Extra Abortion Limitation for Native Americans Only

Mike Lillis

The Senate last week approved an amendment to an Indian health care bill that would permanently prohibit the use of federal dollars to fund abortions for Native Americans except in rare cases. The move has prompted an outcry from women’s health advocates and from tribal groups.

Following scant debate, the Senate last week approved an amendment to an Indian health care bill that would permanently prohibit the use of federal dollars to fund abortions for Native Americans except in rare cases. The move has prompted an outcry from women’s health advocates—who point out that a similar ban has existed on a temporary basis for years—and from tribal groups, who are asking why Native American women should be subject to restrictions not applicable to other ethnic groups. Some charge that the Senate proposal is overtly racist.

The issue is a sensitive one in American Indian communities, where women are statistically more likely to be victims of rape or sexual assault than other American women—but also where victims very rarely use the exceptions to the current federally funded abortion ban in the wake of those crimes. In the face of that discrepancy, advocates say, Congress should encourage victims to take advantage of the available services, not impose tighter restrictions.

The debate pits anti-abortion lawmakers on both sides of the aisle against health-care advocates who fear the latest move could set the stage for broader abortion prohibitions under federal programs outside the realm of Indian health services. In addition, there is the intrigue of scandal, for the sponsor of the controversial amendment, Sen. David Vitter (R-La.), made headlines last year for his earlier entanglement in a prostitution ring. Several abortion-rights sources suggested that Vitter—who built his political career on family-values issues—is trying to bolster his conservative credentials in the wake of that embarrassment.

The controversy swirls around a federal law—known as the Hyde amendment—that prohibits abortion coverage under Medicaid, Medicare and Indian Health Service programs. While the Hyde law must be renewed by Congress each year, the Vitter amendment—which the Senate approved on Feb. 26—would apply Hyde’s restrictions permanently to IHS beneficiaries. For that reason, tribal health advocates charge that the Vitter language treads on the sovereignty of Indian communities and places unique constraints on native women.

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"It’s a very racist amendment," said Charon Asetoyer, executive director of the Native American Women’s Health Education Resource Center, "[because] it puts another layer of restrictions on the only race of people whose health care is governed primarily by the federal government. All women are subject to the Hyde amendment, so why would they put another set of conditions on us?"

Vitter’s office did not return several calls and e-mails requesting comment.

A number of women’s health groups have criticized the Vitter amendment as well, claiming it will have no practical effect on women’s health services.

"Apart from being bad public health policy," Planned Parenthood said in a statement, "this language is duplicative of current law and serves only to politicize important legislation regarding comprehensive health care for Native Americans."

Though the Hyde amendment—named for its sponsor, the late Illinois Rep. Henry Hyde (R)—first took effect in 1977, Congress must reapply it annually through the appropriations process. That, according to Vitter, puts the Hyde language "in a tenuous and precarious posture. It puts it up for debate and possible change of policy every year, every time we debate a new Health and Human Services appropriations bill. Therefore, it doesn’t make the policy very solid, very secure, or very clear.

"Vitter’s amendment, attached last week to the Indian Health Care Improvement Act, would eliminate that uncertainty by codifying the Hyde amendment as a matter of authorization, not appropriation. "I suggest that would be a positive statement for life, for positive values for the future," he said on the Senate floor Jan. 22—the same day that thousands of anti-abortion marchers descended on Washington. A month later, the Senate approved Vitter’s amendment by a vote of 52 to 42.

But critics say the creation of a second law governing IHS-funded abortion services might confuse the issue if inconsistencies are found between the two mandates. Indeed, certain elements of Vitter’s amendment stray from the Hyde language. For example, while Hyde allows federally funded abortions for victims of incest at any age, Vitter specifies that the incest exception pertains only to minors.

Marlene Fried, a founding board member of the National Network of Abortion Funds, said the practical implications of that difference would be minimal. Still, she added, the change is significant as "another way of narrowing the [Hyde] exceptions."

The issue is especially charged because Native American women are more than three times as likely to suffer rape and sexual abuse as other women in the United States. Yet despite that statistic, only 25 abortions were performed at all IHS facilities between 1981 and 2001, according to figures gathered from the IHS by the Native American Women’s Health Education Resource Center. (An IHS spokeswoman declined to release more recent IHS-funded abortion figures, suggesting that a reporter file a Freedom Of Information Act request.)

But, advocates say, Indian women continue to have the procedure off the reservation. "Native American women have abortions," Asetoyer said, "and anyone who tells you differently is out of touch with their community."

Susan Cohen, the director of government affairs at the Guttmacher Institute, a nonprofit reproductive health research group, said the Hyde restrictions don’t prevent abortions, but they can delay them as low-income women are forced to save the money to fund the procedures out-of-pocket. That delay, Cohen added, can lead to dangerous complications. "Having later abortions is in no one’s best interest," she said.

Meanwhile, some tribal advocates are concerned that the Vitter amendment might carry additional political significance, as the Senate bill now moves to the House for consideration. Several sources said the controversial amendment is potentially a poison pill for the overall bill, for House Democratic leaders have been loathe to codify the Hyde amendment.

Not that the issue is entirely partisan. A number of Democratic lawmakers voted to approve the Vitter provision last week, including Sens. Ken Salazar (Col.), Evan Bayh (Ind.), Robert Byrd (W.Va.), Robert Casey (Pa.), Tim Johnson (S.D.), Mary Landrieu (La.), Ben Nelson (Neb.), Mark Pryor (Ark.) and Majority Leader Harry Reid (Nev.). Of that group, Landrieu and Johnson are up for reelection this year in relative conservative states, with Landrieu facing a tight race.

Three Republicans—Sens. Susan Collins (Me.), Olympia Snowe (Me.) and Arlen Specter (Pa.)—voted against the amendment. All three have historic records of bucking their party on the abortion issue.

Vitter, for his part, voted against the final IHCIA bill on the same day that his amendment passed. The final bill was approved, however, by a count of 83 to 10.

News Law and Policy

Anti-Choice Group: End Clinic ‘Bubble Zones’ for Chicago Abortion Patients

Michelle D. Anderson

Chicago officials in October 2009 passed the "bubble zone" ordinance with nearly two-thirds of the city aldermen in support.

An anti-choice group has announced plans to file a lawsuit and launch a public protest over Chicago’s nearly seven-year-old “bubble zone” ordinance for patients seeking care at local abortion clinics.

The Pro-Life Action League, an anti-choice group based in Chicago, announced on its website that its lawyers at the Thomas More Society would file the lawsuit this week.

City officials in October 2009 passed the ordinance with nearly two-thirds of the city aldermen in support. The law makes it illegal to come within eight feet of someone walking toward an abortion clinic once that person is within 50 feet of the entrance, if the person did not give their consent.

Those found violating the ordinance could be fined up to $500.

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Harassment of people seeking abortion care has been well documented. A 2013 survey from the National Abortion Federation found that 92 percent of providers had a patient entering their facility express personal safety concerns.

The ordinance targets people seeking to pass a leaflet or handbill or engaging in “oral protest, education, or counseling with such other person in the public way.” The regulation bans the use of force, threat of force and physical obstruction to intentionally injure, intimidate or interfere any person entering or leaving any hospital, medical clinic or health-care facility.

The Pro-Life Action League lamented on its website that the law makes it difficult for anti-choice sidewalk counselors “to reach abortion-bound mothers.” The group suggested that lawmakers created the ordinance to create confusion and that police have repeatedly violated counselors’ First Amendment rights.

“Chicago police have been misapplying it from Day One, and it’s caused endless problems for our faithful sidewalk counselors,” the group said.

The League said it would protest and hold a press conference outside of the Planned Parenthood clinic in the city’s Old Town neighborhood.

Julie Lynn, a Planned Parenthood of Illinois spokesperson, told Rewire in an email that the health-care provider is preparing for the protest.

“We plan to have volunteer escorts at the health center to make sure all patients have safe access to the entrance,” Lynn said.

The anti-choice group has suggested that its lawsuit would be successful because of a 2014 U.S. Supreme Court decision that ruled a similar law in Massachusetts unconstitutional.

Pam Sutherland, vice president of public policy and education for Planned Parenthood of Illinois, told the Chicago Tribune back then that the health-care provider expected the city’s bubble zone to be challenged following the 2014 decision.

But in an effort to avoid legal challenges, Chicago city officials had based its bubble zone law on a Colorado law that created an eight-foot no-approach zone within 100 feet of all health-care facilities, according to the Tribune. Sidewalk counselor Leila Hill and others challenged that Colorado law, but the U.S. Supreme Court upheld it in 2000.

Culture & Conversation Media

Filmmaker Tracy Droz Tragos Centers Abortion Stories in New Documentary

Renee Bracey Sherman

The film arrives at a time when personal stories are center stage in the national conversation about abortion, including in the most recent Supreme Court decision, and rightly so. The people who actually have and provide abortions should be driving the narrative, not misinformation and political rhetoric.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

A new film by producer and director Tracy Droz Tragos, Abortion: Stories Women Tell, profiles several Missouri residents who are forced to drive across the Mississippi River into Illinois for abortion care.

The 93-minute film features interviews with over 20 women who have had or are having abortions, most of whom are Missouri residents traveling to the Hope Clinic in Granite City, Illinois, which is located about 15 minutes from downtown St. Louis.

Like Mississippi, North Dakota, South Dakota, and Wyoming, Missouri has only one abortion clinic in the entire state.

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The women share their experiences, painting a more nuanced picture that shows why one in three women of reproductive age often seek abortion care in the United States.

The film arrives at a time when personal stories are center stage in the national conversation about abortion, including in the most recent U.S. Supreme Court decision, and rightly so. The people who actually have and provide abortions should be driving the narrative, not misinformation and political rhetoric. But while I commend recent efforts by filmmakers like Droz Tragos and others to center abortion stories in their projects, these creators still have far to go when it comes to presenting a truly diverse cadre of storytellers if they really want to shift the conversation around abortion and break down reproductive stigma.

In the wake of Texas’ omnibus anti-abortion law, which was at the heart of the Whole Woman’s Health v. Hellerstedt Supreme Court case, Droz Tragos, a Missouri native, said in a press statement she felt compelled to document how her home state has been eroding access to reproductive health care. In total, Droz Tragos interviewed 81 people with a spectrum of experiences to show viewers a fuller picture of the barriersincluding legislation and stigmathat affect people seeking abortion care.

Similar to HBO documentaries about abortion that have come before it—including 12th & Delaware and Abortion: Desperate ChoicesAbortion: Stories Women Tell involves short interviews with women who are having and have had abortions, conversations with the staff of the Hope Clinic about why they do the work they do, interviews with local anti-choice organizers, and footage of anti-choice protesters shouting at patients, along with beautiful shots of the Midwest landscape and the Mississippi River as patients make road trips to appointments. There are scenes of clinic escorts holding their ground as anti-choice protesters yell Bible passages and obscenities at them. One older clinic escort carries a copy of Living in the Crosshairs as a protester follows her to her car, shouting. The escort later shares her abortion story.

One of the main storytellers, Amie, is a white 30-year-old divorced mother of two living in Boonville, Missouri. She travels over 100 miles each way to the Hope Clinic, and the film chronicles her experience in getting an abortion and follow-up care. Almost two-thirds of people seeking abortions, like Amie, are already a parent. Amie says that the economic challenges of raising her other children make continuing the pregnancy nearly impossible. She describes being physically unable to carry a baby and work her 70 to 90 hours a week. Like many of the storytellers in the film, Amie talks about the internalized stigma she’s feeling, the lack of support she has from loved ones, and the fear of family members finding out. She’s resilient and determined; a powerful voice.

The film also follows Kathy, an anti-choice activist from Bloomfield, Missouri, who says she was “almost aborted,” and that she found her calling in the anti-choice movement when she noticed “Anne” in the middle of the name “Planned Parenthood.” Anne is Kathy’s middle name.

“OK Lord, are you telling me that I need to get in the middle of this?” she recalls thinking.

The filmmakers interview the staff of the Hope Clinic, including Dr. Erin King, a pregnant abortion provider who moved from Chicago to Granite City to provide care and who deals with the all-too-common protesting of her home and workplace. They speak to Barb, a talkative nurse who had an abortion 40 years earlier because her nursing school wouldn’t have let her finish her degree while she was pregnant. And Chi Chi, a security guard at the Hope Clinic who is shown talking back to the protesters judging patients as they walk into the clinic, also shares her abortion story later in the film. These stories remind us that people who have abortions are on the frontlines of this work, fighting to defend access to care.

To address the full spectrum of pregnancy experiences, the film also features the stories of a few who, for various reasons, placed their children for adoption or continued to parent. While the filmmakers interview Alexis, a pregnant Black high school student whose mother died when she was 8 years old, classmates can be heard in the distance tormenting her, asking if she’s on the MTV reality show 16 and Pregnant. She’s visibly distraught and crying, illustrating the “damned if you do, damned if you don’t” conundrum women of color experiencing unintended pregnancy often face.

Te’Aundra, another young Black woman, shares her story of becoming pregnant just as she received a college basketball scholarship. She was forced to turn down the scholarship and sought an adoption, but the adoption agency refused to help her since the child’s father wouldn’t agree to it. She says she would have had an abortion if she could start over again.

While anti-choice rhetoric has conflated adoption as the automatic abortion alternative, research has shown that most seeking adoption are personally debating between adoption and parenting. This is illustrated in Janet’s story, a woman with a drug addiction who was raising one child with her partner, but wasn’t able to raise a second, so she sought an adoption. These stories are examples of the many societal systems failing those who choose adoption or students raising families, in addition to those fighting barriers to abortion access.

At times, the film feels repetitive and disjointed, but the stories are powerful. The range of experiences and reasons for having an abortion (or seeking adoption) bring to life the data points too often ignored by politicians and the media: everything from economic instability and fetal health, to domestic violence and desire to finish an education. The majority of abortion stories featured were shared by those who already had children. Their stories had a recurring theme of loneliness and lack of support from their loved ones and friends at a time when they needed it. Research has shown that 66 percent of people who have abortions tend to only tell 1.24 people about their experience, leaving them keeping a secret for fear of judgment and shame.

While many cite financial issues when paying for abortions or as the reason for not continuing the pregnancy, the film doesn’t go in depth about how the patients come to pay for their abortions—which is something my employer, the National Network for Abortion Funds (NNAF), directly addresses—or the systemic issues that created their financial situations.

However, it brings to light the hypocrisy of our nation, where the invisible hand of our society’s lack of respect for pregnant people and working parents can force people to make pregnancy decisions based on economic situations rather than a desire to be pregnant or parent.

“I’m not just doing this for me” is a common phrase when citing having an abortion for existing or future children.

Overall, the film is moving simply because abortion stories are moving, especially for audiences who don’t have the opportunity to have someone share their abortion story with them personally. I have been sharing my abortion story for five years and hearing someone share their story with me always feels like a gift. I heard parts of my own story in those shared; however, I felt underrepresented in this film that took place partly in my home state of Illinois. While people of color are present in the film in different capacities, a racial analysis around the issues covered in the film is non-existent.

Race is a huge factor when it comes to access to contraception and reproductive health care; over 60 percent of people who have abortions are people of color. Yet, it took 40 minutes for a person of color to share an abortion story. It seemed that five people of color’s abortion stories were shown out of the over 20 stories, but without actual demographic data, I cannot confirm how all the film’s storytellers identify racially. (HBO was not able to provide the demographic data of the storytellers featured in the film by press time.)

It’s true that racism mixed with sexism and abortion stigma make it more difficult for people of color to speak openly about their abortion stories, but continued lack of visual representation perpetuates that cycle. At a time when abortion storytellers themselves, like those of NNAF’s We Testify program, are trying to make more visible a multitude of identities based on race, sexuality, immigration status, ability, and economic status, it’s difficult to give a ringing endorsement of a film that minimizes our stories and relegates us to the second half of a film, or in the cases of some of these identities, nowhere at all. When will we become the central characters that reality and data show that we are?

In July, at the progressive conference Netroots Nation, the film was screened followed by an all-white panel discussion. I remember feeling frustrated at the time, both because of the lack of people of color on the panel and because I had planned on seeing the film before learning about a march led by activists from Hands Up United and the Organization for Black Struggle. There was a moment in which I felt like I had to choose between my Blackness and my abortion experience. I chose my Black womanhood and marched with local activists, who under the Black Lives Matter banner have centered intersectionality. My hope is that soon I won’t have to make these decisions in the fight for abortion rights; a fight where people of color are the backbone whether we’re featured prominently in films or not.

The film highlights the violent rhetoric anti-choice protesters use to demean those seeking abortions, but doesn’t dissect the deeply racist and abhorrent comments, often hurled at patients of color by older white protesters. These racist and sexist comments are what fuel much of the stigma that allows discriminatory laws, such as those banning so-called race- and sex-selective abortions, to flourish.

As I finished the documentary, I remembered a quote Chelsea, a white Christian woman who chose an abortion when her baby’s skull stopped developing above the eyes, said: “Knowing you’re not alone is the most important thing.”

In her case, her pastor supported her and her husband’s decision and prayed over them at the church. She seemed at peace with her decision to seek abortion because she had the support system she desired. Perhaps upon seeing the film, some will realize that all pregnancy decisions can be quite isolating and lonely, and we should show each other a bit more compassion when making them.

My hope is that the film reaches others who’ve had abortions and reminds them that they aren’t alone, whether they see themselves truly represented or not. That we who choose abortion are normal, loved, and supported. And that’s the main point of the film, isn’t it?

Abortion: Stories Women Tell is available in theaters in select cities and will be available on HBO in 2017.

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