Sunday, March 14, 2010

Legal Shmegal.

Just because abortion is legal, does not mean it is accessible, affordable or available. So what's the point?
Why is getting an abortion so damn hard? Well, I’ll tell you some reasons:

· Laws requiring parental notification and parental consent
· Mandatory waiting periods
· Lack of providers
· "Crisis pregnancy centers" (CPC’s)
· The need to travel long distances for an abortion
· Areas that lack providers
· Appointment arrangements
· Appointment availability
· “Sono-ing over”
· Not having enough MONEY to pay for an abortion
· Harassment of clinics, providers and patients
· Lack of public funding for abortion
· Having private insurance that does not cover abortion
· Having insurance that requires a deductible before getting an abortion
· Confidentiality concerns with insurance
· Gestation limits set by states and providers
· Fewer facilities providing second trimester procedures
· Lack of knowledge about availability of abortion services
· Ambivalence about pregnancy
· Not having proper identification for an appointment (ID, birth certificate)
· Having your driver leave you at the clinic
· Not being able to find childcare
· Forgetting to fast if you’re planning to have sedation
· Car breakdowns
· Missing the bus
· And so many more…

We should always be thinking of ideas to do what we can to make accessing abortion services easier for women. There are things we can’t change on an individual level like legal and policy barriers, so we should focus our energy on problems with access we CAN change. Here are some ideas:

1) Childcare in clinics
2) A volunteer driver’s network to help patients with transportation
3) Texting patients their appointment information
4) Having information available online about what is needed for a successful appointment
5) Your turn! 

Abortion may be legal, but until women can access and afford abortion services, free from judgment and harassment, our work is not done.


  1. Actually, one of the things I learned in med school is: the number of abortion providers is determined by demand. They say 87% of counties have no abortion provider, but if they all had one most of them would stand idle most of the time. Not enough patients.

    Demand has been dropping for a long time as the young end of the baby-boom has been aging. Soon it will reverse, demand will go up again as the young "baby-boom echo generationers" age INTO sexuality. However, new contraceptive technologies (including contragestive/early-abortion, morning-after etc) will blunt the upsurge so it'll probably hover for a while.

  2. OperationCounterstrike, I've seen you make this point many times before. But I don't know why you're hung up on it. Don't tell me that there are no unplanned pregnancies in South Dakota, Mississippi or Wyoming! (Guess how many abortion clinics each state has.)

    It's possible that what you say is true from a whole-population perspective -- that "not that many" women fall through the cracks because rural counties aren't that populous. But I and others here can tell you MANY stories of women who had to travel hours and hours to get to a provider -- and the later into pregnancy you get, the more common this is. What happens to those women matters, too. And I can't help but wonder what happens if those providers, often aging, don't have someone to take over their practice.

    You talk about abortion providers "standing idle" as though you must choose between being an "abortion doctor" or practicing other kinds of medicine, but we know that's not true. More doctors and clinics ought to be offering abortion care in places where it's hard to find, but this doesn't mean they have to give up their current scope of services. More mainstreaming, please.

  3. PS, you are right. Soon (I predict) the stand-alone abortion clinic will be a thing of the past. Unplanned pregnancy will be one of those things you go to your primary-care doc for (or your primary-care doc's medical underling, certified physician's assistant or whatever).


This is not a debate forum -- there are hundreds of other sites for that. This is a safe space for abortion care providers and one that respects the full spectrum of reproductive choices; comments that are not in that spirit will either wind up in the spam filter or languish in the moderation queue.