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 months, working 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? 

Legislators think they are our daddies (and good daddies make things harder on their children)

Happy Fathers' Day! I was going to write you a post about dads, but it'll have to be tomorrow, because I got distracted by an entirely different kind of paternalism. Today I'd like to direct your attention to this post at The Curvature: Anti-Choice Ultrasound Laws Don’t Change Abortion Rates, But Continue Getting Tougher. It's about the wave of state-level legislation that's been passed in the last year or so, much of it having to do with forcing a woman to pay for a medically unnecessary ultrasound, look at it, and/or hear a description of it from the sono tech.

Now, many clinics use ultrasound as a way to determine at what point in the pregnancy the abortion is going to be performed -- there are important technical distinctions between, say, six weeks and sixteen weeks, though ultrasound is not the only way to figure this out -- and I'm all for patients having access to their own medical records if they want it. However!

(a) There is really not that much to see on a sonogram that's made for the purpose of determining gestational age. The screen is pretty dark, the image is fuzzy, and 90% of abortions are performed in the first trimester, a time when all the print-out shows is a roundish grey blur. 

(b) Instructing, as some laws now do, that the technician must turn the screen to face the woman but the woman "may avert her eyes" is pretty ludicrous. So is the idea that a woman averting her eyes must still hear the doctor or tech "describe the fetal development at that stage" (no provision for "averting her ears" in such laws!). If it's in some way relevant to care, a doctor should -- and would -- explain this sort of thing. If it's not relevant to care, well then, it sounds to me like legislators are trying to alter medical practice for political purposes, and as we know that's not OK. Actually it sounds to me like our state reps are practicing medicine without a license -- which happens to be illegal, you know? 

(c) Most of the laws make no provision for victims of sexual trauma who may be re-traumatized by this process. In fact, the Oklahoma bill which was vetoed by the governor even specified that if the abortion is taking place very early in pregnancy, the ultrasound must be done with an intra-vaginal wand, rather than over the abdomen, to "give a clearer image." I was struck to the core when I read this. Like the state was mandating a second rape -- yes, that's what it's called when someone puts something in you that you don't consent to -- if you wanted an abortion. 

(d) Most strikingly: I have never seen a patient change her mind about her abortion because of an ultrasound. My clinic does perform a sonogram before every procedure. By law, clients fill a form indicating whether they want to see the image, listen to the "fetal heart tones if present," both, or neither. We get back forms with all sorts of answers, meaning plenty of clients do choose one or both, but I don't know of anyone who has said, "Oh my god, you know what? I had NO IDEA there was an embryo in there! I thought an abortion was something to do with my bladder! Now that I know, there's no way I can go through with this." 

(e) Which brings us back to the conclusion at The Curvature: it's probably not at all about changing patients' minds, but simply yet another approach in the campaign to guilt, shame, isolate and traumatize women who choose abortion. To punish them for having made this choice that we know she will go through with, because women are not stupid and women are not children, they understand their lives better than a stranger ever could and they already know in their guts what they are capable of at this moment. 

Sometimes that's giving birth and giving her parental rights to another family. 

Sometimes it's leaving high school or going on public assistance in order to afford a wanted, or perhaps unwanted, child. 

And sometimes it's selling her furniture to scrape together 400 or more dollars (have you ever had someone count dollars and nickels on your desk for a medical appointment?), facing a crowd of clueless shame-mongers, listening to maudlin scripts written by state legislators while her pants are down and a high-tech stick is moving around in her vagina, watching a video about a screaming fetus, spending six hours in a crowded waiting room, and having a safe five-minute procedure before going back into the world, back through the clueless crowd, back to her loved ones and not asking them for reassurance that she is still a worthy human being, because they might rebuke her, because they might not understand, because they've heard from ten thousand shame-mongers that anyone in their right mind who's seen an ultrasound would change her mind and leave the abortion clinic. Yes, sometimes women are capable of all that. But god forbid we make it any easier on them. 

Tax time

Sorry, I know you've seen this one before. It's just so apt. 

Did you file your taxes on time? I did, but just barely, because unlike the last couple of years, life was just way too crazy in January, February, and March to even think about anything beyond the coming week.

So I was doing the April-Fifteenth hustle and feeling anxious to hear how much I'd be getting back, because my bank balance has been dropping steadily over the weeks, much to this over-scheduled, under-employed wage-worker/student's dismay. And I thought of my funding clients -- the women who were struggling to make one paycheck stretch to the next, couldn't quite scrape together the full cost of their abortion care, and turned to local or national funds in hopes of pleading for the difference.

A couple springs ago, I was fully immersed in funding cases and found myself really impressed at all my clients who were so on top of their shit that they had already filed their tax returns. At some point it dawned on me that they HAD to be on top of their shit -- and they HAD to get an H&R Block "refund anticipation loan" or something similar, and give the preparers a cut of the return -- so that they could count on their tax return to help pay for their abortion services.

To so many of my clients, the idea of having savings for health emergencies is a nice dream. As shitty as it is to be faced with an unwanted pregnancy at any time, the spring clients could at least say, "Thank God this didn't happen in December," when obligations like traveling home and finding your kids a gift and keeping the gas account open would have made it even harder to raise the needed money for themselves. At least, since it was happening in February, they could get to work on a refund advance right away. Even if the tax people do turn it into a 15%-interest loan.

I can't tell you how sick I got of hearing, during this health-insurance reform circus, the petty selfishness of "Why should my tax dollars pay for abortions?" Even as people say that shit, thousands and millions of women out there are diligently filing their taxes each spring, hoping their measly take-home was measly enough to warrant a refund check to serve as non-existent health savings account, because "we" can't be bothered to provide a basic, extremely-common health service with "OUR MONEY."

This is all a very long, roundabout way of saying: Please fucking donate to the National Network of Abortion Funds Bowl-a-Thon. Even if it's just twenty, ten, or five dollars. Then email it to at least three people who might care. Can you do that? Please? It's the least we can do, living in this country full of very pious people who'd rather save their dollars to be dipped in the blood-bath of foreign wars and police abuse than see one cent of public "support" for the fact that women may choose not to be pregnant.

Utopia

I'm sitting here in my apartment, looking out the window at the trees dancing in the spring breeze. My cat walked by and gently rubbed my foot as I took a sip of tea. I have no obligations for this day except for writing this post and reading my books in time to get them back to the library. It's the kind of nearly-perfect day that makes me think about what would be absolutely perfect: A world where Sunday means nothing but relaxing with a cat and books and tea, no matter how warm it is outside, and also, a world where OF COURSE everyone wants abortion to be included in the new healthcare plan, where woman talk about their (positive) abortion experiences in the same breath as they talk about the frozen yogurt they had last night, where Medicaid pays for all abortions, where birth control is affordable and accessible and side effect-free, where abortion providers are heroes to all, where every child is wanted, where every termination is a blessing, and where no woman has to panic or give up her dignity or feel complete despair because she doesn't have the money or the means to terminate her unwanted pregnancy. Oh, and also a world where I am 5'9" and I have chocolate pouring out of my kitchen faucet and I have a unicorn.

I'd give up my Sunday afternoon leisure and all the tea in my kitchen (the new version of "all the tea in China," because I'm pretty sure I have more, and who talks about China like that anymore?) if I never had to hear another potential patient sob about how she couldn't possibly continue this pregnancy because she had no job and no support and her kids were already wearing clothes that were too small, so how in the world would she be able to get the hundreds or even thousands of dollars needed to have an abortion? And I would love to see someone merrily purchasing Tory Burch Revas (How do I even know about those?) without automatically, bitterly thinking, "Enjoy your flats. Clearly, they will help the average American woman much more than anything else you could possibly spend your money on."

I'm no Tory Burch buyer, and I'm not even a Chuck Taylor buyer--I can only afford the One Stars at Target. But I pledge to forgo my little splurges on coffee, Lush shampoo, clearance rack earrings, and unicorn in favor of making a donation to the NNAF Bowl-a-thon. Dear reader, will you please pledge to do the same?

Empire State of Mind.

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

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

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

Why New York (you may ask)?

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

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

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

What can YOU do to help?

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

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

3) Host an event to raise money.

4) Join their Board.

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

Will The Revolution Be Funded...or Free?

e.t.a. CAUTION: I'm procrastinating on a paper, so this post is really long!

Did you check out Desembarazarme's Thursday post? You should. It rocks. I'll wait while you read it. Okay?

Okay.

Thank god for Desembarazarme, who reminds us how rewarding our jobs are, spiritually if not so much materially. Now here I come barging in, wanting to talk about compensation, but in the crass way.

I want to talk shop. This is aimed more at soliciting thoughts and advice from fellow abortioneers and other do-gooder types. There's these two things I struggle with, similar in a lot of ways and partly intertwined.


I. Money makes the world go round, and private charity steps in where our social safety nets have been unwoven. In most states, clinics and emergency funding programs can only get by financially if they register as official 501(c)(3) non-profit organizations. And those rely on tax-deductible contributions from individuals, funds from grant clearinghouses, or even donations from big foundations set up as tax shelters for privately-owned corporate wealth.

Yet in most endeavors, and certainly when dealing with the corporate-bred (not to mention governments), the biggest pay gets the biggest say. This may interfere with the non-profit's ability to offer certain services, give certain information, or take certain positions even in arenas not touched by the donor's generosity (for at-long-last-vitiated international examples, see: PEPFAR Anti-Prostitution Pledge, Mexico City Policy!). Thus are many clinics and funds drawn into what's known as the "non-profit industrial complex."

From experience, I'd say the longer and more directly your livelihood depends on the structure of the NPIC, the less mental energy you have to think about all its implications for our world. But from outside of it, it's a frustrating thing: you want to be grateful for the private goodwill that makes good work possible, but you hate that the numbers game means some organizations are at the mercy of one or two large donors and might either cave or close if push ever came to shove. It seems wrong, doesn't it? Plus, capitalist blood money! But then, all money is some bloody -- how to get anything done?

II. Money makes our lives more livable, obvi. People who do this thing called "happiness research" say that after the first $40,000, more salary doesn't translate into more happiness. Well, if I had any money to spare, I'd wager that the vast majority of abortioneers wouldn't know what that first $40,000 feels like. I don't. I've earned slightly-above-minimum wage, and then I moved somewhere 50% costlier but made only 40% more money and tried to save like crazy, then slowly raked in pay raises, then traded that for another relocation and the relative poverty of a full-time graduate program. Observations from this:

A) It's pretty hard to live on basic clinic wages and not stress. When I was a full-time clinic employee, I lived happily, but in the sense that I shared a house with four other people and not enough bathrooms, didn't buy clothes or other Stuff, thanked the stars for my no-deductible HMO, ate well, and almost hit the bottom of my account every pay period. Needing new glasses AND a new tire in the same month posed a serious threat.

B) Small raises somehow do make a big difference. Then again, so does lucking out big-time on your housing situation, which for a renter is never solid enough ground to put your fears to rest.

C) The farther away you are from direct client service, the more money you make: true in abortionland as well as most other fields. (Excluding doctors and CNAs, though even they make less than their non-abortionland counterparts.) There seems to be a ladder starting at the clinic and going through small, medium and large research and advocacy organizations. And sometimes it seems like there's an expectation -- maybe from your coworkers, mostly from others -- that you're going to climb that ladder professionally and financially, trading in face-time with women who need it for a series of raises and, sometimes, the supposed authority to speak on those women's behalf.

So Item II often brings me right back to Item I. Abortioneers clearly aren't in it for the money, which is scant, but it seems wrong and exploitative to take that for granted. At present, the most common career model I see is to get promoted out of direct-service abortioneering, yet that's not what many of us want. In addition to removing us from our clients, it brings us further into the non-profit industrial complex, which we then can't help but accept, internalize and reinforce. But the trade-off isn't just money, it's also often a salary instead of an hourly wage, more stable hours, more benefits, more responsibility, and/or simply less in-your-face stress. Sounds like a fair recompense for those burning out in lower-paying positions. And then there's the lifelong clinic staff, the other model, and it doesn't look like their raises are commensurate with their accumulating experiences.

I'm currently in school for a master's degree, even though I'm now unsure what I'll do with it. The program is instructive and fascinating, but it seems to pave the way for me to be some kind of technocrat: smart enough to tell others how to fix problems, and too expensive to be put to work doing something that supposedly "anyone can do" (if only!). It's also assumed that the money spent on this degree will generate dividends of future income. If given time, these assumptions permeate my thinking too. But god knows if I went back to full-time clinic work they couldn't "pay me my worth" for a master's! So are my studies forcing me, financially, out of direct service? Should I quit school right now to remain free of career-defining debt?

Some of the people who graduated from college or high school with me started their first jobs making several times what I made at my last pay raise. Several of them are well on their way to conventionally-approved adulthood: the storied trifecta of homeownership, marriage, children. I'm not sure that's a road I'd want to take anyway, because I like communal living and seeing new cities and not raising kids -- but it's weird to think that it's structurally almost impossible for me to "grow up" even if I choose to. And should I not even bother thinking about retirement?

I've had conversations with some of you, here and there, about old white men's money and the CEOs of women's groups, about this dilemma between the long-term risks of the NPIC and the immediate need to get our work done, and about where our lives will head as the years pass. Do you have any thoughts for me now? How will we do what we do authentically and freely, and perhaps be the movement's future, while enabling a decent-enough material life for each other and those who come after us?

While we brainstorm, I'll be reading this book, the source of my paraphrased title, by INCITE! Women of Color Against Violence, and hoping to make sense of it all.

Fund Spotlight

As we all probably now know, the United States House of Representatives passed their version of health care reform Saturday night. In order to get the bill passed, Speaker of the House, Nancy Pelosi sacrificed women by allowing an amendment banning the purchase of health insurance that has abortion coverage for those using the public option - even when using private money, such as money generated from premiums. Watching the health care reform debate and the frustrating vote of the Stupak Amendment this weekend made me think of the struggles many women face (and that many more could face) with trying to quickly pay for an abortion. We know that with the Hyde Amendment still in force, federal money cannot fund abortions. With this amendment added to the health care reform bill, now even private insurance coverage could now be in jeopardy.

While we know we cannot count on government support of women in some of the most trying and difficult times of their lives, there are people out there that do their best to fill that void. These people run and work for abortion funds - the small local and national groups throughout the country that low-income women can call to get some help with paying for their abortions.

In this blog post, I would like to spotlight the CAIR (Community Abortion Information and Resource) Project. The CAIR Project is based in Seattle and serves women from Washington, Oregon, Idaho, and Alaska. In addition to funding assistance the CAIR Project also has information and resources on getting Medicaid funds (where that's available) as well as finding a provider. Funds like the CAIR Project are struggling to keep up with the demand for their help now, so imagine how hard it could be if the healthcare reform bill, as it stands right now, becomes law. Please help abortion funds like the CAIR Project in any way you can.

Who Knew Funding Abortions Was So Easy?

Last Thursday, an article was published on Slate, “Fetal Extraction: Could a private abortion fund save health care reform?” I found a number of things in this article repugnant, and was so angry I couldn’t even put it into words. Now I would like to.

This first thing that pisses me off was this comment, “Abortions, at an average of $413 a pop, are cheap.” First, if you’re lucky enough to find out you have an unwanted pregnancy under 12 weeks, you may be able to get it for around $400. However, they typically increase in price about $100-$150 each week after that (maybe more, maybe less – it really depends on your clinic). Second, that’s cheap? If you are like many women seeking an abortion, you may have recently lost your job, be on food stamps, have kids, living paycheck to paycheck. If you have a couple of weeks to get $400-$500 together (if you’re under about 12 weeks), that’s not cheap. Then there are those women and girls who find out later in their pregnancy, and the price is anywhere form $500-$2000+. If you’re comparing it to a complicated medical procedure that required hospitalization (like she does in this article), then yes, it will cost a lot less. I would still never say it’s “cheap”. If it were so cheap, we wouldn’t need abortion funds.

Then the author says this, “It wouldn't be much of a stretch for a nonprofit organization with deep-pocketed donors to cover the cost of abortions for America's low-income women.” Excuse me? Now, I don’t know much about what it takes to operate an abortion fund, but I think anyone who does anything in the abortion world knows what a ridiculous statement this is. There’s a reason why there are small abortion funds throughout the country, strapped for cash, doing their best to help women get abortions about $50 at a time. If you doubt this please, go visit the website for the National Network of Abortion Funds.

In this article she estimates the amount of money needed to fund abortions for low income women (in her words “those at or below 200 percent of the poverty line”). She estimates (remember she thinks all abortions cost around $413) a private abortion fund would need “just $311 million per year”. Just? JUST? I’m sorry, but that seems like a lot of money to me. “Could private funders cover that cost? Absolutely.” Really, is that true NNAF? If that’s true, where are all of these private donors with their millions of dollars? The women I talk to would love to speak to them. Seriously. She goes on to say that over $1 billion is donated to reproductive health charities. What she fails to look into is where that money goes. There’s a big difference between funding an organization that advocates for reproductive health, and one that actually funds abortions. There’s a reason why rich people/rich orgs or companies have the money they do. Funding abortions, openly or privately for that matter, would seriously hurt them. Think of the massive boycotts and how much money they could potentially lose. Rich people/orgs/companies, did not get so much money being stupid.

She also says that “supporters of health care reform” would be willing to help fund abortions. Does she have facts to back this up? Once again, WHERE ARE THESE PEOPLE? GIVE ME THEIR PHONE NUMBERS!!!!

“Better yet, progressives could reduce the abortion fund's costs through family planning.” She says these “progressives” (I think it’s pretty clear by now that she wouldn’t identify herself in this group) believe that contraception is the best way to prevent an unwanted pregnancy. Sure. There are hormone supplements, if you’re into that kind of thing. Condoms, if you’re into that kind of thing. There are some options, if you can afford it. However, the problem is that “conservatives” tend to frown upon contraceptives and the public funding of them. Extra- and pre-marital sex is frowned upon by these conservatives, so they really tend to be opposed to funding anything other than abstinence. And I think we all know how effective that is.

“If the family-planning and sex-education programs these pro-choicers support through legislation don't work, the money for the resulting abortions will come out of their own pockets.” Excuse me? Can we properly fund comprehensive sex education and abolish abstinence-only? Also, can we PLEASE STOP DEMONIZING ABORTION? There are women who have a hard time with this decision, they feel bad – like they’ve done or are doing something wrong. Is this because abortion is wrong or because society has decided it’s so and forced people to look at abortion this way? I think it’s the latter, thank you.

The point of this awful article is that she thinks that if progressives give up having abortions funded through a public health care system, that this public option might go somewhere. She thinks that conservatives care so much about abortion that they’d give up other important things, like higher taxes and bigger government. Even if we gave up having abortions funded (which quite frankly we shouldn’t have to), a public health care plan is a long way off – if it ever actually happens. This article was clearly written by someone with means, someone who didn’t grow up having to think how to get $400+ together quickly. She clearly doesn’t work with low-income women. She is lucky. She has a choice and she can exercise it.

If she knows of all these people with all the money to fund private abortion funds, can she have them all contact NNAF? Thanks.

The purse strings are so close, yet so far: Abortion coverage and DC sovereignty

Yellow = no lifesaving needle-exchange programs. White = go for it!

I used to live and work in Washington, DC, a place where you'd think people are powerful and have the ability to make important decisions. But the city of the District of Columbia is not the same as what people call "Washington" when they are thinking of Congress and the White House and the Supreme Court and, you know, the halls of power.

Not everyone knows that the residents of DC do not have a single vote in Congress. (They have one non-voting delegate in the House of Representatives, Eleanor Holmes Norton.) Also, not everyone knows that until 1973, DC did not even have an elected mayor or city council, but was directly administered by federally-appointed commissioners -- and Congress can take away that privilege at any time. Congress also has the power to decide how the District can and cannot spend its own income, i.e. money raised from city taxes. Of course, if DC were a state, this would all be very unconstitutional, but the Constitution dictates that the District of Columbia be governed in this way.

It might seem very arcane or very trivial -- why would senators and House reps from other parts of the country care to get involved in someone else's city budget issues, and if they did would their decisions really be so bad for residents anyway? Unfortunately, the residents of DC do indeed feel the repercussions of this lack of sovereignty, repercussions which often hit the poorest among us the hardest.

Every year, Congress writes and passes a new federal budget. And every year, members of Congress use DC as a place to make cheap political statements about where they "stand" on "issues." A timely example: since the late 1990s, DC was prohibited from using its own money to pay for needle exchange programs to combat the spread of HIV, while several of the "real" states were supporting such programs using not just their own funds but federally-allocated funds as well! Basically, conservatives scored political points with their constituents back home using citizens who are politically impotent and thus expendable; meanwhile, the Washington Post reports that "At least 3 percent of District residents have HIV or AIDS, a total that far surpasses the 1 percent threshold that constitutes a 'generalized and severe' epidemic".

In 2007, Congress finally reversed that ban, but now the House is considering a bill with an amendment that restricts where DC can locate needle exchange sites: they cannot be "within 1,000 feet of a public or private day care center, elementary school, vocational school, secondary school, college, junior college, university, public swimming pool, park, playground, video arcade or youth center." The image you see at the top of this post is a map [pdf] 0f what those restrictions would look like: in the white parts it's OK to provide clean needles in exchange for used ones, but not in the yellow parts. (And, um, the blue is water.) How many people can that possibly reach?

OK, so what does this have to do with abortioneering?? As you might guess by now, abortion is another favorite controversy to take out on the residents of DC. Until 1988, the District was using some of its own funds to include abortion coverage as a Medicaid benefit. Since that year (with a brief break 1994-96), Congress has prohibited the District from spending any of its own revenue to pay for abortions, despite the fact that its residents and city council clearly appear to favor it. Again, conservatives scored political points with their constituents back home using citizens who are politically impotent and thus expendable. This year it appears that the Democratic majority in Congress may finally reverse that position and allow DC the choice to resume covering some abortions, and the city probably will choose to do so.

When I worked in DC, most of my clients were on Medicaid, and the vast majority of those were not from jurisdictions that allocated funds for abortion care. They were on Medicaid because their government acknowledged they were too poor to afford health care, but they were going to have to afford an abortion all on their own. Yet abortion care is a part of health care, and we don't suddenly get richer when we have an unwanted pregnancy! It broke and still breaks my heart to know that so many of my neighbors are getting screwed over by people who go to work just a couple blocks or a couple miles away from them.

Living in the nation's capital, you constantly pass monuments, walk right by the White House, and see other stuff that should make you feel like huge decisions are being made in your backyard; yet all that proximity never gets you any closer to meeting those decisionmakers or participating in those decisions. In fact, aside from the euphoria of Election Day and Inauguration, I doubt any of my clients ever thought about the federal government. So maybe it's no wonder that Congresspersons are making terrible decisions about the drug addicts, pregnant women, gay couples and cancer patients of DC as though the latter lived in some tiny shit village thousands of miles away that no one expected Congresspersons to care about in the first place: they don't feel any closer to the residents of their host city than their hosts do to them.

Yes, Congress legally can do all these things. But it still feels like your landlord showed up at your door, set up camp in your nicest bedroom, then went around to all the other rooms and shat on the carpets. Don't forget rent is due on the first.




EDIT: Also, don't you love it when the House minority leader posts a "Statement of Republican Policy" on the party's more-or-less official site for Congressional workings (hosted at a .gov address) and it's got typos and bad logic and unflattering cut-n-paste aesthetics and everything?!

System of a Down

It is Tuesday. Just another Tuesday in Abortion Land. Today, I am literally weeping in my cubicle.

"Are you okay?" My coworker asks me with a look of concern on her face. You know how when you are already on the verge of tears, and then someone asks you if you're okay? And then it's over, the tears really come pouring out.
"I'm fine, I'm fine, just leave me alone." I am not sure how I managed to say all the that but, I did. She gets the hint and backs off.

I suppose I should go back to the beginning.

Tuesday morning, 3:45 am. Still not asleep. I am trying not to think about the fact that if I don't get to sleep really soon tomorrow will be utter hell because I will be so tired and still have so many women who will need help. I try not to think about the fact that each passing minute I continue to lie in bed wide awake is another minute I am not sleeping and another percentage I will be more tired. My throat hurts, my stomach is upset. Finally, I manage to doze off and wake up when my alarm goes off at 8:00. I snooze until 8:30, when I decide I really do need to get up.

On the way to work, my stomach begins to hurt. Badly. So bad, in fact, I pass out. I come back to consciousness, drenched in sweat. Several alarmed bystanders look at me inquisitively. My first thought: I need to hurry. I need to be available to my patients. I have one particular patient today, a teenager, who was raped by either her step dad or her brother. The patient seemed to be in a state of permanent shock. She is 20 weeks pregnant, twins. Yesterday, her family made her walk to her counseling appointment at the clinic. I routinely wonder how people could be so heartless, but this case especially. I need to get to work so I can make sure she is seen.

I wipe the sweat dripping off my face with my shirt and continue on my way to work. I get to the office and there are a ton of women who need help. More than usual. I start explaining how sick I am feeling to a coworker and she replies, "Why don't you go to the doctor?" I am not sure why this thought hadn't crossed my mind. She is right. I am not okay and haven't been for a few weeks. I should seek medical attention. I call the doctor and, magically, they have an opening today in two hours. I scramble to finish up as much work as I can, and go to the doctor.

When I come back, I have a huge pileup of women who need counseling. Most of them are urgent cases. I am not capable of assisting five people at once, which is what I need to do at this moment. I start scribbling down information and my head starts overloading. I feel like crap and all I want to do is lie down but I can't because I have all these women who need help and I have to help them and if I don't they might have to reschedule and if they reschedule they will need more money and where will they get that money because the father is useless and she is living off food stamps and she already has kids and she already pawned her TV and it's not fair she is even in this situation in the first place and then the next thing I know I am crying. Silently crying in my cubicle. I need to make sure the teenager is seen. I need to make sure the five people who are at the clinic right now are okay and at least let them know I am trying to help them scrape some money together. But, right now, at this moment, it is all too much and I can't do it. I cannot do this right now. I feel ashamed saying it, but I just want to go home.

I allow myself to cry for a few minutes. Then, I tell myself it is time to suck it up. I call everyone back. The teenager, most importantly, will be seen thanks to the help of several national funds who were able to cobble together the vast majority of the funding she needed.

I know we make a lot of pleas on this site for donations to funds, but seriously, they make a huge difference. And on a day when an Abortioneer like myself is not doing so well, wondering if I can even make it through today, it is the coming together of so many different people to help a young woman get seen that makes me see the light at the end of the tunnel. Funds like Third Wave, who exist thanks to monthly donors, cannot continue to aid women who so desperately need help without people donating. Won't you?

Every Woman Has a Story

I work almost every day with women who are trying to get an abortion. Many of my conversations are brief and to the point. I get them what they need, and they’re on their way. I have so many people to talk to in a day. Sometimes they seem to blend in, lost their job, getting evicted, on food stamps. They seem the same, woman after woman, but they are all individual women with their own stories.

Today I spoke to a woman in Illinois. She’s 18 trying to go to school, while working at K-mart and helping her grandma with the bills. When she found out she was pregnant, she started working on getting the money together. She even got help from the man involved, her boyfriend. Unfortunately, neither of them have much money, so she had to do the infamous price chase. She is now well into her second trimester, and the clinic doesn’t have its own anesthesiologist, so she has to wait next week when they can get one in. Even with funding help, she hasn’t gotten all the money together. We talked about her fundraising options. She has already taken out two loans – one for school and one to help her grandma pay bills, she has no other family to get help from, her boyfriend gave her all the money he had, and she already put up the title to her car to help out someone else.

For the past couple of days I have been speaking to a woman, whose story started out pretty simple, pretty ordinary. She was about 7 or 8 weeks by her last menstrual period. She had her appointment, had all her money together. She was all set. Except there’s something else. She was pregnant by an abusive man. The abuse got so bad that she had to leave. She packed a bag, got on a plane, and went to the only safe place she knows. This made her miss the appointment she had and caused her to spend the money she set aside for her abortion on a plane ticket. Now she’s in an unfamiliar city, with no job, no money, and she’s still pregnant. She’s now about 13 weeks. She needs to get seen because now her price will only continue to go up. She now has to rely on the people she is now staying with to get her to the clinic and help her pay for the abortion.

Both of these women and so many others are depending on people they know and small abortion funds to be able to get access to reproductive health care. This is a shout out to abortion funds, and if you don’t already, please consider donating to a local abortion fund in your area or a fund like this one – The Women’s Reproductive Rights Assistance Project. They are a national fund, helping women all over the country, and work directly with clinics to help fund women in need. Times are tough for everyone, you, these low-income women, and these small abortion funds. Really any assistance you could give would be appreciated.