Medical Tourism

I have hosted women from small towns within my own state, women from nearby states, and even a woman from Canada. They come to my large metropolitan city because they are past the legal limit in their state, or there just simply is not a provider trained or willing to perform abortions in the second trimester where they live. For example, the woman from Canada was within the legal limits, but there was not a provider, so her public health insurance PAID for the entire cost of her procedure in OUR country!

I always ask the women if they have been to New York City before. Some of them live only a few hours away and I sort of assumed they had been to NYC on a field trip, family trip, or getaway. However, as far as I can remember, every woman I have hosted said she had never been to NYC until the present trip.

We usually leave the clinic in a cab, which for many of them is the first time in a cab. The cab drivers here are fast and tend to weave a bit, which is not the best environment for an often-queasy woman going through a 2-day abortion. One woman was mesmerized by the TV screen built into the cab that had a map displaying showed our location. The women all stare out the window and ask every block what landmarks we are passing and if we will see famous buildings or people…usually people they know from reality TV or celebrity gossip magazines.

I have had a few women assume they will feel fine the afternoon after their procedure and they tell me they will go shopping, eat at a famous restaurant, or try to get cheap tickets to a Broadway show. I try not to break their hearts, but I am honest that they probably will want to stay off their feet and get some rest. They insist they will be fine and I usually keep my mouth shut.

I think about my first time visiting NYC when I was a small child. We ascended the Statue of Liberty, ate in Chinatown, climbed rocks in Central Park, and saw “Cats” the musical. My memories are so positive, and filled with love from my immediate and extended family. I can’t imagine what it would be like to have my first NYC memories consist of hours in a waiting room, sleeping at a stranger’s apartment, and lying in stirrups with unfamiliar medical staff. It pains me to think about how these women experience NYC for the first (and possibly only) time. I don’t think this is how they ever imagined a trip to the Big Apple.

I hope they find their way back to NYC again, in a different circumstance, at a different time. I would love for them to see this city on their own terms and not in a post-anesthesia haze. NYC is symbolic to so many people for so many reasons, and I like to think that the city plays a role in shaping women’s lives. They come here to take charge of their lives and they return home to Rochester, Albany, or even Ontario, as new people (or renewed people).

Alicia Keys sings it best:

Concrete jungle where dreams are made of,
There's nothing you can’t do,
Now you're in New York!!!
These streets will make you feel brand new,
the lights will inspire you,
Let's hear it for New York, New York, New York

NYC Abortion Rate

A report (1) was released recently from the Bureau of Vital Statistics that indicated that 39% of pregnancies in New York City and the surrounding boroughs end in abortion. According to the report, there were 225,667 pregnancies in 2009, with 87,273 ending in abortion. To put that in perspective, Guttmacher reported in 2008 that 19.6% of all pregnancies nationwide were ending in abortion (2). So the rate in NYC is twice the national average.

If you split the data up by borough, it looks like this:

Percentage of Pregnancies Ending Abortion
Bronx - 47.9%
Brooklyn - 39.3%
Queens - 38.7%
Manhattan - 37.9%
Staten Island - 32.2%

And just for fun, I looked up the poverty information for those areas:

Percentage Living Below the Federal Poverty Line (as of 2009)
Bronx -28.5%
Brooklyn -24.2%
Queens -14.6%
Manhattan -16.6%
Staten Island -10%

Percentage Living Below 50% of the Federal Poverty Line (2009)
Bronx - 13.7%
Brooklyn - 11.6%
Queens - 7.3%
Manhattan - 6.8%
Staten Island - 5.3%

So the areas with larger numbers of impoverished people also have higher abortion rates. This is not a coincidence. If someone is already struggling to make ends meet, pay bills, put food on the table for the kids she already has, how is she supposed carry an unwanted pregnancy to term and pay for all the expenses that come a long with a baby? Further, when you factor in the unemployment rate, the economy sucking for that past couple of years, etc, it shouldn’t really be that surprising women choosing to have abortions.

Archbishop Timothy Dolan said at a press conference, “That 41%(3) of New York babies are aborted, a percentage even higher in the Bronx and among our African-American babies in the womb, is downright chilling.” He then proceeded to criticize sex education programs that promote condom distribution (!).

Dolan’s statement is painting these poor, low-income women as some sort of villains. Using the language “downright chilling” in the same sentence as “babies in the womb” reminds me a lot of “cold blooded murder.” Not that I think that’s what he is necessarily saying, but, you get my point.

I’m sorry, but whose 'fault' is it that these women need abortions? How did they get pregnant? Families from poor areas are more likely to receive NO sex education (4), so they are less likely to be informed about birth control. They are less likely to be able to pay for birth control. They are less likely to have resources to go to a doctor to get their BC prescription refilled. I could go on. Getting resources like Medicaid, food stamps, etc. requires breaking through absurd amounts of red tape. Yet, antis will stop at nothing to prevent these women from obtaining abortions. Sorry, but a basket of baby formula and a few blankets isn’t going to get up in the middle of the night and check on a crying baby. Coupons for discounted diapers aren’t going to pay for new clothes every couple months as the baby grows.
As I looked through the report one thing that struck me was the abortion rates have actually been pretty consistence for the NYC region.



Since the 90s, the number of miscarriages, abortions, and live births has actually declined. However, what is happening in NYC is not a new phenomenon by any stretch of the imagination. New York has had higher abortion rates for the past couple of decades. Why?

I would guess for a bunch of reasons:
• New York has a high number of abortion providers, whereas most places in the US do not.
• Access there is much easier also with the expansive public transportation system.
• New York has a high number of young people. Younger women are more likely to have abortion.(5)

So, what do we take away from this?

First, I think that these religious groups are approaching this in the wrong way. Speaking of this situation in a negative way further stigmatizes abortion. Women go through enough when they have an abortion; they don’t need anyone from our society making them feel shamed or bad about it. If people truly want to reduce the abortion rate, they need to turn to birth control. Access to and proper use of birth control is the easiest and most effective way to reduce unintended pregnancies. Abstinence education does not work.(6) If you want women who do end up getting pregnant to carry the pregnancy to term, expanding social welfare programs to enable her to actually provide for her children would be a good step. Of course, that would require antis to pay more taxes (re: not happening).

What do you guys think? What else can be done to help improve the situation for pregnant women in NYC?

(1) http://cbsnewyork.files.wordpress.com/2011/01/2009sum.pdf
(2) http://www.guttmacher.org/pubs/USTPtrends.pdf
(3) This group included spontaneous miscarriages (aka, natural, natured-produced miscarriages) in their abortion numbers for some reason. I guess because 41% sounds a lot scarier than 38.6%? Anyway, 87,273/225,667 = 38.673%.
(4) http://www.washingtonpost.com/wp-dyn/content/article/2008/03/24/AR2008032401515.html
(5) I am not suggesting that college chicks get knocked up and get abortions as a method of BC (ala any of those stereotypes). Women under 20 have 18% of all abortions, ages 20-24 is 33%, ages 25-29 is 24%, ages 30-35 is 14%, ages 35+ is 11%.
http://www.guttmacher.org/pubs/US-Abortion-Patients.pdf
(6) http://www.washingtonpost.com/wp-dyn/content/article/2007/04/13/AR2007041301003.html

Empire State of Mind.

Spring has sprung. The time has come to support your local abortion fund! Abortion funds are local, grassroots organizations that raise money to support women in need of abortion services.

In honor of my current home, I am highlighting the fabulous New York Abortion Access Fund!!

"NYAAF is a volunteer-run, 501(c)3 non-profit organization that provides financial assistance to low-income women in New York State who cannot afford to pay for an abortion." They are an affiliate of the National Network of Abortion Funds and believe that abortion services should be available to all women, regardless of their ability to pay.

Why New York (you may ask)?

Yes, New York is what abortioneers call a 'Medicaid state' -- in other words, low-income women who are eligible for Medicaid (public health insurance) and can provide documentation can have their abortion paid for, up to 24 weeks (in some cases). Yes, abortion access in New York is better than in most other states (there are no parental consent/notification laws or state-mandated waiting periods). In New York, no metropolitan area lacks an abortion provider.

Even so, many women struggle to come up with the funds for basic reproductive health care. Whether it's because they are undocumented and cannot get on Medicaid, fall in the "donut hole" where they aren't eligible for Medicaid but can't afford private insurance, or a slew of other reasons, the need for abortion funds is substantial because many women fall through the cracks.

NYAAF supports not only women who are from NY, but also women who have to travel there from states where they cannot have the termination because they are too far along, or if it is less expensive in NY than in their own state. NYAAF has made grants to women from New Jersey, Connecticut, Pennsylvania, Massachusetts, and even Texas! From 2008-2009, "NYAAF provided over $43,000 in assistance to support 77 women."

What can YOU do to help?

1) Make a donation directly, http://www.nyaaf.org/how-you-can-help/

2) Volunteer to help with fundraising, technical assistance for the website, stuffing envelopes and other tasks.

3) Host an event to raise money.

4) Join their Board.

Thank you, NYAAF and all the other wonderful, dedicated abortion funds across the country that help women access their reproductive rights everyday. Without you, many women would not have the means to exercise their right to healthcare.