Getting Emotionally Involved

Aspen Baker

Research to promote emotional well-being after an abortion is common ground because there is nothing to compromise, no human right or moral value to sacrifice, no ground to give way.  The only losers are those who fight to keep things the way they are.

When President Obama called for Americans to find “common ground” in the abortion debate, I thought of Exhale and our message of pro-voice.  I know we can all stand on common ground, because I see it under our feet. 
On May 27, 2009, I and fellow Pro-Voice Ambassadors stood together on that common ground and advocated for research that supports the emotional well-being of each woman who has had an abortion.
That day, I gave oral testimony before the National Institutes of Health at a regional meeting in San Francisco, which gave communities a voice in establishing research priorities for women’s health over the next 10 years. 
I asked that the Office of Women’s Health Research (NIH/OWHR) work to better understand what women, and their loved ones, need after an abortion in order to support their own emotional well-being. 

The desire for the emotional well-being of women is common ground.  It doesn’t require compromise of human rights or moral values and it doesn’t require the sacrifice of dearly held beliefs.  The research agenda we proposed to the NIH/OWHR reveals this common ground by addressing three indisputable facts:

1.    Millions of American women have already had abortions.
2.    The personal experience of abortion can be emotional.
3.    People want and deserve emotional well-being.

In my testimony, I spoke about my own experience searching for resources after my abortion, a journey that led me to found Exhale, the nation’s first organization dedicated to promoting emotional well-being after an abortion. 

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Danielle Thomas, a fellow Pro-Voice Ambassador and an Exhale counselor, spoke about her experiences on Exhale’s national, multilingual post-abortion talkline.  We spoke about the important role of emotional health in overall health and well-being. 

Finally, we provided recommendations for the research the NIH/OWHR should undertake to promote emotional well-being post-abortion, which includes the need to:

  • Assess the psychological and emotional needs of women after an abortion.
  • Evaluate the effects of different post-abortion emotional support models on a woman’s well-being.
  • Examine men’s emotional experience with abortion.
  • Understand the characteristics of healthy coping after an abortion in diverse communities.
  • Explore the connection between the social experience and the emotional experience of abortion. 

Common ground is not just a plan to be unveiled by the White House, known only to President Obama and his advisors.  There is no such thing as a “common ground” political position.  You cannot search for common ground or set it as a goal, like ending smoking or drunk driving.  Common ground is what is real, truthful, and undisputed, and it is always beneath our feet.  Our responsibility as pro-life, pro-choice, or pro-voice advocates is to notice it, acknowledge it, and seek to address it.  

The need for this approach is clear when it comes to the emotional experience of abortion.  For too long, the polarizing impulses of the abortion conflict have held this issue hostage.  The facts – abortions have already happened, they can be emotional, and people want emotional well-being – have been turned into political fodder instead of being addressed seriously, comprehensively, and publicly as important information about a woman’s well-being.  Consider the “regret vs. relief” stand-off about what “most women” feel after an abortion.  The dichotomy serves political ends and helps differentiate opponents.  What it doesn’t do is offer a way forward, or paint a picture of how the world would look and feel if these three indisputable facts were addressed.  

Forcing the issue into either-or territory creates false choices, even in how to identify one’s own position on abortion: “Do I side with those who understand that abortion can be emotional, but who want to limit its availability, or do I side with those who try to make it more available but refuse to acknowledge its emotional impact?”    

This has been a choice forced upon many Americans.  It is one choice none of us should have to make.  As Jon Stewart said in his recent interview with Mike Huckabee on The Daily Show, choosing sides on abortion often feels like a choice between “frenzied and maniacal or callous and indifferent.”

We deserve more, and better.  There is common ground upon which to stand. 

Instead of being forced into a false choice, Americans should feel confident that their legitimate concerns about indisputable facts are being taken seriously, and that the emotional well-being of women who have had abortions is being addressed, pro-actively.  

This is what I want.  This is why we started Exhale: to address the reality of abortion in women’s lives and to take a stand next to each and every woman who has had one.  We call our work pro-voice, because it is the voices and experiences of those who have lived this issue that should drive the discussion.  On The Daily Show, when Mr. Huckabee posed a question about how pregnant women think through their rights and responsibilities, what I wanted most was for the women who have called Exhale to have the chance to answer.  Their voices could directly counter the problem with the abortion debate, which Mr. Huckabee described as generating “more heat than light.” 

Of course, as Melissa Harris-Lacewell, Associate Professor of Politics and African American Studies at Princeton University, recently pointed out in a speech to Planned Parenthood, we should not push or prod people to speak out about a personal, stigmatized issue.  This can in fact cause more pain and be detrimental to emotional well-being.  Instead, respect and comfort are the best tools for helping people to build their confidence and resiliency.  This is one more reason why it is important to directly address the facts through research, and create a deep and thorough understanding of women’s emotional experiences with abortion. 

Forward-thinking leaders have already embraced this challenge.  Tracy Weitz is leading a research effort at the Advancing New Standards in Reproductive Health program at the University of California-San Francisco to better understand women’s emotional experiences with abortion, a project that Exhale was proud to join as a partner.  Ms. Weitz is pro-actively addressing the indisputable facts – women have had abortions, abortion can be emotional, and people want emotional well-being – and ANSIRH’s investigation will help identify how best to respond to them.  I hope more leaders will follow her example.   

Research to promote emotional well-being after an abortion is common ground because there is nothing to compromise, no human right or moral value to sacrifice, no ground to give way.  The only losers are those who fight to keep things the way they are. 

But the winners!  Let’s consider them.  Americans will win because their concerns will be taken seriously, and they will reward forward-thinking leaders with new credibility, another win.  Most important, women who have had abortions will win because there will be research, information and services to support their emotional well-being. 

Undoubtedly, there will be big debates over President Obama’s common ground policy.  I hope that leaders will remember that common ground – the indisputable facts: women have had abortions, abortion can be emotional, and people want emotional well-being – is always beneath our feet.  All we have to do is look down, respond, and stand strong together. 

News Health Systems

Complaint: Citing Catholic Rules, Doctor Turns Away Bleeding Woman With Dislodged IUD

Amy Littlefield

“It felt heartbreaking,” said Melanie Jones. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

Melanie Jones arrived for her doctor’s appointment bleeding and in pain. Jones, 28, who lives in the Chicago area, had slipped in her bathroom, and suspected the fall had dislodged her copper intrauterine device (IUD).

Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“I think my first feeling was shock,” Jones told Rewire in an interview. “I thought that eventually they were going to recognize that my health was the top priority.”

The doctor left Jones to confer with colleagues, before returning to confirm that her “hands [were] tied,” according to two complaints filed by the ACLU of Illinois. Not only could she not help her, the doctor said, but no one in Jones’ health insurance network could remove the IUD, because all of them followed similar restrictions. Mercy, like many Catholic providers, follows directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, tubal ligations, and contraception.

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Some Catholic providers may get around the rules by purporting to prescribe hormonal contraception for acne or heavy periods, rather than for birth control, but in the case of copper IUDs, there is no such pretext available.

“She told Ms. Jones that that process [of switching networks] would take her a month, and that she should feel fortunate because sometimes switching networks takes up to six months or even a year,” the ACLU of Illinois wrote in a pair of complaints filed in late June.

Jones hadn’t even realized her health-care network was Catholic.

Mercy has about nine off-site locations in the Chicago area, including the Dearborn Station office Jones visited, said Eric Rhodes, senior vice president of administrative and professional services. It is part of Trinity Health, one of the largest Catholic health systems in the country.

The ACLU and ACLU of Michigan sued Trinity last year for its “repeated and systematic failure to provide women suffering pregnancy complications with appropriate emergency abortions as required by federal law.” The lawsuit was dismissed but the ACLU has asked for reconsideration.

In a written statement to Rewire, Mercy said, “Generally, our protocol in caring for a woman with a dislodged or troublesome IUD is to offer to remove it.”

Rhodes said Mercy was reviewing its education process on Catholic directives for physicians and residents.

“That act [of removing an IUD] in itself does not violate the directives,” Marty Folan, Mercy’s director of mission integration, told Rewire.

The number of acute care hospitals that are Catholic owned or affiliated has grown by 22 percent over the past 15 years, according to MergerWatch, with one in every six acute care hospital beds now in a Catholic owned or affiliated facility. Women in such hospitals have been turned away while miscarrying and denied tubal ligations.

“We think that people should be aware that they may face limitations on the kind of care they can receive when they go to the doctor based on religious restrictions,” said Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, in a phone interview with Rewire. “It’s really important that the public understand that this is going on and it is going on in a widespread fashion so that people can take whatever steps they need to do to protect themselves.”

Jones left her doctor’s office, still in pain and bleeding. Her options were limited. She couldn’t afford a $1,000 trip to the emergency room, and an urgent care facility was out of the question since her Blue Cross Blue Shield of Illinois insurance policy would only cover treatment within her network—and she had just been told that her entire network followed Catholic restrictions.

Jones, on the advice of a friend, contacted the ACLU of Illinois. Attorneys there advised Jones to call her insurance company and demand they expedite her network change. After five hours of phone calls, Jones was able to see a doctor who removed her IUD, five days after her initial appointment and almost two weeks after she fell in the bathroom.

Before the IUD was removed, Jones suffered from cramps she compared to those she felt after the IUD was first placed, severe enough that she medicated herself to cope with the pain.

She experienced another feeling after being turned away: stigma.

“It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

The ACLU of Illinois has filed two complaints in Jones’ case: one before the Illinois Department of Human Rights and another with the U.S. Department of Health and Human Services Office for Civil Rights under the anti-discrimination provision of the Affordable Care Act. Chaiten said it’s clear Jones was discriminated against because of her gender.

“We don’t know what Mercy’s policies are, but I would find it hard to believe that if there were a man who was suffering complications from a vasectomy and came to the emergency room, that they would turn him away,” Chaiten said. “This the equivalent of that, right, this is a woman who had an IUD, and because they couldn’t pretend the purpose of the IUD was something other than pregnancy prevention, they told her, ‘We can’t help you.’”


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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.”


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