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Can spa-like surroundings help reduce the stigma surrounding abortion?

1 in 3 women will have an abortion in their lifetime, so why is there still so much stigma attached to it?

Can spa-like surroundings help reduce the stigma surrounding abortion?

It's been more than 40 years since Roe v. Wade. And it seems like the fight over the right to have an abortion is more intense than ever.

Roe v. Wade is the Supreme Court case that cleared up the question of whether someone has the right to an abortion. As time has gone on, however, opponents of abortion rights have managed to carve out more and more loopholes to make abortion almost impossible to actually get.

The fight against abortion rights has heated up in the past few years.

According to the Guttmacher Institute, there have been 231 new state-level restrictions on abortion since 2011, coming in several forms: bans on abortions past a certain number of weeks, harsh new regulations that make it nearly impossible to keep a clinic in operation, waiting periods, and forced ultrasounds, among other tactics.


10 states restrict private insurance, the health care marketplace, and Medicaid from covering abortion (dark orange below). 14 states have limits on Medicaid and the insurance marketplace (lighter orange), and nine states limit Medicaid coverage (yellow).

That leaves just 17 states without state-level insurance restrictions.

In other words, it's becoming significantly more difficult to access insurance coverage that covers certain reproductive health care.

On top of all this, there's a massive amount of stigma that comes with having an abortion.

There seems to be a sliding scale of what people view to be "acceptable" versus "unacceptable" abortions, based on how the pregnancy happened.

Reproductive rights activist Katie Klabusich spoke with me on the stigma of abortion.

First, I wanted to know why it's so important to fight stigma.

In response, she explained that not only is stigma harmful to the rights of someone seeking an abortion, but it's also dehumanizing.

"Once we aren't categorizing abortions into 'good abortions' and 'bad abortions' and recognize pregnant people as fully human rather than public property, we can demand widespread access-increasing laws and policies."
— Katie Klabusich

She added that it's stigma that fuels the legal restrictions. If people who have had abortions are afraid to speak up, only the voices strongly against the procedure are heard.

"We're never going to see an end to the onslaught of anti-choice laws and abortion provider harassment and violence until our culture shifts. Anti-choice groups and legislators rely on stigma and the silence it brings to pass harmful laws and dress harassment up in the First Amendment."
— Katie Klabusich

When it comes to fighting stigma, one innovative method comes from Carafem, an abortion provider opening near Washington, D.C., this year.

The clinic hopes to create a "spa-like" atmosphere for its clients and makes no bones about what it offers. The ads say, simply: "Abortion. Yeah, we do that."


Organizations like Advocates for Youth, with their #1in3 campaign, and the Sea Change program collect stories and raise awareness in their stigma-reducing efforts.

Reducing stigma is largely about reducing the shame and secrecy involved with an abortion. By having real people tell real stories of how and why they decided to undergo the procedure, a human face is put on what's otherwise seen as a somewhat cold, hushed act.

Fighting stigma can be as simple as speaking up.

Again, talking with Katie, I asked what everyday people could do to help reduce stigma. She says there are three distinct things people can do to fight stigma.

Share your experiences.

"If you have had an abortion and it is safe for you to talk to friends and family about your experience, your words humanize what should be seen as a common medical procedure. You don't have to sit everyone down for story time, just refute assumptions by matter-of-factly offering that you have had an abortion and it wasn't at all the way they're describing."
— Katie Klabusich


Create a safe space for people around you.

"Being available to listen is about creating a safe space. One in three people born with a uterus in this country will have an abortion in their lifetime — which means you know people who have had an abortion and people who will have one. When those people in your life hear you call out stigmatizing media and incorrect information being passed around at the office or the Thanksgiving table, you make it clear that you are available to hear and support them."
— Katie Klabusich

Finally, don't forget about reducing sexual stigma. There's nothing wrong with having sex, and there's nothing wrong with choosing to have an abortion.

"Humanizing reproductive health care is doubly challenging because we have to force our rather puritanical culture to recognize that sex is not just for procreation in a marital bed. For some, admitting that the act that got them pregnant was purely for recreation is a bigger hurdle than admitting they terminated the pregnancy. So, if you're not comfortable speaking out directly on abortion misinformation but are comfortable busting some sexual stigma, that helps too!"
— Katie Klabusich

No matter where you fall on the debate over abortion rights, can't we all agree that people shouldn't be shamed about their personal medical decisions?

For John Shults and Joy Morrow-Nulton, the COVID-19 pandemic brought more than just health threats and lockdown woes. For the two 95-year-olds, it also held something remarkable—another chance at romance.

Both Shults and Morrow-Nulton had been married twice and widowed twice, but they were determined to find love again. They met in May of 2019, brought together by Morrow-Nulton's 69-year-old son, John Morrow.

"She was cute, I'll tell you that," Shultz told the New York Times of their first meeting. "And she was smart and she had a delightful sense of humor. And she smiled at me."

Shultz asked her to lunch a few more times before it became crystal clear to Morrow-Nulton that he was on a mission to date her.

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For John Shults and Joy Morrow-Nulton, the COVID-19 pandemic brought more than just health threats and lockdown woes. For the two 95-year-olds, it also held something remarkable—another chance at romance.

Both Shults and Morrow-Nulton had been married twice and widowed twice, but they were determined to find love again. They met in May of 2019, brought together by Morrow-Nulton's 69-year-old son, John Morrow.

"She was cute, I'll tell you that," Shultz told the New York Times of their first meeting. "And she was smart and she had a delightful sense of humor. And she smiled at me."

Shultz asked her to lunch a few more times before it became crystal clear to Morrow-Nulton that he was on a mission to date her.

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Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."