Sometimes Messy, Often Meaningful, Always Ours: Reflections from a South Asian Medical Student in Texas

As a South Asian, first-generation American and the first person in my family to pursue medicine, I carry many expectations, some spoken, others unspoken. My parents immigrated to the United States with the hope that their children would live stable, respectable lives. Becoming a doctor, to them, represented safety and success. But as I’ve moved through medical training in Texas, a state that relentlessly restricts reproductive healthcare, I’ve realized that becoming a doctor here also means confronting systems of fear, silence, and stigma, especially when it comes to abortion.

When I first learned about self-managed abortion (SMA), it was through activist spaces, not medical lectures. SMA, the process of ending a pregnancy with pills outside of a clinical setting, is often portrayed as dangerous or secretive. But what I’ve learned from people who have self-managed is that it can be deeply intentional, safe, and empowering. It allows people, especially those who can’t access or don’t feel safe in formal medical systems, to take control of their bodies and their timing. Still, empowerment doesn’t always mean ease. SMA can also carry layers of fear, tenderness, and uncertainty.

This year’s theme, Sometimes Messy, Often Meaningful, Always Ours, resonates deeply with me. Growing up South Asian, I was taught to avoid “messiness”, to keep private things private, to maintain a sense of respectability in how I carried myself and what I spoke about. Abortion, especially, was treated as taboo, something distant and shameful. Yet, in learning about SMA and hearing stories of people who have self-managed, I’ve come to see the beauty in messiness. There is a mix of fear and relief; we must make room for it all.

Living in Texas, the conversation around abortion is always shadowed by surveillance and criminalization. There is confusion about what’s legal, anxiety about who is watching, and fear of who might be punished. For people who are undocumented, Black, Brown, trans, or poor, the risks are greater. And for those of us training in medicine here, the silence around abortion education often mirrors the silences in our communities.

I often straddle two worlds, the cultural traditions of my South Asian upbringing and the political realities of being a medical student in Texas. Within my family, conversations about reproductive autonomy are often filtered through fear or misunderstanding. Within the state, conversations about SMA are filtered through fear of punishment. Between these two silences, I’ve found my voice in reproductive justice work, spaces that honor both the empowerment and the complexity of SMA.

Self-managed abortion is not a crisis to be hidden. It’s an experience to be shared and a reminder that liberation isn’t about perfection, it’s about honesty. Sometimes messy, often meaningful, always ours.