Maligning the Ultrasound

07 Feb 2013 Leave a Comment

by abortionfairy in Uncategorized Tags: , , , , , , ,

[note on language: I use "person who is pregnant" or "patient" as gender neutral terms. While most people who are pregnant and seeking abortion care identify as women, not all of them are. While most women have a uterus and can become pregnant, not all can.]

New year, new legislatures, new anti-choice legislation. Sounds about right. Already we have new states trying out heartbeat bans, 20 week bans, mandatory non-factual counselling, TRAP laws meant to close clinics, onerous laws on administration of medical abortions, longer and longer waiting periods, and, the old favorite, mandatory ultrasounds. These laws have been making it onto the books ever since Planned Parenthood v Casey, which granted states the right to regulate abortion as long as restrictions did not create “undue burden.” (While, individually, these laws might not be huge burdens, they add up, and leave persons who are pregnant, especially  persons of low-income, with abortion being legal, but out of reach).

While all of these laws are insidious and insulting, the ultrasound has become a favorite tool. The idea is that people who are pregnant (most often women) are stupid, and don’t know what pregnancy really is, and the second they see the ultrasound some sort of maternal hyperdrive will kick in and the patient will leap off the table and dash into the waiting arms of the so-called sidewalk counselors [read: harassing picketers].

The thing that is most insidious about the ultrasounds laws, currently being proposed in Arkansas, Tennessee, Kentucky, Michigan, and elsewhere, and in effect in Virginia, Texas, and others, not only that they are requiring one medical procedure, in order to allow access to another, but they couple this with requiring a person who is pregnant and seeking abortion care to see the ultrasound and hear a description of it. I know a lot of anti-choice people think that this will somehow make that person realize something or other and change their minds, but it won’t. Most people (over 60%) seeking abortion already gave birth at least once. They kinda know what pregnancy is, and what the potential end result could be, and they thought long and hard about their options before coming in.

However, a lot of the push-back against these atrocious laws is couched in saying that the state is forcing women to have an ultrasound, and often comparing it to rape. I agree that the state has no business telling doctors how to practice medicine. They aren’t doctors. They aren’t OB/GYNS.

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This unfortunately has resulted in a lot of confusion on behalf of the patients I assist. They ask if there will be an ultrasound, and I tell them yes. No matter what the law says. Because they medically need an ultrasound. There are several kinds of abortions, and each procedure requires that a patient be at a certain gestation. For example, the administration of mifeprex, the patient must be under 9 or 7 weeks, depending on if you are going by the evidence based regimen, or the FDA approved regimen. If a patient comes in and says they are unsure of their last period, an ultrasound is required to determine the gestational age and see if they would be able to have a medically induced abortion.

A patient might come in and have a history of fibroids. An ultrasound must be done to determine if the doctor would be able to work around them, or if the procedure must be completed in a hospital setting.

A patient who was on depo-provera, or mirena, or seasonel, and is regularly sexually active might come in and have no clue when she got pregnant as she does not have periods. An ultrasound would have to be done to determine if the provider at the clinic would even be able to see the patient, or if they are possibly too far along for the providers skill set.

There are many reasons that ultrasounds are part of routine abortion care. The push-back pro-choice pundits are giving to the ultrasound laws, however, make it appear that ultrasounds are never done and are evil. This means patients seeking abortion care come in and are immediately defensive about needing one. This means that patients coming and medically needing an ultrasound to be done are becoming distrustful of the providers telling them that it is necessary.

What is NOT necessary is the script that accompanies the ultrasound, the waiting period after it, the description of it. The ultrasound is meant to be a diagnostic tool of the provider to determine gestational age and use that information to provide the best method of abortion care to the patient. It is not meant to be used as a means of coercing a woman out of the abortion she wants, or attempt to make a woman feel shame or guilt for an abortion she needs.

The ultrasound is being misrepresented by anti-choice politicians, it is being used as a means of controlling the thoughts of a person who is pregnant and seeking abortion care. This is wrong. But the means in which the pro-choice pundits are pushing back against the ultrasound requirements is often problematic in that it is creating confusion on whether the ultrasound is something that is needed at all. It is. The ultrasound is needed by abortion providers to ensure the best continuity of care. The push-back should be against the counseling, the description, the wait time after the ultrasound and before the procedure. Can we stop maligning the ultrasound, and instead malign the trappings being placed around it?

The Return of the Back-Alley

05 Jul 2012 2 Comments

by abortionfairy in Uncategorized Tags: , , ,

I’ve had a few extremely rough calls these last few weeks. At abortion funds, every caller is in some sort of distress, usually always financial. Women call who are homeless, fleeing domestic violence, who have been raped, who are minors and know they are not capable of either telling their parents or raising a child without that support.

But with recent legislation being the way that it is, more and more women are seeing their choices taken away. Safe, professional clinics are having to close their doors because states are trying to tell them that their closets are too small. Safe, reliable abortion providers are being harassed both by domestic terrorists and by legislators. Right now the only remaining clinic in Mississippi is fighting to stay open, and several clinics in Pennsylvania are fighting against TRAP laws. Viriginia clinics won a small victory, but it the law deters any future clinics from opening.

What does this mean for the women who call abortion funds? It means they have to travel farther. It means they have to get hotel rooms as more and more states pass mandatory ultrasounds done 24 hours in advance. It means more money, when they already have none to begin with.

Unscrupulous doctors know this, and they know desperation can line their pockets. I have had three callers call the fund specifically to ask not for money, but to ask where can they get abortion pills on the internet? They asked for the phone number for the underground clinic. They asked: “How can I do this myself?”

Yes, abortion is legal. But for these women, it is out of reach. It is inaccessible. And that is exactly what the anti-choice lawmakers want. They know they cannot overtun Roe v. Wade. They know there would be dire political consequences if they actually achieved the criminalization of abortion. But they can still have their cake and eat it, too. They can make it inaccessible. In Mississippi they flat out said the goal of their ridiculous TRAP law was not to make abortion safer, to protect the women seeking abortion, their goal was to close the clinic and make abortion inaccessible in Mississippi. This is the return of the back-alley abortion. Women of means will be able to cross state lines, take time off work, arrange child care, and pay for their abortion with a check. Women with no means will seek out pills on the internet that may or may not work (and may even be poison), they will find doctors with little to no training who may end up killing them, or raping them, or destroying their health. They will find unsafe methods, wives tales, or rumors of a way on the internet.

One woman I spoke to broke down crying when I told her the nearest clinic was ten hours away. I informed her that there was another group who could help arrange travel, and yet another group that existed soley to provide lodgings. It didn’t matter. She couldn’t take that time off work. The call ended with her saying she would find another way. She didn’t mean she would go to a CPC and they would magically help her carry to term (cause they never do, the “help” stops the moment you are too far along for an abortion). She meant she was going to risk her life and her health. She was going to seek out a back-alley abortion, because legislators had systematically taken away all of the clinics she could have gone to in her area a few years ago. I keep hoping this woman calls us back.

And I continue to hope that other women in her situation will call us first, before they attempt to find other means of having an abortion. It doesn’t have to be like this. I’ll leave you with this oldie but goodie:

Full disclosure: I am a bit of a naturopath, and I take herbal supplements to treat my PCOS, and would probably first attempt an herbal abortion myself if I ever found myself unexpectedly pregnant at a bad time (a null point due to my PCOS). I would do so under the guidance of a herbal medicine practitioner, and would seek out a surgical aspiration abortion if the herbal abortion failed. This is my own preference. I have studied herbs, their effects and side effects for a long time as part of my own spiritual and religious education. I always, always, encourage the women with whom I speak to seek out a board certified medical practitioner at a licensed clinic for abortion care, and would never advocate that they treat their medical conditions the way I treat mine. I would never recommend to a woman who called the abortion fund that she attempt an herbal abortion, as they are only so reliable, and you have to have an in depth knowledge of not just the herbs, but your own body.

Self-Care Counseling Belongs With Financial Counseling

19 Jun 2012 Leave a Comment

by abortionfairy in Uncategorized

It is appalling the lenghts anyone has to go through to get quality medical care in thw United States if they are un- or under-insured.

This is most especially true if you are a woman, where you can expect to pay as much as 30% more for insurance just for checking the ‘female’ box. Women are less likely to be insured, and more likely to need an abortion then men.

So women are forced to make difficult calls to family and friends, asking for many. Many women just say it is for an unexpected bill, rather than share their personal information regarding their abortion. These calls are difficult. Often their family and friends are also economically disadvantaged, too. If the friend or family member knows what is going on, and is not supportive, the woman may receive a lecture instead of help.

Women have to gp through the few belongings they might have to figure out if there is anything they could pawn or sell. Often they sell valuable jewelry with significant sentimental value. Or they sell a laptop they were using for online classes, hoping it would lead to a job, or that they were using to look for a job. They might sell a television, which was the only source of entertainment their children had.

These decisions take a great toll on the women, who are already stressed out about feeding their family, getting by, and are heavily shamed for their decision.

There are several unique stressors that are impacting the womans mental health. 1. The societal shame the woman is told she should experience due to her decision. 2. The stress of having to get an extraordinary amount of money together in a short amount of time. 3. The fear of judgement, or  actual judgement. 4. The fear of others finding out. In addition to 5. The stress of her everyday life. If the woman is facing a pregnancy due to rape, incest, or abuse, her stress increases.

This is a time when a woman should be supported, above all else. This is where abortion funds can help out.

I always refer a patient to Exhale, and to Faith Aloud if she indicates she is a person of faith. But often women wait until after the abortion is over to address their stress.

A funding call can be extremely stressful for the woman. She is being asked to have uncomfortable conversations about money with family and friends. She is being asked to part with what few valuables she may have. She is being asked to do odd jobs, ask for an advance on her pay, and other wise go to great lengths to get as much money as she can. And she is being told to do this by someone who is on her side.

We need to incorporate first-responder counseling on self-love and self-care while on the phone with these women.

This can include just listening to them, affirming their feelings and validating their stress.

This can include giving them tools to help deal with this stress. Some tools I commonly suggest are going on walks while listening to uplifting music, reading a happy book, making a list of all the things she loves about herself, and ensuring she is getting enough sleep and food.

I often establish some sort of plan with the caller. Here are the things I often suggest are in that plan:

1.) Creating a schedule for coming up with funds that includes pre-planned breaks (ex: 10am-11pm Call Family Members, 11:00AM-11:30 take a hot bath to relax. 11:30-1:00 pm – search for things that can be sold or pawned). Also, the schedule should include meals, and at least 8 hours of sleep.

2.) Write letters to herself, her friends and family, and to the fetus if she chooses (I’ve heard callers refer to the fetus as their “spirit baby” or “water baby” and it helps them to write a letter directly to it if they feel they need forgiveness). Write a letter explaining why they are doing what they are doing, how they feel about it, and their thoughts and feelings about it. Because of the stigma that anti-choice forces on abortion, many women feel like they should be ashamed, but aren’t ashamed, and then feel guilty because they aren’t ashamed. These women often write letters reflecting this lack of shame, and reflect on that.

3.) Find time to do some exercises or stretches. Exercising and stretching releases happy chemicals, and that can make you think clearer. Going for a brisk walk, a jog, or doing some simple stretches in the living room, or in a park, can release tension.

4.) Talk with a friend or family member who is 100% supportive. If there are no friends or family members the caller feels comfortable confiding in, make sure the caller has the numbers for Faith Aloud, Connect & Breathe, Exhale, Backline, and other talk lines specific to their situation (ex: RAINN). NAMI talkline is a good one, too, to refer them to for general mental wellbeing.

 

Share your tips in the comments!

The Trap

09 Jun 2012 Leave a Comment

by abortionfairy in Uncategorized Tags: , ,

Many women choose to have an abortion because they realize they do not have the time, resources, or support to raise a child at the time. They are women who know what is available, and often have a deep respect for parenthood, and make the informed decision that they don’t have the capacity at the time to be a parent.

No amount of free diapers will change that. And as for adoption, for some women is is not an option, it is something they know they would regret. Women do regret placing a child for adoption. (That doesn’t mean there aren’t some awesome adoption people out there, looking at you Adoption Access Network.)

So, society has set a trap for these women.

Low-income women know they cannot afford a child. But they also cannot afford an abortion. Women who cannot come up with the money in time for an abortion end up having the child they cannot support, and many of them do not place for adoption. They lose their job, even though there are laws prohibiting the firing of an employee based on pregnancy, if she lives in an at-will state, they can find any other reason under the sun. Suddenly, she is without the small income she had, and she is unable to afford prenatal care, or labor and delivery. She is unable to afford nutritional food required for a healthy pregnancy. She gives birth to an underweight baby, and suddenly finds her every decision criticized.

If she managed to keep her job, she now has to weigh the cost of child care against how much money she will be making at work. If she wasn’t able to keep her job, she now has to try to find one while taking care of a child.  Other mothers will criticize her if she goes back to work, which she must do in order to feed her child, telling her she is being a bad mother. If she doesn’t go back to work, she is called a “welfare queen” and is blamed for the bad economy. She can’t win either way. No matter what, society will scorn her, rather than help her.

People will question her ability to be responsible, attempt to pry into her sex life, and often tell her she just shouldn’t have one. They will either pity the child (but do nothing to help him/her), or watch it with a leery eye, already assuming it will grow up to be a criminal.

Many times, the same protesters you see outside the clinics passing out pamphlet with the phone numbers of places that can “help” are the same people you see wanting to take away free and reduced lunch programs, the same people you see protesting against any sort of government program that might help this woman and her child. Inside crisis pregnancy centers, “counselors” tell these young women that they can get on medicaid, that they can get WIC, that they can get housing assistance and that these programs will help her and her future child. Then they go to the polls on election day and vote for politicians who promise to get rid of these very same programs.

I am totally cool with providing material support to women who choose to give birth, despite economic barriers. No woman who wants a child should be told she shouldn’t have one because of her economic circumstances. No woman should feel pressured to have an abortion because she is afraid society will mock and scorn her for her desire to be a mother, despite being single, low-income, or a woman of color. But crisis pregnancy centers offer the material support as a way of coercion, and as a way of stripping that woman of her right to choose.

So this is the trap society sets for the women who find themselves pregnant and impoverished. In order to over come this trap we must not just work for abortion access, but for birth justice, economic justice, racial justice, and for broader access to education.

Women Are Their Own Saviors.

09 Jun 2012 1 Comment

by abortionfairy in Uncategorized Tags: ,

I am one of many young feminists (we exist!) who cares deeply about women’s right to choose. Much of my time is devoted to answering phone calls from low-income women looking for honest, accurate, non-judgemental information about abortion care, information about the nearest clinic, and, the most pressing question, how to pay for it.

The Hyde Amendment restricts funding at the federal level for abortion. This means that anyone employed by the federal government does not have abortion covered on their insurance. This means that any woman in the military does not have access to abortion in her military insurance while on active duty, nor through veterans affairs after she comes back. This means that women who rely on the Indian Health Services are not able to have their abortion covered. This means that women who rely on medicaid will probably not have access to abortion (a few select states allow for elective abortions to be covered with state dollars, as medicaid is a federal-state program.) Aside from the Hyde Amendment, many private insurances also do not cover abortion.

So, that is where myself and many, many other women, organizations, networks, and generous individuals come into play. Abortion funds exist to help these women. A woman’s access to abortion should never rely solely on her ability to pay; the freedom to choose is meaningless if only the rich and wealthy have access to the full range of reproductive services.

I answer the phones all day. Most calls are 10 to 15 minutes. The first two are spent getting basic details (“Have you talked to a clinic? Made an appointment? How far along are you?), and then the rest is spent brainstorming how she might get money together, and finally, letting her know how much the organization can help her with.

No fund can ever cover the entire cost. And most women will still have to get the money together to drive to the clinic (most women travel 2 or more hours), find child care (60% of women getting an abortion already have at least one child), take the hit in their paycheck for the two days of work they will be missing (as many states now require 24 – 72 hours between the ultrasound, and the abortion, meaning two trips, or a hotel stay), and other expenses incurred from incidentals.

Each call requires that I pry some into the woman’s life, and sometimes that is uncomfortable for both myself and the woman. I have to ask some really personal questions, the answers to which not every woman wants to share. Some women are angry that the process is so difficult, that they have to take two trips, that they have to listen to medically inaccurate propaganda mandated by the state (hey, South Dakota). Having to share their story, again, on the phone, to an abortion fund is just one more time they have to share personal information.

By the end of the call, though, when she knows that the women at the organization are on her side, that we are helping her, and that she will be getting the abortion she needs, the anger is often replaced by relief. I often get told that I am a guardian angel, or a god-send, a life-saver, or that I am doing god’s work. The women that I work with, however, are the actual hero’s, and it’s a privilege to have talked to them. They are their own hero’s, they are the ones doing the brunt of the work, while dealing with everything else going on in their life. They are the ones collecting the money for the majority of the cost, and making all the arrangements mentioned above, while dealing with other on-going personal problems.  The monetary assistance empowers them to be able to make the decision they know is right for them. But they are the ones who empower themselves, and save themselves.

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