"The only good abortion is my abortion"

I may not be writing much, but I can link! And I really wanted to share a post from BoingBoing. The posts there range from technology, science, art, and culture to unicorns and funny cats, and occasionally more personal posts from the group of authors who contribute.

This post is very personal, and that's why I think we should be grateful that it's being made very public: "The only good abortion is my abortion":

The heart hasn’t sped up. The fetus hasn’t grown. The egg yolk is now bigger than the fetus, which usually indicates a chromosomal abnormality. Basically, this fetus is going to die. I am going to have a miscarriage. It’s just a matter of when.

Because of these facts—all these facts—I get special privileges, compared to other women seeking abortion in the state of Minnesota.

Nobody has to tell my parents. I am not subject to a 24-hour waiting period. I do not have to sit passively while someone describes the gestational stage that my fetus is at, presents me with a laundry list of possible side-effects (some medically legit, some not), lectures me on all the other options that must have just slipped my mind, or forces me to look at enlarged, color photographs of healthy fetuses.

Because I have health insurance, I can afford a very nice OB/GYN whom I chose and who does not exercise her right to deny me this option. Thankfully, I don't live in a state where she can legally lie to me about the status of my fetus, to dissuade me from having an abortion.

Most importantly, from my perspective, I have the privilege of a private abortion in a nondescript medical office. I will not have to go to an abortion clinic. I will not have to walk by any protesters—not even Charlie, the one guy who is paid to protest every day outside Minneapolis’ abortion clinic, where I have volunteered as an escort in the past.

Most of these privileges boil down to the fact that, as far as my doctor and my medical billing are concerned, this is not an elective procedure.

But here’s the thing. It is elective.

The comments, from both men and women who have experienced a pregnancy loss of their own or of their partners, are almost universally compassionate and often share very difficult stories of their own. I think it's important reading.

Everyone should read this: "The Right Not to Know"

In the midst of all the war-on-women contraceptive/ultrasound/domestic violence legislative insanity that I haven't been blogging about in part because, unfortunately, there's so damn MUCH to cover, there are a few pieces that have really stood out to me. This piece really, really stood out to me. It isn't the first account like this I've read, but it's so timely and I think it is so important:

My counselor said that the law required me to have another ultrasound that day, and that I was legally obligated to hear a doctor describe my baby. I’d then have to wait 24 hours before coming back for the procedure. She said that I could either see the sonogram or listen to the baby’s heartbeat, adding weakly that this choice was mine.

“I don’t want to have to do this at all,” I told her. “I’m doing this to prevent my baby’s suffering. I don’t want another sonogram when I’ve already had two today. I don’t want to hear a description of the life I’m about to end. Please,” I said, “I can’t take any more pain.” I confess that I don’t know why I said that. I knew it was fait accompli. The counselor could no more change the government requirement than I could. Yet here was a superfluous layer of torment piled upon an already horrific day, and I wanted this woman to know it.

“We have no choice but to comply with the law,” she said, adding that these requirements were not what Planned Parenthood would choose. Then, with a warmth that belied the materials in her hand, she took me through the rules. First, she told me about my rights regarding child support and adoption. Then she gave me information about the state inspection of the clinic. She offered me a pamphlet called A Woman’s Right to Know, saying that it described my baby’s development as well as how the abortion procedure works. She gave me a list of agencies that offer free sonograms, and which, by law, have no affiliation with abortion providers. Finally, after having me sign reams of paper, she led me to the doctor who’d perform the sonography, and later the termination.

The doctor and nurse were professional and kind, and it was clear that they understood our sorrow. They too apologized for what they had to do next. For the third time that day, I exposed my stomach to an ultrasound machine, and we saw images of our sick child forming in blurred outlines on the screen.

“I’m so sorry that I have to do this,” the doctor told us, “but if I don’t, I can lose my license.” Before he could even start to describe our baby, I began to sob until I could barely breathe.

Read the full article here

Heartbreaking, enraging, and the truth. I want the legislators who wrote that bill to read this piece and understand what it means to intrude on the most intimate decisions people can make.

"I would juggle speculums if they asked"

Do yourself a favor and read this long, funny, and compelling article by an abortion-provider-in-training. Some of my favorite excerpts:

It all breaks down to this: no one is immune to mistakes, whether it’s a mistake of their own making or (more likely) an end effect of the system, especially our fucked-up broken medical system I hate representing. (Sorry, system! Had to say it.) If you think I am making too many excuses for my patients, I will let you know that I am often one of the first people to make excuses for them in their lives and am happy to do so for no fee whatsoever. I would juggle speculums if they asked. I have not yet been asked to do this.

...

Up until recently I’d come out of any closet I found myself in — queer, non-monogamous, I fucking love Tool still, whatever — not that I live to hear the drink-choking sound, but because, to me, coming out was just one of the ways I could pay back the privileges that had been arbitrarily bestowed upon me (educated! white-appearing! “normal!”). My responsibility to normalize as much as I could. But training as an abortion provider is the first thing in my life that I hold back on spilling about. At the core of it, there’s a huge gap between saying “I had one” and saying “I do them.” I don’t want to alienate people. And nothing else I’ve ever done or been has felt like a direct invitation to a motivated someone out there to kill me and get away with it.

...

I speak of my abortion as a positive experience, not to secure the “most awesome abortion” prize (hello judges…?) but to save a seat for the possibility that this doesn’t have to be the worst thing that ever happened to you in your whole life. I don’t want it to in any way represent anyone else’s experience or make them feel disavowed of their own. So let me say: this is my personal experience with abortion! It was positive in every respect. It made me want to help other people also have as positive an experience as possible, so I went into the business. If you think that’s a bullshit line, or it makes you uncomfortable to think about abortion as something that could possibly be positive for a person, think of why you're a person who doesn't want someone to do the best that they can under the circumstances they're in.

If you read the whole thing, you'll learn about how she handles pro-life patients who come for abortions, her interaction with a female soldier who had to fly back from Afghanistan for an abortion, and her reflections on the distinction the law makes between MDs and advanced nurse-practitioners, just for this one fairly simple procedure. I am blown away by her compassion and courage. Please read it!

I found this post through my friend Melissa's new blog in the Feministing community. Melissa comments:

Approaching reproductive justice from a position of love and respect for women means that we recognize the varied experiences women have. Certainly, abortion is a difficult and even harrowing choice for some. But for others, abortion is a positive move forward on their journey to being the person, the partner, or the mother they want to become. If we ignore the positive experiences of those women, we’re adding to the stigma of abortion. To put it simply, although no woman wants an abortion, not every abortion is a tragedy.

Keep an eye out for more posts by Melissa! She is awesome.

Please stand with Planned Parenthood

I am sickened by the nakedly ideological attack by the Republican party on Planned Parenthood.

I cannot count the number of friends I know who have used Planned Parenthood as their ONLY affordable, accessible resource for gynecological care, birth control, STI testing, emergency contraception, and yes, also abortion. Those are services that save women's lives, and allow them to protect their current health and protect their future fertility. Regardless of what anyone may think of Planned Parenthood's provision of abortion services (a LEGAL service for which they use NO federal money, and to which all of 3% of their total funds go) the Republicans are attempting to defund a major source of Americans' access to primary health care. Not just reproductive health care - primary health care, period. For many people - especially women - Planned Parenthood is their primary care provider: they have nowhere else to go.

There is a conception by conservatives I have spoken to that Planned Parenthood pushes abortions and promiscuous sex (via "pushing" birth control?) and relies on somehow manipulating their consumers into these choices, all to make a profit (I guess the fact that they are a non-profit organization is just a minor detail.)

I knew someone exposed to this propaganda who was shocked - shocked - when she met a nurse who worked at Planned Parenthood and found out that this nurse was a normal, nice person who cared about mothers and babies. It was so completely different from the idea of Planned Parenthood that had been marketed to her by conservative religious organizations. It is an idea that is so ludicrous and at odds with my experiences and those of everyone I know who has used Planned Parenthood's services, or worked for their organization.

It's disgusting and disturbing, a ridiculous foundation for legislation, and I cannot imagine where millions of Americans will turn for these services if Planned Parenthood loses their federal funding.

Please stand with me in standing with Planned Parenthood and sign this petition now. Please share it with your friends on your blog, on Facebook, and/or via e-mail.

And please watch this video of a brave and honest woman sharing her personal experience, on the House floor:

Linky goodness: to VBAC or not to VBAC, birth videos, and more!

Time to clear out the starred posts in my blog reader! Sorry, some of them are a few weeks old but of course, still great:

Robin Marty of RH Reality Check on the many reasons she's choosing an elective repeat c-section over a VBAC attempt.

Birth Sense introduces you to the handsome, charming Dr. Justin Case.

Video of baby born in the caul, via Homebirth: A Midwife Mutiny.

Video of frank breech home birth via Gloria Lemay.

Dou-la-la channels Don Draper in explaining why those nice formula companies are so darned excited about breastfeeding.

Why African Babies Don't Cry, via Blacktating.

Mom's Tinfoil Hat linked to a post on abortion and parental notification laws that, very sadly, is no longer up (the author decided to make posts about her work private - I struggle with walking the same line, and totally understand). However, you can still read an excerpt and a long comment from the author in MomTFH's post.

Not birth-related, but something that really touched me to see today: Dan Savage's It Gets Better Project: a collection of videos of adults telling gay teenagers that high school ends and their lives will improve. Read an interview with Dan Savage here, including the reason he decided to start this project.

Health care reform and looking down the road to the next reform

Am I excited about health care reform? Yes, although after all the back-and-forth and ups and downs, it ended by feeling a bit anticlimactic - stumbling across the finish line in a daze, just glad to have gotten here. Remember when Obama said he wanted it done by last August?

I am hugely frustrated, as many other people are, by ridiculous restrictions on abortion coverage. I'm also seriously disappointed by the lack of coverage for immigrants (and not just undocumented immigrants - there's a 5-year waiting period even for documented immigrants to get on Medicaid). And I just want to tell a little story.

The CenteringPregnancy group I'm co-facilitating right now is Spanish-speaking, so obviously most of the women are fairly recent immigrants from Latin America. The way Medicaid works, at least in this state, is that when you show up for your first prenatal visit you get two months of "presumptive eligibility". That means that Medicaid will let you get two months of care, and after that you have to prove that you're Medicaid eligible to continue to be covered. So the clinic tries to get as much done as possible before the two months is over. After that, you're paying out of pocket until you go into labor, at which time emergency Medicaid kicks in to cover the birth and a short period thereafter.

At last month's Centering visit, one of the participants got a call - during the visit - that her husband had been arrested and was about to be deported. At this month's visit, we found out that he was deported and that she was struggling to support her family. She was worried about having enough money for food for her other children. At the end of the group, she began to cry. And on top of this, she has to deal with the expenses for this pregnancy. She has an ultrasound scheduled but will have to decide whether to try to scrape together the money for it, or skip it altogether.

Worse, if she or any of the other women outside of their Medicaid eligibility need to be admitted to the hospital for some reason, like blood pressure monitoring, they'll end up with the bill from that too, and those bills are just insane. This is the reason we're getting health care reform, and yet we are making it impossible for a significant segment of the population to access.

Acting like undocumented immigrants are somehow leeches on taxpayer funds is a falsehood. Undocumented immigrants DO pay taxes. Many pay income taxes, and nearly all have payroll taxes taken out. And all of them pay sales taxes. They put a staggering amount of money into Social Security that they can currently never hope to see returned to them. Is all of this so terrible that they won't even be allowed to purchase insurance, again using their OWN money, on the insurance exchanges? God forbid they ever be able to receive Medicaid coverage for medical necessities.

And the thing that really gets me about all this is the fact that all of these pregnant, uninsured undocumented women? Their babies will be born American citizens. Medicaid will willingly, automatically cover those babies and any health problems they have (perhaps as a result of inadequate prenatal care?), for the rest of their lives. But we won't take care of their mothers, even during their pregnancies.

Obama says immigration reform is coming next; it can't come soon enough after this health care bill.

Link party!

First of all, Happy Olympics! I am so excited. I love the Olympics. My department had an Olympics party last night - come as your favorite athlete, sport, or country. We had everything from Brian Boitano to bobsledding to several people all in white ("Winter") and one Olympic torch. I was Sweden, which is a good Winter Olympics country to pick.

I've been trying to come up with some kind of play on words with the Olympics starting, Olympic rings, the rings are linked, links...I think I'm trying too hard. So let's just say that my Google Reader starred list is becoming too long to contemplate, and that it's time for a link party. I've been saving some of these up thinking "I'll write a post on this!" but the truth is, I might or might not eventually, and in the meantime why let the starred list get longer?

Academic review article on the risks of not breastfeeding for mothers and infants, and the role of obstetricians and hospitals in breastfeeding promotion. A very nice summary.

Via Empowering Birth blog, an informed consent roleplay. Has anyone ever used this with a class? It seems like a great idea to get people prepared to actually advocate for themselves - it's easy to talk about it beforehand, and harder to actually do in the moment.

And another link from Enjoy Birth about choosing hospitals wisely.

A dad talks about his thoughts on breastfeeding.

At Guerilla Mama Medicine, HUGELY important questions and thoughts about race and the natural childbirth movement.

An article from RH Reality Check about The Doula Project, which provides doulas for women who are having abortions and who are relinquishing their babies for adoption. I'm proud to say that I know one of the co-founders, Lauren Mitchell, who has an awesome quote in the piece: "You can't speak for your client, even if what's going on is the opposite of what she wanted - you're not in control of the room. But you are in control of what you are giving your client, and that is an informed ally and a deeply empathetic presence. When you're a doula you have to acknowledge how to be 'human' even when you want to be more than that. What keeps me going is the feedback from the clients that the space that I've created for them is unique and extremely important." If I end up back in NYC I would LOVE to volunteer with them!

From Birth Sense, thoughts about manual rotation of the fetal head. I have seen this happen once, and it was very effective - baby went from making very little progress with pushes, to crowning within minutes. But the midwife writing the article reminds us that it's also extremely important to move the mother!

I've also been enjoying Birth Sense's series, "Your Doctor or Midwife Still Does WHAT?" Here's a sample: #5, Cervical Exams. Reading expectant mothers' blogs I come across so many sighing with frustration that they're still not dilated at all, when is this baby going to come, etc. etc. Since there are very few actual medical reasons to do a cervical exam, it starts to seem like a highly effective method of psychological priming for induction.

Navelgazing Midwife did a great series of photo posts called "Teachable Moments" about placentas, vernix, trailing membranes, etc. Here's a great one on being born in the caul. I guess I should put in a disclaimer that these photos involve vaginas and birth fluids and stuff like that, although I have such a high tolerance at this point I have to remind myself that somebody else might need a warning.

That's all for now - off to watch me some Olympics!

The Stupak amendment.

[Note: I posted this yesterday, then heard an NPR piece that made me think I hadn't understood the Stupak amendment's restrictions. I was heading out the door, so I didn't have time to revise; I took the post down until I had time to research and make sure I was right. This is something I feel very passionate about and I wanted to make sure I was as accurate as possible. Slightly revised version below.]

I called, on Saturday, but what more could I do? Mostly I just tracked the news and crossed my fingers. The fact that this came out of nowhere (at least for me) and was over with in a day feels so utterly unfair.

In case you are not familiar with the Stupak amendment, it is part of the recently passed House version of the health care reform bill. The amendment restricts the ability of public and private insurance plans, offered in government health exchanges, to provide coverage for abortion.

Read that again: AND PRIVATE. This is where I was unclear yesterday, but it is clarified today by this extremely helpful post from legal experts at Planned Parenthood. I'm quoting it extensively because given what I heard on NPR yesterday, I think there is still some confusion out there about the realistic effects of the Stupak amendment on abortion coverage availability in the exchanges:

The Stupak-Pitts amendment prohibits any coverage of abortion in the public option and prohibits anyone receiving a federal subsidy from purchasing a health insurance plan that includes abortion. It also prohibits private health insurance plans from offering through the exchange a plan that includes abortion coverage to both subsidized and unsubsidized individuals.

Thus, if a plan wants to offer coverage in the exchange to both groups of individuals, it would have to offer two different plans: one with abortion coverage for women without subsidies and one without abortion coverage for women with subsidies. These private insurance plans would need to be identified as either providing or not providing coverage for abortion.

Health insurance plans are highly unlikely to operate in this manner, and it is not even clear that this is feasible under the administration of the exchange and affordability credits. As one alternative, the Stupak amendment purports to allow women to purchase a separate, single-service “abortion rider,” but abortion riders don’t exist. In the five states that only allow abortion coverage through a separate rider, there is no evidence that they are available.

Furthermore, women are unlikely to think ahead to choose a plan that includes abortion coverage, since they do not plan for unplanned pregnancy. In addition, it is not clear that health plans would even be allowed to offer two separate plans under other provisions of the act, such as the anti-discrimination and guaranteed-issue provisions. Those elements of the bill, which are very important to consumers, may make it impossible for plans to provide two separate plans, one that includes abortion and another that does not.

Realistically, the actual effect of the Stupak-Pitts amendment is to ban abortion coverage across the entire exchange, for women with both subsidized and unsubsidized coverage.

(emphasis mine)

Why the Stupak amendment? The argument is, as best I can tell, that those people who can't use all their own money to buy health insurance will be eligible for a government subsidy. This will probably be me at some point very soon (like after I graduate from school in May) so let's take me as an example. I could use the subsidy to buy a health insurance plan that covered abortion. Then I could use that money (along with my OWN!) to buy a private plan. Then, if I needed an abortion and that insurance plan covered it, the government would have somehow, indirectly, kinda sorta had a hand in making it possible for me to get a legal medical procedure.

Did I say legal medical procedure? I also meant abortion. They're the same thing, so sometimes I use them interchangeably.

We have had the Hyde amendment in place since 1977, exempting abortion from Medicaid. Poor women, expendable: check. Apparently health care reform is an opportunity to go even farther: to reach into PRIVATE health insurance, paid for with PRIVATE money, and effectively take abortion coverage out of that, too. This applies not just to individuals, but to businesses; companies that buy plans through the exchange? All their employees' families will lose any abortion coverage they had. All women, expendable: check.

The fact that this amendment comes from the party that has been ranting and railing about "government taking over health care" and using scare tactics like death panels and rationing of care...well, I guess irony has been dead to the Republican party for a long, long time, so we shouldn't be too surprised.

Besides women who need abortions, who else will this hurt? How about women who have miscarriages? Is maternity care next? Keep in mind, this comes from the same party that says health insurance shouldn't cover maternity care, because men don't need it.

This just...disgusts me. Last year I went to a talk by Dr. Nick Gorton and blogged about how he predicted this very outcome - that reproductive health care would be one of the issues to suffer when government stepped into health insurance. At the time, I mused about how we could protect abortion and other political hot button issues in health care reform - but reform seemed so theoretical. I guess I haven't been paying enough attention - but that's going to change. I agree, let's not just be satisfied with keeping Stupak out of the final bill - let's go after Hyde.

If you'd like to take further action now, this is a great place to start: While there's a wall of shame for Dems who voted for Stupak and against reform, there are some bright spots. Those are Democrats who voted AGAINST Stupak and FOR health care reform - despite being in highly vulnerable races next year. Click here to donate to those reps, reward their courage, help keep them in Congress, and send a message to the party: Do NOT allow the Stupak amendment into the final bill.