What’s Wrong With the New Pro-Lifers

Frances Kissling

Amid proclamations that common ground has been reached on abortion, a new set of anti-abortion actors has claimed leadership of the movement. These good and decent people nonetheless lack understanding of women's nature and identity.

Each side in the abortion debate has its Achilles’ heel.

For advocates of choice it’s the fetus; those opposed to abortion suffer from a cavalier attitude toward the woman who carries the fetus.

Amid proclamations that common ground has been reached on abortion, a new set of anti-abortion actors has claimed leadership of the movement. They are no longer ultra-fundamentalist Catholics and Evangelicals but anti-war, anti-capital punishment, pro-environment "pro-lifers." Single-issue anti-abortionists thought they diluted the message by claiming abortion and war were equal horrors and other progressives and Democrats thought they were, well, anti-abortionists.

But some of them are also opposed to discrimination against women and call themselves feminists.
Before Obama they were voices crying in the wilderness. Now they have emerged as the face of a new and improved anti-abortion movement. And it is improved — there are few in this crowd who rate abortion issue as the most important moral issue of our time, and they are not single-issue voters. If they were, they would not have supported Obama.

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Now they are embedded in the Democratic party, much to the dismay of some. But the value of their inclusion cannot be underestimated because of the effect inclusion could have on their beliefs. For starters, this group has already decided that a political effort to make abortion illegal is hopeless, which helps the pro-choice cause. The possibility of rational public discourse about all the factors at play in women’s decisions not to continue pregnancy and not to become mothers is exactly what we need. Taking legality off the table makes that more possible. We are, however, far from common ground between the new anti-abortionists and the pro-choice advocates.

These new anti-abortionists have set forth a new ethical frame for dealing with abortion. They say rather than prohibit abortion we should work to reduce women’s use of abortion by making bearing and raising children or bearing children and placing them for adoption more possible. Since data on why women have abortions indicate a significant number of women say they choose abortion because they cannot afford to have a child, the benign anti-choicers think that better economic support for women and girls who are pregnant will result in more continued pregnancies and more women embracing motherhood. They also assert that if adoption policies were friendlier more women would place children for adoption rather than have abortions.

But facts have little place in their strategy, as the very measures they think would lower abortion rates in the U.S. are already in place in much of Europe and few women who face unintended pregnancies in those countries opt out of abortion. Something much deeper influences a woman’s decision about what to do when she is pregnant and does not want to become a mother — and the new anti-choicers don’t seem to have a clue about what this might be.

These are good and decent people who, it seems, suffer from the same lack of understanding of women’s nature and identity as do old-line anti-abortionists. No attempt is made to explore what it means to a woman to be pregnant or the essential way in which becoming a mother changes women’s identities forever — even if they place a child they bore in adoption.

While the new anti-abortionists do not use the same words as their older counterparts, they are thinking the same thoughts. Pregnancy is natural and normal. It lasts for nine months and then it is over. Motherhood is part of almost all women’s life plans. Many thrive on it. It is safe and results in a wonderful thing — a new person. It is not asking much of a woman who faces an unwanted, difficult or unintended pregnancy to shift the plan she had for this time in her life and continue the pregnancy. That’s because the outcome — the new person — is obviously so much more valuable than whatever short-term loss or pain the woman might experience. A woman who does not accept this is lacking some core element of womanhood.

This inaccurate idea of what pregnancy is about is not just dominant among those opposed to abortion. It is pretty much the unthinking assumption in modern Western culture. It denies the reality that even in modern Western culture, in the high-tech U.S., every woman who agrees to be pregnant still risks dying if the pregnancy goes awry. But the new anti-abortionists want to use their rosy view of pregnancy as the frame for public policy, and that is where they become indistinguishable from the old anti-abortion movement. For both groups, women are passive participants in gestation. They are the Tupperware containers in which children grow. "Left alone," anti-abortionists say, "the fetus will develop and be born into the world." Left alone? The development of the fetus into a baby is not a mere matter of geography. It is governed by what philosopher Maggie Little of Georgetown University describes as the "actions and resources of an autonomous agent." That includes the woman’s "blood, hormones, her energy, all resources that could be going to other of her bodily projects."

No new anti-abortionist talks about these physical realities or questions whether or not the woman has any right to object or consent to having her body used in this way. They seem to take for granted that fetal life always takes precedence over the body and identity claims of the woman. The woman’s claim to moral agency is completely disregarded and the traditional anti-choice belief that the fetus’ right to life trumps all other values is mindlessly asserted.

But the absence of a serious moral frame for women’s role in pregnancy leaves unspoken more than the physical realities of gestation. In the anti-abortion movement there is a romantic thread about women and pregnancy that includes the notion of submission alongside of passivity. However difficult the pregnancy or the circumstances of a woman’s life might be, the sign of a good woman is that she submits to the cosmic event. The alteration of her identity from self-identified autonomous person to pregnant woman and to mother are conditions she has no control over — other than to say no to sex.

Four positions taken by the new anti-abortionists illuminate this flawed thinking.

Denying the "need" for abortion. Pro-choicers and the new anti-abortionists have argued over terminology. Pro-choicers believe we should work to reduce the need for abortion. The new anti-abortionists also want to reduce the number of abortions but say there is never a "need" for abortion. Again, you could only say this if you completely minimize or reject that women’s actions and identity are significant moments of moral agency or of the woman’s personhood. You would have to believe that women do not "need" to be themselves when pregnant. According to this mind-set, women do not need the freedom to ask and decide if being pregnant with a disabled fetus or bringing it into the world is contrary to their sense of their duties to a potential child, a family or themselves. Women who have serious or even mild health challenges do not need to decide if the burdens of a pregnancy are more than they are able to bear. Because anti-abortionists see pregnancy as a passive activity by women and part of their innate nature, these questions never spring to mind.

A lack of support for contraception. That same sense of pregnancy as no big deal influences the new anti-abortionists’ unwillingness to embrace contraception, in spite of the fact that any rational attempt to reduce abortions would require rushing to provide contraception to women. If we really understood what it meant for women to consent to becoming mothers, we would want them to be able to meet their moral obligation to their own identity by avoiding becoming pregnant. Not a single Catholic anti-abortion group, including Pax Christi, Network, Catholics in Alliance for the Common Good or Catholics United has had the courage to stand with women and support legislation that will provide women with better and more affordable access to contraception. Evangelicals who have embraced the new approach to abortion opposition have been somewhat more willing to support contraception, but only if they can add that they support it because it will reduce abortions, not because women have a right to prevent becoming pregnant when that is not part of their immediate or long-term identity.

Making sex sacred. This squeamishness around contraception is closely related to the conservative religious community’s concept of sex as sacred. More modern religious thinkers as well as secular philosophers look at sacredness not in the context of individual acts of sexual intercourse, but more broadly at the sacredness of procreation. For anti-abortionists, if women were not invisible, a concept of the sacredness of creation would include understanding that one of the most sacred decisions a woman makes is whether it is appropriate for her to participate in procreation, in bringing a child into the world. If we believe that the act of creating new life is sacred, then we want men and women to have the tools necessary to fulfill the obligation to create life responsibly and not create it when they cannot — or choose not to — bring it to fruition. Moreover, we would respect women’s insights after they became pregnant and honor their obligation to decide if using their life resources to bring a child into the world is the best thing to do. In conditions of poverty, famine, disease, war, unemployment, lack of parenting skills, it is good for women to be able to say, "This is not the time to create a new person."

Redefining adoption. The new anti-abortionists — and a number of pro-choice advocates — say a woman who does not choose to be a mother to a new person can continue the pregnancy and place the child for adoption. This seems to me to be a highly gendered position. I would note that most of the leaders of the new anti-abortion movement are men. They include evangelical thinkers and pastors like Joel Hunter, David Gushee and Jim Wallis and Catholics like Chris Korzen and Douglas Kmiec. There is much to respect in the work of these men and much I disagree with. I do not suggest that any of them are anti-woman. However, they all have a biological relationship to pregnancy that is dramatically different from that of women. Men are always in the position of receiving a child as an act of generosity by a woman. How often have you heard the phrase "she gave him three beautiful children," or from a woman in a second marriage, "I want to give a child to my new husband."

These are not trivial gender observations. If one takes gestation seriously, one must question the wisdom of asking women to alter their identity for not just nine months but forever in order to give a child to someone else. A woman who has had a baby is a mother, even if she places the child for adoption. For many, giving up a child becomes an unhappy part of their lifelong identity.

Historically, adoption had as its purpose finding parents for needy children. And in an age when abortion was illegal and contraception less available and safe, the need for parents was great. We need to think carefully about whether the concept of adoption should change. Is it now a process of finding children for needy parents? And, if we accept that pregnancy and child-bearing are serious and identity-altering events in a woman’s life, do we want to encourage this option of creating a needy child over other options; to define it as the most generous choice a woman can make? Might it not be more generous of us as a society to work harder to make it possible for women to keep their children if they so wish?

The challenge to the new anti-abortionists is whether or not women’s perspectives on the meaning of pregnancy and motherhood will be considered in their project, or whether their ethical frame will remain focused on the fetus. While they set about reducing the number of abortions — again, not the "need" for abortion — will the women whose lives they are affecting ever be seen as moral agents? How many of these women’s decisions will the new anti-abortionists be able to say "yes" to? So far it seems that it is far more than abortion that is a stumbling block to common ground.

Commentary Contraception

Hillary Clinton Played a Critical Role in Making Emergency Contraception More Accessible

Susan Wood

Today, women are able to access emergency contraception, a safe, second-chance option for preventing unintended pregnancy in a timely manner without a prescription. Clinton helped make this happen, and I can tell the story from having watched it unfold.

In the midst of election-year talk and debates about political controversies, we often forget examples of candidates’ past leadership. But we must not overlook the ways in which Hillary Clinton demonstrated her commitment to women’s health before she became the Democratic presidential nominee. In early 2008, I wrote the following article for Rewirewhich has been lightly edited—from my perspective as a former official at the U.S. Food and Drug Administration (FDA) about the critical role that Clinton, then a senator, had played in making the emergency contraception method Plan B available over the counter. She demanded that reproductive health benefits and the best available science drive decisions at the FDA, not politics. She challenged the Bush administration and pushed the Democratic-controlled Senate to protect the FDA’s decision making from political interference in order to help women get access to EC.

Since that time, Plan B and other emergency contraception pills have become fully over the counter with no age or ID requirements. Despite all the controversy, women at risk of unintended pregnancy finally can get timely access to another method of contraception if they need it—such as in cases of condom failure or sexual assault. By 2010, according to National Center for Health Statistics data, 11 percent of all sexually experienced women ages 15 to 44 had ever used EC, compared with only 4 percent in 2002. Indeed, nearly one-quarter of all women ages 20 to 24 had used emergency contraception by 2010.

As I stated in 2008, “All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.”

Now, there are new emergency contraceptive pills (Ella) available by prescription, women have access to insurance coverage of contraception without cost-sharing, and there is progress in making some regular contraceptive pills available over the counter, without prescription. Yet extreme calls for defunding Planned Parenthood, the costs and lack of coverage of over-the-counter EC, and refusals by some pharmacies to stock emergency contraception clearly demonstrate that politicization of science and limits to our access to contraception remain a serious problem.

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Today, women are able to access emergency contraception, a safe, second chance option for preventing unintended pregnancy in a timely manner without a prescription. Sen. Hillary Clinton (D-NY) helped make this happen, and I can tell the story from having watched it unfold.

Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told. On August 31, 2005 I resigned my position as assistant commissioner for women’s health at the Food and Drug Administration (FDA) because the agency was not allowed to make its decisions based on the science or in the best interests of the public’s health. While my resignation was widely covered by the media, it would have been a hollow gesture were there not leaders in Congress who stepped in and demanded more accountability from the FDA.

I have been working to improve health care for women and families in the United States for nearly 20 years. In 2000, I became the director of women’s health for the FDA. I was rather quietly doing my job when the debate began in 2003 over whether or not emergency contraception should be provided over the counter (OTC). As a scientist, I knew the facts showed that this medication, which can be used after a rape or other emergency situations, prevents an unwanted pregnancy. It does not cause an abortion, but can help prevent the need for one. But it only works if used within 72 hours, and sooner is even better. Since it is completely safe, and many women find it impossible to get a doctor’s appointment within two to three days, making emergency contraception available to women without a prescription was simply the right thing to do. As an FDA employee, I knew it should have been a routine approval within the agency.

Plan B emergency contraception is just like birth control pills—it is not the “abortion pill,” RU-486, and most people in the United States don’t think access to safe and effective contraception is controversial. Sadly, in Congress and in the White House, there are many people who do oppose birth control. And although this may surprise you, this false “controversy” not only has affected emergency contraception, but also caused the recent dramatic increase in the cost of birth control pills on college campuses, and limited family planning services across the country.  The reality is that having more options for contraception helps each of us make our own decisions in planning our families and preventing unwanted pregnancies. This is something we can all agree on.

Meanwhile, inside the walls of the FDA in 2003 and 2004, the Bush administration continued to throw roadblocks at efforts to approve emergency contraception over the counter. When this struggle became public, I was struck by the leadership that Hillary Clinton displayed. She used the tools of a U.S. senator and fought ardently to preserve the FDA’s independent scientific decision-making authority. Many other senators and congressmen agreed, but she was the one who took the lead, saying she simply wanted the FDA to be able to make decisions based on its public health mission and on the medical evidence.

When it became clear that FDA scientists would continue to be overruled for non-scientific reasons, I resigned in protest in late 2005. I was interviewed by news media for months and traveled around the country hoping that many would stand up and demand that FDA do its job properly. But, although it can help, all the media in the world can’t make Congress or a president do the right thing.

Sen. Clinton made the difference. The FDA suddenly announced it would approve emergency contraception for use without a prescription for women ages 18 and older—one day before FDA officials were to face a determined Sen. Clinton and her colleague Sen. Murray (D-WA) at a Senate hearing in 2006. No one was more surprised than I was. All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.

Sometimes these success stories get lost in the “horse-race stories” about political campaigns and the exposes of taxpayer-funded bridges to nowhere, and who said what to whom. This story of emergency contraception at the FDA is just one story of many. Sen. Clinton saw a problem that affected people’s lives. She then stood up to the challenge and worked to solve it.

The challenges we face in health care, our economy, global climate change, and issues of war and peace, need to be tackled with experience, skills and the commitment to using the best available science and evidence to make the best possible policy.  This will benefit us all.

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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