Beacon Broadside

The Legacy of George Tiller

Today's post is from Carole Joffe, author of Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us. Joffe is a professor in the Bixby Center for Global Reproductive Health at the University of California, San Francisco. See her much-read original response to Dr. George Tiller's killing, here. Take action here.

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."

Carole Joffe: An Open Letter to Bart Stupak: All Violence Should be Condemned

Dear Congressman Stupak,

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.

Carole Joffe: The Billboard Circus and the Abortion Wars

On International Women's Day, we offer this post from Carole Joffe, author of Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us. Joffe is professor of sociology at the University of California-Davis and a Professor at the Bixby Center for Global Reproductive Health at the University of California-San Francisco, and she contributes to the blog at RHrealitycheck.org.

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!

Link Roundup: Sri Lanka, Schizophrenia, The Abortion Wars

The Sri Lankan election is tomorrow, and the Toronto Star spoke with Adele Barker about the tensions and bitterness of the contest.

African-American men are diagnosed with schizophrenia at rates four to five times more than other groups. The Root talked with Jonathan Metzl about this issue and his new book, The Protest Psychosis.

Sophia Raday is now blogging at Military.com, contributing posts about her politically-mixed marriage.

Carole Joffe discusses the Abortion Wars with Salon.com.

The authors of Hollowing Out the Middle look at an Endangered Species: the American Heartland.

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.

Carole Joffe: Health Reform, Violence and Blanket Warmers: The Status of Abortion on Roe V Wade Day

Today's post is from Carole Joffe, author of Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us (forthcoming in early 2010). Joffe is professor of sociology at the University of California-Davis and a researcher at the Bixby Center for Global Reproductive Health at the University of California-San Francisco, and she contributes to the blog at RHrealitycheck.org.

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.

Carole Joffe: Personal Tragedies and Public Cruelties: Speaking Out Against the Stupak-Pitts Amendment

Today's post is from Carole Joffe, author of Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us. Joffe is professor of sociology at the University of California-Davis and a researcher at the Bixby Center for Global Reproductive Health at the University of California-San Francisco, and she contributes to the blog at RHrealitycheck.org.

"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."

Carole Joffe: What Health Care Reform Could Be for Women’s Health

Today's post is from Carole Joffe, author of Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us (forthcoming in early 2010). Joffe is professor of sociology at the University of California-Davis and a researcher at the Bixby Center for Global Reproductive Health at the University of California-San Francisco, and she contributes to the blog at RHrealitycheck.org.

"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!")

Carole Joffe: The Legacy of George Tiller

Today's blog post is from Carole Joffe, author of Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us (Beacon Press, forthcoming January 2010) and Doctors of Conscience: the Struggle to provide Abortion before and after Roe v Wade (Beacon Press, 1996) and professor of sociology at the University of California, Davis.

"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.

Averting Their Eyes from an Assault on Women’s Health

Today's blog post is from Carole Joffe, author of Doctors of Conscience: the Struggle to provide Abortion before and after Roe v Wade (Beacon Press, 1996) and a professor of sociology at the University of California, Davis.  She is currently at work on a book about contemporary abortion provision.

"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.

Redefining the Pill: Bush Administration Calls Contraception “Abortion”

Today's blog post is from Carole Joffe, author of Doctors of Conscience: the Struggle to provide Abortion before and after Roe v Wade (Beacon Press, 1996) and a professor of sociology at the University of California, Davis.  She is currently at work on a book about contemporary abortion provision.

Fans of Jewish folklore are familiar with tales from the town of Chelm, the legendary center of foolishness. Chelm's citizens unfailingly choose actions guaranteed to achieve the opposite of what was desired. The children need more milk? Buy a billy goat! The synagogue needs a new roof? Build a new floor! There has been much about the eight long years of the George W. Bush presidency that has made one think s/he was living in Chelm (remember how we were told the U.S. invasion of Iraq would be greeted by Iraqis bearing flowers and sweets?). Now, in the waning days of this presidency comes a move that would no doubt earn special respect from the people of Chelm because of its tortured logic. Draft regulations now circulating in the Department of Health and Human Services would redefine many forms of contraception (including most birth control pills) as "abortions."

So an administration that has done everything in its power to oppose abortion–making sure its appointments to the Supreme Court and other key positions are reliably anti-abortion, signing a bill banning a rarely used but sometimes medically necessary abortion procedure and so on–now goes after the main thing that can prevent unwanted pregnancies? In true Chelm-like fashion, this Administration is proposing a policy that virtually assures there will be more abortions.

The Republican Candidates’ Abortion Problem: It's not Just about Abortion Anymore

by Carole Joffe

"I haven’t sorted out the penalties...of course there’s got to be some penalties to enforce the law, whatever they may be." So spoke George H.W. Bush, in one of the major gaffes of his first presidential run in 1988, during a debate with his opponent, Michael Dukakis. Bush, who had only recently begun to trumpet his antiabortion sentiments to dubious Republican social conservatives, was responding to a question about appropriate punishment for women who would obtain illegal abortions should Roe v Wade be overturned. The next morning, after frantic late night discussions, Bush’s handlers called the press for a "clarification." Bush meant to say doctors who performed abortions, not women who received them, should be jailed in such a situation.

Twenty years later, Mike Huckabee, running for the Republican nomination, makes no such missteps. With none of the discomfort that Bush I showed, Huckabee at his rallies gets the party line of the antiabortion movement right: if Roe is overturned, doctors who perform abortions should be punished, while the recipients of such abortions must be seen as "victims."

But Huckabee, a former Baptist preacher and the candidate of choice of evangelicals, is an exception in the clarity and consistency of his position on abortion. There is a long history of "evolution" on abortion from politicians in both parties. For example, Bill Clinton and Al Gore, both from Southern states, had mixed records of support for abortion early in their careers before they each went on to become staunch allies of the abortion rights movement. But in the campaign of 2008, it is mainly the Republican candidates who are squirming.

Et tu, Democrats?! Abstinence-Only Sex Education and The Politics of the Budget

by Carole Joffe

After nearly seven years of the George W. Bush presidency and its regressive sexual and reproductive politics, it is no surprise that this administration continues to staunchly support "abstinence-only sex  education."  The fact that study after study—including one commissioned by Congress itself has shown these programs to be ineffective does not trouble this president, who, in the face of inconvenient findings, has consistently allowed  ideology  to trump science.  Whether the issue is global warming or weapons of mass destruction or condom effectiveness, this administration is infamous for, as a Bush administration official—famously and unapologetically—put it, "creating its own reality." (New York Times magazine, October 17, 2004).

And it is no surprise that the Republican candidates for president support abstinence-only programs. This issue remains of great symbolic importance to the Religious Right base of the Republican Party. Though some observers say this movement is in decline, evangelicals remain very influential in the nominating process (witness Mike Huckabee’s recent meteoric rise), and candidates cannot afford to offend them on this issue. (And to be sure, abstinence-only is more than just symbolically important to many on the right; as The Nation so ably detailed, in "The Abstinence Gluttons," those  who receive  contracts to deliver these programs are raking in millions).

But Democrats supporting "abstinence-only," especially after the November 2006 election, when they regained control of the House and Senate?!  A powerful Democratic committee chair proposing to give even more to these programs than the Bush administration has asked for?!  No, this is not a Saturday Night Live or Jon Stewart parody. This is Washington politics. In a move that stunned advocates for "comprehensive" sex education—that is, programs that include discussion of both abstinence and birth control options—Congressman Dave Obey of Wisconsin, the chair of the House Appropriations Committee, proposed increasing by $28 million the current abstinence-only allocation of $113 million. Obey made this move in order to lure Republican votes for Congress’s main domestic spending bill.    (In fairness, an equal increase was suggested for Title X, a federal family planning program that has been consistently under-funded during the Bush years.)