News Abortion

Australia’s Only Clinic For Later Term Surgical Abortions Will No Longer Provide Services After 24 Weeks

Robin Marty

Any Australian woman needing a later term abortion will now need to induce a pregnancy, and only under very strict circumstances.

Women of Australia will no longer be able to obtain an abortion after 24 weeks unless the fetus has a congenital defect, as the country’s only later term surgical abortion center announces it is discontinuing the service.

Via The Herald Sun:

AUSTRALIA’S only clinic offering women late-term surgical abortions has scrapped the service sparking concerns it could lead to a rise in backyard abortions.

The Croydon clinic will no longer give abortions to women post 24 weeks.

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Health Services Commissioner Beth Wilson said she was concerned that if women could not access the legitimate health service it could lead to unsafe solutions.

“The worst case scenario is that it will lead to backyard abortions,” Ms Wilson said.

It was the only clinic in the southern hemisphere to offer the medical procedure.

Although a woman’s hospital will provide late abortions, they will not allow them in any case that does not involve a fetal abnormality, and will only provide the service by inducing the pregnancy and putting the pregnant woman into an early labor.

Commentary Law and Policy

43 Years Later, Anti-Choice Advocates Continue to Ignore ‘Roe’

Jessica Mason Pieklo

What good is having the right to an abortion as settled law if anti-choice advocates refuse to recognize it as such?

Friday marks the 43rd anniversary of Roe v. Wade, and abortion rights have never been more at risk. Anna Yocca sits in a Tennessee jail, waiting for her next court appearance on an attempted murder charge for allegedly trying to self-induce an abortion with a court hanger. Later this spring, the Roberts Court will hear arguments in Whole Woman’s Health v. Cole, a case challenging provisions of HB 2, an omnibus law that has largely succeeded in basically regulating abortion out of existence in Texas, even with portions blocked by the courts. Meanwhile, cases in Michigan and California are testing whether or not Catholic hospitals can refuse to follow best medical practices and deny reproductive health care to patients based on religious doctrine.

Forty-three years after the Supreme Court decided Roe v. Wade, this is what “settled law” looks like when it comes to abortion rights—a legal landscape arguably as hostile and confusing for many pregnant patients as it was before Roe.

Take, for example, Whole Woman’s Health v. Cole, the abortion access case the Roberts Court will hear later this spring. The challenged provisions of Texas’ HB 2 require abortion clinics to meet the same architectural requirements as stand-alone surgical centers, and also require abortion doctors to maintain admitting privileges at nearby hospitals in order to perform abortions in the state. Proponents insist the measures promote patient safety, despite a mountain of evidence that these kinds of targeted regulation of abortion providers (TRAP) laws do just the opposite—they worsen patient care and health outcomes.

Since Texas enacted HB 2, as Teddy Wilson reported for Rewire, the state has seen the number of clinics that provide abortion services drop from 25 to 19. Should the Supreme Court uphold the law, no more than ten will remain open. Those clinics that have been able to stay open are primarily located in the heavily populated urban areas of the state, leaving rural Texans to travel hundreds of miles to access an abortion provider. A recent study suggested many don’t make the trip: Between 100,000 and 240,000 Texas women of reproductive age have attempted to end their pregnancies on their own.

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Reproductive rights advocates have put forward an impressive case for why HB 2 should fall. And despite a conservative majority hostile to abortion rights, the Roberts Court has once already blocked portions from taking effect. But this will also be the first time the Court jumps back into the abortion debate since its 2007 decision in Gonzales v. Carhart. That decision upheld as constitutional the so-called federal Partial-Birth Abortion Ban, despite the fact that it represented a pre-viability abortion ban—and should have been protected under Roe and 1992’s Planned Parenthood v. Casey—and despite the fact that the professional medical community was largely against it. The win in Gonzales v. Carhart emboldened anti-choice lawmakers to rely on convenient junk science to pass increasingly prohibitive measures with very little worry those laws would be overturned by the federal courts.

Thus, since 2007, anti-choice lawmakers have continued to advance restrictions grounded more in science fiction than science. Those include claims that a fetus feels pain at 20 weeks, so states should ban the procedure at that point, and the assertion that abortion—a medical procedure far safer than, say, some dental work—is so harmful it requires heightened regulation.

HB 2 is the natural, logical conclusion of Gonzales, as anti-choice lawmakers advance legal claims that closing abortion clinics actually improves patient health. To support those claims, attorneys defending HB 2 and similar restrictions in places like Alabama, Louisiana, and Wisconsin have relied on evidence supplied by discredited anti-choice activists rather than the mainstream medical community, which overwhelmingly opposes restrictions like those at issue in Whole Woman’s Health.

Should the State of Texas succeed in defending those restrictions this spring before the Roberts Court, the result could be a fresh new wave of abortion clinic closures across the country. Should advocates succeed, access, for the moment, will be protected.

But what does that protected access look like? In Texas, many patients already must travel across state and sometimes international borders to access abortion care. That likely won’t change with a Supreme Court win this spring. That’s because even a win won’t magically re-open clinics closed under HB 2, nor will it bring back the services and providers lost in those closures.

In places like Michigan and California, that “protected access” often means patients face choosing care from Catholic hospitals and clinics or receiving no care at all. As the Roberts Court considers whether or not to uphold portions of Texas HB 2, the U.S. Court of Appeals for the Sixth Circuit will consider whether or not Tamesha Means should be able to sue the Catholic hospital that turned her away three times while she was heavily bleeding and actively miscarrying her pregnancy because her non-viable fetus still had a heartbeat.

As more and more independent reproductive health-care providers close thanks to TRAP laws, patients like Means or Rebecca Chamorro have only Catholic facilities from which they can seek services. And with those facilities refusing to provide contraception, abortion, sterilization, or related reproductive health care to its patients because of Catholic beliefs that these procedures are “intrinsically evil,” what good is a constitutional right to abortion if doctors and hospitals can legally refuse to provide it?

​For that matter, what good is that right if patients cannot afford it, or are punished for trying to obtain it?

Which brings me back to the case of Anna Yocca. In September 2015, Yocca allegedly filled a bathtub with water, sat in it, and then took a coat hanger and attempted to induce her abortion. She was reportedly 24 weeks pregnant at the time. According to local police, Yocca bled heavily during the attempt, at which point her boyfriend rushed her to the hospital. Medical professionals at Saint Thomas Midtown Hospital in Nashville delivered a 1.5-pound infant boy. The baby survived and will reportedly need extensive medical care. Hospital staff alerted law enforcement officials after, they said, Yocca made “disturbing statements” to them about trying to terminate her pregnancy.

Prosecutors indicted Yocca on a charge of attempted murder under the state’s general homicide statute for her alleged self-induced abortion, sending the express message to other pregnant people in Tennessee that should they try and terminate a pregnancy themselves, they will face a choice: Seek medical care for complications and go to prison, or avoid care for any complications altogether. Yocca has pleaded not guilty to the charge and has her next court appearance in February.

Anti-choice activists were quick to applaud Yocca’s indictment. Senior policy advisor for Operation Rescue and convicted felon Cheryl Sullenger offered this statement following the news, without apparently a hint of irony:

There are plenty of places for her to go. Every state has at least one abortion clinic. There is no excuse for that. Every state has a number of pregnancy help centers that offer free help to women who are pregnant. So you know for a woman to feel like she has to self-induce there is no reason for that in America today. We all have to obey the law whether they are convenient or not convenient. If she felt like she didn’t want to drive a couple of miles down the road to the nearest abortion clinic, she would rather self-induce, then she should be prosecuted.

As if accessing abortion were always that simple.

Forty-three years after the Supreme Court recognized the right to an abortion as fundamental, I feel safe saying that maybe it’s OK for reproductive rights advocates to move past the anniversary. Roe has almost always been at best an empty promise of full reproductive autonomy for low-income patients thanks to the Hyde Amendment’s restriction on Medicaid funding for abortion. Statewide conservative attacks on access means Roe’s unfulfilled promise now extends to anyone who happens to live in the 24 states that hyper-regulate abortion access.

No doubt about it: The anniversary of Roe v. Wade marks an important milestone for gender equality and an important milestone for the reproductive rights movement. But that milestone no longer marks progress forward. Instead it’s more of a reminder that no matter the law, conservatives will never quit with their attacks on women’s bodies and our ability to manage them.

Commentary Human Rights

Cisgender Women Aren’t the Only People Who Seek Abortions, and Activists’ Language Should Reflect That

Cheryl.Chastine

As an abortion provider, I now make a practice of using gender-inclusive language—not only when speaking about the issue on traditional and social media, but also when talking to my patients.

In a column for The Nation last Friday, writer Katha Pollitt questioned the push among reproductive justice activists to use gender-inclusive language when talking about abortion. Pollitt claimed that such rhetoric “render[s] invisible half of the population and 99.999 percent of those who get pregnant.”

I’m a physician who provides abortions. I’m a physician who provides medical therapy for transgender patients. Both areas of care, for me, are aspects of the same commitment: to provide necessary, lifesaving services that center my patients’ autonomy. Still, I’ll readily admit that I, too, was confused at first by calls to use language with regard to reproductive rights and justice that would be inclusive of transgender men and nonbinary individuals. It seemed like common sense to me that of course my pregnant patients were women and would be referred to as such. As a progressive, though, one of the important lessons I’ve learned is that what looks like “common sense” is often a reflection of unexamined biases. And I’ve realized that assuming every person seeking an abortion is a cisgender woman just further reproduces the prejudices that render transgender people invisible and vulnerable.

On the same day The Nation ran Pollitt’s piece, Reuters reported on a survey of trans men regarding health-care use; more than three-quarters of the individuals had transitioned medically, meaning they were using hormone replacement therapy and/or had obtained surgical treatment. Forty-two percent of the respondents reported experiencing health-care discrimination, including denial of equal treatment, verbal harassment, and/or physical assault. Furthermore, the survey respondents disproportionately reflected a privileged minority of transgender individuals: white, college-educated, employed, privately insured trans men. That figure is undoubtedly higher among less well-off demographic groups of trans men and nonbinary people.

Cisgender people, particularly white individuals, have the privilege when seeking health care of being able to present as their authentic selves without fear. Transgender people, especially people of color, do not. Dr. Kortney Ryan Ziegler, an Oakland, California-based filmmaker, writer, and scholar who is also a Black transgender man, told me that for himself and other trans men he knows, the experience of accessing medical services is fraught with bodily exposure and the risk of discrimination.

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For instance, while traveling out of town once, he went to an urgent care clinic for a cold. “The nurse noticed I had a prescription for testosterone and asked me about it. So I ‘came out’ to some random [registered nurse] because I had a cold, [even though] it had nothing to do with anything else,” he said.

He also recalled clearly how, while still presenting as a Black “woman,” “there were many times I know my race played an important role in how I was (mis)treated.”

Explicitly inclusive language is meaningfully beneficial to people like Ziegler, he says, because it can help ameliorate the harms of the fear of being harassed or mistreated: When such rhetoric is used, it can signal that trans men and nonbinary trans people are more likely to be acknowledged and accepted as themselves.

As an abortion provider working in a conservative area of the country, I’ll readily state that nearly all of my patients present as cisgender women. Does that mean that they all are cisgender women, though? We live in a cisnormative society, meaning that the experiences of cisgender people are overwhelmingly centered. In addition to the aforementioned risk of health-care discrimination, visibly trans individuals are subject to employment and other economic discrimination, family and partner rejection, housing discrimination, and a very real danger of violence. When this is the known price of coming out as trans, it’s one many people feel unable to pay.

Feminists like Pollitt who argue against inclusive language assert that because “99.999 percent of the population” seeking abortions are cis women, it is inaccurate and inappropriate to use gender-inclusive language. So how many trans people are we really talking about? It’s more than 0.001 percent. Suppose you time-traveled back to the 1950s and asked the average physician how many of his or her patients were gay. They would probably respond, “None” or, “Maybe one or two.” It’d be easy to conclude, therefore, that 99.999 percent of all people were straight, so there’d be no need to include any forms of non-heterosexual orientation in language or activism. Assuming the proportion of non-heterosexual people has stayed roughly constant, though, our 1950s physician likely did have a number of gay, lesbian, or bisexual patients. The doctor simply took them to be heterosexual. They may have even presented themselves as such, out of a legitimate fear that the physician would behave prejudicially toward them.

Using the same logic, how can providers or activists dare to presume that every patient we can’t “read” as trans is cis? Numerous trans individuals “pass” as a cis member of their gender, or they present—in some or all settings—as a cis member of their assigned-at-birth gender.

So the truth is, we don’t know what proportion of the population is transgender. The blog FiveThirtyEight covered this last year: No national surveys ask the question, and “even if they did, the responses might not be reliable because some people are afraid to answer, while others disagree on what ‘transgender’ even means.” But we do know that trans and genderqueer people within the reproductive rights movement are calling, in significant numbers, to be included.

When those in the reproductive justice movement prioritize trans inclusivity, more trans individuals feel comfortable publicly identifying as such. Furthermore, that visibility can guide people who’d previously lacked the tools to articulate their feelings of difference. Anna Rubin, who was assigned female at birth, identifies as agender, and uses the pronoun “they,” says they were able to figure out they were trans while researching the best uses for inclusive language at their then-employer, a reproductive rights nonprofit.

When writing a blog post for the nonprofit, Rubin had used the term “trans*.” The use of the asterisk is controversial: Some cisgender people have advocated for the asterisk to include transvestites, who are cisgender, so many trans people feel that it represents an attempt by cis people to encroach on the trans identity. “Somebody called me out on using [the asterisk],” Rubin said. “Wanting to do the right thing pushed me toward resources that helped me figure me out.”

In turn, that self-realization equipped Rubin with a way to push back against gendered language.

“Even before I figured out that I was trans,” Rubin said, “I’d not identified strongly with the label ‘woman.’ [So] it was kind of an overload when I came onboard [the organization] and started getting hammered with it. I felt so alienated before I even figured out why.”

This, Rubin continued, reflected the implicit and explicit discrimination they saw in the wider movement. “I was also made uncomfortable by the lack of respect shown to trans people in the movement. … It was really hard to hear, ‘I think genderqueer people are just confused,’ when I was trying on the label ‘genderqueer’ for myself,” they said.

As a result, Rubin said, “I was miserable under the weight of the assumptions. … I feel like I rushed myself out of the closet in order to confront them with someone they needed to respect. Because when I tried to advocate for myself, and people like me, without being able to say, ‘Hey, this is important to me as a trans person,’ I got such disappointing pushback. [But] once it was pointed out that there was a real problem that affected a real person that they saw every day, they changed.”

Parker Molloy, a journalist who is a transgender woman, sees gendered pro-choice slogans of the past as entirely compatible with an increasing understanding of gender variation—and a corresponding update to our word choice. For example, with regard to the frequently invoked phrase “Trust Women,” Molloy said, “In its truest, most earnest form, it is a promotion of bodily autonomy. It’s trusting an individual to make their own choices, and eliminating gatekeepers. … Trans existence and identities push back against social expectations, push back on the idea that someone else should be given control of our bodies, and push back on the concept that biology is destiny.”

“Trust Women,” in other words, is a call to respect bodily autonomy, and that same respect can now compel us to update our language.

The category “women” doesn’t map neatly onto the category “people who can get pregnant,” and not just because people who aren’t women can and do get pregnant. Many women, conversely, are unable to get pregnant. Some of those women are trans, and others have reproductive tract anomalies that make pregnancy impossible.

In addition, reproductive justice advocates, including trans activists, have called for deemphasizing anatomical language as a rallying call. A trans-inclusive worldview is one that acknowledges that there are women (and nonbinary people) who have testes and penises, and men (and nonbinary people) who have vulvas and vaginas. A laser focus on genital anatomy is one of the major ways that cisgender gatekeepers exclude, ostracize, and disbelieve trans people. Cisgender solidarity around presumed shared genital anatomy, too, is a way trans people are excluded and erased. Given that, it makes sense that centering reproductive rights language around specific anatomy can strike trans people as both deliberately exclusionary and reinforcing of their dysphoria.

Furthermore, rejecting anatomy-centered language is also about centering lived experiences. Objections from trans people and supporters to the constant association of “abortion” with “vaginas” have often been met with ridicule from many, including left-liberals: “How could abortion not be about vaginas? It involves a vagina! That’s how you get pregnant and where you have the abortion!”

To that I would simply ask: Is parenting about vaginas? Or, if you prefer: Is motherhood about vaginas? Would we use vaginas as the symbol of parenthood? Should we title, say, a maternity-leave advocacy group “Lady-Parts Leave Equality”? Should a proposed affordable child-care bill be called the “Vagina Defense Alliance”?

We wouldn’t, because we see that parenthood is about lives and families, and incidentally involves vaginas in the physical logistics along the way. Abortion, too, is about lives and families. Historically, it’s been anti-abortion activists who wanted to make abortion about naughty, dirty sex and vaginas; pro-choice activists saw abortion as being about autonomy, the full realization of all of us as humans, whether or not we have the capacity to get pregnant. So it’s perplexing to me to see mainstream left-liberals insisting on titling their abortion events after genitals. I’m all for refusing shame, but that’s an emphasis that detracts from the actual significance of abortions for the people having them.

And, again, it is not as if gender-inclusive language hurts cisgender women. As an abortion provider, I now make a practice of using it—not only when speaking about the issue on traditional and social media, but also when talking to my patients. Never once have I felt that any of my cisgender patients was harmed, confused, or distressed by my talking about “pregnant people.”

When we frame abortion access around autonomy, we should also understand this parallel: Justice for transgender people, too, is a question of bodily and personal autonomy. As physicians and as reproductive justice activists, we are called to recognize each person’s right to inhabit their true gender, rather than participate in forcing them into the category they were assigned at birth. That means that we must give primacy to people’s understanding of themselves. We can’t advocate that each pregnant person be able to effect the best decision for themselves—while simultaneously insisting that people who aren’t cisgender should go along silently with language in which they don’t exist.

As Molloy put it, “Abortion is an issue of bodily autonomy. Being trans is an issue of bodily autonomy. Abortion is a trans issue.” And, I’ll add, transness is a reproductive justice issue. The movement can’t deny trans people a seat at the table in the abortion conversation; they were already there. It’s up to everyone else to acknowledge them.