"For a woman to 'ask her physician' for a safe and effective contraceptive presupposed that she had a physician, that she could afford a contraceptive, and that the physician would be willing to give it to her, regardless of her marital status."
These are the words of the historian Sheila Rothman, writing about the setbacks Margaret Sanger faced in the 1920s and 1930s in trying to realize her vision of making birth control widely available to all women, including the poorest—and about the ultimate “ownership” of contraceptive services during that era by physicians. Sanger’s original vision was a fleet of clinics, to be run by public health nurses. But as Rothman and others have documented, when she attempted to open such clinics, she experienced repeated arrests and the closures of her facilities, as contraception was then illegal. In the years leading up to the 1965 Supreme Court Griswold decision, which legalized birth control for married persons, only physicians were legally permitted to provide such services, and as the quote from Rothman implies, this situation put poor women at a tremendous disadvantage.
Rothman’s critique, written in the 1970s about events in the ‘20s and ‘30s, is remarkably relevant to today’s leading reproductive controversy: the Obama administration’s overruling of the FDA decision to allow over-the-counter status of Plan B, an Emergency Contraceptive product, for young women under the age of seventeen. If one substitutes “teenager” for “woman” and “Plan B” for “a safe and effective contraceptive” in Rothman’s quote, one can readily appreciate how, once again in America’s longstanding reproductive wars, the needs of the most vulnerable are willfully neglected.
Secretary of Health and Human Services Kathleen Sibelius and President Obama justified the Administration’s action because of concerns about pre-teens’ ability to use EC correctly. But as ha been repeatedly observed, only a tiny portion of this age group is sexually active. It is 15- and 16-year-olds who are sexually active in far greater numbers, and therefore, far likelier to have need of EC (and to be able to use it correctly). But many in this group do not have a primary health care provider to whom they can go for a prescription. Some of those who do have a relationship with a provider may be too embarrassed, or afraid of a breach of confidentiality, to ask for such a prescription.
To be sure, some things have improved in the contraceptive world since the dominance of private practice physicians in Margaret Sanger’s time. In 1970, Congress authorized the Title X program, which made federal funds available for family planning services for poor women including, notably, teenagers. (As a sign of how much the reproductive battle lines have hardened in the last 30 years, Title X was signed by a Republican president, Richard Nixon, and one of its most enthusiastic sponsors in Congress was a future Republican president, George H.W. Bush). A number of contraceptive products are available on the shelves of drugstores.
And it is no longer just physicians who can advise and dispense contraception. In public health clinics and Planned Parenthood facilities, nurses are in fact the main providers of contraception. We can hope that some portion of those teenagers who need EC can find their way to a Planned Parenthood or other Title X site in the three day window in which the drug is most effective.
There is another 99 percent group in our country, distinct from but inextricably entwined with the now more familiar #99Percent, those everyday Americans, who--in such a brilliant framing by the Occupy Wall Street movement--are to varying degrees affected by the vast economic inequality that characterizes American society. I refer to the 99 percent of American women who have ever had sexual intercourse and have used a birth control method at least some of the time. (As per the original Centers for Disease Control report, this statistic only includes contraceptive use reported by women during heterosexual intercourse).
Contraception obviously is a deeply held value by American women. But the fact that in the United States a startling half of all pregnancies are unintended makes clear that birth control is used only sporadically by some. There are a number of reasons why this is so, but a chief one is that so many women cannot afford contraception, especially the most expensive—and most effective--methods, such as birth control pills, and long lasting reversible contraception, for example, the newer (and far safer) models of IUDs (intrauterine devices). In short, the same economic disparities that pervade every other area of American life manifest here as well: poor women depend on publicly-funded programs for their contraceptive services, but, according to the Guttmacher Institute, only a little more than half of the 17 million women who need these services currently receive them.
This situation of tremendous inadequacy was supposed to improve considerably. In one of the best pieces of news in the otherwise embattled reproductive health world since the battles over health care reform began, the Obama administration announced last August that it would accept therecommendations of a special panel of the Institute of Medicine and include contraception—including all FDA-approved birth control methods—as part of the basic package of preventative health services that health insurance plans must offer, without co-payments.
Predictably, the August announcement has produced a massive campaign from opponents of contraception, especially the Catholic hierarchy. Though churches in fact have been granted an exemption from this requirement, the U.S. Conference of Catholic Bishops and its allies are pushing for much broader exemptions, for example to universities, social service agencies and other institutions with a religious affiliation—even if these institutions receive public funding. Such a move could potentially affect millions of women, of all religious backgrounds (or none), who work in such institutions.
My young friends who have been involved in the Occupy movement tell me that issues of reproductive justice have been muted, if evident at all, at the various Occupy sites. But as the occupiers put forward their vision of a just society, the old feminist dictum bears repeating: women cannot be full participants in any society unless they can control their fertility. The New York Timesquotes the president of the U.S. Conference of Catholic Bishops, reporting on a meeting with President Obama, as saying the latter “was very open to the sensitivities of the Catholic community.” President Obama, please be open as well to the tremendous struggles of women--members of both 99 Percent groups--who are desperate to control their childbearing in very harsh times.
These groups are asking you to join them in telling the White House not to throw women under the bus:
“Such hypocrites! They don’t like getting unwanted calls at home!”
In an irony that he clearly relishes, Todd Stave, a Maryland entrepreneur, is telling me about the abortion opponents who contacted him and asked that he suspend the phone campaign he initiated against them.
Stave is currently the subject of a certain amount of buzz in the abortion rights community, after his appearance on The Rachel Maddow Show. He came to Maddow’s attention because of his innovative, some would say ingeniously simple, way of responding to harassment from anti-abortionists. Stave is the owner of the property in College Park, Maryland on which sits the clinic building rented by Dr. Leroy Carhart, a longtime Nebraska abortion provider and former associate of the late George Tiller. After Tiller’s assassination, Carhart became a leading target of antiabortion forces, especially so when he began recently began performing later abortions in Maryland. (His move was a result of Nebraska legislation, targeted specifically at him, that banned abortions after 20 weeks). Besides vociferous protests at the site of the clinic itself, abortion opponents showed up on Parents’ Night at the middle school of Stave’s daughter. Brandishing signs with the usual mangled fetuses, as well as Stave’s name, photo and phone number, the protestors urged people to call him and ask that he “stop the child killing.”
Stave was no stranger to anti- abortion activity. His father, the late Carl Stave, was himself an abortion provider in the same community in the period immediately following Roe and was the recipient of protests as well, including a firebombing of his clinic. His son took these earlier protests quietly. But showing up at his daughter’s school was too much for him. He noted the phone numbers of those who called him and organized a group of 20 friends to call the antis back. In a polite but firm way, Stave and his circle of volunteers told the abortion opponents that Stave would not back down from the agreement with Carhart. Moreover, Stave asked his phone support team to notify their friends and associates about this activity and to contact him if they wished to be involved.
As Stave told me, to his astonishment within several weeks some 3000 people contacted him--“from all the U.S., from Europe, from Japan, I couldn’t believe it”-- asking to help with his campaign of call backs. Those who called or e-mailed him told how outraged they were by anti-abortion tactics and how happy they were to take action. Even more volunteers contacted him after his appearance on the Maddow show.
In his most recent campaign, Stave on very short notice mobilized his network to call the leader of a Maryland anti-abortion group that was planning to protest a “Run for the Cure,” in Baltimore, sponsored by the breast cancer group, the Susan G. Komen Foundation. (The Foundation has recently been targeted by abortion opponents because of donations it gives to Planned Parenthood for breast cancer screenings). Stave, who had subscribed himself to an anti-abortion listserv under an assumed name, read of the planned action, and saw to his delight that the leader had posted several phone numbers. Plausibly, he gives his volunteers credit for the reports that the “the planned protest fizzled to nothing.”
Stave has no illusion that campaigns of this nature will end all harassment from the opposition. “About 80 percent of people will stop the harassment after being contacted, 20%, the hard-core, won’t,” he speculates. But there is no question that his campaign has struck a nerve--both among some abortion opponents who have experienced the unpleasantness of receiving unwanted phone calls, and also among the large mass of people who are “pro-choice,” but one step removed from the abortion conflict—“civilians in the abortion wars” is how I have elsewhere referred to them. The response Stave has received thus far suggests the hunger among this group to find acceptable and feasible ways to counter the excesses of the anti-abortion movement. Stave has established an organization, Voice of Choice, which is currently operating with a small, mainly volunteer staff, and which continues to sign up volunteers willing to make phone calls on behalf of those who are harassed. As the organization’s website states, “Now it’s our turn.”
These two statements, the first by Jon Kyl, a U.S. Senator, the second by Michelle Bachmann, a Congresswoman who is also a Presidential candidate, have each received wide public attention. Each of these statements is blatantly untrue. These statements are a disturbing reminder that the field of reproductive health is particularly susceptible to politicians playing fast and loose with the truth in order to curry favor with social conservatives.
Reproductive health services have always stirred controversy, intersecting as they do with issues of sexuality, morality, parental rights, and so on. But it was during the presidency of George W. Bush that the attacks on this aspect of health care—especially abortion care—became increasingly disengaged from the truth.
As I have detailed in my recent book, Dispatches from the Abortion Wars, the Bush Presidency was marked by scandals such as government websites being pressured to list false information on the alleged links between abortion and breast cancer, and the purported ineffectiveness of condoms. An investigation of the curricula used in federally funded “abstinence only” programs found shocking evidence that some 80% of these programs gave misinformation to young people, such as “sweat and tears can lead to HIV transmission.”
The reproductive health community hoped that with the transition to a new administration these egregious distortions would stop. And in some respects the situation has improved. In the thank-goodness-for-small-favors department, we can be gratified that government websites no longer post such gross misinformation. But clearly, as the two quotes above make clear, untrue and irresponsible statements about reproductive health matters have not gone away in public discourse.
In the case of Senator Kyl’s statement, Planned Parenthood restated its frequent claims that abortions constituted 3% of its services, not the 90% the senator had claimed. The incident concluded, to the delight of many late-night comedians, with a Kyl spokesman acknowledging that “the senator’s remark was not intended to be a factually based statement.”
The dangers of non-factually based political discourse
Why do these untrue statements matter? After all, presumably most people—most importantly, the millions of women who go to Planned Parenthood for contraception, cancer and STI screenings—know Kyl was massively off base. Michelle Bachmann’s statement was roundly disputed by experts and seemingly has damaged her political fortunes. Nonetheless, I believe statements like these do very much matter. The normalization of lying about health care issues by prominent figures is a very serious breach of trust, and degrades our culture as a whole.
More specifically, these statements point to two different ways in which the field of reproductive health can be weakened by such deliberate distortions. In the case of Planned Parenthood, the attacks by Kyl and numerous other politicians who have sought to demonize the Federation have created a clever rhetorical trap, where the defense becomes, as shown above, that “only 3% of what we do is abortion.” In a version of the old “have you stopped beating your wife” question, these attacks succeed in further marginalizing abortion from other reproductive health care services in the public’s eye.
The serious damage done by Bachmann’s HPV anecdote is best illustrated by a headline that appeared shortly afterward in the New York Times Science Section: “Remark on HPV Vaccine Could Ripple for Years.” The article makes clear the dismay felt in the public health community about this incident.
In simplest terms, as the author puts it, “When politicians or celebrities raise alarms about vaccines, even false alarms, vaccination rates drop.” The HPV vaccine—most effective when given to young girls at ages 11 or 12, before they have started sexual activity—was already quite controversial, because some in the public felt it was a “license” for promiscuity (and there is increasing distrust of vaccines generally among some parent groups). As a result, even before the Bachmann remark, uptake of the vaccine was below expectations. Now, as a member of the American Academy of Pediatrics quoted in NYT article put it, “These things [politicians' misstatements] always set you back about three years, which is exactly what we can’t afford.”
Rick Perry has only two children?! As the biographical information flashed by on television during a recent debate of Republican presidential hopefuls, it was strangely incongruous to see that the rising star of the religious right was so woefully behind his competitors. Rick Santorum and Jon Hunstman led the pack with seven kids each, followed by Ron Paul, Mitt Romney and Michelle Bachman with five (and the 23 children she had fostered). To be sure, Newt Gingrich and Herman Cain also had a paltry two, but they, unlike Perry, were not considered to be the new favorite of the social conservative wing of the Republican. Recent polls show Perry supplanting Bachman in that role, notwithstanding her impressive numbers.
Perry’s late entrance into the race saved him from the awkwardness of having to deal with the “pro-marriage pledge," put forth by a leading Iowa conservative activist, and signed by some of his fellow candidates who had competed in that state’s straw poll. This pledge, among other things, asked signers to affirm that “robust childrearing and reproduction is beneficial to U.S. demographic, economic, strategic and actuarial health and security.” (Shortly after his official entry into the race, Perry did sign yet another pledge, this one in support of a federal amendment against gay marriage).
The reason that Rick Perry has “only” two children, one can say with confidence about this normally private matter, is because of the widely disseminated fact of his vasectomy. cited in the New York Times among other places. (This procedure, to the delight of late night comedians, was apparently performed by his father-in-law).
Speaking as a reproductive health advocate, I have quite mixed feelings about Perry’s decision (presumably made with his wife) to have a vasectomy. On one hand, I strongly believe that men should share in the task of contraception, and I commend the governor for doing so. Despite tantalizing talk for years of research on a “male birth control pill,” vasectomies and condoms are currently the only contraceptive options for men. Though vasectomies have a proven record of safety, efficacy and satisfaction, only a relatively small number of American men elect this procedure, in part because of a belief that it might affect sexual functioning.
In theory, Perry, whose persona is that of a swaggering alpha-male, could help popularize this method, making clear that “real men” have vasectomies. Just as the late First Lady Betty Ford’s openness about her breast cancer spurred many women to undergo mammograms, Perry’s public endorsement could increase the popularity of vasectomies.
Moreover, Perry has led an attack on family planning services used by low-income Texas women. He recently signed a budget bill reducing the state’s family planning funding from $111 million to just $37 million. Following the playbook of the religious right in other states, Perry and the Texas state legislature have moved to defund Planned Parenthood clinics, the largest state to do so. To gain a sense of the magnitude of these cuts, in just one Texas affiliate—Planned Parenthood of the Texas Capital Region--- some 4,000 patients will lose access to birth control services, as well as breast and cervical screenings, and HIV tests.
It’s too late for Rick Perry to compete with the other Republican presidential candidates in the “robust childbearing” department. Perhaps some of the most fervent Christian conservatives will fault his vasectomy as it violates the biblical junction to “be fruitful and multiply.” But in his relentless attacks on contraception, and of course, abortion and comprehensive sex education, Perry is doing all he can to reassure his base that many of his fellow Texans will not have the same opportunity to control their childbearing as the Perry family had.
How much I appreciated your gracious letter telling of plans for the Western Regional Conference on Abortion and inviting me to attend.
Although my upcoming personal and official commitments will not permit me to be with you, I am grateful for this opportunity to convey my warmest greetings to all attending and my hopes for the success of the Conference.
So wrote Betty Ford, in February 1976, to the organizers of one of the first medical conferences on abortion to take place in the U.S. after the Roe v Wade decision in 1973—a message that would have been inconceivable for any of the Republican First Ladies that followed her. What Betty Ford said publicly about abortion, and what subsequent Republican women in that role could not, speaks both to the spirited and independent character of the former, who died on July 8 at age 93, and to the sea change in American politics that was shortly to come with the rise of the Religious Right and the role of abortion as that movement’s leading wedge issue.
But even in 1976, a newly emerged Right to Life movement was making clear that presidential candidates would be accountable for their positions on abortion, which had been legalized in 1973 with the Roe v Wade decision. And President Gerald Ford, running for his first election to the office (after taking over from the disgraced Richard Nixon in 1974) was under attack from antiabortion forces for his “waffling” views on the subject, arguing that Roe v Wade went too far, and that the abortion issue should be left to individual states. In contrast, his wife at that time publicly reaffirmed her full support of Roe, stating in a television interview that the decision took the issue “out of the backwoods and put [it] in the hospital where it belongs. “
To be sure, it was not only on the topic of abortion that Betty Ford was outspoken. Again, in a way that would be unimaginable for later Republican First Ladies, she identified as a feminist, supported the ERA, and spoke frankly about the realities of premarital sex. Of course, not all her views were, in today’s terms, “liberal”—she was a strong supporter of the Vietnam War, for example. And the admiration she drew from the public—the New York Times in its obituary stated she was among the most popular of all First Ladies—transcended conventional politics. It was her candor about her struggle with breast cancer, at a time when the disease was rarely spoken of publicly, and even more courageously, her public acknowledgement of her struggle with alcohol and prescription drug abuse (which led to the founding of the Betty Ford Center for treatment of chemical dependency) that arguably is the main source of such lasting affection from the American people.
And what of Betty Ford’s Republican successors as First Ladies? Did they speak as freely as she did? On the abortion issue, there is reason to believe that all of the women in question—Nancy Reagan, Barbara Bush, and Laura Bush—were to varying degrees prochoice (as indeed, privately, may have been all their husbands), but all these women felt constrained from speaking frankly. Nancy Reagan’s views are perhaps the most ambiguous, but Lou Cannon, Ronald Reagan’s biographer, has written that while the latter was governor of California, both his wife and father-in-law supported the California Therapeutic Abortion bill signed in 1967. In his memoir the late Donald Regan, Reagan’s chief of staff during his presidency, quoted Nancy Reagan as saying privately to him, “I don’t give a damn about the right to lifers.” The views of Barbara and Laura Bush are much clearer. The latter, in a memoir published after her husband’s presidency stated her support of Roe v Wade. The former, in the summer of 1992, while her husband was campaigning for reelection, even stated her belief that abortion and homosexuality were “personal choices” that should be left out of politics—though whether this was a case of Barbara Bush acting in a moment of genuine independence, or in a calculated move to draw in support of the rapidly diminishing moderates in the Republican party, remains debatable.
What is not debatable is that Betty Ford’s tenure as First Lady was the last time in American politics that someone in that role could inspire bi-partisan admiration—even while expressing her own political views. American politics has become so polarized, and the culture wars so fierce, that First Ladies can only be broadly liked if they suppress their own views on controversial matters. Betty Ford’s passing reminds us of what has been lost in our political culture.
9.pm. In bed at hotel. Landline rings. 'Hello"? "Dr. Benton ?" "Yes. Who is this?" "How many babies did you kill today?"
I hung up. Heart started pounding. Someone who doesn't like me at all at all knows exactly where I am. I disconnect the landline.
Immediately cell phone rings. Blocked number. "Hello?" Same voice. I didn't say anything but listened as he spoke…Heart pounding. Someone who doesn't like me…knows my cell phone number and knows other things about me. …I hang up.
Immediately he called again. I didn't answer. He left a message on my voicemail, saying, "this isn't----(east coast state where Dr. Benton lives)—this is------------(southern state where she traveled periodically to perform abortions)."
I didn't sleep much that night.
The above is an excerpt from an e-mail I received from Dr. Felicia Benton (not her real name). I had recently concluded a phone interview with Dr. Benton about her experience as an abortion provider who travels from her home state several times a month to provide abortions in underserved areas. The matter of these disturbing phone calls did not arise until we continued our conversation via e-mail. Dr. Benton also mentioned that the caller knew in which city she lived, and had even left abusive messages on her elderly mother's answering machine.
The media's coverage of abortion these past few months have focused, understandably, on the seemingly endless assaults on the procedure by Congress and by individual state legislatures , who have passed measures ever more extreme and bizarre: e.g., the House bill that allows hospitals to refuse abortions even if a woman's life is at stake, the recently passed South Dakota law that compels women seeking abortion to first go for "counseling" to a religiously based, anti-abortion Crisis Pregnancy Center and then wait three days before they can legally obtain an abortion, and so on. But Dr. Benton's experience—which is hardly unique-- reminds us that there is, simultaneously, another war on abortion occurring, this one waged directly on abortion providers.
This war on providers has been going on so long that it has become essentially "the new normal," with significant public attention coming only when a member of the abortion providing community is murdered. There have been eight such murders thus far, the most recent being that of Dr. George Tiller of Kansas, in May 2009. Dr. Tiller's murder, and the upsurge of aggressive incidents reported at clinics immediately following this tragedy, continues a pattern of the worst antiabortion violence occurring during the administrations of Democratic presidents. (The seven murders preceding that of Dr. Tiller came during Bill Clinton's presidency).
Apart from these murders, how much antiabortion violence and harassment are there, and at what point can these acts legitimately be called "terrorism?" Certainly, noisy picketing outside a clinic can be annoying to both providers and patients, but such picketing is of a different order than a doctor in a hotel room receiving a threatening call on her unlisted cell phone number, which in turn is different from the firebombing of a facility, which in turn is different than attempted murders, which in turn are different from successfully executed murders.
The Guttmacher Institute, the National Abortion Federation, and the Feminist Majority Foundation are the organizations that have done the most to track violence against abortion providers and each make useful contributions to understanding a complex, and depressing, picture. From the Guttmacher Institute's latest figures, we learn that 88 percent of abortion clinics experienced at least one form of harassment in 2008, most commonly picketing, but—notably—42 percent reported picketing that also involved patient blocking. Nearly one fifth of clinics reported vandalism. Harassment was especially acute at larger abortion facilities: nearly all providers that provided 1000 or more abortions per year reported picketing (with a higher incidence of patient blocking) and nearly one in five of these reported a bomb threat.
The Feminist Majority Foundation's periodic surveys of clinic violence contains the category of "severe violence," referring to blockades, invasions, arson, chemical attacks, stalking, physical violence, gunfire, bomb threats, death threats, and arson threats. The worrisome finding from the 2010 survey is that 23.5 percent of all clinics reported incidents of such severe violence, up from 18.4 percent in 2005. Stalking was the most common event in this category.
The National Abortion Federation has tabulated incidents of violence and disruption against its member facilities since 1977. Here are some of the totals in various categories: besides the 8 murders, there have been 17 attempted murders, 175 incidents of arson, 41 bombings, 1429 incidents of vandalism, 2057 cases of trespassing, 661 anthrax threats, 526 cases of stalking, and 416 death threats.
While this level of violence would be unacceptable—indeed unthinkable-- in any other branch of American medicine, in the case of abortion this violence is seen as acceptable fodder for politicians' wisecracks. For example, at a recent mayoral candidate forum in Jacksonville, one of the contenders, according to a local paper, said "the only thing he wouldn't do was bomb an abortion clinic, then….added, with a laugh, 'but it may cross my mind.'" Even more alarmingly, several states have recently introduced legislation permitting "justifiable homicide" in the defense of a fetus, which many feel would lead to open season on abortion providers.
To be sure, the federal government has tried to respond to the attacks on abortion providers. Most notably, in 1994, President Clinton signed the FACE (Freedom of Access to Clinic Entrances) Act, which made it a federal crime to impede patients' entry to an abortion entry. The FACE Act has been credited with significantly lowering the number of full-scale blockades of clinics that were commonplace in the late 1980s and early 1990s. And there is every reason to believe that President Obama's Justice Department takes seriously threats of extreme violence against providers. Nevertheless, the depth of local law enforcement's commitment to protect providers varies from place to place. The provider community is still haunted by the fact that Scott Roeder, Dr. Tiller's assassin, was seen the day before the murder, vandalizing another clinic, and though his license plate was reported to local authorities, there was no action taken.
And how, finally, should we understand the frightening calls that Dr. Benton received? Should they be seen merely as "harassment" or, as I believe—given the totality of the record of violence against providers since the 1970s-- as one element of a larger campaign of genuine terrorism? Though the three organizations mentioned above have done an excellent job of tabulating incidents on the spectrum of abortion violence, the more qualitative question of the impact of such incidents remains unanswered. In Dr. Benton's case, though admittedly shaken by the calls, she remains resolved to continue abortion work. For unrelated reasons, she no longer works at the southern clinic, but still travels to other facilities. What is unknown is how many providers have stopped such work—or never started it-- as a result of similar intimidation.
"(I am proud of) trying to defund Planned Parenthood and make sure they didn’t have any money, not just for abortion, but money for anything."
This is gubernatorial candidate Scott Walker speaking to Wisconsin Right to Life last April, boasting about his record as a state legislator. And for this constituency, now-Governor Walker has come through. His recently released budget proposes to repeal Wisconsin’s “contraceptive equity” law which stipulates that that health insurance plans in the state that cover prescription drugs cover contraception. The budget also eliminates the state’s participation in the Title V Maternal and Child Health program, which provides family planning services as well as other health services for both men and women, including prostate and cervical cancer screenings. Planned Parenthood of Wisconsin argues that such a move would mean the loss of four million dollars (of both state and federal funds) affecting 50 health centers in the state (PP receives about one quarter of Wisconsin’sTitle V funds).
Scott Walker’s actions in the short time he has been governor (he took office in January) were supposed to serve as a template for the newly energized Republican governors and state legislators who came to power as a result of the November 2010 “shellacking.” That is, please your religious right base by going after birth control services in general and Planned Parenthood in particular, and please economic conservatives by offering generous tax breaks to corporations, massively cutting social programs, and greatly weakening, if not destroying, public sector unions.
As a fascinated country has seen for the past several weeks, that part about destroying the unions hasn’t played so well. Walker’s poll numbers are tanking. The Republican leaning Rasmussen poll recently found that nearly 60% of Wisconsin likely voters now disapprove of Walker, with 48% “strongly disapproving.” Observing Walker’s situation, a number of other Republican governors have backed off from earlier plans to similarly combat public sector unions in their states.
Thus far, however, neither Republicans in Congress or in state houses show signs of retreating from the harsh and increasingly bizarre war they are waging on abortion and contraception. In Congress, Republicans (and a handful of Democrats) voted to defund Planned Parenthood and Title X, a program that funds family planning and other basic reproductive health services, and passed legislation that permits hospitals to deny lifesavingabortions. At the state level, several states are considering legislation that has been interpreted as making the killing of abortion providers “justifiable homicide,” Georgia is considering a “prenatal murder” bill that would make miscarriages suspect unless a woman could “prove” she did nothing to cause it, and S. Dakota has decreed that before a woman can receive an abortion she must first go to a blatantly antiabortion “Crisis Pregnancy Center” for counseling—and then wait three days before seeking an abortion.
But there are signs that the American public is noting with alarm these fanatical measures. Just released data from the Pew Research Center for the People and the Press shows a “movement toward a liberal position on abortion.” While much has been made of a 2009 poll that showed the public evenly divided on the question of whether abortion should be legal, Pew reports that “support for legal abortion has recovered” and now stands at 54%, with 39% opposed. Similarly, two recent polls show voter disapproval of the defunding of Planned Parenthood, with particularly strong opposition among women and younger respondents.
Though both the right and the left have tended to treat economic issues, including the fate of labor unions, and reproductive rights as separate phenomena, with two different constituencies, in the real lives of working people, these issues are very much connected. Hardly surprisingly, in difficult economic times people try to control their childbearing. This was true during the Great Depression of the 1930s, and it is true today. The Guttmacher Institute released a report, at the height of the current recession that showed that many women did not feel they could afford another child and that they they were committed to using birth control more consistently. Yet the report also showed that one in four respondents put off a visit to a family planning center because they could not afford it.
It is too soon to know the significance of the poll numbers cited above, or of the nation-wide demonstrations in recent weeks in support of both labor unions and Planned Parenthood. Possibly, though, this political moment may mark a serious pushback against the Right’s extraordinary overreach, since the 2010 election, in its eagerness to abolish both the workplace conditions and health care services needed by so many.
Though many people are shocked by Congress’ recent withdrawl of funds from Planned Parenthood clinics to provide family planning services, in fact right wing attacks on this organization are nothing new. For example, the Texas legislature in late 2005 passed legislation that redirected millions of dollars from Planned Parenthood and other family planning providers in the state to Crisis Pregnancy Centers, organizations which promote pregnancy and offer no contraceptive services. Here is an excerpt from a blog written by an impoverished Latina woman, “Tanya,” the day this new policy was announced:
So this morning I dragged myself out of bed before dawn to be at planned parenthood at 730 and wait in the freezing morning shade until 9 for my annual exam. At 930, myself and the 25 other women (of color) grumbled in solidarity and confusion, wondering why we were still waiting and shivering, finally an employee opened the doors, and corralled us inside just to inform us that there would be no walk-in exams today. or tomorrow. or ever. Boys at the texas state legislature cut pp’s funding by 40% last Friday.
I stood at the office stunned, while 3 mothers began to cry. Another woman, at least 65 years old, turned to me and asked, “que dijo?” (what did she say?). as I tried to explain what I still didn’t understand, I began to feel my anger swell. Overnight one of the safest, most reliable, most critical social services vanished.
As Tanya’s blog makes clear, low income women come to Planned parenthood clinics for a variety of services. As Planned Parenthood spokespersons endlessly repeat, only 3% of the organization’s services involve abortion, and no public funds are used to subsidize those procedures. The elderly woman mentioned in the blog was presumably there, like Tanya herself, for an annual exam that includes breast and cervical cancer screenings, and Tanya was there as well for reduced -costs birth control pills.
For me, the two most compelling answers to this question lie in the reframing of contraception within antiabortion circles, and the continued dominance of the religious right in Republican circles, all the buzz about the Tea Party notwithstanding. As I discuss at greater length in my recent book, Dispatches from the Abortion Wars, while once politicians on both sides of the abortion divide viewed contraception as true “common ground” (in the late 1970s, as a Texas congressman, George H.W. Bush was such an enthusiast for subsidized family planning, that his nickname in the House was “Rubbers”), over time this understanding broke down.
Particularly after Ronald Reagan was elected in 1980 with the active help of social conservatives, contraception, and the facilities that provided such services, such as Planned Parenthood clinics, came to be seen as “supportive of the abortion mentality,” because often these two services were delivered in the same building (albeit with strict separation of funding). Also, as abortion opponents frequently put it, with a certain logic, those who tried to prevent conception were more likely to choose an abortion if contraception failed.
In yet another evolution, the attack on contraception escalated from being seen as “supportive” of abortion to actually being an “abortifacient,” that is something that causes an “abortion.” Therefore, by the late 1990s, the pharmacy became a new battleground in the U.S. reproductive wars, with numerous instances of “prolife” pharmacists refusing to dispense both emergency contraception and “regular” birth control pills.
Finally, the attacks on Planned Parenthood (as well as other recent appalling legislation we have seen in Congress, for example the Orwellian named “Protect Life” act, which allows hospitals to deny abortions in life-threatening situations) are occurring because clearly the Republican leadership thinks such moves are good politics. The massive budget cuts proposed by Republicans, egged on by Tea Partiers, will not create jobs; indeed economists such as Paul Krugman have argued that such massive cuts are job weakening. Moreover, such cuts have the potential to create hardships for conservative families as well as the hated liberal ones, and in any case, these budgetary actions will not survive intact, after the Senate and the president deal with them. The one part of the Republican core constituencies that can be reliably rewarded is the religious right, an absolutely crucial group for the Party, both in terms of donations and precinct level electoral work.
Of course, one can reasonably hope that neither the defunding of Planned Parenthood nor the various legislative attacks on abortion will survive either, in their present form, once they reach the Senate. But these votes reassure the base that their concerns are being heard, and most importantly, do serious damage by moving the “center” of reproductive politics farther to the right. It may be too much for the Democratic-led Senate or the president to defund Planned Parenthood entirely, but it will seem a reasonable compromise to significantly cut the group’s allotment, and to continue the longstanding policy of inadequately funding contraceptive services more generally. Maybe hospitals will not have the option of letting women die if an abortion would save their lives, but other cruel restrictions (refusing an abortion if it would cause serious health damage) will, again, be seen as acceptable—or at least, necessary--compromises. Until enough American voters see the absurdity of these compromises—not to mention the misogyny of denying poor women cancer screenings at a Planned Parenthood clinic—the United States will fall even further behind other industrialized countries with respect to basic reproductive health care.
Reading the Grand Jury report on Women’s Medical Society in Philadelphia, the now-closed abortion clinic ran by Dr. Kermit Gosnell, is stomach turning. This was truly a chamber of horrors: a filthy facility, with blood stained blankets and furniture, unsterilized instruments, and cat feces left unattended. Most seriously, there was a jaw dropping disregard of both the law and prevailing standards of medical care. Untrained personnel undertook complex medical procedures , such as the administration of anesthesia, and the doctor in question repeatedly performed illegal (post viability) abortions, by a unique and ghastly method of delivering live babies and then severing their spinal cord. Two women have died at this facility and numerous others have been injured. What remains baffling is how long this clinic was allowed to operate, in spite of numerous complaints made over the years to city and state agencies, and numerous malpractice suits against Dr. Gosnell. Indeed, it was only because authorities raided the clinic due to suspicion of lax practices involving prescription drugs that the conditions facing abortion patients came to law enforcement’s attention.
As information about this clinic spread, many have understandably compared Women’s Medical Society to the notorious “back alley” facilities of the pre-Roe era, when unscrupulous and often unskilled persons (some trained physicians, some not) provided abortions to desperate women, in substandard conditions . This is an apt comparison. But Gosnell’s clinic should not only be understood as a strange throwback to the past. Women’s Medical Society represents to me an extreme version of what I have termed “rogue clinics,” facilities that today prey on women, disproportionately women of color and often immigrants, in low income communities.
From our justice system to immigration, our authors have been working within and on behalf of progressive communities agitating for change in our world. Here's a sampling of their many conversations this past week:
In response to a recent New York Times article on the inherent racial biases in police killings, Jason Marsh, co-editor of Are We Born Racist?, remains optimistic in an article he wrote for Greater Good. "New York State's recognition of the problem," he says, "is certainly an important step forward."
John Buehrens, coauthor of A House for Hope, writes openly and warmly about a "liberal religious renaissance" in a guest blog post for Washington Post's "Political Bookworm." In the blog, Buehrens states, "Conservatives in religion too often operate out of lesser rules, and out of cultural stereo-types of what constitutes a loving family. Too often they seem to pander to the fear of change. And for the past 30 years they have had the loudest religious voice in America."
In a fascinating article in The Washington Post on the aging baby boomer generation, Fred Pearce covers the idea of the retirement age, an older workforce, and the inspiration of a lively 108-year-old Japanese woman named Ushi Okushima. A quote from his book, The Coming Population Crash, can be seen over on Grist. The Guardian reported on Pearce's appearance at the 2010 Hay festival.
The Willamette Weekwelcomed a look into the lives of the Hispanic teenagers at the heart of Steve Wilson's debut book, The Boys from Little Mexico: "what this book offers is an actual human face on immigration and the people affected by it." Oregon Magazine applauded Steve's "riveting sports writing coupled with a compassion for his subjects' lives."
In the year since the murder of Dr. Tiller, the polarization around abortion in the United States shows no signs of abating. State legislatures have passed a host of measures restricting abortion provision in various ways, measures which are noteworthy for the mean-spiritedness directed toward women. In Oklahoma, for example, among the new laws are a mandate that women must view an ultrasound of their fetus and hear a doctor describe various parts of the fetal body (with no exception for victims of rape or incest), and another law that requires that women fill out a 36-page questionnaire, giving extensive demographic information as well as the reason for their abortion. Yet another law passed in that state exempts doctors from lawsuits if they decide to withhold information about fetal anomalies from pregnant women, as a strategy to prevent these women from aborting.
In the period since Dr. Tiller's death, many clinics have reported an upsurge in threatening and aggressive behavior by protestors. Tiller himself continues to be vilified by his enemies, most recently at the annual meeting of ACOG (American College of Obstetricians and Gynecologists), where protestors stood outside the conference hotel carrying signs that read "George Tiller is burning in hell."
Far more encouraging, however, are the actions that have been taken by Tiller's former colleagues in the abortion providing community. Aware that Tiller's death left a huge gap for those women needing later (post 24-week) abortions (as discussed in the piece linked here), physicians, researchers and advocates have formed a network which is strategizing how to increase the availability of such services, and which disseminates accurate information about this subject to both clinicians and prospective patients.
Most notably, Dr. Curtis Boyd, a longtime abortion provider in New Mexico, and a close friend for decades with George Tiller, has recently expanded his practice to include post-24 week abortions "on a case-by-case basis." Two of the physicians who worked with Dr. Tiller in Kansas now work with Dr. Boyd. When I asked Dr. Boyd about this change in his practice, he told me, "We felt we had to do it…both for the women who need this service and to honor George's memory."
As a citizen of this country, I was deeply distressed to learn of the abusive behavior and threats of violence that you, your family and a number of your Congressional colleagues have suffered since you and others voted in favor of health reform. A fellow member of Congress screamed “baby killer” as you were speaking on the floor of the House. You have received death threats. I heard on television some of the phone calls you received and they were truly sickening. I understand why your wife has been so tormented by these threatening phone calls, that she has taken the phone off the hook.
Protestors showed up at the home of the brother of Congressman Tom Perriello of Virginia mistakenly thinking it was the Congressman's home, and cut a gas line. Congressman Anthony Weiner of New York was mailed a letter purporting to be anthrax (this turned out to be a hoax, but a very time consuming and frightening one, as workers in Weiner's office had to be decontaminated). Other members of Congress have expressed fears for their families' safety in the wake of the health reform vote.
In a civilized country, no one should be subject to these kinds of actions because of his or her political beliefs. It is not too much to say that what you and other Congressional officials have experienced constitutes authentic domestic terrorism. I'd like to point out to you that there is another group of Americans who have long been terrorized in ways similar to what you and your colleagues have experienced. I refer to members of the abortion providing community. There are literally thousands of documented instances of death threats, anthrax threats, aggressive picketing at providers’ homes and places of worship, and harassment of family members, including children, that this community has suffered. Eight members of this community have been assassinated.
In the wake of the threats that you have received, you have spoken out forcefully against this kind of unacceptable behavior. I truly sympathize with you when you say those threats had made your life a "living hell."
I wonder, however, if your own experience has made you more empathetic with abortion providers, who have for years endured similar behavior from the same antiabortion extremists who have now targeted you? Though obviously you and the provider community do not agree on the abortion issue, perhaps now you can agree with them that the disagreements over this issue must remain civil. How can we call ourselves a democracy if we cannot express political beliefs without fear of violence? Congressman Stupak, I respectfully call on you to disavow violence against all Americans, not just elected officials.
The abortion wars rage relentlessly on, in the United States and elsewhere.
Consider the various abortion-related items in the headlines these first days of March. After months of wrangling and immense concessions from abortion rights supporters, abortion still has the capacity to derail Congressional passage of a health reform bill, as some House antiabortion legislators remain dissatisfied with the actually quite onerous funding restrictions of the procedure in the Senate measure. A woman in Nicaragua, the mother of a ten year old girl, is denied an abortion even though she is a suffering from cancer, and is not allowed to start chemotherapy as long as she is pregnant.
And antiabortion fanatics in state legislatures continue to pass laws that are truly hard to parody. The latest of these is a Utah measure which would permitted life imprisonment for a woman "whose intentional or reckless behavior" caused the death of her fetus—if implemented, this bill which would have the effect of making suspect every miscarriage occurring in that state. (Though the bill passed in the Utah legislature, its sponsor withdrew it for revision in the face of massive national criticism.
Indeed, one of the few genuine abortion parodies around-- the Onion's hilarious account of a law requiring women seeking abortions to first name the baby and paint the nursery-- is actually not that far removed from a real-life incident I recount in my book, Dispatches from the Abortion Wars. In this case, a pregnant woman with the life threatening condition of DVT (deep vein thrombosis, a blood clot in the leg), was scheduled for an in-hospital abortion. While hospitalized for a flare-up of her condition several days before her abortion, she was forced by an anti-abortion doctor to tour the newborn nursery!
CNN Newsroom featured a live interview with Sonia Sanchez on Sunday.
The five minute interview focused on the Smithsonian's Freedom's Sisters traveling exhibit, which features Sonia Sanchez and nineteen other 19th and 20th century African-American female activists. The video is embedded here, but if it doesn't appear, you can follow this link.
Taking stock of where the abortion issue stands at this, the 37th anniversary of Roe v Wade, its hard not to conclude that the present moment is one largely of disappointment and concern for abortion rights supporters. This disappointment is especially poignant, given the exhilaration that many felt a year ago, when Barack Obama took office. After eight long years of George W. Bush, a presidency whose record on abortion and other reproductive matters was so egregious, it is truly hard to parody (remember the proposal to provide health care for fetuses, not the pregnant women carrying those fetuses, or abstinence programs aimed at 18-29 year olds?), there were high expectations, perhaps unrealistically so, for the Obama presidency.
To be sure, some good things in the reproductive realm have happened in this new administration, particularly with respect to international matters. The notorious global "gag rule," which prevented U.S. funding for family planning services in countries or agencies that used their own funds for abortion-related activities, was quickly overturned. The State Department, under the leadership of Hillary Clinton, made clear that abstinence promotion would no longer be a centerpiece of this administration's HIV-AIDS policy. Clinton herself recently gave a powerhouse of a speech, in commemoration of the 15th anniversary of the landmark UN Conferences in Cairo and Beijing in the mid-1990s, reaffirming the administration's commitment to the empowerment of women globally, and the crucial role that reproductive health services play in this.
Domestically, however, there is much less to cheer about. Positions in the federal bureaucracy that may be obscure, but which are central to delivering good reproductive health care (and undoing the damage of the Bush years), such as the deputy assistant secretary for population affairs, the official in charge of all federally funded contraceptive services, remain unfilled while the administration has focused laser-like on health reform.
"Well, it looks like the reinforcements have arrived!" a beaming Diane DeGette, congresswoman from Colorado, and a key leader of the abortion rights forces in Congress, recently told a spirited crowd overflowing a Senate auditorium. The prochoice movement was admittedly caught off-guard by the last minute passage of the Stupak-Pitts amendment to the House health care bill, a measure which would have the effect of massively restricting abortion coverage by insurance plans, even private ones (links to pdf).
But now a rejuvenated movement got its act together and brought approximately 1000 supporters to Capitol Hill for a day of serious lobbying.
The day was full of fiery speeches by legislators and advocates, and visits to thank supportive politicians and to educate/cajole undecided ones. The preponderance of younger women (and some men) in the crowd was deeply heartening to the old-timers. Like many political gatherings at moments of heightened stakes, the event had an almost festive air, as veterans of past campaigns greeted each other, and as strangers from the same states quickly bonded and formed groups to lobby their state's representatives together.
For this correspondent, however, the most moving and significant part of the day was my conversation with three women who had later abortions. They were introduced to me by staff from the National Abortion Federation. All three women-- Dana, Christie, and Mary-- had experienced much wanted pregnancies that took nightmarish turns. Dana found out at 28 weeks of pregnancy that the brain of her baby (and for women carrying much desired pregnancies, "baby" rather than "fetus" is the term typically used) was missing the crucial band of tissue that connected the right and left hemispheres (agenesis of the corpus callosum in medical terms). This and other brain-related anomalies meant that her child, if carried to term, would suffer repeated seizures, and be unable to suck, swallow, feed, walk, talk, or know his or her environment. Dana and her husband saw no alternative to having an abortion-- for the sake of her two year old son, for the sake of their marriage-- but most of all for the baby they already called "Lil W." "When I felt him kick before the diagnosis, I thought 'great'! When I felt him kick after I got the diagnosis, I knew he was having seizures."
"I have seen the future and it works" goes the old saying. Well, this writer has seen how the future of health care in America should work. I recently attended a press briefing on women and health care reform held by four Democratic Congresswomen—Jan Schakowsky of Illinois, Gwen Moore of Wisconsin, Carolyn Maloney of New York and Lois Capps of California. All four have taken leading roles in the current health care debates on Capitol Hill and all support H.R. 3200, the main health care bill passed by the House.
The proposals supported by these legislators struck me as bizarrely reasonable. "Bizarrely reasonable" only because what exists currently in many health insurance plans is so breathtakingly unreasonable when it comes to women's health care needs. The current landscape of health insurance for women is one in which a past C-section, even a current pregnancy, can constitute a "pre-existing condition" that can disqualify one from obtaining coverage; a history of past domestic violence can similarly be grounds for exclusion; some policies do not cover maternity care or contraception. (Ironically, at the same time this briefing was held, over in the Senate, during the Finance Committee's deliberations on health reform, the now famous exchange between Senator Jon Kyl of Arizona and Debbie Stabenow of Michigan was taking place. When Kyl, attempting to strike down a provision that would stipulate any benefits a health plan must provide, pontificated that he "did not need maternity care," Stabenow retorted, "I think your mom probably did!")
"It comes down to who is the patient. Is the woman the patient, or is the fetus the patient? One or other is the patient. I've never heard a fetus talk to me. I've heard thousands and thousands of women share their pain, their desperation, and their hopelessness." These words were spoken to me some twenty years ago by Dr. George Tiller, as I was researching a book on abortion providers' experiences before and after Roe v Wade. Tiller, who was brutally assassinated in his church on May 31, was one of the most compassionate-- and feminist-- individuals I have ever encountered. "Trust women" was his well-known motto, prominently displayed at his clinic in Wichita, Kansas.
He was asked repeatedly by friends how he could continue his work in the face of the unending violence and legal harassment that he endured in the years leading up to his murder: his home and office were frequently blockaded (I recall hearing that he and his wife had to be helicoptered out of their house to attend a child's wedding, as antiabortion fanatics were surrounding his home); he was shot in both arms in 1993; and he was subjected to numerous lawsuits brought by a grandstanding anti-abortion Attorney General in Kansas and by Operation Rescue operatives, all of which he ultimately won, but which took a huge toll, financially and emotionally. His answer was always the same: "Where else can these women go?"
Tiller's answer was not a rhetorical one. He was one of the very few physicians in the United States who provided abortion care well into the third trimester of pregnancy. It is this fact that made him so reviled in antiabortion circles, and unquestionably the most controversial abortion provider in the country. Operation Rescue relocated their offices to Wichita a few years ago, with the specific intent of closing him down. Each day, the women who came to him from all over the U.S., and from abroad as well, had to go through a gauntlet of protestors holding grotesque posters and screaming about "Tiller the baby killer."
It is hardly surprising that antiabortion zealots would find Dr. Tiller such a convenient target, focusing on his late term procedures. What has been more surprising, and disappointing, to me has been the inadequate coverage of Tiller's work in most of the mainstream media in the days since his murder. I myself have spoken to a fair number of reporters, have read numerous stories from papers across the country, and consumed a great deal of television and radio reporting on this event. I have been struck that although all reporters mention that he offered late term abortions, as a way of explaining his notoriety in antiabortion circles, remarkably few of these print or radio and television journalists explained why Tiller did this, and who actually were the recipients of these procedures. The fact that so many of those reporting on Tiller were so oblivious of the circumstances of his patients is in itself a powerful indication of the marginality of both abortion providers and patients in American culture.
"Nothing in this section shall be construed to prevent a pregnant woman from averting her eyes from the ultrasound images required to be provided to and reviewed with her." This is the "good news" of an egregious law recently passed in Oklahoma making ultrasounds mandatory for abortion patients. But though I read the law carefully (available here in its entirety), I couldn't find anything allowing women to also cover their ears during the ultrasound. This is unfortunate, because the law requires that those performing the ultrasound "provide a simultaneous explanation of what the ultrasound is depicting," and also "provide a medical description of the ultrasound images, which shall include the dimensions of the embryo or fetus, the presence of cardiac activity, if present and viewable, and the presence of external members and internal organs, if present and viewable." Even those women who are aborting a pregnancy caused by rape or incest are compelled to undergo such mandated ultrasounds.
Ultrasounds have become one of the key weapons of anti-abortion legislators. A number of states require abortion providers to make ultrasounds available; a handful of others make viewing mandatory, but Oklahoma is the first state, according to the Center for Reproductive Rights, that requires a woman to hear the description of an ultrasound image.
The Oklahoma law has the added perverse feature of preventing a woman from suing her doctor if he or she intentionally withholds other information about the fetus, such as an anomaly. So, women are forced to hear something they may not choose to hear, but are not entitled to information that would be presumably of critical importance to them. Such is the state of public policy when it is in the hands of anti-abortion fanatics.