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.

Lets go to the movies (and have an abortion...or not have an abortion)

Busy day here in abortion land so I am re-posting from a fellow kick a$$ vegan feminist blogger who goes by the name of Opinioness of the World. I subscribe to her posts and you should too! Check out her review of Abortion in cinema: HERE

Hey! Don't I Recognize You? Oh! You're One of Our Protesters!

In my last blog post, I discussed how I outted myself as an abortioneer to a friend. I also mentioned that one of my hints to her that I do abortion work was that I had asked her to find out if guests at a recent dinner party we both attended could be uber pro-life…

…That dinner party was loads of fun, but there was an older couple who looked an awful lot like infrequent Catholic protesters at our clinic. During the dinner, I just couldn’t figure out if they were protesters or not. I searched for hints on whether they were politically conservative. No one mentioned politics. I heard a whisper of “Planned Parenthood” once, but didn’t catch what was said and this only heightened my paranoia. I kept wondering if they thought I, too, looked familiar and whether they would out me to the host of the party (whom I hadn’t told about my abortion clinic work). Conflicted, the only things I could surmise were that they were educated, well travelled, soft spoken, unassuming, and very, very, very nice. I kept playing out in my head a scenario where I would see them the following week outside the building, not knowing whether to quickly duck into the clinic, hoping they wouldn’t see me, or wave and say, “Hey! Hi! How are you? What a great dinner party that was last week, huh? It was lovely to meet you.” In this scenario, I could actually imagine this couple shaking my hand and have a friendly little chat about the dinner, how things are getting on, etc. Part of me wondered: is it possible to be friendly and admire to some extent people who would actually protest at the clinic? Could I really be enjoying these people, liking them, and wanting to continue to hear their stories…even if they protested my clinic?

It was a mind fuck, let me tell you. It would be a better story if my friend confirmed to me that they were, yes, in fact quite conservative and frequently attended pro-life gatherings. The story doesn’t end that way: I was told they were super liberal and would never protest a clinic. I apologize if my story is now a bit anti-climatic, but still, I think it’s a good story. I think it tells a few things (aside from that I have a warped brain): we want to reach out and connect with others; we want to find common ground (even though I don’t think there’s common ground on abortion); there’s this desire to see past differences, beyond values, even, if there are many other things you agree on (maybe that’s the common ground thing); and mostly, I think it shows how by doing the work we do, we can get very worried and concerned about how others in our community view us/see us. It can cause us to be guarded. Not completely open. And we might lose out on relationships with others as a result. I was not as candid with this couple as I could’ve been - or even wanted to be – because I wasn’t sure who they were!

Do you guys have experiences where you feel not quite as open to others, especially strangers, in social situations, because of your work?

Sperm Hitler

Ah-mazing.

I'll call this FSFW (Fairly Safe For Work), but if you're in a bind, maybe skip over to 1:22.

Now, I get that this stuff is just to make a point, and I certainly have no intention of banning masturbation, but this is just too good. I love watching antis squirm.

Enjoy!

Friends of Abortioneers

Today I outted myself as an abortioneer to one of my friends. I’ve given hints that I do abortion work; I told her I worked at a clinic “like Planned Parenthood” and once let it slip that there were creepy protesters that annoyed me. (Oh, and there’s that time I asked her to discreetly find out that if some of the guests at a recent dinner party were super conservative and conservative enough to protest.) We managed to have lunch together this afternoon and I mentioned something about stress at work…blahblahblah. She asked why I didn’t talk about it and I got squirmy, told her I was uncomfortable, that I wasn’t sure if she knew “what I did,” and didn’t want to upset her. She started to laugh and said, “Um, I’m not a rocket scientist, but I’m no dummy either. I pretty much put the pieces together that you work at an abortion clinic.” Fairly painless other than the fact I felt a bit idiotic.

I adore this friend. Our kids play together. Maybe that’s why I was worried about how she’d react. I supposed I feared I’d lose a friend: I mean, I know abortioneers who’ve been dumped by friends for their work at the clinic. It could’ve happened to me, too. Thankfully, it didn’t…

Lesson learned, though. Maybe I shouldn’t always be so slow to talk about myself. To open up. To share about my real life. It only adds to the isolation that we sometimes can feel from being an abortioneer.

Ask Aunt ABby: the morning-after STD test

Time: Surprisingly complicated!

Spring has sprung here at Abortioneers HQ, and there's a new feature on the block! You've got questions. We've got answers. And we received a comment that may or may not deserve its own post.

After reading VV's post on the importance of Backing Up Your Birth Control, Virginia commented:
So much concern about getting pregnant and been able to terminate it...what about getting HIV and STDs while having unprotected sex, do you go check if you got those as fast as you go get a day after pill??


Dear Virginia,

It's hard to tell if you're being snarky or simply not very knowledgeable. Either way, welcome to our new advice column, and thanks for giving us an opportunity to clear up potential misconceptions!

Testing for STIs the morning after unprotected sex (especially HIV, which can take up to 6 months to be detectable) is like testing for pregnancy the morning after unprotected sex -- you won't get a positive result when you test that soon, even though you're not in the clear. So to directly answer your question: No, of course you don't "go check if you got those as fast as you go get a day after pill" [AKA the morning-after pill, emergency contraception, EC, the brand-name Plan B, or any number of generic-label names], as you put it. You literally CAN'T do it right away; whereas with the morning-after pill, you MUST.

That's why, instead of rushing out for a meaningless "morning-after HIV test," many people make it a habit to seek testing at regular intervals. I usually do mine at my yearly physical, because I consider it part of a complete checkup. Many providers suggest you only need to test when exposure is suspected, for example IF you had unprotected sex in the past 6 months or year and haven't yet had a test in that time.

Contraception, on the other hand, is important to seek out as soon as possible after unprotected sex, in order to prevent ovulation -- because that's how ALL birth control pills work, including emergency contraception. The longer you delay, the more time for ovulation to occur, and if it does, then EC won't work and you're left at risk for pregnancy. (This is why taking a regular birth control daily is still most effective -- you've targeted ovulation BEFORE the approach of sperm even begins.) If you miss that window and one of your ovaries does release an egg into its fallopian tube, then at that point all you can do is wait a couple weeks to see if a pregnancy does result, and if so, then (potentially) seek abortion care.

It's important to realize that the "morning after pill" is NOT the same as "getting pregnant and be[ing] able to terminate it." You can only use the morning-after pill to PREVENT pregnancy, and it's only effective in the first 5 days after unprotected sex; abortion, on the other hand, can only take place AFTER pregnancy has begun.

I sure do hope this helps, Virginia. Feel free to follow up with lingering questions, and definitely feel free to share this knowledge with your friends and family.

Yours,

Placenta Sandwich
VP of Taking You At Face Value
Head Know-It-All
Abortioneers

Insurance Assurance?

When I worked at an abortion clinic we had a laundry list of questions we asked clients when making their appointment. The standard question went like this, “do you have Medicaid, military status, or private insurance?” We spend a lot of time in this blog or in other abortion’y type news sources discussing Medicaid, abortion funds, and clients’ all-around inability to pay. But what about those who have private insurance? It was very common for women to be surprised that private insurance was an option, mainly because abortion is so completely stigmatized and compartmentalized that no one assumes it would be covered by their policy; abortion has become so moralized and fraught that we forget it is a medical procedure that deserves coverage just like an appendectomy or cardiac bypass.

Quick and dirty: Private insurance that is employer-based (as it currently stands) can and often covers “elective termination.” However, an employer can restrict this coverage and many do (back in my clinic days: Walmart and Cracker Barrel to name a few). When an employer-based policy DOES offer coverage, there is often a deductible (can be up to a few hundred dollars) or there is a co-pay (usually no more than $100, but can depend what type of facility the procedure is done in). Usually it is much cheaper to use private insurance than to pay out of pocket. However, we had a slew of clients who didn’t want to use their insurance. Sometimes they were afraid their employer would find out. Sometimes I think they just did not want any sort of official record of their abortion.

We should take a few steps back though, because using private insurance is never as simple as swiping a card. In fact, some of the smaller insurance companies we worked with were near impossible to nail down in terms of the costs that a client would have for a deductible and/or co-pay. Or, in the case of employers that only provided coverage for rape, incest, or fetal anomalies, it could take weeks before we got approval or even just a basic response for what a client needed to pay up-front. We would urge clients to call their insurance companies themselves and find out the fees but ultimately someone from our clinic needed to call and confirm the costs, which resulted in endless hours on the phone and bickering with insurance companies over whether or not someone was covered. And yes, we did sometimes encounter the lovely insurance company reps that were easy-breezy to work with and who supported abortion and you never felt like they were rolling their eyes or begrudgingly giving you info that you were legally entitled to.

I’m bringing this up because myself and a few close people in my life have recently tried to navigate the world of private insurance and come up against some significant barriers. I’ve been given three of four different quotes on costs from different sources and I’m still not entirely sure I paid the correct amount for a procedure I had. A friend received bills for services he assumed were covered because at the time of care he called his insurance company to confirm. Now, I like to think that I’m pretty literate when it comes to health insurance, yet I have become so frustrated with receiving care and the confusion over costs that it makes me want to ignore my health altogether just to avoid this HOT MESS that we call health insurance coverage.

Moving forward as we continue to fight for universal health care we must recognize that access to insurance is not enough. There needs to be education around how to navigate the system and also health insurance literacy so that all consumers maximize their benefits. Insurance companies are businesses and they are not incentivized to throw any of us a bone, in fact they will do everything they can to take advantage of us who don’t know how to use our benefits.

16 and Loved

About a year ago, we blogged about "No Easy Decision", an MTV special featuring three young women from the series "16 and Pregnant" who chose abortion under the watch of millions of viewers. These brave, insightful women shared their emotional journeys and unashamedly defended their decisions, with one even referring to abortion as a "parenting decision". It was definitely a victory for honest television.

Last night, viewers encountered another abortion story, brought to us by Exhale, but this time in the context of conflicting pregnancy decisions.



Sisters Brittany and Briana became pregnant at the same time. Brittany, the older, chose abortion, while 17-year-old Briana chose to become a parent. Initially, we see tension between them, as Brittany expresses some sadness about her decision and jealousy about the attention that her pregnant sister receives from their mother.

Eventually though, shit starts to get real. Briana's ex and the baby's father is being a total douche and shows no interest in his daughter. As Briana becomes more stressed and tensions with her sister run high, they have a frank conversation about how their decisions affected each other.

Brittany: “I made my decision so I don't have to eat nobody's shit. I don't know how you do it.”

Briana: “If I could go back and make the decision you made, I would do it. I don't regret having her or anything, but you made a very, very smart decision....I would trade places with [you] any day.”

Having worked on a funding hotline, I heard stories like this all the time. After so many, they started to run together, and I started to nod along to the script that was so familiar. Teenager. Deadbeat baby daddy. Wants to go to college. It got so routine that I even confused the names of callers.

But watching this story, admittedly never having seen the show before, really got me feeling emotional. It reminded me that abortion is not like a McDonald's drive through, regardless of how mundane I've been conditioned to think it is. Having a sneak peek into this woman's life made me see the reality. It was all the things I didn't ever see when I spoke to clients. I've also never been around for the pregnancy of someone close to me, so it was totally eye-opening. And watching this poor girl have to go through her pregnancy without the support of her sister or ex-partner, and later question whether it was even worth it, was just heartbreaking. I was so touched that I also watched the re-run an hour later.

We so rarely see this side of the story. We like to think that having an abortion is a religious experience, but not always. Even if the "abortionee" feels solid in the decision, it's also possible to feel the loss. And, despite what most ob-gyn websites depict, not all pregnant people glow. What's interesting is regardless of their respective decisions, the love for the life that could have been was almost palpable. While one sister mourned the loss of her motherhood opportunity, the other - knowing full well how much she would come to love her daughter - would have chosen differently given the chance. It goes to show, for all the naysayers out there, that abortion can definitely be a decision made out of love and care, and absolutely a parenting decision.

If you'd like to share your love with Brittany and Briana:

• Visit Exhale’s website to add your special message of love.
• Post your message of love on our Facebook community.
• Watch the show live with Katie Stack and join the conversation on Twitter using the hashtag #16andloved.

Back since the days of old Methuselah

You know how everyone is like "Jesus hates reproductive freedom?" Well, you know what predates Jesus by a couple thousand years?

You guessed it!

The above visual was created by Heather Ault, and artist and pro-choice activist with hopes of reframing the abortion debate not around politics, but around human history. 4,000 years' worth, to be exact. See, Abortioneers are forced to defend their positions with inflamed and impassioned speeches, or at least cutting witticisms. But maybe it's time for a gentler approach. Just keep it real!

Check out more awesome posters and factoids at 4000 Years for Choice.