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? 

The Case of the Minor

I would like to piggy back off of Revolutionary Vagina's last post about the young girl who self-induced an abortion using a lead pencil. An article about this was posted on lifenews.com, and contains several false and just plain ridiculous claims.

I am sure this story probably has most people wanting to vomit and cry at the same time as their hearts break for this little girl. I would also guess however that many of those same people would not even bat an eye if her method of killing her child had been a RU 486 prescription from the local Planned Parenthood. -Bryan Kemper, head of Stand True, a pro-life group

First of all, you cannot get the pill from Planned Parenthood to induce abortion after about 9 weeks. From the article, it sounds as if she was much much further along, but who really knows. If she was "delivering a baby," I would guess she had to been late second trimester. If she was that far along, wouldn't her parents have noticed? If she was in her first trimester, she wouldn't have delievered a "baby." She would have bled a lot. Kemper makes it sound like you can just take the pill at 25 weeks and boom you're done. Totally not the case.

Secondly, if this young woman would have been able to go to Planned Parenthood to get her abortion pill prescription, she would have had an interview with a counselor. Obviously, we cannot know if she would have told the truth to the counselor or not, but it would definitely have been in her best interest to talk to an adult about having an abortion before trying to perform one on herself. Thus it probably would have been GOOD for her to go to Planned Parenthood.

It is also a very different thing to perform an abortion on yourself and then have your creepy older boyfriend bury the fetus in a ditch. That is just not normal. That is very sad, scary, and bizarre. Having an abortion in an abortion clinic is normal. It is safe. It is not dangerous. The risk of even minor complications is very, very low when an abortion is performed in a safe, sterile environment with trained medical professionals, like at a Planned Parenthood. So, yes, I would not bat an eye at that. If that makes me a monster, then you have a fucked up definition of what it means to be a monster.

Kemper also said, "I can also hear the spin now, 'this is why we need safe and legal abortion,' -- even though abortions are already legal and are supposed to prevent such self-induced abortions." This goes back to precisely what Revolutionary Vagina was talking about. Pennsylvania has parental consent laws. She obviously did not want to tell her parents. How come none of the anti-choicers want to talk about that? If she was able to go to a clinic she wouldn't have been in this situation. THAT is the problem. Further, she is thirteen years old. She is child. I can say at thirteen I was in no shape to be having sex, and definitely not sex with someone SEVENTEEN years older than me. Can we take a step back and ask, why was this thirteen year old doing this? Her boyfriend/partner/creeper said he had sex with her "hundreds" of times. How did this happen? It troubles me this happened so many times yet nobody seemed to be aware. Of course, teens can be very sneaky and do a good job hiding things from their parents, but she is thirteen! I find it hard to believe a thirteen year old could sucessfully pull that off unless she is some sort of smooth talking magical pixie with a unicorn.

My favorite quote of the article is "'If the girl had gone to Planned Parenthood he would probably still be raping her as I doubt they would have turned him in," Kemper explained."

It is true there are cases where Planned Parenthood staffers did not appropriately follow state rules and turn in a man who was engaging in an inappropriate relationship a minor. I think that is terrible. It is beyond messed up. I would prefer if everyone followed the rules about that. I do think that each staffer was trying to act in the best interest of the minor, even if the staffer might not have been in reality. Either way, it is ridiculous to assume that all Planned Parenthoods everywhere just let minors get raped all the time like it's no big deal, because that is definitely NOT the case. I have worked with plenty of clinics that have bent over backwards to get guys arrested who were doing that kind of stuff. Planned Parenthoods and clinics, for the vast majority of cases, DO follow the rules. And rapists get caught. Which is a good thing because they might otherwise have not.

How come anti-choicers don't want to talk about how clinics often get bad guys in trouble. Or that this girl, who could have died, and just went through something terribly traumatic, didn't have to go through that. She could have just had a regular, safe abortion. It wouldn't have been the horrifying experience of shoving a pencil into your own uterus and then becoming violently ill and having to have your boyfriend who is not a doctor deliver your dead baby for you and then take it and bury it in a ditch. The fact she had to go through that is so fucked up. If she had access to a clinic, she would have been able to have an abortion with a doctor who knows what he/she is doing and with counselors who are trained to talk to her about her decision. A fucking sad state of affairs. Perfect example of what parental consent laws are dangerous.

Also -- if anyone stumbled upon this page by googling the story of the girl who used the pencil, and is thinking of using a pencil or anything to self abort. PLEASE DO NOT DO IT. Self aborting is very dangerous and often leads to at minimum serious complications and even death. If you have questions about where to go please see the National Abortion Federation's list of clinics or contact your local Planned Parenthood for a place in your area.

Ways To Get Screwed By A Pentagon, Henry Hyde, World Wars, and Other Violent Artifacts of the Twentieth Century

[As a promised follow-up to this post.]

I'm visiting home this week and won't be back for months, and I can't safely stay pregnant in Afghanistan much longer. Can you see me before Sunday?

They'll ground me if they find out I'm pregnant, but the Air Force is my last chance out of the dead-end town I'm graduating from. How early in my pregnancy can I have an abortion?

My fiance just left for a second tour, and I can't imagine going through this without him. Where can I find an abortion provider and someone to talk to?
(OR: My fiance was just killed while serving, and I can't imagine going through this without him. Where can I find an abortion provider and someone to talk to?)
(OR: My fiance was just killed while serving, and I can't imagine not having his child in five/six/seven months. Where can I find prenatal care and someone to talk to?)

I'm an Army brat -- we travel around with my mom a lot -- so I don't know this town too well or have a lot of friends I could ask for help. Where's the closest abortion clinic, and will it be OK if I ride the bus there?

We're on my husband's TriCare plan, but they're denying coverage for my abortion even though the pregnancy is shutting down my kidneys. Is there anyone out there that helps with this sort of thing?


(I sure hope so, five or six weeks from the start of your last normal period, here, here, here, you'll probably need a friend to drive you home and may need to check out parental consent laws in your state, and yes thank god but they need our help.)


"Back to the status quo" update in the last two weeks: Military higher-up to reverse official policy punishing pregnancy. OK, now how about you combat that parallel de-facto punishment system too? Reproductive justice in tiny, endless shuffles...

Gate Keeping Freedom

She called me with tears in her voice, the bruises on her face had only begun to swell.

She told her boyfriend she was going to have an abortion and he beat her up and took the money that she worked so hard to raise.

I thought I was talking to a grown woman, someone with kids, and years of life experience. Her voice was tired and sad. Her words were muffled, maybe because her mouth was swollen.

I asked her if she was somewhere safe now and she said, “Yes, my mom is on her way to get me.” I looked at the paperwork in front of me and realized she is 16.

I tried to carefully word my answer as she pleaded with me to help her with enough money to keep her appointment today. I promised I would do my best to help her raise the money and I wish I could make it free but I can only help with a small part of the cost.

She said, I can’t have this man’s baby, he is abusive. I agreed and assured her she would not have to. Except I can’t promise that because she will have to come up with more money on her own to get the abortion. I couldn’t say anything else though I wanted her to know that I would do anything in my power to help her get seen.

I gate-keep a fund with little room for exceptions even when a 16 year old’s boyfriend beats her up and takes her money. I am a gate-keeper because I make decisions day in and day out that grant or withhold resources from people who need them. In this case I provide assistance to women who need abortion health care and need money to access that healthcare, often that assistance and the decisions I am expected to make each day are managed within strict institutional limitations. I would love to make this young woman's procedure completely free, or help her get the procedure with whatever money her mom actually had in her pocketbook. However, I work with an organization that boxes my power in with guidelines, policies, and procedures. I work within a screwed up medical system to help people access basic health care. Sometimes I feel powerless, because I can’t help everyone and I can’t change the fact that getting an abortion often means creating money out of thin air. I can't change the fact that I gate-keep money without controlling the limitations of that money.

She was crying; her mom pulled up and she asked me to talk to her mom. I got on the phone and her mom immediately began to rehash the story her daughter had probably just called and told her. She said, I’m broke and I gave her $150 of what he stole, I might be able to scrape together another $100. Her mom was appalled that I could not help with more money. I was equally appalled at my inability to help. After a short back and forth of ideas about how to come up with money, in a rage her mom said, “so really you're just not going to help, I mean my child has just been robbed.” I told her I could try and help her locate other funds or talk to the clinic but I could not cover the money that was stolen, and then her mom got off the phone with me in a fury saying she would do what she had to do.

I could maybe get a small exception for this patient but regardless this young woman will now have to scrape together a lot more than change to get seen. She is creeping on the 12 week mark so she’s not working with a lot of time. I got off the phone and wanted to cry, I wanted to go home sick, or scream, or maybe have a cigarette even though I don’t smoke. I still want to cry.

The only thing keeping me from losing it, is that actually this isn’t the saddest story I’ve ever heard because her mom is going to do what she has to do, and this patient will have her abortion. They may go without lights or run out of grocery money but the determination in her mother’s voice verified the fact that this patient will get seen. So often the woman calling me with a swollen lip so big she can’t hardly speak, doesn’t have a mom who will do what they have to do.

I know that to do this kind of work I need to be able to leave the experience at work. Otherwise, we who believe in freedom will be burnt out and turned into ashes, who can’t help anyone, not even ourselves. The thing is so much of the experience is so personal. The women in my personal life know what I do and I get calls from my friends and extended network at work and outside of work. Women in my personal life that need information, money, abortions, and a sisterfriend to help walk them through the 400 steps to maintaining their sexual health. I am that friend to a lot of people and I love it. It makes it really difficult to leave work at work. I try to remember that at the end of the day I have done what I can to help the countless women calling me for information, money, a listening ear, or a friend.