Can Pro-Choice People Support the Pregnant Women Support Act?

Cristina Page

Neutralizing income as a determining factor for what a woman does in her reproductive life is reproductive justice. Much of the Pregnant Women Support Act is a means to that end. But the bill would also prop up crisis pregnancy centers.

On the 36th anniversary of Roe v Wade, Senator Bob Casey, who
opposes legal abortion, introduced what he described as a common ground
bill: The Pregnant Women Support Act. He explained, "I
believe there is more common ground in America than we might realize.
If only we focus on how we can truly help and support women who wish to
carry their pregnancies to term and how we can give them and their
babies what they really need to begin healthy and productive lives
together."

Pro-choice people, like myself, get a little defensive over
proposals such as this, and the righteous rhetoric that accompanies
them. This legislation proposes to provide support to low-income women
who want to bring a pregnancy to term. Pro-choice elected officials
have proposed providing more support to low-income women and families
for years. But let’s put aside pride of authorship for the time being.
In the new age of conciliation we might file away such grievances in
the hopes that having the anti-choice side think it was their idea
might help get it done. That’s not to say that the Pregnant Woman Support Act is perfect — it’s not.  (It fails to mention family planning.  Planning a pregnancy is step one to having a healthy one.  And how can any proposal aimed at reducing abortion be taken seriously without including contraception?)  But it
does do a lot of great things and there are solutions for the areas
that are problematic. First let’s review its attributes:

The Pregnant Women Support Act is inspired by the belief that if
women facing unintended pregnancy are provided substantive help they
might continue, rather than terminate, a pregnancy. Two-thirds of all
women seeking abortion care report it’s because they cannot afford to
have a child. Perhaps choosing abortion because one can’t afford to
have a child is not the best choice for her.  In a perfect pro-choice
world, parenting, abortion and adoption would be equally available
options, and, importantly, none would be stigmatized. Neutralizing
income as a determining factor for what a woman does in her
reproductive life is reproductive justice. Much of the Pregnant Women
Support Act is a means to that end. For example it would provide
financial, medical, educational assistance, insurance coverage for
those in need who ordinarily would not qualify for it. A woman can get
nurse home visits, counseling, shelter, help with child care,
assistance to help her stay in school, and a lot of other services that
may broaden her choices. That’s all good.

Here’s where the problem starts for pro-choice people. The bill would:

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"Create
a new pilot program for "Life Support Centers" to offer comprehensive
and supportive services for pregnant women, mothers, and children."

Life Support Centers appears to be a way, among other things, to
funnel money into crisis pregnancy centers. These have been a ruse of
pro-life activists. They are billed as places a pregnant woman can
visit  to consider all her options. But they mislead women about the
options available to them, offering up inaccurate information intended
to scare women about abortion. Misleading women is not something
pro-choice organizations or elected officials will be able to support
(nor should any self-respecting pro-lifer). Removal of the section
should be fought for vigorously.

Or alternatively, find a way to legislate out its heavy-handed
agenda. If the ideological, coercive and misleading tactics that are
the signature of crisis pregnancy centers were prohibited, there could
be a limited but legitimate role for these centers to play in the
delivery of support services. But an affirmative and explicit
disclaimer should be issued right up front.  The Pregnant Women Support
Act would be a good place to begin to insist that crisis pregnancy
centers act in a responsible way. Make  "Life Support Centers" stick to
medical facts rather than ideology.  There ought to be a "no
propaganda" agreement right up front in every common ground campaign.
Anti-abortion activists have, in several states, succeeded in passing
legislation mandating that ideological, medically inaccurate scripts be
read to patients who seek abortions services. Mandating that ideology
and inaccuracy be inserted into a medical environment, as the
anti-abortion movement has done, is ethically troublesome. But what if,
instead, the law mandated that medical and scientific accuracy be
required of ideological organizations masquerading as health centers?
An amendment to the Pregnant Women Support Act could propose that every
"Life Support Center" receiving federal funds be required to provide
medically accurate information to all it counsels and also disclose
that its mission is to convince women not to have an abortion.
Providing accurate information should be a common ground goal and
anti-abortion organizations should have no problem admitting that
convincing women not to choose abortion is their intent. Each center
would be required to read a script that include information like this:

"This is not a medical facility. There are no medical personnel on
staff. The staff of this facility is unable to diagnose complications
of pregnancy or fetal anomalies (birth defects). This facility is
staffed by people who are opposed to abortion and contraception.
Medical research shows that women who have an abortion are at no
greater risk of breast cancer, miscarriage in future pregnancies,
mental distress or any other mental or physical disorder than women who
have never had an abortion. Ultrasound images may exaggerate the size
of the embryo/fetus."  Etc.

Sprinkled throughout the Pregnant Women Support Act is the term
"counseling."  The "no propaganda" rule should apply in every instance
a woman receives counseling. (To pre-emptively address a point that
will be made by opponents of abortion: no, medically, scientifically
accepted, peer-reviewed evidence does not fall under the category of
propaganda.)

Another area of concern is that the bill proposes to promote
adoption as an alternative to abortion. There is no doubt that the
adoption industry has changed dramatically in the last forty years, in
great part because of legal abortion. Many Americans, including women
confronting unwanted pregnancy, are not aware that the adoption choice
now offers many avenues, including open adoption. There is a real need
to update Americans’ understanding of adoption as an option for
unwanted pregnancy. But, it should not be in the context of disparaging
other choices. As the book, The Girls Who Went Away,
and even recent discussions on Rewire reveal, adoption is
typically a difficult choice and many women suffer immensely by being
pressured into that option. For some women abortion is the wrong choice
and for some women adoption is the wrong choice. There is great need
for education about adoption, there’s no need to present it as an
alternative to abortion or parenting. A woman, if given comprehensive
and accurate information about all of her choices, is her own best
moral agent.

The last sticking point for pro-choice people with the bill is that
it seeks to codify the regulation that extends coverage under the State
Children’s Health Insurance Program (SCHIP) to both low-income pregnant
women and unborn children. As long as pregnant women are extended
prenatal care coverage through Medicaid, this is a superfluous section
and a back-door attempt to create independent rights in law for a
fetus. This section would not prevent one abortion or make it any
easier for women to bring a pregnancy to term. It defies the
"common-ground" spirit the bill was intended to cultivate. Keeping it
in the bill could only be interpreted as a cynical attempt to co-opt
"common ground" for anti-choice purposes.

With these important changes, none of which jeopardize the true
intent of the bill, we should be prepared, for the moment, to take
Senator Casey at his word when he says he wants a common ground
approach. Senator Casey stated, "I
introduce this bill with the deepest conviction that we can find common
ground. I believe that we can transform this debate by focusing upon
the issues that unite us, not the issues that divide us."
If that is true, and these slight changes are made to the bill,
pro-choice people are a more likely constituency of support. But if
these proposals remain, common ground will not be achieved and pregnant
women won’t get the support they deserve.

News Human Rights

What’s Driving Women’s Skyrocketing Incarceration Rates?

Michelle D. Anderson

Eighty-two percent of the women in jails nationwide find themselves there for nonviolent offenses, including property, drug, and public order offenses.

Local court and law enforcement systems in small counties throughout the United States are increasingly using jails to warehouse underserved Black and Latina women.

The Vera Institute of Justice, a national policy and research organization, and the John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge initiative, released a study last week showing that the number of women in jails based in communities with 250,000 residents or fewer in 2014 had grown 31-fold since 1970, when most county jails lacked a single woman resident.

By comparison, the number of women in jails nationwide had jumped 14-fold since 1970. Historically, jails were designed to hold people not yet convicted of a crime or people serving terms of one year or less, but they are increasingly housing poor women who can’t afford bail.

Eighty-two percent of the women in jails nationwide find themselves there for nonviolent offenses, including property, drug, and public order offenses.

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Overlooked: Women and Jails in an Era of Reform,” calls attention to jail incarceration rates for women in small counties, where rates increased from 79 per 100,000 women to 140 per 100,000 women, compared to large counties, where rates dropped from 76 to 71 per 100,000 women.

The near 50-page report further highlights that families of color, who are already disproportionately affected by economic injustice, poor access to health care, and lack of access to affordable housing, were most negatively affected by the epidemic.

An overwhelming percentage of women in jail, the study showed, were more likely to be survivors of violence and trauma, and have alarming rates of mental illness and substance use problems.

“Overlooked” concluded that jails should be used a last resort to manage women deemed dangerous to others or considered a flight risk.

Elizabeth Swavola, a co-author of “Overlooked” and a senior program associate at the Vera Institute, told Rewire that smaller regions tend to lack resources to address underlying societal factors that often lead women into the jail system.

County officials often draft budgets mainly dedicated to running local jails and law enforcement and can’t or don’t allocate funds for behavioral, employment, and educational programs that could strengthen underserved women and their families.

“Smaller counties become dependent on the jail to deal with the issues,” Swavola said, adding that current trends among women deserves far more inquiry than it has received.

Fred Patrick, director of the Center on Sentencing and Corrections at the Vera Institute, said in “Overlooked” that the study underscored the need for more data that could contribute to “evidence-based analysis and policymaking.”

“Overlooked” relies on several studies and reports, including a previous Vera Institute study on jail misuse, FBI statistics, and Rewire’s investigation on incarcerated women, which examined addiction, parental rights, and reproductive issues.

“Overlooked” authors highlight the “unique” challenges and disadvantages women face in jails.

Women-specific issues include strained access to menstrual hygiene products, abortion care, and contraceptive care, postpartum separation, and shackling, which can harm the pregnant person and fetus by applying “dangerous levels of pressure, and restriction of circulation and fetal movement.”

And while women are more likely to fare better in pre-trail proceedings and receive low bail amounts, the study authors said they are more likely to leave the jail system in worse condition because they are more economically disadvantaged.

The report noted that 60 percent of women housed in jails lacked full-time employment prior to their arrest compared to 40 percent of men. Nearly half of all single Black and Latina women have zero or negative net wealth, “Overlooked” authors said.

This means that costs associated with their arrest and release—such as nonrefundable fees charged by bail bond companies and electronic monitoring fees incurred by women released on pretrial supervision—coupled with cash bail, can devastate women and their families, trapping them in jail or even leading them back to correctional institutions following their release.

For example, the authors noted that 36 percent of women detained in a pretrial unit in Massachusetts in 2012 were there because they could not afford bail amounts of less than $500.

The “Overlooked” report highlighted that women in jails are more likely to be mothers, usually leading single-parent households and ultimately facing serious threats to their parental rights.

“That stress affects the entire family and community,” Swavola said.

Citing a Corrections Today study focused on Cook County, Illinois, the authors said incarcerated women with children in foster care were less likely to be reunited with their children than non-incarcerated women with children in foster care.

The sexual abuse and mental health issues faced by women in jails often contribute to further trauma, the authors noted, because women are subjected to body searches and supervision from male prison employees.

“Their experience hurts their prospects of recovering from that,” Swavola said.

And the way survivors might respond to perceived sexual threats—by fighting or attempting to escape—can lead to punishment, especially when jail leaders cannot detect or properly respond to trauma, Swavola and her peers said.

The authors recommend jurisdictions develop gender-responsive policies and other solutions that can help keep women out of jails.

In New York City, police take people arrested for certain non-felony offenses to a precinct, where they receive a desk appearance ticket, or DAT, along with instructions “to appear in court at a later date rather than remaining in custody.”

Andrea James, founder of Families for Justice As Healing and a leader within the National Council For Incarcerated and Formerly Incarcerated Women and Girls, said in an interview with Rewire that solutions must go beyond allowing women to escape police custody and return home to communities that are often fragmented, unhealthy, and dangerous.

Underserved women, James said, need access to healing, transformative environments. She cited as an example the Brookview House, which helps women overcome addiction, untreated trauma, and homelessness.

James, who has advocated against the criminalization of drug use and prostitution, as well as the injustices faced by those in poverty, said the problem of jail misuse could benefit from the insight of real experts on the issue: women and girls who have been incarcerated.

These women and youth, she said, could help researchers better understand the “experiences that brought them to the bunk.”

News Health Systems

The Crackdown on L.A.’s Fake Clinics Is Working

Nicole Knight

"Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options," Feuer said. "And therefore every day is a day that a woman's health could be jeopardized."

Three Los Angeles area fake clinics, which were warned last month they were breaking a new state reproductive transparency law, are now in compliance, the city attorney announced Thursday.

Los Angeles City Attorney Mike Feuer said in a press briefing that two of the fake clinics, also known as crisis pregnancy centers, began complying with the law after his office issued notices of violation last month. But it wasn’t until this week, when Feuer’s office threatened court action against the third facility, that it agreed to display the reproductive health information that the law requires.

“Why did we take those steps? Because every day is a day where some number of women could potentially be misinformed about [their] reproductive options,” Feuer said. “And therefore every day is a day that a woman’s health could be jeopardized.”

The facilities, two unlicensed and one licensed fake clinic, are Harbor Pregnancy Help CenterLos Angeles Pregnancy Services, and Pregnancy Counseling Center.

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Feuer said the lawsuit could have carried fines of up to $2,500 each day the facility continued to break the law.

The Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act requires the state’s licensed pregnancy-related centers to display a brief statement with a number to call for access to free and low-cost birth control and abortion care. Unlicensed centers must disclose that they are not medical facilities.

Feuer’s office in May launched a campaign to crack down on violators of the law. His action marked a sharp contrast to some jurisdictions, which are reportedly taking a wait-and-see approach as fake clinics’ challenges to the law wind through the courts.

Federal and state courts have denied requests to temporarily block the law, although appeals are pending before the U.S. Court of Appeals for the Ninth Circuit.

Some 25 fake clinics operate in Los Angeles County, according to a representative of NARAL Pro-Choice California, though firm numbers are hard to come by. Feuer initially issued notices to six Los Angeles area fake clinics in May. Following an investigation, his office warned three clinics last month that they’re breaking the law.

Those three clinics are now complying, Feuer told reporters Thursday. Feuer said his office is still determining whether another fake clinic, Avenues Pregnancy Clinic, is complying with the law.

Fake clinic owners and staffers have slammed the FACT Act, saying they’d rather shut down than refer clients to services they find “morally and ethically objectionable.”

“If you’re a pro-life organization, you’re offering free healthcare to women so the women have a choice other than abortion,” said Matt Bowman, senior counsel with Alliance Defending Freedom, which represents several Los Angeles fake clinics fighting the law in court.

Asked why the clinics have agreed to comply, Bowman reiterated an earlier statement, saying the FACT Act violates his clients’ free speech rights. Forcing faith-based clinics to “communicate messages or promote ideas they disagree with, especially on life-and-death issues like abortion,” violates their “core beliefs,” Bowman said.

Reports of deceit by 91 percent of fake clinics surveyed by NARAL Pro-Choice California helped spur the passage of the FACT Act last October. Until recently, Googling “abortion clinic” might turn up results for a fake clinic that discourages abortion care.

“Put yourself in the position of a young woman who is going to one of these centers … and she comes into this center and she is less than fully informed … of what her choices are,” Feuer said Thursday. “In that state of mind, is she going to make the kind of choice that you’d want your loved one to make?

Rewire last month visited Lost Angeles area fake clinics that are abiding by the FACT Act. Claris Health in West Los Angeles includes the reproductive notice with patient intake forms, while Open Arms Pregnancy Center in the San Fernando Valley has posted the notice in the waiting room.

“To us, it’s a non-issue,” Debi Harvey, the center’s executive director, told Rewire. “We don’t provide abortion, we’re an abortion-alternative organization, we’re very clear on that. But we educate on all options.”

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