Commentary Abortion

Private Practice and Public Laws: The Patronizing Lectures that Television Depicts and Texas Now Requires

Martha Kempner

How a scene from a popular television show and a new law in Texas patronize women who seek abortions. 

Last Friday afternoon, I watched an episode of Private Practice that had aired the week before and was not all that surprised when one of the story lines focused on abortion. The show, which follows the lives of a group of doctors in Los Angeles, has dealt with the topic a number of times before.  It is clear that the writers and producers don’t just support a woman’s right to choose but are willing to risk alienating some viewers in order to use the show as a platform to promote reproductive rights.  In fact, though I often find the writing predictable and overly melodramatic (the show is one of those guilty TV pleasures), I think the writers have done a great job with the abortion debate.  They have given characters a chance to express both sides of the issue but in the end they always present well-reasoned, and even well-researched, arguments for why the right to “safe, legal abortions, without judgment” is so important. 

Still, I was struck by one scene in this episode which reminded me of the mandatory “counseling” some states are now making women go through before they can exercise their legal right to terminate a pregnancy. 

The episode, “God Bless the Child,” focused on the clashing views of two OB/GYNs, Dr. Addison Montgomery who performs abortions (and has had one) and Dr. Naomi Bennett who is opposed to abortion for religious reasons.  A patient, Patty, comes to Addison with uterine cramping and stomach pains about a month after having had an early abortion. It turns out the procedure was not done correctly and the woman is now 19 weeks pregnant. Addison explains that she can still legally have an abortion but that at this stage of the pregnancy it is a more complicated procedure. Patty decides to do it, but Naomi approaches her in the waiting room and pretty blatantly tries to talk her out of terminating her pregnancy.

During the scene to which I am referring, Naomi is bouncing her one-year-old granddaughter on her knee. Patty explains that she is not ready to have a baby: 

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Naomi:  No one is ever ready to have a baby.  You just do it.  My daughter was 16 when she got pregnant with Olivia here, she hadn’t even finished high school and I almost, no I tried, to force her to have an abortion and I’m so grateful that she didn’t. (She looks lovingly at the baby.)  

Patty:  She had you to help her. My boyfriend, Charlie, couldn’t get away fast enough.

Naomi:  That just proves that he wasn’t ready to be a father.

Patty:  I can’t be a mother.  I have nothing. I have to work all the time.

Naomi:  Being a mother isn’t about what you have. It’s about who you are.

So, basically, a wealthy, well-educated woman is trying to convince someone who has had to put off graduate school to work two jobs that being a mother will be fine despite her lack of resources.  If that wasn’t bad enough, she moves on to some of the manipulative tactics common to crisis pregnancy centers.    

Naomi: At 19 weeks do you know that your child can hear you? It can be startled by loud noises. Your child already has vocal chords, and finger prints, and air sacs in her lungs. She can move her arms and legs not unlike Olivia here.  (She looks lovingly at the baby again.)  I know you’re confused, which is why I think you need a little more time to think about it.

First of all, a 19-week-old fetus is nothing like a one-year old child. The comparison is unbelievably manipulative, as is having this conversation with a baby in the room to begin with. Moreover, the character of Patty was not at all confused.  She knew that she wanted to terminate her pregnancy.  She had made a rational decision based on the circumstances of her life; she had determined that she did not have the emotional or financial resources she needed to carry the pregnancy to term or become a parent.  Suggesting she was confused just because she wasn’t making the same choice that Naomi would have made is patronizing, belittling, and insulting. 

And yet, state lawmakers all over the country are doing the same thing when they impose 24-hour waiting periods, mandate ultrasounds, and require “counseling” sessions.

I don’t know if it was irony or coincidence (or totally unrelated) but while I was watching this scene and becoming infuriated—the governor of Texas was signing a law that will force women in his state to sit through a similarly humiliating lecture before they will be able to have an abortion. The new law, which goes into effect on September 1, says that at least 24 hours before an abortion is performed, a doctor must perform an ultrasound and then provide “in a manner understandable to a layperson, a verbal explanation of the results of the sonogram images, including a medical description of the dimensions of the embryo or fetus, the presence of cardiac activity, and the presence of external members and internal organs.”  

Exceptions are made for women who live more than 100 miles from an abortion provider (they only have to wait 2 hours between procedures) as well as for women who were raped and those who are carrying fetuses known to have “irreversible medical conditions that will cause a disability.” Most women in the state, however, will have to endure the sonogram and the lecture. 

When pushing for such laws (Texas is not the first state to enact one), abortion foes argue that they are just enhancing informed consent, making sure women know what they are getting into, and protecting the life and health of the mother (and the fetus, of course).  It’s obvious to me that what they are really doing is trying to put as many roadblocks between women and legal abortions as they can while they work on other fronts to overturn Roe v. Wade and eliminate the right to abortion altogether.  What bothers me most about it, however, is how demeaning it is to women. 

Most women who seek abortions are like Patty, they have made a well-informed, well-reasoned decision based on their own unique circumstances.  Nonetheless, doctors are now forced to say, essentially: “Okay, but are you really sure?  Before you really decide, look at this picture of your baby and listen to this description of her development. I know you think you want this, but why don’t you go home and sleep on it and come back tomorrow?”  These laws suggest—not so subtly—that women are not capable of making such decisions on their own. I can’t help wondering whether those who support these laws think women are capable of making any rational decisions. (And, on a slightly different note, whether anyone would ever impose a remotely similar restriction on men.)

In the end, the character of Naomi came through.  When Patty affirmed her desire to go through with the procedure but admitted she was scared and lonely, Naomi came into the operating room and held her hand. 

Somehow, I doubt the supporters of the Texas law will ever show women that much understanding or compassion.   

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. Her 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.

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 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 inquires 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.

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.

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