Monday, January 31, 2011

Injuring and insulting women: legislative edition (Or, "Hereafter Known As The No-Good-Reason Act")

You need to know about this. Chris Smith, along with several other congressmen (many of them newly elected), feel that our representatives' first priority in the new Congress ought to be the passage of "insult plus injury"-style anti-abortion legislation. Enter the "No Taxpayer Funding for Abortion Act." I want to discuss two especially stupid provisions, which this column summarizes nicely.

The tax credits that are encouraging small businesses to provide insurance for their workers could not be used to buy policies that cover abortions. People with their own policies who have enough expenses to claim an income tax deduction could not deduct either the premiums for policies that cover abortion or the cost of an abortion. People who use tax-preferred savings accounts to pay medical costs could not use the money to pay for an abortion without paying taxes on it.

I mean, this is purely symbolic for the legislators, and purely punitive for people who need an abortion! Republicans are going after tax deductions? Breezing right past that irony, let's consider: Does the fact that I can deduct my spending on medicine or a doctor's visit from my "taxable income" make me more likely to spend on those things? Not really, it just makes it slightly easier on me to afford the things I need without taking extra money from me at tax-time as though I had spent those dollars on "fun" stuff.

At my current income I don't actually have to pay federal income tax (shocker), but assume the default 20% bracket applied -- if I get to subtract, say, $500 spent on a first-trimester abortion from my total taxable income, I'll save $100 come April 15. Not enough to make me decide to have an abortion, and not enough to make me decide against an abortion if Chris Smith bans that deduction.

Another example, going further afield to tax credits, which really are a significant chunk of money credited to you directly (not just deducted from your taxable income base): if I have dependent minor children I can get $1000 taken off my owed taxes each year. Has that affected my decision to have or not have a child? Would it affect yours? Probably not; people decide to have children because they are ready to and want to, not because someone's giving them a coupon on it.

I know taxes are a drag, so we don't have to keep discussing, but you see the gist: this ban's purpose can't logically be to make people less likely to choose abortions -- it's only to injure them for it by taking out an extra $100 of their taxes (or more, depending on their income bracket), and to insult them by refusing to acknowledge that their abortion counts as a health-related expenditure. (Just like tampons and pads and menstrual cups don't count, either. Just like breast pumps don't count, either. I discern a fucking pattern.)

The Smith bill also would take certain restrictions on federal financing for abortions that now must be renewed every year and make them permanent. It would allow federal financing of abortions in cases of "forcible" rape but not statutory or coerced rape, and in cases where a woman is in danger of death from her pregnancy but not of other serious health damage. It would free states from having to provide abortions in such emergency cases.

FYI, as Sady Doyle notes, "70% of rapes are 'non-forcible.' Rapists consciously seek out people and situations where they’ll have to use a minimum amount of 'force'."

Currently I work in a state that doesn't provide any of its own funds for abortion coverage but supposedly abides by federally-funded Medicaid's mandate to cover abortions in cases where a pregnancy resulted from rape. Even the old-timers at my work say that they have never seen Medicaid cover a procedure, even when the rape was "forcible" (all rape is forcible, obvi, since that's the opposite of consensual, but by this Smith really means there must also be beating), even when prosecution occurred, even when the pregnancy was DNA-matched to the perpetrator. Many clinics don't bother trying to bill Medicaid anymore, so the state is passively stripping women of even the limited rights they supposedly have. Abortion patients whose pregnancies are a result of rape, even patients who do have Medicaid, overwhelmingly are already paying for their own abortion care (and often struggling to do so). And women who can't pay for their own abortion care overwhelmingly are already bearing their rapists' children. Doesn't that warm your Republican heart*? (Oh, a few Democrats too!)

So this provision, too, isn't going to prevent women from choosing abortion. If the federal government reverses decades of painstaking progress in legal thought, jurisprudence, and goddamn human rights, it isn't going to make women who were raped but just not beaten too feel that they deserve to remain pregnant any more than they did before. It's just going to bring written law more in line with the outrageous reality of states already not understanding rape or supporting rape survivors; add to the stigma of patients who choose abortion outside of the few 'acceptable' reasons (e.g. "I can understand it in cases of rape, but this wasn't even 'real rape'"); and in the process possibly fuck up criminal justice even worse than it's already fucked up.

Sorry, y'all: every time I tell myself I'll try not to rant, something comes up that just makes my brain start bleeding out my eyeballs.

*Update: also h/t Sady, these dudes aren't even in touch with their own supporters - in a November poll, "71% of American voters who voted for a Republican candidate opposed the Smith bill."

Update 2: Sorry, I should have included a What You Can Do!  The same post I linked above provides a handy-dandy link to your representatives' contact page and helpful hints (for a sample call, see rabbleprochoice):
Click on this, and it should take you to a page where you can find out exactly who your rep is, and what their contact information is. Look that person up on Wikipedia, to get a sense of who they are, if you don’t already know. Then, CALL THEM. Be polite; be professional; do not threaten or use violent or abusive language under any circumstances. Explain to them that their constituents don’t support this bill, explain how and why it’s a bad bill, and let them know that if they support or fail to oppose this bill, they can expect that to impact them in a very bad way when it comes to the matter of keeping their jobs.

Friday, January 28, 2011

More things I would rather do than be forced to carry an unwanted pregnancy to term

Continued from my previous post.

26. Eat a lot of beans.
27. Wrestle with a seasick crocodile.
28. Pronounce "R" like "W" for the rest of my life.
29. Have my arm crushed against the wall of a crevasse in the mountains by a huge boulder and have to amputate it with a dull knife.
30. Sit next to John McCain during the SOTU address.
31. Be surrounded by attack dogs wearing Milkbone underwear.
32. Walk everywhere on my knees.
33. Have a nipple ring ripped out of my nipple by snagging on a bath towel.
34. Run away from lava in swim fins.
35. Transfer sand from one place to another using tweezers.
36. Be a meth-addicted former child actor.
37. Have recurring night terrors in which I am pursued by demon zombie robots.
38. Be pursued by demon zombie robots.
39. Have to watch Nicholas Cage movies for the rest of my life.
40. Have my face sucked off by a giant squid.
41. Have my teeth knocked out by Mel Gibson
42. Have my toenails grow back 3x longer with every clip.
43. Downhill ski the mountains of Mordor.
44. Take a shower in garbage water.
45. Use a cheese grater for a loofa.
46. Write lyrics for Ke$ha.
47. Take voice lessons from Bobcat Goldthwait.
48. Be Carrot Top on "Kick a Ginger Day".
49. Swim naked in the Arctic Ocean.

Happy weekend, y'all!

Wednesday, January 26, 2011

What coffee and abortion have in common

I don't quite understand the obsession with Planned Parenthod. I LOVE Planned Parenthood. I have friends who have been staff and patients of Planned Parenthood, I have a Planned Parenthood T-shirt, I refer clients to Planned Parenthood, and I would gladly submit my resume to Planned Parenthood. The thing about Planned Parenthood is that it has, at least among people I know, become the generic name for "abortion clinic." Dear friends of mine love and support the work that I do, and they even put out calls for support of abortion. But those calls for support always seem to say, "Make a donation to Planned Parenthood!" "If I won the lottery, the first place I'd give to is Planned Parenthood." They know where I work, and it happens to be an independent abortion clinic. An independent clinic that doesn't receive government funding and that always welcomes donation and support, especially in this economy. And I know of plenty of other similar clinics that have had to close because of a lack of funds.

What I'm saying is that if your BFF worked at Independent Coffee Beanery, would you really suggest that Starbucks needed the money more? That's actually not the best analogy because Planned Parenthood isn't a corporate behemoth, and I respect Planned Parenthood and I do want them to benefit from donations...but sometimes, I want my little clinic that could to benefit from some cash money here and there. (I might be jealous of Planned Parenthood, but I'm also human and I heart my clinic.)

So if you're a little flush or if your rich pro-choice aunt wants to contribute to the cause, maybe think about checking FAN or Abortion Clinics Online for contact info of lesser-known but super-important clinics in your area that might need a little help, especially in this political and economic climate (Also, think about patronizing your independent coffee shop.)

Tuesday, January 25, 2011

Where do babies go?

I am not a mom, and I don’t take the fact that I may or may not ever be one for granted. No doubt, children have a magically profound effect on our existence.

That being said…

During my first month of abortioneering, I was given two plastic fetuses—sucking their thumbs and labeled 11-12 weeks on their thick, fetus necks—by a protestor who stands in the alleyway with a basket and a handful of brochures regarding the anti-abortion, pregnancy center that moved-in on the other side.

Imagine having an abortion then leaving the clinic in a post-surgical haze only to be immediately harassed by a rosaried figure clutching a basket of dozens of plastic fetuses and a jab at your heart that their father will forgive you.

In my case, I can only imagine that abortion protestors are absurdly humorous people who are unable to conceive that abortion is a sacred (and deeply private) rite of passage.

I’ve kept the semi-precious (too precious to be viable) fetuses ever since. The first year, my sister and I played passive hide n’ seek with them. First, I put them in the cereal box so they fell into her morning bowl, and then I found them in my shoes, in place of a bar of soap, behind the dictionary on the bookshelf. They’ve become such a pivotal presence in my living room that friends acknowledge them when visiting. For several years, they rested in my sweet, stevia plant.

Right now, they suck thumbs atop a crystal bookend on this round, wooden table. My mate was rearranging the books recently and they toppled onto the table. “Oh, I’m so sorry!” He feared.

“Please don’t worry for them,” I said. “They’ve got an entire ludicrous movement behind them!” I kissed their eternal, half-brain heads, and set them back on high.

Monday, January 24, 2011

Happy Birthday Abortioneers!

The Abortioneers is 2 years old.

On January 22, 2009, Placenta Sandwich kicked off The Abortioneers blog calling it "A Blog for Justice". The idea was to create a blog by pro-choice advocates truly working on the front lines of abortion - future abortion providers, health educators, clinic escorts, etc. In the field of abortion blogging, we are sorely lacking in those that have first hand knowledge of working in abortion care. I'm not saying that policy folks, journalists, academicians, and other non-clinical abortion rights workers and advocates aren't important to the movement, but people need to hear from those that work daily in abortion care. It's important to hear the truth about what abortion is and means to women.

Over the past two years we have touched on many things including the women we serve, the barriers to abortion care (financial, legal, geographic, etc), and our thoughts and feelings on the ever increasing restrictions. We've discussed how barriers affect women directly and the need for safe, legal, abortion care. We've also discussed how it affects us and our ability to help.

Here's to another year of open discussion of the truth about abortion. No more misconceptions, no more lies from antis, just the truth.

Sunday, January 23, 2011

Happy Roe Day!

Yesterday was the 38th anniversary of the Roe versus Wade decision. Though I was aware of this, I happened to forget yesterday, until I unwittingly stumbled into an anti-abortion rally.

I was surprised at the sheer volume of people present. They carried signs that read:

I was struck by how much the rhetoric has changed over the years. Immediately post-Roe, women who had abortions were demonized as "sluts." They were attacking the women themselves. When they realized this type of demonization would never work and ended making themselves look unstable, they began to reframe the debate. They have done a pretty amazing job. Women are now the victims of abortion. Abortion is a big mean monster out to hurt them. They are no longer blaming women, and instead making a very emotionally evocative statements, however untrue they may be.

Abortion does NOT hurt women. What hurts women is decreased access to family planning, birth control, and other important types of medical care. It hurts women when legislation is passed that forces women to look at a sonogram even if she is a rape survivor. It hurts women when you allow pharmacists to deny said woman her emergency contraception. It hurts women when she cannot afford to feed her children and she cannot find a job and there are not enough social programs available to assist her.

Instead of "women deserving better than abortion," perhaps they deserve pregnancies that don't develop fatal abonormalities. Women deserve partners who do not rape and abuse them. Women deserve access to legal medical procedures without being harrassed on her way into the clinic.

Women don't regret abortion. The greatest indicator of a woman's mental health post-abortion is her health pre-abortion. Either way, relief is the most commonly reported emotion post-abortion.

Despite antis BS rhetoric, abortion is still safe and legal in the United States. I have an amazing network of colleagues and friends who help fight the battle to keep abortion legal with me. So, on that note, I'd like to say Happy Roe Day!

Friday, January 21, 2011

Even sadder times: Bad doctors, system failures, lost lives

Terrible news. Kermit Gosnell has made the news again. You might remember, we wrote about him in March when his medical office was discovered to be practicing abortion in improper ways and under unsafe conditions.

Now he has been charged with multiple counts of murder. I'm warning you, the story is long, sad and gross; also, both the article and the grand jury report have some unsourced descriptions and apparent speculation. But ignore those and the allegations are still clear. Investigators say that some of the wrongdoings are too old to press charges or too many files have been destroyed to amass sufficient evidence; nevertheless, from the evidence they did gather, they're charging Gosnell and several other people with the deaths of seven prematurely-delivered infants and one woman who sought his services. In fact, because of how much the piece (and all the headlines and abbreviated news pieces going around) lingers on the dead newborns, it's easy to miss the few lines mentioning that he and his staff caused the deaths of at least two women and injuries for many others.

Gosnell's lawyer, while maintaining that everyone's innocent until proven guilty and the case must have its day in court etc, also apparently attempted to mitigate Gosnell's actions by saying he "served patients in a low-income city neighborhood for decades." Would he really have us believe this is what serving the underserved looks like? It's not even like this happened in the middle of nowhere, Wyoming. It's west Philly. It's devastating that society, our insurance system and Medicaid laws, state regulators and medical services have abandoned some women to a situation where they can't obtain the safe, legal and ethical care available a few miles from them. The other side of the tracks may as well be the other side of the world.

Another stupid thing to say:
State regulators ignored complaints about Gosnell and the 46 lawsuits filed against him, and made just five annual inspections, most satisfactory, since the clinic opened in 1979. The inspections stopped completely in 1993 because of what prosecutors said was the pro-abortion rights attitude that set in after Democratic Gov. Robert Casey, an abortion foe, left office.
It strikes me as fucked up and crazy that someone would blame this disaster on a "pro-abortion rights attitude." No pro-choice person wants women to be injured and killed because they sought abortions! In fact, many people are pro-choice because they're aware that women risking injury and death is part of the status quo for most times and places in which abortion is illegal. If there were actually a pro-abortion-rights attitude in Pennsylvania government, they'd have been collaborating with experts who actually care about improving the quality of abortion care.

In fact, if more states did exactly that, then we wouldn't have situations like this in Pennsylvania on the one hand, and state agencies like Louisiana's shutting down clinics for no cause simply to prevent abortions on the other hand. (As Robin Rothrock -- RIP -- said at that time, "No one in their right mind would think the state of Louisiana is interested in quality abortion care. It is interesting that the state sees itself as an expert on these issues when it does not provide any such care, and when it prohibits use of any public dollars for abortion care, including training.")

The most frustrating, haunting thing in all of this is summed up by an excerpt from the March article:
More than a decade ago, CHOICE, a Philadelphia abortion referral service, contacted the state medical board about Gosnell because some of his patients had called CHOICE with appalling stories, said Brenda Green, the organization's executive director. "We were told that we could not file a complaint. It had to be a patient. It could not be a third party," Green said.

Reproductive health activists and Gilbert Abramson, a lawyer who filed the 2008 case that was later dropped, said they urged Gosnell's patients to file complaints with the state. But when the women learned that they would have to provide medical records and other forms, plus attend a hearing in Harrisburg, they changed their minds.
As Rob wrote at Abortion Gang yesterday, states keep getting the oversight wrong. Many states harass providers baselessly. Yet Gosnell was a concern of pro-choice advocates and case managers for years, but the medical board said only an actual patient could file a complaint. Apparently, the state can pursue an abortion clinic relentlessly and routinely without a particular basis, but review of a doctor in private practice (any doctor, not just an abortion provider) must be prompted by a patient. If this is true (confirm, anyone?), I just don't understand it.

Thursday, January 20, 2011

What Could Your Clinic Do With Just a Bit of Funding?

I've been thinking about how I wish abortion clinics got more funding. It sure would be nice if RFAs went out - publicaly - on a fairly regular basis, for clinics. Of course, this doesn't happen much and it's a shame. If my clinic could get a good influx of money, I would love to see some of the things at other surgi-centers I've seen recently.

For example, really nice, big, cushy recovery/pre-op chairs. Chairs where you can do the labwork, but also recover in. Warm blankets. Comfy socks for each woman with no-slip little soles. Perhaps a little duffel bag women can take home (a place to put their clothes when they undress from the waist down, instead of having to put them on a chair for all to see. It would be a convenient place for the meds to go, too!). Perhaps gift baskets for overnight clients who use contracted hotels that offer a discounted rate for our clinic's women. Something simple could be in that basket: some fruit, maybe some crackers or juice to have after their abortion. A thank you note. Follow-up calls for all clients the very next day to check-in on them and see how they're doing. Maybe a website for a "registered clients only" section with a question board so clients can chat - kinda of like yahoo groups or something - where staff respond to any inquires.

Oh! Electronic Medical Records for all! Including a way to electronically send prescriptions to pharmacies!

Other streamlined physicians offices do these sorts of things. Okay, not normal physician offices, but some surgi-centers do.

...seriously, my wish list would look a lot larger than this, but imagine what could be done with just a bit of funding!

Just AboutAGirl dreaming again. Bill Gates? Warren Buffet?? Anyone listening? FUND ABORTION CLINICS.

Wednesday, January 19, 2011

Saluting our soldiers

I went to an NFL football game recently and was shocked by the amount of “military worship” (as I like to call it). During the game there were multiple video stories of vets and what they went through and they also presented an injured vet with the home team’s football helmet (apparently replacing one form of armor for another). Ever since “Operation Iraqi Freedom” began in 2003 it seems that many mainstream events and media outlets tend to do segments/pieces where they honor a military vet, or a current soldier, or their family, or someone who was injured serving in the war.

The language around these events and soldiers use lots of phrases like “fighting for our freedom”, and “fighting so you don’t have to”, and “heroes in the war on terror”.

I do agree that soldiers face many risks and do honorable things. However, I have always felt that there are many more people who are not in the military who deserve just as much appreciation and dare I say worship! The same things we say about soldiers can easily be said about those who work in abortion. WE are fighting for women’s freedom. WE are fighting so you don’t have to (yes, I’m talking to you Mr. anti abortion-until-your-daughter chooses one and then suddenly it’s great that people like me have fought to keep abortion legal). WE are heroes in the war on terror due to the domestic terrorism we are constantly faced with.

I also noticed that the airports waive baggage fees for soldiers. What about abortion providers who fly across states to work in a clinic that has no providers that live locally? Shouldn’t those providers get free luggage check too? What about providers who travel abroad to places without safe and clean equipment for family planning? They should get the same courtesy that soldiers do.

Soldiers also get to go through a fast lane in many airports for the security screening. I’ve been on planes where the pilot will announce soldiers who are returning from war and the entire plane will clap. Shouldn’t an abortion provider receive the same show of appreciation? They provide a vital service and are also risking their life.

When I flew out of an airport yesterday there was a parade of soldiers weaving through the atrium. There was a woman from the USO leading them and waving a flag. There were maybe 200 or so soldiers and the entire airport atrium was applauding them. I think we should try something similar for abortion providers at the next ACOG meeting. Who’s with me?

Tuesday, January 18, 2011

Things I would Rather Do.....

I would like to revisit Anti-Anti's post from March of 2010. While my list, of things I would rather do than carry and unwanted pregnancy, may not match exactly I think this blog warrants a shout out. Today I forgot to post a blog, then I went to Job 1 which happens to be in abortionland, then I got a call from job 2, a gig I do once a month, there was a bit of an emergency and they needed me NOW. I still had an errand to run for Job 1 and a 13 year old cousin to tutor as previously planned. I would like to pat myself on the back for accomplishing all of the above, and redirect you to a Anti-Anti's blog: "Things I would Rather Do Than Carry an Unwanted Pregnancy"just because that is how I feel today and I would rather work a 13 hour day every day than ever carry an unwanted pregnancy.

Monday, January 17, 2011

Maybe you should ask, "Why did we make her wait so long?"

I'd wanted to write a good solid post expanding on my last one -- about why some women "wait so long" to have an abortion -- and connecting the dots to social justice. It is Martin Luther King day, after all, and while we ought to be carrying his goals of racial and economic justice in our minds every day, it always helps to describe the links aloud. But: I've been getting sick this weekend and today I woke up with puffy eyes and that underwater feeling in my head and it's making me feel dizzy. I'm going to limit this to my research summaries, because you're smart and insightful enough to connect the dots yourself, and because I can't see my keyboard very well. 


In 2008 researchers at ANSIRH published an unusual study of delay in obtaining abortion care [PDF]. For purposes of analysis, they divided the process into three stages -- between the first missed period and the first pregnancy test; between the first pregnancy test and the first call to an abortion provider; and between that first call and actually having the abortion -- and then identified the circumstances that were closely associated with longer time for each stage. The factors associated with delay varied based on stage. In the first stage, significant delay before the pregnancy test occurred for women who were obese, weren't sure of the date of their last period, were assessed as being in denial about pregnancy or "afraid of an abortion," abused drugs or alcohol, or had had a second-trimester abortion in the past. (A lot of these seem logical, don't they?) 

However, these were not significantly associated with delay in the second stage; rather, women had a longer stage 2 if they had had trouble obtaining MediCal (California's health insurance for low-income residents, which includes coverage for in-state abortion care), and if they had "had difficulty with their decision to terminate this pregnancy." In the third stage, delay in having the abortion itself was associated with (again) having had a second-trimester abortion in the past; having been initially referred to some other clinic than the study site; having an unsupportive partner; and having had difficulty coming up with the money to pay for an abortion. 

So logistical barriers emerge in stage 2 and 3, and especially economic ones. Social/emotional barriers are still present, but different from in stage 1. (Understandably you might delay your call to the clinic if you're having a hard time deciding what to do with your pregnancy; you might try to reconcile a reticent partner to your decision before you head to the appointment -- or your partner might be actively trying to prevent you from getting there!) 

(Additional interesting findings from the last stage: what shortened the time between calling a clinic and having an abortion? (1) Nausea and vomiting [heh, shocker]; (2) having had “difficulty deciding” to seek an abortion. That is, if a woman struggled with her decision, she was likely to have a longer time than other women between taking a pregnancy test and calling a clinic, and a shorter time than other women between calling a clinic and having an abortion.) 


From several of the same California researchers, a 2006 multivariate logistic regression study: "Delays in suspecting and testing for pregnancy cumulatively caused 58% of second-trimester patients to miss the opportunity to have a first-trimester abortion. Women presenting in the second trimester experienced significantly more delaying factors, with logistical delays occurring significantly more frequently for these women (63.3% versus 30.4%). Factors associated with second-trimester abortion were delay in obtaining state insurance, difficulty locating a provider, initial referral elsewhere, and uncertainty about last menstrual period." Interestingly, second-trimester abortion was associated with both having had a prior second-trimester abortion and never having had an abortion before. 


In 2006 the Guttmacher Institute published a study on timing and reasons for delay [PDF] as well. They broke the process into more steps, and measured median time for each. 
-From the last menstrual period to suspecting pregnancy: 33 days (which makes sense if you imagine the average 28-day cycle then add about a week for your first missed period); it was a week longer for minors than for adults (which also makes sense if you consider how irregular most young people's cycles are)
-From suspecting pregnancy to confirming pregnancy (pregnancy test or sonogram): 4 days
-From confirming the pregnancy to deciding to have an abortion: zero days
-From deciding to have an abortion to first attempting to obtain abortion services (calling to make an appointment): 2 days
-From first attempting to obtain abortion services to obtaining the abortion: 7 days
...So that's 48 days right there (and that's just adding up medians, meaning half of women have a longer delay in each of these steps), yet I think somehow a lot of people hear "seven weeks" and think that's a really long time to "wait." I saw an actual published writer write that abortions should only be legal up til six weeks because "forty-two days is plenty of time to decide to have an abortion." Reality to actual published writer, please come in. 

58% of women reported that they would have rather had the abortion sooner, and these women were asked about the reasons for the delay they experienced (women could give multiple reasons). Most commonly, these respondents said: 
-It took a long time to find out about the pregnancy: 36%
-It took a long time to decide to have an abortion: 39%
It took a long time to make arrangements: 59%. Poor women were about twice as likely to be delayed by difficulties in making arrangement. (This includes money, referrals, appointments, transportation, judicial bypass for minors, legally required waiting periods, etc.) 

Patients mentioned a lot of other reasons, including:
-As partial response to Frances Kissling's question, 0.2% stated they found out late about a fetal anomaly (but this isn't broken up by trimester or week; I still think the later abortion patients she was asking about would give this response more often). 
-Only 2% said they "didn't think it was important to have it earlier." (Granted, this doesn't include possible similar answers from the 41% of women who didn't say they'd have rather had the abortion earlier, but I imagine a lot of those 41% had theirs quite early. I wish I could see a full data set on this.) 

I highly recommend reading the rest of this article because it has a section on qualitative findings from in-depth interviews that I just couldn't do justice here. Among other things, it shares the words of women who "knew right away" that they were decided on seeking an abortion, and of  women who found it a "hard decision" and took longer to feel firm in their choice.** 


What about demographic characteristics? Poor women with no insurance coverage for abortion, black women, and young women are likely to have later abortions than other women. However, being poor and lacking insurance coverage disproportionately co-occur with being black and being young. In some studies, each of these effects persists even after controlling for the others; in other studies, they confound one another and only the poverty/insurance effect remains significant. 

I think you can guess what I was going to say about all that. To make a long story short: justice in healthcare access must include attention to reproductive matters. If you care about making a more just society, please express support for public funding for contraception and abortion; donate to your local abortion fund; work to reduce stigma against both abortion and pregnancy; combat racist, ageist and classist stereotypes of appropriate motherhood; and learn about domestic violence and sexual assault prevention. 

**If you want to read more about abortion decision-making, here are some articles to try [unfortunately a few only give the abstract for free]: 
2010: Kjelsvik M. Pregnant and ambivalent. First-time pregnant women’s experience of the decision-making process related to completing or terminating pregnancy – a phenomenological study. 
2005: Finer LB et al. Reasons US women have abortions: quantitative and qualitative perspectives.
1985: Faria G, Barrett E, Goodman LM. Women and abortion: attitudes, social networks, decision-making.
1984: Friedlander ML, Kaul TJ, Stimel CA. Abortion: predicting the complexity of the decision-making process. 
(And if anyone can find the following in English, let me know:) 
1999: Tornbom M et al. Decision-making about unwanted pregnancy.
1990: Ytterstad TS, Tollan A. The decision process in induced abortion. 

Thursday, January 13, 2011

Nurturing Choice

I've heard the argument for parental notification/consent laws that reasons, "Why shouldn't the parent be involved in the daughter's life and decisions and choices?" It sounds so innocuous and Norman Rockwellian when it's stated like that, but we Abortioneers all know that sometimes it's more like, "This girl is going to be beaten into next week and into the foster care system and into teenage parenthood if lawmakers require consent/notification."

But laws and barriers to reproductive justice aside, I wanted to give a shout out to the parents of all abortion patients (not just minors) who are so involved and so loving. I've always known that if I had an abortion, my mom would be my first choice as a driver/support person. Even when I was in a long-term relationship, I would have chosen her. Above anyone else, I would want her comfort and humor and company. And I have absolutely no doubt that even if it meant taking a day off from work and driving a few hours to my city, she would be there for me.

My friend had an abortion a few years ago, and she came to my clinic with her mom in tow. She, too, had a partner, and she was well above 18, but her mom was her first choice. I could tell her mom was glad to be at her side, but it wasn't easy for her. I knew from past conversations that my friend's mom was pro-choice, and she had even had an abortion and a D&C (for miscarriage management) herself, but that day was hard for her. Although I was friends with the mom, too, I didn't delve into it, but I can only assume that her tears were from memories of her experiences or from the fierce desire to protect her daughter. But whatever baggage she carried, she was at her daughter's side, trying not to cry and trying to make the day about her adult child.

I also remember fathers of clients who were or were not required to accompany their daughters to the clinic, but who were obviously distraught. They weren't distraught because their daughters were killing their grandchildren (anti-choice rhetoric, right there), but because their daughters were faced with their first major adult decisions or because it was the first time their adult daughters had come to them for help or support. They didn't have to say what was running through their minds, but it was evident from the way they softly asked me, "How is she doing?" or implored, "Take good care of her." More than one burly man had tears in his eyes.

I've also seen a mother who accompanied her very young daughter to the clinic and whose boyfriend was responsible for the pregnancy, unbeknownst (until now) to the mother. In another case, the mother's son had brokered the rape of her daughter, also unbeknownst to the mom. Both mothers were clearly heartbroken over the complexities of the situations, as well as the implications of blame that they shouldered. In each of those cases, I made it a point to take the mothers aside and hug them and whisper simply, "You're a good mom."

Thank you, endlessly, to all of the good parents who support their daughters who chose abortion or who chose parenthood or who chose adoption. And thank you to all the parents who chose abortion, parenting, or adoption in order to give better lives to their daughters and sons.

Some details of each of these stories have been changed in order to protect client privacy.

Tuesday, January 11, 2011

The Cider House is pro-abortion too

“Conventionality is not morality. Self-righteousness in not religion.” –Charlotte Bronte

Hark! Remember the good old-fashioned novel? Not an article, feature, broadcast, moving picture, essay, memoir, debate, speech, blog….

Albeit, you can now read the first chapter or so of any book on your Kindle or Nook. You can do this at the bookstore too. Hell, you can read the whole thing at the bookstore or through the library for free. Though, if you try to finish it in one sitting, you’ll need your sleeping bag.

I realize in many respects I am woefully late to the table. But, in reading
The Cider House Rules by John Irving like climbing effervescent, lime green, singing trees to the sky to eat ruby, juicy apples (only if you like them so you choose to). The sun is tickling you from the inside, giving you everything you need. Right. Everything you do is right.

In other words, if you haven’t read
The Cider House Rules, you must. In fact, I’m pretty sure if it hasn’t been an Oprah Book Club pick, such oversight is entirely her mistake. Reading The Cider House Rules will make you think there is hope that Abortion will be Oprah’s guest on her last show.

I won’t say much more about it except that a part of me felt so silly for missing the single most endearing novel about abortion up to now in my humblest but awe-stupefied mind’s eye, but most of me was wallowing in gratitude and delightedness for just the moment I experienced a brilliant, truly storytelling.

Sunday, January 9, 2011

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?

(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%.
(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%.

Thursday, January 6, 2011

Healing Words

The Lessons of the Falling Leaves...

The leaves believe such letting go is love
Such love is faith
Such faith is grace
Such grace is God
I agree with the Leaves
-Lucille Clifton

I love this poem. It is a poem about healing, for me it reminds me that letting go is an act of love rather than hurtful. Often when I sit down to write I am bogged down by the intensity of the work I do. I wish I were able to set aside my memories and experiences completely at moments. I love what I do and I do not have bad memories, but it is an intense line of work. So tonight after a hectic day at work, healing keeps coming to my heart.

Lucille Clifton's poetry often addresses the beauty and pain of real life. I decided to read a bit about her poetry concerning abortion. She has a unique story concerning abortion. In the poem "the lost baby" Clifton expresses a since of ambivalence and sadness about a terminated pregnancy and alludes to financial strains. I believe this poem is beautiful, not because all women *should* experience sadness after an abortion, but because some women do experience some kind of sadness just like some women experience relief and joy.

I have spoken to a few women in both my professional and personal life who experience regret in some form after an abortion. I believe that just like any difficult and life altering decision abortion can be intense and hard.I wish that rather than offering judgment we could find ways to help women heal. No one wants to face an unintended pregnancy, no one.

Lucille Clifton wrote another poem about abortion called "donor". I was unable to find the poem online but from what I have read she attempted to self abort unsuccessfully and 30 years later her daughter donated a kidney to her. This story would probably make an anti-abortion radical hyperventilate with excitement. Based on Clifton's experience I wonder what about her opinions on keeping abortion safe, legal, and accessible. I have no idea if Clifton is pro-choice, but for me what is revolutionary about this poetry is her willingness to make herself vulnerable by sharing her experience of abortion access and choice.

I dream of abortion provision that allows women to express their feelings without the expectation that they should feel any one way. Last week, a woman stated that she felt many of the women in the clinic were taking the procedure "too lightly." I explained to her that each person who walks in the clinic had different life experiences and circumstances and each person will respond to their choice differently. I further explained there is not one way someone should feel or act through their abortion appointments.

*It is hard to write about regret and sadness and abortion. I fear some crazy person on the internet will skew my words. This blog is a place to address all aspects of abortion both as providers and as women.

Wednesday, January 5, 2011

Need for the Women's Movement?

So, I'm slightly obsessed about Lauren Zuniga now. I'm not ashamed. She's fucking amazing. And if you haven't watched her yet, then watch her. Now. Yes. Now. Take a minute. Sit down. Turn up the volume. Consider it a reminder of what our worth is. Our worth as women.

If you want more, check her out on YouTube or re-watch my previous post here.

Tuesday, January 4, 2011

Another FAQ: "Why did she wait so long?"

Yes, it's a frequently-asked question, and I kinda hate it. Like she "waited" around until her schedule cleared up or something. If a woman finally makes it to an appointment at 18 weeks, it's safe to assume she wasn't "waiting," she was being delayed. 

This came up for me yet again last month when Frances Kissling, who formerly led Catholics for Choice, controversially questioned whether we really know anything at all about why some women have later procedures.* To make a long story short, Kissling said we don't know how many abortions are done because of fetal anomaly,** said that "there is no evidence regarding shame over sexual abuse leading to pregnancy denial, indecision etc as a major factor," and asked "Do we really think women who do not have the money for a first trimester abortion find the larger amount needed for a later procedure in any significant numbers?"

Apparently, even people (like Kissling) who have experience providing abortion care and emergency abortion funding for second-trimester patients may feel this way. But that baffles me, honestly. Because I have those experiences too, and I've spent so many days/weeks/months, yes monthsworking with the same women who are still trying to obtain treatment for the same pregnancy, and heard all of the trials and tribulations along the way. How could someone who's done this still feel they "don't know" why women "wait until" the second trimester, while I feel I know it all too well?

Here is your frequently-given answer:

Women DO suffer, sometimes terribly, from shame and denial -- young women especially. They don't tell their parents, who might beat them, throw them out of the house, or simply 'be disappointed' about either consensual sex or rape (outrageous but not uncommon) or the pregnancy itself; imagine how much more complicated and traumatic when abuse by a trusted relative or family friend is involved. Will they even believe her? How can she bring herself to speak up?

Then there's the surprising number of women who simply don't realize for a few months that they're pregnant: they have urgent things on their mind, like keeping their children clothed and fed, where outgrowing their shoes can be an unaffordable problem, and maybe to scrounge up some shoe-money they'll forgo lunches at work, so feeling tired and slightly sick all the time is nothing new; you get the picture. Or they keep getting their "period" (actually implantation bleeding, 1/3 of women have it through the first trimester) or are in some other way among the "lucky" women who barely have any symptoms.

And yes, HELL yes, women do spend months getting the money together. In my area, most of the quality providers charge around $500 for a first-trimester abortion; some places are able to discount $100-150 with proof of Medicaid. This is low compared to most out-of-pocket medical costs, and has barely kept up with inflation since 1973, but of course if you're on Medicaid you probably don't have $350 in your pocket. Sure it doesn't "make sense" to try to get $2700 instead of $350, as Kissling says, but the logical conclusion of that view is If they can't get the $350 right away, why are they bothering at all? Yet we know women are much more determined to decide their pregnancy outcomes than that. Plus, when I work on funding, a lot of the second-trimester patients I talk to got their price information when they first called a clinic in the first trimester, and had a terrible shock when they called back several weeks later and the price was higher.

Then, if they are lucky enough to find out about emergency funds, which many clinics don't even know about (!), they will still be disappointed to learn that the fund can't always pay everything they are missing. "Can you pawn your TV, get a predatory payday loan or a loan for your car title, can you borrow ten dollars from everyone you know, can you find five houses to clean after work this week?" (It sucks to talk about these options -- even more so if they've already been checked off.) They painstakingly set that money aside. Then, maybe, a drug-addicted relative steals it from them. (Yes, really.) They're back at square one. Or they have to help their family move before the eviction date and the delay takes them from week 12 to week 13, and they've moved to another neighborhood/town and have to find a new clinic with a new price, or a ride to the old clinic. And so on.

The funny thing is that when I mentioned all of this in a comment on Kissling's article, I felt shy and embarrassed, because someone with her experience has surely heard it all before! But why do the detailed memories come back to me so readily whenever this subject comes up, and not to her? These stories and examples are not statistical evidence (which might be what she was calling for without naming it as such), but they are not nearly rare, either. I've heard them for years -- sometimes alldayeveryday -- but never lost my trust in women and girls' good-faith efforts to TCB as efficiently as they were able, or implied that their own words about "why" the delay (not that I was owed an explanation at all) were not reliable enough.

The entire post I just wrote is only a small handful of common examples, in a health care context where abortion is mostly privately provided and privately paid for. There's no one Major Reason (or 3 or 5) explaining the course of all women's pregnancies up til their appointments. To sum it up in different words: the British Pregnancy Advisory Service reviewed a full month's worth of requests for abortion past 22 weeks in the UK. The article where I read about this, A Moral Defence of Late Abortion, is fantastic in itself, but if you want to get to the details of the audit, scroll down. There you go: your frequently-given answer, woman by woman.

Prolixly yours,
Placenta Sandwich

PS: I don't hold it personally against Kissling. I still like other things she's written. Like this article, for example, that I think everyone supporting abortion rights ought to take to heart this new year - Twelve Things You Can Do To Help Increase Abortion Access.***

*The main point of Kissling's article was to address the calls for "honesty" from pro- and anti-choice camps alike; she stated she isn't comfortable with some pro-choice advocates' rhetoric, like typical characterizations of "reasons" for the 10% of abortions that occur beyond the first trimester. By way of example, she quoted Catherine Epstein writing that major reasons for the vaguely-defined "late abortion" include fetal anomaly, shame or denial following sexual abuse, and the struggle to get enough money for the abortion. 
**What we know about abortions sought because of fetal anomaly is that they represent less than 1% of ALL abortions, but probably much more of what are vaguely referred to as "late abortions" (I'll try to find exact percentages, but the reporting is not uniform across states). Between Epstein's and Kissling's articles, the distinction between "second trimester" abortions (after 12 weeks) and "late abortions" (after 20 or 21 or 22 weeks, depending who you ask, when fetal anomalies are more often detected) became blurred in the arguments. 
***Even though, as the National Network of Abortion Funds pointed out, many clinics and doctors DO already forgo payment to provide urgently-needed abortions. I had to go and be argumentative, didn't I? 

Monday, January 3, 2011

Everything you wanted to know about abortion hosting but were too afraid to ask

I know that sometimes us abortioneers take for granted that we understand the ins and outs of all things abortion and we leave our readers confused or seeking information. In past blogs we have written about the basics of 1st trimester procedures, 2nd trimester procedures, medical abortions, etc. I wanted to take the opportunity to go over some commonly asked questions about abortion hosting. Listed below are the questions I get most often, but feel free to ask about anything I forgot in the comments section.

How do women get connected with volunteer hosts?

Women usually do not get linked up with our service until their first day at the clinic (the women we host are almost always having 2-day second trimester procedures). When they arrive at the clinic they often find out that the cost of their procedure is more than they anticipated and they no longer have hotel money. Every now and then women know in advance that they will need hosting but it is usually the day of that everything transpires. The clinic staff will screen the woman to make sure she is a good fit for volunteer hosting and then the clinic staff will contact our volunteer hosting service to let us know there is a woman who needs to be hosted that night.

How do women get to your apartment?

I always go to the clinic to meet the women at the end of their first day. The law requires that women have someone pick them up from the clinic after being administered anesthesia. In addition, many women are not familiar with my city and would have a hard time navigating to find my apartment. When I go to the clinic to meet them the clinic staff always introduces us and the women are eager to get out of the clinic and head to a relaxing home and eat some food. I always offer to get a cab for the women, even though I rarely take cabs myself. Luckily I do not live too far from the clinics we work with so the cab ride is not super expensive. I know this is an added cost for myself but I try to put myself in their shoes and I think it would be hard to take mass transit during rush hour after all the anesthesia and long day at the clinic.

Do you cook meals for them?

Every woman I have hosted has either wanted to order takeout or has brought some food with her. After midnight they need to be NPO (no food or drink in their system) so breakfast is not an issue. In regards to the meals, I always offer to pay and the women usually appreciate and accept the offer. The money for the meals (and cabs) comes out of my own pocket and for me I see it as similar to a monthly donation that I give to improve abortion access.

Has anyone ever started passing the pregnancy or bled on your bed?

No! I have heard 1 or 2 stories about this but it has never happened to me. I knew when I signed up for this gig that it is a possibility, but it is one I am willing to accept.

Aren’t you worried that strangers will steal from you????

It definitely crosses my mind, just like it would cross my mind if I left my car door unlocked over night. Any person is at risk for being mugged or having property stolen from them at any time anywhere. I like to have faith in people and not assume the immediate worst. If I lived my life expecting the worst out of people that would be pretty shitty of me, right? Most of the women I have hosted (and their guests) have been extremely appreciative and truly thankful for my hospitality.

How do you feel about hosting the male partners?

We are given the option as hosts to pass on hosting a woman if she comes with a male guest (but don’t worry we will find a host who is open to hosting male partners). Many of us have tiny apartments and often these are studios with little privacy. In my first few months I said I was not going to host any women who had men with them, mainly because I will still getting used to hosting and was not 100% comfortable with an unknown male in my home. The clinics do a good job of screening for women who might be in an unsafe situation where the male partner could be abusive or could create a dangerous situation. If one partner wants the abortion and the other does not, this can lead to intimate partner violence (I think all of us who work in abortioneering have seen this in one form or another). It would not be safe for a volunteer host to have a couple in their home who might get violent due to the circumstances around their abortion. About six months ago I got a call to host a woman and her boyfriend and as I have mentioned before, they were the best guests I have had so far (my Beefaroni guests!).

What do you and the women (and their guests) do all night?

We talk a lot. We talk about their lives and my life and their abortion or not their abortion. We talk about future birth control methods, we talk about their gay brother, we talk about their career dreams of being a nurse, we talk about how they want to lose weight after the abortion, and we talk about celebrity gossip. We talk about my veganism and we talk about their children. We talk about the next day and what they can expect from the procedure and the weeks after. We watch the few TV stations that come in through my antenna; American Idol is a favorite. We watch my Netflix DVDs of Glee and we even once watched “Boys Don’t Cry”. Women go on walks in the park near my apartment and they go on my porch to smoke or they spend the entire night on their cell phone. Or they pass out right after dinner. Every woman has different needs and wants different things from me, and I do my best to provide.

Sunday, January 2, 2011

Happy New Year!

It may be slightly arbitrary, this idea of a new year and a chance to start fresh, but I think it gives us all a chance to reflect and how we can set goals and make improvements.

It's been a year of ups and downs in the abortion field (as pretty much every year is).

Health care reform was finally passed and signed by the president (yay!) but an abortion exclusion was included (boo!). As always states were active in restricting access to abortion. To name only a couple - Nebraska passed a law banning abortion after 20 weeks, the Oklahoma legislature passed a law requiring an ultrasound "that provides the best image. If a woman is early in her pregnancy, when most abortions are performed, that likely means a transvaginal procedure, said Oklahoma City ob-gyn Dana Stone, MD. Physicians also must display and describe the ultrasound image or be subject to significant penalties." ( In addition to the president's restriction of abortion coverage in the new government funded health care programs, many states added restrictions, so that women can't use their own privately funded health insurance plans if they are sold through the health care reform program. In November we saw a more conservative, anti-choice U.S. House of Representatives elected.

Don't lose heart abortioneers! We did see some positive news in 2010. In Phoenix, an administrator (a nun) of St. Joseph's Hospital allowed a critically ill woman to have an abortion. She faces penalties for this (apparently including excommunication), but she did what was right for this woman regardless of how it affected her. Scott Roeder was given a life sentence for the murder of Dr. Tiller as he ushered parishoners into church in May of 2009. Charlie Crist (soon to be former Governor of Florida) vetoed a bill that would have required women seeking a first trimester abortion to get an ultrasound.

In this new year, let's all think of how we can improve our lives and those of others. My resolution is to be healthier and happier in 2011, and I'm adding something to that - to help others be healthier and happier. One way we can all do that is to help small abortion funds (, become clinic escorts at our local abortion clinic, and get involved in campaigns to improve access and to avoid these heinous laws that hurt women.

On behalf of all of the abortioneers, I wish everyone a wonderful new year filled with good health and happiness.