Category: Reproductive rights

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Ahead for women: good news & bad

by Fran Johns

The years ahead could be not good times to be a woman.

Childcare support? Abortion access? Equal pay? Contraception coverage?

How we will fare in the years ahead — those of us who are females of the species — is an open question; and some of the answers being bandied about are not pretty.

Paul Ryan’s budget would repeal benefits and protections currently enjoyed by millions of women, forcing us to pay out-of-pocket for potentially life-saving things like mammograms and cervical cancer screenings. Cuts in food stamps would hit women disproportionately, cuts in Medicaid would have a similar impact: women make up 70 percent of Medicaid’s adult beneficiaries. Prescription drug costs? Up, thanks to the re-opened Medicare drug coverage gap, the late and un-lamented donut hole. The list goes on, almost as glaringly as the list of benefits to the super-rich goes up. There are not a lot of women, especially single head-of-household wage earners, among the super-rich.

At a recent Planned Parenthood Shasta Pacific (CA) gala, former Michigan Governor and Current TV host Jennifer Granholm ticked off these and other ways GOP policies take from women and give to the super-rich. But Granholm, in a conversation with CA Attorney General Kamala Harris moderated by San Francisco Chronicle columnist Carla Marinucci, framed the opposing political policies as overall good news. With the GOP’s social and economic attacks on women in such sharp focus, she said, they can be seen for what they are — and defeated.

One can hope.

There are plenty of smart, honorable registered women Republicans. Whether they will worry about senior women having to pay more for drugs, or low-income women losing health benefits, or all women continuing to have to work three months more per year just to make what men make, that’s one of the questions still open. Reproductive justice? All women lose when reproductive rights diminish.

But at another meeting last week the focus was on distaff good news. The National Abortion Federation held its annual meeting, complete with continuing medical education for physicians, nurses and all those who will enable the progress and preservation of reproductive rights in the years ahead. This writer was fortunate to be invited to the Membership and Awards Luncheon, surrounded by extraordinary men and women including several award winners I am privileged to call friends. NAF President and CEO Vicki Saporta was among the speakers, and her report was one of optimism. My own optimism about the future for women in the US.is centered in three of the award winners whom I quite fortunately happen to know. They include:

Maggie Crosby, Senior Staff Attorney with the ACLU of Northern California, honored for her decades-long fight for reproductive justice — or, more accurately, her repeatedly successful fights for reproductive justice wherever it was about to be compromised.

Beverly Whipple, an extraordinary woman whose story — at least some small snippet of it — is included in Perilous Times. Whipple was leaving immediately after the NAF meeting for an extended motorcycle trip around Europe with her partner, but they slowed down long enough for a table-full of us to celebrate at the awards luncheon. More on Beverly Whipple in a few days.

Sarp Aksel, Past president of Medical Students for Choice and current Executive Clinic Chair of the ECHO Free Clinic at Albert Einstein College of Medicine in New York City. For those of us in despair about the future of abortion rights, Sarp Aksel is the face of hope. Bright, highly skilled and highly trained, and totally committed to women’s health and autonomy, Aksel is representative of the men and women determined to protect women’s reproductive rights.

Those who would take away women’s right to choose or ability to earn might well make gains for the super-rich in the near future. But they will have to contend with people like Saporta, Granholm, Crosby, Aksel and a host of other fighters for justice… including most of the women of America.

Abortion/courts/Health/Healthcare/Reproductive rights/Women
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In the Abortion Wars: A Judge Speaks of Women’s Rights, Women’s Needs

by Fran Johns

This article first appeared on Huffington Post

U.S. District Judge Myron Thompson, in his recent ruling that Alabama’s abortion law must go to trial, raises the interesting issue of an “undue burden” on pregnant women.

Imagine that. Bringing the focus around to women.

In the frenzy to ban abortion anywhere, anytime that’s currently going on across the U.S., it is all about the fetus. Opponents of choice and sponsors of restrictive laws often frame their measures as “protective of women,” as if wider hallways, more parking spaces or the host of line items proven to be medically inappropriate were aimed at anything but preventing women from having abortions. Once fertilization happens, the zygote takes precedence.

It’s heartening, therefore, to have a judge speak about the person who is solely able to know the full circumstances: the woman.

The specific issue in Alabama – as with states including Texas where it’s being used to force clinic closures – has to do with requiring doctors to have hospital admitting privileges. There is extensive evidence that admitting privileges are unnecessary. An in-depth article by Imani Gandy of RH Reality Check titled “Why Admitting Privileges Laws Have No Medical Benefit” covered some of that evidence: only a tiny fraction (less than 0.3%) of women experiencing complication from abortion require hospitalization; the risk of death from childbirth is 14 times that of abortion; should something go wrong with an abortion, the ambulance EMT can make the appropriate choice of hospital.

Other laws, such as those restricting medical abortion or many citing physical details of abortion facilities, are cloaked in “protecting women” language. They do exactly the opposite.

Abortion opponents cheer passage of these laws for one reason: they create more roadblocks to abortion. Thus, opponents reason, more women will be denied access, forcing them to bring unwanted pregnancies to term. It is hard to find any good news for women here.

But Judge Thompson said, in an 86-page opinion, that the Alabama trial will focus on whether the law violates women’s constitutional rights by imposing “a substantial obstacle,” possibly placing an “undue burden” on women seeking an abortion. Since abortion clinics more often than not use traveling physicians, the law could result in closure of all but two of Alabama’s five facilities. Alabama has a total land area of 52,419 square miles. It’s hard to believe there would not be an undue burden on countless women required to travel very long distances to exercise their constitutional right to an abortion.

Not all judges seem overly concerned with women. In letting the Texas admitting privileges law stand, Judge Edith H. Jones of the extremely conservative Fifth Circuit Court of Appeals located in New Orleans said she did not believe that driving 300 miles round trip would pose a serious obstacle to Texas women seeking abortions. Judge Jones spoke of good highways and 75 mph speed limits as if the impoverished women of the Rio Grande Valley all had Cadillacs at their disposal.

And more recently, District Court Judge David C. Bury let stand an Arizona law restricting the use of the drug mifepristone to the first seven weeks, despite extensive evidence that it can be safely taken outside doctors’ offices through the ninth week of pregnancy. What this means is that countless Arizona women, unable to have the safer, preferable medical procedure, will be forced to have more expensive and complex surgical abortions… and to travel hundreds of miles, twice to comply with the regulations. But this does not concern Judge Bury. None of that, he wrote, qualifies “as irreparable harm.”

For now, Judge Thompson’s words offer some solace, whether or not his decision ultimately goes in favor of the women of Alabama.

“If the court finds that the statute was motivated by a purpose of protecting fetal life, then the statute had the unconstitutional purpose of creating a substantial obstacle,” Thompson wrote in his opinion. “Evidence establishing that the legislature passed a statute with the purpose of closing down the clinic would suffice to establish a constitutional violation.”

Abortion/contraception/courts/Family and Friends/General interest/Healthcare/Medicine/Religion/Reproductive rights/teens/Women
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Wanted children, planned families… Why not?

by Fran Johns

This article first appeared on Huffington Post

The wanted child, the planned family. Can anybody argue that the wanted child and the planned family are not infinitely better off for everyone: child, family and society in general?

So why are we fighting these battles?

The Supreme Court, for example, is taking up the question of whether Hobby Lobby — which presumably prefers unwanted children and unplanned families — can refuse to provide contraceptive insurance for its employees because doing so would somehow offend (the Religious Freedom Restoration Act uses the word “burden”) the religion of its corporate soul. Assuming corporations have a soul, which may or may not be true for Hobby Lobby — this is subject to individual opinion. The RFRA is, of course, also about people, but the Court has already hopelessly blurred the line between people and corporations.

This writer is not a Supreme Court judge, which most U.S. citizens would deem a good thing. But can we think this through? Hobby Lobby goes to a church that thinks sex should occur strictly for purposes of procreation, and conception should therefore never be prohibited. Never mind any Hobby Lobbyists who may have planned their own families; Hobby Lobby still finds it offensive that he should be required to help an employee plan his or her own family. Excuse me?

In particular, Hobby Lobby does not want poor people to plan their families. People of means (and Hobby Lobby is definitely a corporate person of means) have plenty of access to contraceptives enabling them to plan their families. Poor people could use a little help. According to a report recently completed by the Guttmacher Institute (full disclosure, this writer supports the Guttmacher Institute; Hobby Lobby does not), almost nine million disadvantaged women every year get help protecting their health and planning their families through the successful U.S. family planning effort. This effort — which includes funding for contraceptives — substantially reduces the rates of unintended pregnancy. In the process it saves us taxpayers some $10 billion per year.

Some of the details of the Guttmacher report, excerpted below, are worth noting:

• Nearly nine million women receive publicly funded family planning services each year. Three-quarters of these women (6.7 million) received this care from safety-net health centers and about 2.2 million from private physicians. Of these nine million women, 4.7 million obtained care from a health center that receives some funding through Title X.

• Publicly supported contraceptive care enables women to avoid 2.2 million unintended pregnancies each year; absent these services, U.S. rates of unintended pregnancy, unplanned birth and abortion would be two-thirds higher than they are.

• Underscoring the critical role these safety-net providers play in women’s lives, six in 10 women receiving contraceptive care at a health center consider that provider their usual source of care. For four in 10 women who visit a reproductive health-focused health center despite having other options, that provider is their only source of medical care throughout the year.

• Every public dollar invested in helping women avoid pregnancies they did not want to have saves $5.68 in Medicaid expenditures that otherwise would have gone to pregnancy-related care; in 2010, that amounted to a net government savings of $10.5 billion. Safety-net providers that receive some funding from Title X accounted for $5.3 billion of those net public savings.

Dollars saved, wanted children, planned families, individual rights and everything else aside, Hobby Lobby insists that provision of contraceptive coverage infringes upon its religious rights.

It is encouraging to note, though, that 47 religious organizations, through their leaders, have weighed in on the side of wanted children and planned families. They are Christians, Muslims, Jews, and others.

This Presbyterian is proud to join them.

Abortion/compassion and choices/courts/Death and Dying/End-of-Life/Health/Healthcare/Reproductive rights/seniors/Women
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Laboratories of the States: The good… and then, the very bad and ugly

by Fran Johns

This essay first appeared on Huffington Post

Will a few states rule the United States? Or fundamentally change it? And if so, who are the winners and losers? Depending on your point of view, this “laboratory-of-the-states” business is good news today… or not.

The metaphor dates to the dissenting opinion of Supreme Court Justice Louis Brandeis in a 1932 case, New State Ice Company v. Liebmann and is often used today to assert the success of one social program or another. The best most recent — and decidedly successful — laboratory-of-the-state demonstration is Oregon’s Death with Dignity law. This writer’s extraordinary attorney friend Kathryn Tucker published a paper in the 2008 Michigan Law Review, when she was Director of Legal Affairs for Compassion & Choices, titled “In the Laboratory of the States.” Tucker wrote, “Because Oregon’s Death with Dignity Act has proven both useful and harmless, this Article concludes that it is time for other states to follow Oregon’s lead and enact their own legislation to allow their citizens an alternative to what otherwise could be a prolonged and painful death from terminal illness.”

Tucker deserves much of the credit for expanding the Oregon law into the movement that now seems a clear national trend, along with Compassion & Choices (full disclosure: this writer has long been a C&C supporter, volunteer and local board member). Washington and Vermont have passed similar bills and Montana wisely concluded that it’s none of the state’s business what a doctor and patient decide to do, making physician aid in dying now legal in those states. A handful of other states have pending bills and still others are mounting strong movements. So Oregon’s laboratory of success is likely to be the nation’s overall policy in the foreseeable future, and we’re all better off for that. (Opposition has come from religious and political forces that hold onto a belief that God requires some sort of existential suffering be visited upon Her dying creatures.)

The laboratory-of-the-states pathway is both effective and well trodden, said San Jose State Professor/author Larry Gerston at a recent Commonwealth Club political panel event. The panel was looking at other current trends, but Gerston specifically cited the Oregon Death with Dignity model as an example of how it all works.

Now — what if Texas becomes a laboratory for the denial of reproductive rights?

In Texas, just for a rough overview, recent laws have passed requiring parental notification and now parental consent; requiring abortions to be performed in ambulatory surgical centers with hospital-grade operating rooms; requiring women who seek abortions to submit to ultrasounds and then wait 24 hours for the procedure. The list of harsh, medically unnecessary restrictions and requirements is long, and a clear violation of both ‘best medical practice’ and women’s rights.

It is worth noting who are the winners and losers in these state laboratories. In Oregon, the winners are we the people everywhere. Few of us would turn down the right to a humane and compassionate death, which is made a possible choice by death-with-dignity laws. Losers? No one. No one is compelled to choose a hastened death, anywhere, any time.

In Texas, however, the scorecard is seriously skewed. The winners are archconservatives that have learned that this is a good way to get votes. Winners also include those, men and women alike, whose religion teaches that life begins at conception and thus all abortion is wrong. This writer can appreciate those who hold such views, but it is not possible to uphold the rights of a fetus without denying the right of the woman in whose body it resides. Many of us come down on the side of already-alive women and on the doctrine of church/state separation.

And the losers in Texas: women. All women. Primarily they are women without money or resources, who are frequently disadvantaged and disproportionately women of color. These women are already turning to desperate measures to end unwanted pregnancies; increasingly they are turning up in emergency rooms with failed attempts to self-abort. To a lesser degree, but still worth considering, the losers include those — men, women, boys, girls — who need the other services provided by rapidly closing clinics: birth control, sex education, STD testing, breast cancer screening and many other critically important needs that will now go unmet.

It’s hard to contemplate the win-lose picture of this Texas laboratory. But if it indeed becomes a laboratory-of-the-states argument in upcoming Supreme Court cases, and elsewhere, the losers will be all of us. You and me. We the people.

Abortion/Health/Healthcare/Reproductive rights/Women
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The (Abortion Docs) Holiday that Wasn’t

by Fran Johns

This post first appeared on Truthout.com as a SpeakOut essay

With abortion providers and abortion rights fast disappearing, it is particularly regrettable that the National Day of Appreciation for Abortion Providers came and went on March 10 with little fanfare. It was well worth celebrating and its passage is worth noting.

The day did indeed get some good coverage, including at least one excellent blog post noting the degree of vilification and abuse that providers suffer today. And it raised the hackles of a few on the right fringe: a blogger on Free Republic, for example, called it “the most disturbing holiday of the year,” – tossing in the opinion that abortion providers are “people who make lucrative piles of money for tearing babies apart.”

Not exactly. Abortion providers, many of whom work hard to keep services available to the mostly poor and voiceless women who are victims of today’s fringe politics, would be surprised to hear themselves described as making “lucrative piles of money.” What they do is in fact poorly compensated in dollars but richly rewarded by the gratitude of women who seek their services.

A National Year of Appreciation for Abortion Providers – while their ability to provide this fundamental women’s healthcare need remains – would be appropriate.

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Celebrating abortion providers

by Fran Johns

This essay first appeared on Huffington Post

You’d think, what with the incessant campaigns to hobble, harass and vilify them, that abortion providers would be somewhere right up there with ax murderers, and at least lying low under the radar. But you would be wrong.

The National Day of Appreciation for Abortion Providers is at hand. It is officially celebrated on March 10 by Planned Parenthood, NARAL Pro-Choice, assorted other reproductive rights organizations and every woman whose life has been honored and restored following the decision to have an abortion. The day comes exactly 21 years after the murder of Dr. David Gunn at his clinic in Pensacola, Florida, a tragedy that was followed by the killings of Dr. John Britton and clinic escort James Barrett in 1994, Dr. Barnett Slepian in 1998 and Dr. George Tiller in 2009.

The irony of such losses is that abortion providers – who still face serious risks – save the lives of countless women every day. Is a day of appreciation enough? One day, in return for all the millions of days of life returned to millions of women? I vote for celebrating at least throughout the month of March.

My own abortion, a back-alley experience following a 1956 workplace rape, was emblematic of a time when there were no such people to honor. Luckily, I got my life back. No one will ever know how many women did not, how many were left maimed or dead because they had no safe, legal option. Since 1973, thanks to passage of Roe v Wade (but no thanks to those who are trying to send us back to the dark ages) they have had trained professionals motivated by compassion – and stories of women like me.

Early on there were individuals like Dr. Harry S. Jonas, now retired after long years of medical practice, teaching, and advocacy for family planning. Jonas speaks of a woman he met when doing an Ob/Gyn residency some years before Roe v Wade. She was dying of massive infection and multiple abscesses from a botched self-induced abortion after having endured 14 pregnancies. “I still remember that patient,” Jonas says, “I remember what she looked like. I remember the bed she was in on Ward 1418. I will never forget it.”

Today there are providers in heavily regulated states – most of whom remain anonymous for very good reasons – with similarly tragic stories. They tell of women who misuse abortion-inducing drugs because they can’t get to a clinic, or girls barely past puberty too frightened by protesters to access care that is their constitutional right. Of a 14-year-old incest victim pleading for help to reach the nearest clinic many miles distant. Of a sick, troubled mother of five having to choose between multiple required – and unnecessary – trips to the clinic and the job she desperately needs to keep. The physicians who are there for these women often face the need to treat their souls as much as their bodies.

Among those who choose to be open in their activism is my personal hero, Willie J. Parker. I have never met Dr. Parker, an African-American Ob/Gyn, other than on phone calls while researching Perilous Times: An inside look at abortion before – and after – Roe v Wade. He speaks with passion and conviction. Currently Associate Medical Director of Family Planning Associates Medical Group in Chicago, Parker grew up Southern Baptist, in a community which taught that abortion is wrong. His own views changed on hearing a sermon about the Good Samaritan preached by Martin Luther King, Jr. “(King) said that what made the good Samaritan ‘good’ was that instead of thinking about what might happen to him if he stopped to help the traveler, he thought about what would happen to the traveler if he didn’t stop to help. That led me to …place a higher value on compassion. I couldn’t stop to weigh the life of a pre-viable or a lethally flawed fetus against the life of the woman sitting across from me.” In addition to his day job, Parker offers help in other parts of the country where help is critically needed. He shrugs off questions about personal risk.

Almost any one of today’s providers could make more money, and have a far easier life, in another job. Instead, they choose to do what they do, so women can choose to control their bodies and their lives. That’s worth celebrating.

So light a candle. Write your congressperson. Send a few bucks to the nearest clinic and the organizations that fight for women’s reproductive rights. One national day is just a fraction of the appreciation abortion providers deserve.

Abortion/Family and Friends/Health/Healthcare/journalism/Lifestyle/Religion/Reproductive rights/Women
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Shameless theft from ThinkProgress: a great source for progressive truth, and some new insight into Arizona craziness

by Fran Johns

Every now and then, when you’re dismayed and distressed about having zero time to put down any thoughts worth someone else’s time, you remember the excellent thoughts of someone else. In this case, a blog about recent goings-on in Arizona that was posted last week by my friend and very astute reporter on reproductive justice, Tara Culp-Ressler, Health Editor of ThinkProgress.org.

Arizona actions are a little difficult to follow, but they have to do with large issues. Issues like: when does your right to your religion trump my right to be who I am? Or, can your religion control my life? As in, does your religion have the right to determine whether or not I may choose to abort an 8-week fetus?

There is also a great deal of word-play going on (see ‘On choosing one’s words’ below.) As a general rule in these Arizona debates, “religious liberty” can be translated “I really don’t like gay people.” And “protecting women’s health” usually refers to limiting access to abortion. It’s easy to get lost in the wording and inuendo, and that’s why I appreciate others’ careful reporting and analysis. Here is the beginning of a thorough explanation of recent happenings in Arizona, lifted from Tara Culp-Ressler’s ThinkProgress page, which you may want to bookmark.

“All eyes were on Arizona this past week, after the legislature approved an anti-gay bill that would allow businesses to discriminate against LGBT individuals under the guise of preserving religious liberty. The intense national backlash culminated in Gov. Jan Brewer’s (R) decision to veto the legislation. But that doesn’t mean the lawmakers in the Grand Canyon State are putting controversial social issues to rest.

“Just one day after Brewer’s widely publicized veto, lawmakers in Arizona advanced new legislation to attack abortion rights. HB 2284, misleadingly named the “Women’s Health Protection Act,” would allow for surprise inspections at abortion clinics to try to catch them violating state law. The measure also stipulates that abortion clinics need to “report whenever an infant is born alive after a botched abortion and report what is done to save that child’s life,” inflammatory language that the anti-choice community often deploys to suggest that some doctors are committing infanticide.

“HB 2284 is being spearheaded by the Center for Arizona Policy, or CAP, the same right-wing group that was behind the controversial “right to discriminate” bill.

“State lawmakers gave the measure preliminary approval on Thursday. “I mean, for goodness’ sake, we even do unannounced inspections of Burger King and McDonald’s, but we’re not allowing them at abortion clinics?” Rep. Debbie Lesko (R), the bill’s sponsor, said during the legislative hearing on the measure.

“In reality, Lesko’s legislation is seeking to solve a problem that doesn’t actually exist. Abortion is already one of the safest medical procedures in the country, and the clinics that perform these procedures are already highly regulated. There’s no good reason to single out abortion providers for this additional red tape. Enacting these type of laws simply gives abortion opponents the opportunity to trigger state investigations — and, depending on the political affiliations of the people who serve on state health boards, this can be an avenue to force clinics out of business.

“’As an organization, we support bills that truly protect patient safety, but House Bill 2284 opens the door to provider and patient harassment,’ Jodi Liggett, the director of public policy for Planned Parenthood Arizona, told ThinkProgress in a statement.

“HB 2284 is part of a coordinated strategy to close abortion clinics that’s advancing across the country. And it’s also a clear reminder that, regardless of Brewer’s recent veto, the fight against “religious liberty” legislation isn’t over. This line of argument is driving efforts to restrict LGBT rights in other states across the country — and it’s directly related to attacks on reproductive freedom, too.”

For the rest of the story, surf over to ThinkProgress. Click those buttons at the top of the page if you appreciate it as much as this writer.

Abortion/California/Death and Dying/End-of-Life/Family and Friends/Health/Law/Medicine/Reproductive rights/Women
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On choosing one’s words…

by Fran Johns

I was taken to task, rightly so, by a reader who categorized my saying “no one… has an abortion without anguish” (you can read B’s articulate comment, and my response, in the 2/22 Comments) as “hokum.” She might also have said “hogwash.” Mea culpa. “Anguish” was a poor descriptive choice. “Serious thought” maybe; “self-reflection,” “concern.” Actually, the decision does involve anguish for many women, especially those whose rights are being denied by lack of access or harsh state restrictions.

But one word can wreak havoc.

Take the hyphenated word “pro-life,” which has been appropriated by those who are ferociously anti-woman. As if the issue of abortion — always complex and private, and occasionally anguishing — involved nothing at all beyond the (potential) life of a fetus. I consider myself ferociously pro-life, it’s just that I value the life of a woman. And am pro-woman’s-life enough to honor and trust her ability to make her own decisions about her body.

Or the emotionally charged word “suicide.” Those of us who believe in the individual’s right to a compassionate and dignified death have worked hard to get that word out of the discussion. Suicide is the desperate act of a despairing person; “physician aid-in-dying” is a compassionate choice made by a terminally ill, mentally competent adult.

Word choices took much of the focus in a fascinating panel on “Defining Death” sponsored recently by the University of California San Francisco Medical School. More about that event on HuffingtonPost as soon as I can get to it. Cases under study included the tragic, ongoing story of 13-year-old Jahi McMath, and the equally tragic story of 14-week-pregnant Marlise Munoz, whose brain-dead body was briefly kept on “life” support because the hospital and the State of Texas placed the potential life of that pre-viable fetus above the expressed wishes of her husband, parents and even Munoz herself. The distinguished UCSF panel of experts on medicine, law and ethics spoke repeatedly of how much anguish — the word definitely fits here — might have been prevented if only a few, kind words could have replaced some of the jarring words that unfortunately must eventually be said.

Imagine you’re the patient, or family, or attending healthcare worker (try to leave the lawyers out of this.) When does a moments-ago-healthy person become a “corpse”? A “dead body”? Who decides if a pre-viable fetus is a “person”? How can the average person even understand “brain-dead”? If you bring the lawyers in, you encounter “property.” In more than a dozen states there are laws on the books that say that if a pregnant woman dies her body must be maintained until the fetus can be delivered… no matter what advance directives she may have that specify her wishes to the contrary. One family fought against this outrageous miscarriage of justice by claiming their dead loved one’s body — which was, in the eyes of the law, their “property.”

It’s a scary world we live in. But that word JUSTICE. If we can only hang onto that one.

 

 

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