Hobby Lobby, 1 – Women, 0

(This first appeared on Huffington Post)

It is hard not to despair.

A woman entering a clinic for personal healthcare now must wade through potential hordes of obnoxious strangers getting in her face with stuff – often angry stuff, often misinformed and always unrequested. Where is the right to privacy, to lead one’s own life without the interference of obnoxious strangers?

And now, a woman working for Hobby Lobby, or for that matter any other corporation headed by a religious fanatic who believes his employees must submit to his beliefs, can be denied healthcare coverage for the most basic, most personal reasons: the need to control her own body, to make her own reproductive choices and family decisions.

Following the Supreme Court these days is hazardous to one’s health.

But let’s hear it for Ruth Bader Ginsburg.

Ginsburg read the riot act to the five men – surprise, surprise, all of them were men – who dealt this latest blow to the women of America.

Saying that religious freedom demands “accommodation of a for-profit corporation’s religious beliefs no matter the impact that accommodation may have on third parties who do not share the corporation owners’ religious faith,” Ginsburg wrote in her dissent, is likely to wreak havoc. The havoc is only beginning. And only a small part of it will be the suffering of Hobby Lobby employees. No contraceptive coverage, no abortion coverage, no options, and – because we are not talking about rich people here – no justice.

One wonders. Are mandatory burqas next? Stranger things have happened than corporate CEOs whose religious sensibilities are offended by women’s uncovered heads. There are serious concerns that the ruling could lead to other corporations denying coverage for things that bother other religious groups – blood transfusions (Jehovah’s Witnesses, Christians Scientists), psychiatric treatment (Scientologists) for example.

Freedom of religion? Bah, humbug, Ginsburg says in so many words. “(Y)our right to swing your arms ends just where the other man’s nose begins.” She might more properly have said, “where the woman’s uterus begins;” because indeed the religion-guarding gentlemen are swinging directly at women’s guts.

Call it what you will – religious freedom, protecting the unborn, freedom of expression, social conservatism – the denial of women’s rights will always, eventually run up against the voices of women who will not be denied.

Thanks, Justice Ginsburg

Chris Christie, Anais Nin and the Enforcement of Motherhood

What do New Jersey Governor Chris Christie and writer Anais Nin have in common? Not a whole lot, Christie would probably say. But a case can be made for their similar positions on one major issue: the importance of motherhood.

Christie has been everywhere in the news since his speech to the conservative Faith and Freedom Coalition, in which he drew loud applause when explaining his anti-abortion stance. Christie, like Mitt Romney and assorted other deft politicians, was pro-choice for a while. But he reportedly changed his mind when his wife was pregnant and he heard a heartbeat.

The way this works, for Christie, Romney and the Faith and Freedom Coalition, is that life in utero becomes sanctified to the exclusion of its carrier. The woman becomes simply that, a fetus-carrier, until she delivers a baby. And there it is: Motherhood.

The Faith and Freedom Coalition, along with Christie, Romney and conservatives everywhere, promotes the notion that once conception occurs motherhood must be enforced, and the fetus protected. This creates the noble, if tragically erroneous, belief that if abortion is banned it will simply never happen. But forced motherhood is not always possible.

This writer claims no insight into Gov. Christie’s soul, or expertise on Anais Nin, but I do know a lot about illegal abortion. If you tell women with unintended pregnancies that they may not terminate those pregnancies, they won’t listen. They will simply do desperate things to end their pregnancies, and unfortunately a lot of them will die trying. This is already happening in the U.S., thanks to conservatives’ success in denying access to safe abortion: poor women desperate to terminate unwanted pregnancies are again facing suffering and possible death.

Knowing of my interest in preventing more unnecessary deaths, a friend recently forwarded this comment made by Anais Nin in a 1940 diary recounting her abortion experience:

“Motherhood is a vocation like any other.”

Gov. Christie would agree, or proclaim it more exalted than others – except, perhaps, politics. But he and the Faith & Freedom folks would doubtless take umbrage with Nin’s following line:

“It should be freely chosen, not imposed upon women.”

 

Vessel: New documentary, powerful voice

Working with Women on Waves – the organization determined to make safe abortion available around the globe – is not for the faint of heart.

Vessel, a new documentary currently being shown around the U.S., traces the progress of Women on Waves from its beginning more than a decade ago and through its now sister organization Women on the Web. That progress winds through angry protest mobs pushing, shoving, shouting “Murderer!” “Go Away!” and worse, and throwing eggs (and worse.) The women of WoW, mild-mannered though they may appear, retaliate by cutting the ropes of police boats attempting to tow them away, going nose-to-nose with burly guys on protest lines and breaking the seals of locks placed on their supply cabinets.

Meanwhile, the movement steadily grows.

Women on Waves was founded in 1999 by Rebecca Gomperts, MD, MPP, who was trained in both medicine and visual arts in her native Amsterdam, the Netherlands. (It doesn’t hurt, for the film, that Gomperts is also attractive, articulate in several languages and highly photogenic.) As a young Ob/Gyn Gomperts traveled – one might say trained – with the Greenpeace ship Rainbow Warrior as its doctor and an environmental activist. While sailing in South America she was struck by the numbers of women suffering from lack of access to reproductive health services and safe, legal abortions – and inspired by their stories to start Women on Waves.

The group built a clinic-in-a-box, loaded it onto a ship and sailed into such unwelcoming ports as Morocco, Portugal, Spain, Poland and eventually scattered cities around Africa, Central and South America. The strategy was to anchor 12 miles offshore in international waters, where local authorities had no jurisdiction. Local authorities were seldom pleased. Gomperts was often on land, hanging banners announcing the phone number for pregnant women to call, drumming up press – usually unfriendly press – agitating the authorities and spreading the word, smiling pleasantly in the face of incredibly hostile opposition.

Once the medical abortion procedure using misoprostol became widely available and safe, if used as directed, Women on the Web began its own ambitious program of making the procedure available through the internet. And safe abortion slowly gained through changing laws.

The movement has one simple goal: to reduce the number of deaths from unsafe abortion. It is the same goal that motivates every other reproductive justice organization, from the Center for Reproductive Rights to ACCESS: Women’s Health Justice to NARAL Pro-Choice America.

But the film ends with a litany of places where poor women (if you’ve got money, you can manage to find a safe abortion somewhere) remain at risk for lack of access to safe abortion, notably including much of the U.S. Watching it in the U.S., where abortion has been legal since 1973, and being reminded again that women here are suffering and dying today, is sobering, and indescribably sad.

The sadness comes from hearing the same, tragic stories that first inspired Rebecca Gompers, and some years ago inspired this writer to create the book you see at the right. They come through the voices in the film:

“I’m scared to death.”

“I tried hitting myself in the stomach…”

“My family would disown me if they found out.”

“Can you help me?”

How can we be ignoring these voices in the United States today?

 

 

 

Hanging out with a hero

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I first met Willie Parker three or four years ago, researching my then work-in-progress book Perilous Times: an inside look at abortion before – and after – Roe v Wade. Couldn’t believe his generous affability and apparent fearlessness in the phone calls and emails we traded, his willingness to be quoted, identified, you name it — despite the obvious dangers facing abortion providers in areas of the country where opposition is fierce and hostility strong. It matters not to Willie Parker. He is dealing with real, live women and the injustice they face when denied control of their own bodies.

Fast forward to May, 2014. In an earlier email exchange the remarkable Dr. Parker had mentioned being briefly in California around this time and hopefully having a chance to meet. I held him to that, and managed to get him over for a visit. Here’s the report of that visit that appeared just now on Huffington Post:

It’s not every day you get to hang out with your hero.

For anyone invested in reproductive justice today, Willie Parker, MD, MPH, MSc, is at the top of the hero list. My own such list is long, thanks to the many people I’ve met in recent years who are tirelessly at work keeping justice alive for women everywhere — but Willie Parker is #1.

Parker holds degrees from Harvard and the Universities of Iowa and Michigan; has served as Medical Director of Planned Parenthood of Metropolitan Washington DC, Associate Medical Director of Family Planning Associates Medical Group in Chicago and Assistant Professor of Obstetrics and Gynecology in the John A. Burns School of Medicine at the University of Hawaii. His list of writings, honors, accolades and nonprofit board jobs is longer than my hero list, but in Real Time he is simply Willie. A man who believes ferociously in a woman’s right to make her own decisions, whatever her race or socioeconomic status, whatever her unique circumstances and needs.

This does not make Willie Parker an “abortion on demand” physician. Once the fetus has the possibility of survival — with or without “extraordinary support measures” — he will not perform an abortion. But Parker believes in a woman’s right to make her own healthcare decisions and to control her own body, and knows it is women of color and women without money or resources who are most often denied these rights. That’s where the complex issue becomes a simple matter of justice.

Parker sees what he does — which is, provide abortions up to 24 weeks and six days — purely through the eyes of the woman who seeks him out. She is usually a woman of color, African-American or Latino. More often than not she is someone who already has more children than she can care for. Sometimes she is still barely more than a child herself, unmarried, abused by a casual acquaintance or a favorite uncle. She has a story.

Once the woman with a story — and an unintended pregnancy — reaches Willie Parker, she’s in a safe harbor. He listens to her story, calms her fears, holds her hand.

Such women may be safe, but the abortion provider is decidedly not. Especially when he’s a big, affable, outgoing, very dark-skinned, gray-bearded guy like Parker.

“I sort of hide in plain sight,” he laughs. Walking around in casual clothes and a friendly grin, as he customarily is, he hardly looks the part of a multi-degree, high-powered physician. It was probably little comfort to the white, business-dressed reporter leaving a building with Parker recently when the latter remarked with a smile, “If they’re coming after the doctor, they’re gonna shoot you.”

Parker, grounded in Christian tradition and secure in his faith, says he is uniquely blessed by the certainty of knowing that his core moral, ethical and social beliefs come together with his education and skills. So yes, he will go right on being a very public advocate for reproductive justice — including the current fight to preserve the one remaining abortion clinic in Mississippi — and no, he’s not worried about personal danger.

“I don’t think about how I’m going to die,” he says. “I think about how I’m going to live.”

This is what makes hanging out with Willie Parker such a lovely way to spend an afternoon.

Ahead for women: good news & bad

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.

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.”

Wanted children, planned families… Why not?

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.

Laboratories of the States: The good… and then, the very bad and ugly

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.

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