News Abortion

California Bill to Expand Access to Safe Abortion Care Gets Stuck In Committee

Robin Marty

A deadlock has the bill on hold until May 8th at least.

California’s proposal to allow nurses, midwives and physicians assistants to perform first trimester abortions has undergone a few changes, but is still far from becoming law, and may never be thanks to a deadlock in senate committee.

Via UTSanDiego:

Both sides have been lobbying senators leading up to key votes in various committees this week. Among those: Sen. Juan Vargas, D-San Diego.

Vargas ended up casting a crucial “no” vote that produced a 4-4 deadlock in the Senate Business, Professions and Economic Development Committee Thursday.

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The original version of the bill, which would have allowed up to 24,000 medical professionals to be able to perform abortions, was torpedoed by the state’s Nurses Association, resulting in the watered down version that would instead only allow 41 providers who were involved in a special program be approved instead.

But even the new version seems too controversial to come up for a vote, likely due to Vargas’s national congressional aspirations, according to the report.  However, the bill will be reheard on May 8th.

Culture & Conversation Media

It Shouldn’t Take a Superhero to Access Abortion Care in Prison, But in ‘Jessica Jones’ It Does

Renee Bracey Sherman

Critics have hailed the show for its realistic feminist-leaning plot lines and discussions of sexual consent, rape, and addiction. But while the show offers a depiction of a confident abortion decision, the reality of the situation is pure fiction.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

The protagonist of Netflix’s Jessica Jones series is a former superhero with extreme strength who is trying to make it as a freelance private investigator in New York City. Played by Krysten Ritter, Jones is a cynical and whip-smart character who self-medicates with alcohol as she attempts to destroy her mind-controlling arch nemesis, Kilgrave (David Tennant).

Critics have hailed the show for its realistic feminist-leaning plot lines and discussions of sexual consent, rape, and addiction. But while the show depicts a confident abortion decision, the reality of the situation is pure fiction.

In the sixth episode, titled “AKA You’re A Winner!” Jones is called to a local jail after hearing that a young woman she rescued from Kilgrave, Hope Schlottman, was beaten by another incarcerated woman. Jones learns Schlottman paid the woman “$50 and a pack of smokes” in hopes of forcing a miscarriage because she was pregnant by Kilgrave. (Viewers learned in earlier episodes Kilgrave had taken Schlottman under his control—along with other women, including Jones—forcing her into sexual acts and to murder her parents, for which she was in jail.)

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“I’m pregnant … still,” she tells Jones. “I can feel it growing in me, like a tumor.” Schlottman says she wants an abortion but a provider cannot see her for at least two months. She tells Jones that she will pay for additional beatings until she terminates the pregnancy.

“Every second it’s there, I get raped again and again,” Schlottman says, adding, “I wanna live. I wanna have children, but I won’t give life to this thing. I won’t do it.”

Jones works with Schlottman’s lawyer to obtain an abortion pill. When presenting Schlottman with the pill, Jones tells her, “Once you take this there’s no do-overs. You’ll be sick as shit for about eight hours so I need you to be 1,000 percent sure.” Schlottman grabs and swallows the pill before Jones can finish her statement to show how sure she is, muttering, “Please work fast. Please work fast.” The show later depicts Schlottman cramping in her hospital bed as the abortion completes.

While the show does depict a young woman who is confident and determined to end her pregnancy, and who is able to access a medication abortion with the assistance of a superhero, for incarcerated people, this is not nearly the case.

One in 25 women at state prisons and one in 33 women in federal prisons are pregnant at the time they are admitted, according to the Sentencing Project. Like Schlottman, some will seek an abortion. While a set of court cases show how the constitutional right to abortion in the United States applies to people incarcerated, that hasn’t ended the barriers to accessing care. Many barriers are similar to the ones people outside prison face when seeking care, such as mandatory delays, financial hurdles, and transportation challenges, especially when multiple trips to a clinic are mandated under state law, Dr. Carolyn Sufrin, an OB-GYN who works with incarcerated women, told Rewire in an email.

But other barriers, she continued, are manufactured by local sheriffs and administrators, including requiring the cost of transportation and security to be paid up front, demanding additional administrative bureaucracy and court orders, and having incarcerated women cover the cost of the procedure due to the Hyde Amendment and the burden of Medicaid health-care costs shifting to the correctional facility. Women in prison also are more likely to experience unexpected delays and costs, as well as an overall loss of privacy during their decision.

Because courts and prison administrators view abortion as an elective medical care, it is subject to stigmatizing rules, which delay access and increase costs. Some incarcerated people call the American Civil Liberties Union to help expedite the legal process, or the National Network of Abortion Funds, where I work, for funding assistance, but only if they know that’s an option.

But back to Jessica Jones: At the end of the first season, the writers elevate one of the many false tropes about women seeking abortions in media when Schlottman dies by suicide.

More than 15 percent of women depicted in abortion story lines die after choosing to terminate, and 11 percent of those die by suicide, according to a study by the University of California, which looked at film and television from 1916 to 2013. Even when the deaths are not explicitly tied to the characters’ abortion decisions, this pattern reinforces the false narrative that people choosing the procedure experience negative mental health outcomes related to those decisions—rather than, for example, negative outcomes because of their circumstances created by unjust systems and anti-choice legislation—and deserve violence.

All of these circumstances make the depiction of abortion on Jessica Jones implausible. In reality, incarcerated people have a very difficult time accessing abortion care, particularly medication abortions.

Dr. Sufrin explained that the experience of a medication abortion in prison wouldn’t be as pleasant in real life as it is depicted in Jessica Jones.

“[I]t is highly unlikely that a prison or jail will have a provider who is certified to dispense mifepristone, which requires a special dispensing agreement with the manufacturer, and even more unlikely that the facility would stock the medications for medical abortion on site,” said Dr. Sufrin. “What’s more, medical abortion requires at least two visits to a clinic, the first to take the medications and the second for follow-up to confirm the pregnancy has passed. Each trip off-site to a clinic involves extra logistics and staff to transport the woman.”

Dr. Sufrin added that many prisons ration pads, tampons, and pain medication an incarcerated person can have, thus the pregnant person might not receive enough for the bleeding and cramping they’d experience during an abortion. Additionally, incarcerated people seeking a medication abortion are often afforded less privacy because there is no space for them to complete the abortion within the prison, unlike in a clinic for a surgical abortion, Dr. Monica McLemore, assistant professor at the University of California San Francisco School of Nursing, told Rewire.

“[M]edication abortion isn’t really offered as an option because of logistical space issues and ability for pain management, comfort care, and sanitary supplies in the jail,” she said.

“Medical abortion is practically just not a great option for incarcerated women,” said Dr. Sufrin.

The type of correctional facility in which an incarcerated person is held also makes a difference in the care they are able to receive, said Dr. McLemore. She explained that in California, access to an abortion while incarcerated is dependent on whether someone is housed in a public facility where the health services are run by the state health department, or a private facility where the services are privately contracted out.

“In our experience, getting women second-trimester abortions is very difficult at Santa Rita [a private prison] because of delays related to dealing with Corizon [the company with whom the health-care services are contracted],” said Dr. McLemore.

She recently supported a patient who wanted to terminate her pregnancy when she was around 18 weeks, Dr. McLemore said, but was forced to wait until her release over a month later to actually have her abortion.

Being forced to carry an unwanted pregnancy longer than one wants, or to term, can have negative impacts on mental health for anyone, especially an incarcerated person without adequate access to health care and mental health services. Unsurprisingly, a recently released report, called Who Pays? The True Cost of Incarceration on Families, found a majority of the incarcerated people surveyed experienced negative health impacts associated with being in prison. This can be compounded by the experience of not receiving urgent medical care there. Even in cases where the incarcerated person wants to carry the pregnancy to term, they are often denied basic prenatal care to ensure a healthy pregnancy and child.

Serious changes are needed to ensure all incarcerated people receive comprehensive and compassionate health care while in prison, including abortion care. Dr. McLemore said she’d like to see more sheriffs trained on reproductive and gynecological care and the role staff plays in patients receiving it while in custody. Health care should not be dependent on whether a correctional facility’s health system is privately contracted or not, she added.

Similarly, Dr. Sufrin would like to challenge the notion of “elective” and “medically indicated” abortions within the prison system. “An elective procedure is one that can be delayed indefinitely without a significant impact on someone’s life or healthwhich is clearly not the case for pregnancy,” she said. “And when you have women who are not able to access abortions by virtue of being incarcerated, then they are forced to carry unwanted pregnancies as part of their punishment.”

Simply put: It shouldn’t take a superhero to get an abortion in prison.

CORRECTION: A previous version of this article incorrectly stated the U.S. Supreme Court has taken up this issue. In fact, a set of lower court cases show the constitutional right to abortion in the United States applies to people incarcerated. We regret the error.

News Law and Policy

Anti-Choice Groups Try ‘Texas Playbook’ in Attempt to Block Health-Care Access in California

Jessica Mason Pieklo

The fight to open a Planned Parenthood health-care clinic in El Centro, California, shows that national anti-choice groups are intent on rolling back reproductive health care gains in even the most progressive parts of the country.

California may be traditionally progressive with a history of protecting reproductive rights, but Imperial County has become a new front in the anti-choice movement’s effort to erode abortion access well outside the confines of GOP-controlled red states.

Imperial County sits on California’s southeastern corner, bordering Arizona and Mexico. Go west and you’ll hit San Diego; north, and you’ll hit Palm Springs. About 80 percent of the county’s households identify as Latino and 65 percent speak predominately Spanish at home, according to the last census.

Despite its desert landscape, Imperial County has wide swaths of farmland thanks to irrigation fields fed by the Colorado River on its eastern border and the Hoover Dam. Jobs in agriculture account for about a quarter of all employment in the county, and even though the state is in a historic drought, water for the area is all but guaranteed because of local politics.

The same cannot be said for reproductive health care, as national anti-choice activists have focused their attentions on a Planned Parenthood health-care facility opening in the valley’s El Centro, California.

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“Imperial Valley statistically is now rated fourth highest in the state for teen births,” Tracy Skadden, general counsel for Planned Parenthood of Pacific Southwest, told Rewire in an interview. “It has one of the highest rates of unemployment in California; the high schools sometimes have day care centers.”

Skadden said Planned Parenthood agency members spent about five years on the ground in Imperial Valley meeting with members of the community and local organizations to get an understanding of the area’s unique health-care needs before putting together the effort required to open a new facility.

“We know that they don’t have any reproductive health-care access specifically as it relates to abortion services,” Skadden said. “We know that they have very long waits to get in to see a doctor. A lot of the men and women who come to see us, because they don’t have any insurance coverage they really don’t go to doctors very often.”

“Some of the women in their 30s and 40s who come to see us have never had a pap smear,” she continued. Through the Planned Parenthood facility, “they get wellness checks, they get their cholesterol checked, possibly they get screened for diabetes. We don’t treat those things, but we do refer them to other health-care clinics that can.”

The El Centro facility is the only one to provide abortion care anywhere in Imperial County. Still, despite a chronically underserved population in need of comprehensive reproductive health care, Planned Parenthood faced what Skadden described as opposition that was “unprecedented for California” in opening the new facility in El Centro, the heart of Imperial Valley.

After funds for the new facility had been raised, architectural plans were approved by government officials, and all necessary permits were obtained, Planned Parenthood broke ground and finished building the facility this spring.

Then the protests started.

“The thing that triggered the protesters from the very beginning was our ‘now hiring’ sign that we put up under our logo,” Cita Walsh, vice president of marketing and communication, said in an interview with Rewire. “When we put the sign up we had hundreds of people apply for jobs at our health center.”

While the facility applied for a standard transfer agreement for patients with the city-owned El Centro Regional Medical Center, an area church organized about 500 protesters to come to the hospital’s board meeting and complain that by signing the transfer agreement, local officials were “authorizing abortions to occur in Imperial Valley.”

The city, in response to the anti-choice backlash, agreed to hire a third-party law firm to review the transfer agreement. That law firm told the city council the transfer agreement was legal and there was no reason the center should not open.

Walsh said that harassment escalated after the transfer agreement was complete, with more than 2,000 anti-choice protesters complaining to the El Centro city council about the opening of the health-care center.

“The National Right to Life Movement inserted themselves as outsiders into the Imperial Valley in an attempt to embed Imperial County and ignite the local churches and help them organize,” Walsh said.

National anti-choice activists, from former Minnesota Rep. Michele Bachmann (R) to Alveda King, came to the Valley to raise funds for efforts to stop the clinic’s opening.

“They brought in people from out of state to try and get the Imperial Valley Coalition for Life funded in order to teach them how to use the Texas playbook,” Walsh said. The Texas playbook, as described by Walsh, is centered on pressuring local officials into endorsing TRAP (targeted regulations of abortion providers) measures.

“It starts with you try to stop them with transfer agreements and then you have a lot of protesters,” Walsh said. “It felt a little like Mississippi or Texas, but right here in California.”

Days before the facility was set to open, after city officials had told Planned Parenthood of the Pacific Southwest to invite trained staff in to begin setting up, El Centro city officials denied Planned Parenthood of the Pacific Southwest its occupancy permit on the grounds that the building had been improperly classified and would need significant, additional upgrades before opening.

No other comparable facility in California is subject to the more burdensome requirements city officials want to impose on the El Centro facility.

The decision to reclassify the building just prior to its opening was made by El Centro Fire Chief Kenneth Herbert. Herbert explained to Rewire in an email that architects made the initial occupancy classification, but that “[b]ased upon conditions observed,” he decided the building needed more stringent requirements and denied fire clearance.

Herbert declined to elaborate on what conditions he observed that prompted his decision that the facility needed a more stringent classification. He told Rewire that since the initial permit denial, there have been changes made to the building in an attempt to comply with the “occupancy classification B requirements.” After a five-week delay, the city issued the facility a temporary certificate of occupancy.

In other words, the state-of-the-art health-care facility meets all the health and safety requirements it was required to all along.

In signing the licensing document, however, Herbert put in special conditions for their license to remain in place, Skadden said. One condition provides the fire chief with the authority to revoke the document pending a review of the building code by the state’s Fire Marshall Department. Herbert has requested from the State Fire Marshall’s office “a formal interpretation of the occupancy based on the use of the building.” That process could take up to 90 days.

“We complied with all the building, fire, and safety requirements for licensure, but the City of El Centro fire chief made an arbitrary and unilateral decision to deny our final documentation,” Skadden said. “The dispute is over a California building code. But it was clear this was about our abortion services.”

Planned Parenthood of the Pacific Southwest successfully fought back this round of challenges to providing reproductive health care in Imperial County, but more challenges lie ahead. The Imperial Valley Coalition for Life reported on its Facebook page that “friends” of its organization purchased the property right next to the new Planned Parenthood clinic.

The anti-choice group charged that the property is now “available to our prayer warriors from the 365 days for life to park and to pray and it will be available for sidewalk counseling also.”

Meanwhile, those opposed to legal abortion care continue to protest outside the El Centro facility. “We’ve had some vandalism already, but we are very vigilant with our security and our number-one priority is to the safety of our patients and staff,” Skadden said. “California has a long history of protecting reproductive rights, which, thankfully, we were able to rely on our safety and health codes and our California Constitution and other laws that do protect reproductive health care.”

The hope for Planned Parenthood of the Pacific Southwest is that the political fight to provide reproductive health care in Imperial Valley is over. “We intend [to] provide health care in Imperial Valley and to work with the city,” Skadden said. “We all have a mutual goal of increasing the health outcomes of the community in Imperial Valley.”