Episode 19: Abortion and women's rights

Dr.Sophia:
Hello everyone. Welcome to the Dr. Sophia Obgyn podcast. I'm an obgyn practicing for over 15 years in my native New York City. I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we talk openly and with heart about all things affecting women from pregnancy, menopause periods, sexual health, fertility, and so much more. Disclaimer, this is general medical information. Based on my professional opinion and experience. For specific medical advice, please refer to your physician.

Hello everyone, and welcome to the Dr.Sophia, obgyn podcast. I am so excited to announce our guest. We have a guest speaker for today's episode, and she happens to be one of my closest friends, Dr. Sandy Dorcelus. The reason why we're so excited to have Dr. Dorcelus with us is because she is a specialist in family planning, and we felt the need to have the conversation surrounding women's rights, women's right to choice, women's reproductive rights and abortion, especially in this climate of a presidential campaign and our VP Kamala Harris as our presidential nominee. So, whoop, whoop, whoop. We're so excited. so I'd like to give a warm welcome to my friend Sandy Dorcelus. As always, we have with us our favorite co-host doc-

Touseef Mirza:
I'm a doctor now.

Dr.Sophia:
My good friend, Touseef Mirza. Welcome Sandy.

Dr.Sandy:
Wow, thank you, Sophia. Thank you for that wonderful welcome. Nice to meet you Touseef. I'm so grateful for you ladies, for having me on your show. This is such an important topic and I can't wait to dig right in. So, welcome, thank you everyone.

Touseef Mirza:
Thank you so much, Sandy. Thank you for being here.

Touseef Mirza:
Yes, we're super excited to have this conversation. Me and Sophia have been talking about doing this topic, this such an important topic, and we felt like right now is such a perfect time to have this conversation. If you're listening to the podcast like later on, this was actually taped at the end of August, 2024. So at this point, Kamala Harris basically came to the forefront three weeks ago as a presidential nominee. So obviously we're super psyched about it and we know she's gonna become the next president. So we are just really excited to really talk about all of these aspects from a hopeful lens as well, and seeing how we can transform the future while also recognizing how we got here. I know that Sophia and Sandy know both of each other really well, so I'd love to hear how both of you know each other.

Dr.Sophia:
Well, Sandy is one of my like road dogs, like Sandy and I met back in college and we've been bosom buddies ever since. What's really interesting about our friendship has been the fact that we're always kind of piggybacking off of each other throughout our career’s over the years. So it first started out, first of all, we were both science majors in college, and we both knew that we wanted to go to medical school, but we took a different kind of journey in getting there. I remember I had Tyler, so my first son just at the end of college. I remember you were working at Sloan and I needed a job. So I applied to a position at Sloan.

But then afterward I left and decided to become a teacher because I had Tyler and was like, okay, not that I don't wanna go to medical school, but, I wanna do something to be more involved in my child's life, et cetera. I wasn't sure if I was really ready to make that kind of sacrifice. I became a teacher. Then soon after I became a teacher, Sandy ended up leaving Sloan and became a teacher also. So we were both science teachers. I was teaching middle school. You taught high school, right?

Dr.Sandy:
No, middle school, sixth-grade science.

Dr.Sophia:
Oh, yeah. So there you have it. We both taught sixth grade science. Then of course we were both like, oh my God, this is horrible. Like, what are we gonna do? We wanna go to medical school, right?

Dr.Sandy:
Yes. Kudos to your teachers because woo.

Dr.Sophia:
That was the hardest job I know I ever had, right? Teaching middle school science. Like I'll go to medical school three times before I have to go back and do that again.

Dr.Sandy:
Middle school is rough.

Dr.Sophia:
So definitely kudos to our teachers because we need you, and the job you do is unforgiving and definitely not recognized enough. But after that, we were both like, okay, well what are we gonna do? Then Sandy was like, well, I think I'm gonna apply to PA school, which is physician's assistant. So basically I end up going to medical school at some point, and Sandy's in PA school, she's about to finish. I'm now starting medical school and I just had Max.

So now I'm talking to Sandy, I'm like, Sandy, you really gonna do this PA thing? You wanna be a doctor, right? It's not because being a PA is not a wonderful profession, but there is a certain level of autonomy and the different interaction in terms of the things that you can do clinically that are a little bit different from being a physician's assistant to being a physician.

Touseef Mirza:
Would you agree with that?

Dr.Sandy:
I agree wholeheartedly. Sophia knows me well, as you guys can tell. She knew that my personality was better suited to be a physician. She knew that I would always have that drive of wanting more. So, thank God for having friends like that in your corner, that's gonna hold you accountable.

Dr.Sophia:
For sure. So even though she was almost done.

Dr.Sandy:
Literally, like, I think I had one more class left.

Dr.Sophia:
I was like, no, girl, you need gotta go back. You need to apply to this medical school.

Touseef Mirza:
So when you went into medical school, did you know you were gonna become an obgyn or you weren't sure at that point?

Dr.Sandy:
Oh my god. So I definitely was not sure. Zero, zero clue. I went to medical school thinking I was gonna be an ophthalmologist. I was like, yeah, but it doesn't do it for me. I did my OB rotations and even though there's a lot of lack of sleep, what really drew me to the field was one minute is quiet, the next minute you're on your top. I like that. I like the adrenaline rush. There was nothing else that excited me as much, despite everything.

Touseef Mirza:
You're also in family planning, correct? So are all obgyn’s automatically also family planning or are those two separate things or it's an add-on? How does that work?

Dr.Sandy:
I would say it's an add-on. So when you do residency in whatever field, you do residency, let's say in obgyn or internal medicine, you're a generalist within that field. However, if you want to specialize, let's say if you wanna do just GYN cancers, you go into GYN oncology fellowship. If you wanna do infertility, you go into a reproductive endocrinology fellowship. I decided while I was a resident that I wanted to learn more about the field of family planning. I found it interesting. I knew that I wanted to do it based on one particular case. I'll circle back around and tell you what really got me interested. So after four years of general obgyn, I applied to become a family planning specialist. I went to BU for that. So that's an additional time after the residency.

Touseef Mirza:
So when we say family planning, what does that mean exactly as a specialty?

Dr.Sandy:
So as a specialty, the formal name is complex family planning. What that encompasses is your learning how to deal with all aspects of contraception. Some patients that would, that require contraception that are unable to, let's say a patient that's on dialysis and then you wanna help her prevent pregnancy, you would refer her to a specialist. A complex family planning specialists, because we have additional training to know exactly what type of contraception would be safe in someone that's considered high risk. We also learn about providing abortion services because abortion care is a part of obgyn, and is encompassed throughout the entire learning process. But as a family planning provider, you are trained to provide abortion services for up to about six and a half months, 24 weeks gestation to provide safe comprehensive abortion care that includes medical or surgical, depending on the circumstances.

Touseef Mirza:
Okay. So does that mean because you deal with complications that, for example, somebody like Dr. Sophia as an obgyn might refer a patient to somebody in family planning?

Dr.Sophia:
I refer to family planning all the time because they have, as she said they take care of the complicated cases. So if someone has a medical reason why they may need an abortion and it falls out of the scope that I feel comfortable to do it, then yes, I would then refer that person to a family planning specialist. Also, there are certain special cases, for example, what we call a c-section scar ectopic, which is a very dangerous place to have a pregnancy. But I would refer a pregnancy like that to someone like Sandy, who is a family planning specialist because they handle those kinds of complicated cases. They see them more, they have more experience, and more tools in order to handle major complications.

Touseef Mirza:
Are all family planning specialists obgyn’s?

Dr.Sandy:
No, it's a loaded question. So obgyn’s are formally trained in family planning, but a general obgyn is also trained to provide abortion services up to a certain point. However, we do have our family practice practitioners that can also provide abortion services as well. However, they are not trained to go as far as we are. For instance, I can provide abortion services for someone that's up to, like I said, six and a half months. Most family practice practitioners can feel comfortable within just the first trimester, which ends at about 14 weeks gestation.

Touseef Mirza:
So in terms of what, you said that there was a defining moment with a particular patient that made you understand your decision about going to family planning. What was that?

Dr.Sandy:
So I was a third year resident in my residency program. We, the third year, weren't responsible for all the obgyn difficult cases. We had a patient that came in, she was about, I would say 23 weeks. So 23 weeks gestation came in seizing. She had severe preeclampsia at this point. So preeclampsia, eclampsia is a condition in pregnancy where the mom develops really severe high blood pressure, worsening blood pressure and the treatment is delivery. If the mom continues to become toxic, it can affect your liver, enzymes can affect your vision.

Worst case scenario, you develop seizures, which can eventually lead to stroke and organ damage, et cetera. So we had a patient that came in via ambulance seizing, and the treatment would be delivery because she was so medically ill, an induction. So induction is when we give patients medication to go into labor. But that's a long process. It doesn't happen right away. It usually takes several hours, or several days, and she needed to be delivered immediately. The only way in which she can safely be delivered would be a DNE, dilatation evacuation. So you're dilating the cervix and evacuating the pregnancy from the uterus.

Touseef Mirza:
So is that basically abortion?

Dr.Sandy:
Yes. But you have to be trained to do so at such an advanced gestational age. At my institution, the only person that knew how to do that procedure was our chairman. Our chairman lived in New Jersey. Patient came in in the middle of the night seizing, we had to call our chairman at two o'clock in the morning in New Jersey to come to Brooklyn to come and perform a DNE. At that point I realized I need to learn how to do that because I want to be the person that's able to provide that care. Because if we didn't have him, we would have to transfer the patient out. But she's too unstable to be transferred out, which could have meant the mom's life.

Touseef Mirza:
Because she was literally in a critical situation.

Dr.Sandy:
Yes, she was. She was knocking at death's door. Yes.

Touseef Mirza:
Wow, okay.

Dr.Sandy:
But that was the defining moment for me.

Dr.Sophia:
Wow. Thank God you guys were able to provide that kind of care. I'm assuming you saved her life.

Dr.Sandy:
Yes. We saved her life. She turned around her liver enzymes trended downwards, and she stayed in the hospital for a few days, and then she was able to go home with an intact uterus, able to conceive at a later date in time if she desired. This is why this post-Dobbs decision of restrictive abortion care is such a critical thing that I need everyone to understand that it's really important that we vote for people who are gonna respect women's rights because Sophia and I are on the front lines. We see patients who are harmed by this decision.

Dr.Sophia:
Absolutely.

Dr.Sandy:
So it's really important that we get out and vote.

Touseef Mirza:
I just want to relay back for a second and, and just go down more in terms of the basics. So you explained a little bit what abortion is, but is there one definition of abortion or in terms of the different ways of having abortion? Like, could you just level set in terms of what we say abortion, what do we mean?

Dr.Sandy:
Sure. So abortion as a catchall phrase in the medical field, we refer to abortion, whether it's a miscarriage or whether it's what we call an induced abortion. That is the catch-all phrase for us. Any pregnancy interruption in the medical field is considered an abortion. So let's level the playing field there.

Touseef Mirza:
So you're basically saying when a woman has a natural miscarriage that is out of her control, that's also considered an abortion.

Dr.Sandy:
Yes.

Touseef Mirza:
So that's not commonly known because people think that abortion is something that you decide upon, but it's not the case.

Dr.Sandy:
Exactly. That is not the case.

Dr.Sophia:
So with any, any interruption of pregnancy-

Dr.Sandy:
But before actual delivery time, it's considered an abortion. When it's a miscarriage, it's known as a spontaneous abortion. If it's an elective termination, you're not ready to have a child right now. In the case of my patient who was seizing, she needed to have an abortion. It's called an induced abortion.

Touseef Mirza:
Okay. So it's the difference between spontaneous abortion and induced abortion. Either way, it's abortion.

Dr.Sandy:
Exactly. So that's first, in terms of different ways of doing abortions, you can do is known as a medical abortion or you can do a surgical abortion. I have to reel it back a little. So the pregnancies are divided into trimesters. So from the time of conception to about 14 weeks gestation is considered your first trimester. During that time, you can have a medical abortion or a surgical abortion. A surgical abortion can be done at any time during the pregnancy. Most medical abortions are done only during the first trimester.

Touseef Mirza:
Okay. When you say most, do you mean like literally over 75%?

Dr.Sandy:
I would say even upwards of 80 to 85%.

Touseef Mirza:
When we say the majority, we're talking about abortion, that includes miscarriages as well?

Dr.Sandy:
As well. So after 14 weeks gestation, the procedure goes from a medical abortion to a surgical abortion or what we call a medical induction. So when we're doing a medical induction, the nuance is that that's usually done on labor and delivery. We're giving the patient medication, it's like inducing a pregnancy. We're inducing the patient on labor and delivery. We're giving them medication to deliver vaginally.

Touseef Mirza:
Because it basically, it basically like stimulates-

Dr.Sandy:
The uterus to go into labor.

Touseef Mirza:
Got it. Okay.

Dr.Sandy:
But at that point, if the patient, or for whatever medical reason a surgical abortion is warranted, that's when we do DNE, dilatation and evacuation. That's the surgical abortion.

Touseef Mirza:
So what is the difference between medical abortion and surgical abortion?

Dr.Sandy:
The major difference is for the medical abortion, you're using medication to elicit interruption of the-

Dr.Sophia:
Contractions.

Dr.Sandy:
Contractions and dilation of the cervix to expel the pregnancy. Versus in surgical abortions, you are dilating the cervix mechanically. You are doing the dilatation with the instrument. Then you're using either an electrical vacuum to evacuate the pregnancy or a manual vacuum like a big suction syringe. I don't know how else to describe it.

Touseef Mirza:
Then depending on the case, depending on the timeframe, one of the two is more preferable?

Dr.Sandy:
Yes, and also patient preference.

Dr.Sophia:
Is there also a point Sandy, where there's even a safety issue with one versus the other?

Dr.Sandy:
Yes. For example, let's say you've had a patient that's had multiple c-sections and for whatever reason, either decides they want to interrupt their pregnancy or needs to interrupt their pregnancy for a medical reason, it's safer to do a surgical interruption as opposed to a medical interruption because of the medication that we use to elicit a medical abortion can be harmful to a uterus that has previously had a surgical scar.

Dr.Sophia:
It's important to understand that sometimes having a surgical termination or abortion is warranted because of the fact that going the medical route may actually do harm or not be able to give you the best chance of keeping what we call an intact uterus.

Touseef Mirza:
So I think one of the things, and this has really brought to the forefront since 2023, 2024, when we've had all these laws reprimanded from an abortion standpoint. I think one of the things that is a huge misconception is that abortion in certain cases is actually medically necessary and is actually not about choice and choices. We're all about choice, but I think that the other part is not really talked about as much.

Dr.Sandy:
I agree. The problem with all these people commenting on abortion is that they're not actually asking the medical experts. We're just letting people with opinions dictate what should be done with a woman's body and not really understanding the science behind it, not really understanding the complications. Like I tell my residents, whether you believe, whether you're for abortion or not, everyone should learn how to care for a patient that has had an abortion that requires an abortion. Everyone should know the basics because you never know when you'll be faced with a patient. You could have a patient that had an abortion elsewhere and comes to you hemorrhaging. You still need to know about abortions in order to care for that patient because the complications, if you're not aware and you're not heightened, the patient can die from bleeding, from et cetera.

So I think it's really important where I think the medical community needs to do a better job of educating everyone about what exactly abortion is and what it's not, and just getting the basic knowledge out there because there's a lot of misconception about the process of abortion, whether or not fetuses can feel pain, whether or not the fetuses are delivered alive, et cetera. All of these are misconceptions and myths and not actual scientific facts. It's my job as an abortion advocate to promote and let everyone know that abortion care is women's care.

Dr.Sophia:
Amen. Say it loud, say it louder. Say it proudly. It's a part of taking care of women.

Dr.Sandy:
It is.

Touseef Mirza:
It's like other organs that we have in our body. Like our heart, our liver, and our uterus are part of the organs we have.

Dr.Sandy:
Yeah. It baffles me every time I have these conversations, I'm really truly amazed at how people have such strong opinions about abortion care. I remember a story where, as you guys know, I provide abortions. I am proud, I have no shame in providing abortion services. I was pregnant and a nurse asked me, how do you feel about providing abortion being pregnant? I said, how do you feel about providing diabetes care for a patient who comes in and hasn't been taking the insulin and requires an amputation? Don't you still provide the care? My job is to provide care, not to judge. That's just how I approach it. I'm here to provide a service and to acknowledge my patient, not to judge. I have no opinion one way or the other. I'm here to provide a service. I can provide the service. I do it well, and I'll continue to do it.

Touseef Mirza:
That's such an important difference because everything else, it's coming really from a science-based, health-based lens. Versus abortion, it comes from a judgment lens first.

Dr.Sandy:
It does.

Touseef Mirza:
Meanwhile, it's all just different organs in our bodies. It's the same thing.

Dr.Sandy:
Yeah. Like, I really wanna know why people are so polarized by abortion?

Dr.Sophia:
They are. They really are. For me, it's just a mere fact, there is nothing about a man's body that anyone in any way, shape, or form has any control over. We don't think that a man has no agency over his body. We know that men are the least likely to go visit a doctor to take care of their health. If a man does better who is married or has a woman in his life will actually be healthier because that woman will take care of her whole family. She makes sure that everybody in her family gets healthcare. So she's actually advocating for a healthier man. Yet in society, men think, or people in general who are advocates for the fact that women cannot make decisions or have agency over their own bodies, like you said, Sandy is baffling.

Touseef Mirza:
I mean, I think it was the key word that you said is control. At the end of the day, it's about control. It's about how they don't want us to have full control, to have full agency. That's been historically there. That is sort of like the last frontier where they still wanna control us biologically.

Dr.Sandy:
It’s sad, when I look at the statistics that the politicians are spewing in terms of it's mostly unwed women, uneducated women that are coming for abortions. That's actually furthest from the truth.

Dr.Sophia:
Tell it. I knew she was gonna come with this.

Dr.Sandy:
If you look at the numbers, the majority of people that are getting abortions are women that are actually in relationships. It's their second or third child. they just feel it's not the right time. So this myth about it being uneducated, unaware women who just have no desire, no control, no education is false. It is so false. it angers me. As you can tell, I'm very passionate about this because I just cannot understand why. I just do not get it. I'm so happy, I'm so excited for Kamala. because I know that she's gonna fight for us. Make sure that women's rights are on the forefront and hopefully, we can turn this thing around that the Supreme Court had just shot down with a stroke of a pen.

Dr.Sophia:
You're a hundred percent correct. I mean, we need to be on an equal playing field. If a man has full agency over his body, there is nothing that the government is controlling when it comes to a man's body, then there is absolutely nothing that should be controlled in terms of a woman's body. We are human beings and there should be zero control regardless of what our gender is, our gender identification is, et cetera. We should be able to have control of ourselves.

Dr.Sandy:
We should.

Touseef Mirza:
I would say also, I mean, I'm a relentless optimist. Even when bad things happen, I try to figure out, okay, well what does this mean? Of all the atrocities in terms of what has happened on this issue for the past year and a half? The silver lining about this is that we're actually talking about this. I think that even If we didn't have this before, there was always a ridiculous stigma and judgment against women who had abortions or were considering abortions. Now we can actually talk about it openly and actually say, no, actually no, this is part of who we are. I always try to see, okay, so what is the flip side of this? How can we use this to actually empower us and empower culture in terms of evolving our thinking? So when it comes to stigma, do you feel that it has evolved over the time that you've been in this position of helping women go through this? Or do you feel it's remained the same? Or, how have women dealt with the whole sort of psychological aspects of abortion?

Dr.Sandy:
That's a very good question. I think that it's a moving target. At times. I feel that we are progressing ahead in terms of the stigma that's surrounding the word abortion. At times people wouldn't even use the word though. We have euphemisms, termination interruption, pregnancy interruption, et cetera. Even myself, you see how I started it because there is a stigma around the word abortion. However, post-Dobbs I have seen more people actually coming and admitting, well, I had an abortion when I was in college, or I had an abortion for this, et cetera. So I feel that Dobbs has actually, as you said, humanized the element of abortion and has allowed more women to come forward and explain their story about why they had to do it. I want everyone to understand that having an abortion, whether you wanted to or whether it was medically indicated, is the hardest decision a woman will ever have to make.

I wanna reiterate, it is not easy for a woman to say, I think this is not the right time and I'm gonna proceed with an abortion. Because of the way abortion is stigmatized, it makes people feel as if the people that are doing are flippant or callous. That is not the case. These women are torn apart and are crying literally right before we put them to sleep. Before we do the procedure, they are crying hysterically because they feel the guilt, they feel the stigma of people judging them. So I just want people to understand that the people, the women that are making these decisions, it's really gut-wrenching. If you've never been in that position, I really employ you to have some empathy because it's really hard doing this work every day. I see it from all aspects and I just want people to have empathy.

Touseef Mirza:
When you say like, women are feeling guilt or feeling judgment, I think there's that level, but also their own sentiments of what they're going through in terms of their decision. Like regardless of the people around, it's like a double-weighted emotional load. Do you feel that it's that almost the external judgment has a greater weight than their own? Or it depends.

Dr.Sandy:
I feel that the external judgment makes its way into their own internal psyche. Then they incorporate that and it heightens their own internal conflict. I've had patients ask me, do you think I'm gonna be punished? Or, a lot of women that are religious that choose to abort feel that, will God allow them to have children in the future if they do this? Again, I just wish we had medical people who could actually stand up to the politicians and really educate the public about what an abortion is and what it’s not and the weight of having an abortion. Sometimes it's the best option. Sometimes it's really truly the best option and you shouldn't feel guilty for doing what's best for you. You should not feel guilty for that.

Dr.Sophia:
So from my experience, I just wanna talk about one thing, and that is as an authoritative figure. So as a physician and in my relationship with a patient in that role, I like to really as much as I possibly can, destigmatize the choice that they're making and the guilt, that internal conflict. I do so just by asking them sometimes some simple questions. How would this affect your life right now if you had a pregnancy and went through with the pregnancy? If this is not the right time, that is okay. Because we make decisions about things that are not the right time for us in so many different aspects of our lives. Whether that's getting married, whether that's going to school, whether, that's the type of job that you take and that this is no different when you make a decision to have an abortion, it's because you're making a decision for your future self. A decision like that, for sure, is never taken lightly, but to feel secure in your decision. So that way you don't have to live in this constant level of guilt, of shame that is associated with abortion because you chose yourself.

Dr.Sandy:
Exactly.

Touseef Mirza:
I think that's, I mean, I love that. Also, it's a very feminist perspective, which is what we wanna be.

Dr.Sandy:
Yes.

Touseef Mirza:
Unfortunately, a lot of women, when you say, you come first, unfortunately in this society, we have not been brought up that way.

Dr.Sophia:
I don't think of it as being feminist. I really don't. I think of it as being self, which is everybody.

Touseef Mirza:
Feminist just means that you're basically putting yourself first as a person.

Dr.Sophia:
To me, I think even the word making it the word feminist, calling it woman and feminine, I think is where the confusion sometimes comes in. I'm not saying that's not in fact the case. It's just that it's more so to really dig down and have women understand that you're making a decision that is going to be best for you and that you should not feel guilty in making that decision. I think when it comes from a provider that gives them that level of support, that opportunity to say it is okay. I do think that that allows them to renegotiate in their minds that level of guilt or that level of shame. That is the part I think as medical providers, as you say, Sandy, that we really need to do a better job of promoting in society and promoting that kind of narrative that doing the best thing for yourself is definitely okay.

Touseef Mirza:
I hundred percent agree. I also totally agree with the level of authority that you have and bringing that level of understanding to your patients, to women. I'm just saying that a lot of women have not put themselves first in their lives. Because they're brainwashed that they should put others first. So that thinking is very difficult to-

Dr.Sophia:
Undo.

Touseef Mirza:
Correct.

Dr.Sophia:
I agree.

Touseef Mirza:
Especially with a huge decision like this that also has all this judgment around. So how can somebody help them move through that, I guess?

Dr.Sophia:
Well, it's with the support, I think that's the whole point, is to even bring it to the forefront. Having that conversation upfront and saying that you can, it's okay for you to choose yourself because that's not what they're thinking. I think that just by saying it allows them to now start to conceptualize it in a different way. I'm not saying that it always works, but at least it allows them to have the thought process. Where judgment comes from, the fact that you think that somebody else has more authority over yourself. So if we're able to take away that sense of judgment because other people, society, what have you, have that control over you, you start to reinvigorate or reimagine self-control. Bring that back and put that back into their hands, then now let the judgment be between you and whatever your God is, if that's who you feel is judging you, and let that be a conversation that you have that way. But otherwise, if it's just from a societal standpoint, I like to really remind women to think about it as the most important person to them should be them. We move from there.

Dr.Sandy:
I one hundred percent agree.

Touseef Mirza:
So I one hundred percent agree too. I'm just saying me as a woman, I'm 52, and even if I was brought up to be independent, it took me a long time to decode stuff that I didn't even know was what area that I was brainwashed. So it's a process, like even if you know it should be my decision and that's the way it should be. It's these programs that are defaults in our brain. It's just difficult to deprogram. So I do agree with you, like for both of you, for being physicians and allowing that person to say no, you actually matter. Coming from both of you is very important because you're giving them more agency as a person that they entrust. So that's even more important. Would you add anything to that, Sandy, in terms of how you approach your patients?

Dr.Sandy:
Yeah, definitely. Like Sophia, I always tell them that they're making the right decision for themselves at that time. I usually tell them that how life is about changes, life is about acceptance and life is about realizing that what might be right today, might have a different view tomorrow and that's okay. Because I have patients that come a lot that say, I never thought that.

I was like that's okay. You're here now and it's okay. I think just telling them that it's okay and that life is dynamic and things change. I feel that has really helped a lot of my patients, a lot of patients, especially the ones that were once judgemental. I have one patient in particular who was devout Catholic, did not believe in abortion until her daughter needed an abortion. Then she apologized and said that she couldn't believe that she was once this way, et cetera. I told her, it's okay, it didn't affect you directly and so you really didn't have a sense of what goes on.

Now that you're here, I'm just happy that you are aware and you're okay. You've come around and it's fine. I tell people all the time, I'm okay with you having one view, but then after we have an intellectual discourse, you can see my view and you can accept my view. I'm not trying to change your mind, but I want you to accept whatever my decision is and don't judge me for it. I think that's what people need to realize. We're not here to try to change anyone's mind. We're not here to try to change your religious view, your moral beliefs, et cetera. I just want you to accept whatever my decision is and be okay. Then I don't feel judged by it. We can coexist. We don't have to agree, just be willing to accept and learn. I think that's my message for today, acceptance and learning.

Dr.Sophia:
You're absolutely right. Because at the end of the day, no one is forcing abortion down anybody's throat. It's an individual and personal decision. So if it's not for you, that is also fully okay. We fully support that. Hey, I'm still delivering babies so-

Dr.Sandy:
Exactly, that's how I make my living and

Dr.Sophia:
Super happy to do it. But at the same time, if I have a patient who comes in and decides that an abortion is what they need, I'm also equally supportive and happy to provide a service that I can provide. I'm with you there. I'm totally with you there, Sandy.

Touseef Mirza:
What's really interesting with this conversation is it's so dense in terms of physiologically, then you have politics, then you have psychologically. It's so intricate- that I'm sure you have very interesting conversations Sandy in your office every day. Sophia too. In terms of where we're moving forward towards like Kamala all the way, obviously, but what, is there anything that you would recommend people to be aware of as we're entering a more hopeful phase? Just in terms of politics, but also just in terms of what we talk about in terms of women's rights when it comes to their bodies?

Dr.Sandy:
Yes. I will say that, the number one thing, I want people to realize, is not that the presidential election doesn't matter, but our local elections matter more because those are the people that are gonna be your, your activists, your lobbyists that are gonna go to Washington to try to get different laws that are passed. New York I know is trying to codify abortion. So New York can always be a place where abortion services will be provided. The only way that that can happen is if we vote in our local elections, nominate, and vote for the local people that are, that are in support of women's rights, that are in support of abortion. Because if not, by the time it gets to the presidential election, it's too late.

Dr.Sophia:
As we have seen with Dobbs.

Dr.Sandy:
With everything. Yes.

Dr.Sophia:
Agreed.

Dr.Sandy:
So it's really important that people get out and just vote locally, listen, and hold your politicians, hold their feet to the fire. What are you doing for women's rights? Why is women's rights important to you? Let them know that women's rights are everyone's rights because women, we're the backbone of society. We're the moms, the sisters, the daughters. They need us. We have to start making them realize that they need us and we need to be able, in order for us to be a fully functioning self-sufficient woman, we have to be able to have agency over our bodies. Whether that be we decide to have 10 children, or we decide that we don't want any, that's our right. We shouldn't have anyone interfere with that.

Dr.Sophia:
Tell it sister!

Touseef Mirza:
All the way.

Dr.Sophia:
Tell it. No one is supposed to interfere.

Dr.Sandy:
No one.

Dr.Sophia:
That is your choice. My choice, my choice. Touseef’s choice.

Touseef Mirza:
My choice.

Dr.Sandy:
Yes. My choice continues to be my choice. I have a son, Sophie has sons, and I know that we're raising our sons, that it's a woman's right. It's a woman's right.

Dr.Sophia:
Amen. They know it.

Touseef Mirza:
That too. There's no question that's another way. That's another way to be involved, is to start right away with the younger generation.

Dr.Sandy:
Yes.

Touseef Mirza:
So they know this way of thinking and understanding.

Dr.Sandy:
Definitely. I think Gen Z is the way I think they're motivated. They're woke as we like to say. They understand the issues at hand. I feel optimistic. I feel that this is gonna be it. Kamala's gonna take us home and we're gonna figure this out.

Touseef Mirza:
Go Kamala.

Dr.Sophia:
Go Kamala. So I think in closing, Sandy, if it's possible, just give us your final thoughts on how women can truly embrace themselves with the concept of abortion care.

Dr.Sandy:
I think it's important that when a woman seeks an obgyn, that they ask the hard questions. They ask, you're gonna be providing my obgyn services, how do you feel about it, do you provide abortion services? If you don't, do you have somewhere I can go speak to and open up the dialogue? Because again, like we said earlier in our talk, abortion has been so stigmatized that a lot of people don't even bring it up until they need it. Then at that time, they find themselves scrambling often where they didn't realize their provider doesn't provide those services or doesn't know anyone doesn't know where to send them. Oftentimes we're getting referrals from all across, well, even though we're in New York, we're getting referrals from all across New York because abortion is not on everyone's forefront.

It's not a thing that a lot of people do, or a lot of people don't wanna admit that they do it. So I just feel that if patients are bringing it up more and more, it's gonna force the conversation and it's gonna become something of a topic. Then more people are gonna feel comfortable, even though they don't necessarily provide the services, they'll be more willing to say this is my colleague. She provides these services. You can go to her if you ever need them. So what I say is just talk about it. You have to talk about it. Don't be afraid to admit that you provide abortion services. Don't be afraid to talk about it, because a lot of providers won't say that they provide abortion service services. I tell people all the time, yes, I'm a family planning specialist, I do abortions. It's like I'm a diabetes specialist. I treat patients with diabetes. It's the same thing. You gotta make it a common day language

Dr.Sophia:
Because abortion care is healthcare.

Dr.Sandy:
And that's that.

Dr.Sophia:
And that's that.

Touseef Mirza:
Thank you so much, Sandy. This was an amazing conversation. I'm so happy we had it.

Dr.Sandy:
Oh my God, thank you guys for having me. I really enjoyed it and I'm willing to come back anytime.

Dr.Sophia:
Aww yay Sandy then you will! Thank you Dr. Sandy Dorcelus for joining us here on the Dr. Sophia Obgyn podcast. It was wonderful to have you and have a great rest of your day.

Dr.Sandy:
You too. Thank you guys. Bye

Dr.Sophia:
Bye.

This is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.