“She stuck a piece of vacuum cleaner into her vagina,” the nurse says.

It’s 2015. I’m working as an interfacility paramedic in a large conservative state. I and an EMT working with me have just been dispatched out to a rural hospital. We need to transport a female patient from the smaller hospital to a large surgical center on the coast.

The EMT and I are at the hospital receiving the patient’s report from her nurse. The minute we walk in through the ambulance entrance, the nurse greets us briskly and gives us a report about our future patient. “Female patient with a uterine prolapse,” she says, “Plus there’s suspected perforation of the uterine wall.”

I wince hard internally. My EMT, a 19-year-old guy who only just got certified last month, looks a little puzzled. I explain to him that a uterine prolapse means that the uterus has descended into the vagina. It’s pretty common, especially for older women. Far less common is the fact that my patient’s uterus has also apparently been torn.

“Did she explain how her uterus was perforated?” I ask the nurse.

The nurse mentions the vacuum cleaner.

“Oh wow,” the EMT standing next to me gives a sort of laugh/ cringe reaction. “I’ve never heard of THAT sexual kink before.”

The nurse and I exchange a glance. We’re both middle-aged women. We know the probable reason why our patient stuck part of a vacuum cleaner up into her vagina, perforating her uterus. It had nothing to do with sexual gratification.

In 2015 abortion was legal, of course. The state I worked in was a conservative state but it had abortion clinics. Most of the abortion clinics were in the larger metropolitan areas. The closest abortion clinic to the hospital where we were standing was over a hundred miles away. The rural communities in the center of the state were what my colleagues called “redneckistan.”

If you were pregnant and scared and alone and living in a rural part of the state, good luck.

Twenty years earlier, when I was in high school, my mother and I went to Indiana-Purdue University one evening to hear a debate between Sarah Weddington and Phyllis Schlafly. Weddington was the famous lawyer who argued “Roe v. Wade” back in 1973. Phyllis Schlafly is an infamous name among feminist circles. She was the conservative activist who has been blamed for the failure of the Equal Rights Amendment back in the late seventies. Schlafly was the pundit who started the “potty panic” line of argument against equal rights. She painted grim pictures of women being assaulted by men in unisex bathrooms because private women’s bathrooms would be illegal if the ERA were passed. “Do you want (co-ed bathrooms) in grade schools?” was one argument of hers. Her rhetorical tactics were so successful at stopping the ERA on its tracks that conservative activists to this day use “potty panic” arguments for everything, whether it be protesting trans rights or stopping women from serving in combat.

I remember Schlafly that evening back in the nineties. She stood by her podium in a salmon-colored blazer, debating Weddington. Weddington, however, was the woman who had the most impact on teenage me. During the question-and-answer portion of the debate, Weddington picked me out of the audience. An usher brought a microphone close to me so I could ask my question, which I thought was so cool.

“Can you talk about illegal abortion?” I asked Weddington.

She did. Weddington described how there were wards in hospitals back when she was a young woman that were exclusively reserved for women who had had “accidents” during pregnancy. You couldn’t say “abortion” back then. It was illegal. Women did not want to get arrested. So women would come to hospitals with bleeding or hemorrhaging or “things hanging out of them” saying they had had an accident during pregnancy.

To this day I remember Weddington’s gruesome descriptor of “things hanging out of” women who had attempted illegal abortions on themselves. That’s a direct quote. The horrifying imagery it conveyed stuck with me through the ensuing decades.

Weddington was, of course, talking about uterine prolapse and sometimes intestinal prolapse protruding through a perforated uterus and into the vagina.

Fast forward now to 2015. I’m writing down the last set of vitals of the uterine prolapse patient, who is dozing in the hospital bed. According to the nurse the patient has had a dose of painkillers for her transport and is very comfortable. Her blood pressure is okayish (a little low) but I don’t like how her heart rate is in the 120s despite her being on painkillers.

“Well, she’s bleeding internally,” the nurse says, “That’s why she has to go right now.”

I turn to the EMT. “We’re going lights and sirens on this one, okay?”

“Right,” he says, his eyes sparkling. For most young EMTs, going lights and sirens for the first time while driving an ambulance is a huge thrill.

I’m glad he’s excited. I just want the patient taken to the surgical center as soon as possible. The EMT and I transfer her to our stretcher and we load her into the ambulance. I’m keeping my eyes plastered to the portable monitor keeping track of her vital signs. I’m praying that her systolic blood pressure doesn’t drop below 90 or her heart rate doesn’t spike. Right now her vital signs show her kissing the outer edge of hemorrhagic shock and I don’t want her to destabilize further. I take another blood pressure reading, apologizing to the patient for the arm discomfort. She is still happy about the painkillers and does not complain. Her pressure is slightly lower than it had been earlier, making me even more anxious. “BEHAVE yourself!” I tell the monitor silently, as if it’s the machine’s fault that my patient has a pelvic hemorrhage.

The trauma team is ready when we arrive at the larger hospital’s surgical center. They are gowned, booted and masked. They waste no time transferring our patient onto a hospital stretcher and wheeling her into surgery. I talk to the nurse, type out my own report and tell dispatch that we are available again.

It’s now 2022 and I’m thinking back to how I had to treat patients suffering from the effects of unsafe illegal abortions even back when abortion was still technically legal. I’ve read articles dating back to 2013 about women in Texas getting “flea market abortions” by purchasing “Cytotec” at an open-air market in McAllen, Texas. “Cytotec” is a stomach ulcer drug which is said to induce miscarriages.

This all happened when abortion was merely restricted. What will happen when abortion is banned outright?

I have been inspired by how women are pushing back against the repeal of Roe. I have seen the memes on Facebook of the two women hiking and the words “If you are a person who suddenly finds yourself with a need to go camping in another state friendly towards camping, just know that I will happily drive you, support you, and not talk about the camping trip to anyone ever.” It makes me happy how many women are offering homes and rides and transportation for people who will need to go “camping” in another state in a post-Roe future. I am hoping women will just decide to go “camping” in states with safe, legal abortion clinics instead of turn in desperation to the vacuum cleaner.

Sarah Weddington passed away in 2021. I hope both she and Roe rest in power.