SOS Midwest

Basically.

Midwest abortioneers and others-- did you see this? This Ohio bill will require abortion providers to obtain hospital admitting privileges BUT ALSO specifically prohibit them from making such arrangements with any public hospital or even any doctor employed at one. Funnily enough, in the US the largest operator of non-public hospitals is...the Catholic Church.

Even before these new tighter restrictions are voted on, one Toledo clinic has just closed due to these issues and another is expected to do so soon. You can read more details at the Salon article.

Ohio's provider landscape will look something like this, I guess:

I've been thinking about this issue a lot since the admitting privileges strategy seems to be increasingly popular in the past 1-2 years (and alarmingly effective) in the quest to eliminate providers -- but this is the first state hospital requirement I've seen where state hospitals would be explicitly off-limits in your efforts to comply with the state's hospital requirement. That feels like some next-level, Vonnegut-Kafka-MontyPython type shit (cause I can't decide whether to laugh then cry, or cry then laugh).

If you work in a hospital or ED setting, I want to hear about it: Has the topic of admitting agreements with abortion providers ever arisen in your hospital? And while we're at it, what about emergency treatment for pregnant intakes (including urgent abortion care) more generally?

Images from: The Notebook, Toothpaste for Dinner

Bad Freaking News, with helpful annotations

AZ Abortion Law to Take Effect After Judge's Ruling
Mon, Jul 30 2012, Reuters

Arizona's law banning abortions after 20 weeks will go forward, says U.S. District Judge James Teilborg.

The law is a change from the current system in Arizona. Under the previous law, abortions were permitted up until viability which occurs around 24 weeks. Starting Thursday, abortions after 20 weeks will not be allowed unless there is a medical emergency.

Judge Teilborg was asked to stop enforcement of a new Arizona law passed by the legislature. He declined to do so by ruling that the law is acceptable under the Constitution.

Arizona is not the first state to ban abortions around 20 weeks but it's still a tricky decision, legally speaking, for a state to ban abortions before viability. The Judge acknowledged that the Supreme Court has blocked states from implementing outright bans on abortion before viability as an unfair burden [but he says that] the Arizona law is acceptable in part because it doesn't impose much of a burden on a pregnant woman.

His reasoning is that there is relatively little time between 20 weeks and the 22-24 weeks when viability occurs,[1][2] according to Arizona Daily Star.

Part of the burden on women in pre-viability abortions is that they may not know of fetal abnormalities before that time. The evidence presented to Judge Teilborg indicated that there are few conditions that would be diagnosed after 20 weeks that could not have been diagnosed earlier.[3] As a result, banning abortions after 20 weeks would not significantly increase the burden on the woman.[4]

He did note that if a unique circumstance arose where fetal abnormality was diagnosed after the first 20 weeks, it would be appropriate to challenge Arizona's abortion law.[5][6] But until that actually happens, the typical situation will dictate the constitutionality of the law.

To uphold a restriction on abortion, the state must also show a legitimate reason for the new restriction. Teilborg was convinced that the state's respect for life[7] and concern for preventing fetal pain[8] was a sufficient concern to justify the law, reports Arizona Daily Star.

Arizona's new abortion law is not the first of its kind, although it may be the first law banning abortions after 20 weeks to be challenged in federal court, reports Reuters. The plaintiffs had not filed an appeal as of Monday.

Footnotes, placenta sandwich 08/01/12:

[1] More like 24-26 weeks; it would be ludicrous to use 22 weeks as a general theoretical threshold for viability, even in a high-tech, high-cost US hospital context.


[2] (Also, how is 4 weeks just a "little time" to be cutting off? Is it really? What did he base this on? Has he experienced a crisis pregnancy before? I'm honestly curious what makes a person decide this rather than something else. Because for every person talking about banning later abortions who calls 4 weeks "relatively little time" [as in, "I don't really understand your life, but a couple weeks' less time is not a big deal, just get to the clinic earlier"], there's another person talking about banning later abortions who calls 4 weeks "plenty of time" to find out you're pregnant, decide what you're going to do, and seek out the necessary care [as in, "I don't really understand reproductive biology, but you're already 8 weeks pregnant, what took you 8 whole weeks to get an abortion?"]. Somehow, they're both wrong.)


[3] I don't know what evidence this refers to, as there is plenty of time past 20 weeks for plenty of fetal development to go wrong, and it does.


[4] Few conditions are undetectable before 20 weeks, and "as a result" it wouldn't be burdensome to ban abortion after 20 weeks? Wow, so many people are erased in that one little phrase. Including women who are seeking later abortions for reasons other than fetal anomaly.


[5] Sad but true. Assuming this ruling isn't overturned, the last hope for people needing abortion care in Arizona is for an already-pregnant person to be adversely affected by this ban and have the means to bring their specific case to court. Of course, as in Roe v. Wade, the individual adversely affected will be well past their pregnancy by the time of the court's decision -- which sometimes results in a judge saying that the claimant is no longer affected and thus no longer has standing! Isn't this the original meaning of "Catch 22"?


[6] But also, why is it that the only person hypothesized to have standing as an adversely-affected party is a woman whose pregnancy was diagnosed with a fetal anomaly after 20 weeks? What about those who face other kinds of situations and obstacles in obtaining their abortion care before 20 weeks (see footnote [3])?


[7] Not WOMEN'S lives, silly!


[8] We don't know when a fetus is capable of experiencing pain, but it's definitely not at 20 weeks. In fact, it's not anytime before 27 weeks and it may be even later. This is the general consensus of embryologists, neonatologists, neurologists and other people knowledgeable about the development of the nervous system.

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

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

So...

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

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

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

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

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

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

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

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

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

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

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

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

Some days I can't bear to look

I know I haven't been around much. Frankly, keeping up with the insane and nonstop political assaults on abortion and related care has been nearly too much to bear. You'd think I'd be writing nonstop, because SO MANY FEELINGS, but at times the feelings kinda drain my emotional energy. I know some of my co-bloggers have been feeling that same drain, lately, in various ways -- and I bet fellow abortioneers in the field have, too.

So it seems almost futile to single out one law and one group of politicians. But if any law has earned that, I guess it'd be the latest restriction out of the magnolia state. Mississippi, come on down!

Maybe you've heard? The lawmakers who passed Mississippi's House Bill 1390, while claiming to be motivated by a desire to protect women from dangerous abortion providers, are also cheering the fact that the bill will have the effect of shutting down the only existing legal abortion provider in the state.

Sen. Kenny Wayne Jones (D-Canton) asked Sen. Dean Kirby (R-Pearl), who chairs the Senate Public Health Committee*, whether ending abortions in the state would force women to resort to dangerous, back-alley abortions.

"That's what we're trying to stop here, the coat-hanger abortions," Kirby replied, in reference to the abortions provided at the clinic in Jackson. "The purpose of this bill is to stop back-room abortions."

*I would also like to call your attention to the fact that Sen. Dean Kirby chairs the Senate Public Health Committee. Presumably, that is a Senate committee on public health. But maybe it's...a Senate committee against public health? I guess the title isn't super specific.

Oh, speaking of the Legislative Brotherhood Against Public Health, see also the breathtakingly cavalier Rep. Bubba Carpenter announcing afterward:

"We have literally stopped abortion in the state of Mississippi. Three blocks from the Capitol sits the only abortion clinic in the state of Mississippi. A bill was drafted. It said, if you would perform an abortion in the state of Mississippi, you must be a certified OB/GYN and you must have admitting privileges to a hospital. Anybody here in the medical field knows how hard it is to get admitting privileges to a hospital.

"It's going to be challenged, of course, in the Supreme Court and all -- but literally, we stopped abortion in the state of Mississippi, legally, without having to-- Roe vs. Wade. So we've done that. I was proud of it. The governor signed it into law. And of course, there you have the other side. They're like, 'Well, the poor pitiful women that can't afford to go out of state are just going to start doing them at home with a coat hanger.' That's what we've heard over and over and over.

But hey, you have to have moral values."

Wow. Was that a sneer I just heard? And then...a shrug?

He has a point, right? Sure there might be some poor pitiful women who can't afford to go out of state for their medical care and end up injured or dead using coat hangers and home remedies -- but aren't we pro-choice people (the other side) just talking about those women to score political points? I mean, why else would you bother talking about them? We say it over and over and over because we don't have better talking points, I guess. But hey! Those deaths are so trivial we can mock them and the people who talk about them.

(Later, Rep. Carpenter also shrugged off his coat hanger 'quote' as "just some language that some of the African-Americans used.")

(You thought I made up that last bit, didn't you? But no. He really did. I mean, it sounds like he's saying that therefore those accounts amount to nothing worth examining? But hey! That's okay, because African-American women (and other black women, and other women of color) definitely don't have even more experience with unsafe abortion than white women.)

Gosh, wonder why I feel so tired?

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.

~~~~~~~~~~~~~~~~~~~~~


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.

Crushed

You guys, it passed. I really don't know what to say, do, feel. Much less what my colleagues in Georgia are feeling. Please give me a couple days to find my words :(

Thanks, as always, to those of you who spread the word or contacted state representatives in Georgia.

Tuesday night homework: please help Georgia!

Can't you see my crazy eyes? Don't make me a law! 

Friends, readers, countrypersons: lend me your eyeballs! I have an important piece of evening reading for you, followed by a super-quick writing assignment. Scroll down if you want to skip my navel-gazing and discover your mission.

[COMMENCE NAVEL-GAZING]

Lately I've been feeling like I can't even keep up with the onslaught of legislation designed to prevent would-be abortion patients from getting the care they need and to make their providers give up, board up the clinic and retire or something.

Not tryna brag, but in previous years I was pretty damn knowledgeable about the status of abortion legislation, regulation and jurisprudence at the federal level and in most states. If you asked me about a state-level bill I could usually tell you what its language really meant or what stage in the legislative process it had reached so far or what its practical implications might be.

This year, though? This year, if you told me "I saw on facebook that Hawaii is going to require married women to get a permission slip signed by their mother and their boss and then wait 7 to 10 business days before having an abortion," well idunno, maybe they are! Who am I to say, "No way, no way would lawmakers ever try to do something so awful and insane"? Recent evidence points to the contrary!

Honestly, it was difficult just now to dream up an example that's plainly absurd, because real-life happenings have been so goddamn absurd. But when a bill becomes law, whether or not it is too crazy to exist doesn't matter -- because suddenly it does exist, period. Suddenly you can't get the care you need. Suddenly your doctor has to decide between following her duty to care for her patients' needs, or obeying a law she knows is unjust.

That moment when the laughably absurd bill becomes the terrifyingly absurd reality has happened to me before, most starkly in 2006 when the Supreme Court decided Gonzales v. Carhart. The ruling allowed Congress's so-called Partial Birth Abortion Ban Act to take effect, via an unprecedentedly patronizing position on the part of Justice Kennedy that the government has an interest in protecting "mothers" (any pregnant person) from making decisions they might "come to regret." On the day of that ruling, I was at work, speaking with a woman whose baby was dying in utero; she asked if it was possible to remove the fetus relatively intact so she and her husband could hold it and "say goodbye." I found myself telling that woman, and others like her later, that we could not attempt to honor her request because Congress had just outlawed it. Your representative called; he says to tell you tough titties, crybaby.

[END NAVEL-GAZING]

Those terrible moments will happen again and again unless we refuse to feel helpless and instead move to take action. Your assignment is to foment urgent last-minute opposition to Georgia HB 954, yet another insane proposal to outlaw certain abortions. Georgia has seen and defeated similar bills in past years; but this one has gotten quite far in the legislative process -- meaning it's in grave danger of passing.

I once lived in Georgia. I still feel a strong connection to it, and I really hate that it feels like the rest of the country considers Georgia a lost cause when it comes to rights and liberties, or thinks such legislation won't make that much of a difference for that many women. They're wrong. Many people don't know this, but Georgia has several providers who currently care for patients with later pregnancies and patients with severe or complicated health conditions. Without appropriate providers in Georgia, these patients would have to travel clear across the country or receive care in less well-equipped facilities.

There are three days left to the legislative session, and that's when the crazy backdoor shit goes down. If you have any connection to Georgia, please contact the state representative in your area and ask them to OPPOSE HB 954; if you have no connection to Georgia, please spread the word to others ASAP.

Here's the update (and news item clarification) that I received today from the organizers on the ground with Planned Parenthood Southeast:

Today, the Atlanta Journal Constitution covered the bill in an irresponsible piece of reporting and on the front page no less. Contrary to the story, last night the bill was not stripped and was not killed for the session. The bill is not based on sound science and seeks to intrude on the doctor-patient relationship of women facing some of the most difficult medical circumstances. 

Among other things, here's what's still wrong with HB 954:

• The bill is still unconstitutional. It still has only a narrow health exception and includes no exception for the mental health of the mother.
• The bill still requires the physician to use the method most likely to save the life of the unborn child even if that method causes health risks to the mother.
• The bill still includes no exception for rape or incest.

We know all too well that it isn't over until it's over when it comes to the General Assembly. Session ends on March 29, and we need to keep up the pressure to ensure that private medical decisions are left to a woman and her doctor.


Lawmakers need to look at how similar bills have impacted women in other state and understand that Georgia women deserve better. This bill is an example of the level of government intrusion that takes place in women's health care and we need to let our legislators know that we've had enough. Contact your senator now. Tell them you've had enough of their lack of concern for victims of rape or incest, their intrusion into how doctors practice medicine and their intrusion into women's lives.

UPDATE: Good news, but don't exhale yet! The bill appears to have died after revision by the Senate...because Republican House members refused to accept the addition of an exception for women with "medically futile" pregnancies (i.e. dead or dying fetuses). In other words, House members remain committed to a no-exceptions ban -- and there are 48 hours left in the session for them to try to revive one. A few years ago, this was more than enough time for them to pass a last-minute mandatory-ultrasound law right under everyone's noses. PLEASE stay on top of this until the session is officially over.

Limiting Abortion Care One Uninformed Law at a Time

I was looking through the news today for inspiration on my post, and I saw articles about states that are currently passing new limits on abortion. Iowa could approve the tightest restrictions in the country at 18 weeks. Alabama just passed a fetal pain bill that puts a limit at 20 weeks.

I'm amazed by those who make medical claims to gain support for these bills, as if they had actual medical training. They irresponsibly pass their opinions off as fact.

In the article I linked to by the Iowa Independent, they quoted the Executive Director of the Iowa Right to Life Committee as saying, "We’re not talking about abortion, we’re talking about infanticide. We’re talking about viable children who can live outside the womb." At 18 weeks?! There's a lot of debate over viability, but the likelihood of viability at 18 weeks (like of it even being biologically possible) isn't high. I am honestly surprised someone will go on record claiming that it is.

Then there's this gem from an Alabama state senator, Scott Beason: "It's clear that a baby at 20 weeks experiences pain. There's no doubt about that." It's clear, is it? Where is your data to back up the claim that a fetus experiences pain at 20 weeks? How is this man even qualified to make such a statement? Oh right, he isn't; he has a degree in Geology.

I'm tired of having to hear antis make these claims. They offer no proof to back any of it up. They don't have medical training, yet they get away with it because the uninformed will go along with it. When will our laws start being passed with facts to back them up?

Sunday Douchebaggery Interlude

Take a gander at this shit:

"The billboard depicts an Alamogordo businessman, [Greg] Fultz, 35, holding what appears to the outline of a baby in his arms as he is looking down at it. Next to the picture, in large print, is the statement, 'This Would Have Been A Picture Of My 2-month Old Baby If The Mother Had Decided To Not KILL Our Child!'"

Last week the woman targeted by this billboard brought suit against Mister Douchebag, on the grounds that he's violating her privacy and causing emotional distress. The judge ruled in her favor, ordering the billboard to be removed and granting the plaintiff an order of protection. Thank goodness.

Further gross details and aspects:

A) As Greg "Douchebag" Fultz admits in the rest of his letter, he is "not sure" that his ex actually had an abortion! He doesn't have proof so is guessing. The plaintiff says she miscarried.

B) Of course, whether or not she had an abortion remains HER business alone, anyhow! We don't need to explore her medical history to determine whether she did or did not "deserve" this.

C) Aside from the violation of privacy, to me this also sounded like a violation of the Freedom of Access to Clinic Entrances (FACE) Act, which prohibits intimidation to prevent people from receiving or providing reproductive health services. Unfortunately, it's not that straightforward; it turns out the language of the law forbids the use of "force, threat of force or physical obstruction" -- so, although I'd argue that this could constitute intimidation with a chilling effect on care-seeking ("If I have an abortion my manipulative douche of an ex may put up a billboard about me, like what happened to that woman in New Mexico"), a judge might not agree. But I still wonder about all the things that happen when women have good reason to fear stigma and public excoriation; one woman who survived the dangerous care at Kermit Gosnell's illegal practice (but not without lasting injury) said that she initially headed to Planned Parenthood but turned around when she saw the protesters.

D) Bonus grossness! Mr. Douchebag is 35; the plaintiff is 20. Twenty. Twenty years old! Jesus Christ, that adds a whole OTHER layer of slimy sleazy selfishness to this guy's actions. As though they didn't already sound enough like intimidation and punishment for not doing what he wanted, on top of that he's nearly twice her age and she's still at practically the beginning of her life, and HE's the one who feels robbed? Because he didn't have the right to decide how the rest of her young life was going to go?

Indeed he does feel robbed. In statements to newspapers and to the New Mexico legislature, he says:

"Women have all the power when it comes to pregnancy. The men get no say when a woman wants to go and have an abortion without the say of the father. I believe that is wrong because men are 50 percent of the result of the pregnancy."

and

"I'd like to get a bill created in honor of my baby (Baby Fultz) for all fathers. My idea is to get a bill introduced that gives biological fathers equal rights as to the welfare and decisions being made of the unborn child with exceptions to those of rape and incest and other means of illegal fatherhood."

Of course, the fact that a spermatozoon and an ovum contribute equal numbers of chromosomes doesn't really mean that "men are 50 percent of the result of the pregnancy." That's not how it works; I've never seen a male partner carrying and feeding a fetus for 4.5 months. Simpleton's math aside, I do honestly want to know, exactly what would he consider "equal rights" to a decision about abortion? If one partner (or ex-partner) decides in favor of ending the pregnancy and the other doesn't, what should happen? How do you make that a 50/50 decision?

EDIT: Further information highlights just how much this abortion-billboard stunt is part and parcel of Mr. Douchebag's manipulative, abusive strategy. The billboard reads "Created for N.A.N.I. (National Association of Needed Information"; turns out Nani is his target's first name. He abused his then-wife and has harassed and stalked her and other exes; he created a website named after his ex where he publicized her contact information; he published gross comments and "jokes" about extreme violence toward women and toward his ex in particular; he may or may not have been lying about always wanting a child, as there are allegedly court documents concerning his child-support deadbeatery. Can't say I'm shocked, as divulging private and socially-stigmatized information is a common weapon in the abuser's arsenal; but I sure as hell remain grossed out.

Sweet Tooth Sez Who?

Check out this REALITY-BASED pie chart of services offered by Planned Parenthood. Nom Nom (we're still hungry)

Conscience Clause

So I finished the book that I reviewed/ranted about a couple weeks ago. Learned a lot and I highly recommend. Makes you very angry about the state of pro-choice affairs, especially internationally. And though I really don't need another reason to hate antis even more, I found one thanks to Christina Page. I'm even shocked that I, in my infinite wisdom, hadn't though of it before.

Why can docs/pharmacists opt out of learning about abortion/performing life-saving abortion services/writing scripts for or dispensing contraceptives, but pro-choice professionals can't opt out of reading the slime to their patients that abortion takes the life of a "little, tiny" person that is a separate being independent of the woman carrying it?

Take a look at all the states that have so-called "conscience clauses", reserving the right of providers and pharmacists to refuse to do their jobs. Consider a doctor in, say, THE GREAT STATE OF SOUTH DAKOTA, where the conscience clause exists, plus doctors are required to read this tripe to patients before an abortion:

"Under the law, doctors must say that the woman has "an existing relationship" with the fetus that is protected by the U.S. Constitution and that "her existing constitutional rights with regards to that relationship will be terminated." Also, the doctor is required to say that "abortion increases the risk of suicide ideation and suicide."

Why can't that doctor refuse, based on his/her deeply-held scientific - or even religious - conviction, to speak to something that s/he does not believe? CAN THIS CASE NOT BE MADE?! WHY CAN'T WE TAKE THIS TO COURT?!

Legitimate questions, not just my own anger speaking. Why has this point not been brought up or acted on? (or am I just unaware?) It seems airtight to me, but then again I have common sense. THOUGHTS?!

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.

"Schooling Chris Smith" on abortion's role in the UN's Millennium Development Goals

Good evening! Just wanted to let you know that Kelly, the brilliant and gracious creator of Schooling Chris Smith, is hosting a cross-post of sorts by yours truly.

Before I get ahead of myself-- do you know who Rep. Chris Smith is? Well, number one, he's a douchebag, and number two under-informed and number three not very good at rhetoric; let's just say all that up-front before you read his op-eds and injure yourself trying to understand what the fuck he's going on about.

Number four, he's also a member of Congress (R-NJ4), and among other things he's the ranking member (second only to the chair) of the House Committee on Foreign Affairs's Subcommittee on Africa and Global Health. What does all that mean? Well, as Schooling Chris Smith puts it, it means he gets "to be seen as a strong proponent of human rights despite his complete opposition to full human rights for women." To continue quoting Kelly:

Back in September, the Washington Post published an op-ed by Chris Smith urging activists not to sidetrack the U.N. summit on global poverty by talking about abortion (which is kind of hilarious, considering this is one of the guys who sidetracks women veterans' health care into abortion politics). His op-ed obviously speaks for itself by claiming all abortions cause psychological damage for women and implying that human trafficking and child soldiering are caused by abortion (I have to admit, that's a new one for me).

Some letters were published in response to this piece, but one wasn't. [That's mine! -PS]

So, yeah, being ranking member of the House Committee on Foreign Affairs's Subcommittee on Africa and Global Health (takeanotherbreath) also means he gets to say things about global health and international development policy and have them published in newspapers. Even though he hasn't done his research, doesn't know his facts, and can't string together a logical argument. (Am I bitter that I do ALL these things but don't get published in the paper? Not at all!) The Post published a couple responses that (rightly) pointed out Smith [a] was dragging abortion into the conversation from out of nowhere and [b] had glaringly omitted mention of the life-saving importance of contraception. But those responses themselves completely omitted mention of the many errors and false claims Smith made about the role of abortion in saving lives.

Even though it's well past September now, the inauguration of Schooling Chris Smith got me thinking that I shouldn't let a good letter die unread. (If I do say so myself.) Without further chitchat, here it is:

Re: "Abortion does not further children's health," Chris Smith, op-ed 9/19

Rep. Chris Smith's op-ed was long on claims, but short on facts. Having engaged in research, education and service provision in the field of reproductive health, I am left wondering on what evidence Rep. Smith based his assertion that abortion harms children's and women's health (the focuses of the UN's Millennium Development Goals 4 and 5). His attempt to exclude abortion from MDG efforts, discarding established medical evidence in the process, is the real threat to the health of women and the children they already have.

The statement that abortion is "by definition, infant mortality" is silly, as all abortions are, "by definition," performed before birth, which precedes infancy. Terminology aside, Smith's concern for embryo survival leads him to overlook the actual women who die when safe abortion care is out of reach: some develop severe pregnancy complications; some have ectopic pregnancies; others drink bleach, insert sharp objects, or jump from tall heights in an attempt to end pregnancy themselves. Each year an estimated 50 million women worldwide obtain abortions, half under unsafe conditions; worse, the vast majority (95%) of those unsafe abortions take place in the developing world where treatment for complications is harder to obtain. As a result, around 70,000 women die each year due to unsafe abortion, and millions more suffer nonfatal injury and illness. Yet abortion performed by a trained provider in a sanitary setting is one of the safest medical procedures in existence -- much safer than carrying a pregnancy to full-term delivery, as a matter of fact! Contrary to Smith's insinuation, repeated and rigorous cohort studies demonstrate the error in claiming that properly-performed abortion causes physical or psychological complications.

Disregard for the value of human life, as Smith calls it, is made manifest in the poverty, illness, and avoidable death experienced by families who cannot afford another mouth to feed or who lose a caretaker to eclampsia, hemorrhage or sepsis. If safe abortion is struck from the agenda, then unsafe abortion will simply continue to kill women and orphan their children.


placenta sandwich, A.D.D., I.B.S.
Vice-President of Irritated Blogging and Letter-Writing
The Abortioneers
Credentials Out The Ass

(Actually, I gave them my real name and my real credentials-out-the-ass.)

There was so much more I had wanted to say, but brevity is the soul of getting published, I was told. (Am I bitter that I chopped a bunch out but didn't get published? Not at all!) Like I also wanted to say that there's empirical evidence at the family level that maternal morbidity and mortality (for example from unsafe abortion) results in greater child mortality. Not a shocker. And also that anyone who knows anything about health infrastructure can tell you that women in Chile and Ireland survive (mostly survive) their countries' abortion bans because they have access to doctors trained to treat complications of illegal/DIY abortion, not because they've stopped having abortions! Anyone who thinks an abortion ban would not increase mortality in a country with poor health infrastructure and lots of remote rural area -- like, say, Ethiopia or Zambia -- would surely not qualify to be on anyone's Subcommittee on Africa and Global Health, right?   Oh... wait. (Still not bitter!!)

I'll leave it there and ask you to head over to Schooling Chris Smith to discuss Kelly's question: What would your letter in response look like? What else has been left out?

Media Monday! "Abortion Democracy," the documentary

A few weeks ago I met a German woman named Sarah Diehl, who's in the US doing a screening tour for her documentary, "Abortion Democracy: Poland / South Africa." I saw a short preview of the film and have been looking forward to seeing it ever since.

Poland is one of the few countries in Europe that has criminalized abortion in almost all cases -- and this isn't an ancient law, either, but one passed in 1994. I remember a few years ago reading about a Polish woman who sued the government in the European Court of Human Rights after being denied an abortion that would have saved her deteriorating eyesight. Alicja Tysiac is functionally blind as a result of this denial; the court found that the Polish law did not even uphold the narrow exceptions it claimed to make for cases where a woman's health was endangered by pregnancy, the government had failed by the standards of its own law and  Tysiac's human rights had been violated. The court awarded her compensation, but of course that won't restore her sight. The story both outraged and terrified me: abortion policies aren't an abstraction limited to proving ideological points -- they are terribly, viscerally real for the women whose decision-making they vitiate.

South Africa, on the other hand, is one of the few countries in Africa that has legalized elective abortion. The law was changed in 1996 to allow abortion "on demand" in the first trimester and abortion on certain legal, medical or socioeconomic grounds in weeks 13-20. (Quick fact: "on demand" means that women are not required to stand before a judge, panel of doctors, or other jury who will approve or reject their 'case' for an abortion.) Yet legally-qualifying abortions are still quite difficult to obtain for many South African women, especially in the second trimester. In fact, "Abortion Democracy" suggests that it may be "easier to obtain an illegal abortion in Poland than it is to obtain a legal abortion in South Africa." In this sense, national policies are not the only thing that determines the nature of on-the-ground access, not by a long shot.

I'll be watching the movie tonight, so I'll be back with an update on how it was. In the meantime, I hope this trailer gets you as intrigued as I am.

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. 

Restricting Abortion

I am so tired of the many abortion restrictions happening throughout the country right now. New ultrasound laws, parental notification/consent laws - all these do is hurt women who have already experienced a lot of pain. They don't stop someone who really wants an abortion from getting one. They just cause her to go through more trauma.

By now you all may have already heard the story of a 13-year old from Pennsylvania who tried to self abort with a pencil. This girl, impregnated by her 30-year old boyfriend chose to risk her life in order to end her pregnancy. Why did she do this to herself? Pennsylvania has a parental consent law. In order for this girl to have had a safe abortion, she would have had to get the consent of one of her legal guardians. Why wouldn't she talk to her parents? Well, she's 13 and was having a relationship with a 30-year old. Now, of course I don't condone the relationship those two had, and who knows what kind of control this man had this girl under. The fact is, she was afraid of being found out, so she inserted a pencil into her vagina, hoping to give herself an abortion, and ended up miscarrying. Why are these laws continuing to be created? Why do people think these laws are a good idea? This story shows that if someone wants an abortion, they will find a way do it and possibly hurt or kill themselves in the process. It makes me angry.

Some light in this bleak scene can come from unlikely sources. In Florida, Governor Crist appears likely to veto a law that would require all women seeking an abortion in the state of Florida to get an ultrasound. He made the following statement to the Pensacola News Journal.

"I have concerns about it," he said. "The notion that there would be a forced ultrasound, if you will, that would have to be paid for by the woman involved — you know, those are the things that seem to be pretty difficult for a woman already in a difficult situation."

Wow. I am amazed to hear a politician say this, and a Republican at that. Could there be hope?

case report

On my ob/gyn rotation, a 30 year old woman presented to our clinic with diffuse abdominal pain for 6 weeks. She noticed increase girth in her abdomen for the past month and had increased satiety. Additionally, she also noticed a 10 pound weight loss in the past 4 weeks.

Her lab results returned with an increased white blood cell count (noting inflammation) and an elevated CA-125 (a non-specific marker for ovarian cancer). On ultrasound, we saw an enlarged right ovary with a solid mass. After discussing options with the patient, we recommended doing a biopsy of her right ovary. The next week, the biopsy came back positive for ovarian cancer.

After a long discussion as a team, we decided to tell the patient that everything came back normal with her biopsy and it was a benign mass. We would then convince her to get pregnant as soon as possible by convincing her that this mass could possibly cause fertility issues in the near future. We feared if we told her the true results, she might opt for a hysterectomy -- wasting a perfectly good opportunity to bring a child into this world. Although we only knew this patient for a couple of weeks, we thought it best to make a decision for her by not telling her the results of the biopsy. Clearly, as physicians, we know what was best for this patient and her life. And, if she followed our advice by getting pregnant, she could die in her mid-30s from ovarian cancer knowing that she served her ultimate purpose as a woman. And we could all sleep better at night.

ARE YOU KIDDING ME???? As if you couldn't figure it out, this is a completely made up story. However, piggy backing off of Mr. Banana Grabber's post on Friday, not completely different from what Oklahoma is doing with this insane law.

As a future physician and ob/gyn, I cannot imagine looking my patient in the face knowing that something was seriously wrong with her baby, and telling her everything is perfectly fine. It's sick. And any doctor who knowingly does that should lose their license and never be able to practice again. Women and men on all sides of the debate should be outraged. Even if you are rabidly pro-life, you should be extremely offended that a doctor could make a decision for you and not tell you crucial information that you would need in order to prepare for the birth of a special-needs child. Even Sarah Palin should be outraged, as the mother of a baby with Down syndrome.

Imagine if the daughter of one of those moronic legislators delivered a severely deformed baby, thinking the whole time it was perfectly healthy because the doctor said it was...there would be hell to pay.

Abortion Abroad: Part 2

I visited a semi-rural reproductive health clinic in Kenya. Impressive! My org has done a great job recruiting talented clinic staff and outreach counselors to give women accurate information (save for one glaring translation typo!) and quality services that I myself have utilized. They even have a system for providing affordable services to women who would otherwise not be able to afford prenatal care or birth control. I donated anyway; do you know how far a measly few dollars goes??

I sat and discussed patient issues with the provider at one clinic: how many IUD insertions he completes in one month (a lot); how many women have them removed (none); how many women/babies had been lost during delivery (only one woman, due to a surprise post-partum hemmorhage). Naturally, I asked - knowing the answer in advance - if he had ever performed an abortion. He had not. But he had seen a handful of women who had sustained injuries or illnesses from clandestine abortions. Every village has its man or woman who has abortion secrets and serves dozens of women in the community. Injuries happen frequently, he explained, though few women present for treatment because they are a) afraid of being punished, or b) dead already. These village practitioners use herbs, potions, sharp objects, the usual. Of course, we in the "developed world" know how dangerous these methods are (right?), but by the time a woman actually presents for treatment from such complications her condition is more dire than this comprehensive, yet limited, clinic can accommodate. The provider sends those cases to the area hospital, many kilometers away from his clinic, down a dirt road with a heavily worn surface that makes for a very uncomfortable, perhaps deadly, ride. The provider was excited, though, about the advent of MVA in the developing world. He had never performed an abortion, nor had he been trained in the technique, but he was optimistic that rural women would be able to receive safe abortion care (where permitted) in low-tech environments without issue. However, he lamented, MVA can only do so much for botched procedures and life-endangering cases. Alas.

Kenya passed its new constitution within the last week, including some controversial language about abortion. This was the subject of debate for months, rife with anti-abortion rhetoric and TV infomercials akin to clinic-protesting signs (yuck). And I just hope that clinic providers like my guy above can band together to, at the very least, uphold the life endangerment clause. I have my doubts however; a female doctor in one of those anti commercials described, in her "medical opinion", that abortion is a "senseless death". I guess having a new perspective helps me appreciate the way things are in the Nifty Fifty.

It's a long road ahead, for all of us.

Does A Parent Have a Right to Know?

I know this has been talked about on this blog before and probably done better, but please humor me.

Those of us that work in the abortion field, and probably many that don't, know that a minor's ability to get an abortion can be a tricky thing. Depending on the state the minor lives in or is going to for their abortion, they may or may not need to have their parents notified or get consent for their abortion.

In 34 states parental involvement in a minor's abortion is required - 20 require parental consent, 10 require parental notification, and 4 require both. There are exceptions to these including a judicial bypass, medical emergency, and 6 states allow a grandparent or other adult relative to be involved instead. For those that might not know a judicial bypass is a process where a minor goes before a judge and that judge decides whether that minor can make the decision without parental involvement. (Stats from the Guttmacher Institute)

What set me off on this is the recent issue of the parental notification law in Illinois. I will try to explain this as clearly as I can. Illinois has a 15 year-old parental notification law that wasn't being enforced, but in November the Illinois Medical Disciplinary Board decided to change that. A temporary restraining order was immediately issued - filed by the ACLU of IL. After what to me is a confusing series of grace periods and restraining orders, the law is still not going to be immediately enforced, but the initial restraining order has been lifted. Currently there is a 60-day grace period in effect while appeals are pending.

Do parents really have a right to know? What is it about being a parent that allows you to control every move and decision your child makes? It's not like abortion is illegal (I don't want to hear the argument about if the parent being held responsible if a minor engages in illegal activity - which I don't think is necessarily true). Aren't teens people? I know they're not legal adults, and many if not most or all of them have growing up to do. But why can't they at least have autonomy over their body? Why do parents get to control that? Isn't that weird or wrong to anyone? I know I'm preaching to the choir here, but I really don't understand. The pregnant girl/woman is ultimately the person who has to live with the decision that is made, so why can't she make it without interference?

Health Scare

So. About that health reform.

Can I admit that I stopped following it months ago? Can I admit that, more than frustrating, I find the debates on health care utterly uninteresting? I simply can't pay attention. It's like arguing with a parrot who can only respond in one of three wise cracks, only far less amusing. We Abortioneers go through this time and again. You come at them with the knowledge, they retort with the yakety yak. YAWN.

That said, I proceed with my confession to admit that when the bill was signed, I had no idea what was in it. I Google it on occasion to see if anything interesting pops up, but what I've learned amounts to "Obama rules" and "It's better than nothing". What I do know, however, without having to watch CSPAN or read regurgitated AP articles, is that anti-abortion congresspeople just won't let up. What's the deal with this executive order? What does an executive order even mean? I had to ask my politically savvy BF, who informed me that it means dick and does not hold water in many cases. It sound to me like the antis calling for blood where it is not warranted or necessary. So what does this E.O. actually mean for abortion? Probably nothing, right? The Hyde amendment is still firmly in place (God bless it), and Lady Abortion is still dangling by a thread. I guess this just reaffirms what I already knew: our country sucks and always will.

As a self-proclaimed ignoramus on this issue, please enlighten me. But what I figure is we're sticking to the status quo and fighting in the trenches as per usual. I'm happy to do that, but at this point making myself angry by indulging anti banter is just not the way. Discuss, dear Abortioneers!