The Great Macy's Fourth of July Abortion Sale: Get 'em while you can! (offer valid only in Mississippi until 7/11/2012)

This is actually a breadline, not a bank run or a premodern Black Friday. But when I thought about it, the breadline matched the vibe of the clinic waiting room better than those. People are there -- with their spouse, mom, kid, infant -- because they really need to be. 

So...

Remember my last post, where I was kinda sick and tired of legislators playing doctor (and not in the sexy way) (but also, is playing doctor actually sexy to anyone?), and I was writing about the last abortion clinic in Mississippi being legislated out of existence, and about Rep. Bubba Carpenter, and how he was talking in what I imagine is a too-bad-so-sad wah-wah voice about how the other side talks way too much about "some poor pitiful women" who might risk their health and lives trying to end their pregnancies by any means available, and I think I might have blacked out shortly after that as an internal defense mechanism?

Yeah, I know: oof. But let's talk about Mississippi some more!

So the bill passed and was signed by the governor and its stipulations include that abortion providers must have hospital admitting privileges -- something Bubba Carpenter noted was notoriously difficult for anyone to obtain, not just abortion providers -- and that means that this last clinic in Mississippi, which has not been able to secure admitting privileges, will have to close. But then, since as Bubba Carpenter noted this law is not trying that hard to be constitutional, a judge stayed the new law until a court hearing planned for July 11 -- giving the clinic a reprieve of, uh, about a week.

And here's something that interests me as an abortioneer.

But it has also created a rush of women from across Mississippi wanting to have abortions. The clinic's three doctors normally perform about 40 abortions a week, but received more than 100 calls in one day last week from women trying to schedule appointments. Two of the doctors live out of state and will fly in to perform abortions this week, said Diane Derzis, the clinic owner.

"What women are hearing is, You may not be able to have an abortion soon," she said. "If you're pregnant and you don’t want to be, you’re thinking, 'By God, I've got to get in there fast.'"

Seems kind of weird, doesn't it? Like a run on the banks, as my arm candy quipped. You'd think that the need for abortion care is pretty much static over the course of a year, since pregnancy can occur in any season and any abortion clinic is the potential provider for at least several million people of reproductive capacity. But demand for services really does seem to have a certain flux to it. While I can't remember hearing of a run on the clinics (though I guess it's not hard to understand), I have noticed other ups and downs and maybe patterns.

I've mentioned before that I had many clients who were able to finally secure their abortion care when their tax refund came back -- and even some who specifically filed early in order to make sure they raised enough money before they reached 12 weeks when the fee would start progressively increasing. Those patients were very resourceful and very on top of it. And I sympathized with their certainty that they made little enough to be owed a refund -- my full-time job qualified me for both a tax refund and assistance from an emergency abortion fund should I ever need it.

But demand also seems to drop on holidays, especially big ones. It's hard to seek an appointment while hosting extended family, driving to grandma's, juggling your parents' or grown children's multiple Thanksgivings after a divorce, entertaining your school-aged kids at home, or arguing with your teenager about sharing the family car over winter break. You don't have as much privacy, time, or energy for taking care of yourself. Shit's hectic.

Then, weeks after a holiday, demand bounces back to levels even higher than before. Phones ring off the hook at the emergency abortion fund, they ring all day although you have multiple phone lines and someone answering every line. Same thing happening at the clinic, which is also jam-packed with people -- you have to bring more chairs into the waiting room -- and clients want to know what is the point of making an appointment if you still have to wait all damn day. (The answer is you struggle with turning people away from care, and wish there was such a thing as walk-in care, but in your state there's a law requiring advance appointments so pregnant people can take time to "cool off" and think hard about their impulsive and flighty decisions. As Sarah Silverman says, maybe they're not as hungry as they think they are.)

I say "weeks" after a holiday but we'd often remark that it seemed to be about four to six weeks after a holiday. Kind of joking, because that's how long it takes from fertilization (four) or last normal menstrual period (six) to the earliest point in pregnancy that most clinics are able to offer abortion care. Kind of not joking, because it really happened. At least three years I noticed that after a December-January lull, we'd have the most insane February and March. That's the time of year that I first became an abortioneer, actually. At first I thought that was just how it was -- that we'd have 100 appointments per day forever. (On the plus side, a lot of those were double-bookings or ambivalent patients who ended up going to another clinic for prenatal or abortion care. We didn't actually check that many patients in per day.)

I could surmise that stereotypically hectic and overburdened times (Thanksgiving/Christmas) or stereotypically romantic times (New Year's/Valentine's) or stereotypically hedonistic times (spring break, New Year's again) lead to unintended pregnancy. And surely the delaying of one's own needs during family-heavy holidays would explain part of the resurgence of appointment requests afterward. But I don't really know and I don't think there's any way to find out on a large scale. It'd be interesting, though, to ask individual women to recount the story of what prompted them to seek abortion care when they did, and why. If only such questions weren't so politically loaded, so likely to suggest there's a right and a wrong answer, maybe we'd hear a lot of honest and interesting stories.

Guest post: TRANSVAGINAL ULTRASOUNDS! Or How We Missed the Real Story in Virginia

If you work in any field related to abortion, you probably remember that our so-called "win" in the battle over Virginia's ultrasound bill was actually somewhat horrifying. But Amy Littlefield's telling of that story is among the best I've seen, so and she's graciously shared it with us here. You can also catch the original at her beautiful new site for the Provider Project.

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TRANSVAGINAL ULTRASOUNDS! Or How We Missed the Real Story in Virginia


To demonstrate why we need stories from abortion care workers in the struggle for reproductive justice, I want to share a little story about an recent legislative attack you may remember...

A couple months ago, some legislators in Virginia decided to pass a law mandating ultrasounds for women seeking abortions. Their thinking seemed to center on a few monkey-brained assumptions:

1. Women seeking abortions may not realize they’re pregnant until they have an ultrasound.

2. After viewing a blurry, black-and-white blob, women will become so overcome with motherly emotions that their financial/logistical/emotional/spiritual reasons for seeking abortion will disappear.

3. Women can’t make decisions for themselves. Legislators should make decisions for them.

4. People who know nothing about medicine are qualified to dictate medical policy.

The legislators might have benefited from speaking to someone in abortion care who had a basic grasp of what happens between providers and patients. If they did, they might have realized:

1. Most women seeking abortion realize they are pregnant.

2. Ultrasounds are routinely provided as part of abortion care.

3. The level of detail required of the ultrasound image would mandate a TRANSVAGINAL ULTRASOUND for many women in early pregnancy.

Then something glorious happened. People who had a basic grasp of medical knowledge noticed that the law would require a specific medical procedure that involved putting.something.potentially.unecessary.into.my.vagina. The rage of the feminist community was unleashed upon Virginia. More than a thousand people protested outside the State Capitol and some were arrested. The word “vagina” was EVERYWHERE.

“Transvaginal,” said the TV anchors.

“Vaginal probe,” agreed the newspapers.

“Holy crap!” said those of us unaccustomed to seeing the word “vagina” in such places.

Many decried the bill as state-sponsored rape. Here, the feminist community may also have benefited from the wisdom of abortion care workers, who might have noted that transvaginal ultrasounds are in fact a routine medical practice that clinics often use to accurately diagnose gestational age.

Some in the world of abortion care worried that patients might come to see all transvaginal ultrasounds as rape. Others hoped patients would understand it was the legislative force -- not the actual probe itself -- that was a violation of will. For the most part, these voices were drowned out by sound bites.

The outcry forced Governor Bob McDonnell and the Republican legislators to back down, instead passing a watered-down version of the bill that required an abdominal ultrasound and the offer of a TRANSVAGINAL one.

But the debate ignored another key provision of the Virginia law -- one that many in abortion care believed would far more dramatically impact the lives of women seeking abortions. The bill required a waiting period between the ultrasound appointment and the abortion -- you know, so women could get a good hard look at that fuzzy, black-and-white picture. Women who lived within 100 miles of the clinic would need to wait 24 hours. Those who lived more than 100 miles away would need to wait two hours.



I spoke to Rosemary Codding, Director of Patient Services at Falls Church Healthcare Center in Virginia. She suggested it was the waiting period that worried her most, not the transvaginal ultrasound requirement. For many patients it meant two days of childcare, two days off from work. Some women would need to wait a week between the ultrasound and the abortion because of their schedules, meaning the clinic’s diagnostic ultrasound -- you know, the one with an actual medical purpose -- would need to be repeated. Insurance companies bill patients every time they walk in the door, so it would mean two co-pays at least -- or even more for women without insurance.

“If you’re 99 miles away, you’re looking at a 200-mile drive,” she told me.

But the workers at this clinic in Virginia hardly had time to worry about this law, she went on. Because Virginia had passed a series of onerous TRAP laws, part of a nationwide effort by anti-choicers aimed at stopping abortion by imposing ridiculous requirements on things like the size of a clinic’s janitor’s closet. I’m serious about that. That’s not a joke. The janitor’s closet is actually part of this law.

“We have a very nice janitor’s closet that is really well-organized,” sighed Codding.

The law requires things like eight-foot-wide hallways and a cavernous size for surgical rooms, she said. Already, thousands of dollars had been spent determining whether the clinic could come into compliance with the law -- or whether they would need to close.

The ultrasound mandate was an outrage, yes, but it was only one of many threats faced by providers in Virginia. And unlike the issue of TRANSVAGINAL ULTRASOUNDS, the TRAP law received little coverage by the mainstream media.

And that is why I believe we need to listen to the stories of abortioneers. As we face unprecedented attacks on women’s access to abortion, we need to be informed about what a TRANSVAGINAL ULTRASOUND actually is and when it is necessary. We need to know the impact laws will have on the ground -- not just in theory, but in practice. When we listen, we may come to understand the situation is far more complicated -- and far more urgent -- than we may have imagined.

The South Dakota 3 Day Waiting Period, and Other Reasons I Am Angry

South Dakota, South Dakota, South Dakota. What are we going to do with you? Recently, the illustrious Governor of South Dakota, Dennis Daugaard, signed a law, which requires a woman seeking an abortion to wait three days after meeting with the doctor before she can obtain said abortion.

That is bad enough, right? South Dakota is a big place. To put it in perspective, it is 210 miles wide, and 380 miles long. That’s a lot of space. There were two abortion providers in 2008.

So, it’s safe to assume women in South Dakota already have to do a fair amount traveling to get to an abortion provider.

Once she has made up her mind, driven to the clinic, been counseled by the clinic staff, met with the doctor, had her blood work, etc, she must then turn around and go back home and wait THREE DAYS. You know, just to make sure. If you have a job, need childcare arrangements, have transportation issues, an unsupportive partner, or whatever – good luck getting an abortion in South Dakota! You’ll need it.

BECAUSE, on top of all this crap, a woman seeking an abortion must all consult with a crisis pregnancy center (CPC) before she can get her abortion. CPCs are anti-abortion and basically lie to women and say whatever to convince visitors not to have an abortion. They’ll tell you that you’ll get breast cancer, that you’ll become infertile, that God will not forgive you, that you’ll spend an eternity burning in Hell – if you get this abortion. They’re just so filled with Christ’s love, right?

There is no real relevant comparison in the real world, because shit that this whacked doesn’t actually happen for any other medical procedure. Suppose you were 15, homeless, pregnant, and wanted to give birth. Before giving birth, you had to go to the doctor, consult with him, be counseled by the doctor's staff, have medical work done, then go home and wait three days before you could formally decide if you wanted to give birth. During those three days, you would also have to visit an Anti-Birth Center, wherein the staff would do anything in their power to convince you to not give birth. They could tell you lies, including that God would never love you again if you carried this pregnancy to term. That tons and tons of women die during childbirth. That women who carry pregnancies to term often go crazy afterwards and their breasts fall off. Then, after three days, you could drive X hundred of miles back to the doctor. Whom your state just tried to legalize the murder of.

It seems completely f*cked up and ridiculous to try to force someone who wants to give birth not to. I'm sure most of us would be completely appalled if our pregnant friends had to go sit in an abortion clinic before they could give birth. You know -- just to let them "cool off." After having all that sex, they ought to think about what they've done and reallllllly truly ponder if motherhood is for them.

JEEZ THAT SEEMS SO AWFUL, MR. BANANA GRABBER. Well, it is JUST as f*cked up to do this to a woman seeking abortion.

For many women, obtaining an abortion is the kind, sensitive thing to do. Most women who seek abortions are already mothers, young, and low income. I feel like a broken record on this, but sometimes when women already have children and cannot make ends meet having another child is not a reality for them! Or their partner is jerk and won't provide! There are 9.3 million different reasons and they are all valid and deserve the same amount of respect as a women who choose to carry their pregnancies to term.