News Abortion

Maryland Congressman Claims More Women Undergo Sex Selection Abortion Than Get Pregnant By Rape

Robin Marty

In the world of Roscoe Bartlett rape victims seldom need abortions but gender selection is a rampant epidemic.

Maryland Rep. Roscoe Bartlett is just the latest to weigh in on whether or not women can be impregnated through rape or have the right to choose to terminate a pregnancy conceived through violent assault. But unlike some of his more strident anti-choice colleagues, he’s willing to let them make their own choice, since it’s such as small number of women, as opposed to what he claims is the large number of women choosing sex selection abortion.

Via Think Progress:

“Oh, life of the mother – exception of life of the mother, rape and incest. Yeah, I’ve always — that’s a mantra, you know, I’ve said it so often it just spills out,” he said. “If you really – there are very few pregnancies as a result of rape, fortunately, and incest — compared to the usual abortion, what is the percentage of abortions for rape? It is tiny. It is a tiny, tiny percentage.” …. [I]n terms of the percentage of pregnancies, percentage of abortions for rape as compared to overall abortions, it’s a tiny, tiny percentage,” Bartlett said. […]

“Most abortions, most abortions are for what purpose? The just don’t want to have a baby! The second reason for abortion is you’d like a boy and it’s a girl, or vice versa. And I know a lot of people are opposed to abortion who are pro-choice,” Bartlett said.

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Alleged gender-based abortions have become an odd fixation for anti-choice politicians within the last year, especially since the LiveAction “sting” meant to offer Congress a guise to add more scrutiny on abortion providers and open up a line of questioning as to why a woman is seeking a termination. But as studies have shown, there is no indication that sex selection is widespread in the United States and civil rights groups see potential “solutions” as being nothing more than thinly veiled attempts to limit abortion access for communities of other ethnicities.

Commentary Abortion

My Latest Reproductive Health Procedure Makes Anti-Choicers Seem Even More Hypocritical

Katie Klabusich

If anti-choicers truly cared about women to the degree they claim, surely they would treat abortion procedures just like any other reproductive health need—and leave decisions about safety and comfort up to women and their doctors.

Over the past decade or so, the public language in anti-abortion lobbying has shifted from “Save the children!” to “For the health of the mother!” Having apparently determined that over-the-top tactics of lying down in front of cars and chaining themselves to clinic doors were turning off the public at large, prominent groups like the National Right to Life now often push for laws they say benefit “everyone involved”—including the pregnant person.

While anti-choice groups still use inflammatory language like “infanticide” and “abortion mill” in their newsletters and blog posts, the emphasis has shifted to passing targeted regulation of abortion provider (TRAP) laws—all under the guise of protecting, as the National Right to Life puts it on its website, “mothers and their unborn children.”

As a reproductive justice advocate who has had a first-trimester abortion, anti-choicers’ language around these laws became even more clearly hypocritical to me following a different, in-office reproductive health procedure I recently underwent to save my life. Given the degree of anti-choice rhetoric about how much stress women undergo to get abortions, I hadn’t even considered the thought of being uncomfortable and emotionally exhausted by any other reproductive health service. After all, the public doesn’t hear much about the thousands of women like me who are at high risk for cervical cancer, and we certainly aren’t a priority of any anti-abortion group I’ve encountered. If anti-choicers truly cared about women to the degree they claim, surely they would treat abortion procedures just like any other reproductive health need—and leave decisions about safety and comfort up to women and their doctors.

An Arbitrary Standard

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One TRAP law that has been particularly damaging in recent years requires abortion providers to adhere to ambulatory surgical center (ASC) standards. Conveniently omitting that first-trimester abortion only sends a tiny fraction of patients to the hospital in need of follow-up care, anti-choice groups and legislators have continuously maintained that the width of a facility’s hallways, number of parking spaces, and size of the janitorial closets guaranteed through certification as an ASC will be what safeguards the patient’s health during their five-minute procedure.

Dr. Leah Torres, a Salt Lake City, Utah-based OB-GYN specializing in reproductive health, says these laws do exactly the opposite.

“TRAP laws are passed under a false premise of patient safety,” Torres told Rewire. “Patient safety is the top priority of any physician, yet the laws that are passed prohibit me from taking care of people in the safest way I know how. This does, in fact, hurt my patients. Harm is done when physicians’ hands are tied.”

The most famous ASC law was penned in Texas, where its parent omnibus anti-abortion law, HB 2, is winding its way through the appeals courts, due to be heard by the full Fifth Circuit on January 8. Texas is certainly not the only state with this requirement. Anti-abortion groups across the country have pushed laws, such as the model legislation from Americans United for Life, that have proven to close the doors of clinics. Accreditations and building specifications are a matter of public record, so it’s easy to determine whether or not local clinics meet the expensive building requirements to become ASC-certified. If they—like many of the Texas facilities—do not meet those requirements, anti-choicers conceivably know that having the construction done to meet the standards is often a multi-million dollar ordeal that results in closure rather than renovation. 

Occasionally a right-to-lifer will slip and publicly admit that abortion is safer than pregnancy, or that all the talk about “women’s health” is just a façade to divert attention from their intention to close clinics. With those missteps on the record, let’s just be honest about the whole thing: Anti-choice groups and the legislators they back aren’t interested in the health of the patient. Their interest stops at the health of the embryo or fetus. If they cared about the whole health of the patient, that interest would have revealed itself at some point during their more than 40 years in existence as a movement. 

Dr. Torres says she has yet to see someone calling themselves “pro-life” advocating for preventive and life-saving care.

“It is discriminating to profess concern for patient safety for one procedure, for one population—women of reproductive age—and not for all people across all specialties,” says Torres. “It is hypocritical and it feels false, as well as insulting.”

Indeed it does.

Selective Concern

Abortion is, after all, the only reproductive health-care procedure that seems to matter to these groups. Having spent time volunteering and organizing as a clinic defense escort in Chicago, New York, New Jersey, and Los Angeles, I can attest to the very singular focus of the picketers and the groups they represent: With the exception of the occasional anti-contraception sign, all the misinformation-filled pamphlets, screaming, and photoshopped, gory placards are abortion-motivated. This seems curious, as any “life”-focused activist should be interested in the lifesaving services offered at most clinics and doctor’s offices. You never see them screaming on their capitol building’s steps demanding the expansion of preventive care like Pap tests, STI testing, prenatal support, and the like. They aren’t passing out condoms at AIDS walks, or even offering child-care assistance for the children a patient already has. If a National Right to Life, Pro-Life League, or Operation Rescue member is holding a sign somewhere, their only concern is forcing a pregnant person to carry to term.

This gap in empathy and what constitutes “saving a life” exhibited by millions of anti-choicers was particularly evident to me when I went in to my gynecologist this August for a loop electrosurgical excision procedure (LEEP), which removed abnormal tissue on my cervix both for further testing and to hopefully excise any pre-cancerous cells, thus preventing cervical cancer. I am on what I call the “HPV merry-go-round,” having contracted a strain of the human papillomavirus (HPV) in my 20s that my immune system has not yet successfully fought off ten years later. HPV is so common that, according to the Centers for Disease Control and Prevention, “nearly all sexually active men and women get it at some point in their lives,” so I’ve never felt particularly “damaged” by the diagnosis, just frustrated and extremely inconvenienced. 

Most strains don’t cause health problems (especially in men, who often never discover they were or are a carrier). The handful of problematic strains, however, lead to annual HPV-associated cancer diagnoses in approximately 20,000 women and 12,000 men, with cervical cancer in women being the most common (12,109 cases and 4,902 deaths in 2011). As a consequence, preventive treatments such as colposcopies and LEEPs can be literally lifesaving. 

Over the past decade, I’ve gone through occasional stretches with normal Pap test results and just the one doctor’s visit for that year. More often than not, though, I’m back for additional Paps, the now routine-for-me colposcopy to determine just how abnormal or pre-cancerous the cells of my cervix are, and, most recently, a LEEP.

So after three colposcopies and a LEEP—all performed in my doctors’ offices—I’ve had more than my share of “work” done in terms of reproductive health procedures. Personally, I am comfortable saying that my first-trimester abortion was a less stressful appointment and came with less discomfort than the four procedures performed to prevent any developing cervical cancer. My LEEP in August was particularly traumatic because my doctor and her staff had what I will politely describe as a lack of bedside manner. Picturing the cold procedure room where I was left for nearly 90 minutes in only a gown, with no information or counseling from my doctor, makes my pulse race even months later. (According to Torres, the pre-procedure counseling for LEEPs should take place in an office setting with the patient fully clothed.)

When I got home, after having used Twitter heavily during my lengthy wait for the doctor, I checked my feeds. Many people had responded with words of concern and love. Two of my best friends—knowing I have an anxiety disorder and that the lidocaine used to numb my cervix might still be causing heart palpitations in addition to the ones my body was producing on its own—had continued to check in on me while I was on the subway without cell phone service. Everyone, it seemed, was concerned with my health. 

Everyone except the anti-choicers who routinely harass me online for my abortion advocacy, that is. Their silence on my experience—and on the everyday experiences of patients who visit their doctors’ offices for procedures carrying risks similar to abortion—is deafening. They seem to trust medical professionals to perform all manner of non-abortion-related care without bystander intervention; do they not understand that the abortion specialty operates just like the rest of medicine? 

As with other medical fields, best practices for obstetrics and gynecology procedures are governed by associations of medical professionals like the American Congress of Obstetricians and Gynecologists and the National Abortion Federation. Torres says that she spent time developing skills for both LEEPs and first-trimester abortions early on in her career; she considers the “level of surgical skill,” as she put it, required for each to be comparable. 

And the risks for both procedures are comparably negligible, too. The LEEP takes longer because of the time spent waiting for the lidocaine to fully numb the cervix (think the time you spend in the dentist’s chair waiting for the Novocain to kick in before a filling). According to Planned Parenthood, it’s rare to have issues requiring follow-up care after either procedure; the organization’s website counsels patients to watch for similar symptoms, including abnormally heavy bleeding or signs of infection such as fever or vomiting. 

When compared to my LEEP this August, my abortion experience four years earlier at a Planned Parenthood in Chicago was warm, comforting, less painful, and over much more quickly. In fact, I can theoretically see a more understandable case for some of the ASC guidelines being pertinent to the LEEP than to the abortion, as the former felt more invasive—the doctor wears a mask to keep the smoke produced during cauterization out of their eyes, and I was in stirrups more than twice as long. 

Still, no one is demanding legislation to regulate it. Nor, as Torres points out, are they rallying against colonoscopies, which are 40 times as risky as abortion, or dental procedures that require anesthesia.

“There are many riskier procedures done by other specialists in the office and no mention is made of their needing admitting privileges”—another common TRAP law—“or that their procedures require a surgical center,” said Torres. “No one demands [gastro-intestinal] specialists only perform [colonoscopies] in an ASC. Also, if you think about the sedation procedures dentists perform, those medications are also used in surgical procedures in ASCs yet dentists are not required to be in an ASC to use them.” 

In fact, Torres has never seen a law proposed to regulate how she performs any other procedures, including LEEPs, in her office—or how dentists and proctologists and plastic surgeons perform procedures in theirs. 

A LEEP, Torres said, “Saves the life of the patient. I don’t know why those who value life do not advocate for all surgical procedures be performed in ASCs if they are that convinced [ASCs] ‘safer’ and ‘saves lives’ over anything else.” 

She’s not advocating in favor of more of these laws, of course, as they increase the financial and logistic burden on both patients and providers, along with occasionally decreasing safety. She is simply pointing out the reality of which procedures get held up for additional scrutiny. 

“Medically, sometimes the office is safer for a procedure and sometimes the hospital is safer. That [decision] should be made by the medical professional—not the patient, not the lawyers, not the politicians,” said Torres.

“I’m prohibited from performing abortions in Utah hospitals, for example. You’d think that would be the ‘safest’ place, but state laws prohibit facilities receiving state funds from performing abortion—and all Utah hospitals receive state funds. Lots of contradiction,” she continued. “So, if I think I can’t safely perform the abortion in the office, even [one] with ASC standards, then I have to send the patient to another state. This happens all over the country.” 

The Growing Restrictions

Torres couldn’t be more right. Legislators in nearly every part of the country are wasting time and money exhibiting a complete disregard for women’s basic humanity as autonomous persons. Hundreds of laws have been introduced restricting abortions across the country. In fact, since Roe, nearly every state in the union has enacted legislation inserting the state house into exam rooms.

Why do we not trust providers and patients when it comes to one of the safest procedures in medicine? Because, apparently, the patient seeking an abortion has a uterus and presumably was so bold as to have sex, and that means legislators—overwhelmingly rich, white men—have a centuries-old right to dictate what happens next. While no one, not even an anti-abortion “advocate” or legislator, would deny me access to the procedures that have hopefully prevented me from developing cervical cancer, they don’t recognize my right to control the contents of my uterus.

The abortion that I know saved my life? That, anti-choicers feel compelled to weigh in on.

If “pro-life” organizations and legislators truly cared about women’s health, they would be campaigning for wider access to HPV screenings and vaccines. Or, just perhaps, they would stop to consider leaving it up to the experts: the doctors and patients. 

Certainly, the incoming wave of new Republican legislators following the 2014 midterms won’t lead to a lessening of the country-wide trend anytime soon. As Rewire has reported, Americans United for Life is well-funded thanks to wealthy donors like the Koch brothers; its model legislation is ready and waiting for right-wing legislators to introduce this January. Meanwhile, likely Majority Leader Mitch McConnell has promised to introduce a federal 20-week ban in the Senate to match the one the now farther-to-the-right House passed last year. The president is opposed to the ban and would probably veto such legislation, but the national prominence of a bill pushed and passed “for women’s health and safety” gives undue validity to the state-level measures that will follow on its heels. 

Providers like Torres are not opposed to the public discourse and legislator interest in their profession; Torres simply takes issue with the motivation revealed by the way they circumvent evidence and care guidelines from physicians.

“I have no problem with elected representatives involving themselves in public health issues. I think political involvement in health care is necessary,” said Torres. “However, political dictation of how medical care is provided should not occur without the proper medical training and knowledge to support it … Just as I do not walk into a courtroom and start practicing law, they should not interfere with the safe, evidence-based health care [being provided] to their constituents.”

Analysis Abortion

States Continue to Enact Abortion Restrictions in First Half of 2014, But at a Lower Level Than in the Previous Three Years

Rachel Benson Gold & Elizabeth Nash

So far this year, 13 states have adopted 21 new restrictions designed to limit access to abortion, about half the number (41) of similar restrictions that had been enacted by this point last year.

So far this year, 13 states have adopted 21 new restrictions designed to limit access to abortion, about half the number (41) of similar restrictions that had been enacted by this point last year. These restrictions range from requirements that abortion providers have admitting privileges at local hospitals to bans on insurance coverage to limitations on medication abortion. At the same time, and building on momentum from last year, three states moved to protect access to abortion services, while four states and the District of Columbia took steps to improve access to other reproductive health services.

Several reasons exist for the drop in abortion restrictions. Some of the decline is the result of cyclical trends, as states historically have shorter sessions in election years and some state legislatures that have been particularly active on abortion issues (Montana, Nevada, North Dakota, and Texas) are not in session in even-number years (see A Surge of State Abortion Restrictions Puts Providers—and the Women They Serve—in the Crosshairs). In addition, an array of other issues (responses to the heroin epidemic, the expansion of full-benefit Medicaid as allowed by the Affordable Care Act, the common core educational initiative and minimum wage increases) moved to the front burner in many legislatures, perhaps limiting legislative attention to abortion.

Targeted Regulation of Abortion Providers (TRAP)

Nonetheless, access to abortion will become even more difficult in many states because of actions taken this year and, once again, restrictions known as targeted regulations of abortion providers (TRAP), are taking center stage (see TRAP Laws Gain Political Traction While Abortion Clinics—and the Women They Serve—Pay the Price).

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The number of states with TRAP restrictions has more than doubled since 2000

Perhaps spurred by a decision handed down by the U.S. Court of Appeals for the Fifth Circuit upholding a Texas law, Louisiana, and Oklahoma enacted measures requiring abortion providers to have admitting privileges at a local hospital. Once these two new laws go into effect later in the year, seven states will require abortion providers to have admitting privileges (see Targeted Regulation of Abortion Providers). In addition, Arizona and Indiana, which already had stringent requirements on facilities where abortions are performed, moved to allow the state health agency to make unannounced inspections. Altogether, 26 states have some sort of TRAP law, a sharp increase from 2000, when only 11 states had such requirements. With the addition of these new laws, 59 pecent of women of reproductive age live in a state that has enacted TRAP provisions.

Other Abortion Restrictions

In contrast to the momentum gained as a result of court actions on TRAP requirements, interest in banning abortion at about 20 weeks post-fertilization may have been dampened by court rulings. In January, the U.S. Supreme Court declined to review a lower court decision striking down an Arizona law banning abortion at 18 weeks post-fertilization based on the notion that a fetus feels pain at that point in pregnancy. In 2013, three such bans were enacted (and 11 have been enacted since 2010). This year, however, only Mississippi enacted this type of measure. West Virginia Gov. Earl Ray Tomblin (D) vetoed a similar measure. Including Mississippi, ten states now have laws in effect that ban abortion at about 20 weeks post-fertilization (see State Policies on Later Abortion).

State abortion restrictions affect a substantional proportion of American women

Similarly, the Supreme Court refused to review a state court ruling striking down a ban on medication abortion in Oklahoma. (That action did not affect a separate state ban on the use of telemedicine to provide the medication.) Following the Court’s ruling, the state enacted a measure mandating use of the outdated FDA-approved protocol that requires higher doses of the medication, has an increased risk of side effects and is more expensive; this new restriction goes into effect in November (see Medication Abortion Restrictions Burden Women and Providers—and Threaten U.S. Trend Toward Very Early Abortion). So far this year, Oklahoma is the only state to restrict access to medication abortion, compared with seven that did so in 2013. Currently, 16 states limit access to medication abortion (see Medication Abortion) including 15 that bar use of telemedicine and two that require use of the outdated FDA protocol (Texas is the only state that has both types of restrictions in effect).

Two states have adopted restrictions on insurance coverage of abortion so far this year. Georgia moved to limit coverage in policies sold on the insurance exchange established under the Affordable Care Act to cases of life endangerment and significant risk to the woman’s health, and codify what had been a similar administrative policy that prohibits abortion coverage in the health plan for state employees except when the woman’s life is endangered. Similarly, Indiana, which had already restricted coverage on the exchange to instances of life endangerment, rape, incest and significant risk to the woman’s health, expanded its restriction to apply to any private insurance policy purchased in the state. A total of 25 states restrict coverage of abortion in private insurance plans (see Restricting Insurance Coverage of Abortion).

South Dakota enacted a new provision to ban abortion for purposes of sex selection. This new law brings to seven the number of states with such a ban (see A Problem-and-Solution Mismatch: Son Preference and Sex-Selective Abortion Bans).

In addition, eight states moved to expand existing abortion restrictions relating to counseling requirements, waiting periods, parental consent, Medicaid funding, gestational limits, and provider refusal (see full analysis here).

Proactive Legislation

Three states have moved to expand or protect access to abortion services so far this year:

  • In early June, New Hampshire adopted a law that would establish a buffer zone of up to 25 feet around clinic entrances. (The law came before the Supreme Court decision in McCullen v. Coakley in late June that invalidated a 35-foot buffer zone in Massachusetts; the impact of this ruling on the New Hampshire law is still to be determined.) Two other states, Colorado and Montana, have so-called floating buffer zones that prohibit a protester from getting within eight feet of a patient when the patient is within a specified distance from the clinic (see Protecting Access to Clinics); these floating zones were upheld by the Court in 2000.
  • In March, Utah moved to remove obstacles to obtaining an abortion in cases of fetal impairment by waiving counseling requirements in those cases.
  • In April, Vermont repealed its pre-Roe abortion ban; the move would protect access to abortion services in the event Roe is overturned (see Abortion Policy in the Absence of Roe).

Four states and the District of Columbia took steps to expand access to other sexual and reproductive health services:

  • A new law in Maryland seeks to provide access to confidential care for individuals insured as dependents on someone else’s insurance policy, such as a parent or spouse; the law is similar to one enacted in California in 2013 (see A New Frontier in the Era of Health Reform: Protecting Confidentiality for Individuals Insured as Dependents).
  • The District of Columbia joined 28 states to allow health care practitioners to provide at least some STI treatment for the partner of a patient diagnosed with an STI without first examining the partner (see Partner Treatment for STIs).
  • Three states—Connecticut, New Mexico, and South Carolina—expanded requirements for sex education; a new law in Connecticut requires education on dating violence and the laws in New Mexico and South Carolina require education on sexual abuse (see Sex and HIV Education).

Read about sexual and reproductive health and rights in the states (updated each month).
Read about the current status of state policies (updated each month).
See a chart of laws enacted in 2014 (updated each month).

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