Abortion Gang

The fight against marriage equality is a losing one. As the SCOTUS spends the week hearing oral arguments on Prop 8 in California (in which voters overturned a court decision that had allowed same-sex marriages in the state) and the Defense of Marriage Act (DOMA, which prohibits the federal government from recognizing same-sex marriage because everyone is an asshole), half a dozen high-profile politicians from both sides of the aisle have tripped over themselves in a rush to support marriage equality and be able to point back in a few years and say they were on the right side of history, however closely they may have timed it. One of these politicians is former Secretary of State Hilary Clinton, whose husband, while President, signed DOMA (because he is an asshole). That’s which way the wind is blowing, and no, you don’t need to a weatherman.

Public support for marriage equality has expanded so far so fast for several reasons. Some of it is growing public awareness, while some of it is the result of on-the-ground, grassroots legislative and communications efforts that have been decades in the making. And some of it is very simply that the arguments against marriage equality, now having been stripped down, over and over, to their composite pieces, have proven to stand on extremely thin legal ground. As the cases go before the SCOTUS, the arguments against marriage equality now break down into two recognizable composite pieces: plain old hate and homophobia, and children.

The debate about what’s good for children belongs to both sides of the marriage equality fight. Justice Kennedy, likely to be the swing vote on the issue, raised the question during Tuesday’s argument about the “immediate injury” suffered by children in California whose same-sex parents were not allowed to marry, saying, “They want their parents to have full recognition and status.” Justice Antonin Scalia, who is a well-known asshole, also raised the issue of children raised by same-sex parents while expertly trolling the nation, stating, erroneously, “There’s considerable disagreement among sociologists as to what the consequences of raising a child in a single-sex family, whether it is harmful to the child or not.”

But more important than the general debate over the welfare of children being raised in this country is the essential question of what power the not yet conceived, future children of our nation should have on defining marriage. That may seem to be a ridiculous question, but that ridiculous question now forms almost the entire recognizable legal basis for the fight against marriage equality (hate and fear are perfectly legal but do not qualify as a legal basis for an argument).

The argument being made against marriage equality is known as “responsible procreation,” and Jeffrey Rosen explains it:

If the Court does decide the Perry case on the merits, it will come down to this claim: Because only straight people can impulsively and accidently have illegitimate children out of wedlock, they need a stable institution of marriage to discourage them from doing so and to force them to focus on the consequences of their animalistic passions. But as Justice Kagan noted, the idea that denying marriage equality to gay couples would encourage monogamy and responsible procreation by straight couples is hard to follow, let alone to fathom.

That is a fairly kind and comprehensible way of explaining what is actually an extremely opaque argument brought forward by the lawyers for Prop 8, which went as follows:

[S]ociety’s interest in responsible procreation isn’t just with respect to the procreative capacities of the couple itself. The marital norm, which imposes the obligations of fidelity and monogamy, Your Honor, advances the interests in responsible procreation by making it more likely that neither party, including the fertile party to that … marriage will engage in irresponsible procreative conduct outside of that marriage. Outside of that marriage. That’s the marital—that’s the marital norm.

This is what’s so fascinating: the right’s last great hope of limiting the definition of marriage is to do it by insisting that it the only way to continue to effectively legislative reproductive options. That’s amazing. This is an argument against same-sex marriage that actually says, “We need marriage as a tool to control what people who can have children without planning them are allowed to do. Same-sex couples have to plan children* so they don’t need to be controlled by us so we should not give them marriage.” I mean guys. Really. What. I can’t even.

Equally fascinating is the notion that marriage equality has come so far in the 12 years since the state of Massachusetts first allowed it that simply arguing against LGBTQ rights is no longer as effective as arguing in favor of controlling people’s reproductive options. Conversely, arguing the need to control people’s reproductive options, no matter how bizarre an argument that is, is now so effective that other kinds of rights can be allowed or denied based on the perceived need for this control.

An interesting side-note to all of this is Justice Ruth Bader Ginsberg’s argument directly relating marriage equality to Roe v Wade. She had previously raised, and raised again on Tuesday, the issue of marriage equality simply moving too fast – based on her conviction that that was the issue with Roe. “It’s not that the judgment was wrong, but it moved too far too fast,” she said, and has expressed concerns that marriage equality could face the same difficulty if not handled properly by the court.

I am over-the-moon excited by the push and the public support for marriage equality I am seeing this week. I can only hope we see something like it in the near-term for reproductive rights, and the framework we are seeing in these arguments is not a portent of legal battles to come.

*Uuuugggghhhhhh wild assumptions inaccuracies etc these people are assholes.

A guest post by Lauren Herold and Tobias Rodriguez.

Earlier this week, an Indiegogo campaign went viral: Emerson College’s Phi Alpha Tau fraternity raised money for their frat brother, Donnie Collins, a trans man who needs top surgery. Donnie initially tried to pay for the surgery through Emerson’s insurance, Aetna, since Aetna offers coverage for trans*-related surgeries and hormone replacement therapy; Donnie’s request was denied, however, because Emerson College did not opt in to those services. After Out.com  featured an article about Phi Alpha Tau’s Indiegogo campaign, the brothers raised more than twice the $8,000 Donnie needs for the surgery.

Donnie’s frat brothers spoke in their Indiegogo video about wanting this fundraiser to start a conversation. There are (at least) two important conversations we’d like to address.

First, not every insurance company covers trans-related services. Colleges are typically hesitant to add these services for financial reasons. When colleges opt in to services for insurance plans they offer to students, they want to ensure they are getting their money’s worth. If a college doesn’t have any trans students, they can claim that these additional services will be paid for by all but enjoyed by few. Their most obvious incentive to add the services is to attract a more diverse student population, but the chances of the college attracting even dozens of trans students who need these services is slim.

It’s good that insurance companies like Aetna are beginning to cover these services, and many colleges are beginning to follow suit by opting into these services. But “many” is not enough. People like Donnie oftentimes don’t have time to wait for their insurance plan to decide to cover necessary services. Raising funds for an individual’s surgery may be successful in the short term, but we shouldn’t have to settle for hoping that the kindness of strangers will make up for the shortcomings of insurance companies and their clients. We need to push for institutional change so that all policies include these services. There are trans people around the country with similar medical needs who spend years saving or raising funds for these procedures and sometimes do not succeed. What about them?

We also need to talk about media coverage around the Indiegogo campaign. Most reporters have focused on a hook: that fraternity members defied the frat bro archetype by launching a campaign in support of a trans member. Donnie’s frat brothers deserve a lot of credit for demonstrating what it means to be a trans ally. But when media coverage focuses on the actions of cisgender individuals, it moves focus away from the fact that lack of proper medical care for trans people is a systemic issue and shifts our gaze to the stories of cis allies. The frat brothers are the conversation piece: they both created the conversation and are the subject of it, while Donnie’s experiences are discussed only briefly. Who gets to talk about trans people’s bodies and experiences? Cis people create the storyline and drive the narrative, and articles about the Indiegogo campaign reaffirm this trope.

This pattern perpetuates the assumption that cis people can talk about trans people’s bodies and experiences without their consent and without repercussions. In this case, Donnie welcomed the Indiegogo campaign as another platform he can use to share his experiences with the world, and has already made a variety of YouTube videos documenting his transition. However, for many trans people, their transition is a private journey. Stories like these make invisible the trans people who don’t medically transition as well as those who don’t want their transition to be public knowledge.

These stories also reify a singular trans narrative: that every trans person comes out, is supported, and begins a medical transition that includes hormone replacement therapy and at least one surgery. This is the story most people are comfortable hearing, but it does not reflect all trans people’s experiences and it alienates trans people whose experiences differ. It leaves out trans people who do not medically transition (whether because of personal preference or lack of access), who do not have a support system, and/or who are not vocal about their trans status.

We applaud the efforts of Donnie’s brothers–their campaign has helped change his life, and will continue to benefit trans people: they have pledged to donate the extra money they raised to the Jim Collins Foundation. Yet these efforts are not enough. We have to work toward systemic change in our healthcare system so trans people are not constantly fighting individual battles. And when we tell trans stories, we need to do so with a media that captures the full complexity of trans experiences.

*We use the asterisk here to suggest that the term “trans” can refer to a lot of identities under the trans umbrella. Here’s a great explanation of why. Our choice to use the asterisk in our first use of trans* and not thereafter was for readability.

When the first rumors began to spread about a woman who had died following an abortion performed by Dr. Leroy Carhart, one of the last doctors in the country willing to perform third trimester abortions, the Gang gathered around our proverbial fireplace to talk it out.

It has now become clear that the woman died of rare complications that can occur after vaginal birth, c-section, or abortion. There is no way to tell if a woman will experience these complications.One source in the article describes it as the obstetric equivalent of being hit by lightning. All appearances, including a gift registry, suggest that this was a wanted child and that health complications for either the mother or the fetus required the third-trimester procedure.

4) Seriously engage with the real issues. Once you know what the real issues involved in the case are, consider them. In this case, the real issue is that a woman experienced an extremely rare complication; it has nothing to do with abortion one way or another. But it’s also the case that a woman who wanted to keep her pregnancy found out very late that it wasn’t viable and required a third-trimester abortion, which is illegal in almost every state. She was lucky to find a doctor who would perform the procedure, and that doctor is under constant attack, a fact which this incident only serves to highlight. There may come a time in the next few years where someone with an unviable pregnancy has literally no options. Let’s talk about that.

_______________________________

*This should be a sign that our maternal care is fucking abysmal and in a comprehensive reproductive justice framework we should really try to do something about that. However, that being said, pregnancy itself is a project that takes a significant toll on the body and, even under optimal circumstances (which the US does not offer, especially for poor people and people of color), poses inevitable risk. Being pregnant is and will always be riskier for someone’s health than an abortion. So bless all of you willingly and happily bringing bright and beautiful children into this world, cause it is no easy thing.

Wall Street Journal: 7 in 10 Americans support Roe v. Wade.
Gallup: Americans favor legal abortion, they don’t overwhelming support abortion after the first trimester.
Pew: Most millennials don’t know that Roe is about abortion, but favor the decision once they’re told what it’s about.

How do we make sense of this data? What do these polls actually mean for the pro-choice and reproductive justice movements?

Interpreting polls is not easy. We can dissect each and every poll, hoping it will get to the truth of our nation’s beliefs about abortion, but in reality, these polls are brief snapshots–they tell us part of the story, but not the whole story. The many barriers to abortion access that we fight on a daily basis–from waiting periods to forced ultrasounds to the Hyde Amendment–are the result of coordinated, well-funded anti-abortion campaigns at the national and state level. If we think about social change as happening only in legislatures, then I can see why so many people are so pessimistic  about the future of abortion rights and access in the United States. While it may look bleak from a purely legislative standpoint, I think there’s actually much to be hopeful about.

Instead of looking at our movement as scrambling to catch up to the anti-abortion movement, I would like to see us shift gears and see how abundant our resources are, and figure out how to use them to our greatest potential. We have at least a dozen well-established, well-funded national organization that a majority of the American public supports. Many of these organizations have affiliates with local activists in every state. There are dozens and dozens of smaller organizations such as COLOR, National Advocates for Pregnant Women, Spark Reproductive Justice NOW,  and the Native Youth Sexual Health Network, working to fight for the reproductive rights of all people, not the privileged few, and encouraging our legacy pro-choice organizations to consider the reproductive justice framework. There is a growing and vocal movement of activists, many under 40, who work outside the traditional pro-choice movement power structure and are also urging our legacy organizations to be bolder in their visions. It is limiting and shortsighted to look only at our problems; it’s also not a very good recruitment strategy. Who wants to be a part of a movement that appears to be in constant crisis?

In addition of naming all the struggles we are facing (and there are many), what if we also thought about our potential? Fighting anti-abortion bills in state and national legislatures is not enough. Are we a political movement only? Or are we also a movement for social and cultural change?

Some people are inspired by phrases like “the war on women”—it galvanizes them to participate in the struggle. Others find that kind of language exhausting and exclusive. How many times can you read the headline, “this is the WORST attack we’ve seen” without getting compassion fatigue?  In addition to taking stock of what’s going wrong, what if we also provided support and opportunities for people to re-engage with activism on their own terms? I’m thinking specifically of a new initiative called CoreAlign, which is providing people with a space to discuss the tough questions faced by the pro-choice and reproductive justice movements: Do we want the government in or out? How do we talk about gender in our movement? What kind of abortion stories do we tell to advance our goals? Evaluating where our movement’s been and where it’s going can only make us stronger. And we’ll need a strong movement to fight the legislative hurdles we’re facing.

Engaging in these exploratory, movement-focused questions is often seen as  competing with our legislative work. We can’t function on this binary. We must set gears in motion for both political and cultural change and engage everyone in the process–grassroots activists, abortion fund volunteers, people with mixed feelings about abortion, people who have and haven’t had abortions, political organizers of all stripes. Leadership requires us to go beyond public opinion polls and lead people to where we want them to be. The anti-abortion movement has been doing this for decades. It’s time we stepped up to the plate.

40 years ago in a momentous Supreme Court victory abortion became legal in the US. Politicians were changed by the champions of the feminist movement. They agreed that all people deserve to plan families and space their pregnancies and that the days of back alley abortions and coat hangers were over. No longer would anyone have to risk their lives to end and unwanted pregnancy.

That was the dream, but it is not the reality. There is no question that Roe made history and laid the foundation for the work we do in abortion access today. But we also know that it didn’t ensure complete accessibility and affordability of care. Despite the passing of Roe in 1973, the Hyde Amendment, prohibiting federal Medicaid dollars from covering abortion, was passed only three years later in 1976 and set the stage for the many abortion restrictions that have followed.

Every person deserves to be able to make the best decisions for themselves and for their families, but abortion coverage restrictions can make that difficult or even impossible. Abortion fund volunteers talk to people unable to afford abortion care every single day. People without insurance coverage of abortion have to struggle, some by putting off paying bills, rent, or even risking their personal safety to come up with the money for an abortion. There is a big difference between making abortion legal and making it accessible.

Our feminist leaders spoke up 40 years ago to legalize abortion and made significant change. As feminists, reproductive justice activists, families, and communities, must speak up again, and shout until the current administration hears us. To continue to let people struggle to afford abortion care, to make it impossible for our friends and communities to access health services, is unconscionable. Sign the petition now and tell President Obama that we are standing strong in support of comprehensive reproductive health care access and abortion coverage for all people, not just those who can afford it.

2011, my first year immersed in reproductive justice activism, was not a year for reflection; it was an unquestionably desperate time. States enacted a record number of abortion restrictions, blowing prior records out of the water. We were introduced to the vast, sprawling results of a decade of quiet, on-the-ground dedication by the anti-choice movement to eradicating not just our right to an abortion, but our rights and access to a wide array of other reproductive options as well. “Personhood” became a thing. It was that kind of year.

In important ways, it was a year that galvanized many sane, rational people. who might otherwise avoid anything that could be construed as a political fight, to throw their collective hats in the ring. For decades, young women, poor women, and women of color especially had lacked comprehensive access to abortion services. With middle and upper-class people’s access suddenly threatened, reproductive rights were, for the first time in a long time, a perpetual front-page story.

2012 was, without a doubt, The Year They Went Too Far. While we settled into the Sisyphean grind of rolling back 2011′s anti-choice advancements, anti-choice legislators set out to make such complete asses of themselves that they did the forward-progress work we simply didn’t have the time or energy for on our behalf. 2012 was the year of “legitimate rape,” “some girls rape easy,” “emergency rape,” and, you know, “the rape thing.” In 2012, while we were desperately trying to make sure states didn’t shut down every single abortion provider within their geographical boundaries, anti-choice activists were rolling out our public relations campaign for us, revealing, as they never had before, that real, human lives were worth nothing to them in the face of their ideologies, and that those ideologies were inherently, viciously misogynistic. 2012 saw the second-highest number of abortion restrictions ever enacted - but the number was still less than half that of 2011′s staggering assault. Things went, in a year, from essentially the worst ever, to only slightly worse than average.

But really, fundamentally, 2012 was the year that the carefully invisibilized monopoly white men have held on power since the founding of our nation began to obviously, visibly slip. Money didn’t win the election. We sloowwwly rolled back the anti-choice tide. It wasn’t just ok to say that “some girls rape easy” – every member of the “rape caucus” up for re-election lost their bid. And when I went to visit a friend in a deep red state, his usually polite, white, conservative, deeply religious father veered off from what had been a casual discussion of politics and yelled at me until I cried.

One minute we were talking in their perfectly normal suburban kitchen, and the next moment I was symbol for every misplaced frustration this man was feeling. White men haven’t lost power: they still have all the money, all the corporate boards and presidencies, and almost all of Congress. But they have lost what they took for granted, what they took to be understood - that the world was a certain way, that certain things were the absolute truth, that their absolute truth was known and accepted. For years, politicians ranted that the wealthy and the white and the heterosexual were losing the country, and they loved to get everyone fired up. They’d all shake their heads and talk about the “hostile takeover” and lament that it was all slipping away and they couldn’t stop it. But it was never real; the possibility that a black man would be President, gay people would be allowed to adopt children and get married, and people would generally agree that rape really, actually wasn’t something women asked for was just the bogeyman they used to keep the donations coming in and gun sales up. They had no idea what it would truly feel like to lose. They never, ever lost. And watching the results come in election night, they knew what it meant to lose – and frankly, it’s driven a lot of them completely batty.

None of this is to say the war for equality, justice, and open access to resources, in the US or certainly world-wide, is close to over. Climate change may wipe out humanity before we achieve any of those things (I am totally serious about this). But like the anti-abortion initiatives we turned back this year, the tide on the Unquestioned Reign of White Male Privilege has, in fact, begun to turn. This is real.

I love new beginnings. I love a fresh start. I go into 2013 with enthusiasm and arms wide-open. But that doesn’t make history disappear, and we can’t leave any of the violence of recent history – mass shootings, targeted assassination attempts, subway hate crimes, mass sexual assault in war-time – behind in 2012, to simply fade into obscurity. 2013 doesn’t start clean. 2013 starts with the fight for recognition and justice for a 23 year old woman in Delhi, India, who was gang-raped so brutally that she died of organ failure in the hospital.

Her courage in speaking out about her rape and murder was the spark that lit a fire that has spread across Delhi. On the second day of 2013, thousands of women marched in silence, signs held aloft, declaring that rape-culture’s day had passed in their city. Women who live or have lived in Delhi have written fiercely enraged blog posts and made demands in The New York Times. Their story is the story of a thing gone too far, an unspeakable act that has silenced and galvanized a city. And Newtown might be the story of how a tragedy so unimaginable it still doesn’t seem real woke a nation from the cherished myths that were killing their children. And Malala might be the story of how a world realized that girls everywhere need us to pay attention and protect their right to live freely, to go to school, and to dream.

But I think there’s a chance that this is one story. There is a chance that this is the story of how people with more power learned to listen to those with less; how people accustomed to having a voice learned to listen to those who have not been given the opportunity to speak. There is a chance this is the story of how vital global conversations began, how we refused to allow the same violence to continue in perpetuity until our daughters sons daughters were marching through the streets to win for themselves what we had failed to bequeath them. There is a possibility, however slim, that 2011 was the story of how bad things can get; that 2012 was when we declared the status quo wholly unacceptable; and that 2013 is the year that we rise.

Many astrologers insist that Mayans didn’t believe the world would end in 2012; they believed the worldas we know it was coming to an end. There is a school of thought that says 2013 ushers in an age of enlightenment; there are astrological phenomena similar to those that occurred during the Renaissance and parts of the Romantic period. I don’t think everything will get better this year. But I believe this could be the year we insist things must get better, that we will make them better, and that “no” is simply not an option.

A guest post from Elizabeth, who supports parents of kids w/disabilities by day & work with @EMA_Fund by night.

Sunday was the 36th anniversary of the Hyde Amendment, the law that prevented using Medicaid to fund abortions. That law serves to make abortion accessible to people with money to pay for it, or to pay for private insurance, or in states that have chosen to use their own funds to make it doable. Essentially, the law is a penalty on poor people. Part of my reproductive justice agenda is to overturn Hyde.  But the anniversary also made me think about all the other things that I want when it comes to repro justice. A partial list (spoiler alert: most of them are really about ending capitalism):

• I want people to never have to choose to have an abortion because they can’t afford another child. I want people to have their needs met enough that questions of economics can be separate from questions of family raising.
• I want people to never have to choose to have an abortion because of disablism. This goes both ways: I want kids with disabilities and their parents to be supported enough that it isn’t a question of resources when it comes to raising kids with disabilities, and I want parents with disabilities to be supported enough that they know that they can parent well and thoroughly and that they will have a support network around them, whatever that needs to look like.
• I want people to not be excluded from foster parenting and adopting based on disablist and classist criteria. I want rules like “People with certain mental illnesses cannot be foster parents” to be eliminated and I want actual reviews of actual people when it comes to parenting.
• I want state services (if we have to have a state) to get people the supports that they need to parent and resources around addiction, instead of often racist and classist removal of kids from their homes. I also want  clear and thorough and trained and resourced abuse screenings/screeners.
• I want teen parents to be supported with whatever resources they need to live the lives they want and to raise their children with the networks they need.
• I want an end to forced and coercive sterilization. This includes, for me, figuring out wtf to do with our legal guardianship system where people can speak for others (kids, adults with disabilities) and sterilize them. It also includes coercive rules around welfare, and pressure to get iuds after abortions, and racism in our health care system that pressures women of color to be sterilized, and laws about trans people’s reproductive capacity in relation to legal status, and over-economically-incentivized clinical trials for sterilization and long-term birth control, and undisclosed clinical trials.
• I want people to be able to choose abortion freely, without needing to take economics into account, without having to wait/wade through roadblocks, without the number of weeks gestation playing into what they can do, without needing to travel hundreds of miles to the nearest clinic.
• I want people to have full (comprehensive, sex-positive, body-positive) sexual health information, full information and training and expectations around consent, full access to reproductive and physical and psychiatric health care, full access to both hormonal and barrier methods of birth control (oh and the copper iud if they want it).
• I want an end to rape, to coercion, to sexual abuse and assault, to street harassment, to misogyny, to heteropatriarchy, to racism, to disablism, to capitalism and the view of sexuality as an exchange. I want an end to non-consensual power dynamics. I want an end to domestic violence. I want people to be able to freely make decisions about their bodies and their sexualities.
• I want the end to nations and borders. Failing that, I want having kids to not be impacted by nationhood or citizenship. I want kids to be able to get educated, I want preventative and ongoing health care for all people, I want families to be able to access supports and services regardless of whether or not they have documentation or citizenship status.
• I want enough resources put into AIDS and other STIs that we actually fix that shit. No more super-gonorrhea.
• I want people to make their own decisions about how they want to birth children, what interventions they want used, and how they want to raise their children. I want those decisions to be supported with physical and economic resources as needed. I want people to be able to make these decisions with full information about how their bodies, health statuses, etc can be supported in each context.
• I want us to look at parenting outside of heteropatriarchy. I want us to figure out how to talk about misogyny and how that impacts reproduction and parenting, but I want us to do it in a way that is trans*-inclusive and doesn’t reduce people to language that they wouldn’t use.
• I want everyone to have access to anti-racist and culturally-oriented/specific/sensitive health care and education, throughout their lives. I want a culture that values the contributions and work of people of color, particularly women of color, and that centers their concerns, needs, and voices. 
• I want people to be able to decide what is important to them around reproduction, families, and children, and be able to easily and consistently access the resources to make those things happen.
• Added by others: “ I would add to the one about birth some more explicit stuff around demanding that all parents have access to skin on skin, breastfeeding support, and the ability to have anyone they consider family present before, during, and after the birth…” and “No one should have to be pushed into choosing adoption because of money, age, or other people who are convinced they can’t possibly do a good job. And people who relinquish their children without that pressure should be fully supported in the choice they made,” and “full and enthusiastic support for those choosing abortion from friends, family, and partners,” and Non-fear-based nformation about birthing options- home birth, hospital, birthing center and access to these choices regardless of income and education level.”

I am sure there is more! What am I missing?

We talk about Hyde all the time, but we rarely talk about the 17 states that have extended their own funds to cover abortion in all or most cases. (However, research shows what advocates have long known—that two of these 17 states (Arizona and Illinois) do not offer that coverage to women in practice.)

Amanda Dennis, Associate at Ibis Reproductive Health, explains: “In states like Massachusetts, New York, and Oregon, Medicaid covers abortion regardless of personal circumstances in both policy and practice. Individuals seeking abortion in these states report being able to weigh their pregnancy options, easily secure accurate information about whether their insurance plan covers abortion, find a health care provider who accepts Medicaid, and make an appointment with confidence.” In these states (“Medicaid states”), a person on Medicaid is able to receive care with fewer stressful complications, compared to his or her counterpart in a non-Medicaid state, where he or she, unable to afford it, may not be able to get an abortion at all.

As people who have worked in Medicaid and non-Medicaid states will tell you, the differences are stark. For a person who has comprehensive health insurance coverage, finding out that it does not cover abortion is unexpected, jarring, and upsetting. It means that she or he can’t get care quickly, will struggle to come up with the money on top of other living expenses, and may jeopardize his or her health or safety. The landscape is vastly different in Medicaid states, where state governments have stepped up to fill the gap and to make it possible for more people to obtain coverage for abortion, trusting that each person should have the ability to make the best decisions for themselves and their families. For people accessing abortion services in these states, it is covered like other health services are covered. That is how it should be: abortion is a legal health service in our country. It is unfair for the federal government to interfere with personal decision-making, and we should applaud the states that allow individuals to think for themselves.

There is still work to be done in Medicaid states to ensure that all people can obtain abortion, particularly for immigrants and minors, We know that Medicaid states aren’t perfect, and the work that we are doing despite Medicaid-covered abortions is necessary and will not go away any time soon. We do not live in utopias, but we do acknowledge abortion is vastly more accessible and affordable. If we don’t talk about Massachusetts, New York, and Oregon, among others, as successes, we will not be able to demonstrate the importance of insurance coverage for abortion, which is desperately needed in the current climate. We, no matter the state we live in, must work together repeal Hyde and to ensure that all people are able to access abortion care regardless of their financial means or insurance status. We can also be proud of those states that have stepped up when the federal government has failed. Let’s shout our success stories loud enough until more state and local governments hear us, loud enough that they take on the responsibility of protecting the health of all of their citizens, not just the ones who can afford it.

“An estimated 500,000 pregnancies in the United States each year involve women who have or who will develop psychiatric illness during the pregnancy.”

Think about that. Half a million women each year.

We know about 1 in 4 Americans suffer from mental disorders, 15-20% of American women suffer from depressive symptoms DURING pregnancy, and that depression during pregnancy is a global issue. Clearly, psychiatric disorders during pregnancy are common, and in my experience are not acknowledged nearly often enough.

Depression is a symptom of pregnancy seen all over the globe, and most moms do just fine. Is it fun? No, but that’s why it’s called depression. It is the opposite of fun. Does that preclude you from carrying a pregnancy to term? No. Can we connect the dots to say that if women who experience temporary mental illness shouldn’t be stopped than women who experience semi-permanent mental illness shouldn’t be impeded from carrying to term? Yes, yes we can. [President Obama gets a shout out after all the women’s health love at the DNC. Though I’m pretty sure he would still be afraid to have one of us AGers go up on stage.]

“Mental competence” in pregnancy is surely often an excuse stemming from socially unjust motivations to prevent a pregnancy from going to term. Its more socially acceptable for some people to be a parent than others. Poor people, shouldn’t parent. Rich people, should parent. Some folks have too few kids, others too many. Women contending with mental illness shouldn’t. Not because they are inherently incapable, but because they are disenfranchised. These cases are not about mental capabilities, but about privilege. Social injustice is the determining factor here. This is just another realm where we see the same patterns replicated, only with different excuses.

What is perhaps most strange to me, is that there is a cultural dialogue about postpartum depression, see: Gwyneth Paltrow’s confession, but almost no external discussion of depression during pregnancy. We are all so beholden to the image of the glowing orb of sunshine pregnant person, there is no space for an alternative leaving women without models and information. We need to create this space, and we need to make sure to discuss mental health at-large.

The two major stories I’ve seen make their way through the reproductive health circuits (which does not mean there are not more) are one of a young schizophrenic woman was who ruled mentally incompetent, and her parents forced her to have an abortion and be sterilized against her will. The ruling was made on the basis that if the young woman, Mary Moe, were “mentally competent” she would have sought an abortion. The other is thankfully slightly more uplifting. Here a woman pro-actively chooses to stop taking her mental health medication to pursue a pregnancy to term and paid a full-time babysitter to keep her from hurting herself. We need to hear more of these stories, or really the half a million women grappling with mental illness (in a wide range of forms), each year during pregnancy need to hear these stories. They need to know they are not alone. That there are women in situations more difficult than themselves, and women who have made conscious choices after considering their options (and that this is something they can be empowered to do too). We especially need models for dealing with depression during pregnancy, which is the most common illness faced.

Now we got that out of the way, what about the women who decide to continue using medications for mental disorder during their pregnancy? Though the scientific evidence is still limited, the results are tentatively promising, but women still need to be educated about the risks of drugs on themselves and the fetus, and enabled to make decisions for themselves. But there is a clear need for more research, especially studies longer periods of over time. In the interim, if you decide not to go off your medication, you are not without alternatives to care. However, many women are faced with slightly more complicated medical circumstances and often run from doctors who either says your only choices are to go off/not start medication or have an abortion, which happens. It is very common for women with mental illness to be untreated because they are pregnant, not just untreated with medication, but unable to get a spot at a psychiatric hospital. So everything I said about alternative care is true, to the point you can actually access it. Which without access, it all goes out with the baby and the bath water and we are left back where we began with disenfranchisement through social injustice.

Remember the 500,000 pregnancies are affected each year, in the US. It could easily be you one day sitting across from a doctor leaving you a choice between an abortion or your necessary medication, and simply ignoring your choice to carry to term in the best way you deem fit.

The United States is not at the top of the list for safe births. In fact, we have the highest maternal mortality rate ofany industrialized nation; women here have a higher risk of dying of pregnancy related complication than 49 other countries, including Kuwait, South Korea and Bulgaria. All this is true, even though we spend more money on maternal healthcare than any other country.

Why is birth in America so dangerous? Perhaps it’s because it takes so long for evidence to change public policy. According to the EBAW page, it takes 20 years for proven research to be implemented in practice. We spend money on birth, but are we spending it in the right places, on the right practices? The World Health Organization recommends that c-section rates be at 15%, yet the USA c-section rate is 34%, and higher in some individual hospitals, even getting so high as 61.8% of births in 2010 at South Miami Hospital. C-sections are more expensive than vaginal deliveries, and actually have twice the risk for the mother and baby when the infant is positioned correctly.

For many people, the meaning of EBAW is to educate the general population. But for some women, EBAW can have a bigger meaning: whether or not they will give birth in chains.

The United States has a large female inmate population. Being in prison does not stop or prevent pregnancy. Women who become pregnant in prison or who enter prison while pregnant end up facing extremely dangerous situations where their rights are ignored and their bodies are harmed.  Sometimes, the medical needs of pregnant women are ignored, leading to miscarriages and stillbirths. Other women are moved to a medical facility to give birth, only to be chained to a bed by both hands and both feet. Only 16 of our 50 states have any regulation against women giving birth in shackles and chains. And even some of those states still practice shackling women even though it’s illegal. The American Medical Association and the American College of Obstetricians and Gynecologists are both against this practice, but there is little publicity about it, and thus, it is very hard to make any progress to stop it.  Luckily, there are organizations like the Prison Birth Project, which is working to help these women.

EBAW started on Monday with rallies across the United States called Improving Birth National Rally. Mothers, fathers, children and their advocates joined together in front of hospitals (who often welcomed them and provided refreshments and bathrooms) to educate the public. It continues with supporters sharing information through facebook, twitter, blogs and in person communication. The more people who share data, the more lives we can reach- and perhaps, save. If you want to get involved, visit Improving Birth and Birth Power.