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I wish I could say it was a single event that inspired me to go back to school in my 40s to get my family nurse practitioner (FNP) degree, but that wasn’t the case. Sure, the fall Roe v. Wade in 2022 was devastating, especially for a pro-life activist in a rural, deep red (read: lots of MAGA flags) community. But even so, I didn’t really take action.

I complained. I was angry. I donated to abortion funds. I went through doomscroll mode. I taped construction paper to billboards and marched in protest. I was even angrier. I went out and bought all the Plan B drugs out of hate at several local drug stores (which have since been moved to a women’s shelter in a state with a total abortion ban), but I did nothing. Frankly, like many others, I wasn’t sure what to do. All I knew was that I wanted to help people who needed abortions.

Then came the almost uninterrupted avalanche of events – some major, others seemingly inconsequential – following the Supreme Court’s decision in Dobbs v. Jackson – Women’s Health Organization. It seemed like every day brought new horror. “Trigger” bans, patients being told to wait and bleed in parking lots, gynecologists leaving their state because their practices were targeted, and a torrent of hate directed at Dr. Caitlin Bernard, who cared for a 10-year-old rape victim during an abortion.

It has become a war on reproductive health. The goal: Anyone who wants to have control over their reproductive health and future, And all the people who care about them. It makes me angry. It’s disgusting. And it’s heartbreaking. I was moved, but then I kept asking myself, “What can I do?” and my momentum ran out.

Somewhere in the midst of the dismay, the question shifted to “How can I help?” and then to “How can I be most effective?” Suddenly, the answer couldn’t be more obvious. I would go back to school to get my FNP to work in the reproductive health field. This is how I will fight in the fight for bodily autonomy. That is my sole focus. This is how I can help. I will advocate for people and provide them with services they want and need.

It was that simple the whole time.

I can still remember the first time I really experienced abortion as a medical treatment. I have been a registered nurse for 18 years, and most of that time has been spent in the PACU, the recovery room where patients wake up after surgery. As a PACU nurse, I cared for a patient who was critically ill before her surgery: heart rate too high, blood pressure too low, breathing too fast, fever – almost septic shock. She was sick and needed a surgical abortion, also known as a procedural abortion.

I don’t remember all the details (nor would I give them away), but what I will never forget was the patient’s absolute relief and joy when she woke up in the recovery room. “I’m so glad it’s out,” she said. She knew she couldn’t begin healing until the cause of her suffering was removed. Within the short time I had her in the recovery room, her vital signs began to stabilize and she began to feel better. She had necessary Health care in the form of abortion.

This example will surely elicit ridiculous comments like “but her life was threatened, there are exceptions for that,” and I’m here to say: don’t buy into that. I can say unequivocally that I don’t want legislators to determine what they consider “medically necessary or life-threatening.” I’ve heard the Supreme Court argue whether it’s life-threatening when women physically lose parts of their reproductive organs (fallopian tubes, ovaries, etc.). In these situations, the medical professionals present should determine what is “medically necessary,” and a life-threatening situation should not occur before they can act.

Was the woman I was caring for in a life-threatening situation? She was critically ill, but she was breathing on her own and her heart was beating on its own. She was not actively dying, but her condition was decompensating. What are the quantifications of “medically necessary”? Heart rate less than 30 beats per minute? Respiratory rate less than six breaths per minute? Who decides that?

The problem is: medicine is a gray area. What works for one patient may not work for another. And there are many nuances. There are more factors to consider than a patient’s external vital signs and which (non-life-threatening) organ they might lose. Blanket statements about health care are dangerous – especially when they are linked to legal regulations.

I only share this story because it illustrates what I believe abortion access should be: a decision between the patient and their health care provider, with no restrictions of any kind. On a national level. Health insurance in Missouri should be the same as in Vermont. I want to be assured that I have universal access when I visit another state. My health issues don’t change when I cross state lines—why should my health care options change? Pregnancy is complex and can wreak havoc on even a healthy body. How can anyone else dictate what the best choice is for me, my body, and my future? How dare they even try!

Most importantly, healthcare providers should act in my best interest in an emergency—not wait until I’m near death for fear they’ll lose their license to practice. No one should have to suffer while waiting until they’ve crossed some imaginary “life-threatening” threshold (if that option is even available) to receive medical treatment. And no one should have to brag about their trauma or disclose why they want an abortion (or contraceptive; shoutout to you, potential future Supreme Court decision). I frequently tell my patients, “Your business is your business,” and that couldn’t be truer than when it comes to reproductive health. I know those are lofty goals, but they’re the right ones. Period.

So here I am, at 43, having (almost) completed my first full year of FNP teaching. I learned how to create a Google Doc and attend Zoom meetings. I brushed up on my APA skills and learned Grammarly. Yes, there were some hurdles to overcome—applying to programs, figuring out finances, re-familiarizing myself with discussion papers, and the general expectations of a graduate program—but it doesn’t matter. I’m getting through them. I’ve changed my work schedule to fit in with school and now work 12-hour shifts at a hospital every Friday, Saturday, and Sunday.

Of course, I would rather have a free weekend again than write a paper on public health, but, and I say this with all my heart: This. Is. Important. This is my motivation. In the end, none of the hurdles will matter. What I will ultimately do is what counts. Ideally, I would like to open a clinic one day. To be announced. First school, then the big plans.