Roe has been around for 50 years, and we’ve not really imagined a world post-Roe,” Hicks said. “And that’s really what we’re trying to do with this council.”
Taub said that since The Chronicle first wrote about her in September, several colleagues have asked her how they could become traveling abortion providers. But depending on how the court cases and subsequent policy battles play out, trips to some states might no longer be possible. They may be needed in California, too, as more women flock here.
Taub said she will travel to wherever she is needed. She remains inspired by her mentors, some of whom started practicing in the pre-Roe era when women were getting sick or dying from infections after trying to end their pregnancies on their own.
One of them told her that “when there’s a new chemotherapy drug that comes out that extends cancer patients’ lives another six months, it’s like an incredible achievement that we are able to extend their lives.
“But when you do an abortion for someone,” Taub recalled, “you’re giving them their whole life back.”