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.
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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.
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Posted on 5.02.2012 by Lily
This article came out in December, but I wanted to talk about it as a follow-up to Amy’s post from a few months ago. Amy interviewed the courageously innovative Dr. Deborah Oyer, an abortion provider who has uploaded YouTube videos of herself describing abortion options in hopes of demystifying the information, counteracting the ubiquitous anti-abortion propaganda, and reaching those who may be afraid to actually call a clinic. These videos have received tens of thousands of hits; clearly, Dr. Oyer has figured out something very important about communicating with patients today.
And she’s not the only one. As covered by the Times, many organizations now offer sex ed services online and through text message. Planned Parenthood of the Rocky Mountains runs a text-chat program that allows teens to get text responses to their anonymous questions. Other clinics and programs have found various ways to supplement the traditional classroom models with outreach focused in the main place where teens are already looking for information about sex. This is, for lack of a more eloquent word, awesome - and practically bursting with potential!
We badly need to adopt this 21st century-type thinking in abortion services. I can only imagine how many patients would take advantage of being able to ask their questions while “wrapped in the Internet’s comfy blanket of anonymity,” as Amy put it, (I love that line!) if we allowed them to text or email us. Or what if we posted videos where patients could take a virtual tour of the clinic’s waiting room, lab, counseling space, operating room, and recovery area? How about videos of staff introducing ourselves (as Dr. Oyer has also done), putting a human face on abortion provision and showing patients that we are not such scary monsters after all? What if the website explained the process of making an appointment so timid patients knew exactly what to expect when they picked up the phone? Hell, what if we allowed them to book their appointments online, and gave them all the necessary information right there?
Countless patients have confessed to me the fears that plagued them before they set foot in the clinic. Would we be mean? Would we judge her for x, y, z about her situation? Would the clinic be dirty? Were we a real, licensed medical facility? Would it be an actual doctor performing the procedure? Isn’t abortion so dangerous? Were we going to maim her, cause her to be infertile, give her breast cancer? (No, no, no, yes, yes, no, no, no, and no, for the record.)
It’s no wonder patients can be so freaked out about the clinic experience; many of them have been unfortunate enough to go to a so-called "crisis pregnancy center" first, or they’ve researched abortion online and found only anti-choice propaganda. Patients often express surprise and relief to find out that our staff is non-judgmental, helpful, and compassionate; that abortion is one of the safest medical procedures with minimal risks; and that, in general, the quality of care is very high. Of course every clinic and clinic experience is different, but many patients have told me that their abortion was by far the most positive experience they’d ever had with the health care industry.
All too often, patients navigate the United States health care system never expecting to be treated with compassion and empathy, or to be regarded as a fully integrated human being rather than as a set of body parts and symptoms. (See Kelly’s recent post for more about these all-too-common experiences.) It’s emblematic of the bigger picture of the health care disaster in this country, in which services are fragmented, insurance companies call the shots, patient-centered care is pushed to the back burner, and patients are left to struggle their way through however they can.
Obviously, online services won’t fix all these problems. But I think new media does provide unique opportunities to mitigate thorny access to good health care by allowing patients and young people to expand their health education and health literacy without ever stepping foot into a health care facility. And then, when they do need to go to the doctor, or hospital, or abortion clinic, they may well be better equipped and more empowered to be their own best advocate.
What ideas do you have for reaching patients online or through other types of new media? Can any fellow abortioneers or health care workers who offer online services speak about those experiences?
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Posted on 4.27.2012 by Amy
Access to abortion is defined by thousands of teensy decisions made by dunderheaded policymakers. Each one of these decisions is extremely significant and dangerous. Each makes all the difference in how one single person lives.
That’s what I told a friend recently when he questioned whether it makes much difference who wins the presidential race.
Actually, it didn’t quite come out like that.
Here’s what I really said, more or less:
President Obama is the President of the United States. You can’t expect much.
Seemingly small differences can make a big impact on the way people live their daily lives. I know. I was an abortion counselor. This is my story. Dun-dun.
As an abortion counselor, I worked in two different New England states. In the first, a comprehensive state insurance plan paid for abortion as a medical service. In the other, a state law prevented public insurance from covering abortion unless the woman had been the victim of rape or incest. Ironically, the former plan was developed by the Republican candidate for president. But that’s another story.
In the first state, many of the poorest women who came to our clinic seeking abortion did not have to worry about the financial burden of the surgery or medication. They could weigh their options based on long-term factors like support, relationships, future goals, and yes, the long-term financial burden of having a child.
Meanwhile, in the other state, the women on public insurance (most of the low-income patients we saw) were not covered unless they had been raped. Most had not, although as a side note, no documentation was required, so the women could easily have chosen to lie without consequence. As far as I could tell, none did.
Thanks to the National Abortion Federation and other local funds (SERIOUSLY, THANKS), we were able to connect patients with financial aid. But most funds did not cover the entire cost. Much of my time as a phone counselor was spent making calls, begging for money on behalf of women, or having conversations with them along the lines of: “Is there anything you can sell?” and “Are there any family members or friends who can lend you money?”
Women were faced with having to raise anywhere from a few hundred to a few thousand dollars (depending on how far along they were in their pregnancies) in the span of a few days or weeks in order to pay for their abortions. I spoke to many, many women whose decision-making was entirely consumed with figuring out whether or not they could afford the up-front cost, which is flabbergasting when you consider how much more a child costs. Based on the number of cancelled appointments we had from women who were having trouble raising even a small amount to pay for the procedure ($50? $100?) I knew some continued their pregnancies because they felt forced to do so by their financial circumstances.
As a private clinic struggling to survive, we couldn’t give the services away for free. Many days I wished we could have. In a better world, we will.
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Posted on 4.25.2012 by Lily
Well, isn’t this interesting? Wikipedia has asked its users to determine what the sides of the abortion debate should be called, considering such options as “anti-abortion movement vs. abortion-rights movement” and “support for legality of abortion vs. opposition to legality of abortion”. I like the idea of this conversation; it’s long time to do away with the ridiculous notions of “pro-choice” and “pro-life”. (“Pro-life”, of course, is anything but. “Pro-choice” is a simplistic trivialization of the need for abortion, in which the consumerist concept of choice rarely enters the equation.) I would advocate for reproductive justice to become our dominant framework as the issues extend far beyond abortion rights, but alas, the RJ movement has yet to overtake the American public’s love affair with catchy little slogans.
Via.
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