I see a lot of people who are pregnant and don’t want to be. I also see a lot of people that are pregnant that want to be.

But there’s a lot of room in between definitely wanting to be pregnant and definitely not wanting to be.

Recently the nurse practitioners at the clinics I work at started meeting with everyone who is in need of pregnancy tests and gestational ultrasounds. Until now, by the time I see patients for their abortions they are usually firm in their decisions. But now I see all the women and their partners that have just found out about their pregnancies, some planned and some not.

Half of pregnancies in the US are unplanned, and half of those end in abortion. Most of the time when I counsel women who are unsure about terminating or continuing their pregnancies there isn’t anything I can answer or tell women that will help them make their decision. It’s a decision only she and she alone can make. Most of the time she needs nothing more than information and time.

Sometimes women have abortion appointments set and in the middle of it all decide that they aren’t ready to terminate. Recently I was talking to a woman who immediately burst into tears as soon as she sat down in my office. She unexpectedly found out that she was carrying twins from the ultrasound and it amplified the feelings of uncertainty she was already having.

Most of the women that I see for terminations either opt to see the ultrasound image or want copies of them to take home. By and large, seeing ultrasound images of their pregnancies doesn’t change women’s minds, as many anti-choice legislators insist. Furthermore, if women’s minds are changed by seeing their ultrasounds, then those decisions must be respected  and most likely signal that she wasn’t ready to make the decision today.

There is a trope in the pro-choice movement that we must insist that abortion is an easy choice, and that we must counter the anti-choice narrative that abortion is a tortuous decision. While I agree that sometimes abortion is an easy decision, sometimes it is a difficult one. Sometimes women feel grief and sadness after their abortions and that’s ok. Choosing to have an abortion is sometimes complicated, and that’s ok.

Many reproductive justice activists have begun to counter the singular trope from many feminists that abortion should only be discussed as easy decision that women only feel relief about. Women’s lives are complex and to boil it down is insulting to women in general, and doesn’t give ground to the antis.

The woman who was pregnant with twins twisted and folded her tissues in her hands. I asked if she wanted to talk about it. She shook her head.

I don’t know, she replied. It’s just…two of them. It’s special, that there’s two.

It’s a feeling I personally don’t understand, but many women have second thoughts after finding out there’s multiple pregnancies.

You know, this isn’t a decision you have to make today. You have time, I remind her. She drops her tissues and states at me.

Can I go talk to my sister? She’s in the waiting room, she asks.

Of course, I tell her. I encourage her to take all the time she needs.

She left that day after I encouraged her to talk to her family and take a walk around the block. I have no idea if she decided to continue her pregnancy or terminate. All I know is that she wasn’t ready to terminate that day, and that’s all that matters.

I often feel ambivalence about my own job–some days I absolutely love my job and my work, but some days I leave the clinic and don’t know how I can manage to come back the next day. I have gotten better at taking better care of myself so that I can do my job every day. I have a feeling there are many health care providers that face this same ambivalence, feeling exhausted and wondering why on earth we chose this profession but know that we could never do anything else.

Ambivalence is a difficult and complex emotion to grapple with. The farther into this first year of practice I have gotten the more I am enjoying living right in the middle of this feeling and helping my patients explore their own ambivalence.

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