Dr. Shelley Sella on Her New Book: Beyond Limits

There are many reasons why someone may require a third-trimester abortion, including both fetal implications and maternal implications (such as health diagnoses and difficult life circumstances). Dr. Shelley Sella, retired OB-GYN, first woman to openly provide third-trimester abortion care in the U.S., and author of Beyond Limits: Stories of Third-Trimester Abortion Care, sits down to share her expertise, discuss the multitude of reasons why someone seeks a third-trimester abortion, and touch on the personal stories shared in the book.

Dr. Sella became involved in the women’s health movement in college, which eventually sent her to medical school to begin her journey studying to be an OB-GYN. Dr. Sella was mentored by Dr. George Tiller, who provided late term abortions and who was assassinated in Kansas in 2009. Beyond Limits follows Dr. Sella during a week at the abortion clinic, sharing stories of patients requiring third-trimester abortions for a myriad of reasons.

Links from this episode

Beyond Limits: Stories of Third-Trimester Abortion Care
Dr. Shelley Sella
Dr. Shelley Sella on Instagram
Dr. Shelley Sella on Bluesky

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Transcript

Jennie: Welcome to rePROs Fight Back, a podcast on all things related to sexual and reproductive health, rights, and justice. [music intro]

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Jennie: Hi rePROs. How's everybody doing? I'm your host, Jennie Wetter, and my pronouns are she/her. So y'all, I hope you had a wonderful holiday weekend and got to enjoy some good weather where you are. I am recording this on Friday before the weekend so I'm hoping for nice weather all weekend. It's been like really rainy and gloomy and kind of gross here so I haven't been able to enjoy being outside or having my windows open very much so I'm very much looking forward to a nice weekend where I can you know go for some walks and spend some time outside and have my windows open I know the kitties will be very excited for me to have the windows open. They have clearly been pouting, not being able to sit in the windows. So, hopefully it will be very nice this weekend. Other than that, I don't really have any big plans. I'm really just kind of looking forward to some downtime, maybe doing some fun reading. I don't know. We'll see. Maybe even baking. I don't know. I'm hoping to maybe get some rhubarb and maybe do... my mom used to always make a rhubarb upside down cake that I loved. So, I'm hoping to find some rhubarb so I can make that this weekend and that'll just be thinking of home and will make me very, very happy. So, that is my plan for the holiday weekend. But yeah, not a whole lot. But there has been a lot going on that we do need to talk about. The House passed a funding bill that y'all is bad. It's bad. They're calling it their "big, beautiful budget bill," which, okay... but it is bad. It's bad. It would really gut Medicaid, kicking millions of people off of their insurance. It also really slashes the SNAP program, which is food stamps. Again, kicking a lot of people off of those services. Again, millions and millions of people. It is just all of this to fund tax cuts for the most wealthy. We're going to cut programs helping those the most in need. And that is just disgusting. That is just disgusting. There is no other word for it. It is just disgusting that we are hurting people who need help to give more money to the people who don't need it. And those weren't the only things. There are so many terrible things in that bill. It would also "defund" Planned Parenthood, which we've talked about before. It's not like there's this line item that says, here, all this money is going to Planned Parenthood. It means that people on Medicaid who go to Planned Parenthood for their healthcare, often their only healthcare they access, will no longer be able to do so. So, it means that patients who are going there for their family planning services who are on Medicaid cannot do that. It's going to have devastating impacts. I'm going to have somebody on in the next week or so to talk about that and what that will mean for people accessing healthcare, what it would mean for Planned Parenthood. We'll dig more into that later. And then I think the other really important thing we need to flag in this bill is that they added a provision that would prevent trans people from accessing gender-affirming care through Medicaid. And by that, it's not just young people—which is what we have seen a lot of the attacks on access to gender-affirming care be about was young people—this is anyone. Anybody on Medicaid would not be able to access gender-affirming care using their Medicaid coverage. Again, that would be absolutely devastating. The important thing to note with all of the things I just talked about: that was the bill that passed the House. It has not passed the Senate yet. It is not in place. It is not law. There is still time to push back and let your senators know that you do not support these cuts. Honestly, also let your House members know because I'm sure the Senate is not going to pass the exact same version of the bill that the House did. There will be some negotiation that is going to have to go back and forth. So make sure that you are letting your representatives know that you do not support these cuts to Medicaid, to SNAP, to access to gender affirming care, to cutting funding for Planned Parenthood, all the things. And there are so many more you could talk to them about. This is a really bad bill. So, make your voice heard. It's really important right now at this moment to speak out. So, yeah. Lots happening. Let's see. I guess it's been a while, so let's maybe do a little quick housekeeping. One, did you know that rePROs Fight Back has a newsletter? 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I love that bag so much and I love the stickers—they're on all my things—so if you want to get yours make sure that you donate to support rePROs Fight Back and then also just like stay tuned: we are busy, busy, busy working to set up a merch store so you will be able to buy some of the things on T-shirts or mugs or I don't know we're still working on it so if you have some you would like us to put our designs on let us know and maybe we'll add it to the merch store so feel free to reach out to us on social or reach out to me. Like I said, I always love to hear from y'all so feel free to reach out to us anytime.

Jennie: Okay with all of that, let's turn to this week's interview. I'm so excited to have on today Dr. Sella. She was an abortion provider. She provided abortions later in pregnancy, and she wrote this really great book, Beyond Limits: Stories of Third-Trimester Abortion Care, that y'all, I cannot recommend it enough. I really enjoyed reading it. I learned so much, not just about how she provides abortion later in pregnancy but having a deeper understanding of her patients and what they have gone through. I think so often the stories we hear about abortion later in pregnancy are so focused on those who get a late fetal diagnosis that we don't often hear all of the other stories. And this book was a really great opportunity to understand the full range of people who need to access that care and what is happening in their lives. It just really puts personal faces behind all of the stories. And I just found it increased my empathy so much. I had already felt for all of these people who were in these situations and I already supported abortion later in pregnancy but this just, like, even more so now and there were tears there was just like so much so much pulling on my heartstrings hearing these stories and thinking through what all of these people had been through that just it was a lot just to hear all of the hurdles they had to go to access this care. So, with that, let's go to my interview with Dr. Sella. Hi, Dr. Sella. Thank you so much for being here.

Dr. Shelley Sella: Thank you for having me.

Jennie: I'm so excited to talk to you today. But before we dig in, would you like to take a second and introduce yourself?

Dr. Shelley Sella: Sure. I'm Dr. Shelley Sella. I'm a retired OB-GYN, and I'm the first woman to openly provide third-trimester abortion care. In the United States, that is.

Jennie: I'm so excited to have you on. I just finished reading your book that is coming out next month, and it's called Beyond Limits: Stories of Third-Trimester Abortion Care, and I just, I absolutely loved it. It was so moving, and... we'll talk through multiple parts of the book, but I just wanted to thank you for writing it because it really did make an impact. And I think it will be a really powerful tool.

Dr. Shelley Sella: Well, thank you for saying that. And that's really the intent of the book, really, is to help change people's hearts and minds about third-trimester abortion care, which, as you know, is the most stigmatized and misunderstood aspect of abortion care. So, to hear you say that is actually very, very gratifying, and I hope that other people who read it have the same experience. My intent was not to write an overtly political book. It was really to talk about the patients that I saw, to talk about my particular journey to providing that care. And with the hope that by focusing on stories on people, that it would have an impact, it would have a different kind of impact, it would affect, it would impact people's hearts and then help move them.

Jennie: So, one of the things I really loved about the book is you telling your story. And we do an annual episode every year where we have people tell their origin stories on how they either got their job or like how they got into this field. Would you like to share your sexual and reproductive health origin story here?

Dr. Shelley Sella: Well, I'll give you the abridged version. And for the more complete and complicated version, you’ll have to read my book. But I became interested in the women's health movement in college. And I went to the University of Wisconsin, Madison, and we just talked about how you went there too, but it was a different time.

Jennie: Yeah, and one thing I think I forgot to mention, I think my mom might have been there at that same time.

Dr. Shelley Sella: Oh, wow. Maybe we were friends. So that was, at that time, there really was a burgeoning women's health movement and a women's movement. And at the time, and right now, it may seem odd to even be talking about a women's health movement when we now are so much more expansive in our understanding. But then at that point, that was how people were referred. And so that interest led me to an internship at the Los Angeles Feminist Women's Health Center. And they were really at the vanguard of the women's movement. And just to stop for a moment and to explain what I'm talking about when I say the women's health movement, it was really a response to this very male patriarchal model of health care. It was about giving power back to women, giving power back to patients, educating them, having them control their bodies and also control the experience in the doctor's office. So, it was really kind of a ground, from the ground up movement rather than a top-down movement. So, for example, at the Los Angeles Feminist Women's Health Center, the doctors were there, but had a minimal role. They were essentially technicians. And actually, when I got to the clinic is when I realized they were providing abortions. I didn't even know that. But the doctor was the one who provided the abortion. The patient, the lay health workers, as everyone was called, did everything else. They did the lab test. They ran groups. And so, rather than an individual experience between a health care provider and the patient, it was a group of women sitting together with the lay health worker. So, for example, pregnancy tests were done in a group. Results were discussed in a group. And then if someone decided to have an abortion there was a lay health worker who was a counselor with that patient and actually, I'm using the word “patient,” but we were told not to use the word patient we were... because it was a peer relationship. We weren't better than the person we were caring for. So, we used "women." And that's a shift, I think. And so, the doctor was the one who performed the abortion. And that's it. That's all they did. The health workers did everything else. So that was kind of the model that was in my head. Group experiences, using healthcare or healthcare as a way to empower people. Providing healthcare in a different way. And so, from that experience, I actually decided to become a doctor, which is funny because there was such a bias in that movement against doctors. Like, why would you want to be a doctor? But... I wanted to be able to not just offer the emotional care, the educational care. I wanted to offer the technical part of it. I wanted the whole thing or to learn everything. And so, I did go to medical school with the intention to provide abortions. And that's a whole other long story. But I would describe it as a journey. But that was the beginning. Really, the foundation was at the Los Angeles Feminist Women's Health Center.

Jennie: I really loved how you interspersed your story with the week that you had these patients. It was just brilliantly done. And I loved seeing how you took all of these past experiences you had with these different parts of care you encountered to find the way you ended up providing care and you could feel the patient-centeredness of it. And it was just really wonderful to see how it all came together to provide this service, and you could feel the way that it was helping people who came to see you for the abortions later in pregnancy.

Dr. Shelley Sella: Yeah, I mean, when you're saying that, I'm thinking one of the really important experiences I had subsequently was the two years I worked with home birth midwives in Santa Cruz, California. And that also was this model of care, which is called the midwifery model of care, that again, centers the woman and her experience and empowers her, honors the process, honors the birthing process, honors her and her family. And that was key to how I subsequently provided abortion care. I mean, that was the thing about third-trimester abortions, because it's a longer process. It's not a quick, in-clinic, first-trimester abortion or medication abortion. It occurs over several days. So, it gives the provider time to understand what's going on, to spend time with the patient and their family, and to develop trust between provider and patient. The process of a third-trimester abortion where I worked was the induction delivery of a stillborn. So, it was a delivery. So, it was using the same philosophy, the same orientation that I had learned from working with midwives and translating that or transferring it to abortion care.

Jennie: Yeah, I really appreciated that. And I really appreciate the way you brought in the group dynamic, because I think from a lot of the stories you hear, how so often people talk about how they have felt alone and didn't feel like they could talk to people or were dealing with it on their own. And it was really wonderful to see the way, again, when you all read this book, you'll see that each chapter is a day talking about this, like, multi-day process and following six people. And it was really wonderful to see the thought. I could feel it built into all the steps where you had the two groups, you had the maternal indications and the fetal indications, and then each had their own support system of group counseling. And I could just feel the thoughtfulness that went through all of it as to why there were the separate groups and the ways that these people were supporting each other to know that they weren't alone in this process.

Dr. Shelley Sella: Yeah, and I think the group process was very important and key to the care that we offer. And I would like to say that that was started by Dr. George Tiller. So that was the physician who was my mentor, and then we worked together in Wichita, Kansas, until he was assassinated in church. So, he was one of the first people to provide third-trimester abortion care in the United States, and it was his idea to have the groups. And so, when I came to the clinic to visit for the first time and I saw the groups, it's like, ah, I've seen this before, and it works. It's actually very helpful. And then After he was assassinated, a doctor in Albuquerque, New Mexico, Curtis Boyd, invited one of my colleagues, Dr. Susan Robinson and I, to start a third-trimester abortion practice at his already existing practice. That clinic was really known for its excellent counseling that they offered patients in the first and second trimester. But it was one-on-one counseling. So, what we did when we came, we... combined the two so that patients would still have that really good one-on-one counseling, and they would also have the groups. And I think patients really appreciated it. You know, there would be times where people would say at the beginning, oh, I don't like groups, I don't want to talk.

Jennie: I could totally see myself being that person.

Dr. Shelley Sella: And then they would, and I would say, you know, just even just sitting in a room with other people might be helpful.

Jennie: Yeah.

Dr. Shelley Sella: And invariably, that person would start talking once they were in the group, because you're in a group with people who completely understand what you're going through. And it's a support group. Part of the purpose of the group was to transmit information, but the majority of the time spent was people talking to each other. And they formed connections, like... in the book, I talk about one group afterwards, they all went out to dinner. That wasn't that uncommon. And then sometimes people would stay in touch for years, offering support, and through good and bad. I know of one couple where they heard, oh, so-and-so had a baby, they were doing well, so-and-so went back to school. I mean, different situations where people stayed connected to each other. So, it's powerful. I think the groups were very powerful.

Jennie: I also really appreciate it. I mean, this was a general week that you picked that you told the stories for, but it was, I think, really important to the book to see all of the individual stories so that people get a better understanding because I think there's so much myths and disinformation about why people get abortion later in pregnancy and a lot of judgment and stigma around it. And I think this book did a really great job of dispelling that and showing who these people who were accessing care were, and why they were making those choices

Dr. Shelley Sella: Yeah, I think that's certainly an important part of the book. The stories are, the patients are composites. Each patient represents patients that I saw. So, they're composites of true patients. But I did, I was deliberate about deciding what kind of patients I would talk about. And I was also deliberate about having three, you mentioned fetal indications and three maternal indications. Let me explain that a little bit. Fetal indications are patients who come because their baby, and that is the word that they use, has a condition that's been diagnosed at some point in the pregnancy. It could be a condition that was picked up early in the pregnancy and then they keep following it and it gets worse and worse, more serious. Or it could be something that's picked up very late in pregnancy. Those are the stories we often hear about. Like, if the media is going to talk about one kind of patient in the third trimester, they're going to talk about them. And I think there's that decision made, like, these are the most deserving, perhaps, of compassion, that maybe these will pull at our heartstrings and maybe we will change our mind about third-trimester abortion. And I think their situation is compelling and deserves compassion. And equally-

Jennie: Yeah, I mean, like I said, I told you, I think, before we started recording that I cried multiple times reading this book, but I found the fetal, I mean, the maternal indication stories often just as heartbreaking for all of the situations that all of them were in to be in that place.

Dr. Shelley Sella: Exactly, yeah. So, the maternal indication patients that I saw were ones who had difficult life circumstances, and anything you can imagine can happen. I talked about one person who was a victim of domestic violence, one person with a diagnosis of cancer who couldn't get treatment while she was pregnant, but whose symptoms were hidden by the cancer recurrence. And I talked about a teenager, which I thought was very important to talk about, because teenagers are stigmatized even more than anyone else. And so, I wanted people to really understand what was going on for a teenager. And I believe that the maternal indication patients are as deserving of our compassion as the fetal indication patients.

Jennie: Absolutely. I thought all of the stories were told in just such a compassionate way. I could just feel your compassion for your work and for all of the patients just bleeding through on the page. Like it was just, just so well written.

Dr. Shelley Sella: I got a lot of help. I'll start with my wife, Julie, who was the first editor. And, you know, this is the first book I've ever written, and I really had no idea what I was doing. And I also had no idea how long it would take. I thought when I wrote the first draft, I thought, oh, okay, I'm done.

Jennie: Yeah. [chuckles]

Dr. Shelley Sella: Little did I know. It's really quite a process.

Jennie: As somebody who is a big reader, anybody who can write a book is magic to me. Like I just, so I, yeah, I find the whole thing just magical. So it was, like I said, it was a really wonderful book.

Dr. Shelley Sella: Thank you.

Jennie: So, what is one thing or two, you may have a couple, that you wish people knew about abortion later in pregnancy?

Dr. Shelley Sella: What I want people to know is that, and I want to reframe it a little bit, not what I wish people knew about third-trimester abortion, but what people knew about the people who get third-trimester abortions, who need third-trimester abortions. And their situations are similar. to those seeking first- and second-trimester abortions, but they are a lot more desperate, meaning they know that if they are turned away or if they can't obtain a third-trimester abortion, if they're turned away at this clinic, that's it. They are going to be forced to have a child. I think it's more and more an issue these days because of all the restrictions and bans. Restrictions and bans lead to later abortion. So we're seeing increasing numbers of people who are traveling out of state. At this point, it's one in five. Before Roe was overturned, it was one in ten, which is also way too many. But it’s one in five women are leaving their state to access an abortion, and that's leading to more and more delays. But that's not the only reason why people seek third-trimester abortions. And even if abortion was accessible, free, legal in all states, there would always be a need for third-trimester abortions. And that's something else I wish people would know.

Jennie: That's such an important point.

Dr. Shelley Sella: Yeah, because... we just don't know. We cannot predict what will happen. Someone with a highly desired pregnancy cannot predict that the baby may develop a condition, or be born, or have one that may worsen with time. We can't predict that birth control fails. We can't predict that someone has cancer and their symptoms are hidden. We can't predict... there's so much... that life circumstances change, that maybe you thought you could manage a third child, but you just lost your job, and your rent just went up, and you can barely feed the kids that you already have. Life is complicated. I guess that's what I want to say, what I want people to acknowledge, because we know this—but people need to acknowledge that life is complicated, and it doesn't fit into gestational limits that the state has decided, that that's how we should decide who can have an abortion or not.

Jennie: Yeah, I was just thinking that, like, there is no way the state can legislate for the complexity of people's lives in gestational bans where, you know, hear them talk about exceptions and stuff. And if there's anything we have seen. I mean, always, but particularly since the loss of Roe, is how exceptions are not clear and do not work. That you have people who are miscarrying who still can't get care because there is still a fetal heartbeat, and they are waiting until the person is sick enough before they can provide the care that that person clearly needs and will get. But you just can't legislate the complexity of the reality of a pregnancy in a person's life.

Dr. Shelley Sella: Yeah, and I agree. Exceptions are absurd. And as I write in the book, I really don't believe in a hierarchy of desperation. And there's always, not always, sometimes when there are exceptions, there will be exceptions for rape and incest. And then I think, wait, are those the worst things that can happen to someone? Yes, they are bad, and there are a lot of other bad things that can happen to people that make that person decide that the pregnancy is not viable for them. And so I do talk about this notion of viability, which is not what was codified in Roe, a fetus who can survive pregnancy outside the womb with or without support, it's the pregnant person themselves deciding that the pregnancy is not viable and taking into account all the complexity of their lives and coming to a decision. The decision comes from them and not from the government.

Jennie: Yeah, I mean, who knows your life and what you can do and handle better than you?

Dr. Shelley Sella: Exactly, exactly.

Jennie: Like I said, I really did enjoy this book and... I really appreciated getting to understand the process better. I think I had a general idea. I've worked in this field for a long time. I knew generally how third-trimester abortions worked, but it was really illuminating to sit through all of the chapters where you had, like, here's what happened Tuesday morning, here's what happened Tuesday afternoon, and really seeing how the process worked and getting a better understanding of that, but also how the patients were supported throughout it. I think that was just really well written.

Dr. Shelley Sella: Thank you. Well, that was very deliberate on my part. When I thought about writing a book, I thought I wanted for people to understand the patients, why they come to the clinic, why they have a third-trimester abortion, and I also wanted people to understand the care. And the care is emotional, and we talked about the groups, but there's also a physical component to it. And when I think about how abortion care in general, but especially in the third trimester, is misunderstood and stigmatized and vilified, part of it is that people don't have a conception of what actually happened. And so, I really, I thought, I really want to describe the process. Because when you understand that, and again, it's an induction delivery of a stillborn, then maybe it will help reduce the stigma and the fear and the lack of understanding and the lack of compassion. You know, if you have some crazy idea of how it happens, then you have less compassion for the person who is coming to the clinic. So yes, that was a very deliberate part to really break it down for people.

Jennie: I really always appreciate the attempts to knock down the stigma. You know, we talked about both going to school in Madison. When I was there, there was often this family that came to Library Mall that had like, you know, the big gory signs that were there, you know, street preaching. I feel like it was like every Monday or something, I don't remember. And then I would always see them and also I work on Capitol Hill, there used to be a truck that drove around with similar things on it, so you can see the ways they really do try to stigmatize and vilify the service, but also the provider. And so, I really did think the thoughtful way you talked about it and made it clear what the process is through all of the conversations with your patients, was really well thought-out. Yeah, I'm just thinking about those photos and thinking that despite those gory photos, people still have abortions. You know, it's not like it prevents people from needing an abortion and having an abortion, but it just augments the stigma. And I guess that's the point of that, really. Third-trimester abortions are different. It's a different process. And I do want to say different clinics have different techniques. I describe what it was like where I practiced. But it's different in the first trimester and the second. It's a different process than the first and second trimester. I'm always a big fan of seeing stigma be chipped away at. I've talked about it on the podcast before, but I went to Catholic school K through eight. So definitely, I think I was lucky compared to a lot of other people. Like I didn't, my school was not one of the ones that was like really preaching and pushing on that. But it was definitely like, you know, It was Catholic school sex ed, if you could call it that. So, you know, all the shame and stigma baked in. But I also was very lucky to have my mom who, like I said, Catholic school. So, a friend asked me if I wanted to go protest at the Planned Parenthood in Madison. Well, I wanted to go save babies with her and her family that weekend and going home and talking to my mom and being like, oh my God, I'm going to go save babies. And her sitting me down and just having a really age-appropriate conversation of thinking through people's lives and just really kind of doing that person-centered, have you thought about if this person is in this situation or what about this or what about that? And then did the... I think very smart of: if you still want to go, you can go, like make your own decisions. And obviously, I did not go. But she really did that work, whether she knew it or not, of like breaking down the stigma of putting yourself in that place and thinking through all of the situations in people's lives and understanding why a person would make those decisions, which I just thought was so important.

Dr. Shelley Sella: Yeah, your mother sounds amazing. Kudos to her. I mean, really, that's wonderful. What she was demonstrating to you was empathy—see why they're making the decisions that they do. And really, empathy has no limits. So, I really appreciate your mother. I do want to talk about religion just for a moment, because there is also this belief, oh, you know, a Catholic person would never have an abortion. But, you know, that's just not true. And I saw people from all religions, all, and all political persuasions, all of them. And it didn't matter. You know, when you are faced with a difficult situation, you have to make a decision. You'll make the decision that's the best for you and your family. And you're not going to think, oh, you know, my church believes so and so, you know, is against abortion, so I won't have an abortion. But the problem is, though, and I do talk about that in the book-

Jennie: Yeah, those two stories were really profound. Do you want to talk about it real quick?

Dr. Shelley Sella: Yeah, I talk about two couples who came in because of a fetal condition, that they felt that the best thing that they could do to prevent their baby from suffering was to have an abortion. And one couple was very religious, Catholic, and the others were kind of evangelical Christians. And it was really interesting, the contrast between the two. One, the Catholic couple felt very isolated and isolated. Shame. They felt that their religion was not able to support them. And that was hard. It was very hard for them. They felt very isolated. And the other couple was the opposite. They were equally religious Christian, but their pastor supported them, and their congregation supported them. And they offered them literal support by giving them money to be able to travel to the clinic. And what was great, though, was the group. Because in the group, those couples could meet each other and talk to each other and get support. But that kind of shows how it can be that you don't have to abandon your religious beliefs to have an abortion, but religion can be a source of support. And it also could be a source of censure and lack of support, condemnation. And that just makes it harder for the person who is seeking an abortion.

Jennie: Yeah, those two stories really hit me hard thinking through. I mean, it just made it so much harder for that couple who didn't have the support that they were really struggling with the decision and just thinking through, you know... was Catholic and the guilt and shame that is really just baked in and takes a long time to get rid of. I'm sure I have not gotten rid of all of it, but even with the work I do, there's still a lot of that that got baked in early that is hard to shake. I really resonated with those two stories and seeing the difference in how those two couples were dealing with all of it.

Dr. Shelley Sella: Yeah, and how difficult. I mean, I think the situation was inherently difficult for both couples. They both, you know, accepted this pregnancy, were expecting the pregnancy to go a certain way, and it didn't. But for one couple, there was the support of their community. That's what their religious...their church was. It was part of their community, and they had the support of the community, and the other did not.

Jennie: Okay. So, I always like to wrap up our conversations thinking about the audience, and what can the audience do? So, how can they support third-trimester abortions, or what can they do that would be helpful right now?

Dr. Shelley Sella: I think reading the book will be very helpful because it will give you a different perspective. For those who are confused about the issue or for those who feel uneasy, I think this book will help. And for those who already support all-trimester abortion, I think you'll enjoy the book. But I think third-trimester abortion care needs to come out of the closet. And I think it's starting to, really. This is the beginning. And so, I think the more people talk about it, the more people acknowledge that it is part of abortion care, the better. So even just starting these conversations, I think, is very helpful. And then when issues come up, when ballot initiatives, for example, come up, thinking beyond viability limits, beyond gestational limits, beyond bans, I talk about that at the end of the book, where Roe is over. The age of Roe is over. And so we have an opportunity to create something different. better. And I think that's where education and better understanding comes in so that we don't need to go backwards and say, oh, yeah, let's restore Roe because Roe was so problematic. Let's move beyond that. Let's move beyond gestational limits. Let's think of viability as just what we were talking about. Viability is the person themselves deciding that the pregnancy is viable or not. This is an opportunity. But we can have that opportunity when we understand the issue. That's my hope.

Jennie: Yeah, and I see this tool as a great resource for people who may support abortion at any time, but don't have the language or the comfort with it to be able to speak about it when they hear other people talking about it. I think this book would be really helpful for those people to be able to talk about it better. I feel like I am better equipped with a deeper understanding, and I've been doing this work for a long time, and I think one thing I just thought of as we were talking that we didn't really mention is gestational bans are in place in so many states and there aren't that many providers of third-trimester abortion. So, we talked about why it's so important to have access, but that there is very little access and people have traveled great distances to get it, which pushes it further out of reach because It's more expensive if they have to travel a long way, all of those things. So, maybe we just want to talk about that really quick.

Dr. Shelley Sella: Yeah, I mean, I think just what we were saying, the need has increased. There are more providers of all-trimester. By all-trimester, I mean clinics that provide first-, second-, and third-trimester abortions. So, when I first started, there were two providers that offered this care. And then I started, there were three, and then Dr. Robinson. I mean, gradually, there were a few more. But now it's really changed. There are more clinics offering all-trimester care. There are more young providers coming into the field who are very interested in providing this care. And they are. The problem is all the bans that are in so many states. I mean, the lack of access. But in terms of third-trimester abortion care, there are providers who are doing that. It's different than it was even 10, 15 years ago. And I think that's great. I think that means that people who are coming out of training have a different view of abortion. They're seeing it in an expansive way, not in a restrictive way. So, I think that's a wonderful thing.

Jennie: That's so wonderful to hear.

Dr. Shelley Sella: A little bit of light.

Jennie: Yes!

Dr. Shelley Sella: Yeah, a little bit of light.

Jennie: Well, Dr. Sella, thank you so much for being here. I very much enjoyed talking to you. I really enjoyed your book, and I hope my audience will check it out. I've already been talking about it with people, so I already know we have a few people who are going to be going out and buying it.

Dr. Shelley Sella: Great. Well, thank you so much. And I do want to mention, actually, on my website, ShellySella.com. It has a list of events and where I'll be because I am going on a book tour. And I may be in your city. So, I hope to see you all.

Jennie: Yes, I'm going to make my best effort to come see you when you're here.

Dr. Shelley Sella: Wonderful. And that's June 28th in DC.

Jennie: Yes.

Dr. Shelley Sella: Okay, thank you so much.

Jennie: Okay, y'all, I really, like I said, I cannot recommend Dr. Sella's book enough. It is Beyond Limits: Stories of Third-Trimester Abortion Care. It's so good. I highly, highly recommend it. I hope you enjoyed my conversation with Dr. Sella and that you're enjoying this series on abortion later in pregnancy. And I will see everybody next week. [music outro] If you have any questions, comments, or topics you would like us to cover, always feel free to shoot me an email. You can reach me at jennie@reprosfightback.com or you can find us on social media. We're at @RePROsFightBack on Facebook and Twitter or @reprosfb on Instagram. If you love our podcast and wanna make sure more people find it, take the time to rate and review us on your favorite podcast platform. Or if you wanna make sure to support the podcast, you can also donate on our website at reprosfightback.com. Thanks all!