Without Providers, There is No Choice

Julia Kaye

A steady decline in abortion providers, due to violence and/or the threat thereof, and a shortage of new providers among young doctors and medical students, underscores that legality does not guarantee access.

“The Last Abortion Doctor.” “The Abortion Evangelist.” “Abortion Stigma Affects Doctors’ Training and Choices.” In the wake of Dr. Tiller’s murder last May, news articles are finally trumpeting a steadily emerging reality: the number of abortion providers in the U.S., and particularly providers that perform abortions after the 20th week of pregnancy, is plummeting.  An article in the Washington Post this week attributes this steady decline to a toxic combination of violence and/or the threat thereof, and a lack of urgency among young doctors and medical students who never had to witness the horrific consequences of back-alley abortions in the pre-Roe era.  The result is that legality doesn’t guarantee access to abortion, even—especially—for women and families in the most desperate and dangerous of situations.

There now remains only a handful of doctors in the country specializing in the 1 percent of abortions that take place after the 20th week—including Dr. Warren Hern and Dr. Leroy Carhart.  The doctors work in war-time conditions, driving bulletproof cars and avoiding rooms in their clinics where the windows are too exposed.  They are the ones who care for a woman whose fetus would be born with a lethal heart abnormality, or without a face. The ones who help a woman who may face a life-threatening uterine rupture were she to carry the pregnancy to term.  The ones who provide relief to a rape victim who would rather commit suicide than carry to term a fetus whose every kick induces flashbacks of the attack.  They provide life-saving care to women and families in dire situations; they are doctors in the most heroic sense.  But they are few, and they don’t have enough hours in the day.  Though they are doing all that they can to cover the patients that Dr. Tiller would have seen, his death was a profound loss that has made it all the more difficult—and in some cases, impossible—for women to find the care they may desperately need.

It is not only post-20th week abortions that threaten to become inaccessible for lack of providers; the number of doctors willing to perform even first-trimester abortions has also dropped precipitously in recent decades.  The Post reports that, “although nearly one-third of American women will have an abortion by age 45, according to the Guttmacher Institute…the number of abortion providers dropped from 2,908 in 1982 to 1,787 in 2005. Eighty-seven percent of counties in the United States and 31 percent of metropolitan areas have no abortion services.”  In Mississippi—the state with the greatest number of women living in poverty — a woman seeking an abortion at any stage must travel and wait to see 65-year-old Dr. Joseph Booker, the sole abortion provider in the state.  For poor women, who may struggle to take time off work, find childcare, or afford transportation, abortion’s legality provides little comfort if it cannot be accessed.

And therein lies the troublingly effective strategy of many segments of the anti-choice movement: weed out existing abortion providers through harassment, violence and scare tactics, and stomp out new growth by denying medical students, or convincing them that they do not need, fundamental and sometimes life-saving information on one of the most common procedures in American medicine.  According to the Post, “veteran antiabortion activist Randall Terry says he is gratified that Tiller’s killing and recent media interviews given by Hern, who drives a bulletproof car and works behind four layers of bulletproof glass, have succeeded in scaring young doctors who might contemplate providing abortions.”  Kristan Hawkins, the executive director of Students for Life of America “said her group’s goal is to drive abortion out of medical school and residency training altogether. Both those of us who fight to protect the right to choose and those who fight to deny it recognize that without providers, there is no choice. 

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Fortunately, groups like Medical Students for Choice (which has seen an “unprecedented outpouring of support” since Dr. Tiller’s murder) and the National Abortion Federation are on the case.  And Dr. Carhart has received calls from three physicians since Dr. Tiller’s murder who want to learn how to do abortions—two of whom have already begun training.  Many students take up medicine in order to provide the critical care that people need at their most vulnerable moments. Providing abortions is squarely in line with that moral goal.  

News Abortion

Anti-Choice Leader to Remove Himself From Medical Board Case in Ohio

Michelle D. Anderson

In a letter to the State of Ohio Medical Board, representatives from nine groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Anti-choice leader Mike Gonidakis said Monday that he would remove himself from deciding a complaint against a local abortion provider after several groups asked that he resign as president of the State of Ohio Medical Board.

The Associated Press first reported news of Gonidakis’ decision, which came after several pro-choice groups said he should step down from the medical board because he had a conflict of interest in the pending complaint.

The complaint, filed by Dayton Right to Life on August 3, alleged that three abortion providers working at Women’s Med Center in Dayton violated state law and forced an abortion on a patient that was incapable of withdrawing her consent due to a drug overdose.

Ohio Right to Life issued a news release the same day Dayton Right to Life filed its complaint, featuring a quotation from its executive director saying that local pro-choice advocates forfeit “whatever tinge of credibility” it had if it refused to condemn what allegedly happened at Women’s Med Center.

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Gonidakis, the president of Ohio Right to Life, had then forwarded a copy of the news release to ProgressOhio Executive Director Sandy Theis with a note saying, “Sandy…. Will you finally repudiate the industry for which you so proudly support? So much for ‘women’s health’. So sad.”

On Friday, ProgressOhio, along with eight other groupsDoctors for Health Care Solutions, Common Cause Ohio, the Ohio National Organization for Women, Innovation Ohio, the Ohio House Democratic Women’s Caucus, the National Council of Jewish Women, Democratic Voices of Ohio, and Ohio Voice—responded to Gonidakis’ public and private commentary by writing a letter to the medical board asking that he resign.

In the letter, representatives from those groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Contacted for comment, the medical board did not respond by press time.

The Ohio Medical Board protects the public by licensing and regulating physicians and other health-care professionals in part by reviewing complaints such as the one filed by Dayton Right to Life.

The decision-making body includes three non-physician consumer members and nine physicians who serve five-year terms when fully staffed. Currently, 11 citizens serve on the board.

Gonidakis, appointed in 2012 by Ohio Gov. John Kasich, is a consumer member of the board and lacks medical training.

Theis told Rewire in a telephone interview that the letter’s undersigned did not include groups like NARAL Pro-Choice and Planned Parenthood in its effort to highlight the conflict with Gonidakis.

“We wanted it to be about ethics” and not about abortion politics, Theis explained to Rewire.

Theis said Gonidakis had publicly condemned three licensed doctors from Women’s Med Center without engaging the providers or hearing the facts about the alleged incident.

“He put his point out there on Main Street having only heard the view of Dayton Right to Life,” Theis said. “In court, a judge who does something like that would have been thrown off the bench.”

Arthur Lavin, co-chairman of Doctors for Health Care Solutions, told the Associated Press the medical board should be free from politics.

Theis said ProgressOhio also exercised its right to file a complaint with the Ohio Ethics Commission to have Gonidakis removed because Theis had first-hand knowledge of his ethical wrongdoing.

The 29-page complaint, obtained by Rewire, details Gonidakis’ association with anti-choice groups and includes a copy of the email he sent to Theis.

Common Cause Ohio was the only group that co-signed the letter that is decidedly not pro-choice. A policy analyst from the nonpartisan organization told the Columbus Dispatch that Common Cause was not for or against abortion, but had signed the letter because a clear conflict of interest exists on the state’s medical board.

News Politics

Missouri ‘Witch Hunt Hearings’ Modeled on Anti-Choice Congressional Crusade

Christine Grimaldi

Missouri state Rep. Stacey Newman (D) said the Missouri General Assembly's "witch hunt hearings" were "closely modeled" on those in the U.S. Congress. Specifically, she drew parallels between Republicans' special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life.

Congressional Republicans are responsible for perpetuating widely discredited and often inflammatory allegations about fetal tissue and abortion care practices for a year and counting. Their actions may have charted the course for at least one Republican-controlled state legislature to advance an anti-choice agenda based on a fabricated market in aborted “baby body parts.”

“They say that a lot in Missouri,” state Rep. Stacey Newman (D) told Rewire in an interview at the Democratic National Convention last month.

Newman is a longtime abortion rights advocate who proposed legislation that would subject firearms purchases to the same types of restrictions, including mandatory waiting periods, as abortion care.

Newman said the Missouri General Assembly’s “witch hunt hearings” were “closely modeled” on those in the U.S. Congress. Specifically, she drew parallels between Republicans’ special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life. Both formed last year in response to videos from the anti-choice front group the Center for Medical Progress (CMP) accusing Planned Parenthood of profiting from fetal tissue donations. Both released reports last month condemning the reproductive health-care provider even though Missouri’s attorney general, among officials in 13 states to date, and three congressional investigations all previously found no evidence of wrongdoing.

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Missouri state Sen. Kurt Schaefer (R), the chair of the committee, and his colleagues alleged that the report potentially contradicted the attorney general’s findings. Schaefer’s district includes the University of Missouri, which ended a 26-year relationship with Planned Parenthood as anti-choice state lawmakers ramped up their inquiries in the legislature. Schaefer’s refusal to confront evidence to the contrary aligned with how Newman described his leadership of the committee.

“It was based on what was going on in Congress, but then Kurt Schaefer took it a step further,” Newman said.

As Schaefer waged an ultimately unsuccessful campaign in the Missouri Republican attorney general primary, the once moderate Republican “felt he needed to jump on the extreme [anti-choice] bandwagon,” she said.

Schaefer in April sought to punish the head of Planned Parenthood’s St. Louis affiliate with fines and jail time for protecting patient documents he had subpoenaed. The state senate suspended contempt proceedings against Mary Kogut, the CEO of Planned Parenthood of St. Louis Region and Southwest Missouri, reaching an agreement before the end of the month, according to news reports.

Newman speculated that Schaefer’s threats thwarted an omnibus abortion bill (HB 1953, SB 644) from proceeding before the end of the 2016 legislative session in May, despite Republican majorities in the Missouri house and senate.

“I think it was part of the compromise that they came up with Planned Parenthood, when they realized their backs [were] against the wall, because she was not, obviously, going to illegally turn over medical records.” Newman said of her Republican colleagues.

Republicans on the select panel in Washington have frequently made similar complaints, and threats, in their pursuit of subpoenas.

Rep. Marsha Blackburn (R-TN), the chair of the select panel, in May pledged “to pursue all means necessary” to obtain documents from the tissue procurement company targeted in the CMP videos. In June, she told a conservative crowd at the faith-based Road to Majority conference that she planned to start contempt of Congress proceedings after little cooperation from “middle men” and their suppliers—“big abortion.” By July, Blackburn seemingly walked back that pledge in front of reporters at a press conference where she unveiled the select panel’s interim report.

The investigations share another common denominator: a lack of transparency about how much money they have cost taxpayers.

“The excuse that’s come back from leadership, both [in the] House and the Senate, is that not everybody has turned in their expense reports,” Newman said. Republicans have used “every stalling tactic” to rebuff inquiries from her and reporters in the state, she said.

Congressional Republicans with varying degrees of oversight over the select panel—Blackburn, House Speaker Paul Ryan (WI), and House Energy and Commerce Committee Chair Fred Upton (MI)—all declined to answer Rewire’s funding questions. Rewire confirmed with a high-ranking GOP aide that Republicans budgeted $1.2 million for the investigation through the end of the year.

Blackburn is expected to resume the panel’s activities after Congress returns from recess in early September. Schaeffer and his fellow Republicans on the committee indicated in their report that an investigation could continue in the 2017 legislative session, which begins in January.


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