A Third-Year Law Student Discusses Her Work on Abortion Access in Texas

Sarah Erdreich

One of the biggest challenges for small abortion funds is that our resources are so limited that often we can not adequately train people to deal with some of the hard cases. If there was something that I [didn’t] know how to handle, I would often call one of my colleagues and debrief and take care of myself first, to make sure that I was available to my client and wasn't doing them more harm then good.

Author’s note: During the summer of 2009, I talked to
dozens of young pro-choice activists and doctors about what motivated
their work for reproductive justice, what concerns them most about the
current state of abortion rights, and what they think the future holds
for legal abortion in the U.S. In the three interviews included here, four
young activists – a law student, an attorney, and the creators of a
pro-choice website – discuss these issues and also share their thoughts
about why it’s so important for their peers to not take legalization
for granted.  The interviews will appear in my forthcoming book,
Generation Roe.  Sarah Erdreich 

Kyle Marie Stock: Third-year law
student, University of Texas; former board member, Lilith Fund for Reproductive
Equity

[The Lilith Fund is] a small, all-volunteer organization, we
have about ten people on the board now. We cover Austin and south to the border
and all the way west to El Paso, it’s a huge area. We have a hotline which is
twenty-four hours, people basically leave messages and then the volunteers call
them back. We actually have a relatively diverse board in terms of age, there’s
early 20s all the way up to 60s; relatively diverse in terms of faith and
different sexual orientations. We haven’t been so good with racial diversity,
that’s been difficult for us.

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We have people from all over the state call, from the big
metropolitan areas to the tiniest, little towns. A lot of people are already
parents; that’s definitely one of the things that come up often. People already
have children and they can’t necessarily provide adequately for another kid,
and they’re really trying to make sure that they’re able to raise their family
in a healthy manner.

The [story] that sticks with me, that I was like oh my gosh,
I cannot do this anymore, this is horrible, was a young woman who was in her
teens. Her mother had kicked her out of the house and she was living on her
own; the only thing she had to cook with was a microwave. She was in a
metropolitan area in Texas and she was relatively far along already, so it was
going to be a very expensive procedure. She told me that she had gone to her
boyfriend, the father of the child, and he basically told her, I don’t know who
you are, get out of my house. And to this day I don’t know what happened to
that girl. I don’t know if she got her abortion, I don’t know where she is now,
I don’t know any of that stuff. It was so heartbreaking because I wanted to
drive to the city and help her, do something for her. It was awful; I couldn’t
change any of this. I imagine that she probably had the child; it was one of
those several-thousand-dollar abortions. 

On the other hand, I spoke to one woman who was in her
mid-30s, and she was so empowered by the process. We had this really fantastic
conversation about access to abortion, she was really grateful for my help and
so happy that she had somebody to commiserate [with]. She got her abortion. I
asked her to call me back and tell me how it went and she did, and she said
thank you so much, it was really helpful to have you to talk to. It was so
exciting, I was like I’m doing something good, I’m making a difference. It’s
really it’s an emotional roller coaster, it’s the kind of work that’s very –
one minute it’s really exciting, and another minute it’s heartbreaking.

One of the biggest challenges for small abortion funds is
that our resources are so limited that often we can not adequately train people
to deal with some of the hard cases. What I did [was], if there was something
that I [didn’t] know how to handle, I would often call one of my colleagues and
talk it out with them and debrief and care of myself first, to make sure that I
was available to my client, to make sure that I wasn’t doing them more harm
then good. I think that if we could do a better job training, people would burn
out less. I definitely got to a point where I was like, I can’t do this
anymore. The best thing to do is know your limits and use other resources when
you’ve reached that point. We certainly have people who answer the hotline who
have MSWs, people who do abortion counseling at clinics, people who are
extremely well trained, and then there [are] other people that are new. But
it’s really important to have as much new blood in the organization, to be
drawing people into the community and really having people participate as much
as they can, so it’s kind of a balancing act.

It’s interesting to me because Texas is so large, and there
aren’t a lot of abortion providers. Certainly they’re out there, but often
they’re in the metropolitan areas, so if you’re in a rural area you may have to
travel four, five hours. Especially if you’re in West Texas; there, you may
have go to New Mexico. It’s frustrating, and also because Texas is religiously
and ideologically conservative, the conversation itself is even hostile. I
mean, when you’re sitting in the Austin bubble, sure, people are more
conversant about it. But I remember speaking to someone on the hotline where
she was like, you are literally the first person I’ve told that I’m pregnant
and I’m getting an abortion. She would be horribly ostracized and probably
coerced, in terms of the way people present the argument, into not getting the
abortion at all. And like I said, a lot of these people are already mothers so
it’s not like they don’t want to have children, but they want to raise their
children in an effective manner so it’s really crazy. With the sex ed stuff, it
starts from the beginning: you don’t talk about any of that stuff, you’re not
supposed to talk about sex let alone abortion, that would just be the end of
the world.

When I talk about this issue with people, [they] have this
expectation that abortion is used as a contraceptive method, that people
repeatedly get pregnant and have abortions. It’s frustrating because that’s not
completely unheard of, but at the same time that’s not the typical story. There
are so many more factors and particulars of each story that if you are being
sympathetic or even open to hearing someone’s story, you realize that this is
never an easy decision. There’s always a host of factors that go into thinking
about it. One of the good things that I found, though, is that the Lilith Fund
makes sure that the clinics that we are working with are going to do a more
holistic look at the situation. They’re going to give people counseling,
they’re going to make sure they’re secure with the decision, they’re going to
treat the person respectfully. I think that is really lost in the discussion,
that even people who are funding abortion are really aware of people’s feelings
on the issue and we want to make sure that there’s support throughout the whole
process. People don’t get to that level of discussion often, though, because so
often it’s like oh, you’re pro-choice, well, you’re horrible.

I absolutely think most people are not aware of what the
realities are in terms of barriers to access. They aren’t worried about Roe, they’re not worried about Carhart, they’re not worried about any
of these Supreme Court cases that have chipped away at this right. They don’t
see it as an immediate threat. When South Dakota had that outright ban [under
consideration] most people were like eh, whatever, no big deal. And I’m like
no, you don’t understand, they did this on purpose so that someone would sue
them and then they would take it to the Supreme Court. This isn’t going to just
affect the people in South Dakota – 
and even if it did, that’s horrible and we should really pay attention
to that because as it is they only have one abortion provider in that state.
It’s just frustrating because I think a lot of people don’t think about this
issue until if affects them, until that day when they have that pregnancy
scare, or their cousin gets pregnant and they’re like, what do I do.

 I certainly
think people who grew up post-Roe
take it for granted. So many people don’t know of the history, the stories
about women who died, the stories that about women who are dying now in other
countries because they can’t get an abortion. The conversation about abortion
in this country is so black and white, it’s yes or no. [That’s] something I
think that we as activists are failing to do, is putting real faces and real stories
with this issue. I’m not saying that that’s easy, because you start a
conversation and the word “abortion” pops up and all hell breaks loose.
[People] also take access to birth control and access to emergency
contraceptive for granted in a lot of cases. This is not a stand-alone issue,
it’s all interconnected. The reality is that rich women are always going to be
able to get an abortion; whether it’s legal or not, people with means will be
able to access it. It’s the marginalized communities that are going to be most
affected by any of the restrictions on abortion.

Another interesting thing that I’ve been reading about, and
a way to turn the conversation around, is when people say that they want
abortion to be illegal. Asking people what they expect the punishment should be
  saying ok, so you want this to
be illegal, so should we put the doctors in jail? Should we put the woman in
jail? Should there be fines? What are the consequences to the people who attempt
or perform abortion if it’s illegal? I think that is an interesting twist on
the question, what are the implications of this instead of just thinking about
this very abstract idea. This is not solved by criminalizing abortion, it just
sets off a whole new set of issues. But like I said, people stop at the first
question, they don’t dig deeper into the problem.

Roundups Politics

Campaign Week in Review: ‘If You Don’t Vote … You Are Trifling’

Ally Boguhn

The chair of the Democratic National Convention (DNC) this week blasted those who sit out on Election Day, and mothers who lost children to gun violence were given a platform at the party's convention.

The chair of the Democratic National Convention (DNC) this week blasted those who sit out on Election Day, and mothers who lost children to gun violence were given a platform at the party’s convention.

DNC Chair Marcia Fudge: “If You Don’t Vote, You Are Ungrateful, You Are Lazy, and You Are Trifling”

The chair of the 2016 Democratic National Convention, Rep. Marcia Fudge (D-OH), criticized those who choose to sit out the election while speaking on the final day of the convention.

“If you want a decent education for your children, you had better vote,” Fudge told the party’s women’s caucus, which had convened to discuss what is at stake for women and reproductive health and rights this election season.

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“If you want to make sure that hungry children are fed, you had better vote,” said Fudge. “If you want to be sure that all the women who survive solely on Social Security will not go into poverty immediately, you had better vote.”

“And if you don’t vote, let me tell you something, there is no excuse for you. If you don’t vote, you don’t count,” she said.

“So as I leave, I’m just going to say this to you. You tell them I said it, and I’m not hesitant about it. If you don’t vote, you are ungrateful, you are lazy, and you are trifling.”

The congresswoman’s website notes that she represents a state where some legislators have “attempted to suppress voting by certain populations” by pushing voting restrictions that “hit vulnerable communities the hardest.”

Ohio has recently made headlines for enacting changes that would make it harder to vote, including rolling back the state’s early voting period and purging its voter rolls of those who have not voted for six years.

Fudge, however, has worked to expand access to voting by co-sponsoring the federal Voting Rights Amendment Act, which would restore the protections of the Voting Rights Act that were stripped by the Supreme Court in Shelby County v. Holder.

“Mothers of the Movement” Take the National Spotlight

In July 2015, the Waller County Sheriff’s Office released a statement that 28-year-old Sandra Bland had been found dead in her jail cell that morning due to “what appears to be self-asphyxiation.” Though police attempted to paint the death a suicide, Bland’s family has denied that she would have ended her own life given that she had just secured a new job and had not displayed any suicidal tendencies.

Bland’s death sparked national outcry from activists who demanded an investigation, and inspired the hashtag #SayHerName to draw attention to the deaths of Black women who died at the hands of police.

Tuesday night at the DNC, Bland’s mother, Geneva Reed-Veal, and a group of other Black women who have lost children to gun violence, in police custody, or at the hands of police—the “Mothers of the Movement”—told the country why the deaths of their children should matter to voters. They offered their support to Democratic nominee Hillary Clinton during a speech at the convention.

“One year ago yesterday, I lived the worst nightmare anyone could imagine. I watched as my daughter was lowered into the ground in a coffin,” said Geneva Reed-Veal.

“Six other women have died in custody that same month: Kindra Chapman, Alexis McGovern, Sarah Lee Circle Bear, Raynette Turner, Ralkina Jones, and Joyce Curnell. So many of our children are gone, but they are not forgotten,” she continued. 

“You don’t stop being a mom when your child dies,” said Lucia McBath, the mother of Jordan Davis. “His life ended the day that he was shot and killed for playing loud music. But my job as his mother didn’t.” 

McBath said that though she had lost her son, she continued to work to protect his legacy. “We’re going to keep telling our children’s stories and we’re urging you to say their names,” she said. “And we’re also going to keep using our voices and our votes to support leaders, like Hillary Clinton, who will help us protect one another so that this club of heartbroken mothers stops growing.” 

Sybrina Fulton, the mother of Trayvon Martin, called herself “an unwilling participant in this movement,” noting that she “would not have signed up for this, [nor would] any other mother that’s standing here with me today.” 

“But I am here today for my son, Trayvon Martin, who is in heaven, and … his brother, Jahvaris Fulton, who is still here on Earth,” Fulton said. “I did not want this spotlight. But I will do everything I can to focus some of this light on the pain of a path out of the darkness.”

What Else We’re Reading

Renee Bracey Sherman explained in Glamour why Democratic vice presidential nominee Tim Kaine’s position on abortion scares her.

NARAL’s Ilyse Hogue told Cosmopolitan why she shared her abortion story on stage at the DNC.

Lilly Workneh, the Huffington Post’s Black Voices senior editor, explained how the DNC was “powered by a bevy of remarkable black women.”

Rebecca Traister wrote about how Clinton’s historic nomination puts the Democratic nominee “one step closer to making the impossible possible.”

Rewire attended a Democrats for Life of America event while in Philadelphia for the convention and fact-checked the group’s executive director.

A woman may have finally clinched the nomination for a major political party, but Judith Warner in Politico Magazine took on whether the “glass ceiling” has really been cracked for women in politics.

With Clinton’s nomination, “Dozens of other women across the country, in interviews at their offices or alongside their children, also said they felt on the cusp of a major, collective step forward,” reported Jodi Kantor for the New York Times.

According to Philly.com, Philadelphia’s Maternity Care Coalition staffed “eight curtained breast-feeding stalls on site [at the DNC], complete with comfy chairs, side tables, and electrical outlets.” Republicans reportedly offered similar accommodations at their convention the week before.

Analysis Law and Policy

After ‘Whole Woman’s Health’ Decision, Advocates Should Fight Ultrasound Laws With Science

Imani Gandy

A return to data should aid in dismantling other laws ungrounded in any real facts, such as Texas’s onerous "informed consent” law—HB 15—which forces women to get an ultrasound that they may neither need nor afford, and which imposes a 24-hour waiting period.

Whole Woman’s Health v. Hellerstedt, the landmark U.S. Supreme Court ruling striking down two provisions of Texas’ omnibus anti-abortion law, has changed the reproductive rights landscape in ways that will reverberate in courts around the country for years to come. It is no longer acceptable—at least in theory—for a state to announce that a particular restriction advances an interest in women’s health and to expect courts and the public to take them at their word.

In an opinion driven by science and data, Justice Stephen Breyer, writing for the majority in Whole Woman’s Health, weighed the costs and benefits of the two provisions of HB 2 at issue—the admitting privileges and ambulatory surgical center (ASC) requirements—and found them wanting. Texas had breezed through the Fifth Circuit without facing any real pushback on its manufactured claims that the two provisions advanced women’s health. Finally, Justice Breyer whipped out his figurative calculator and determined that those claims didn’t add up. For starters, Texas admitted that it didn’t know of a single instance where the admitting privileges requirement would have helped a woman get better treatment. And as for Texas’ claim that abortion should be performed in an ASC, Breyer pointed out that the state did not require the same of its midwifery clinics, and that childbirth is 14 times more likely to result in death.

So now, as Justice Ruth Bader Ginsburg pointed out in the case’s concurring opinion, laws that “‘do little or nothing for health, but rather strew impediments to abortion’ cannot survive judicial inspection.” In other words, if a state says a restriction promotes women’s health and safety, that state will now have to prove it to the courts.

With this success under our belts, a similar return to science and data should aid in dismantling other laws ungrounded in any real facts, such as Texas’s onerous “informed consent” law—HB 15—which forces women to get an ultrasound that they may neither need nor afford, and which imposes a 24-hour waiting period.

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In Planned Parenthood v. Casey, the U.S. Supreme Court upheld parts of Pennsylvania’s “informed consent” law requiring abortion patients to receive a pamphlet developed by the state department of health, finding that it did not constitute an “undue burden” on the constitutional right to abortion. The basis? Protecting women’s mental health: “[I]n an attempt to ensure that a woman apprehends the full consequences of her decision, the State furthers the legitimate purpose of reducing the risk that a woman may elect an abortion, only to discover later, with devastating psychological consequences, that her decision was not fully informed.”

Texas took up Casey’s informed consent mantle and ran with it. In 2011, the legislature passed a law that forces patients to undergo a medical exam, whether or not their doctor thinks they need it, and that forces them to listen to information that the state wants them to hear, whether or not their doctor thinks that they need to hear it. The purpose of this law—at least in theory—is, again, to protect patients’ “mental health” by dissuading those who may be unsure about procedure.

The ultra-conservative Fifth Circuit Court of Appeals upheld the law in 2012, in Texas Medical Providers v. Lakey.

And make no mistake: The exam the law requires is invasive, and in some cases, cruelly so. As Beverly McPhail pointed out in the Houston Chronicle in 2011, transvaginal probes will often be necessary to comply with the law up to 10 to 12 weeks of pregnancy—which is when, according to the Guttmacher Institute, 91 percent of abortions take place. “Because the fetus is so small at this stage, traditional ultrasounds performed through the abdominal wall, ‘jelly on the belly,’ often cannot produce a clear image,” McPhail noted.

Instead, a “probe is inserted into the vagina, sending sound waves to reflect off body structures to produce an image of the fetus. Under this new law, a woman’s vagina will be penetrated without an opportunity for her to refuse due to coercion from the so-called ‘public servants’ who passed and signed this bill into law,” McPhail concluded.

There’s a reason why abortion advocates began decrying these laws as “rape by the state.”

If Texas legislators are concerned about the mental health of their citizens, particularly those who may have been the victims of sexual assault—or any woman who does not want a wand forcibly shoved into her body for no medical reason—they have a funny way of showing it.

They don’t seem terribly concerned about the well-being of the woman who wants desperately to be a mother but who decides to terminate a pregnancy that doctors tell her is not viable. Certainly, forcing that woman to undergo the painful experience of having an ultrasound image described to her—which the law mandates for the vast majority of patients—could be psychologically devastating.

But maybe Texas legislators don’t care that forcing a foreign object into a person’s body is the ultimate undue burden.

After all, if foisting ultrasounds onto women who have decided to terminate a pregnancy saves even one woman from a lifetime of “devastating psychologically damaging consequences,” then it will all have been worth it, right? Liberty and bodily autonomy be damned.

But what if there’s very little risk that a woman who gets an abortion experiences those “devastating psychological consequences”?

What if the information often provided by states in connection with their “informed consent” protocol does not actually lead to consent that is more informed, either because the information offered is outdated, biased, false, or flatly unnecessary given a particular pregnant person’s circumstance? Texas’ latest edition of its “Woman’s Right to Know” pamphlet, for example, contains even more false information than prior versions, including the medically disproven claim that fetuses can feel pain at 20 weeks gestation.

What if studies show—as they have since the American Psychological Association first conducted one to that effect in 1989—that abortion doesn’t increase the risk of mental health issues?

If the purpose of informed consent laws is to weed out women who have been coerced or who haven’t thought it through, then that purpose collapses if women who get abortions are, by and large, perfectly happy with their decision.

And that’s exactly what research has shown.

Scientific studies indicate that the vast majority of women don’t regret their abortions, and therefore are not devastated psychologically. They don’t fall into drug and alcohol addiction or attempt to kill themselves. But that hasn’t kept anti-choice activists from claiming otherwise.

It’s simply not true that abortion sends mentally healthy patients over the edge. In a study report released in 2008, the APA found that the strongest predictor of post-abortion mental health was prior mental health. In other words, if you’re already suffering from mental health issues before getting an abortion, you’re likely to suffer mental health issues afterward. But the studies most frequently cited in courts around the country prove, at best, an association between mental illness and abortion. When the studies controlled for “prior mental health and violence experience,” “no significant relation was found between abortion history and anxiety disorders.”

But what about forced ultrasound laws, specifically?

Science has its part to play in dismantling those, too.

If Whole Woman’s Health requires the weighing of costs and benefits to ensure that there’s a connection between the claimed purpose of an abortion restriction and the law’s effect, then laws that require a woman to get an ultrasound and to hear a description of it certainly fail that cost-benefit analysis. Science tells us forcing patients to view ultrasound images (as opposed to simply offering the opportunity for a woman to view ultrasound images) in order to give them “information” doesn’t dissuade them from having abortions.

Dr. Jen Gunter made this point in a blog post years ago: One 2009 study found that when given the option to view an ultrasound, nearly 73 percent of women chose to view the ultrasound image, and of those who chose to view it, 85 percent of women felt that it was a positive experience. And here’s the kicker: Not a single woman changed her mind about having an abortion.

Again, if women who choose to see ultrasounds don’t change their minds about getting an abortion, a law mandating that ultrasound in order to dissuade at least some women is, at best, useless. At worst, it’s yet another hurdle patients must leap to get care.

And what of the mandatory waiting period? Texas law requires a 24-hour waiting period—and the Court in Casey upheld a 24-hour waiting period—but states like Louisiana and Florida are increasing the waiting period to 72 hours.

There’s no evidence that forcing women into longer waiting periods has a measurable effect on a woman’s decision to get an abortion. One study conducted in Utah found that 86 percent of women had chosen to get the abortion after the waiting period was over. Eight percent of women chose not to get the abortion, but the most common reason given was that they were already conflicted about abortion in the first place. The author of that study recommended that clinics explore options with women seeking abortion and offer additional counseling to the small percentage of women who are conflicted about it, rather than states imposing a burdensome waiting period.

The bottom line is that the majority of women who choose abortion make up their minds and go through with it, irrespective of the many roadblocks placed in their way by overzealous state governments. And we know that those who cannot overcome those roadblocks—for financial or other reasons—are the ones who experience actual negative effects. As we saw in Whole Woman’s Health, those kinds of studies, when admitted as evidence in the court record, can be critical in striking restrictions down.

Of course, the Supreme Court has not always expressed an affinity for scientific data, as Justice Anthony Kennedy demonstrated in Gonzales v. Carhart, when he announced that “some women come to regret their choice to abort the infant life they once created and sustained,” even though he admitted there was “no reliable data to measure the phenomenon.” It was under Gonzales that so many legislators felt equipped to pass laws backed up by no legitimate scientific evidence in the first place.

Whole Woman’s Health offers reproductive rights advocates an opportunity to revisit a host of anti-choice restrictions that states claim are intended to advance one interest or another—whether it’s the state’s interest in fetal life or the state’s purported interest in the psychological well-being of its citizens. But if the laws don’t have their intended effects, and if they simply throw up obstacles in front of people seeking abortion, then perhaps, Whole Woman’s Health and its focus on scientific data will be the death knell of these laws too.