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Archive for the ‘abortion’ Category

For the first time since our congresscritters launched their attack on Planned Parenthood last winter, I have the feeling that public outrage has risen to a boiling point. The attacks continue, of course, but their extreme brazenness is finally provoking a robust counter-reaction. Maybe I’m just spending too much time on Facebook (and certainly my Facebook friends are far from a representative sample), but the Komen Foundation’s de-funding of Planned Parenthood – and subsequent backpedaling – seems to signal a change in the people’s tolerance of the war on women’s bodily autonomy. At the very least, it showed that millions of pissed-off women could use social media to defend health services for the most vulnerable among us.

Then Obama actually stood up to the bishops and told the insurance companies to cover contraception, period. As Katha Pollitt noted, he finally noticed that American women are more numerous than the bishops. Darrell Issa’s farcical all-boyz hearing on religious freedom contraceptive coverage earned a backlash as furious as the Komen decision’s. As usual, Jon Stewart perfectly skewered the hypocrisy:

Now, after a couple of days of public shaming by silent protestors at the state capitol, Virginia’s governor has been forced to “reconsider” supporting a bill that mandates transvaginal ultrasounds prior to abortion – and (in breaking news) its sponsor says she’ll kill the bill altogether! She claims an attack of conscience. (Yes, a woman sponsored this rapey bill. No, she didn’t have any ethical pangs until it became a national disgrace.) As Jon Stewart put it, the poor governor evidently didn’t realize the procedure is “like a TSA patdown for your vagina.”

Hey, we’d better not give the TSA any new ideas.

I’m also tickled pink at state legislators’ over-the-top proposals to regulate men’s bodies, for a change. Virginia Senator Janet Howell countered the transvaginal-ultrasound madness with a bill that would’ve required rectal exams before a man could be prescribed an ED drug. In Oklahoma, Senator Constance Johnson proposed (then withdrew) an amendment stating “any action in which a man ejaculates or otherwise deposits semen anywhere but in a woman’s vagina shall be interpreted and construed as an action against an unborn child.”

Now, Georgia Representative Yasmin Neal has put forward a bill to sharply restrict vasectomies: “It is patently unfair that men avoid the rewards of unwanted fatherhood by presuming that their judgment over such matters is more valid than the judgment of the General Assembly. … It is the purpose of the General Assembly to assert an invasive state interest in the reproductive habits of men in this state and substitute the will of the government over the will of adult men.”

It’s high time someone stood up for spermato-Americans!

Of course, no one’s seriously out to punish men. These legislators just put anti-choice laws through the Regender translator, instantly exposing their absurdity and cruelty. It’s telling that these mock proposals hold the power to shock, while anti-choice legislation remains business as usual. Georgia, for instance, is weighing one-to-ten-year jail terms for abortion after 20 weeks – which last I heard was still constitutionally protected under Roe v. Wade.

I’m hopeful, though, that these extremist proposals are galvanizing a majority that will force extremist legislators to back down. But not just yet. Let them keep horrifying every voter who’s ever used contraception. Maybe we can throw out all the Tea Partiers and Blue Dogs, come November.

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Remember when proponents of Ohio’s proposed “Heartbeat Bill” tried to get a fetus to testify in favor of the legislation, which would ban abortion once a fetal heartbeat becomes detectable? (That’s usually between the 6th and 8th weeks, when many women still don’t know they’re pregnant.)

Well, apparently pre-born witnesses aren’t awfully reliable. One of the two pre-born tykes invited to testify last spring flat-out refused to make a statement. No galloping hearttones were entered into the legislative record for her (or him).

The lastest trick, now, is to bring in post-born children. This age group is bound to afflict our legislators with a new level of chaos. The messes! (I still have one prone to wreaking EVIL with crayons.) The backtalk! (Ditto for both of my beloved boys, though vastly improved.) The irreligiosity! (At our annual Christmas Eve foray to church, my Tiger kept asking loudly what “Amen” meant. Meanwhile, his older brother the Bear managed to set his church bulletin aflame during “Silent Night,” the candlelit portion of the service.)

But not all post-born children are like the hoydenish heathens I’m raising.** Those who testified were surely obedient, docile Christian children. They know when to say Amen. Granted, they’re no longer imbued with the perfect innocent of the pre-born, but at least their heartbeat is reliable.

This is how the testimony of post-born children played out last week (thanks, Daily Record, for covering it):

Christian Harrington didn’t mince words during his moment at the Statehouse Tuesday.

The 8-year-old wants the Ohio Senate to take action on the Heartbeat Bill, legislation that would ban abortions within weeks of conception.

“I’m here to save babies with beating hearts,” Christian, barely tall enough to peer over a podium, told a packed committee hearing room. “And I want to tell the senators to pass the Heartbeat Bill right now. And when I mean right now, I mean right now.”

The youngster was one of more than 50 children who were in Columbus Tuesday as part of the latest attempt by backers of the Heartbeat Bill to convince lawmakers to pass the legislation.

They had a press conference with reporters, held a faux committee hearing showing lawmakers how to vote in favor of the bill and delivered Teddy bears, complete with real heartbeat sound chip, to all 33 Ohio senators.

“Do not believe the stuff the people tell you at the abortion clinic,” said 11-year-old Sydney McCauley. “The just say it’s a blob of tissue, and that is not the truth. That blob of tissue is actually forming into a baby.”

She added, “Think if someone aborted you. That would be a whole generation of people who (would not) be able to live their lives.”

Fifty kids? That’s a veritable Children’s Crusade. These children are being brainwashed into a key tenet of movement pro-life belief: that their existence was predestined. No one is telling these kids, “Well, you wouldn’t exist had the condom stayed put.” “You were only possible because Mama lost her first pregnancy after four months, and you came along 12 months later.” “The only reason you came into this world is that my ex was just too damn hot, and oh, I know I shouldn’t have – I know it! – but I just could stop loving him. A week later he punched me in the jaw. Never seen him since.” Or even: “You can be glad your Mom and I got drunk and horny on New Year’s. Otherwise, you wouldn’t be here today.” (This last one came to me via my own father, though I’m pretty sure he didn’t quite say “horny.” I was, in any event, a September baby – and fortunate to have been wanted and well-loved.)

The “Heartbeat” movement has no truck with chance. Its obsessions with the pivot point of abortion as the arbiter of live and death effaces all the other contingencies and serendipities – every crazy chance of fate – leading up to the conception and birth of  a particular baby. It constructs a teleology in which every baby was always and forever meant to be, and thus their (potential) mothers are obligated to carry every pregnancy to term.

Catch me if I’m wrong, but are there Christian religions other than Mormonism that envision a pre-heavenly waiting room of souls? Otherwise, it’s just silly luck that you were born as opposed to another combo of gametes in your parent’s DNA deck of cards.

But this seemingly philosophical question – “what if you’d never been born?” – is a standard cudgel in the hardcore anti-abortion toolbag. It’s as simple as it is existentially threatening. No wonder it resonates with the tween crowd.

The kids hauled into Columbus to testify can’t begin to gauge the depth of dishonesty and muddy thinking in the slough of despond (first their churches, then the Ohio Legislature) to which their parents have led them. And so it feel abusive to me to use children to try to score a few cheap emotional points. All kids can do until their early to mid teens is to parrot their parents’ opinions. I mean, my Tiger has political ideas at 8, but danged if I’m gonna force him to the mat to defend them. I’d much rather test and challenge my kids’ ideals –  in hopes that they will eventually understand what is truly their own.

Let us hope to all the gods – their God, my Buddha-Jesus, and the Ceiling Cat – that these kids urged to perform for the legislature will someday find enough distance from their manipulative parents that they can later make their own wise, considered sexual decisions.

And let us hope that the Heartbeat Bill, which was left to languish last month, won’t be revived by this small horde of child crusaders.

Further, we can only hope that the vicious overreach of the Heartbeat Bill – its overly broad provisions, sloppy thinking, contempt for women, prima facie unconstitutionality, and far-ranging interference with the rights of both doctor and patient – will doom it, no matter how many post-born children mount testimony, church pageants, or lemonade stands in its favor.

But given that the latest  Quinnipiac Poll found public support for the Heartbeat Bill at a dead heat (45% favoring, 46% against), I’m skeptical that Ohio has any chance of electing pro-choice legislators (the theme for this week’s Blog for Choice day).

Instead, we need to start pointing out how the self-styled champions of children are using other children as a political ramrod. We need to question their leaky teleology of sex –> pregnancy –> birth –> earthly arrival of souls from heaven. And we need to howl to the moon about the lunacy of the Heartbeat Bill, which – like a zombie, a vampire – isn’t dead yet, but poses a mortal threat to women’s autonomy.

** My kids are actually quite wonderful, in my wholly unbiased opinion. But the incident with the church bulletin aflame really did happen.

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When the Ohio Senate didn’t pick up the Heartbeat Bill immediately after the House passed it, I started to hope that it would be allowed to die a quiet death. No such luck. Last week, it was discussed in committee, and it’s liable to come before the entire Senate this week. If it passes this hurdle, Governor Kasich is almost sure to sign it.

Why is this a bad idea? Well, here’s what I wrote to my local newspapers:

This week, Ohio’s Senate begins deliberations on the so-called “Heartbeat Bill” (HB 125) – anti-abortion legislation so extreme that it failed to garner the support of Ohio Right to Life. [By now, it's "last week," and the bill has made it out of committee.]

Imagine you (or your daughter, or your sister) were six weeks pregnant and didn’t know it. This bill would take away your right to choose even at that early date. It’s very common for women to be unaware of their pregnancy when they are only six weeks along. For those women, the Heartbeat Bill would effectively outlaw abortion altogether.

Even in cases of rape, incest, or threats to the woman’s health, HB 125 destroys a woman’s right to choose. This is an extreme position that most Ohioans do not embrace, including many folks who have qualms about abortion.

Perhaps you’re sure you would never get an abortion yourself. But do you really want the government deciding instead of women? Should legislators be making medical and moral decisions that impact a woman’s health and future? That’s what I’d call big government.

Would you want to criminalize health care providers who serve women? This bill would make felons of doctors or nurses who help terminate a pregnancy unless they can document a “serious risk of the substantial and irreversible impairment of a major bodily function of the pregnant woman.” Medical professionals will be forced to weigh legal risks to themselves against the physical risks to their patient.

The Heartbeat Bill is so extreme, it’s almost surely unconstitutional. The framework set forth in Roe v. Wade (the 1973 Supreme Court opinion affirming a woman’s right to choose) says that states cannot ban abortion prior to fetal viability – the point when a fetus can live outside the woman’s body. Even with all our technological advances, viability occurs no sooner than the 22nd week of pregnancy, much later than the six-to-eight week deadline set by the Heartbeat Bill.

If the Heartbeat Bill passes, it will be appealed up to the U.S. Supreme Court, where it’s nearly certain to be struck down. (That’s why Ohio Right to Life opposed its introduction into the House.) First, though, the state of Ohio would be exposed to a costly legal battle funded by us taxpayers.

This week [again - last week!], the Senate committee on Health, Human Services, and Aging is holding hearings on this extremist bill. I urge our legislators – especially Republicans committed to “small government” – to do the common-sense thing: vote NO on HB 125.

————-

If you’re an Ohio resident and feel moved to contact your senator, here’s a locator.

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As of this writing, our so-called leaders are still engaged in budget brinksmanship. Alternet called it correctly: This is the Republicans applying shock doctrine. They are doing their damnedest to break democracy. They’re such patriots that they’re willing to delay paychecks reaching our already-underpaid rank-and-file troops.

The Tea Partiers, in particular, are willing to hold our government hostage to their unhinged plan to defund Planned Parenthood.

For the Tea Party, this seems to be a win-win. If they get to defund Planned Parenthood, they’ll have achieved an unimaginable victory in their war against women’s bodies, which otherwise the Senate would block. If they get to shut down the government, then it’s party time. Woo hoo! We’re gonna party like it’s 1995!

A lot can happen in 16 years of politics. Since Newt Gingrich threw his slimy wrench into the works, we’ve had presidential blowjobs, welfare reform, the rise (and now fall?) of the DOMA, hanging chads, Enron and Bernie Madoff, 9/11 and the security state, at least three U.S. wars (that we know of), torture and secret prisons, an economic meltdown, election of our first black president, the rise Mama Grizzlies, pistols at Tea Parties, the attempted assassination of a congresswoman, and gallons of Boehnerian tears. Oh, and a substantial portion of the present electorate was still in the Blues Clues or Britney Spears demographic in 1995, and they have no memory of Newt’s machinations.

Even Newt’s own memory seems to have blurred. In the late ’90s, the conventional wisdom held that the shutdown hurt the Republicans, making them look like the extremists they were (and are), and paving the way for Bill Clinton’s re-election. Back then, the Newtster concurred with with this view. By now, though, he’s hyping the shutdown threat as a positive, viable tactic for his comrades.

The Tea Partiers are practically drooling over the prospect of a shutdown. What more dramatic way to demonstrate their small-government cred to the voters back home? What better way for Rep. Mike Pence to show that women’s bodies are expendable that he really, really hates abortion? Sure, some of us will see it as childish and irresponsible to practice blackmail and hold women’s health hostage. We are the same people who already found the “me-first, me-second, and me-third” attitude of the Tea Party childish and irresponsible. (Not to mention cruel.) We are the same people who know that the Planned Parenthood funding in question cannot legally be used to subsidize abortions.

For Tea Party supporters, though, a shutdown is red meat.

As I write this, the talking heads on MSNBC are discussing whether John Boehner can deliver on a potential compromise deal that may have been hammered out behind closed doors this evening. My take on it: I don’t think he can. As right-wing as Boehner is himself, his Tea Party colleagues are neck deep in anti-government, anti-woman ideology. They see this as a matter of principle. They perceive, again, a win-win.

So I fully expect a shutdown. My hope is that the party will end as it did in 1995: with a lose-lose for the Republicans, who will look petty and extreme. (Which is, of course, exactly what they are.) In any event, the Democrats have already made such deep concessions that no one will be dancing. The compromise already reported includes the $33 billion in domestic spending cuts that Republicans have demanded.

What do y’all think? Will the shutdown happen tomorrow? Will it be deferred ’til later? Or will Captain Boehner deliver?

And is there any hope that Obama would veto a package that included the demolition of Planned Parenthood and/or the full $33 billion in cuts? Remember: The 1995/96 shutdowns only occurred after President Bill Clinton vetoed the heaping pile of a budget that the Republican Congress sent him. Obama frequently tries to frame himself as Reagan’s successor, but it’s Clinton who learned from Reagan not to negotiate with hostage-takers.

Update, 4/8/11, 12:15 p.m.: Maddow had a great segment on the potential shutdown tonight, arguing that unlike the mid-1990s, there’s no high-profile Republican to take the heat, as Newt did in 1995/96. I am now feeling like the game may be lose/lose, after all.

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Oh, Ohio. The batshittery just never ends. As you may have heard, we’ve got pending legislation (House Bill 125, aka the Heartbeat Bill) that would make abortion illegal as soon as a heartbeat can be detected. That would be at six or seven weeks, when a woman might well not know she’s pregnant. (Keep in mind that spotting is fairly common during the first month of pregnancy when one’s period would usually be due, so even a woman tuned into her body could be fooled.)

This is the same bill for which Republican lawmakers called a fetus to testify. Actually, it was two fetuses, whose heartbeat was played for our esteemed legislators via ultrasound. (Quite sensibly, one of the fetuses refused to cooperate with the proceedings.)

Yesterday, the bill emerged from committee, but House Speaker William Batchelder won’t yet commit to a date for a vote. Batchelder is a Republican and a hardcore pro-lifer. Why would he waffle?

Turns out that this bill is splitting the anti-abortion camp. Ohio Right to Life – the biggest anti-abortion lobby in the state – is actually begging state legislators to back off of the Heartbeat Bill. They fear the bill couldn’t pass constitutional muster. Of course, this isn’t a principled objection. Ohio Right to Life remains committed to overturning Roe v. Wade. They just realize Anthony Kennedy is unlikely to vote to uphold a measure this extreme. (It doesn’t even include a rape/incest exception.)

I say, bring it on. Anything that divides the Republicans and anti-abortion lobbies is good by me. This direct challenge to Roe – which is what the Heartbeat Bill’s supporters actually crave – will go down in flames. If it passes the Senate and goes to the courts, the Supreme Court will surely refudiates it. This will strengthen Roe’s basic finding that the state cannot prohibit abortions prior to fetal viability. A successful court challenge might even take down Ohio’s 24-hour mandatory waiting period and “counseling” – or so fears Ohio Right to Life! My, this bill is sounding better all the time.

Here’s what really worries me. While we’re all distracted by chatter about vaginal sonograms in the Statehouse and the circus of fetuses “testifying,” another bill (H.B. 78/S.B. 72) has passed both chambers and is headed for the desk of Governor Kasich, who’s certain to sign it. That bill’s viability (so to speak) looks much stronger. It would ban abortion after 20 weeks (instead of Ohio’s current 22-week limit). In addition, H.B. 7 – which would place the burden of proof on abortion providers to show a fetus was not viable – is still lurking in the wings, along with other anti-choice legislation.

At least none of my representatives has threatened to criminalize miscarriages. Not yet.

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This week I’m reading Michelle Goldberg’s masterful The Means of Reproduction: Sex, Power, and the Future of the World with one of my classes. In it, Goldberg traces the history of foreign aid for women’s health – especially reproductive health – from its Cold War, Rockefeller/Ford/Guttmacher beginnings to the present era.

In 2011, well into the second decade after the UN International Conference on Population and Development in Cairo, you’d think we’d be well along the path blazed there: foregrounding women’s need for education and autonomy. Nuh-unh!! Instead, the proponents of women’s reproductive autonomy in developing nations and the Global South face constant friction and opposition from groups funded by the Radical Christian Right in the U.S. This trajectory toward radical rightwing interference is lucidly, chillingly described in Goldberg’s book. It’s as though women’s bodies became a proxy war for the tensions over reproductive rights and justice back here in the U.S.

And now, with the House of Representatives today voting to defund Title X funding, that proxy war has come home. For details, see excellent recaps by Lindsay Beyerstein and Jill Filipovic. The legislation wouldn’t affect abortions – except to inflate their numbers by making birth control less accessible to poor women and young women. No, the target here is broader. It’s a war against all women, but especially those who are poor.

When I was young and underinsured, I too turned to Planned Parenthood, and I’m forever grateful for their services. Some women are transiently poor, like I was. Many struggle with poverty throughout their childbearing years. All of us deserve affordable access to basic services like a Pap test.

I believe this even though – or especially because! – I had a few dodgy Pap test results in my early twenties. Those diagnoses of “cervical dysplasia” scared me. Cone biopsies were threatened. The cellular abnormalities resolved on their own, as HPV usually does. Had I progressed toward cervical cancer, Planned Parenthood might well have saved my life.

All women deserve preventive care, and that includes the prevention of pregnancy. This is sooo not rocket science.

Odds are good that the Senate won’t stand for the House’s crap. Still, I’m appalled that a majority in the House signed onto it. While some members may try to hide behind a figleaf of fiscal responsibility, that’s balderdash, as Amanda Marcotte argues:

Of course, rhetoric that attacks federal funding for contraception as a state-subsidy for promiscuity obscures the fact that continuing Title X is one of the more fiscally sound things the government can do: Research from the Guttmacher Institute demonstrates that every dollar spent on family planning saves the government four dollars down the road.

(Read her whole piece – it’s excellent.)

No, this is strictly culture war ammo, just as the Mexico City rule and all the other right-wing meddling into brown and black women’s bodies has to do with ideology and misogyny – not fiscal soundness.

This is merely the continuation of funding politics imposed on the “Third World” – now aimed at women that Chandra Mohanty once called the “Third World” in the United States. This is the redirection of contempt for brown and black women’s bodies to those women living within U.S. borders. Women like me – white, securely middle-class, employed, insured, and slouching toward the end of my reproductive years – will be just fine. It’s poor women of color who will suffer. College students who can’t tell their conservative parents that they’re on the pill. Appalachian women lacking any form of health insurance.

Senate? The ball’s in your court. Please show us that you consider women human beings whose health is as important as men’s – who should have a chance to participate fully in society – and who should not be written off if they lack racial or class privilege.

In the clip below, Michelle Goldberg suggests that the U.S. culture wars have affected women outside the U.S. more profoundly than women here at home. Up until now, she’s been right. As to the future? Well, that might just be up to the Senate.

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This year’s Blog for Choice Day theme is to contemplate what the electoral gains of the anti-choicers will mean for “choice” this year. I’m sure other bloggers will ponder the damage liable to be wrought by our virulently anti-choice new Congress. For my part? I think most of the mischief will occur at the state level, where a new crop of reactionary leaders will exploit the abortion issue to pander to their base.

Take Ohio. (Please! Or at least, deliver me from our new “leadership.”) With John Kasich, we now have a blithering idiot as a governor. He’s so far right that if the earth were flat, he’d tumble off  its right edge. We have a completely Republican legislature. The anti-choicers are emboldened. And they’ve already made their first move.

Modernesquire at Plunderbund reports that one of our Democratic (!) legislators, Lorraine Fende, has introduced a bill that she and the media are framing as a ban on all late-term abortions. As Modernesquire notes, Ohio already has a law in place that prohibits “partial-birth abortions”: Ohio Revised Code 2919.151.

Modernesquire (who unlike me, is an actual lawyer) suggests that the late-term ban is redundant with ORC 2919.151, except in one crucial respect:

It potentially criminalizes all abortions.  H.B. 7 enacts a new section 2929.17 that makes the performance of any abortion in which the fetus is arguably “viable” a fourth-degree felony.  “Viable” is defined under the bill as:

“the stage of development of a human fetus at which in the determination of a physician, based on the particular facts of a woman’s pregnancy that are known to the physician and in light of medical technology and information reasonably available to the physician, there is a realistic possibility of the maintaining and nourishing of a life outside of the womb with or without temporary artificial life-sustaining support.”

The statute also creates a rebuttable presumption that any fetus at 24-weeks gestational age is viable.  But note that the statute does not create a converse rebuttable presumption that any fetus before 24-weeks ISN’T viable.  The bill declares the issue of the viability of the fetus to be an affirmative defense.  What does that mean?  It means that the State has no burden to proof that a fetus was viable to criminally prosecute a doctor under this provision, even in instances that don’t involve a late-term abortion.  Instead, the doctor has the burden at trial to convince a criminal jury unanimously that the fetus was not viable, or that the abortion was necessary to protect the life of the mother, or to protect from serious and irreversible impairment of the pregnant woman’s medical health.

If a doctor carries the burden of proof to show that the fetus was not viable, this bill would surely have a chilling effect. It would be still be pointless for a prosecutor to pursue first trimester abortions, but what’s to stop him from questioning the viability of a 20-week-old fetus? An 18-week-old fetus? Second-trimester abortions.

In criminal cases the burden typically falls on the state to prove the defendant’s guilt beyond a reasonable doubt. Here, the burden of proof is reversed in a stunning disregard for basic principles of jurisprudence. Modernesquire again:

Normally, affirmative defenses are things in the criminal law in which the law recognizes that the Defendant committed a crime, but holds that certain factors require the Defendant to not be held culpable for the crime such as insanity and self-defense.  In this instance, however, it takes what should be a major element for the State to have to prove beyond a reasonable doubt and forces the accused to prove the negative instead.  Such element shifting can only be by design to encourage prosecutions against any abortion provider.

Yes. Furthermore, this “element shifting” constructs second-trimester abortions as presumptively illegal. It essentially says that any abortion within the latter part of the second trimester is assumed to be a crime – unless proven otherwise.

With all due respect to Modernesquire’s legal smarts, I do notice a difference between the proposed bill (House Bill 7) and the existing law. They don’t appear to be entirely redundant, because existing law is limited to a single procedure (which it charmingly terms “feticide.”) ORC 2919.151 explicitly distinguishes between dilation and extraction (aka “partial-birth abortion”) and other techniques; it explicitly exempts dilation and evacuation, another late-term technique that is often an implicit target of restrictions on “partial-birth abortions”:

This section does not prohibit the suction curettage procedure of abortion, the suction aspiration procedure of abortion, or the dilation and evacuation procedure of abortion.

House Bill 7 is silent on these other procedures. It does not exempt any particular procedures. It appears to broaden the scope of the earlier “partial-birth” ban to any technique used in the second trimester – and even to those, like suction curettage, which are used only for early abortions!

Fende’s bill contains another little bombshell: it significantly narrows the health exemption for late-term abortions. Where the law previously included multiple sclerosis and diabetes as conditions that impose a “serious risk of the substantial and irreversible impairment of a major bodily function” and thus permit abortion late in pregnancy, now those two diseases are downgraded: they may be included among such conditions, but they’re clearly ranked lower than preeclampsia, which isn’t saddled with such a qualifier:

A medically diagnosed condition that constitutes a “serious risk of the substantial and irreversible impairment of a major bodily function” includes pre-eclampsia, inevitable abortion, and premature rupture of the membranes, may include, but is not limited to, diabetes and multiple sclerosis, and does not include a condition related to the woman’s mental health. [my emphasis]

In what appears to be a very substantial change, mental health would never qualify as a reason for late-term abortion. Where Fende invokes the image of a woman cavalierly choosing to abort at 8 1/2 months, my imagination conjures up a woman struggling with psychosis – a woman in acute danger of ending her own life. We are not talking about a woman who’s having a lousy day, feeling a tad blue, and flips a coin: an abortion or a pedicure as a quick pick-me-up? Hmm, if I get the abortion, I can paint my own toes??

Oh, and in any case where the fetus could be remotely considered viable, H.B. 7 mandates that the doctor performing the termination get a written certification from a second physician that abortion was medically necessary. The only exception would be for dire, acute emergencies.

The Columbus Dispatch reports that some Ohio lawmakers want to tinker with H.B. 7 to define a fetus as potentially viable all the way back to 20 weeks. As far as I know, no fetus born at 20 weeks has yet survived. For those of us who get ambiguous test results during the 19th week (as I did in my second pregnancy) and need to pursue further testing to learn what we’re up against, a 20-week deadline would be a nightmare. It would trigger precipitous decisions to abort in some instances, while potentially criminalizing those who choose termination after additional tests.

I’d like to close with some comforting words about how this bill doesn’t stand a chance. But you know, the Statehouse leadership saw fit to introduce this bill among its first ten. The Repubs are making it a priority. It’s sponsored by a Democrat. And Governor Kasich is shaping up as the kind of guy who’ll make G.W. Bush appear intelligent, humane, and pro-feminist.

If by some miracle this bill flounders, it’ll only be a matter of weeks before the anti-choicers launch their next salvo.

And that’s just my adopted state of Ohio. My purportedly purple state. I cringe to think of what will happen in those states that are even more retrograde.

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You probably caught the story a couple of weeks ago about Dubya seeing the remains of his mothers’ miscarriage in a jar. As New York Magazine reported:

After Barbara Bush suffered a devastating miscarriage, “she said to her teenage kid, ‘Here’s the fetus,'” [George W.] Bush told [interviewer Matt] Lauer, “gesturing as if he were holding the jar.” According to the Post, Bush says he got special permission from his mom to recount the private incident in print. Lauer reads an excerpt from the memoir where Bush, who had to drive his mother to the hospital, wrote, “I never expected to see the remains of the fetus, which she had saved in a jar to bring to the hospital.” In the interview, he tells Lauer, “There’s no question that affected me, a philosophy that we should respect life,” adding that, “[The anecdote] was really to show how my mom and I developed a relationship.”

As Knitting Clio explains, it’s actually not surprising that Bush mère and père were pro-choice, like other Republicans of their day. Dubya thus couldn’t claim a lifelong affinity for the anti-choicers. Given his fondness for conversion stories (e.g., the tale of how he was saved from alcoholism), it makes perfect sense that Dubya would present a dramatic tale to explain his departure from the family’s pro-choice legacy. Bush Jr. has denied that it was meant as a political morality tale, but it’s been received as one anyway.

What I originally found astonishing about the story was Barbara Bush’s apparent presence of mind. How many of us, in the midst of a miscarriage, would think to catch the fetal remains and put them in a jar? Grisly as it may sound, the remains might have been medically useful, indicating whether the miscarriage was complete, though I imagine her doctor performed a D&C regardless. I thought this was mildly strange but also strangely admirable.

Showing the remains to her son was a bit odder. Dubya offering this story to illustrate an evolving relationship? Well, that’s a whole ‘nother dimension of weird. Once upon a time, my mom showed me her gallstones in a jar. (Said jar resided in her medicine chest for at least decade, and might still be there.) Even accounting for the difference between gallstones and a miscarried fetus, I wouldn’t consider my mother sharing her gallstones a key event in our relationship. Frankly, I thought Dubya would’ve been well advised to just let the story stand as his anti-abortion conversion tale – full stop.

Today, the fetus-in-a-jar story took a turn for the outright bizarre. Here’s Politico’s transcript of Larry King interviewing Barbara Bush (via Shakesville):

KING: You also disclose, Barbara — George discloses something very personal about you, which he says you gave him special permission to write about. He wrote that when you once had a miscarriage, you showed him the fetus in the jar.

BARBARA BUSH: No, really, the truth is …

KING: We touched on it before. But we didn’t elaborate.

BARBARA BUSH: I didn’t put it in the jar.

KING: What?

BARBARA BUSH: It’s not in the library. No …

KING: I know.

BARBARA BUSH: George — Paula put it in the jar. And I was shocked when she gave it to him to. But, you know, memories dim a little bit.

“Paula” is evidently their long-time housekeeper. Why, for heaven’s sake, would Dubya tell the story differently after checking with his mother before publishing it? Barbara says memories dim, but why present this as the truth if they have two different recollections? Methinks her son is just in the habit of truthiness.

But the oddest thing of all is that Barbara Bush’s housekeeper would be handling a miscarried fetus. This raises all sorts of unsavory questions, such as where the fetus resided before it was placed in the jar. Did Paula handle the fetus on her own initiative, or did Barbara ask her to package it? And why would Paula give the fetus to Dubya?

Still left unanswered: the burning question of where that jar is now. I’d originally thought it went to the hospital with Dubya and Barbara – end of story. Now, all we know is “it’s not in the library.” Perhaps in the conservatory? With Professor Plum and a candlestick?

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Yesterday at 1:29 EDT, I was lecturing on fundamentalism in my religion class, listing some of the phenomena fundamentalists generally condemn as symptoms of moral decay – among them, abortion and pornography.

Yesterday at 1:29 EDT, someone using the server of the Pro Life Action League in Chicago accessed an older post of mine, “Feminist Porn: Where Are the Men?”

I made the point to my students that people aren’t as simple as their ideologies might sometimes imply. Here’s a great case in point.

I’m not even sure that one should call this hypocrisy. I think I’d rather regard it more charitably as an instance of people perhaps being creative and flexible in their ideas and behavior – a case of refusing to conform to stereotypes.

Of course, it’s also possible that this reader was looking for ammo to prove how sexually depraved feminists can be. He or she might have a guilty relationship with sexuality that projects one’s shame onto the abjection of women that appears frequently in industrialized, mainstream porn.

But I’d prefer to imagine this reader as embracing his or her desires – not least, because it’s impossible to sustain a hard line against abortion if one regards sexual pleasure as a birthright for women and men alike, part of a full and fulfilling human life.

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A few days ago Bond of Dear Diaspora published her responses to this pro-choice values survey. The questions were thought-provoking enough that I decided to follow suit. I’d be interested in any dissenting opinions, so please drop them in the comments – or include a link to your own blog if you want to respond in detail.

My own responses are actually a little more restrictive than Bond’s, since I do see moral and philosophical reasons for state regulation in the final stages of pregnancy. The fundamental reason I support abortion rights is that unwanted pregnancy severely compromises women’s bodily autonomy – and thus our access to full legal and moral personhood. If the fetus is clearly able to survive outside the woman, then her right to autonomy can be  honored without destroying the fetus.

Do you agree or disagree with the following statements?

1. Every woman has the right to choose to terminate a pregnancy regardless of when during the pregnancy. Actually, I think Roe was correct in asserting that the state has a legitimate interest in regulating abortion beyond the point of fetal viability. “Viability” is somewhat spongy, since advances in technology may push it back beyond the current limit of 22-23 weeks, and I’m torn on the wisdom of trying to save the lives of such early preemies, who almost always have grave health problems in the unlikely event that they survive at all. I believe abortion should be universally and inexpensively available up to the point of viability. But I’ve got moral qualms about permitting termination on demand at a point when the fetus could survive outside the womb. I wouldn’t impute full legal “personhood” to that fetus, but if it’s able to survive outside the womb, then the argument for women’s autonomy is pretty weak. At that stage of pregnancy, I’d prefer induction of labor over abortion, though I realize most doctors wouldn’t oblige. If a woman wants an abortion at 27 weeks without any medical or psychiatric grounds, I don’t think it’s unreasonable to expect her to see the pregnancy to term, or alternatively to look for a physician who’s willing to induce early.

2. Abortion should be allowed even beyond 24 weeks of pregnancy. Well, 24 weeks is a reasonable proxy for viability, and so I support some legal restrictions on third-trimester abortions. However, there need to be broad provisions cases of medical necessity, including serious fetal deformity, fetal demise, and a serious threat to maternal health. I’d define that last category fairly broadly. As far as I can see, George Tiller’s practice served women who had compelling reasons for needing late abortions, and I’d have no problem seeing his practice guidelines enshrined in laws.

3. Parental consent should be required for any teen under the age of 18 requesting an abortion. Parental consent laws ought to be viewed as a crime, themselves, because they amplify the harms of sexual abuse. I’m not suggesting that every underaged pregnant girl has been abused, but if she was impregnated by a family members, these laws often force her to obtain consent from her abuser. Judicial bypass is terribly inadequate, because the more immature the girl, the less likely she’ll feel able to make her case in court.

4. Women who have more than 5 abortions are irresponsible. If they are irresponsible, is that a positive qualification for motherhood? Yipes!

5. Women who have more than 10 abortions are irresponsible. I do agree that a woman who has five or ten abortions probably has issues, but moral outrage – while it may feel satisfying – won’t help her avoid another unplanned pregnancy. Assuming she’s of at least average intelligence, she’s unlikely to be clueless about birth control. The question then becomes, why doesn’t she consistently use birth control? Those reasons can more complicated than simple ignorance or financial and practical barriers to access.  Does she feel that she has no hope – no control over her future – and thus sees no point in trying to steer her fate? Is she re-enacting earlier traumas? Is she torn between a desire for motherhood and the reality of a life where she can’t care for a child? Does she have a controlling or uncooperative partner? Does she actively eroticize the risk of pregnancy? Is she embroiled in any sort of addiction? There are lots of reasons people fail to use birth control. Shaming women won’t help reduce the need for abortion. Understanding why women and their partners don’t consistently use effective contraception just might help.

6. Women should not use abortion as a form of birth control. Not as a primary means of birth control – of course not. Abortion must be available as a back-up, though. And I’m very wary of the “abortion as birth control” trope, because I hear it constantly when I teach about abortion. It quickly devolves into woman-blaming and a good-for-me-but-not-thee condemnation of women who’ve had more than one abortion.

7. I think reproductive health advocacy organizations should promote the use of emergency contraception in order to decrease the number of abortions in the US each year. This is a no-brainer. Every heterosexually active woman at risk of unwanted pregnancy should have Plan B in her drawer. Its side effects are no fun – much like early pregnancy, though mercifully shorter! But its costs – financial, physical, and emotional – are much lower than the costs of abortion and unplanned pregnancy. Community clinics and college health centers should give Plan B away for free. Then again, I think all forms of birth control should be free! Even a cold-hearted cost/benefit calculation would show that prevented unwanted pregnancies will lead to net savings in public expenditures – which is why anti-choice politicians’ opposition to family planning subsidies is so revealing. They’d rather limit women’s options, sexual and otherwise, than pursue a fiscally conservative policy that would ultimately reduce government spending.

8. I feel uncomfortable if a woman has an abortion because of the gender of the pregnancy. Yes. I tend to think that if you’re having a baby, you need to accept that you cannot mold it into your imaginary ideal child. Apart from the potential for misogyny (or even misandry, as women in the U.S. tilt toward preferring girl children), it’s just lunacy to have a baby if you’ve got rigid ideas about who and what your child must become. You’re setting yourself up for bigger surprises and disappointments. Even worse, you’re setting the stage for your child to feel loved conditionally, only if she or he meets your arbitrary standards.

9. Male partners should have the right to be a part of the decision to terminate a pregnancy. The right to bodily autonomy can’t hinge on a partner’s whim. In a healthy relationship, women will weigh his desires and preferences, but the final decision still has to be hers. If the relationship is dysfunctional, then it’s even less appropriate for the law to barge in and give the male partner any “rights.”

10. I think a woman’s right to choose to have an abortion is an absolute and inalienable right no matter what. Up to the point where the fetus can survive outside of her body – yes, absolutely.

Finish the sentence:

1. Abortions are: an essential aspect of women’s bodily autonomy, and thus our full moral and legal personhood.

2. Women who have abortions are: your next-door-neighbor, your friend, your sister – a pretty ordinary cross-section of those who are fertile and female.

3. A woman facing an unwanted pregnancy needs to: search her heart for her own best path, although in an ideal world she’d also be able to turn to her loved ones for counsel and support.

4. In this country, abortion should be: not only legal but affordable and accessible – even (especially!) in places like Mississippi and North Dakota, where the closest clinic may require a full day of travel.

5. People working to restrict abortion should: stop trying to violate the Constitution by imposing Christianist laws on the rest of us; we’re a democracy, not a theocracy.

6. People working on behalf of women’s right to choose should: be celebrated as heroes, because lots of them are putting their lives on the line.

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So I just finished grading a set of 74 undergraduate essays. The assigned topic: abortion. And indeed, I read a lot of moving stories about pregnancy scares, boyfriends who saw their girlfriends through an abortion, friends who got pregnant at 16.

What I didn’t expect: a flurry of even tougher stories about rape. Out of those 74 papers, four volunteered heartrending stories of how their author had been raped. Another young woman had told of her rape in discussion last week. That makes 5 out of 74, or 6.8%.

No, this doesn’t rise to the the much-ballyhooed, much-maligned “one in four” statistic from Mary Koss’ research in the early 1990s. No, my sample size isn’t big enough to draw any broad, statistically significant conclusions.

However. These were all forcible rapes (mostly by acquaintances). They are what even Whoopie Goldberg would call “rape-rapes.” If you asked about lesser sex crimes, the overall number of sexual assaults would likely be much higher. (Koss also counted attempted assaults when she measured the prevalence of sexual assault among college women.)

When I hit the last of these stories, I burst into tears of anger and grief.

Four of the five women were 15 or younger when they happened. The other two were 18 or younger. Most of the students in this class are early in their college careers. Their high schools weren’t safe, but we can’t claim they’re any safer here at the university.

Here’s what really kicked me in the gut: These are only the stories that emerged when a completely different question was posed! The assignment had nothing to do with rape, intrinsically. But for some of these girls, rape is now inextricably linked to how they view their risk of pregnancy. A couple of them blame themselves for being in the wrong place at the wrong time, or failing to report promptly. How can they arrive at a place where sexuality isn’t forever entwined with danger? (Some of them have, remarkably, and I was privileged to hear their stories. Of course, I’m obligated to protect their privacy, so those stories stop with me.)

And how many more stories were left untold? How many other stories would surface, if a different question were asked?

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In a couple of my previous posts on Mary Daly, I mentioned that her secularized notion of “idolatry” – which she saw in first-wave feminists’ singleminded focus on suffrage – can be applied to modern-day feminism as well. Today, on the 37th anniversary of Roe v. Wade, I’d like to dwell on how “choice” has served as an idol – as a foundational concept that can’t bear the weight it’s been given.

“Choice” was an attractive term to the defenders of abortion rights in the 1970s because it provided a way to counter a growing “pro-life” movement without having to say that they were “pro-abortion.” Even today, defending “abortion” is a politically dodgy proposition. My Democratic ?? !! @*&$# congresscritter, Charlie Wilson, D-Bluedognia, proudly claims at every opportunity that he’s pro-life. He and his cronies are sure not going to come out in favor of abortion.

By now, though, we need a more flexible strategy, as lots of folks – especially radical women of color – have argued before me. What about access to abortion, birth control, sex education, prenatal care, and fertility treatments? How about reproductive rights and justice? What about bodily autonomy and self-determination?

Yes, it’s important that women have choices. It’s even more crucial that we have the material, social, and cultural wherewithal to exercise them.

Denying the means to exercise choice shows that we, as a society, just don’t trust women – especially those women who don’t already enjoy a panoply of privileges. Conversely, “trusting women” doesn’t matter a whit as long as their choices are highly constrained.

And while we’re at it, let’s remember than no one –  female or male, fertile or not – has real bodily autonomy without access to health care. Reproductive autonomy isn’t just a women’s rights issue. It’s a matter of human rights.

Addendum, 1/24/10, 3 p.m.: Based on the comments to this post, it looks as though I haven’t fully clarified why I think feminists would be wise to walk back from our overreliance on “choice.” From the get-go in the 1970s, “choice” referred to narrowly to the formal legality of abortion. It was a product of liberal feminism, which framed abortion in terms of negative liberty – or freedom from interference. However, that wasn’t nearly enough to secure reproductive rights for women, broadly conceived, including a right to birth control, sex ed, etc. This would have required the issued to be reframed in terms of positive liberty, which includes the resources and means to act and exercise one’s liberties. (I’ve written about these disparate concepts of liberty here.) “Choice” also failed to highlight even the violations of negative liberty perpetrated on women who were poor or non-white, such as coerced sterilizations and pressure to use abortion or long-term birth control.

In theory, of course, “choice” could embrace both notions of liberty and and could include issues beyond abortion. Despite some feminists’ efforts to expand the term, however, it continues to carry historical baggage. The popular understanding of “choice” is that it’s shorthand for legal abortion. Its meaning has constricted and frozen. I hear this from my students in women’s studies classes, as well as from critics within feminism. That’s why I’d prefer we stop privileging “choice” in favor of “reproductive rights” and “reproductive justice.” These concepts highlight the importance of positive liberties and challenge us to think about the whole spectrum of gendered health issues.

Thanks to figleaf and kb for pointing out that I didn’t connect all the dots – a hazard of writing when I probably ought to have been sleeping instead. :-)

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There! Much better! My title carries a whole different set of connotations than the anti-abortion media’s headlines: “Catholic nurse forced to participate in abortion, lawsuit filed” (Catholic News Agency) and “Nurse ‘Forced’ to Help Abort (the New York Post). Despite vigorous googling, I’m not finding much other reporting on this story at all, except from Jill at Feministe. You know your sources are thin when the Washington Times appears to give the most dispassionate and complete account:

Catherina Lorena Cenzon-DeCarlo, 35, a Filipina nurse who is a permanent U.S. resident and married to an American, says that Mount Sinai Hospital in Manhattan “blatantly” violated a 35-year-old federal law that protects health care workers with religious objections from having to assist in performing abortions.

The hospital performed a late-term abortion on a woman whose health was not at risk, she says. The nurse is asking for a jury trial that could strip the hospital of hundreds of millions of dollars in federal funding until it complies with the law….

According to the 26-page complaint filed in U.S. District Court for New York’s Eastern District, the lawsuit says when Mrs. DeCarlo was hired in August 2004, she told hospital officials outright that she would not participate in abortions. She is Catholic and her uncle is Bishop Carlito J. Cenzon, who leads the Roman Catholic diocese of Baguio in the northern Philippines.

The hospital did not object to this and gave her a form to complete that indicated her refusal to take part in the procedure. During the nearly five years from her hiring date until this May, the lawsuit said, the hospital had avoided asking her to assist on abortions, as it has a cadre of other nurses who have indicated their unwillingness to do so. …

But it was on May 24, a Sunday morning shift over Memorial Day weekend, when matters came to a head. The nurse said she was told she was assigned to help with a “D&C,” signifying “dilation and curettage,” a procedure to remove the remains of a miscarriage from a woman’s womb. But when she began preparing the operating room, she learned she had been assigned to help with aborting a 22-week pregnancy.

Dr. Noel Strong, the resident on duty, said the mother had preeclampsia, a medical complication involving hypertension and protein in the urine that is treatable with magnesium sulfate. Mrs. DeCarlo thought the preeclampsia not to be life-threatening and thus not an immediate cause for an emergency abortion. A flurry of calls then erupted between her and supervisors Fran Carpo and Ella Shapiro after Mrs. DeCarlo refused to take part in the procedure, the lawsuit says.

Ms. Carpo – on instructions from Ms. Shapiro – then forbade the nurse to try to find a substitute, adding that the doctor performing the abortion had called her, furious about the delay, the lawsuit charges. While Ms. Carpo said the patient was in mortal danger, Mrs. DeCarlo pointed out the patient was not even on magnesium therapy, the first step of treatment for the condition.

Ms. Carpo, the lawsuit said, was the manager on duty and could have easily stepped in as a replacement but instead threatened to charge Mrs. DeCarlo with “insubordination and patient abandonment,” charges that could have ended Mrs. DeCarlo’s career.

Mrs. DeCarlo broke down at this point and offered to get her priest on the phone to explain her point of view, says the lawsuit, but hospital officials were adamant that she participate. When she pointed out the abortion could be delayed until another nurse could be found to take part, she received more threats, the lawsuit says, until she finally capitulated, saying she would take part “under protest.”

When asked why she didn’t simply walk out of the building, one of her attorneys, Matt Bowman of the Alliance Defense Fund, said the plaintiff “strenuously protested to the point of tears. Employees should not be forced to choose between their jobs and their beliefs.”

The nurse said she was “forced to watch the doctor remove the bloody arms and legs of the child from its mother’s body with forceps” and carry those body parts in a cup to another area of the operating room.

Bear in mind that the only source of info for this story is the lawsuit filed. Everyone else is refusing comment. Of course the patient’s identity and history are being kept confidential, as well they should.

Jill and her commenters have done a fine job discussing the legal and moral obligations of hospitals and medical practitioners. I don’t want to rehash that here. I’ll just say that no nurse or doctor should be hired to work in the ER, as DeCarlo was, if they would withhold lifesaving treatment.

Instead, I want to look more closely at the medical issues. Preeclampsia is a fairly common complication of pregnancy, occurring in 5 to 10% of all pregnancies. It’s signaled by a rise in their blood pressure, protein in their urine, and (sometimes) edema, or swelling, especially of the extremities. Many women experience no overt symptoms and might not even know that they have it. Most women survive it just fine.

But in a small number of women – between 5 and 7 per 10,000 deliveries – preeclampsia progresses to full-blown eclampsia, which includes seizures sometimes followed by coma and death. It accounts for 17.6% of maternal deaths in the U.S and 15% of premature deliveries.

Just because preeclampsia is a fairly common condition doesn’t make it harmless. I know someone who died of it, a college classmate of mine. A former colleague of my husband’s lost his partner to it.

We don’t have many more tools to predict or control eclampsia than we did 100 years ago, although one major reason health officials tout prenatal care is that it can catch and monitor preeclampsia while it’s still mild. We also don’t understand its causative mechanisms, despite countless research studies. Magnesium sulfate can be given by IV to prevent seizures, and while it saves lives, it’s no miracle drug. The only definitive treatment is delivery of the fetus – and even then, the new mother remains at risk for a few days thereafter. Of the three major killers of expectant mothers 100 years ago – hemorrhage, infection, and eclampsia – we’ve only made great inroads against the first two, thanks to transfusions and antibiotics. Mortality from eclampsia remains significant.

So what was going on with the pregnant woman in DeCarlo’s case? Well, according to the Catholic News Agency, she wasn’t really in jeopardy at all:

Hospital officials told Cenzon-DeCarlo that the situation was an “emergency,” although evidence suggests that this was not the case.  The hospital itself labeled the case as a “Category II,” meaning that the operation needed to take place within six hours.  This would have allowed enough time to find another nurse without moral objections to assisting in the abortion, her lawyers said.

Matt Bowman, legal counsel for the ADF, explained that the hospital could not legally have required the nurse to participate in the abortion even if the case had been a “Category I,” meaning that the patient required “immediate surgical intervention for life or limb threatening conditions.”  Federal statutes prohibit recipients of federal health funds from requiring employees to perform abortions, Bowman told CNA.

However, the evidence in the case suggested that the patient was not even at the “Category II” level, as the hospital had claimed.  When the woman was brought into the room, Cenzon-DeCarlo observed no indications that the case was a medical emergency.  The woman’s blood pressure was not at a crisis level, and standard procedures for patients in crisis [administration of magnesium sulfate] had not been taken.  Yet the nurse was still required to aid in the abortion.

Since we don’t have any hard information, I’d like to put on my historian-of-childbirth hat and offer some informed speculation. Severe preeclampsia at 22 weeks’ pregnancy is not very common. However, it can occur, and there’s one variant that would demand immediate action: HELLP syndrome. Here’s how Reese at Feminist Mormon Housewives describes her experience with HELLP:

Earlier this year I had my first child. He was born at 28 weeks because my life was in danger. It turned out that I had HELLP syndrome, which is basically preeclampsia turned up to 11. My blood pressure was 186/110, my organs were failing, my red blood cells were disintegrating, and my platelet count was dropping making it so that my blood wouldn’t clot. If I could manage to function with my organs failing, and if I could have avoided having a stroke or heart attack, I would have bled to death in childbirth.

If the patient at Mt. Sinai was suffering from HELLP syndrome, the attending physician could have very reasonably determined that there was no way she could hold out for several more weeks, hoping for a viable but very premature fetus. Indeed, he judged her case serious enough to require intervention within the next several hours. This suggests either HELLP or another serious complication, such as a severe headache (indicating a high risk of seizure) or chest pain (possible embolism). If you’re going to go straight to delivery (in this case, abortion, because the fetus was still a couple weeks short of the very outer limit of viability), then you might start administering magnesium sulfate as seizure prophylaxis as part of pre-op procedures, but the main priority would be to get the operation underway. Ordinarily a nurse would start an IV. In this case, the assigned nurse was arguing with her supervisor instead of tending to the patient. Could that possibly have anything to do with why the patient wasn’t on magnesium sulfate?

The patient’s relatively normal blood pressure is a red herring, because as emedicine notes, HELLP can present differently than regular preeclampsia:

HELLP syndrome (hemolysis, elevated liver enzyme, low platelets) is a form of severe preeclampsia that has been associated with particularly high maternal and perinatal morbidity and mortality and may be present without hypertension or, in some occasions, without proteinuria. [my emphasis]

So we don’t know all the details, but certainly my speculations are a whole lot more believable than a scenario where mild preeclampsia was used as a pretext for elective abortion at 22 weeks. This was presumably a wanted fetus. On the off chance that it wasn’t, the woman could have sought elective abortion, which can still be carried out legally at 22 weeks. While it can be tough to find a provider for late-term terminations, last I knew New York City was one of the meccas for women needing such abortions. So there’d be absolutely reason to show up in the ER, hoping on spec that you could get an elective abortion. There’s also no reason why an ER doctor would prioritize a procedure if it weren’t urgent. Folks in the ER have a few other problems on their plate.

Just imagine you’re a woman hoping to bring a child into the world. Imagine you get sick with a condition in mid-pregnancy that you’d never even heard of. Imagine hearing the ER doctor – whom you’ve never met in you life – tell you that you need to abort in order to save your own life; otherwise, HELLP syndrome is liable to put you into liver failure, possibly complicated by kidney failure and blood that refuses to clot. And then imagine that your story of loss is plastered throughout the court system and the yellow press, trumpeted by pro-lifers as evil incarnate, and held out as an example of women’s and doctors’ supreme depravity.

No, we don’t know exactly what happened. But my speculative reading of the paltry facts is a whole lot more coherent and compelling than the tale DeCarlo tells in her court filings. Given that DeCarlo is the niece of a Catholic bishop, this whole thing stinks of a set-up. If it’s not, why she didn’t she just quit on the spot when her boss ordered her to aid in an act she considered murder? I’d like to think that I’d have that much moral courage. Instead, DeCarlo cooperated just enough to add drama to her lawsuit – after she’d gambled with a woman’s life.

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A couple of months ago, I wasted a half-hour of my life listening in on a town hall conference call with my congresscritter, Charlie Wilson. Amid all of his reassurances to reactionary constituents that he wouldn’t sign off on death panels, he kept repeating: “I am a Blue Dog Democrat. I am pro-life.” This weekend, he delivered on that promise by becoming one of the 64 Democrats who sold out women’s health by voting for the Stupak amendment to the House healthcare bill.

In case you didn’t hear, the Stupak amendment will prevent all private insurers who participate in the new insurance exchanges from covering abortion as part of their basic benefits package. As a result, millions of women who currently have abortion coverage will lose it, unless the Stupak amendment is removed during the process of reconciling the House and Senate bills.

I thought about posting on this yesterday but I wasn’t up for writing anything because I was dealing with pain. I have suffered from this particular pain since I delivered my first baby. For the first couple of years, it was my constant companion. After I had a second baby, it receded to a day or two every month. It is not the normal pain that women get with their period. It is the direct result of structural damage done by childbirth.

So instead of blogging yesterday, I took half a Vicodin, cranked up my heating pad, and waited for the day to end.

I am lucky in that I don’t suffer from stress incontinence. You know all those boxes of Poise and Depends in the supermarket? That market is much, much larger than the elderly. Plenty of young women use them, too, thanks to damage incurred during pregnancy and childbirth. Incontinence is a serious risk factor in elderly women for landing in a nursing home. Just over 11 percent of all women will have surgery to repair damage to their pelvic floor at some time during their lives. About 12 percent of these women will undergo repeat surgeries after the first one fails.

These days, American women count on surviving pregnancy. But that doesn’t mean childbirth has become risk-free. Just in my acquaintance, I have one friend who acquired a serious postpartum infection, another who suffered a stroke after giving birth, and a college classmate who died of eclampsia.

It’s one thing to undergo the health risks of pregnancy when you deeply want a child. It’s quite another to be forced to bear a child – and the attendant risks -against your will.

This is why any healthcare package that reduces women’s access to safe, legal, and affordable abortion isn’t reform. It’s a blow to women’s health. It should not be negotiable – especially by congresscritters like my own who will never, ever have to put their health on the line in an unwanted pregnancy.

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Via Ann at Feministing, I came upon Dana Goldstein’s excellent analysis of why a public option sans reproductive health coverage is doomed. She notes that while our congresscritters are under pressure not to fund abortions with taxpayers’ money, women will be less likely to choose the public option if it excludes abortions and other basic reproductive care:

After all, the typical woman spends five years of her life pregnant, or trying to become so, but a full 30 years avoiding pregnancy. Without good reproductive-health coverage and strong buy-in from women — who use more health care than men — it is difficult to see how a public plan would gain strength over time.

(Read the rest here.)

And there’s more: Women with private insurance may find their plans dropping reproductive care, whether due to market forces (as Ann implies) or conservative lawmakers’ meddling in insurance regulation (as Dana suggests).

Really, though, this whole debate rests on false premises. While the Hyde Amendment has prohibited Medicaid from covering abortions for over 30 years, abortions are already financed indirectly by taxpayer subsidies. Anyone with an employer-sponsored health plan gets their insurance tax-free. That’s a massive federal subsidy. Ann cites a NYT story that claims 50 percent of employers offer abortion services among their health benefits.

So taxpayers are already subsidizing abortion for women of the more prosperous classes. It’s just those poor women who’ve been excluded – ironically, the very same people whom anti-choicers demonize for having too many children. (I’m not advocating eugenic abortions for the poor, just noting the logical and fiscal inconsistency of many dogmatic foes of abortion.)

Up ’til now, even after a quarter-century of supporting abortion rights, I’ve tended to think, “Get reform passed, and then we’ll worry about specific services.” But Dana has convinced me that this isn’t just a distraction, though the ‘wingers will surely conflate public subsidies for reproductive health with their phantom death panels. This is a matter of reproductive justice for poor women, and a sustainable system for all Americans.

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A few months ago I mentioned a Cochrane review that found caffeine didn’t adversely affect full-term outcomes of pregnancy. However, the reviewers located only one study that met their criteria. Now, an apparently solid study provides reassurance that caffeine also is not implicated in causing miscarriage – which another study claimed in early 2008.

Here’s the abstract from Anna Z. Pollack and her colleagues:

Caffeine consumption has been equivocally associated with miscarriage, despite an absence of prospective longitudinal measurement of caffeine intake during sensitive windows of human development. In response to this critical data gap, we analyzed daily caffeine consumption while attempting pregnancy through 12 menstrual cycles at risk for pregnancy and found that caffeine consumption did not increase the risk or hazard of miscarriage, even after adjusting for relevant covariates.

I can’t get the full text, even with my library privileges, but the crucial point is that this study was prospective, meaning it followed women over time as they attempted to conceive. Thus, it didn’t rely on people’s usually faulty memories to gauge how much coffee or Pepsi they drank and when. It’s not evident to me whether it was also a controlled study, which was one of the Cochrane criteria.

By comparison, the study by Dr. De-Kun Li that caused all the anxiety about caffeine and miscarriage was retrospective. It relied on women’s memories. Only one interview was conducted with each study participant. In most of those cases where the woman miscarried, the interviews occurred after the pregnancy loss. It seems sort of obvious how grief and hormones might lead to self-blaming. Oh, if I’d only given up my coffee! Broadsheet had a good rundown of the other blatant weaknesses of the study. The media, naturally, blew it up into yet another Rule for Pregnancy, and Dr. Li did his best to add to the guilt-tripping.

While this new study has little direct bearing on me, personally (I am so done having babies!), I’d be just delighted if there were one less realm that the Pregnancy Police saw fit to patrol.

CoffeeAddictCoffee kitteh from I Can Has Cheezburger?

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In comments on my last post, Reg asked if aborting a viable fetus wasn’t actually illegal in Kansas, where Dr. George Tiller’s clinic was located. Well, the answer is complicated. It’s not completely illegal, but Reg is correct that the U.S. has a patchwork of state laws that vary quite widely.

Like every other state, Kansas is bound by the provisions of Roe v. Wade, which permits abortion of a viable fetus only if the woman’s life or health is in danger. Like many other states, Kansas has attempted to circumscribe the health exception:

Kansas’ post-viability abortion restriction provides that no abortion may be performed after viability unless the attending physician and another financially and legally independent physician determine that an abortion is necessary to preserve the woman’s life or continuation of the pregnancy would cause a “substantial and irreversible impairment of a major bodily function” of the woman.  Kan. Stat. Ann. § 65-6703(a) (Enacted 1992; Last Amended 1998).  The Kansas Attorney General has interpreted this exception to include mental health. Op. Kan. Att’y. Gen. 2000-020. [my emphasis]

(Source: NARAL’s state profile for Kansas)

It’s this mental health exception that allowed George Tiller to terminate viable pregnancies when the fetus was severely impaired. Having borne two children, I’m certain I’d experience less trauma from abortion at 30 weeks than from going to term only to watch my baby die, slowly and painfully, within hours or days. This is a perfectly reasonable application of a mental health exception. I don’t see any evidence that “feeling blue” drives women to terminate a pregnancy at that stage, nor that Tiller’s practice accommodated women who just frivolously changed their minds about being pregnant, as his enemies suggest. On the contrary, their stories are often heartbreaking (via Feministe).

Other states interpret “health” even more narrowly. Here’s how NARAL summarizes the Texas law, for instance:

Texas’ post-viability abortion restriction provides that no abortion may be performed in the third trimester on a viable fetus unless necessary to preserve the woman’s life or prevent a “substantial risk of serious impairment” to her physical or mental health or if the fetus has a severe and irreversible abnormality.  Tex. Health & Safety Code Ann. §§ 170.002 (Enacted 1999), 170.001(3) (Enacted 1999; Last Amended 2001).

Another statute limits the health exception even further, stipulating that no abortion may be performed in the third trimester on a viable fetus unless necessary to preserve the woman’s life or prevent “severe, irreversible brain damage” or paralysis or if the fetus has a severe and irreversible “brain impairment.”  Tex. Occ. Code § 164.052 (Enacted 1999; Last Amended 2005).

(Source: NARAL’s state profile for Ohio)

So if you’re in Texas and you’re threatened with, say, permanent damage to your heart, it doesn’t justify late-term abortion, because you wouldn’t be left paralyzed, brain damaged, or dead. In practice, a woman who is, say 30 weeks pregnant and facing serious complications would typically want to deliver a live infant. But if doing so would put her at additional jeopardy, Texas would force her to assume that risk, unless her doctor decided brain damage, paralysis, or death would ensue.

California, by contrast, sticks very close to the original Roe wording:

California’s post-viability restriction provides that an abortion may be performed on a viable fetus only if in the good faith medical judgment of the physician, the continuation of the pregnancy poses a risk to the life or health of the pregnant woman.  Cal. Health & Safety Code §§ 123464 – 123468 (Enacted 2002; Last Amended 2003).
NARAL Pro-Choice America supports the legal framework established in Roe v. Wade and does not oppose restrictions on post-viability abortions, such as California’s, that contain adequate exceptions to protect the life and health of the woman.

(Source: NARAL’s state profile for California)

Here we see the word “health” without any additional frippery. The decision is properly left up to the physician. That seems about right to me. While I’m skeptical of vesting too much power in medicine, it’s the most appropriate authority here. Someone has to weigh the potentially irreconcilable interests of the woman against those of a viable fetus; that’s what Roe requires. Legislators can only issue blanket proclamations. A doctor, however, can respond to each woman’s specific situation. And I won’t entertain the trope of the “greedy abortionist” whose judgment is clouded by dollar signs. People like Dr. Tiller aren’t in this for the money. Virtually every other branch of medicine is more lucrative – and less likely to get you killed.

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In the wake of George Tiller’s murder, I’ve been pondering the incongruity of his providing the most controversial abortion services in Kansas, of all places – a solidly conservative state. He’s not the only one. Dr. LeRoy Carhart – of Gonzales v. Carhart fame – practices in Nebraska. He too offers late-term abortions, including past the point of fetal viability when warranted. (Carhart has offered to take over Tiller’s clinic, but Tiller’s family says the clinic’s fate remains uncertain. Plus one wonders what Carhart’s patients would do.) Then there’s Dr. Warren Hern in Boulder, Colorado. It’s Hern who said, “The main difference between the American anti-abortion movements and the Taliban is about 8,000 miles.” All three of these men knew each other and were friends.

Are there more American doctors willing to perform third-trimester abortions? These names are familiar because Carhart and Hern have been talking to the press these past few days. There may be others, but I googled like crazy trying to find them, and I failed. (“Like crazy,” because I actually tried to find the Army of God’s hitlist online. No dice. Thankfully!) I wouldn’t blame any doctor who wanted to stay under the radar. After all, as Dr. Hern said (via DailyKos): “I am next on the list.”

Plenty of others have already observed that the killing of Dr. Tiller greatly reduces the number of doctors who are able and willing to perform these very late abortions. (A larger number will perform the procedure up to 24 months weeks.) Others have also remarked that these third-trimester abortions are virtually always tragic: a much-loved and anticipated child suffers from severe hydrocephalus or has other anomalies that will doom her to painful short life and an early death.

What I’m wondering is this: Why does the heartland seem to spawn these pragmatic yet idealistic doctors? Tiller and Carhart come from Kansas and Nebraska. They are constantly embattled – not just by vandals but by the court system, aka the Will of the People. Hern shares his home state with the main campus of Focus on the Family. Why do they persist despite hostile geography? Where are their blue-state equivalents? If you go back to the early days of underground abortion resistance in the 1960s, big cities like New York and Chicago led the way. Why must a woman with a disastrously impaired fetus now travel from a coastal city to Wichita?

I don’t have any answers. I think a Midwestern work ethic may play into it. Surely you’ve got to be mule-stubborn to carry on in the face of harsh local and national opposition. You’ve also got to believe in the cause more than your own life, but Midwesterners haven’t cornered that market. It’s not even that Kansas has especially lax laws; a late-term abortion requires the assent of a second physician. Partly, I think Tiller and his colleagues were moved by plain old practicality – there’s a job and someone’s gotta do it – mixed with compassion for women’s sufferings.

I’d love to know if any of you has a more coherent theory on the geography of third-trimester abortion providers.

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I ventured onto the Army of God’s website this afternoon, and this is what I found:

The lives of innocent babies scheduled to be murdered by George Tiller are spared by the action of American hero Scott Roeder.
George Tiller the Babykiller reaped what he sowed and is now in eternal hell.
Psalm 55:15 Let death seize upon them, and let them go down quick into hell: for wickedness is in their dwellings, and among them.

George Tiller will never murder another child again.

[This is followed by animated hellfire, which I'm deleting because it links back to the Army of God.]

Abortionist George Tiller, now in eternal hell fire for shedding the blood of innocent children.

[I'm not linking them because they scare me. You can find their homepage through Google; it'll be the first hit, sorry to say. If you scroll down on the page, you immediately come to pictures of dismembered fetuses.]

These guys are domestic terrorists. Compare them with Randall Terry (via Pam Spaulding at Pandagon):

The point that must be emphasized over, and over, and over again: pro-life leaders and the pro-life movement are not responsible for George Tiller’s death. George Tiller was a mass-murder and, horrifically, he reaped what he sowed. [Pam's emphasis]

The only real difference? Terry disavows responsibility. But they both say that Tiller deserved to die. Either way, it’s hate speech. Either way, it’s incitement to terrorism.

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Kittywampus doesn’t usually aim to provide breaking news (there are thousands of sites that do it better), but I’m so disturbed by this that I have to say something.

Dr. George Tiller, one of a handful of doctors who performed late-term abortions in this country, has been murdered in cold blood. Cara at Feministe reports that he was shot dead as he was entering his church this morning in Wichita:

Dr. Tiller was one of the few late-term abortion providers in the country.  He had previously been shot, his clinic burnt down, harassed by ideological anti-abortion attorney generals, and threatened with death countless times.  We’ve written about his many trials and tribulations here numerous times. Still, Dr. Tiller continued to provide abortions to women who desperately needed them, to save their own lives or health, or due to tragic fetal deformities.  He put the health of women above his own life.

And now he is dead.

(More from Cara here.)

That little detail of him being on his way to church? It says so much about the ruthlessness of the hardline anti-abortion movement, their adamant refusal to recognize that those who condone abortion are ethical, moral, and often religious people.

I’d thought – hoped – that the wave of anti-abortion violence had ebbed. As Cara notes, it had been over a decade since the last anti-abortion murder. I figured that the less-crazy wing of their movement had prevailed, recognizing that murder is not politically persuasive to the people in the mushy middle. Guess I was wrong, though it only takes a single fanatic with a gun. Rhetoric like “murder of innocents” and “the worst Holocaust the world has ever seen” is guaranteed to produce at least a few such fanatics.

I’m sad and angry on behalf of Dr. Tiller, his family, and all the other abortion providers who’ll have to live in even more fear.

You shouldn’t have to be a hero to provide a needed medical service.

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