If Kansas state lawmakers have their way, women seeking an abortion in the state will first have to receive a detailed professional history of the doctor performing the procedure — and it must be in black, 12-point Times New Roman font on white paper.
The bill, believed to be the first of its kind in the country, would require abortion clinics to provide patients with printed information detailing doctors’ educational history, disciplinary and malpractice record, and when they started working at the clinic.
Doctors would also have to disclose whether they have malpractice insurance and admitting privileges at a local hospital, and if they are Kansas residents. Critics argue that such admitting privileges — which many states have sought to mandate — are not only difficult to obtain but medically unnecessary, as abortion clinic patients rarely have to go to a hospital. And due to a number of factors, including a lack of trained and willing local doctors, abortion providers often live far from their clinics or even out of state.
“I think this is a bill that will help women make the right choice or an informed decision,” Republican Sen. Rob Olson told the Kansas City Star.
Republican state Sen. Mary Pilcher-Cook added, “Women don’t leave abortion clinics whistling and jumping up and down…. They are in a very vulnerable state because the nature of abortion is ugly and is evil because it kills a human being.”
But other lawmakers condemned the bill as “simply harassment” and “discriminatory,” arguing that doctors who perform other medical procedures doctors are not held to the same standard. And Democratic state Sen. Marci Francisco pointed out that the state legislature routinely uses 10-point font on its bills.
“We should not ask to have someone provide something in a larger font than we provide the information to ourselves and our constituents on bills that are very important,” Francisco told the Associated Press.
The bill is still awaiting the signature of Republican Gov. Sam Brownback, who has signed every abortion restriction that has crossed his desk since he took office in 2011.
According to the Guttmacher Institute, a nonprofit that researches and supports abortion rights, Kansas already has a number of abortion restrictions on the books, including:
Women must wait 24 hours after getting counseling that describes the details and risks — a requirement critics argue is meant to discourage abortion — before they can receive an abortion.
Women must also receive ultrasounds of their fetuses, and the provider must offer to show them the ultrasound image.
Except in medical emergencies, abortion is prohibited at 22 or more weeks after a woman’s last period. Supporters say this is because fetuses can feel pain at this point in their development, a statement that is not backed up by medical research. According to the American College of Obstetricians and Gynecologists, fetuses generally become viable at 24 weeks.
A proposal in the U.K. Parliament would change a 19th-century criminal law that allows prosecution of people who end their own pregnancies. And in New York state, a bill moving through the legislature would remove abortion, including self-induced abortion, from the penal code.
The experiences of people seeking abortions from the U.K. to New York teach us that access to affordable clinic-based abortion is critical, but is not enough to ensure that no one goes to jail for ending their own pregnancy. Shutterstock
Abortion is among the safest medical procedures in the United States. Yet, myths about its safety abound. False Witnesses reveals the individuals behind these lies.
No one should face jail or arrest for having an abortion, especially in places where abortion is legal and generally accessible. That is exactly the scenario that politicians in the United Kingdom are trying to address by moving antiquated criminal abortion laws off the books. Legislators in the United States should follow.
Abortion is legally available in the United Kingdom, with the exception of Northern Ireland (where the procedure is only allowed when the pregnant person’s life is in danger). But even under the 1967 Abortion Act that is in effect in England, Wales, and Scotland, two doctors must agree that a woman’s continued pregnancy poses a greater risk than ending that pregnancy. Though doctors typically interpret the law liberally so that getting the signatures does not significantly delay most abortions, the law also requires that abortions much take place in a hospital or other clinical premises that have government permission to perform the procedure. That means family doctors cannot supply medication and women cannot use it at home, even when it is legally prescribed.
The result: Women who use abortion pills without doctors’ permission can face jail terms—which criminalizes patients in a way that doesn’t apply to any other health care procedure.
In March, U.K. Member of Parliament Diana Johnson introduced a bill that took the first steps toward decriminalizing abortions in the first two trimesters in England and Wales. Under the proposal, abortion would be regulated in the same way as other clinical procedures and women would not face jail for inducing their own abortions.
“There is no other medical procedure in this country governed by legislation this old, this out of step with medical developments and public attitudes,” she said.
Johnson was referring to the U.K.’s 1861 Offences Against the Person Act, which she proposes amending. This law made ending one’s own pregnancy a crime punishable by life imprisonment throughout the U.K., with the same penalty applying to anyone who assists. The 1967 Act did not overturn this 1861 law; rather, it created exemptions to prosecution for women and their doctors when certain criteria were met.
But both the Offences Against the Person Act and the 1967 exemptions were drafted at a time when no one could imagine safely and effectively ending a pregnancy with pills.
Medication abortion is increasingly preferred by women in the U.K.—and in Northern Ireland, where only 16 legal abortions were performed in 2015-2016. And women are increasingly obtaining pills online. While the choice for women in Northern Ireland used to be starkly positioned between finding the funds for travel to England for abortion care or having a baby, today women can find a safe solution on the internet.
But while Irish women who have used mail-order medications from organizations such as Women on Web report relief and satisfaction with the process, they face a serious danger that’s not medical in nature: punishment by the state.
In the last two years, women have been dragged through the courts in Northern Ireland, and police in Belfast raided activists’ homes looking for pills while they attended International Women’s Day rallies in March. In Northern Ireland’s two-tiered system where abortion is punishable under criminal law, some people seek abortion care under the looming threat of jail time.
And even where the Abortion Act does apply and lawful abortion is accessible, any U.K. woman who uses abortion medication purchased online could be sent to prison for life under the same 1861 Act used against women in Northern Ireland. For women with work and child-care commitments, the fact that lawful medical abortion can require multiple appointments and that pills cannot be taken at home at the time that best suits them makes unlawful online supply attractive.
Those of us in the United States, where Roe v. Wade remains the law of the land, might wonder: How is it possible that a legally protected medical procedure can be a crime? We need look no further than New York for an answer.
New York has long been a leader in ensuring reproductive rights, liberalizing its abortion laws in 1970—three years before Roe. But, as in the U.K., change came in the form of exceptions to a criminal law. To this day, even though abortion is generally accessible in urban areas and may be covered by Medicaid, abortion remains in the state’s penal law. In fact, any attempt to end one’s own pregnancy–even if it is unsuccessful, and even if the person isn’t actually pregnant–may be prosecuted as criminal self-abortion, which can carry a sentence of up to a year in jail.
Having such an outdated law lingering on the books is no idle threat: A handful of New Yorkers believed to have ended their own pregnancies have been arrested, most recently in 2011. Even if they weren’t convicted, the women were invasively interrogated about their sexual and reproductive lives, separated from their families, and shamed in the media. These prosecutions follow the usual pattern of criminalization in the United States, falling disproportionately on women of color and low-income women who are most likely to come under scrutiny of law enforcement or social services agencies.
But, like U.K. lawmakers, New York legislators have an opportunity to make a long-overdue change to the law. Propelled by concerns about federal rollbacks of abortion rights, New York lawmakers have proposed the Reproductive Health Act (AB 1748/SB 2796), currently awaiting consideration by the state senate after having been approved by the assembly months ago. This proposal would repeal abortion and self-abortion from the penal law, finally making good on Roe’s promise of decriminalization of abortion.
The experiences of people seeking abortions from the U.K. to New York teach us that access to affordable clinic-based abortion is critical, but is not enough to ensure that no one goes to jail for ending their own pregnancy. Nowadays, people may be pushed toward self-directed care by clinic closures and unnecessary restrictions, or pulled toward it by the private and personalized experience promised by abortion with pills.
At a time when aggressive, regressive anti-abortion forces are on the rise, it is tempting to batten down the hatches, defend the gains we have made, and make the best of the laws we do have. But it is also not enough that the law insulate certain types of people with certain types of abortions from criminalization. It should not create a threat in the first place.
Nancy Pelosi called the draft of a new rule “sickening.”
WASHINGTON ― The Trump administration is on the verge of rolling back a federal rule that requires most employers to cover birth control in their health insurance plans at no cost to women.
The White House Office of Management and Budget posted on its website that it is reviewing an interim final rule that would allow religious employers to deny contraception coverage to their female employees. The details of the rule have not been announced, but Gretchen Borchelt, the vice president of the National Women’s Law Center, said it is certain that “some women will lose birth control coverage.”
House Minority Leader Nancy Pelosi (D-Calif.) called the move “sickening.”
“The draft rule announced today attempts to tear away women’s control over their own private health decisions and put that control in the hands of employers and politicians,” she said.
The contraception mandate, enacted under President Barack Obama in 2012, for the first time in U.S. history deemed birth control an essential preventive health service that should be fully covered alongside well-woman visits, mammograms and sexually transmitted infection screenings. It guarantees coverage to more than 55 million women, saved women $1.4 billion on birth control pills in the first year it went into effect, and has contributed to the lowest U.S. abortion rate since the procedure became legal in 1973.
Some religious employers have been fighting the mandate since it was announced. The Supreme Court ruled in 2014 that closely held corporations like Hobby Lobby, a Christian-owned craft supply chain, cannot be required to provide contraception coverage for their employees. The Obama administration tried to accommodate those employers by directing them to state their religious objections to the government, which would then direct a third-party insurer to provide the coverage to the organization’s female employees.
Some groups, like an organization of nuns called Little Sisters of the Poor, have continued to challenge the rule. President Donald Trump signed an executive order in March directing the Department of Health and Human Services to re-examine the birth control coverage rule, promising the Little Sisters at the time that their “long ordeal will soon be over.”
“Bring me one woman who has been left behind,” he said at the time. “Bring me one. There’s not one. The fact of the matter is, this is a trampling of religious freedom and religious liberty in this country.”
The Center for Reproductive Rights, a legal advocacy group, said it plans to challenge the new rule.
“Without health coverage of contraception under the [Affordable Care Act], countless women will lose their basic right to prevent pregnancy and plan when they have children,” said Nancy Northup, president and chief executive officer of the Center for Reproductive Rights. “Plain and simple: President Trump’s executive order will hurt women. And the Center for Reproductive Rights is ready to fight back in court.”
“IUDs are making a serious comeback.” I say to a girlfriend over a Sunday morning walk.
“I thought IUDs were a new thing. Didn’t you just get one?” she asks me. It suddenly occurs to be that IUDs do feel new; this once retro form of birth control was relatively unknown when I was a teenager. I didn’t even hear of this option until I was at my first job at 23.
I caught myself pretending I knew everything about these devices when chatting with my friend, but my knowledge was relatively limited … and I have an IUD. Why is that? Why now? Women everywhere are in a rush to get IUDs, due to the uncertain political climate. I was among them. I got an IUD in January, just before Trump took office and documented my experience.
“Even before the Trump disaster, an IUD has been for many women the best method of contraception in terms of safety, reversibility, and efficacy,” Dr. Lauren F. Streicher, MD, Clinical Associate Professor of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern Memorial Hospital, tells Bustle. “By getting an IUD now, they will be protected for 3-10 years depending on which one they choose. Possible defunding of Planned Parenthood will make access even more limited. If Roe is overturned, not only will abortion become illegal, but many types of birth control as well (such as IUD’s) since far right extremists such as Mike Pence put their own personal beliefs above science.”
I stepped into the OB/GYN ready to have this implant inserted through my cervix and into my uterus without even doing that much research on the effects. I just assumed everything was going to be fine. Having an IUD is hip now — it’s cool.
According to a 2013 survey from Planned Parenthood, IUDs are the #1 choice of OB/GYNs for birth control. “I think the best candidate for the IUD are women who do not want to get pregnant for at least the next two years,” Dr. Fahimeh Sasan, Consultant Medical Doctor at Progyny and OBGYN at Mount Sinai tells Bustle. “It’s a great form of contraception because it doesn’t require you to do anything—once the doctor places the IUD you are all set.”
The recovery process from my procedure was arduous and painful. I didn’t feel OK for over two weeks. Even though I’m fine now, I still have questions about the IUD and why everyone’s so obsessed with it.
Due to my own neurosis, I’ve become hell bent on knowing everything there is about the intrauterine device … including its history. In case you too want to know, here is a brief history of the accidental winding road that lead to modern day IUDs — and our recent interest in getting implanted.
IUDs Date Back To The Victorian Era
When I think of birth control, I don’t think of the Victorian Era, but the history of birth control does go back further than you might think. IUDs were first invented in 1862 and the diaphragm in 1882.
The early invention of the IUD was not intentionally feminist. They were not originally designed to prevent pregnancy, but were meant to treat vaginal infections and injury such as prolapse, pregnancy prevention was somewhat of a happy accident (for us ladies, anyway). According to the Sexual Health Charity in the UK, “These were small button/cap shapes attached to stems, made of a number of different materials, which extended into the cervix.”
In the 1930s, smaller and safer IUDs (Ota rings) were introduced. These silver rings were far more effective than their predecessors at preventing unwanted pregnancy.
During the Sexual Revolution of the 1960s, IUDs were recognized as medically safe forms of birth control, and the copper IUDs we still use today hit the scene in 1962. See, you really are vintage after all.
IUDs Become Infamous
IUDs lost popularity as hormonal birth control pills hit the market in the ’60s. As Vouge points out, the pill was easier to get than an implant — making it the preferred form of birth control into the early 2000s.
IUDs became truly controversial thanks to, the Dalkon Shield in the ’70s. This notorious IUD allowed bacteria to enter the uterus and was allegedly the cause of death of 18 women do to infection. Nothing like 300,000 lawsuits and claims of death to deter someone from using an IUD, amiright?!
IUDs were only used by 6.4 percent of women in 2013. Up until then, they were out of fashion (er, to put it lightly) — right around when myself and my girlfriends became aware of them. From 2010-2013, IUDs saw a 33 percent spike.
The IUD’s Comeback
Now that memories of the Dalkon Shield are beginning to fade, and hormonal models like the Mirena and Skyla are down to a science, IUDs are finally making a glorious comeback.
Are We Going Fully Natural In Every Aspect Of Our Lives?
Whenever I ask a friend why she favors an implant, it’s always a similar answer, “I don’t want all of those hormones in my body. It’s not natural.”
Is an IUD just the next phase in our Millennial quest to be fully organic and all natural? Is placing a foreign object inside your uterus the best option? Have we gotten so entrenched in all things vintage or are we just reveling in the upgraded models of the past? There are certainly benefits. For instance, I recently wrote about the impact IUDs have on sex drive. Indeed, having a reliable form of birth control can relieve a lot of stress, but as many experts point out, the best birth control for you ultimately depends on you.
The controversy around contraception, the female body, and what is safe is far from over and as we move into the future, we have to take a dose of history with us so we don’t slip backward.
As for me, if I can have something popped into my uterus that allows me to have control over my reproductive system, I’m in.
Visiting a clinic privately and in peace should be a basic right, Philip Goldstone writes.
Dr Philip Goldstone: Providing safe zones where patients can access sexual and reproductive health services, including abortions, is a public health issue. Photo: supplied
This is not a new concept; Victoria, the ACT and Tasmania have these zones and shortly so, too, will the Northern Territory.
The zones ensure patients can enter a clinic without being harassed by protesters and recorded without their permission. They provide a bubble of safety around a clinic so patients can have their privacy upheld and can access sexual and reproductive health services without being intimidated.
Fortunately, there is a second chance to implement safe access zones with a private member’s bill due to be debated in the NSW legislative council. The bill, introduced by Labor’s Penny Sharpe, is a second chance for women in NSW to have some form of protection when it comes to seeking sexual and reproductive health services.
For me, and many of my colleagues working in sexual and reproductive health clinics across the country, safe access zones are a personal issue.
I am used to being told daily that I am going to hell. I am used to standing up to protesters who block my path when I am entering my workplace. I can handle the criticism spat at me angrily by strangers. I can do this because I strongly believe in providing sexual and reproductive health services to Australians no matter who they are or where they are.
While I am based in NSW, I have the privilege of working in Marie Stopes clinics across the country. There is a marked difference between places that have safe access zones and those that don’t. Since the zones were implemented in Victoria in 2016, the experience of entering our Maroondah clinic has changed. Where once staff and patients were yelled at and had graphic images thrust at them that are designed to misinform and manipulate, they are now able to attend the clinic in peace.
Whenever safe access zones have been implemented, anti-choice activists assert they will stifle freedom of speech and the right to protest. That is simply untrue. There is no evidence that the implementation of these zones limits debate on the issue of abortion.
The reality is that providing safe zones where patients can access sexual and reproductive health services, including abortions, is more a public health issue than a challenge to free speech.
Studies in the United States, most recently in 2013, have found a direct correlation between a patient’s negative emotional state and the presence of anti-choice activists at clinics. A qualitative study of women’s experiences accessing abortion clinics in the US between 2006 and 2009 also revealed patients attending clinics with protesters found the experience negative and, in some cases traumatic.
The decision to have an abortion is not one that is taken lightly, but it is a legitimate medical decision for a woman, her doctor and any other person she wants to bring into that decision. To stand in her way, literally and metaphorically, is not only a danger to her wellbeing, it is discriminatory.
In 1979, the Convention on the Elimination of All Forms of Discrimination against Women was adopted by the United Nations General Assembly. The convention defines discrimination against women as “… any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field”.
Australia signed this convention more than 30 years ago, yet still we are debating whether to protect a woman’s right to access a medical procedure without discrimination.
The politicians of NSW have the power to stop the harassment and vilification of women entering clinics. It is the decent thing to do and it is the right thing to do.
Dr Philip Goldstone is the medical director of Marie Stopes Australia.
“California has great public policy regarding abortion access, but great public policy does not always translate to women being able to have greater access to care,” especially in the more rural spaces of the state’s Central Valley.
In California’s breadbasket, the Central Valley, the nearest abortion provider may be an hour’s car ride away or even farther on public transportation.
Evidence provided to Congress by state attorneys general and health departments proves that abortion is both extremely safe and highly regulated. Searchable by state.
Rosalinda Hernandez-Guzman grew up in the same Central Valley town where she is now raising her daughter. Visalia is rich in agriculture—fields of grapes, olives, and citrus ring the city—but it falls behind many other parts of California in access to reproductive health services.
Despite California’s progressive bent—there is a Democratic supermajority in both houses of the state legislature—pockets of the state are staunchly conservative, including some in the Central Valley. Even though abortion is legal under federal and state law, women here often have a tough time actually finding abortion providers.
“California has great public policy regarding abortion access, but great public policy does not always translate to women being able to have greater access to care,” said Amy Everitt, state director of NARAL Pro-Choice California.
This was the case for Hernandez-Guzman, now 21. Last summer, when her daughter was 2, Hernandez-Guzman became pregnant but knew immediately that she and her husband couldn’t support another child at the moment. They didn’t have enough money for a car or, at times, cell phone service, and Hernandez-Guzman had plans to go back to college to earn her bachelor’s degree.
“When it comes to diapers and clothes and formula and bottles, it’s overwhelming,” she said. “When you have prior bills and another child in diapers … the financial aspect was a huge part of the decision.”
Her decision made, Hernandez-Guzman needed to find a clinic. “There are zero” abortion services in Visalia’s Tulare County, population 460,000, said Sarah Hutchinson, senior policy coordinator for the nonprofit ACT for Women and Girls in the town. “Even for medication abortion, which is up to about 10 weeks [of pregnancy], women have to go to Fresno to get the pills.” That’s a 47-mile drive each way.
The situations for Hernandez-Guzman and others in similar towns show what could happen state- and nationwide if the Republican-controlled Congress and President Donald Trump limit abortion access and funding. When running for president, then-Republican nominee Donald Trump said that he would nominate anti-choice judges and that if Roe v. Wade were overturned, states would have jurisdiction over abortion access.
That would likely mean fewer resources for all communities, but compounded barriers for already underserved areas. If abortion does go back to the states, economic security and access to health care could even more heavily “depend on your ZIP code,” said Everitt.
Transportation Challenges
If Hernandez-Guzman had not talked with a friend who worked for ACT, she wouldn’t have known where to turn. Like many in the Central Valley, she was raised in a conservative Catholic Latino family and didn’t think she could ask her community for help. In her family,“we don’t talk about abortion,” she said. So Hernandez-Guzman approached her friend, who shared her story of an abortion at age 17, and helped Hernandez-Guzman make an appointment at one of two Fresno abortion-providing clinics.
“But then it was, ‘How am I going to get there?’” Hernandez-Guzman recalled. “It was just a frustrating feeling that I couldn’t just hop on a bus and just go.”
Buses do run between Visalia and Fresno, Hutchinson said. But the trip typically takes about two hours one way, and some routes can take up to four hours. Also, many people live in rural areas of Tulare County with no bus service. A California nonprofit, ACCESS Women’s Health Justice, has a hotline that people in need of transportation to an abortion appointment can call, but few in the Central Valley know about it, Hutchinson said.
Growing distraught, Hernandez-Guzman finally found transportation to the clinic. “It was hard, but luckily I had a good friend that just took me, no questions asked,” she said.
For women who live in more remote areas of the Central Valley, or for those who need later abortions, access is anything but guaranteed.
The Planned Parenthood clinic in Fresno performs abortions up to 17 weeks of pregnancy. But many Californians must generally go to Los Angeles or San Francisco to access a later abortion, Hutchinson said.
Furthermore, options tend to narrow for the 13- to 18-year-olds who are ACT’s clients. Hutchinson told a story of a 17-year-old girl whose mother found out that she had had a birth control implant in her arm and forced her to get it removed at a local clinic. When the girl became pregnant soon after, the physician assistant at the same clinic shamed her and tried to convince her not to have an abortion, Hutchinson said.
“These are a majority farmworker people breaking their backs with no health insurance, and the things that [health-care workers] say resonate with them and those folks believe them,” she said. “That’s what’s really upsetting to me.”
The girl, who was in an abusive relationship, eventually found help through ACT. “She said, ‘I need to not have a kid now—I need to get a college degree because I’m undocumented,’” said Hutchinson.
Hutchinson now is also working on state legislation, Senate Bill 320, which would require public college campuses with student health centers to offer medication abortion. Though the bill, introduced by Sen. Connie M. Leyva (D-Chino), won’t help young teens who need access to reproductive health care or women who aren’t enrolled in college, it would still greatly expand access across California, and particularly in the Central Valley—home to at least nine colleges that would fall under the umbrella of the legislation, Hutchinson said.
The bill passed with a 6-2 vote through the Senate Health Committee in mid-April and now moves to the Education Committee.
Nearly a year after her abortion, Hernandez-Guzman is preparing to enroll in college and working a secretarial job. She’s thankful she was eventually able to access the care. “I feel like, because of the position I was in,” she said, “I was making a mature decision in my life.”
Once upon a time, a woman found a gold coin she exchanged for an abortion.
The woman was Codie Pete, a then-25-year-old living in a rural part of New Mexico, where the nearest abortion clinic was an hour and a half away from home.
At the time, Pete was making meager wages as a teacher and couldn’t afford health insurance through her employer, which put birth control out of reach, too. So when she unexpectedly became pregnant, she found herself in a tough predicament: The financial straits that left her unable to prevent the pregnancy were the same ones that would stop her from terminating it.
“When the clinic told me over the phone that, even using a sliding scale for my income, the procedure would cost $600, I was floored,” Pete recalled. “I remember being on the phone saying, ‘What do people do if they can’t come up with the $600?’ They couldn’t answer me. At that point I just got off the phone. I didn’t even tell them to schedule me.”
As Pete contemplated which of her belongings — her car? her couch? — she could sell to pay for the procedure, she thought back to, of all things, gold coins her mother had bought Pete and her sister when they were children. By some stroke of fate, her mother confirmed it: Years later, the coins were still in her dad’s office safe. A week later, Pete sold hers for almost exactly $600.
“My abortion story is about this magical coin that just sort of appeared — it was the pot-of-gold or shamrock kind of luck,” Pete said. “That’s what’s terrifying, though. Women’s choice is restricted by our ability to pay for a procedure.”
Pete’s predicament might sound far-fetched, but it’s not uncommon. The last few years have seen drastic cutbacks to reproductive health care access. With plans to defund abortion clinics and cut Medicaid coverage, President Donald Trump‘s administration is slated to drastically reduce the number of individuals who can afford safe abortions.
There’s no understating the effects of those cuts: Some 75% of Planned Parenthood‘s patients are “at or below” 150% of the federal poverty level. As the number of clinics offering abortion services dwindle, many patients have to travel farther to get to one. The money spent on transportation and hotels, as well as lost wages if patients must take days off from work to get the procedure, all add up to put abortion financially out of reach for many people.
Meanwhile, in states where it’s legal for Medicaid to cover abortion services, 89% of abortion patients with Medicaid use their insurance to pay for their care.
There’s a lot of discussion about the legislation preventing people from effectively accessing reproductive health care, but rarely do we talk about how it can also be cost-prohibitive — a barrier that spans from states red to blue.
According to Planned Parenthood, an in-clinic, first-trimester abortion procedure can cost as much as $1,500. For patients who can’t get financial assistance through insurance or Medicaid, the median out-of-pocket cost for an abortion is $575. For more than half of those patients, the $575 amounted to roughly one-third of their monthly income, according to a 2014 study.
These costs skyrocket the longer a pregnant person waits to undergo the procedure. The cruel twist? About 60% of U.S. women live in states that require them to wait — anywhere from 24 to 72 hours — between their initial consultation and their appointment for the actual abortion.
Dr. Sarah Roberts, an associate professor at the research group Advancing New Standards in Reproductive Health and one of the 2014 study’s authors, said such laws mean pregnant people often find themselves caught in a tough situation.
“The vast majority of women who want an abortion are very determined to get one and will get one regardless of the barriers,” Roberts said. “But funding is one of those barriers that’s more difficult for women to overcome.”
“Divine intervention” — in the form of a perfectly timed check in the mail
For Shae Jackson, the only way out of her unintended pregnancy came in the form of her boyfriend’s tuition refund check.
Jackson found out she was pregnant during her sophomore year of college, shortly after she’d gone off birth control due to a life-threatening blood clot. She said the decision to get an abortion was a no-brainer. “No matter how much it cost, [I knew I would] figure it out because I had to get the abortion,” she said.
But Jackson wasn’t sure how she could possibly come up with the $500 it would cost her at the nearest clinic. She and her boyfriend were both unemployed students with no income who couldn’t come up with several hundred dollars on a whim.
Just when things began to look hopeless, an unexpected check arrived in the mail for her boyfriend. “It was divine intervention,” Jackson said. “I found out I was pregnant in early March, and that was the exact same time the school issued his [tuition] refund check.”
“When I tell my story, I say I was ‘lucky’ quite often because it certainly was a gift that [the check] came when it did — otherwise, I have no idea where I would’ve gotten those resources,” she said.
Pro-abortion rights advocates rally outside the Supreme Court in March 2016.
“The good ol’ ‘raising money for my friend’s abortion’ pregame fundraiser”
There was certainly some amount of luck involved when Cecilia Graña-Rosa counted on friends to help come up with the money to fund an abortion for her friend, Julie*.
When Julie found out she was pregnant, she almost immediately informed the father, who offered to Venmo her $50 for an abortion.
“He thought it cost the same as Plan B,” Graña-Rosa said.
The 23-year-old unemployed grad student knew she wanted an abortion the minute she found out she was pregnant. She’d collected five positive home-pregnancy tests in a plastic cup in her bathroom, Graña-Rosa said.
Despite living in a blue state, Julie had a difficult time asserting her right to an abortion. Before she was allowed to entertain the notion of going through with the procedure, she was required to endure multiple sonograms in two different family planning clinics, where staff encouraged Julie to continue with her pregnancy. She paid for these out of pocket because she feared her parents, who oppose abortion, would notice her insurance claims.
“He thought it cost the same as Plan B.”
As she watched her friend’s medical bills pile up, Graña-Rosa had an epiphany: She would turn a party she was planning to host into a fundraiser. As a former student at Vassar College, she said she saw it as both an opportunity to help a friend in need and to see whether her pro-abortion-rights friends from the liberal arts school would “put their money where their mouth is.”
So, in February 2016, Graña-Rosa made a Facebook event titled “The good ol’ ‘raising money for my friend’s abortion’ pregame fundraiser.” While the concept may seem crass or insensitive, Graña-Rosa isn’t the first to think of crowdfunding an abortion.
A GoFundMe search for “abortion” results in such campaigns as “My 15-year-old sister needs an abortion” or “Emergency abortion.” These represent people in situations so dire that they’re looking for financial assistance not from friends, but from perfect strangers. Bailey, a then-23-year-old from Illinois, was among the first to use the platform to crowdfund an abortion when she launched a campaign called “Stop Bailey From Breeding Fund” in 2014.
GoFundMe temporarily removed Bailey’s campaign page, and decided a week later to ban all abortion-related content from appearing on the site. A spokesperson told Mic the site has since changed its policies to allow users to crowdfund all kinds of legal medical procedures, including abortion.
Through Graña-Rosa’s own IRL crowdfunding, she was able to raise $350. But before she could give her friend the money, Julie — uncertain if she’d ever be able to afford the procedure — induced a miscarriage with vitamin C pills. With no abortion to fund, she ended up using the $350 to pay for the sonograms the family planning clinics had required her to have.
That Julie escaped from the situation without any major health complications is, as Graña-Rosa said, “lucky.” Self-induced or so-called “back-alley” abortions are extremely dangerous. Some 68,000 women worldwide die of unsafe abortions every year, placing it among one of the leading causes of maternal death.
Roberts, the associate professor from ANSIRH, said this sort of “luck” can easily run out for many people who become pregnant and don’t want to be.
“These are women who were able to figure it out and pull [the money] together,” Roberts said. There are other women for whom that’s not the case.”
*Name has been changed to allow source to speak freely on sensitive topics.
A sweeping anti-abortion bill leaves prosecutors wide discretion over who is charged for unlawful abortions.
Representative Joe Moody, D-El Paso, on the House floor. SAM DEGRAVE
Representative Joe Moody, a former prosecutor, was sure there’d been a mistake.
The sweeping anti-abortion bill that passed the Texas House May 19 could allow nearly anyone involved in the process of an unlawful abortion to be charged with a state jail felony, Moody said. That includes the doctor who performed the abortion, but also the person who drove the woman to the clinic, the receptionist who booked the appointment and even the bank teller who cashed the check that paid for the procedure.
“I’m not trying get into policy; I believe this is an unintended consequence of the law,” Moody said on the House floor Friday evening as he introduced an amendment to Senate Bill 8 that would limit who can be prosecuted. Three hours into the abortion debate, there were several calls to order as the El Paso Democrat pleaded with fellow lawmakers to pay attention.
“If the goal is to prosecute people who perform these acts, what’s written here goes way beyond that,” said Moody, one of the leading criminal justice experts in the House. He chairs the Criminal Jurisprudence Committee and worked as a prosecutor in the El Paso County District Attorney’s Office for four years.
It wasn’t a mistake. The amendment failed, 51-83 and only one Democrat, Representative Ryan Guillen of Rio Grande City, voted against.
The Observer spoke to several other attorneys who each interpreted the bill’s applications differently — indicating, at the very least, that the bill provides a subjective tool for prosecutors, who can be politically motivated. And that has Moody worried.
SB 8, which awaits final approval from the Senate, would criminalize “partial birth abortions” and “dismemberment abortions” — both nonmedical terms used by anti-abortion advocates. The first is for a procedure already prohibited under federal law, and the second describes a dilation and evacuation (D&E) procedure, one of the most common forms of second trimester abortions. Both bans would subject a doctor who performs the abortion to a state jail felony, punishable by up to two years in prison, and exempt the woman who had the procedure. But under Texas law, prosecutors could come after anyone else involved in the process, unless they’re specifically exempted in the legislation.
State Representative Donna Howard, D-Austin, speaks against SB 8 Friday evening. SAM DEGRAVE
The “law of parties” in Texas allows a person connected to but not actually committing a crime to also be charged. A person is criminally responsible under Texas law if he or she, acting with intent, “solicits, encourages, directs, aids, or attempts to aid the other person to commit the offense.” The law is intended to help take down criminal networks, Moody says, but can also be wielded against, for example, individuals loosely connected to the provision of an unlawful abortion.
“I think by rejecting my amendment, [opponents showed] their intent was not only to go after physicians. I guess I misunderstood,” Moody told the Observer. “[This bill] is so poorly drafted, so poorly worded, that I think it shows they’re not really concerned about making good policy.”
The key question is whether a person was knowingly involved, said Representative Jeff Leach, R-Plano.
If a bookkeeper or receptionist has no idea what’s going on, they shouldn’t be held to the same responsibility as the doctor performing the abortion, Leach told the Observer. But if they do know, that’s a different story.
State Representative Jeff Leach, R-Plano SAM DEGRAVE
“If there’s any individual who may not actually be performing the abortion but is knowingly assisting the criminal enterprise — that may not be a good way to put it — who is knowingly assisting in the provision of an unlawful abortion — then our laws ought to be narrowly tailored to hold those responsible,” said Leach, who was concerned Moody’s proposal might have let them off the hook and requested it be withdrawn.
As GOP lawmakers move to expand the scope of prosecution, they’ve also broadened the definition of what constitutes an illegal abortion. Following the 2016 Supreme Court ruling that struck two main provisions from Texas’ House Bill 2, members have shifted their rhetoric on abortion. Instead of claiming to protect women’s health, they’re criminalizing the procedure.
The Abolish Abortion Act, proposed by Arlington Republican Tony Tinderholt, also of the far-right House Freedom Caucus, would criminalize abortion at any stage and charge women and providers with a felony, without exemption for rape or incest. Tinderholt told the Observer the proposal would “force” women to be “more personally responsible.” Another proposal by fellow caucus member Matt Schaefer, R-Tyler, would remove the exception for fetal anomaly from the state’s 20-week abortion ban.
Leach, an attorney and Freedom Caucus member who describes himself as “pro-life and for the death penalty,” says there is a problem with how the “law of parties” is used in capital punishment, and he’s worked on bipartisan efforts this session to reform the law.
Without Moody’s failed amendment, the “partial birth abortion” ban does not exclude anyone besides the woman from criminal prosecution. The D&E ban, meanwhile, does clarify who cannot be prosecuted: “an employee or agent acting under the direction of a physician… or a person who fills a prescription or provides equipment” used in the abortion.
Joe Pojman, executive director of Texas Alliance for Life, said that he would support individuals who knowingly assist with the abortion facing prosecution, but that Moody’s inclusion of drivers and receptionists was “far-fetched.”
“It’s possible a third party could be prosecuted, but it would have to be someone close to the physician that is knowingly performing the abortion, like a nurse,” added Pojman, who said that in his 25 years lobbying against abortion in Texas, he’s never heard this kind of objection.
Leach also said he didn’t think Moody’s amendment was necessary, because the bill already protects unknowing participants from criminal prosecution.
“That’s wrong, and I told him that,” said Moody. The “knowingly perform” language in the bill is referring to the abortion provider only, but “others don’t have to know what’s going on, they can just be part of the process…The law of parties casts a wide net,” Moody said. “Prosecutors have wide discretion on the charges being brought.”
This ample freedom granted to prosecutors concerns critics of SB 8.
“We worry about rogue or malicious prosecutors,” said Blake Rocap, legal counsel for NARAL Pro-Choice Texas. “The point of this bill isn’t smart criminal justice; it’s targeted prosecution of people who want to help women access health care.”
“I believe that as an abortion provider, I am doing God’s work,” writes Parker in his new memoir, “Life’s Work: A Moral Argument for Choice.” “I am protecting women’s rights, their human right to decide their futures for themselves, and to live their lives as they see fit.”
That is why he’s been invited to California on this lovely Tuesday evening. Parker has come from Alabama to accept a Person of the Year award from a 26-year-old abortion rights group that is not famous, but certainly deserves to be.
The group is the Women’s Reproductive Rights Assistance Project, or WRRAP. Founded 26 years ago by Joyce Schorr, a former sales executive for Reynolds, WRRAP gives money to women who can’t afford to pay for their abortions. (Previous winners include Gloria Steinem, Dr. George Tiller, Sarah Weddington … and Kelsey Grammer, who was for abortion rights before he was against them.)
Since the early 1990s, Schorr estimates, the group has helped 40,000 women, chipping in relatively small sums, usually between $200 and $500.
“The women we help are very, very poor,” said Schorr, who owns an entertainment company with her husband, Arny Schorr, a former Rhino Records executive. “Everything is a struggle. It’s hard for them to find transportation. The last thing they need is another child to take care of.’’
Parker grew up poor and fatherless in Birmingham, Ala. At 15, under the tutelage of a coach who was a Pentecostal minister, he became a born-again Christian. The first member of his family to attend college, he carried a Bible door to door in his dorm, spreading the gospel of Jesus. After he became an OB-GYN, he refused to perform abortions for religious reasons, but would refer women to doctors who did.
Eventually, though, as he practiced at the Queen’s Medical Center in Hawaii, he started to see abortion as a critical part of his patients’ care, its restriction as a profound injustice.
One day, as he contemplated the parable of the Good Samaritan, he had an epiphany: “It was like a punch, all at once in my spiritual gut,” he writes in his memoir. “The Scripture came alive and it spoke to me. For the Samaritan, the person in need was a fallen traveler. For me, it was a pregnant woman. It became not: Is it right for me, as a Christian, to perform abortions? But rather, is it right for me, as a Christian to refuse to do them? Now I saw, without doubt, fear or ambivalence, that it was appropriate, even ethical for me to provide this care.”
In his book and in conversations — including a recent appearance on “The Daily Show” — Parker compares forcing a woman to bear a child to slavery. It’s generally unwise to compare anything that is not slavery to slavery, but Parker is unbowed.
“I know it’s a powerful analogy to draw, and people are skittish,” he told me, “but if you look at what was evil about slavery and what happens to women when they are forced to give birth, it’s apt. When we make fetuses ‘people’ and demand that women be subordinated in servitude to them… women become a means to an end. It’s no different from slavery.”
The conventional wisdom is that to be devoutly religious is to be antiabortion — but like Parker’s epiphany, Schorr’s impulse to help women obtain abortions also has spiritual roots, though perhaps in a more roundabout way.
Her moment came in 1991, as she watched an episode of the “Phil Donahue Show.’’ His guests were Quaker women who ran a kind of underground railroad for women needing abortions in the years before the Supreme Court legalized abortion. “In 1969, when I was in college, my best friend had almost died from an illegal abortion,” Schorr told me. “It just triggered me: I can’t let this happen. We need to help these women get abortions.”
She approached the National Council of Jewish Women in Los Angeles and was given permission to start WRRAP under its auspices. Four years later, WRRAP became an independent nonprofit, run by Schorr, who has never collected a salary. About 50 volunteers help out.
There is no physical location; two volunteers take calls from clinics for five hours each day. “We fund anyone who calls us,” Schorr said. In the beginning, she said, she took calls from desperate women, but discovered it was far more efficient to have clinics call on behalf of patients. (Patients — and donors — can make direct contact through the group’s website.)
Until recently, WRRAP’s annual budget had been about $35,000. “We finally caught the eye of some very big donors,’’ she said. In the last two years, these anonymous philanthropists have given a total of $550,000.
The money will enable Schorr, who at 65 is nearing retirement, to finally hire an executive director, and put a succession plan in place.
The abortion debate in this country waxes and wanes. The fundamental precept enshrined in Roe vs. Wade, that women have a fundamental right to control their own bodies, still stands.
But we appear to be in a moment when the antiabortion forces are ascendant, both in statehouses, which are defunding critically important abortion providers like Planned Parenthood, and at the federal level, where the Trump administration is systematically dismantling America’s commitment to family planning programs around the globe.
Heroes like Willie Parker and Joyce Schorr, and the people who work in the trenches with them every day, give me reason to believe that no matter how hard some folks try to turn back the clock on women’s rights, the antiabortion mission is doomed to fail.
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