Taking Direct Action to Reclaim Health Care

Posted on 5.18.2012 by Kelly

As a someone who identifies as an anarchist, direct action is central to my philosophy of social change. But what exactly is direct action? Mainstream media portrayal of radical action often paints a picture of black-clad protesters breaking windows of corporate targets or locking themselves together in front of a bank headquarters. Indeed, property destruction and blockades are forms of direct action often undertaken by people who identify as anarchists, but I am not going to discuss either their merits or disadvantages here. Expressing dissent towards an unjust system and disrupting business as usual is important, but there are other forms direct action can take. As Wikipedia defines it, “Direct action occurs when a group of people take an action which is intended to reveal an existing problem, highlight an alternative, or demonstrate a possible solution to a social issue.”

While I see validity in the point Amy recently made about electoral politics having a direct effect on people's lives through the seemingly small things that impact access to reproductive health care, I am sick of giving control of my body to the whims of a bunch of rich, white, heterosexual men. Even with Obama as president, our profit-driven and hierarchical political and economic system continues to wage a war on the bodies of women and other people with uteruses, and its effects are amplified by race, class, citizenship status, sexual orientation, gender, disability status and other forms of oppression. To me, direct action means finding ways to provide community access, control, and self-sufficiency over fundamental human rights such as accessible and appropriate health care, food, and shelter.

“But what exactly does this look like?” you ask.

Great question! Let's look at a few examples of communities who have taken direct action to provide necessary health care services.

USA Today Article Urges Civil Disobedience by Doctors Against Attacks on Reproductive Health Care

Posted on 5.17.2012 by Amy

This important column in USA Today asks "Where are the doctors?" and urges doctors to stand with their patients against attacks on basic health care rights:

Physicians, both as individuals and as a profession, should stand with their patients. They should make it clear that they will not perform procedures, such as ultrasound examinations, unless they are medically indicated and desired by their patients. And they should refuse to provide inaccurate information about the consequences of abortion, or to follow any other prepared script in counseling their patients, particularly when it involves treating women like children.

Such acts of civil disobedience by individual doctors should be only the starting point. The profession as a whole, as represented by its professional organizations, needs to become involved, so that physicians are not left to fend for themselves.

Read the whole column here.

Birth Control On Demand, Without Apology, and Over-the-Counter!

Posted on 5.15.2012 by Lily

Last month Amy and I went to CLPP, a 3-day reproductive justice conference filled with fabulous, progressive people working in all sorts of social movements. One of the workshops I went to was run by the OCs OTC Working Group, which is a coalition working to make birth control pills available over-the-counter.* This is a tough idea for a lot of people to swallow, including reproductive justice folks. But over-the-counter contraception actually makes a ton of sense.

In the US, hormonal birth control access has traditionally been tied to the annual pelvic exam and Pap smear. Women know that if they wish to prevent pregnancy pharmaceutically, they must jump through the Pap hoop. (How ‘bout that image?) But this connection is a mistake of history. No Pap result contraindicates the use of hormonal birth control; contraindications are found by taking a medical history and checking blood pressure. No exam necessary.

(Lest anyone think I’m saying Paps and well-woman exams are irrelevant, please be assured that I’m fully aware of their importance. Of course everyone needs regular check-ups, and the Pap is the best tool we have to prevent cervical cancer - although many practitioners still don’t follow the updated Pap protocols, which say that most women need a Pap only every 2-3 years rather than annually and no one needs one before age 21, period.)

Nor am I saying that birth control has no place in the doctor’s office. Over-the-counter access should ideally supplement, not replace, consultations with your provider. But providers should not be the gatekeepers between women and these needed medications. Clinicians will often withhold refills until patients come in for their appointments, which definitely affirms who has control over women’s bodies, but accomplishes little else - besides contributing to rates of unintended pregnancies and abortions, naturally. A cardiologist would not deny a patient their blood pressure prescription as punishment for blowing off a follow-up appointment. Birth control is no less important a medication, but it is firmly entrenched in the social and political arena of the War on Women and Our Bodies.

Unpacking the 20-Week Ban

Posted on 5.10.2012 by Amy

As Georgia, Arizona and other states have banned abortion at various points in later pregnancy, some pro-choicers have moved to confront medical misinformation embodied in the bans with...well, more medical misinformation.

As was the case with the hubbub over transvaginal ultrasounds in Virginia, some well-intentioned commentators fixated on what may have seemed the most salacious point in the Arizona ban -- that it appeared to define pregnancy as beginning on the first day of a woman's last menstrual period, or about two weeks before fertilization and implantation.

Amanda Marcotte slammed Arizona legislators for "arguing that you're 'pregnant' while you're actually getting your period." (Marcotte later nixed many parts of her article.) A Jezebel headline blared "Batshit Insane Lawmakers Attempting to Declare Women 'Pregnant' Two Weeks Before Conception." Even Stephen Colbert seized on the absurdity, saying legislators had moved beyond pro-life, becoming "pre-life."

There was only one problem. The medical community generally defines pregnancy based on a woman's last menstrual period, so in a sense all women, in the eyes of their doctor, are two weeks pregnant by the time a fertilized egg implants in the uterus. Health care practitioners use gestational age to measure pregnancy because unlike fertilization and implantation -- which are tough to pinpoint, since they don't necessarily occur on the same date as intercourse -- a woman's last menstrual period marks a fixed point in time when her body is beginning to prepare for a possible future pregnancy. Gestational age, in other words, wasn't invented by Republicans.*

In fact, the laws that use gestational age as a measure of pregnancy (yes, the ones that label you two weeks "pregnant" around the time you ovulate) are more medically accurate than those -- modeled on the Nebraska ban -- that redefine pregnancy as beginning at fertilization. Many fertilized eggs never implant in the uterus but are simply flushed from the body. Reproductive health advocates have noted that attempts to define life as beginning at fertilization could threaten birth control and in vitro fertilization.

Robin Marty breaks down the recent bans and the various ways they define gestation in this helpful article in RH Reality Check.

The Arizona law is in fact stricter than the Georgia ban. (Interestingly, Marty notes this strictness may have been an accident resulting from medical ignorance, not necessarily an attempt to be the most fetus-loving.) Arizona moved to ban abortion at 20 weeks, as other states had done. But they specified that the ban was for pregnancies after 20 weeks gestational age -- or 18 weeks "postfertilization" -- two weeks earlier than Georgia.

Disgruntled Feminist Workers of the World Unite!

Posted on 5.07.2012 by Chantal

A recent post on Abortion Gang has got me really excited. You know that excitement that can only come from shared misery, disappointment, and rage? Well, if you've ever worked in reproductive health (or if you identify as an anarchist), you probably know what I mean.

The post, entitled "Toxic Work Environments in the Reproductive Rights, Health, and Justice World," explores one of the most taboo subjects in the women's health community. Perhaps even more taboo than abortion itself.

As a former abortion care provider, this post struck a chord with me. I've been lucky enough to surround myself with a group of amazing women (and men) who are fellow advocates of abortion rights and reproductive justice. Many of them are also current or former providers. When we're all in a room together, our conversations buzz with all the usual topics: late-term abortion, our contraception of choice, the financial and emotional struggles that our patients face, and how best to approach those difficult questions that inevitably come up in an options counseling session. (What? That's not what you and your friends chat about over beers?)

But this post touches on something different. As feminists and abortion care providers, we face an often heavy burden. We care deeply about our work and the women we meet each day, many of whom are in crisis. We face the daily stress of being asked that all-too-innocent question, "So what do you do?" Our workplaces, our peers, and our role models are the targets of violence and hate. The work that we do and the women we serve are stigmatized. And now more than ever, the movement we care so deeply about is in jeopardy. So really, it's not that surprising that we're shy to admit that we don't always love our jobs.