Stay tuned to Abortion Gang for more blog posts on CLPP!
Stay tuned to Abortion Gang for more blog posts on CLPP!
On February 14th, the Birthing Center of Buffalo opened, making it the first combination birthing center and abortion clinic in the country. Buffalo Womenservices & The Birthing Center of Buffalo are located within the same building, have the same waiting room and the same provider. As a licensed and accredited free standing birth center, The Birthing Center of Buffalo offers certified midwifery and OB care. Buffalo Womenservices has a staff consisting of RNs, LPNs, social workers, counselors and physicians who offers abortions up to 22 weeks, and additional reproductive health care services including contraception.
Dr. Morrison opened the center after working with Eileen Steward, a homebirth midwife. During that time, she “realized that the women coming to her for abortions were being treated much better than women having in-hospital birth,” and Dr. Morrison wanted to change that. With that in mind, Dr. Morrison started the very long process of opening a birth center, a feat that is really hard to accomplish in New York and one that requires a lot of hard work, dedication and money.
Since opening, the feedback from patients has been extremely supportive. There has long been a desire for better maternity care in Western New York, and the birthing center offers an alternative for those who want a different birth experience. While not all Birthing Center patients are pro-choice, they continue to come to the Center because they see the importance of offering birth options. And even though there are protestors at Buffalo Womenservices, patients haven’t been deterred by them.
While there has been a lot of support and encouragement from around the Country, there remains ambivalence and mixed reactions from others. The Buffalo medical community and media have been mostly silent. Insurance coverage also remains a significant challenge, as most insurance companies have been resistant to covering the facility fee even though birthing center births are more affordable and have greater positive health outcomes when compared to hospital births. Since making services affordable and accessible is a priority for The Birthing Center, identifying ways to increase insurance coverage, like supporting New York to sign on to the ACA provision that requires coverage of birth centers, is a top priority of the Center.
The opening of The Birthing Center of Buffalo is an exciting and much needed addition to the healthcare landscape. Apart from providing important accessible care to those in Western New York, it is an example of integrative and holistic reproductive health care that addresses the whole patient and their life span. The Center represents that individuals who choose to have abortions and those who choose to give birth are not separate people. In fact, many individuals will experience both over their lifetime as 60% of those seeking abortions are already mothers and one in three women will have an abortion during their lifetime. But too often we treat these decisions as separate ideas when really we need to acknowledge that the reproductive choices one makes are intertwined. Abortion shouldn’t be stigmatized and treated as a siloed type of healthcare, because even if someone chooses to have an abortion, it doesn’t mean they aren’t going to also want to learn about breastfeeding, VBACs or birth options in the future.
The Birthing Center of Buffalo also reminds us that choice extends to all our reproductive decisions. When asked about the parallels between abortion care and birth options, Dr. Morrison mentioned how her background in abortion care helped her place on emphasis on a person’s ability to make decisions best for them, which includes the chance to choose different birth options. This is an example of the type of reproductive care we need more of. Where healthcare providers provide options, and honor that individuals are the experts on their bodies and experience. Because whether it’s getting an abortion, an IUD, or choosing a homebirth, excellent reproductive health is about respecting an individual’s choice in those decisions and supporting in their capacity to do so.
By: Catrina Otonoga
Ohio has been fighting a quiet battle for our lives. Across the state, clinics struggle to find partnerships with private hospitals in order to remain open, the Board of Health is in disarray after the resignation of the Director amid rumors he was not closing clinics quickly enough, and Ohio Right to Life is in the ears and offices of our highest state officials.
It’s not an uncommon refrain these days in America. Michigan is fighting back against a ban on including abortion in insurance policies. And, who hasn’t heard about Texas – with Wonder Woman Wendy at the helm of, perhaps, the greatest reproductive rights uprising in United States history?
But, in the Buckeye state we are under attack, and we haven’t had much of a rallying cry.
Here in Ohio, the heart of it all, we have another heartbeat bill on the table. A bill that contains no exceptions for rape or incest, and would make performing an abortion after a heartbeat is detected a felony. That’s as early as six weeks into a pregnancy.
Clinics are closing across the state. Women in the Toledo area are traveling to Michigan because their rights are being chipped away in their own backyard. Abortion is legal in Ohio, but restrictions are becoming so onerous that clinics can no longer operate, and women cannot access services without crossing the state or state lines.
And, at the helm of it all is Governor John Kasich. Behind the seemingly moderate exterior that got him elected, is a politician who has enacted some of the harshest abortion restrictions in the United States. Do a search for “Kasich, Abortion” and the articles that pop up are from the last time Ohio wasn’t under a blanket of snow – last summer, when he signed the budget into law, and with it, a host of laws that have led to massive consequences for women’s health in Ohio. Aside from a few quotes put out by advocates for abortion rights in the state, Kasich has remained clean of a lot of the backlash.
The upcoming Gubernatorial race in Ohio promises to focus on abortion issues, but many political experts agree that people who make abortion a priority during an election have already sorted themselves onto the Democratic side.
Like Virginia in their Gubernatorial, it’s time for Ohio to rally, to take ourselves off the defensive, and to stop letting extremists run our state and control our bodies under the guise of moderate politics.
Amazing & inspiring art courtesy of the Repeal Hyde Art Project
Here’s what some of us at Abortion Gang have been paying attention to lately:
Most of my reading has been for classes but this week we are talking about conscientious objection and with the Supreme Court cases coming up this has been one of my favorite break downs of what’s at stake in this decision: http://kff.org/womens-health-policy/issue-brief/all-eyes-on-the-supreme-court-more-than-birth-control-at-stake/
Kaiser does a great job of outlining how this case isn’t only about contraceptive coverage and religious freedom, but also whether corporations should be considered people and the implications this case could have on corporate law.
I’m reading my friend Tiffany’s post on why she’s fasting to support immigration reform: http://365breakfasts.wordpress.com/2014/03/23/fasting-for-families/
Steph and Chanel’s piece on abortion stigma and culture change at Cosmo: http://www.cosmopolitan.com/celebrity/news/these-women-want-to-change-the-way-you-think-about-abortion
Latest Hyde blog post from Andrew Jenkins at Choice USA: http://thehill.com/blogs/congress-blog/healthcare/200991-abortion-hyde-and-the-presidents-2015-budget
Taja Lindley on RH Reality Check about queer women & sexual health: http://rhrealitycheck.org/article/2014/03/18/exam-rooms-bedrooms-navigating-queer-sexual-health/
I’ve been reading about abortion access in Latin America using resources at the Guttmacher Institute and an article from RH Reality Check called The Politics of Abortion in Latin America.
I’ve been watching the hysteria from the anti-abortion zealots over the coathanger necklaces from the DC Abortion Fund , and am giddy at the thought of how much DCAF has been able to capitalize on the negative publicity to help women in need. Looking forward to being able to spot fellow supporters on the street and be able to match up our necklaces like a secret handshake. This is my personal favorite blog post I’ve seen.
I’ve been reading up on the Hobby Lobby birth control case, and am looking forward to standing outside of the Supreme Court in DC on Tuesday with other women’s healthcare supporters as oral arguments are heard.
In NC, we had a hell of a year in 2014 with a Motorcycle Vagina law that threatened to close every clinic but one, a wonderful clinic in the furthest corner of our state called Femcare (if you have a short memory or live under a rock, catch up on Motorcycle Vagina here and here.) With the 2014 session starting in less than two months and NC feminists waiting at the doors to find out how our general assembly will continue their path of destruction, Femcare’s owner has decided to retire and put the clinic up for sale. Planned Parenthood has announced plans to open a health center providing abortions in the same town and we await further developments. There is a lot of uncertainty and some genuine concern about making sure one of our most dedicated NC providers is treated well.
As those of us in the reproductive justice community have become increasingly familiar with, many of our clinics that provide basic services and healthcare to individuals around the country are routinely under attack. On March 3, All Families Healthcare, a clinic in Montana, was vandalized. A project on Indiegogo is aiming to raise $25,000 dollars towards the clinic so that it can continue to provide services that are desperately needed by millions throughout our country. To donate, please click here.
U.S. District Judge Catherine Eagles came to the defense of North Carolina women on January 17, 2014, ruling that a provision in a state law requiring providers to perform an ultrasound four hours prior to an abortion was unconstitutional based on restriction of free speech. The law, called the Woman’s Right to Know Act, was passed by a Republican-controlled general assembly in 2011 and promptly vetoed by Democratic then-governor Bev Perdue. Both houses were able to override the veto and thus it became law; however the ultrasound portion of the law was enjoined as reproductive justice advocates promptly sued on grounds of constitutionality. The requirement was in limbo for two and a half years, but Justice Eagles ruled just two months after the U.S. Supreme Court declined hearing a challenge to the unconstitutionality of a similar law in Oklahoma.
North Carolina’s ultrasound abortion requirement not only would have required an ultrasound four hours prior to the procedure – use of ultrasound to determine gestational age and location are standard medical practice – but mandated that the physician orient the ultrasound monitor so that patients had to view it (though they had the option to avert their eyes), describe the fetus including size and external and internal bodily observations, and offer the patient the opportunity to hear the fetal heartbeat. While the patient could decline the last component, physicians were required to continue their description of the fetus despite protest or request to cease.
This four hour period is actually arguably more inconvenient than the original stipulation, though the four hour period was the result a previous court review that found a 24 hour waiting period to be an excess burden. The law in its original approved form required in-person counseling and the ultrasound one day prior to an abortion. After review, the counseling was permitted over the phone but the 24 hour period stood. The ultrasound waiting period was changed to four hours. Therefore, a patient had a counseling session at one point, then had to go into the clinic a day later for the ultrasound, and wait for a large portion of the day for a procedure. There were no exceptions permitted for this, including for cases of sexual assault and fetal anomaly.
Justice Eagles had powerful words in her decision, calling the law “one-size-fits-all” and “an impermissible attempt to compel these providers to deliver the state’s message in favor of childbirth and against abortion”. Only Louisiana, Texas, and Wisconsin have similar laws on their books, though seven states require that patients must be offered the opportunity to see the ultrasound. In the Woman’s Right to Know Act, not only were no exceptions made, but Justice Eagles expressed concern that regarding the forced “state’s message to women who do not want to hear it or who are at risk of significant psychological harm from receiving it”. But ultrasounds are already standard practice and general practice includes permitting women to see their ultrasounds. Carolina Abortion Fund board member and former clinic employee Kelsea McLain says, “…I performed about 400 [ultrasounds]…My process involved asking the patient what she wanted to see, or know, if anything. I was surprised at how many women ended up wanting to see their ultrasound and almost everyone wanted to know how far along they were. I’d say maybe a tenth of them would change their mind.”
Thus it is conceivable that forced ultrasound viewing and verbal description would actually decrease the number of women changing their minds (as frustration tends to lead to anger and women may simply emotionally shut down and insist on moving through the process), and this legislation was actually intended to restrict access, either blocking women who do not have financial means for a two day event or causing scheduling conflicts and making the appointment-making process more challenging.
Cecile Richards, president of the Planned Parenthood Action Fund, said in a statement, “Today’s ruling marks a major victory for North Carolina women and sends a message to lawmakers across the country: It is unconstitutional for politicians to interfere in a woman’s personal medical decisions.” Julie Rikel of the Center for Reproductive Rights called it a great win for the first amendment, saying, “What the judge said here is that the state is not allowed to use doctors to force its own ideology onto patients, especially when the doctor feels that doing that could harm the patients.”
Anti-woman groups were not celebrating though. Tami Fitzgerald of the NC Values Coalition dramatized to the Raleigh News & Observer, “The founders would roll over in their graves if they knew that the First Amendment is being used to keep women from receiving sound medical advice about their own bodies.” State House Majority leader Paul Stam, a co-sponsor of the bill along with co-sponsors of the famed North Carolina “Motorcycle Vagina” legislation, stated his confidence that a state appeal would follow shortly.
But Governor McCrory thankfully had other ideas, surprising even RH Reality Check, who previously predicted appeal “almost certain”. On January 25, the Governor’s office issued a statement saying that the financial and time obligations required to defend this single provision of the law were not justified and that “[t]he heart of the legislation remains intact and patients will still receive access to important information and ample time needed to make decisions”. The administration’s surprising decision is perhaps in light of the renewed vigilance with which North Carolina reproductive justice advocates have watched the administration after the summer 2013 antics in which the “Motorcycle Vagina” TRAP legislation was born. After increasing pressure and outcry, including now frequent mockery of the state’s political affairs on the global stage of social media and cable news, McCrory’s administration has appeared to ever so slowly soften on some of its most polarizing issues, including the subject of abortion access to which he promised while campaigning to protect access to.
Congratulations to the plaintiffs in this suit against the state, to North Carolina and national reproductive health advocates who are fighting tirelessly against each antic the Republican-led assembly displays, and most importantly to women in North Carolina or who have to travel to North Carolina to access abortion.
It’s a story that by now most of America has already heard, and no matter what side of the fence you sit on, it is heartbreaking. In the early morning of November 26, 2013, 14-week pregnant Marlise Muñoz of Texas was found unconscious in her home and rushed to a hospital. Her husband Erick was told that she most likely suffered a pulmonary embolism, she was brain-dead, and that the fetus may have been deprived of oxygen. Marlise and Erick were both trained paramedics, and Erick believed that she would never choose to prolong her suffering, so he and her family chose to terminate her life support.
The hospital, however, had different plans, and informed the family they would not remove her ventilators and respirators, citing a Texas law that hospital spokesperson Jill Labbe says prevents them from “withhold[ing] or withdraw[ing] life-sustaining treatment for a pregnant patient”. The law was passed in 1989 and amended in 1999, and while the hospital maintains that it has followed the letter of the law, medical ethics experts say they are misinterpreting it. Legal experts and Muñoz’s family are speaking up to change the law. The essential question is whether the law applies to brain-dead patients or whether it was intended for pregnant women in comas or vegetative states.
While my effort to research the history of this particular law to trace anti-choice influence failed, a New York Times article did attribute Drexel University bioethicist Katherine A. Taylor with the information that this and similar laws nationwide were adopted in a period in which the public was concerned with “advance directives about end-of-life care like living wills and health care proxies…The provisions to protect fetuses, she said, helped ease the qualms of the Roman Catholic Church and others about such directives”. Another medical ethics expert, Jeffrey P. Spike of the University of Texas – Houston, said in the same article that other brain dead women had been kept on life support to keep the fetus alive, but every case he was aware of was supported by the family’s wishes.
While this is not a case that involves abortion, it is interesting to note that at 14 weeks gestation, Marlise Muñoz, had she been conscious, could have legally chosen to obtain one for any reason. Yet after brain death occurred, her husband who legally would hold power of attorney rights could not make an end of life decision for her and their unborn child, who most likely would either not live or have gravely impacted quality of life due to lack of oxygen.
And let me clear, because the fetus we now know has been very seriously harmed. At 14 weeks gestation, all the doctors knew was that the fetus had a heartbeat. They said they could do more testing between 22 and 24 weeks, and this week, at 22 weeks, they have now conceded that the fetus is not viable. It has fluid build-up on its brain, its lower extremities are so deformed that gender cannot be determined, and it may have a heart problem. The suffering of Marlise Muñoz and her family has been mercilessly prolonged while the state forced her to be an incubator for a fetus that could not survive anyway. This was hardly a guessing game; medically there was very little chance that the fetus would survive. NYU bioethicist Arthur Caplan wrote an editorial for the LA Times detailing why John Peter Smith Hospital was misinterpreting law and also argued that the law was unconstitutional. In a later exchange with Emily Bazelon at Slate, he says there are “almost no cases of trying to bring a 14-week-old to term in this circumstance”.
The story does seem to be coming to a just but sad end, as a Texas judge on Friday, January 24, ordered the hospital to remove Marlise from life support by 5:00 p.m. on Monday. The hospital may appeal but Labbe has said, “the courts are the appropriate venue to provide clarity, direction, and resolution in this matter”. The judge declined to speak to whether the law in question was constitutional.
While the Muñoz family is hopefully reaching the end of this terrible battle and can lay to rest Marlise and the once potential child they had looked forward to welcoming into the family, this case must serve to open the eyes of those concerned with reproductive justice issues. This law is the sort that sounds good on paper but is pushed by anti-choice zealots to further the precedent for giving the fetus rights that supersede those of women. Thirty-one states have laws on the books restricting end of life decisions for terminally ill pregnant women, and Texas is one of 12 with the most strict laws, requiring life support even in earliest pregnancy. Let me rephrase that: in more than 60% of states, women, their families, and even their doctors may have no say-so in a decision to be removed from life support if the woman is pregnant. In almost one-quarter of states, it does not matter if the pregnancy just began and the fetus has been harmed to the point of having no quality of life. It seems to me that when a woman has the legal right to terminate a pregnancy, a woman who is legally dead should not be kept mechanically alive to incubate a fetus despite her next of kin’s wish to remove life support.