Abortion Rights: the X(treme) Games

The “pro-life” publication that ran an article suggesting Robin Williams’ depression – and subsequent tragic suicide – was related to a girlfriend’s abortion many years ago hit a new all-time low. One can only hope that nobody with a brain reads such drivel, but then, this writer… oh, never mind.

On the heels of that one comes Rand Paul saying he doesn’t “think a civilization can long endure” unless fetuses get “personhood rights.” There may be no way to get through to Mr. Paul’s brain – which is reported to be a highly functional brain indeed – that for every fetus to whom “personhood rights” are granted one woman is denied womanhood rights.

The black tar-pit of extremism into which this abortion issue has descended can make a body weep. Especially if you are somebody who remembers the day when there were no womanhood rights. Those days, before Roe v Wade changed them in 1973, were desperate times in the extreme.

Women died. Doing things such as drinking or douching with poisonous substances, which desperate women without access to abortion are doing today. The extreme distress of women denied access to reproductive rights is what results from the extremism of the anti-abortion forces.

To be honest, there is extremism on both sides. This writer is uncomfortable with the “Abortion on demand and without apology” slogan, not because of any disagreement with the message, but because the in-your-face tossing of the gauntlet seems to push the sides into ever more ferocious conflict.

It was Senator Barry Goldwater, campaigning for the presidency a decade before Roe v Wade, who famously said that “extremism, in defense of liberty, is no vice.” The remark got him a bunch of votes – though not quite enough to win—and is widely quoted and misquoted (or quasi-quoted.) It could be applied here.

But whose liberty?

It is not possible to preach liberty for a pre-viable fetus – which would not enjoy life, liberty or the pursuit of happiness outside of the womb – without preaching bondage for the woman. The extremist interpretation of anti-abortion aims (“Abortion is never the right choice”) is just that: A fertilized egg = nine months of bondage.

There may be no middle ground on reproductive rights. But if the fetus wins, if a girlfriend’s abortion decades ago gets blamed for someone’s suicide, if “personhood rights” take precedence over women’s rights, we will be back in the dark ages,

We’ve been there before. Some of us remember.

Should Abortion Be ‘Rare’?

This first appeared on Huffington Post

Beware the Rare-word.

Many of us — fiercely pro-women, fiercely pro-choice — bought into the “keep abortion safe, legal and rare” mantra of several decades back. It was, in fact, a useful mantra — until it was sunk by the potential anti-women interpretation of the word “rare.” The endless focus on the ‘rare’ word at times approaches the “it-depends-on-what-the-meaning-of-the-word-‘is’-is” hubbub.

In defense of both sides:

Make abortion rare! By supporting universal contraceptive coverage. By supporting Planned Parenthood. By expanding education. By reducing unplanned pregnancies in all ways that empower women and reduce violence against women.

But get rid of the ‘rare’ word. It is, apparently, sending the wrong message. Jessica Valenti covered the issue well in a recent piece in The Guardian, citing two leaders in the area of women’s reproductive justice. One is Dr Tracy Weitz, co-founder and former Director of Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco. In a paper published in 2010, Weitz wrote that “rare suggests that abortion is happening more than it should, and that there are some conditions for which abortions should and should not occur. It separates ‘good’ abortions from ‘bad’ abortions.”

None of this — ‘good’ abortions, ‘bad’ abortions, whether or when there should be abortions — is anybody’s business but the woman involved. Only she and her physician can know the circumstances, and the circumstances of no two women are the same. So if the ‘rare’ word is clouding the issue, let’s dump the rare word.

Valenti also quotes Steph Herold, Deputy Director of the Sea Change program, who says abortion needing to be rare “implies that abortion is somehow different than other parts of healthcare. We don’t say that any other medical procedure should be rare.” Sea Change is working to remove the stigma attached to abortion and other reproductive issues, a laudable, and monumental task. More than a few of the women who share their stories in Perilous Times: An inside look at abortion before – and after – Roe v Wade speak of suffering almost as much from the stigma attached to this most personal of women’s issues as from any physical harm, real or feared. While breast implants, sex-change details and erectile implantation (among other personal decisions) are fair game for cocktail party conversations, when is the last time you heard anyone volunteer information about her abortion? One in three women have an abortion; we Do Not Talk About It.

But here is the fact: There are bad abortions. They happened before 1973; they are happening today.

A mother of two physically challenged toddlers, pregnant with a third in 2014, unable to get to the nearest clinic — which is hundreds of miles away and impossible to access (despite the famous comment made by Texas Judge Edith Jones that it’s easy to go 75 mph on those flat roads) — punctures an interior organ trying to self-abort the old-fashioned way. She lives, but this is a bad abortion.

A desperate teenager in the rural midwest manages to get what she hopes is the right abortifacient through an internet site. Wrong drug, wrong instructions, wrong outcome. She gets to an ER before she bleeds to death. She lives, but this is a bad abortion.

This writer, pregnant from a workplace rape, overcome with shame and sheer terror, managed to find a kitchen-table abortionist in 1956. It was a bad abortion. We thought those stories were ended in 1973 when abortion was made legal and safe. But they are being repeated daily in this country, the land of the free; every one of them speaks of a bad abortion.

Women are suffering and dying again today from bad abortions, or because they are being denied access to safe, legal care. Whatever it takes, whatever words we use, the lives of those women are worth fighting for.

 

Can 70% of us be wrong?

Depending on which poll you read, anywhere from 55% to 70% of the people of these United States believe that abortion should be safe and legal. At the high end of that percentage are those who believe Roe v Wade should remain the law of the land.

How, then, could we be where we are? Today, more than half of the states have restrictions that effectively deny many women access to safe and legal abortion, never mind the Constitution.

Reproductive justice organizations, though, are far from caving.

Donna Crane, Vice President for Policy, NARAL Pro-Choice America, recently met with groups of supporters in the San Francisco Bay area to go over details of all this, and to reassure supporters that “although these (restrictive state laws) keep happening and we are losing ground, we’ve not lost power.” That power, Crane says, comes from the solid, and growing, percentage of people who want to keep abortion safe and legal and believe it is a woman’s right to control what happens to her own body.

“The public,” Crane says, “is not the problem. The problem is that our opponents have figured out how to get their way: they have switched (from working to overturn Roe v Wade) to the state legislatures. And there is a disconnect with American values.”

Crane outlined the dramatic increase in TRAP laws (Targeted Regulation of Abortion Providers), state regulations designed to put unnecessary burdens on abortion providers – but not other medical professionals – as a way to drive doctors out of practice and to make abortion care more difficult and expensive to obtain. Anti-choice measures in the states have increased from 18 in 1995 to a cumulative total of 807 by 2013. They include such requirements as unnecessary hallway widths in clinics, forced untrasounds, repeat visits and forcing physicians to lie to their patients. That’s just to name a few.

To this writer, none of this is about one side winning and the majority losing, it’s simply about justice. Anybody, anywhere with money and resources can access safe and legal abortion. But if you’re poor, down on your luck, living in a remote or impoverished area, and you want or need to terminate an unplanned pregnancy? Forget it. Legislators don’t have time for you; you probably don’t vote much. Politicians don’t care about you; you aren’t funding their campaigns. Anti-choice forces don’t care about you, only about your fetus. For you, there is no justice.

NARAL, however, has your back. Now we just need to get the rest of the 70% out front.,

 

Introducing a new abortion provider

I’ve gotten to know the author of the following essay in recent months, and was delighted to have seen him honored with a 2014 Unsung Hero Award from the National Abortion Federation.  With re-publication of his blog (from sherights.com) it’s my pleasure to introduce Boomers & Beyond readers to a future physician — who represents the future hope of women’s rights and women’s health.

 

WHY I’M BECOMING AN ABORTION PROVIDER — by Sarp Aksel

Growing up, I was quickly labeled an ana kuzusu – Turkish for “mamma’s boy.”

This came from a love for my parents’ holiday parties. Each year, the gatherings brought promises of leftover turkey, börek, and Rus salatasi – a delightfully creamy potato salad I was only allowed to indulge during the peri-holiday period. They were also occasions for storytelling. While my dad would entertain the men with the latest happenings in Turkish futbol – a constant stream of scandalous player trades, colorful diatribes of overly glorified coaches against crooked referees, and frequently contested league rankings – I often found myself cozying up to my mother and her friends. Their tales had power and emotion, and they meant so much more to me.

Even at that young age, I recognized that it was a privilege to be allowed into their space. Those evenings weren’t to be taken for granted and I was grateful to be included. Still, I wasn’t always sure if I was welcome.

As a feminist man and future obstetrician-gynecologist, I recognize that I am not, and nor will I ever be, in a position to fully understand the myriad factors that women must consider when tackling certain challenges. This does not mean I cannot be present and supportive. It would be arrogant at best and offensively misogynistic at worst to be anything other than an observer, a supporter and a witness to the uniquely difficult decisions that women face. This means that I believe whole-heartedly in the principle of autonomy as it pertains to healthcare and women’s dominion over their bodies and healthcare decisions. It requires having a profound respect for female autonomy, particularly of bodily integrity.

The slogan “Trust Women” is well known in the reproductive rights movement. While I am an ardent supporter of Dr. George Tiller’s dictum, I have recently found myself questioning its relevance. As a pioneer and hero to #FeministMen, Dr. Tiller was steadfast in his commitment to woman-centered care. His clinic in Wichita for decades served as a beacon of hope for women who had no other options – and continues to do so to this day. And yet, I can’t help but wonder – why do we still need to be told to trust women? Why are we still suspicious of a women’s ability to govern her own healthcare decisions?

Unfortunately, across our country we see politicians legislating abortion care from mandating ultrasounds to waiting periods and counseling requirements that often contain scientifically inaccurate information. They find themselves compelled to make decisions on behalf of women about matters that they deem women incapable of resolving on their own.

But really I’d prefer to keep legislators out of the conversation entirely. For me, identifying as a feminist provider means actively rejecting the notion that anyone other than the woman is the expert of her life-defining circumstances.

This means asking a woman how she feels about an unexpected positive pregnancy test without making assumptions about what that test result means to her.

It means being there for her as an objective source of medical information regardless of what birth control method she chooses, if she chooses one at all.

And it means advocating for women on a public policy level to ensure that women have unfettered access to comprehensive reproductive healthcare, including abortion and contraception.

My interest in women’s health sprang from years of working as a teenager at a specialty-maternity hospital in upstate New York – with women, for women. On my first day, an energetic young woman was orienting me to the facilities, my responsibilities, and my colleagues. A couple hours into the day, my supervisor noticed me trailing uncomfortably behind her through the hospital’s hallways. After several attempts to get at the cause of my odd behavior, she finally stopped to ask me what was wrong. With much hesitation I answered:

“I need to use a restroom, but this is a women’s hospital.”

She gave me a reassuring grin, placed her hand on my shoulder, and pointed me down the hall.

“Of course we have a men’s restroom.”

And just as there was room for men in a women’s hospital, there is room for men in the feminist movement. After all, feminism is synonymous with humanism.

Aksel_headshotAbout the author: Sarp Aksel is a member of the M.D. Class of 2015 at the Albert Einstein College of Medicine, and is currently applying for residency training in obstetrics and gynecology. As an advocate for comprehensive medical education, he has developed tools to help students raise awareness and fill curricular gaps in sexual and reproductive health training, including abortion and contraception. He is also the immediate past president of Medical Students for Choice, where he served as chair of the international nonprofit’s board of directors,

In the Abortion Wars: A Judge Speaks of Women’s Rights, Women’s Needs

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.”

On choosing one’s words…

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.

 

 

The power of stories

Talk talk talk talk talk talk...
Talk talk talk talk talk talk… (Photo credit: THEfunkyman)

Storytelling is on the move. In the past few days there have been encouraging reports from the 1 in 3 Campaign, “a grassroots movement to start a new conversation about abortion.” Other news is circulating about an upcoming art installation and a planned documentary film — all focusing on the telling of personal stories.

The 1 in 3 (as in, 1 in 3 women will have an abortion) Campaign recently launched its own Facebook page. You can visit the site, you can Like the page, you can buy the book — 40 stories of 40 years of Roe v Wade — you can read other stories, or write your own. It is a project of Advocates for Youth, another story-supporting nonprofit that’s been around and helping young women since 1980.

Then there is the film: Kickstarter efforts to fund The Pro Voice Project —  “A behind the scenes documentary about five women speaking publicly about their abortion experiences in spaces free from politics and moral judgment,” are tantalizingly close to the set goal. Check it out. You may want go over there right this minute and pledge a few bucks! The film will tell the “human stories and shades of gray hidden in our black-and-white abortion debate,” and it is definitely a project whose time is here.

Another unique and powerful project is underway at 4Choice2013, wherein you can tell your story through art or with a letter in your own words. Organized by the Northern California Women’s Caucus for Art, “Choice” is a juried exhibition focusing on women’s reproductive rights. Its motivation? “Our rights to safe legal reproductive care are slipping away, but our silence around our need for reproductive care allows that right to be stolen from us.”  Part of the “Choice” exhibit will be an art installation of letters “telling of what it means to have access to safe, legal abortion.” Anyone can write a letter for inclusion in the installation — the writers will remain anonymous, but the power of the installation will be in the power of the stories they tell, There’s still time to send your own letter.

There are other story-telling projects underway at NARAL Pro-Choice America, at My Abortion, My Life — and over at Catholic Planet there are stories of women who had abortions and now regret it,

This is all we have: our stories. Each story is unique because every woman is unique. When enough of the stories are heard we might well reach the point where real, thoughtful, courteous civil dialogue happens. It’s a conversation that is long overdue.