Katherine Spillar's blog

A Referral You Don't Want

2008-11-13T08:00:00-05:00

You're a college freshman, and you think you might be pregnant. Your campus health center doesn't handle pregnancies, so you're given a list of nearby clinics. You pick one, thinking that's where you'll get a pregnancy test and, if it's positive, be counseled about your reproductive healthcare choices.

Instead, at this clinic you go to, you're given a lecture on abstaining from sex. You're also harangued about the "dangers" of abortion, and you're handed a plastic model of a purported 12-week-old fetus, complete with a fact-sheet on "pre-born babies." Abortion is obviously not an option here.

That's because you've been referred to a so-called "pregnancy resource center" or "crisis pregnancy center" (CPC). There are as many as 4,000 of them in the U.S. (twice as many as the number of abortion providers), many affiliated with evangelical Christian ministries and all with a mission to persuade young women with unplanned pregnancies not to have abortions. But they often mask this mission with deceptive advertising tactics, such as listing themselves under "abortion services" in the yellow pages and pretending to offer women a range of options.

Yet college heath centers routinely refer young women to these places, which are often purposefully located near college campuses. A survey conducted this past summer by the Feminist Majority Foundation (FMF) and reported in the Fall 2008 issue of Ms. magazine (I'm vice president of the FMF and executive editor of the magazine), found that of 398 campus health centers at four-year colleges that responded to a questionnaire, 48 percent routinely refer women who think they might be pregnant to CPCs.

"We want to give students all of the options," is the best reason that health center directors could give FMF researchers for making referrals to CPCs (81 percent of the health centers also refer students to full-service clinics). But the situation is troubling for women's health advocates.

For one thing, students often face delay tactics at CPCs to discourage them from finding out whether they're pregnant, thus increasing the chance that they'll be too late for a safe, early-term abortion. CPCs have also been shown to promulgate false and misleading information-such as telling young women that abortions increase their risk of breast cancer, increase their risk of infertility, or cause mental-health trauma. All of these notions have been widely discredited by health researchers. Most recently, the American Psychological Association, in a study released this past summer, confirmed that "there is no credible evidence that a single elective abortion ... in and of itself causes mental health problems."

If students visit CPCs instead of full-care clinics, they might also be putting their health in immediate jeopardy. "Any attempt to delay care and try and scare a woman into keeping an unwanted pregnancy only serves to put her at higher risk-especially if she has an ectopic pregnancy," says Beth Jordan, M.D., a women's health specialist and medical director of the FMF.

Is this the sort of care and counseling parents expect from their childrens' colleges to provide? No, it's time to expect more. Campus health centers should establish policies to refer students only to comprehensive health clinics, not to ideological masqueraders. Think about it: Would we want a college to refer students with illnesses to a so-called clinic that didn't believe in medicine and only handed out placebos?

We should also be demanding regulation of CPCs so that they're no longer allowed to deceive women about their mission. Several states are considering bills that would require CPCs to state that they are not medical centers and do not provide factual medical information. On the federal level, bills remain stalled in both the House and Senate that would prevent CPCs from using deceptive advertising. Write your congresspeople and ask them to take a stand.

Finally, there's been nearly $14 million in federal abstinence-only-until-marriage money channeled to CPCs under the Bush Administration. We must ask the next presidential administration to halt that runaway gravy train.

Young women's health is at stake.

For more on crisis pregnancy centers, check out the Fall 2008 print edition of Ms. magazine.

Saving a Last Resort

2008-05-21T08:00:00-04:00

Mary was more than 22 weeks pregnant in 2003 when she was told the baby she was carrying had a rare and severe fetal abnormality that would cause it to live in a vegetative state, if it survived at all. In disbelief, she consulted with several additional doctors and specialists hoping there had been a mistake; this was a long-hoped-for pregnancy. But in the final analysis, with the support of her partner, she decided she would terminate.

For women like Mary (not her real name) who are diagnosed with severe fetal anomalies late in their pregnancies, or whose late-term pregnancies threaten their health, there are few doctors and clinics willing to perform later-term abortions. In order to get the medical care she needed, Mary had to travel from her home in the Midwest to Wichita, Kan., where she was seen by Dr. George Tiller of Women's Health Care Services.

Having received "compassionate" care at the clinic, Mary was distressed to learn earlier this year that a Wichita grand jury, investigating whether Tiller had violated Kansas abortion laws, had subpoenaed the private medical records of approximately 2,000 patients who had visited Women's Health Care Services over the previous four and a half years. The grand jury had been convened as a result of a petition drive by Kansans for Life and the extremist anti-abortion group Operation Rescue, who gathered more than the roughly 4,000 signatures required under an 1887 state law that allows citizens to empanel grand juries.

The Center for Reproductive Rights, a nonprofit legal advocacy group, now represents the 2,000-some women patients in their efforts to halt the grand jury's access to their medical records. "This is nothing more than a fishing expedition spurred on by anti-choice zealots," says Bonnie Scott Jones, the Center's lead attorney on the case. "It has nothing to do with any legitimate investigation of possible crimes-it is simply a gross and cruel intrusion on extremely private moments in the lives of these women and their families."

Mary and several other former patients have submitted official affidavits in support of the Center's lawsuit to quash the subpoena, fearing that their personal records, once placed in the hands of a grand jury, could also find their way to the general public. And they have good reason for concern: During a prior grand jury investigation of Tiller, evidence was disclosed by a member of the grand jury to Operation Rescue. Having already endured "highly aggressive" harassment by anti-abortion protesters when she visited Tiller's clinic, Mary worries about the safety of herself and her family if her identity becomes known. "I am being forced to open these wounds in a new and fresh way, to relive it like this," she explains in her affidavit.

Operation Rescue is also trying to insert itself into the current grand jury investigation: When the organization's president, Troy Newman, testified before the grand jury, he offered photographs of patients taken with a high-powered lens as they entered Tiller's clinic. He says he urged the grand jury to subpoena and examine Tiller's patient records from a four year period, between 2004 and 2007. Shortly after his testimony, the grand jury issued its subpoena of the patient records.

"This latest grand jury is part of a new strategy of anti-abortion ideologues to use the court system as a tool of harassment and abuse of Dr. Tiller and other Kansas abortion providers," says Laura Shaneyfelt, of Monnat & Spurrier, one of Tiller's lawyers. She points out that previous attempts to prosecute him for violations of Kansas abortion law have been resolved in his favor-but his opponents appear willing to stop at almost nothing to drive Tiller out of practice, in court or out of it.

In 1985, Tiller's clinic was bombed, causing $100,000 in damages. In 1991, it was the target of Operation Rescue's "Summer of Mercy" siege for more than six weeks; U.S. Marshals were eventually ordered in by the district court judge when local police failed to keep the clinic open. In 1993, Tiller survived an assassination attempt by an Army of God follower who had participated in Operation Rescue's 1991 blockades, suffering gunshot wounds in both arms. His clinic has also been vandalized and his staff tracked to their homes, their garbage rifled through.

So intense is the focus on Tiller that Newman moved to Wichita from Southern California in 2002 with the declared intention of closing down the clinic. Former Kansas Attorney General Phill Kline, an ardent opponent of abortion, has been on a similar mission. For more than two years, Tiller was relentlessly investigated by Kline, who ultimately filed 30 criminal counts alleging Tiller illegally performed later abortions. All the charges were eventually dismissed by a state court judge-and now Kline has been criticized for allegedly withholding exculpatory evidence when he filed his charges.

Kline was defeated in his re-election bid, but his successor charged Tiller with 19 new misdemeanors, claiming that he failed to follow Kansas law when securing the second opinion required for later-term abortions. Each charge carries a maximum sentence of one year in jail and a $2,500 fine, and could cost Dr. Tiller his medical license.

Tiller's attorneys maintain he is innocent, and also that the Kansas State Board of Healing Arts (the state's medical oversight body) knew and had approved of his practices in regard to second-opinion physicians.

Moreover, his attorneys believe that the statute requiring a second Kansas physician's approval of an abortion violates the federal and state constitution since it infringes on a physician's right to practice medicine and places an unreasonable burden on a woman's right to access a lawful abortion. "Every challenge to a state law mandating a second approving physician has been held unconstitutional," says Shaneyfelt.

Although Dr. Tiller remains the primary target of anti-abortion extremists in Kansas, Operation Rescue, along with other anti-choice groups, also gathered enough signatures to empanel a grand jury to investigate the Planned Parenthood clinic in Overland Park, a suburb of Kansas City. Following a court fight over patient records similar to that in the Tiller investigation, that grand jury disbanded in early March, concluding there was no evidence of criminal wrongdoing.

However, the relentless Phill Kline, now the appointed district attorney for Johnson County (which includes Overland Park), has recently charged the Planned Parenthood clinic with 23 felonies and 84 misdemeanors, alleging the clinic falsified records and performed illegal late-term abortions. Planned Parenthood is vigorously contesting these charges.

Meanwhile, the Kansas State Supreme Court has agreed to hear arguments about the records subpoenas from Tiller's office in April; it's unclear when it will make a ruling. If the anti-abortion forces succeed in their mission to close down Tiller, the impact will be far from local. It will reverberate around the country, as women like Mary will lose one of the last places they can turn to for help.

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This article first appeared in the Spring issue of Ms. magazine, available on newsstands and by subscription from www.msmagazine.com.