Commentary Abortion

The Fence

Stigma Shame and Sexuality Series

It takes immeasurable courage and compassion, strength and caring, to choose to have a child—and equal amounts of the same to choose not to have a child. The choice of either could be, for any particular woman, sacred.

This post is by Wendy Ortiz, and is part of Tsk Tsk: Stigma, Shame, and Sexuality, a series hosted by Gender Across Borders and cross-posted with Rewire in partnership with Ipas.

Another afternoon had fallen over the clinic, the morning bustle turned sleepy lull. In the waiting area, the patients seemed more sedate than I’d come to expect on such days.

Perfumes mingled in the air and dissipated with every opening of the door as patients or their companions entered or left, ignoring as best they could the protesters in the parking lot.

I was invited to leave the front desk and enter the small hallway where a doctor and certified nursing assistant stood, focused on a tray situated on a countertop in front of them.

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I was told to put on a blue paper smock, paper mitts, and a mask. My fingers felt unsure touching the crinkly paper.

“This one’s about nine weeks.” The doctor studied and turned over the little bits of blood and matter in the tray with an instrument. Our very pregnant CNA took notes.

I observed the fetus as it was surveyed and reported—all the parts of a fetus needing accounting, because fetal matter left in the woman’s uterus can cause complications. The doctor’s voice brought me back as she suggested that I’d be a good candidate to help with noting fetal measurements on future abortion days.

I was the receptionist at the only feminist women’s health care facility that offered abortion in my adopted county in the Pacific Northwest. To me, this was a pro-choice activist’s dream job. The fact that the job offer came just five days after I myself had traveled a couple of counties away for an abortion just made the job seem ever more appropriate, possibly fated.

I embarked on my activist dream job in earnest. Now I was looking at the remains of a fetus in a tray with a sense of awe I couldn’t yet place.

There are photos of me holding a megaphone, standing in the gazebo of our downtown park. After the march from the Capitol building to the rally itself, the last thing I wanted to do was travel to the west side of town for what would be my first pregnancy test ever. Later that afternoon, I left behind a urine sample at the HMO clinic and was told I could call for the results after four.

At four sharp, I sat on the couch and punched the numbers on the phone.

A perky female voice answered. After telling her the reason for my call, she asked, Which way do you want it to be?

I started to say something, sighed, said nothing.

The test came out positive, she replied after an awkward moment. My breath caught in my throat. Another moment of silence eclipsed everything until she said, It sounds like that’s not the news you wanted. Here’s who to contact.

I was twenty-four, just a few months shy of twenty-five. A few weeks prior, newspapers around the country, including ours, noted the 25th anniversary of Roe v. Wade. I hung up the phone.  I had crashed into my fertility.

I’d always felt like I was on one side of a fence; my friends who had abortions stood on the other side. I was holding their hands through this fence, but we were indeed separated. I was perfectly content to stay on my side of the fence for as long as possible, if not forever.

Back then, I often collected statistics and rational, practical analyses of most issues in order to compose arguments that would stand up in discussions and even in the most personal dilemmas. My notebooks were filled with talking points to make my case or compose a talk about the latest issue I was involved in.  In the case of women’s reproductive rights, I was well-versed in what I believed were the most important facts.

Women average about thirty years of potential fertility. One article I read in a progressive magazine told me that forty-six out of 100 women (presumably American, presumably with insurance coverage…so many things to presume) would have at least one abortion in their lives. One (or two, and even three) unintended pregnancies in thirty years seemed pretty low in that context.

I was buffered by facts, padded with statistics. Pregnant, I wanted to hear about actual experiences, not talking points, not rhetoric.

I opened my black address book. My hand scrawled red curlicues and circles on the edge of each page as I called every friend I knew who had had an abortion. I had to abandon my fact sheets and statistical notes, and surrender to the fact that I was now going to join the women on the other side of the fence.

I worked next to a pregnant woman four days a week at the clinic. She’d had more than one abortion herself and now assisted women during their own procedures. People constantly asked her, Isn’t it weird working here while you’re pregnant? Don’t you find it hard?

Their questions reminded me of the phone conversation I had with a customer service representative of my HMO when I called to inquire about coverage. It went like this:

 Does my coverage include abortion?

Ahhh. Voluntary termination of pregnancy.

Oh. Yeah.

Let me see. His tone was friendly. He paused. In that pause, I could hear the click of the computer keyboard under his fingertips. I could practically hear him searching for something to say.

Abortion…such an ugly word, he finally said.  And then, Yes, voluntary termination of pregnancy is covered. I breathed a sigh of relief and thanked him. The part-time state job I was leaving to work full-time at the clinic offered me the kind of insurance I needed for facing this unwanted pregnancy.

There was no dialogue to be had in this instance. I had to accept his comment and move forward.

It also wasn’t until long after I hung up the phone that I realized there was a language to consider and learn. It was the protective, sterile coating that voluntary termination of pregnancy provided, instead of the word people often found shameful, ugly, or rife with political meaning. It was the doctor’s office and insurance carrier’s vocabulary substituted for the more common designation, and I would sometimes find it useful later when explaining the procedure to countless patients.

When people asked my co-worker if she found it difficult, or unsavory, to be working at the clinic while pregnant, she told them, No. It’s not weird, or hard. In fact, she told me in private, she was easily irritated by women who couldn’t utter the words ‘abortion’ or ‘termination.’  Eventually I felt exactly the same way.

In January of that year, 1998, protestors and demonstrators turned out in many cities across the country for the 25th anniversary of Roe v. Wade. Norma McCorvey, otherwise known as “Jane Roe,” was no longer a representative of abortion rights. She, had, in fact, been baptized three years before in a swimming pool as part of her conversion to Christianity, and ended up working for Operation Rescue.

Days after the anniversary, a clinic bombing maimed Emily Lyons, a nurse at a clinic in Birmingham, Alabama. Later that same year, Dr. Barnett Slepian, an obstetrician who provided abortion services, would be murdered in his home, the soup he had been warming going untouched once the bullets hit the window glass. More similar stories, too many, would follow, right up to the present time.

On that day in which I witnessed the aborted fetus in a tray, after finally removing the smock and the mask, I returned to the clinic desk. The last patient left the clinic, and soon after, I was set free to ride my bicycle home.

I thought about what I had seen in the tray that afternoon as I pedaled, knowing I’d want to talk about it with my boyfriend, but not yet knowing the words or the emotions I might express. By day’s end, I had seen one more fetus, estimated at fourteen weeks, a rare occurrence at our clinic. The image felt burned into my brain.

As I locked my bike to the post outside my front door, I remembered the Operation Rescue posters I’d seen when passing by a protest, or when I’d come face to face with demonstrators. It was obvious they were looking for a particular response, and what more provocative way to accomplish this than to have posters of two-inch aborted fetuses enlarged to the size of the six-foot-tall anti-choice protestor holding the sign?

And still, the size of the fetus, or the poster, didn’t matter.

In the days after, I realized that my beliefs were not fundamentally changed. In fact I believed, more so than ever, that it takes immeasurable courage and compassion, strength and caring, to choose to have a child—and equal amounts of the same to choose not to have a child. The choice of either could be, for any particular woman, sacred.

Wendy C. Ortiz is a writer and a Marriage and Family Therapist Intern at a community counseling center. Wendy holds an M.A. in Clinical Psychology and an M.F.A. in Creative Writing from Antioch University Los Angeles. She has been a creative writing teacher of both youth in juvenile detention facilities and college students, a journalist, library worker, and editor and publisher of a handbound literary journal. She received a B.A. from The Evergreen State College in 1995 and lived in Olympia, Washington for eight years before returning to her hometown of Los Angeles, where she lives now with her partner and daughter.

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (R-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.