McCain appeared incredulous that Bush could support such an extremist platform, without those exceptions. In 2007, McCain reaffirmed his commitment to change the Party's platform to reflect these changes.
That was then. Now it is widely assumed that McCain will drop his call for these changes. In the words of Tony Perkins, head of the Family Research Council, for McCain to continue to call for a revised platform, "would be political suicide...I think he would be aborting his own campaign because that is such a critical issue to so many Republican voters."
Are Perkins and other Christian conservatives courted by McCain, such as Senator Sam Brownback, co-chair of the nominee's Justice Advisory Committee, correct in their view that a challenge on the abortion plank would doom his run for the presidency?
This question, of course, captures the larger dilemma swirling around
McCain's candidacy -- go too much to the Center and lose the base, swing
too much to the Right and lose the independents and moderate
Republicans (yes, there still are some left). Which is more costly a
strategy for him? Or put another way, how long can McCain get away with
at one moment seeking the endorsements of right-wing preachers whose
statements are every bit as incendiary as those of the Rev.
Jeremiah Wright, and at the next, go on the Daily Show and act like a
very charming and hip person who could not possibly believe the
outrageous positions he is forced by circumstances to take?
McCain's "maverick" image has misled a considerable number of voters into believing he is for abortion rights.
In fact, he has long been opposed to abortion. The differences now is that the "straight talker" appears more than willing to overlook his previous more thoughtful positions in order to please his extremist friends. Several years ago, McCain was on record as saying reversing Roe would not be a good idea, because of the likelihood of women resorting to illegal and dangerous abortions; today, he calls for the immediate overturning of Roe.
While McCain struggles to keep both the right and the center happy, it is our job, as progressives, to let the American people know what his party -- and presumably, he -- is capable of supporting. The utterly draconian nature of the Republican party's official position on abortion has not gotten the attention it deserves, either from the media or, surprisingly, from abortion rights advocates themselves. No exception for the life of the woman?!
Recall that South Dakota voters in 2006 voted down a ban on abortions that had a life exception, but did not have one for rape and incest. Assuming there are reporters and debate moderators willing to call him on it, how possibly will McCain defend a position on abortion that, even if symbolic, is breathtaking in its callous disregard for women?
There is no question that in the coming general election campaign Barack Obama (assuming he will be the Democratic nominee) will be targeted by antiabortion forces because of his support for abortion rights. In particular, we can expect that Obama's expressed disagreement with the most recent Supreme Court decision on abortion, Gonzales v. Carhart, will be relentlessly revisited in TV and radio ads to selected audiences. Obama's statement after the decision voiced his concern that the Court for the first time upheld an abortion law that did not allow an exception for women's health.
Since this decision involved a ban on a rarely used procedure, that has been successfully sensationalized for years by opponents as "partial birth abortion," and which many Americans find upsetting, we can expect Republicans to hammer him on this point.
But I believe that if Americans are told that John McCain, and the party for which he is a standard bearer, stand behind the proposition that it is preferable that women die, rather than have an abortion, that will be substantially more upsetting. Words matter. If McCain insists on placating the fanatics in his party, let him start paying a price.
]]>Later on Thursday, Yale University issued a statement announcing that Shvarts' project did not involve actual pregnancy or induced miscarriage. But even before their statement, I was skeptical. Most puzzling to me was her claim to have used "abortifacient drugs that were legal and herbal." If she had really terminated her own pregnancies repeatedly, she could have been subject to legal prosecution -- as occurred recently to a number of poor, mainly immigrant women who have tried to terminate their unwanted pregnancies by themselves, in situations vastly more grave than Schvarts' "senior project."
Even though Schvarts did not actually become pregnant and self-abort, this is a disturbing and irresponsible project. Shvarts told the Yale Daily News that her project was not designed for "shock value" and it was not her intention to "scandalize anyone." She also told the paper that she "believes strongly that art should be a medium for politics and ideologies, not just a commodity."
It is very hard to take such statements seriously. If she truly believed that claiming to get herself pregnant "repeatedly," only to then terminate those pregnancies, would not shock and scandalize, then she clearly has not a clue about reproductive politics, and should not be sticking her nose, er, her uterus, into a highly charged issue she knows nothing about. Art should be a medium for politics, but the responsibility of the artist is to know something about the politics with which she is engaging.
What useful "conversation" has Shvarts provoked with this project -- other than the fact that not all ideas for performance art are good ones? Does anyone -- on either side of the abortion debate -- gain any new insight from her work? All that seems to be accomplished with this project is a highly visible trivialization of the issue of abortion and a phenomenal insensitivity to women who suffer repeat miscarriages.
As someone who has been a college professor for over thirty years, I know it is not uncommon for eager students to have fanciful ideas for projects, and some of these, for various reasons, simply should not take place. It is the job of faculty mentors to give appropriate guidance and to point out that not everything that is "provocative" is necessarily worth doing. The Yale art department, and her advisor in particular, has failed Aliza Shvarts big-time. And in ways that clearly Ms. Shvarts does not understand, her "artistic" contribution to politics fails the rest of us.
]]>Linda and her mother didn't know how soon they would be calling on Fran to make good on her promise of help. The second encounter was hardly pleasant. As Linda tells it, "Not five minutes after the nurse leaves, someone else comes into the room -- it's Ann Marie Starr, my stalker!" This Ann Marie, it turns out, is head of the local antiabortion forces, and for years has not only protested at Linda's clinic, but periodically follows Linda around town. "If she sees me in the grocery store, she'll start screaming at me … I just wait for the manager to throw her out."
Ann Marie, a regular volunteer at the nursing home, apparently had seen Linda's car in the parking lot, and had tracked down the location of her mother's room. "She started hassling my mother, telling her she'd pray for her, but given what I'd done, she might have to go to hell anyway. My mother begged her to leave, but Ann Marie refused, and started yelling about her 'right' to be there." The bizarre episode ended when Fran, hearing the uproar, rushed back to the room. "Fran is a good-sized woman and she just physically dragged Ann Marie out of there."
In reflecting about this incident, I began to see an aspect of the unending abortion wars in America I had not fully appreciated before. That those who provide abortions, either as clinicians or administrators, can be relentlessly pursued in their communities by their opponents -- hounded not only at their workplaces, homes and churches, but virtually anywhere where they might be spotted, as this nursing home story shows -- is hardly news. And while presumably any nurse, whatever her personal history, would have stepped in to remove an unwanted intruder, Fran's participation in this drama reminded me that there are millions of supportive "civilians" aiding the community of abortion providers in this war, many with a history of deep gratitude for the abortions they or a loved one once received.
Linda's recollections to me about the nursing home incident came in the context of a larger conversation about the various acts of threatened or real violence her clinic had faced over the years, and the many outsiders who were unwittingly drawn in. She told me of a sobering meeting with an FBI agent, which led to her informing her Fed Ex driver, her UPS delivery person, and her postman of the possibility that they might be handling dangerous mail. Indeed, when her clinic was among the hundreds of abortion clinics receiving letters claiming to contain anthrax, it was her postman who was the first to handle that letter. He was subjected to various precautionary medical procedures until the substance could be definitively ruled as harmless. When antiabortionists (led by Ann Marie, she suspects) attacked her clinic with an infusion of butyric acid -- a colorless liquid with an extremely unpleasant vomit-like odor -- it inconvenienced all the tenants in the building in which her facility leased space. When her clinic received a package that looked suspicious enough to call the bomb squad, again all those in her building were put on alert.
To my considerable surprise, Linda told me that in all in the above instances, these outsiders were very supportive and showed no rancor toward her or the clinic. The postman told her "he was just doing his job," and the other tenants in the building saved their anger for "the crazies" who were massively disrupting everyone's day.
To be sure, not all past abortion patients remain as grateful as Fran, the nurse in this story, as the existence of groups like Women Exploited by Abortion makes clear. And even if most of the millions of former abortion patients do remain pro-choice, the beleaguered abortion providing community understandably wishes that this "silent majority" was more often outspoken, for example by pressuring politicians to support legal abortion.
Nevertheless, speaking with Linda made me realize that the antiabortion movement would be much farther along in its goal to stop abortion care were it not for the largely overlooked determination of many everyday decent Americans to stand with the provider community against its foes.
*All names in this article have been changed.
]]>Huckabee of course would help McCain where he is weakest--among Republicans who identify as evangelicals, about one third of the Republican electorate. Unlike McCain and Romney, who have changed their positions to one degree or another on abortion, Huckabee has been consistently and fervently anti-abortion. He has also a long record of opposition to gay marriage. Most pertinently, he will not avoid speaking about these issues that still have considerable power to mobilize an important bloc of voters.
Is there a downside to McCain choosing Huckabee as his running mate? After all, Huckabee is on record as not believing in evolution, as wanting to abolish the IRS, as wanting the Constitution to more accurately reflect "God's law," -- not positions held by most Americans. So yes, there are some negatives.
But recall that the vice-presidential candidate doesn't usually play a very high profile role in national elections. There will be likely only one vice-presidential debate, i.e. only one time where Huckabee would have to spin for voters his disbelief in evolution and various of his other controversial statements. Bottom line, McCain would probably gain more than he would lose by such a choice. And if the Republicans are victorious, we would have a 71 year old president and a vice-president--the proverbial one heart beat away from the presidency--who might well make Bush's policies on reproductive and sexual health look reasonable.
]]>Huckabee of course would help McCain where he is weakest--among Republicans who identify as evangelicals, about one third of the Republican electorate. Unlike McCain and Romney, who have changed their positions to one degree or another on abortion, Huckabee has been consistently and fervently anti-abortion. He has also a long record of opposition to gay marriage. Most pertinently, he will not avoid speaking about these issues that still have considerable power to mobilize an important bloc of voters.
Is there a downside to McCain choosing Huckabee as his running mate? After all, Huckabee is on record as not believing in evolution, as wanting to abolish the IRS, as wanting the Constitution to more accurately reflect "God's law," -- not positions held by most Americans. So yes, there are some negatives.
But recall that the vice-presidential candidate doesn't usually play a very high profile role in national elections. There will be likely only one vice-presidential debate, i.e. only one time where Huckabee would have to spin for voters his disbelief in evolution and various of his other controversial statements. Bottom line, McCain would probably gain more than he would lose by such a choice. And if the Republicans are victorious, we would have a 71 year old president and a vice-president--the proverbial one heart beat away from the presidency--who might well make Bush's policies on reproductive and sexual health look reasonable.
]]>The problem--and there are, to be sure, worse problems in politics--is that Berkeley is full of people who have passionate lifelong commitments to all three of the social movements represented by the candidates. Though the contest might now be constructed, at the simplest level, as between the feminist movement and the civil rights movement, John Edwards' support of the labor movement resonated deeply in this community. So though on one level, many are ecstatic at the history-making nature of this race--whoever is ultimately the Democratic nominee will be precedent-making, and a tribute to the staying power of the social movements of the 1970s--many are also agonizing over for whom to vote.
Endless discussions, similar to those already reported on RH Reality Check, are held among friends and acquaintances. "She's more experienced and ‘ready' ." "Yes, but he's more electable. He'll bring in the youth vote." "Yeah, but you can't count on the youth vote. She can better take the dirt the Right will throw at whoever is nominated," and so on.
The reality is that there are very slight differences between these candidates on matters of domestic policy. They are very close on most issues Californians hold dear--environmentalism, reproductive rights, support for labor, and education. Perhaps the one non-trivial difference is their respective health care plans (hers calls for a mandate for all who can to purchase coverage, his doesn't).
The main difference of course is their historic position on Iraq. And this seems to be pushing many Berkeleyites to Obama's corner. Obama signs outnumber Clinton signs in all the neighborhoods I've walked in the last week. If Obama indeed carries the city on the basis of foreign policy, it will hardly be surprising. Berkeley is a city noted for the intense involvement of its city government in national and even international issues, periodically voting, for example, against nuclear weapons. Most recently the City Council voted 8-1 to declare Marine recruiters were "unwelcome" in Berkeley (a move some Council members are now rethinking).
In such a thoroughly Democratic environment as Berkeley, and the surrounding Bay Area, one presumes that whoever wins the nomination will ultimately get the support of most voters. But some have concerns that Obama supporters have been more deeply critical of Clinton than vice versa. For example, Robert Scheer, a long time progressive journalist in California, in an article promoting Obama on the basis of his anti-Iraq stance, was devastating on Clinton's record, and finished his article by reluctantly admitting that "Hillary would probably be better than the Republicans." "Probably"?! No difference between her and McCain who wants to stay in Iraq indefinitely? Not to mention their differences on tax cuts and reproductive rights? This statement is frighteningly reminiscent of the Ralph Nader pronouncement that Gore and Bush were essentially the same. One hopes that political purity among some on the Left will not snatch defeat from the jaws of victory again.
]]>The problem--and there are, to be sure, worse problems in politics--is that Berkeley is full of people who have passionate lifelong commitments to all three of the social movements represented by the candidates. Though the contest might now be constructed, at the simplest level, as between the feminist movement and the civil rights movement, John Edwards' support of the labor movement resonated deeply in this community. So though on one level, many are ecstatic at the history-making nature of this race--whoever is ultimately the Democratic nominee will be precedent-making, and a tribute to the staying power of the social movements of the 1970s--many are also agonizing over for whom to vote.
Endless discussions, similar to those already reported on RH Reality Check, are held among friends and acquaintances. "She's more experienced and ‘ready' ." "Yes, but he's more electable. He'll bring in the youth vote." "Yeah, but you can't count on the youth vote. She can better take the dirt the Right will throw at whoever is nominated," and so on.
The reality is that there are very slight differences between these candidates on matters of domestic policy. They are very close on most issues Californians hold dear--environmentalism, reproductive rights, support for labor, and education. Perhaps the one non-trivial difference is their respective health care plans (hers calls for a mandate for all who can to purchase coverage, his doesn't).
The main difference of course is their historic position on Iraq. And this seems to be pushing many Berkeleyites to Obama's corner. Obama signs outnumber Clinton signs in all the neighborhoods I've walked in the last week. If Obama indeed carries the city on the basis of foreign policy, it will hardly be surprising. Berkeley is a city noted for the intense involvement of its city government in national and even international issues, periodically voting, for example, against nuclear weapons. Most recently the City Council voted 8-1 to declare Marine recruiters were "unwelcome" in Berkeley (a move some Council members are now rethinking).
In such a thoroughly Democratic environment as Berkeley, and the surrounding Bay Area, one presumes that whoever wins the nomination will ultimately get the support of most voters. But some have concerns that Obama supporters have been more deeply critical of Clinton than vice versa. For example, Robert Scheer, a long time progressive journalist in California, in an article promoting Obama on the basis of his anti-Iraq stance, was devastating on Clinton's record, and finished his article by reluctantly admitting that "Hillary would probably be better than the Republicans." "Probably"?! No difference between her and McCain who wants to stay in Iraq indefinitely? Not to mention their differences on tax cuts and reproductive rights? This statement is frighteningly reminiscent of the Ralph Nader pronouncement that Gore and Bush were essentially the same. One hopes that political purity among some on the Left will not snatch defeat from the jaws of victory again.
]]>Twenty years later, Mike Huckabee, running for the Republican nomination, makes no such missteps. With none of the discomfort that Bush I showed, Huckabee at his rallies gets the party line of the antiabortion movement right: if Roe is overturned, doctors who perform abortions should be punished, while the recipients of such abortions must be seen as "victims."
But Huckabee, a former Baptist preacher and the candidate of choice of evangelicals, is an exception in the clarity and consistency of his position on abortion. There is a long history of "evolution" on abortion from politicians in both parties. For example, Bill Clinton and Al Gore, both from Southern states, had mixed records of support for abortion early in their careers before they each went on to become staunch allies of the abortion rights movement. But in the campaign of 2008, it is mainly the Republican candidates who are squirming.
Mitt Romney’s notorious flip-flops on the issue--reminiscent of another hapless Massachusetts politician, Romney was for abortion before he was against it–-may ultimately be seen as a key factor that led to voter disillusion with his candidacy.
Rudy Giuliani, who is attempting the daunting task of winning a Republican nomination with a record of support for abortion and gay rights, astonished observers across the political spectrum with his nonchalance when he stated, in response to a question about his feelings were Roe to be overturned: “It’d be ok to repeal it. It would also be ok if a strict constructionist judge viewed it as precedent.”
Fred Thompson, in the early stages of his campaign, first denied and then admitted that he had worked briefly as a lobbyist for an abortion rights group. The “straight-talking” John McCain has also changed his position on abortion. Several years ago, he was on record as saying reversing Roe would not be a good idea, because of the likelihood of women resorting to illegal and dangerous abortions; today, he calls for the immediate overturning of Roe.
The abortion issues in the Democratic campaign have thus far been much more low profile. To be sure, Dennis Kucinich, who for most of his political career was against abortion, suddenly became converted to a prochoice position when he first ran for president. And in the final days of the New Hampshire primary, the Clinton campaign sent out a mailing accusing Obama of not being a sufficiently reliable prochoice vote when he served in the Illinois legislature.
But in fact, the positions of the top three Democratic candidates are nearly identical on abortion. All three spoke out against the most recent Supreme Court decision on abortion, Gonzales v Carhart, announced in April 2007--decrying the fact that for the first time the Court held that an exception to protect the health of a woman was not constitutionally necessary in abortion legislation. But since Gonzales also upheld a ban on intact Dilation and Extraction, a rarely used method of performing certain second trimester abortions-- sensationalized by opponents as “partial birth abortions”–-it is certain that antiabortion forces will target whoever becomes the Democratic nominee for his or her statement on that case.
So how big a role will abortion play in the upcoming election? An economy in recession, not to mention ongoing wars in two fronts, presumably will command far more attention than abortion. But abortion plays too central a role in American politics to disappear altogether as an issue. In particular, if Mike Huckabee is the nominee (or, more likely, the vice presidential candidate), then abortion will inevitably have a higher profile. Even if Huckabee is not on the ticket, if either McCain or Giuliani becomes the presidential nominees, he will likely choose a running mate who can energize the Religious Right segment of the party–and that means talking about abortion.
What can the Democrats do? This time around, the Democratic candidates have an excellent opportunity to do more than be defensive about their support for abortion, especially the controversy around later abortions, which account for a tiny proportion of all abortions performed in the U.S.(90% of all abortions occur within the first ten weeks of pregnancy and less than 2% occur after 20 weeks).
The record of the Bush presidency with regard to sexual and reproductive policies is so egregious, because of the relentless quest to please the Religious Right, that there is a real opening to expose the extent to which the Republican party is out of step with mainstream values of the American electorate.
If baited about "partial birth abortions," here is how a nominee might respond. "Leading medical organizations have testified that sometimes this banned method is the safest one for the woman--and I want women to have access to the safest procedure possible. But this infrequently used procedure is not the main issue here. I want to know if my opponent, should he be president, will continue to support abstinence only sex education--on which our government has wasted over a billion dollars to date, and which has repeatedly been shown to be ineffective. I want to know if my opponent, on record as opposing abortions, will continue George Bush’s policy of cutting funding for family planning programs? I want to know if my opponent agrees with the Bush policy of posting incorrect information about condom effectiveness and other reproductive health issues on government websites? I want to know if my opponent will continue with the Bush policy of making one third of all U.S. HIV/AIDS assistance funds in the developing world go to abstinence programs–-a policy decried by public health experts? And since we are talking about reproductive issues, why is my opponent on record as supporting George Bush’s veto of the expansion of S-Chip–-that wonderful health care program for children?"
In short, abortion is best defended when it is discussed in the context of a larger vision of reproductive justice–one that speaks to the many different ways a compassionate government can help its citizens to achieve the family lives they wish for. And the woeful Bush record of the last seven years offers a perfect opportunity to present this vision.
]]>This article originally appeared on the Beacon Broadside.
Let us apply a similar thought experiment to Jamie Lynn Spears, the younger sister of Britney, who is a star in her own right of a television show for young teens. Spears, as everyone on the planet presumably now knows, is pregnant at the age of 16. She has announced that she will continue with her pregnancy. While Spears has been subject to some criticism from conservatives because of her sexual activity, she has repeatedly been praised by various anti-abortion spokespersons, including presidential candidate Mike Huckabee, for her decision to not end her pregnancy.
For the sake of argument, let us assume that Jamie Lynn actually prefers to have an abortion, an option chosen by nearly half of teenagers faced with unintended pregnancies. Just as the imaginary Judith Shakespeare's talents would have been met by a society deeply hostile to women writers, so too the real Jamie Lynn's decision to end this pregnancy would take place in a society deeply polarized around abortion.
Such a move would, at a minimum, be a career-ender. Abortion has become so stigmatized in the contemporary United States that public admission of an abortion by someone in Spears' position would most likely mean the loss of acting roles, personal appearances, endorsements and so on. Admittedly, Spears' current career prospects are uncertain, with her television show on hold; but given reports that her mother, Lynne Spears, has already arranged the sale of the first baby pictures to a fan magazine, it is quite conceivable --no pun intended-- that Jamie Lynn might be able to create a new celebrity persona as teenage mom.
Moreover, were Jamie Lynn to seek out an abortion in Louisiana, her home state, her mother would have to give consent, as is required by that state's laws. And that would seem highly unlikely, in light of Lynne's marketing plans for her forthcoming grandchild.
But loss of career opportunities would only be the beginning of Spears' difficulties if news of an abortion became public. She would be denounced in the pulpits of evangelical preachers, castigated on various websites and right-wing television shows, and receive abusive and threatening phone calls and letters. Every public outing-say, an evening with friends in a restaurant -would carry the risk of strangers coming up and screaming epithets in her face.
This worry about exposure as an abortion recipient is not limited to celebrities. Attempts to "out" abortion recipients are a tactic with a long history in the antiabortion movement-- for example, the many instances of photographing the license plates of cars in clinic parking lots. So fearful are some women of having their abortions revealed that clinic administrators report that often patients with insurance plans that cover the procedure prefer to pay cash, so there is no paper trail of their abortion.
The fact that a history of an abortion can taint one's identity-or serve, in sociological parlance, as a "discrediting device"-- is a serious problem that goes well beyond the travails of Jamie Lynn Spears. Consider, for example, the world of electoral politics. The most recent data suggests that more than one third of American women will have an abortion by the time they reach the age of 45. Some portion of these women, no doubt, will run for elective office. Will the standard "oppositional research" that is part of modern politics now routinely include attempts to find out if women candidates have ever had an abortion? Will such information be enough to derail their campaigns?
Given the immense success that the antiabortion movement has had in the decades since Roe v Wade in demonizing abortion, it is no simple matter to visualize how to destigmatize the procedure, as well as those who receive and provide it. One promising start, however, comes from a still relevant quote made some years ago by Rachel Atkins, then the director of a women's health center in Vermont. Speaking to a New York Times columnist about the women in her waiting room, Atkins said, "The country really suffers from thinking that there are two different kinds of women -- women who have abortions and women who have babies. They're the same women at different times."
To be sure, not all abortion recipients currently or eventuallyexperience motherhood-though this is an accurate description of most. But Atkins' perceptive comment reminds us that abortion is just one of several significant reproductive events that women will experience in their life times. And whether an unwanted pregnancy occurs to a famous 16 year old like Jamie Lynn, or-- as is far more common-- a poor teen of color, an ambitious college student who one day wants to run for office, or a waitress who has all the children she can care for, we should strive for a culture in which abortion is recognized as an honorable option.
]]>And it is no surprise that the Republican candidates for president support abstinence-only programs. This issue remains of great symbolic importance to the Religious Right base of the Republican Party. Though some observers say this movement is in decline, evangelicals remain very influential in the nominating process (witness Mike Huckabee’s recent meteoric rise), and candidates cannot afford to offend them on this issue. (And to be sure, abstinence-only is more than just symbolically important to many on the right; as The Nation so ably detailed, in "The Abstinence Gluttons," those who receive contracts to deliver these programs are raking in millions).
But Democrats supporting "abstinence-only," especially after the November 2006 election, when they regained control of the House and Senate?! A powerful Democratic committee chair proposing to give even more to these programs than the Bush administration has asked for?! No, this is not a Saturday Night Live or Jon Stewart parody. This is Washington politics. In a move that stunned advocates for comprehensive sex education—that is, programs that include discussion of both abstinence and birth control options—Congressman James Obey of Wisconsin, the chair of the House Appropriations Committee, proposed increasing by $28 million the current abstinence-only allocation of $113 million. Obey made this move in order to lure Republican votes for Congress’s main domestic spending bill. (In fairness, an equal increase was suggested for Title X, a federal family planning program that has been consistently under-funded during the Bush years.)
This (mis)appropriation may not see the light of day, given the wrangling taking place on the hill, but whatever transpires in the next few weeks, reproductive justice advocates are deeply demoralized to see how casually an issue of such intense importance could be horse traded away. As James Wagoner noted on RH Reality Check:
With one breathtakingly cynical move, the Democratic leadership has now stamped its brand on one of the biggest ideological boondoggles in congressional history. More disturbingly, they have placed the health and safety of young people at risk by promoting programs that spread ignorance in the era of HIV/AIDS. Placing politics before public health and ideology over science have now become bipartisan follies.
What exactly is abstinence-only sex education, and why are its opponents so distressed over Obey’s cynical maneuvers? Briefly, this form of sex education has its roots in the Reagan era of the 1980s, when a newly formed Religious Right started to expect payback in the domestic policy realm for its work on behalf of Reagan’s election. The Reagan administration funded programs known colloquially as “Chastity Centers,” typically administered by church-affiliated groups, and then, as now, such programs became embroiled in lawsuits over issues of church/state separation.
Abstinence-only funding received major boosting as part of the landmark 1996 welfare reform measure (the Personal Responsibility and Work Opportunity Reconciliation Act). The administration of George W. Bush increased abstinence funding even more. In total, in the words of Congressman Henry Waxman, one of the program’s leading critics, "American taxpayers appear to have paid over one billion dollars for programs that have no impact."
Abstinence-only programs infuriate its critics both for what such programs don’t say and what they do say. Programs receiving federal funding are not allowed to mention contraception "except to point out (grossly inaccurate) failure rates. Abortion, needless to say, cannot be presented as an acceptable option in the face of unwanted pregnancy, though many programs are able to get away with unsupportable statements about high suicide rates of abortion patients and the discredited link between abortion and breast cancer.
What abstinence-only programs must address includes the following: "a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity," "sexual activity outside the context of marriage is likely to have harmful psychological and physical effects," "bearing children out of wedlock is likely to have harmful consequences for the child, the child’s parents, and society."
In a devastating exposé of abstinence-only programs, Waxman’s staff found widespread misinformation and outright lies being told to young people. Most notoriously, some programs were teaching that HIV could be spread by "sweat and tears." Overall, the report concluded that, "over 80% of the abstinence-only curricula contain false, misleading, or distorted information about reproductive health." (Complete report)
Meanwhile, according to James Wagoner, every day in the United States some ten thousand young people get an STD, two thousand become pregnant and fifty-five contract HIV. These threats to young Americans’ health and well-being are what your tax dollars are not addressing. At least not in the thirty-six states that still accept abstinence-only funding.
]]>This article first appeared on the Beacon Broadside.
"I actually went down on my knees begging him-but I think he felt he had been doing too many lately, and his hospital had been breathing down his neck. I walked out of there shaking...."
"I groveled and flattered him as much as I could. I sweet talked him. Finally he caved."
These are two stories of women physicians imploring male colleagues on behalf of patients who need abortions. The two events took place more than forty years apart, but the dynamics are eerily similar. The first speaker, Dr. Ethel Bloom (not her real name), now a retired general practitioner, is recounting for me her memories of what it meant to be an abortion-sympathetic doctor before Roe v Wade.
The daughter of her best friend, about to leave for college, had become pregnant. Dr. Bloom tried to obtain an abortion for her from an ob/gyn colleague who occasionally took risks and did abortions in his hospital, violating the rules of that time by claiming "medical necessity." (Bloom's gutsy, and ultimately successful, strategy for obtaining an authorized abortion in this case was to lie to another doctor that the young woman had tested positive for rubella, also known as German measles. The hospitals in the area had just begun to approve abortions for women with rubella, as evidence accumulated of the severe birth defects associated with the disease. As the first generation of tests were expensive, Bloom gambled -- correctly -- that the hospital would not retest her.
The second speaker, Dr. Margaret Riley (not her real name), is a vibrant and witty ob/gyn in her forties. In a just world, a woman like this would not have to "grovel," as she put it, before colleagues to get needed care for her patients. She currently is the medical director of a freestanding abortion clinic in an East Coast state and I recently heard her speak at a conference. A small portion of the patients who come to her clinic are too sick to have their abortions performed there safely and require having the procedure done in a hospital. This is when the groveling starts, as Riley has to deal with individuals and institutions beyond the clinic.
The case she discussed at the conference concerned a 17-year-old teenager with a history of recurrent pulmonary embolism (blood clots in the lungs). When the teen became pregnant, her hematologist suggested termination as the safest course, as pregnancy could dangerously exacerbate her condition, possibly leading to death. With the hematologist's backing, Dr. Riley arranged to perform the abortion in a local hospital. The young woman was admitted to the hospital, and prepared for surgery.
Literally as she prepared to leave for the hospital to do the procedure, Dr. Riley was informed by a clinic staff member that someone from the patient's insurance company had just called to announce that the company refused to authorize payment for the abortion. An in-hospital procedure would cost thousands of dollars, money which the family of the teenager did not have. Riley called the medical director of the company. "He said they would only pay if the ‘condition is life-threatening.' Of course, I wanted to shout, ‘You moron! Don't you know pregnancy in a patient with pulmonary embolism is life threatening?!' But I restrained myself. I calmly kept telling him how sick she was. I told him that the she had been on the pill but had to go off because of her condition....Finally, the breakthrough came when I got the hematologist to call him, and confirm how sick she was. Then he agreed. Of course, he thought that I, the abortion doctor, was doing this just for the money -- but a hematologist, well that was a a different story."
This case of the 17-year-old with pulmonary embolism was just one of several that Dr. Riley discussed which described the challenges she faces when advocating with gatekeepers for women too sick for clinic abortions. The negotiations that Riley has to undertake routinely with hospital administrators, insurance executives, and physicians in other specialities in such instances gives us yet another window into the chaotic and Kafkaesque world that is contemporary abortion provision, even as Roe remains technically legal. Some of those with whom Riley must plead are quite upfront with her on their anti-abortion views, others have different motivations. When I asked her, in a follow-up interview, whether she thought the insurance director was motivated primarily by anti-abortion sentiments or by a desire to cut costs, she gave an answer that seemed to encompass both: "I think it was sexism actually."
Margaret Riley's situation, in fact, is in some respects better than that of her fellow clinic directors in other areas. She operates in a fairly liberal state, and over the years, has worked out an "understanding" with a local hospital that usually lets her perform abortions for very ill patients in its facilities. But in other places, hospitals' refusals to deal with seriously ill women seeking abortions is so egregious that a new term has entered the vocabulary of abortion advocates -- "ambulance cases." Mainly, but hardly exclusively, occurring in Catholic hospitals or hospitals which have merged with Catholic institutions, the phrase refers to situations in which very ill women are sent from one hospital to another in an ambulance because the first hospital refuses to treat them. Here the pleading done by abortion providing ob/gyns with members of hospital ethics committees or heads of departments often falls on deaf ears.
Two particularly notorious cases occurred a few years ago in a Chicago suburbs, in a community hospital that merged with a Catholic institution. In the first case, a woman with an ectopic pregnancy -- a potentially life threatening situation -- was discharged from the hospital and sent by ambulance to another hospital. Because a fetal heartbeat was detected, the first hospital refused to perform an abortion (though they did offer to remove her fallopian tube, which would have compromised future fertility).
In the second case, a patient's water membrane burst prematurely at 18 weeks, putting her at risk of chorioamnionitis, an infection of the uterus that can cause high fever and is associated with sterility. Though the typical course in such situations is to induce labor before the infection develops, the hospital refused to do so until the patient developed a fever. The frustrated admitting physician sent the patient to another hospital for immediate treatment.
As Leo Tolstoy famously said at the beginning of Anna Karenina -- "all unhappy families are unhappy in their own way" -- we can say of the contemporary abortion scene, that all sites of provision are deeply challenged in their own way. The clinics, of course, have no shortage of problems, facing onerous restrictions and constant harassment. But hospital-based abortion care, especially when very ill patients are involved, pits the abortion provider against a host of more powerful forces, some truly astonishing in their disregard for women's health and wellbeing. And proud physicians like Margaret Riley are resigned to the fact that they will be doing a a lot of begging.
]]>But the presence of the speaker, Charlotte Brody–-there to receive ARHP’s “Preserving Core Values in Science Award”–-and the connections she drew between Carson’s legacy and the concerns of ARHP members reflect a very promising new direction for the reproductive health movement. Brody, a distinguished environmental health advocate, is the executive director of Commonweal, a nonprofit health and research institution in Bolinas, California, and a founder of the group, Health Care without Harm.
Brody took the audience through Carson’s early work on the dangers of pesticides and other chemical agents. When she mentioned the rage Carson evoked from various quarters, including the chemical industry-–she was called “a fanatic defender of the cult of the balance of nature,” a “Communist,” and a “spinster” who had no right to “worry about genetics”--I thought of the similar demonization of Margaret Sanger and Emma Goldman, some of the earliest voices for reproductive freedom in this country, and of course the harassment and abuse directed at contemporary ARHP members who are involved in abortion care.
But the most relevant part of Brody’s talk for this audience was her discussion of the specific threats to reproductive health posed by various widely used chemicals in the United States. There is mounting concern in the scientific community about the impact of these chemicals on rising infertility rates and on hazards to early fetal development. Consider the chemical compound bisphenol A (BPA), used in many plastic products, including baby bottles and microwave containers. BPA has been under increasing scrutiny because of its alleged health effects, and animal studies have linked this compound to a host of reproductive problems.
Indicative of ARHP’s increasing involvement in the world of environmental health, Dr. Beth Jordan, the organization’s medical director, recently testified at a government hearing on BPA. She stated, “Research indicates that BPA may be related to increased trends in humans regarding abnormal penile/urethral development in males and early maturation in females, increased neurobehavioral disorders such as attention deficit hyperactivity and autism, increased childhood and adult obesity....regional decreases in sperm count.”
The BPA hearing, before the National Toxicology Center, moreover revealed another point of common ground between the reproductive health community and the environmental one: both operate in a political climate in which the integrity of science is under attack. Just as reproductive health professionals have had to contend with Bush operatives posting distorted information on government websites (about the alleged link between abortion and breast cancer, about condom effectiveness, etc), so too has the environmental health community seen scientific results trumped by political concerns, with the Bush administration’s egregious behavior on global warming being the best known example. (As has been well documented, government scientists who came up with unwelcome findings found their work either censored on “edited” by political appointees). In the former case, the Bush administration is catering to its religious right supporters, in the latter case, to its economically conservative, anti-regulatory supporters. But the net effect in both cases is the same: the health and well-being of Americans is jeopardized because of political considerations. With respect to BPA, numerous scientific groups, including the ARHP, have accused the National Toxicology Program of relying disproportionately on industry-funded studies-–which somehow found no problems with BPA–-as it prepared its final report on the safety of this chemical.
ARHP’s incorporation of environmental health concerns once again shows how important it is for groups working in the reproductive sphere to reaffirm the broadest possible mandate for this work. Becoming visible players in campaigns for environmental health allows groups like ARHP to make the point which should be obvious, but after thirty-four years of polarization around abortion, sadly appears lost on many Americans. Those clinicians who provide abortion and contraception also are profoundly committed to helping people have the families they want.
]]>Bush's Orwellian reason for opposing the expansion of SCHIP is that the program works too well! Namely, that people would get the idea that perhaps a proper role of government is to provide health care to its citizens. "My concern is that when you expand eligibility...you're really beginning to open up an avenue for people to switch from private insurance to the government."
But Bush's deplorable response to expanding SCHIP is not just about opposing government provided services. Like so much else in his presidency, his administration's record on SCHIP is also entangled in anti-abortion politics. In 2002, his Department of Health and Human Services issued a regulation that stipulated "unborn children" -- but not the pregnant women carrying them! -- were eligible for SCHIP funds. This move contradicted well established standards within the medical community. Both the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics have stated that the pregnant women and her fetus should be treated together.
Immediately after this regulation was issued, health care providers feared that funding for crucial pregnancy-related services that did not directly relate to the "unborn child" -- such as pain medication during delivery and postpartum services -- would be denied to women under SCHIP. However the twelve states that have elected to use SCHIP funds for pregnancy care have largely managed to get around this restriction through various maneuvers, and the worst fears of massive amounts of denied care did not materialize.
Some gaps remain however. For example, in Texas, the SCHIP program does not pay for certain services that could affect a woman during her pregnancy, such as cardiac care and asthma management (PDF). And although that state does pay for postpartum care, it does not provide for family planning services at that visit, which is the expected standard of care, according to medical guidelines.
Why did the Bush administration propose this cruel and absurd policy in the first place? The services that poor pregnant women could or could not get were not the point. The distinction that this SCHIP regulation drew between the "unborn child" and the pregnant woman can only be understood as part of a larger antiabortion strategy (enthusiastically supported by the Bush administration) to lay the groundwork for establishing a legal basis for "fetal personhood." The SCHIP measure is of a piece with the "Unborn Victims of Violence Act" passed by Congress and the "fetal pain" legislation that has been introduced at the federal level and passed in several states. Such legislation requires doctors to offer women getting abortions at various points in the second trimester of pregnancy anesthesia for the fetus, even though an exhaustive review of the literature by respected researchers that was published in the Journal of the American Medical Association concluded that fetuses were incapable of feeling pain until the 29th week of
gestation.
In a similar vein, a number of states are pushing legislation which would require women to see an ultrasound before obtaining an abortion. SCHIP's privileging of the health needs of the fetus over that of the mother is echoed in the recent Supreme Court decision, Gonzales v Carhart. There the Court (with the help of Bush's two appointees) ruled that it was appropriate to override the medical community's judgment about patient safety, and ban a certain procedure "in order to promote respect for ... the life of the unborn." And most stunning of all, for the first time since Roe v Wade, the Court held that considering the health of a pregnant woman is no longer constitutionally necessary in abortion law.
The saga of George Bush's treatment of SCHIP therefore represents a perfect marriage of two of the main pillars of his presidency: a full throttle opposition to effective government programs, and a relentless promotion of measures favored by his Religious Right base.
]]>Check out Bush v. Choice for an article on last week's close call in the Senate -- an anti-choice amendment to the children's health bill was narrowly defeated.