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FORTY YEARS AFTER ROE V WADE, GETTING AN ABORTION IS STILL A MAJOR CHALLENGE
by Eleanor J. Bader
Ramona, 32, mother of a four-year-old daughter, is dropped off at the Summit Women's Center in Bridgeport Connecticut at 8 a.m. on a frigid December Saturday. As she gets out of the car to walk the thirty feet to the clinic, she notices a dozen people holding weathered pictures of mangled babies bearing the words "abortion kills." The protesters can't trespass on clinic property or enter the fenced-in parking lot, but plastic bullhorns amplify their voices. "The Lord loves you," they shout. "He has a purpose for every life. You don't need to go in there and murder your child."
"I didn't want to be rude so I approached them when they called out to me," says Ramona, once inside the clinic. (All quotes are verbatim; name has been changed to protect privacy). "They bombarded me. They said that if I go through with the abortion I'll become so depressed that I'll start to drink and do drugs and will think about suicide.
"I was dropped off this morning by my mom," she continued. "My little girl was also in the car and I don't know what she understood or heard. These people say they want to help me, but how does traumatizing my child help me? They've made my life harder because now I have to worry about whether she heard them, saw the pictures they were carrying, or is scared because she heard people yelling at her mommy."
As she speaks, Ramona's voice rises with indignation and fury. "I know that this is not the right time for me to have a second child. I've discussed the pregnancy with my family and with my personal physician and I know I'm doing the right thing, the best thing, for all of us. How can these strangers think they know better?"
Good question. Forty years after the Supreme Court's Roe v. Wade decision was issued, the idea that abortion may at times be the best option for women and families remains contentious. True, great advances in the availability of safe abortion care have been made since 1973. But the vigilance of anti-abortion protests has also ramped up.
Members of the Connecticut chapter of the North Carolina-based Operation to Save America (OSA) are a frequent presence outside the Summit Women's Center in Bridgeport. And while regular picket lines, like this one, are fewer and farther between than they were 25 years ago, OSA continues to conduct "sidewalk counseling" in many cities throughout the United States. Ringleader Marilyn Carroll, the head of the state's OSA chapter, is at the Summit Women's Center when Ramona is accosted.
Fortunately, once Ramon is inside Summit the atmosphere changes. The Center, which opened in 1975 and is now owned by David Lipton, is located on Bridgeport's Main Street. Its ambiance is pleasant and inspiring signs decorate the walls:
"The staff in this office does sacred work and though you may hope to never come back, we return each day to hear your stories, hold your hands, and ease your fears. Our lives are consumed with caring for yours. In these walls and in our hearts you are forever valued, treasured, respected and safe."
TARGETING POOR WOMEN AND MINORS
Despite being rattled by the antis, Ramona's decision to have an abortion is ironclad. Indeed, the presence of the antis has done little stop women from terminating unwanted pregnancies. According to the Guttmacher Institute [guttmacher.org] nearly one-third of U.S. women will have an abortion by the time they turn 45. Ninety per cent will end these unwanted pregnancies—either medically or surgically—during the first trimester. Like Ramona, 61 percent already have at least one child at the time of their abortion.
At the same time, Guttmacher notes that the current number of annual terminations is lower than it was a decade ago. Still, more than one million abortions a year continue to be performed and given the frequency of the procedure, it would not be far-fetched to imagine abortion facilities being as ubiquitous as nail salons or dental offices. But they aren't. In fact, five states—Arkansas, Mississippi, North Dakota, South Dakota and Wyoming—have just one provider and OSA head Flip Benham has publicly declared that he intends to turn these states into "anti-abortion refuges."
Guttmacher confirms that the number of clinics has shrunk, from approximately 2500 in the early 1980s to less than 1800 today. While the reasons for this reduction are complex, at least part of the decline rests with the anti-abortion movement's relentless crusade to malign the procedure. Popular culture has also played a role. Television is replete with constant just-in-the-nick-of-time miscarriages– with the notable exception of one episode of Friday Night Lights several years back- keeping abortion off the small screen. The big screen is no better. In the Academy Award-winning film Juno, to cite just one example, a young teenager contemplates having an abortion—that is, until she enters a drab clinic where healthcare is dispensed by a callous and uncaring staff.
Combine this with the efforts of state legislators who want to make a name for themselves by pandering to the religious and secular rightwing, and the upshot, Guttmacher reports, is that by 2011 more than half of all US women of reproductive age were living in states deemed hostile to abortion rights. Among the many roadblocks: Only 17 states currently allow Medicaid to pay for the abortions of low-income women. The remaining 33 allow Medicaid to be used only if the pregnancy is the result of rape or incest or would likely result in death if carried to term.
Poor women are not the only targets: Thirty-seven states require parental involvement when a minor wants an abortion—the consent or notification of one or both parents/guardians or a judge in cases in which parental involvement is impossible or is counter-indicated. Seventeen states require a 24-to-72 hour waiting period between pre-abortion counseling—which frequently includes the well-refuted link between abortion and breast cancer--and the procedure and 18 states bar "partial birth" abortions, a specific and once-rare late-term surgery. In addition, five states—Alabama, Idaho, Indiana, Kansas and Oklahoma--ban abortion after 20 weeks, a restriction pushed by antis who charge that fetuses older than 20 weeks feel pain, something that is impossible to know. What's more, seven states [Arizona, Kansas, Nebraska, North Dakota, South Dakota, Oklahoma and Tennessee] ban telemedical conferencing for medication abortions. In these locales, patients must come into a clinic, in person, before a prescription can be issued, posing an often-severe hardship for the underserved rural women that telemedicine was established to help.
And lest you wonder how and why state after state passes similar restrictions, the answer lies with Americans United for Life, an anti-choice organization that has crafted 32 pieces of model legislation that are peddled to law makers interested in limiting abortion access. Their well-honed message has gained a toehold in political life and in outreach to people of color: AUL insists that abortion and birth control are part of a Caucasian plot to annihilate people of color and limit the growth of future generations.
Anti-abortion materials also target young people: Pamphlets such as "This is Not Your Only Choice," created by the Human Life Alliance, are left in medical waiting rooms, community centers and public and parochial schools—and posted online and on social networking sites. They plant the idea that abortion is physically and psychologically damaging.
"When I discovered I was pregnant I felt desperately alone. I cried myself to sleep," the brochure begins. "I decided to confide in a couple of college professors who collected money to fly me out of town to have an abortion. Now I felt obligated to go through with it. Still, I agonized. I was summoned to the room where the abortions were being performed. I could hear a woman sobbing in the recovery room. That memory still haunts me." The pamphlet then describes a change of heart and the subsequent birth of a child who is loved and cherished. Then—surprise--this woman's story is juxtaposed with that of another woman, and the second tale is replete with uncontrollable depression, anxiety and regret—all of it caused, you guessed it, by the abortion. A section called "After-Abortion Trauma" hammers the message and in case you missed the point, everything from eating disorders to suicidal ideation is attributed to the termination. If you don't know better, it's scary stuff.
PROVIDERS RISE TO THE DEFENSE
Needless to say, the relentless attacks on the efficacy of abortion and the incremental chipping away at abortion availability—to say nothing of the murder and wounding of 20 clinic staffers since 1993--have infuriated providers of reproductive healthcare, feminists, and prochoice activists. Worse, the constant attacks have kept these constituencies scrambling, constantly working to defeat the onslaught of anti-choice legislation on the state and federal levels. At the same time they've labored to undo the stigma that has taken hold.
Prochoice organizing--demonstrating, lobbying, and doing clinic defense and post-abortion counseling-- has kept reproductive health advocates extremely busy, trying to hold access steady and fight incursions on who can have an abortion and when they can have it. It's been an uphill struggle. In addition to trying to ensure patient and staff safety, providers in several states have also had to fend off a host of indirect attacks promulgated by anti-choice forces, including boycotts and pickets of suppliers, rental agents, delivery services and construction crews. Arkansas' Little Rock Family Planning, for example, was informed last winter that the oxygen and nitrous oxide supplier they'd used for 15 years was suspending deliveries because the antis had brought them negative publicity. Although the clinic was able to find another provider, staff had to spend valuable time making new arrangements.
The antis hope that creating distractions and extra work for clinicians will drive them out of the field, says Charlotte Taft, the director of the Abortion Care Network, an organization of independent abortion and reproductive health care providers. In Texas, she says, anyone can file an anonymous complaint with the state health department or environmental control board and it will be investigated. "Every single time a complaint is filed an inspector comes to the clinics and casts doubt on them. The antis then use the fact that an inspector showed up as a recruitment tool, saying, 'See, the conditions here are so awful that the inspectors had to come out and check everything again.'" Taft calls it harassment and admits that the near-constant scrutiny makes it difficult for providers to do their jobs.
Likewise TRAP laws, short for Targeted Regulation of Abortion Providers. Taft charges that such laws are often unnecessary and, more-often-than-not require clinics to become ambulatory surgical centers. "One of the ACN clinics in Pennsylvania has been renting an office space for the past 20 years but thanks to passage of a TRAP law, they've been told that they need to enlarge their hallways by four inches. They don't own the building and there is no logical reason for them to have to do this. At a time when everyone's money is tight, if they have to reconstruct the facility it will drive up the cost of health care." That's not even the worst of it, Taft continues. "The most appalling thing is that widening the halls will do absolutely nothing to improve the safety of this already extremely safe medical procedure."
The illusion of improving safety is also at the heart of a spate of newly-introduced bills to require abortion providers to have admitting privileges at local hospitals. On the face of it, it sounds sane. After all, if you have an abortion in St. Paul, Minnesota, doesn't it stand to reason that your doctor should be able to have you admitted to a specific St. Paul hospital, rather than send you to an Emergency Room, should complications arise? What the requirement fails to acknowledge, prochoice experts argue, is that abortion patients almost never need to be hospitalized. Secondly, since clinics typically employ doctors from out of town, most hospitals are leery of granting privileges to someone who is present only once or twice a week.
The Volunteer Women's Medical Clinic in Knoxville, Tennessee is a case in point. Thanks to state passage of The Life Defense Act, the 38-year-old facility had to be shuttered in August after its longtime physician, a man who had local admitting privileges, passed away and his replacement was unable to obtain them. The closure likely cheered abortion foes who are relentlessly pursuing a campaign to close each and every abortion facility in the country. The delusion, says ACN's Charlotte Taft, is that closing abortion facilities will end abortion.
"Before Roe women who needed abortions were willing to get into a strange car, be blindfolded, pay the equivalent of thousands of dollars, and not know where they were going or who was going to perform their surgery. Even though it was hard for women to find abortionists, they did what they had to do. Abortion comes from women's sense of responsibility, and it is important to understand that roadblocks to abortion don't stop them."
Want to be truly prolife? Taft asks. Then support comprehensive sex education, childcare, equal wages for women and accessible and affordable birth control.
Indeed, staff at Bridgeport, Connecticut's Summit Women's Center point out that if the antis cared about women's lives as much as they say they do, they would move their protests far from clinic entrances. "Having the antis out front is horrible for our patients," says clinic administrator Tanya Little, a staffer since 1999. "It's also horrible for those of us who work here. Some days I find it difficult to restrain myself from talking back. On the other hand, seeing the protesters every day reaffirms my dedication to do this work because who are they to tell anyone else what to do? I feel good about providing women with options and supporting them in whatever choice they make, whether it's childbirth, adoption, or termination. Our entire staff is adamant that we are going to continue and not be afraid or bullied."
W.J.Horemans posted: 2013-01-22 07:40:35
Why is it that in the USA, supposedly the land of freedoms (sic.the gun lobbies), are the religious nuts allowed to harrass and persecute women who are just taking care of their own health and bodies? Religion seems to be able to trump all personal rights and dignity.
Chicago posted: 2013-05-16 06:34:36
I used to work for a women's health distributor, my territory included the Bible belt- if I called the wrong person (sometimes they were naming themselves as "clinics") they would blast our phone lines for 2-6 hours so we couldn't work. Even though we sold basic equipment any provider needed! I sometimes spoke with the physicians and always thanked them for their service, esp the late term providers, who are truly fearless. My GYN is a retired Uni woman who works in a clinic offering abortions, I have been going there for 15 years for check-up's, just to help fund their work. As for the crazy people outside, they oppose any social help to children or society (health care etc) but force women to have unwanted children. They can't see the irony in their bible
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