Commentary Abortion

Passionate Engagement: Two Doctors Speak About Their Activism for the Right to Safe Abortion

Carole Joffe

I suggest that that these doctors’ statements point to a paradox of the abortion conflict in the United States; whether abortion provider or supporter, engagement with this issue introduces these clinicians to a diverse group of allies, with a shared sense of mission, that is rare elsewhere in medicine.

Cross-posted with permission from www.ansirh.org.

 “I thought I might get in over my head and I might have done so! But I’m glad I did it anyway and in the process got connected to some folks I might not have met otherwise, it is definitely worth doing.”

Speaking is Dr. Pippa Abston, a pediatrician in Alabama, recounting for a journalist her decision to become involved in the fight against Alabama’s forced ultrasound law—an involvement that has included interviews with local media, making a Youtube video condemning the law, speaking at a pro-choice rally, and drawing up a new “right to medical judgment” bill that stipulates health care providers should not be forced to perform medically unnecessary or unwanted procedures.

Dr. Abston is not herself an abortion provider. Moreover, besides being a busy pediatrician and medical school faculty member, she is already deeply involved in other areas of medical politics—she is the coordinator for her local chapter of Physicians for a National Health Care Program, and she also is an advocate for improved mental health services in her state. She told me in an interview that her initial involvement in the mandatory ultrasound issue was “accidental”—when the television station called her clinic looking for comment, “no one from ob/gyn was around and they knew I was outspoken!”

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When I read Dr. Abston’s words, quoted at the beginning of this piece, they sounded eerily familiar to me. I then recalled another physician talking to me, in quite similar terms, about the social consequences of her decision to publicly engage with the abortion issue. Dr. Jane Hodgson was a very prominent ob/gyn in St. Paul, Minnesota in the 1950s and 1960s, with a thriving private practice and a faculty position at the University of Minnesota School of Medicine. She was the first woman elected president of the Minnesota Obstetrical/Gynecological Society.

Hodgson’s conventionally successful career in medicine—and her personal life—took a dramatic turn as she grew increasingly frustrated by the lack of access to legal abortion for her patients. As one of the few women ob/gyns in practice in her community, she received numerous requests from desperate women for abortions—some of whom she knew would end up in the hands of inept illegal abortionists. She was particularly enraged at the cruelty shown by her colleagues at her hospital, who often denied the procedure even for those very sick patients who theoretically could qualify for medically approved abortions.

In 1970, wanting to provoke a test case, she openly performed an abortion on a patient with rubella (which had recently been shown to cause severe fetal anomalies) and became the only U.S. physician ever to become convicted of performing an illegal abortion in a hospital. Her Minnesota medical license was suspended, and was only restored to her after the Roe v Wade decision in 1973.

In the three years between her arrest and the Roe decision, Hodgson became immersed in abortion provision and abortion politics. She became the medical director at the Preterm clinic in Washington, DC (where abortion was legal) and wrote some of the first articles demonstrating the safety of legal abortion. After her return to Minnesota, she helped establish some of the states’ first abortion clinics, and became active on the legal front as well, serving as lead plaintiff in several cases challenging that state’s restrictions. She published a textbook and numerous articles on abortion. Up to the time of her death in 2006, she was a board member of the Center for Reproductive Rights and involved in numerous other abortion rights activities.

Dr. Hodgson paid a price for her visibility on the abortion issue. She lost some longtime friends, her favorite nurse quit her practice, her faculty appointment was threatened, and when she went to deliver a paper at the medical society of which she had formerly been president, a number of the attendees shunned her. Like many abortion providers, she was periodically targeted by picketers at her office and home.

But Jane Hodgson never regretted her decision to get involved in the abortion issue, feeling she had gained far more than she lost. As she said to me, “The people I’ve known who are involved in this issue are on the whole more interesting to me—I’ve made friends I never would have made.”

Thankfully, Pippa Abston has so far received only minimal negative reaction to her quite visible involvement in abortion politics. Unlike Dr. Hodgson, she reports no loss of patients or personal acquaintances. Both however, in strikingly similar terms, cited as a benefit of their abortion-related activity the connections made with those they otherwise would not have encountered. What should we make of this?

I suggest that that these doctors’ statements point to a paradox of the abortion conflict in the United States. The constant legal and legislative attacks on abortion that started shortly after Roe, not to mention the physical attacks on abortion providers themselves, have helped create a vibrant pro-choice community that draws actors from many different social worlds, and whose members often forge very deep bonds with one another. Dr. Abston spoke with admiration about the “passion” she had seen among the abortion rights activists she had met. Similarly, Dr. Hodgson said to me of her involvement with the abortion issue, “I think I’ve been lucky to have been part of this… If I hadn’t gotten involved, I would have gone through life probably being perfectly satisfied to go to the medical society parties, and it would have been very, very dull.”

There should be no misunderstanding. I am not arguing that it is a “good” thing that abortion has been under such siege because this opposition has, in turn, contributed to building to a strong pro-choice community. Rather, Jane Hodgson’s and Pippa Abston’s reflections align with what I have heard from so many other physicians over the years: that whether abortion provider or supporter, engagement with this issue introduces these clinicians to a diverse group of allies, with a shared sense of mission, that is rare elsewhere in medicine.

Analysis Human Rights

Inside El Salvador’s Women’s Prison: What ‘Las 17’ Face for Their Abortion-Related Charges

Kathy Bougher

Last week, Rewire met with six of the 17 Salvadoran women imprisoned for what amount to pregnancy complications. The women discussed the challenges they face, including harassment from other inmates and overcrowded conditions.

Read more of our coverage on the campaign for Las 17, the 17 Salvadoran women imprisoned on abortion-related charges, here.

The El Salvadoran Legislative Assembly voted last month to grant a pardon to Guadalupe, one of “Las 17” imprisoned for what amounted to pregnancy complications. But 15 other women are still incarcerated on abortion-related charges, with 13 serving their sentences in Ilopango, the country’s single designated women’s prison. Last week, Rewire met with six of these women, accompanied by Ivonne Polanco, a member of the local advocacy group Agrupación Ciudadana por la Despenalización del Aborto (Citizen Group for the Decriminalization of Abortion), and La Agrupación attorney Dennis Munoz.

The imprisoned women didn’t always see themselves as part of a unit, let alone the focus of a campaign for pardons that has grown to attract global attention. But on April 1, 2014, they heard about the demonstration La Agrupación held outside the prison gates to mark the beginning of the organization’s formal request for pardons on their behalf. After that, they began to identify as “Las 17”—and with that identity has come a sense of connection among the women and toward La Agrupación. All have taken part in numerous interviews with journalists, as well as with groups such as Amnesty International, which visited the prison in September 2014.

“The work of La Agrupación opens doors for us. If it weren’t for La Agrupación, we know we would all be here for 30 years,” commented Theodora, now in the eighth year of her three-decade sentence for aggravated homicide.

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Still, being identified as part of Las 17—and by extension, one of the women in jail on abortion-related charges—has its downsides. The women say that when they first entered prison, they attempted to keep secret the nature of the crime with which they had been charged. It is common, they say, for other prisoners to stigmatize, verbally harass, and sometimes physically assault women convicted of aggravated homicide in the death of a child, so they wanted to downplay their history with the justice system.

However, their trials were frequently featured on television news, which prisoners can watch. Then, the name-calling and physical threats would begin. “We have to live with these people,” reflected Theodora. “When I was first here, but before I had actually been convicted, I didn’t tell anyone why I was here, but they figured it out from the television. To protect me, the prison put me in the section for older women. … Now when I do talk with those people I tell them, ‘Only the woman herself knows what really happened. Others don’t know.’ But when there is a woman who has a baby that died, then [other prisoners] assume it was a homicide committed by the woman.”

“Sometimes we know we’re being discriminated against for the type of conviction we have,” affirmed Marina, who, at 31, has served eight of her 30 years in prison.

Guadalupe, who expects to be released within the next few weeks, described what she too called “psychological discrimination” from the other prisoners: “They call us ‘assassins’ or ‘animals,’ or they say we eat children. Several women have been beaten. Fortunately, I haven’t been.”

Two women noted that they have changed the first names they use among the other prisoners so they cannot be identified by TV news reports.

Still, things are improving—in part because Las 17 have begun to help other women facing similar struggles. Teresa, the only one of Las 17 with a 40-year sentence, notes that earlier in her prison term, she experienced much greater rejection and mistreatment than she does now. Now, she provides moral support for another woman who just entered prison on abortion-related charges, whose preliminary hearing was featured on TV news in recent days.

“I try to help her deal with the derogatory comments she started receiving once other women found out what the charges against her were,” she said.

In addition to the treatment from other inmates, Las 17—and all the women in Ilopango—must overcome the miserable conditions of their facility. All prisons in El Salvador are notoriously overcrowded, as Nelson Rauda, then-director of the National Penal System explained in a 2012 interview, in which he noted that the women’s prison was at 945 percent of capacity.

Three years prior, the Salvadoran Attorney General for the Defense of Human Rights had reported that the Women’s Prison in Ilopango population had been at 1,125 in a facility meant for 220, or about 511 percent of capacity. Notably, of those 1,125 women, only 430 had been convicted; the rest were still going through trials or appeals. In 2014, La Agrupación requested updated figures from the attorney general, but that office responded with its 2009 report.

According to the women Rewire interviewed, such overcrowding means they often wait years to have access to a bed. As Alba, who has been in prison for five years, put it, “The prison doesn’t have enough mats for those who sleep on the floor. When I first entered prison I had a mat, but they took it away, saying it was falling apart, and they were going to give me a new one. But that was years ago and I never got anything. Three of us sleep in the corner with one thin blanket.”

Newcomers sleep on the floor for years before getting a bed. Over time, a woman’s increased tenure lets her move from the crowded open floor to the space under the lower bunk, then to a lower bunk shared by two-to-four women, and eventually to a shared upper bunk.

These anecdotes confirmed the findings in the Human Rights report, which stated:

The dormitories in all the sections provide bunk beds; nevertheless, due to the overpopulation a significant number of women were found to be sleeping on mats and on the floor.  … Many … share a bed with another inmate.

And the high population numbers affect provisions too. In a 2011 letter to El Salvador’s legislative representatives, then-Human Rights ombudsman Oscar Humberto Luna emphasized, “The overcrowding of detained individuals becomes in itself an additional punishment … and brings with it … problems with … the quality and quantity of food.”

The report from the Attorney General for Human Rights further explained:

The [Human Rights] office checks regularly the food situation due to the constant complaints from the prisoners.  In this observation … it was not abundant but sufficient in proportion to the Salvadoran diet. Nevertheless, it was detected that some foods, such as the beverages, contain iodine, which was easily detected by smell.

The water from the public system … serves for consumption by the inmates and their children. They store it in plastic bottles … The inmates affirmed that the water generally comes from the tap dirty and with a bad odor.

This impression was also reinforced by the interviews from Las 17. The food “is nasty,” Alba told Rewire. “I’m thankful to God that we have food, understand that, but sometimes it’s really bad. The beans are foul and the plantains are so hard we can’t eat them.”

The women also say that shortages of water for bathing occur frequently and that the only drinking water comes from a cistern, which they say is not always clean.

Salvadoran prisons do not provide hygiene supplies such as soap, shampoo, toilet paper, and sanitary napkins, nor do they provide clothing, sheets, or towels, as the Human Rights report documented and the six women confirmed. (Prisoners do not wear uniforms.) Incarcerated women depend on family to bring them these basic personal items. In addition, family can bring in designated amounts of money so that women can make other purchases inside the prison. But for those who do not have supportive relatives who are able to make the trip to the prison to visit, life inside is much more difficult.

Theodora explained that her family, who lives several hours by bus from the prison, is very poor: “They work to eat that day, but they try to give me some money and things I need.” Her mother comes to see her once a year. That visit actually takes three days: one for travel, the second to get in the long line by 7 a.m. so that by the afternoon Theodora’s mother can get inside to have a few hours with her daughter, and the third to return home. In a country where a minimum wage income for a poor rural family can be as low as $118 a month, the $8 to $10 for bus fare and meals present a huge obstacle. Theodora’s older sister, who lives closer, does her best to meet her younger sister’s needs.

Meanwhile, Mayra, who has served 12 out of 30 years, explained that it has been a year and three months since her family visited. As with most of the women, she could provide the exact date of the last time she’d seen her loved ones. They also live in a distant part of the country, and are very poor. She depends on friends in the prison to help her with personal needs such as shampoo and clothing.

Guadalupe’s mother, for her part, tries to visit every two-to-four weeks, as her mother explained in a separate interview with Rewire on the day the legislature voted to pardon her daughter. “But first I have to go to friends and relatives and ask them to help me buy the personal items and food I need to take to Guadalupe,” she said.

Occupying one’s time inside the prison is a challenge too. The prison offers workshops and programs, and all of the women try to enroll, but it can take five-to-ten years or more to get admitted to the more desirable programs. In addition, the rules for enrolling are complicated, and some of the women believe they are discriminated against because of the nature of their convictions. The workshops are mostly pursuits such as crocheting and embroidery, cosmetology, and piñata-making.

Catholic and Protestant church groups who come to the prison also offer religious services, which many of the women Rewire met have taken advantage of. Most have also participated in the prison’s elementary and secondary education programs: Several of the women hope to join La Agrupación’s efforts as soon as they have the opportunity. Guadalupe, who entered prison with a third-grade education and has now completed high school, wants to go to college when she is released. When Polanco asked her what career she would like to study, she grinned at La Agrupación attorney Munoz. “Lawyer!” she said.

Overall, many of Las 17 continue to take solace from the efforts of the activists standing up on their behalf. As Marina put it, “Knowing that so many people are fighting for us gives me great hope.”

News Abortion

As Voters Consider Abortion Rights Crackdown, Two North Dakota Women Speak Out

Teddy Wilson

North Dakota voters will decide on Election Day whether to add an amendment to the state constitution defining life as beginning at conception. While the debate surrounding so-called personhood amendments often takes the form of competing ideological and political differences, the human impact is often omitted, or wildly distorted.

Read more of our articles on North Dakota Measure 1 here.

North Dakota voters will decide on Election Day whether to add an amendment to the state constitution defining life as beginning at conception. While the debate surrounding so-called personhood amendments often takes the form of competing ideological and political differences, the human impact is often omitted, or wildly distorted.

North Dakota’s radical “personhood” amendment, giving full legal rights to zygotes, is widely seen as the country’s most sweeping crackdown on abortion rights.

Becky Matthews was born in South Dakota and moved to North Dakota in 1984 while she was in the fourth grade. “I’m a good ‘ol Dakota girl,” she said in a heavy Dakotan accent during an interview with Rewire.

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“I grew up in a very conservative church,” Matthews said. “I was never going to be a woman that needed an abortion.”

After having two children, Matthews and her husband decided that they wanted to once again grow their family.

Matthews remembers the exact date. “It was May 30, 2007.” She was 16 weeks pregnant and an ultrasound had revealed that she was pregnant with identical twins. A day later she received a phone call and was told that the twins shared a placenta.

A week after that phone call, it was revealed that her doctor suspected twin-to-twin transfusion syndrome, a rare condition that causes the fetuses to share blood. One fetus becomes a “donor” and the other becomes the “recipient.” At the time only 14 health-care facilities in the country could treat such a condition.

Matthews and her husband flew to Cincinnati to seek care at one of those facilities.

After testing and consultation with medical professionals at the Cincinnati Fetal Center, Matthews and her husband carefully considered their options. One option was for Matthews to go on bed rest in an attempt to prolong the pregnancy until at least 24 weeks of gestation and attempt to deliver both twins early. Another option was an invasive laser surgery to separate the fetuses, which could have had negative consequences for both of them.

The final option was termination: abort the “recipient” fetus to save the “donor.”

Matthews and her husband flew back home to North Dakota on Father’s Day weekend. She was nearly 20 weeks pregnant. All of the options were on the table. On the Tuesday after Father’s Day she went to her doctor’s office for an ultrasound.

“We didn’t have heartbeats. I delivered them on June 21, stillborn.”

Matthews looks back at her memories at the Cincinnati Fetal Center and the difficult decisions she and her husband had to contemplate and comes to one conclusion: “There’s no right decision, they all stink,” she said, her voice brimming with emotion. “I remember saying to my husband ‘How did we end up here?’ Three weeks ago we were in a healthy pregnancy. How did we get here?”

“I remember looking out the hospital window at the busy street and thinking, ‘Everyone else’s life is going on.’ I felt like my life was never going to be the same. To be honest, after a loss like that, your life is never the same,” she said.

While Matthews never struggled with questioning the decisions she and her husband made, she questioned her faith. “It was really hard to make sense of how … you’re supposed to be six months along and all of a sudden you’re visiting a cemetery.”

When a friend shared with her that she had an abortion due to a genetic diagnosis, she realized how close to that decision they had been. “I was like, that could have been me,” Matthews said.

North Dakota lawmakers considered HB 1305 during the 2013 legislative session, raising red flags for abortion rights advocates nationwide. The bill would have made it a Class A misdemeanor for a physician to perform an abortion based on gender or a genetic abnormality. Matthews said that reading about the bill in the local newspaper made her angry. The conversation around HB 1305 had no consideration for the difficult decisions women and families are forced to make.

“I just kept thinking about how difficult it is to make those decisions and how dare [lawmakers] think they should tell a family what their decisions should or should not be,” said Matthews.

After contacting reproductive rights advocates in the state, she told her family that she would testify against HB 1305. Matthews would also testify against other anti-choice bills, including SCR 4009, which was the legislatively referred amendment that became Measure 1, the ballot initiative North Dakotans will vote on next Tuesday.

After being signed into law by Gov. Jack Dalrymple (R) in May 2013, the Center for Reproductive Rights, on behalf of Red River Women’s Clinic, filed a federal lawsuit challenging HB 1305. The lawsuit was later dismissed at the request of the Center for Reproductive Rights.

Matthews said she’s been motivated to speak out about her experience in part because of the countless people who have shared their stories with her privately. Many opponents to the anti-choice measures, she said, feel they can’t speak publicly about their opposition.

“There is some family that will hear my story and not know it will impact them for years to come. I hope they know that whatever decision they make is OK,” she said.

Many of Matthews’ friends and family consider themselves “pro-life.” But, she said, “they still love and respect me” because they see her story as “different.”

“It’s not different,” she said.

“I don’t feel horrible about the decision I made. I feel horrible about the people who called me … a baby killer”

Angie Brown, born and raised in rural North Dakota, had an abortion a quarter century ago. She has never spoken about her abortion publicly, and said that she has only told three people in those 25 years. Brown said the stigma surrounding abortion in her home state is so pervasive, she fears that if her story became publicly known she would be shunned by friends and family. She even fears being fired from her job.

Brown spoke to Rewire on the condition that a pseudonym be used to protect her identity.

Brown was sexually assaulted when she was a student in college. Her first boyfriend in the wake of the rape pressured her into having sex, and she became pregnant as a result. She was 19 years old. She had quit college due to the trauma of the assault, and then her boyfriend left her.

“I didn’t know what to do,” she said.

Brown went to a crisis pregnancy center—facilities that are infamous for distributing false information and deploying scare tactics—but she was concerned about the singular focus the counselors had on her carrying the pregnancy to term. “It was pretty clear that she was more interesting in the pregnancy than she was me as a human being,” she said of a CPC staffer.

Brown’s mother was the first person who told her abortion was an option.

“Don’t you have to go to the cities for that?” Brown asked her mother. “She said that I could go to Fargo. I actually had no idea that there was a clinic in Fargo or that [abortion] was an option at all.”

This was in the late 1980s.

When Brown confided in a friend about the situation, he put her in touch with his sister, who had both carried a pregnancy to term and had an abortion. “She didn’t tell me to do one or the other. She just told me what it was like to have an abortion, and what it was like to have a baby,” Brown said.

At nine weeks pregnant, Brown made an appointment to terminate the pregnancy. A friend drove her to Fargo, three hours away from her home, where she had an abortion.

Now 44 years old, Brown is a college graduate with a career. She is also a mother to a 13-year-old son. She does not regret her decision.

“I don’t feel horrible about the decision I made. I feel horrible about the people who called me a ‘slut’ and the people that called me a ‘baby killer,’” Brown said, “knowing that those people could be living next door to me, or working with me or could be my friends and family.”

“The stigma is the judgement people place on you for doing what you know is best for you,” she said.

Recent research reveals how difficult it can be to even study the stigma of abortion, and advocates at organizations like the Sea Change Program are working to both understand and combat the stigma surrounding abortion.

Both Matthews and Brown think that if more women spoke about their abortion experiences, it might change minds and add much-needed voices to conversations dominated by extreme anti-choice politicians.

“If I’m a group of 50 women or 100 women that came out and said, ‘Yes, I did this,’ that would be different. But as far as I know, I’m a group of one,” Brown said.

Matthews worries about the consequences on women and their families if Measure 1 is passed on Election Day. “I’ve thought about that,” Matthews said, no longer able to control her tears. “I have two daughters, and I don’t know if I’ll be able to stay here and raise them.”

“For a girl that loves horseback riding and doing stuff with the cattle—I just don’t know how long I could stay [in North Dakota] and fight.”