Underground abortionists? Today? Believe it.

The back alley abortionist of pre-Roe days came in all types: men, women, trained, untrained, compassionate or just in it for the money. They existed, all of them, because women desperate to end unwanted pregnancies sought them out. In almost every case the woman and the abortionist had little or no contact either before or after the event, but in many cases — including my own — there was a strange sense of gratitude to someone who managed to give you your life back. In countless other cases the woman died herself, because these were dangerous procedures in perilous times.

And they’re back.

Not in the same form, probably not in anywhere near the same number as was the case before Roe v Wade. But the Underground Abortionist is here. Loss of access to safe and legal abortion, thanks to layers of state restrictions, is causing women with unplanned pregnancies to seek out ways to end those pregnancies. They are, by and large, women without money or resources, very often women with more children already than they can care for. Some of them are just frightened children with nowhere to turn — abused by a family member or victimized in any of a million ways.

Enter the underground abortionist. Today’s illegal abortion provider is most often a drug dealer who knows where to get misoprostol and mifepristone, the drugs needed to end a pregnancy. The potential dangers are different from the assortment of dangerous methods used by illegal abortionists before 1973, but they surely exist: if the drugs are not pure, if they are taken in the wrong dosages, any number of conditions can make today’s illegal abortion as dangerous as those in days of old.

But happily for some women who are denied safe abortions today, there are compassionate other women trying hard to help. One wrote about her work on Jezebel and subsequently participated in a fascinating interview with Robin Marty of RH Reality Check. I hope you’ll read the entire piece.

This underground abortionist is motivated by what she hears, through emails, from women with unplanned pregnancies: “Desperate, scared, broke women write to her, wanting to terminate a pregnancy without turning to sharp instruments, unknown drugs, or old wives’ tales,” Marty explains. So she does her best to instruct them on proper use, and sends the drugs.

Is this any way to settle the critical, complex issue of unwanted pregnancy? At this point, for poor women in much of the U.S., it’s all there is.

The underground abortionist says, in this eye-opening interview, much with which I heartily agree. Particularly in these closing lines, when Marty poses hypothetical questions the interviewee might be asked:

“I think “pro-life” and pro-choice activists don’t talk enough to each other. I think we can actually sometimes find unusual common ground. I think that while a lot of the people at the top of the pro-life movement are cynical and misogynistic, a lot of the pro-life rank-and-file are people who are honestly well-intentioned and have been told a lot of lies.”

In other words – Can We Talk?

Rape doesn’t cause pregnancy? Excuse me?

Trent Franks

Trent Franks (Photo credit: Wikipedia)

Well, according to Rep. Trent Franks, the incidence of pregnancy resulting from rape is negligible, so probably we don’t need to consider allowing abortion when rape or incest is involved.  Franks is not big on considering women at all, or the issues women face.

Franks would have us consider only the fetus. His Pain-Capable Unborn Child Protection Act, currently being discussed by himself and a lot of mostly men in Washington, would ban abortion after 22 weeks.

Franks was himself unborn when I became pregnant after an incidence of workplace rape. Such occurrences are probably less common today, progress having been made in workplace protection since 1958. But I would be willing to bet they still happen. I wonder if Franks cares. I wonder if he has heard about sexual abuses in the military? Or unreported date rape? They happen; unintended pregnancies happen.  I wonder if Franks is able to get his mind around the fact that there is a woman before there is a zygote?

I appreciate Franks’ concern with the unborn; I just want him to consider the already-born. They are real, live women facing difficult, complex issues that no one — NO ONE — could possibly understand but they themselves.

Abortion is a difficult and complex issue. I personally wish it would never be necessary. But for Franks and his fellow ideologues to inch it back toward criminalization, as they would like, is a violation of the basic rights of the women whose existence they prefer to ignore.

Sad (abortion) stories; happy endings

“Beatriz,” as the 22-year-old pregnant woman in El Salvador was known, has now been delivered of a fetus that could not have lived. Beatriz is fine. She could have lost her life had the pregnancy continued. In another story out of El Salvador, the physician attending another Salvadoran woman named Melanie speaks of having performed an abortion to end Melanie’s 8+-week ectopic pregnancy, and Melanie says she was never worried about losing her life.

But the reality is that politics and religion control the issue of abortion in El Salvador; the woman and her physician are shuttled pretty far aside. (Melanie’s physician describes herself as “deeply religious.” She apparently has some coincidental belief that allows her to perform abortions when necessary.) Down near the end of these stories are statistics about the number of women and physicians who have been convicted of the crime of abortion. There are not a lot of them; but if you were one of them it can’t be good news.

The U.S. is happily not El Salvador. But there are certainly plenty of politicians, and not a few religiously motivated others, who seek to criminalize abortion. It is, in their view, morally wrong under any circumstance.

My question is:  Who knew best what should be done in the above cases? The El Salvadoran government? The Catholic church? Or perhaps Beatriz, Melanie and their physicians? Who knows better than the woman and her physician in the U.S.?

Sometimes, only personal stories tell truth.

(Unpaid plug: there are a lot of personal stories in my new book, Perilous Times: An inside look at abortion before – and after – Roe v Wade. You’re invited to consider them and I welcome your thoughts.)

Surprise! Contraception reduces abortion rates

Much is being made of a recently completed study by Washington University in St. Louis that showed use of contraceptives reduces abortion rates. Well, duh. All those teenagers who didn’t get pregnant subsequently didn’t need abortions. Nor did they need to wreck their lives bringing unwanted children into the world, and there might have been an instance or two wherein some young person avoided contracting HIV, though these issues were not studied in the study.

Could someone point this out to all those folks who want to ban contraceptives? You know, inhabitants of that parallel universe wherein no one ever has sex except to procreate?

The two-year Contraceptive Choice Project enlisted more than 9,000 women in St. Louis, many of them poor and/or uninsured, and offered them a range of free contraceptives. The results? As reported in the New York Times, there were 6.3 births per 1,000 teenagers in the study, compared with the national average of 34 births per 1,000. There were 4.4 to 7.5 abortions per 1,000 women in the study, compared with 13.4 to 17 per 1,000 women in the St. Louis area. The national rate is close to 20 per 1,000 women.

There seems to be a triple-disconnect loose in the land: Sex happens, even when the participants aren’t thinking about making babies. Unwanted pregnancies happen, especially when people can’t get contraceptives. Abortion happens when women — and teenage girls — get caught in human biology.

Why would it not make sense to quit shouting obscenities, making judgments and trying to force one group’s belief on everyone, and focus instead on these realities? Who knows, fewer tragedies of messed up lives and unwanted children could result.

New 'morning after' pill meets opposition from abortion foes

MADRID, SPAIN - SEPTEMBER 27:  In this photo i...

Image by Getty Images via @daylife

With global overpopulation among the most critical problems of the 21st century, news of a highly effective contraceptive becoming available in the U.S. would seem very good news indeed. But as health writer Rob Stein reports in the Washington Post, it may not happen:

A French drug company is seeking to offer American women something their European counterparts already have: a pill that works long after “the morning after.”

The drug, dubbed ella, would be sold as a contraceptive — one that could prevent pregnancy for as many as five days after unprotected sex. But the new drug is a close chemical relative of the abortion pill RU-486, raising the possibility that it could also induce abortion by making the womb inhospitable for an embryo.

Plan B (the last emergency contraceptive vetted by the FDA), which works for up to 72 hours after sex, was eventually approved for sale without a prescription, although a doctor’s order is required for girls younger than 17. The new drug promises to extend that period to at least 120 hours. Approved in Europe last year, ella is available as an emergency contraceptive in at least 22 countries.

“With ulipristal (ella), women will be enticed to buy a poorly tested abortion drug, unaware of its medical risks, under the guise that it’s a morning-after pill,” said Wendy Wright of Concerned Women for America, which led the battle against Plan B.

Plan B prevents a pregnancy by administering high doses of a hormone that mimics progesterone. It works primarily by inhibiting the ovaries from producing eggs. Critics argue it can also prevent a fertilized egg from implanting in the womb, which some consider equivalent to an abortion.

Ella works as a contraceptive by blocking progesterone’s activity, which delays the ovaries from producing an egg. RU-486, too, blocks the action of progesterone, which is also needed to prepare the womb to accept a fertilized egg and to nurture a developing embryo. That’s how RU-486 can prevent a fertilized egg from implanting and dislodge growing embryos. Ella’s chemical similarity raises the possibility that it might do the same thing, perhaps if taken at elevated doses. But no one knows for sure because the drug has never been tested that way. Opponents of the drug are convinced it will. “It kills embryos, just like the abortion pill,” said Donna Harrison, president of the American Association of Pro-Life Obstetricians and Gynecologists.

A federal panel will convene this week to consider endorsing the drug. Those favoring approval are worried that the ambiguous sentiments, and the power of abortion foes who seem poised to weigh in against it, will influence the outcome.

“FDA should be a ‘Just the facts ma’am’ organization,” said Susan F. Wood, an associate professor at the George Washington University School of Public Health and Health Services who resigned from the FDA to protest delays in making Plan B more accessible. “I’m hoping the FDA will take that position.”

There is an great unmet need out there for emergency contraception that is effective as this for so long,” said Erin Gainer, chief executive of HRA Pharma of Paris. Studies involving more than 4,500 women in the United States and Europe show that ella is safe, producing minor side effects including headaches, nausea and fatigue, she said.

The company has no plans to test ella as an abortion drug, but it did not appear to cause any problems for the handful of women who have become pregnant after taking the drug, she said.

“The people who are opposing this are not just opposed to abortion,” said Amy Allina, program director at the National Women’s Health Network. “They also opposed contraception and they are trying to confuse the issue.”

Back to the issue: the planet has a finite amount of space for human beings. When one human being (and often two human beings acting as one) seeks not to add an unwanted human being, would it not make sense to furnish all available safe, legal tools to assist in that humanitarian effort?

Stay tuned for the answer from the FDA.

New ‘morning-after’ pill, ella, raises debate over similarity to abortion drug.

Abortion foes are winning, folks

WASHINGTON - JANUARY 22:  A pro-choice advocat...

Image by Getty Images via @daylife

Will women in the U.S. soon be unable to have a safe, legal abortion? That scary possibility becomes more likely every day. Does anyone really understand the pre-Roe v Wade horrors which abortion foes want to see returned? Not really. That’s because huge numbers of women who could have told the horror stories died at the hands of back-alley abortionists, and those of us who did survive are dying off fast, unheard.

This space welcomes writer John Leland’s front page article in today’s New York Times to the voices crying in the wilderness — just in case someone other than Nancy Keenan might care to listen.

At least 11 states have passed laws this year regulating or restricting abortion, giving opponents of abortion what partisans on both sides of the issue say is an unusually high number of victories. In four additional states, bills have passed at least one house of the legislature.

In a flurry of activity last week, Gov. Haley Barbour of Mississippi signed a bill barring insurers from covering abortion in the new insurance exchanges called for under the federal health care overhaul, and the Oklahoma Legislature overrode a veto by Gov. Brad Henry of a bill requiring doctors who perform abortions to answer 38 questions about each procedure, including the women’s reasons for ending their pregnancies.

It was the third abortion measure this session on which the Legislature overrode a veto by Mr. Henry.

At least 13 other states have introduced or passed similar legislation this year. The new laws range from an Arizona ban on coverage of abortion in the state employees’ health plan to a ban in Nebraska on all abortions after 20 weeks, on the grounds that the fetus at that stage can feel pain.

Fetal pain is a subject of debate in the medical community, and the United States Supreme Court has recognized the government’s right to ban abortions only after a fetus becomes viable, which is more than a month later.

“Fetal pain” is just one ploy; its determination can easily go from 20 weeks backward to ban the morning-after pill. Other ploys? Forcing a pregnant woman to look at ultrasound pictures, prohibiting a physician from discussing fetal abnormalities with his/her patient, and “in Utah, after a pregnant 17-year-old paid a man $150 to beat her in an effort to induce a miscarriage, legislators passed a law that would allow a woman in such circumstances to be charged with homicide.”

Unwanted pregnancies happen. When they do, the man involved can simply walk away, as countless millions have done and will continue to do. Why, then, should so many men purporting to have such omnipotent wisdom be empowered to eliminate a woman’s right to choose what happens to her body?

It’s going to get worse. Unless people — and that includes males of the species who still have brains and some concern for the future of womankind — start paying attention, and standing up to the fundamentalists of all stripes, the U.S. Conference of Catholic Bishops and the religious factions who claim authority over all women, it’s going to get worse than many people in today’s society can even begin to imagine.

Opponents of Abortion Advance Cause at State Level – NYTimes.com.

Abortion foes winning with fear tactics

This is the way abortion rights end (apologies to T.S. Eliot): not with a bang, but with something worse than a whimper. The steady, relentless chipping away of those rights, state by state. And where a straightforward denial of women’s rights might face opposition, abortion foes are stooping to emotion-twisting, privacy-invading, fear-inducing tactics the likes of which have not been seen in a half century.

The “pro-lifers” (which is to say, the people who worry about some potential, unwanted life but don’t give a tinker’s dam for the lives of grown — often just barely grown — women) want abortion absolutely banned in this country. They are pushing closer to that goal every day. They like to talk about “protecting the unborn,” but the big losers in this dangerous game will be those who most need protection: poor, disadvantaged, un-empowered women.

New York Times editorial writer Dorothy Samuels offered a sharp overview of the dangerous times ahead for women’s rights, after reporting on a recent lunch celebrating the 40th anniversary of New York’s becoming the first state to fully legalize abortion. That law, Samuels notes, “began to reduce the death and injury toll from back-alley abortions and set the stage for the Supreme Court’s Roe v. Wade decision in 1973, which made abortion legal nationwide and recognized a constitutional right to privacy.

But abortion-rights groups are newly anxious about new assaults on women’s reproductive rights, including a fight over abortion that snarled the last days of the health care reform debate. Anti-abortion groups are newly emboldened.

The health care reform law contains advances for women’s reproductive health care, including enlarged access to insurance coverage for maternity care, contraception and other services. But President Obama and pro-choice Congressional lawmakers made abortion coverage vulnerable as part of the effort to secure the measure’s passage.

Kelli Conlin, head of Naral Pro-Choice New York, told guests at the lunch that “anti-choice forces are mobilizing in every single state to limit a woman’s access to abortion in more insidious ways than we can imagine.”

As Ms. Conlin was speaking, members of the Oklahoma House were getting ready to override vetoes of two punishing abortion measures. The state’s Democratic governor, Brad Henry, rightly viewed these intrusions into women’s lives and decision-making as unconstitutional.

One of the measures, which seems destined to spawn copycat bills in other states, requires women to undergo an ultrasound before getting an abortion and further mandates that a doctor or technician set up the monitor so the woman can see it and hear a detailed description of the fetus.

The other law grants protection from lawsuits to doctors who deliberately withhold fetal testing results that might affect a woman’s decision about whether to carry her pregnancy to term.

Several states have either passed or are considering bills that would ban abortion coverage in insurance plans sold through the state exchanges established by the federal health care law.

A new Utah law criminalizes certain behavior by women that results in miscarriage. Embarking on a road that could lead to the Supreme Court, Nebraska last month banned most abortions at the 20th week of pregnancy based on a questionable theory of fetal pain.

About two dozen states are looking at bills to increase counseling requirements or waiting periods prior to abortions. About 20 states are considering new ultrasound requirements. This is on top of an already onerous regimen of state restrictions that has drastically cut down on abortion providers and curtailed a woman’s ability to exercise a constitutionally protected right.

Draconian laws will not stop unintended pregnancies. Once abortion foes succeed in eliminating a woman’s right to privacy and ability to make her own, often difficult, choices the lucrative business of back-alley abortions will once again thrive. And women will die.

Editorial Observer – A Spreading Peril for Women’s Privacy and Freedom – NYTimes.com.