News Abortion

Abortion on Women Who Aren’t Pregnant? Doctor Refutes Abby Johnson’s Claims

Robin Marty

Former Planned Parenthood employee Abby Johnson sent a written statement in support of Todd Akin's claim that abortion providers do abortions on women who aren't pregnant. She explains how it happens in an email interview. Her assertions are refuted by a medical doctor.

We have mentioned before that the claim that abortion providers do “abortions on women who aren’t even pregnant,” is a common talking point among the radical anti-choice movement. Recently, activist Abby Johnson came to Congressman Todd Akin’s defense when he repeated this claim, saying that as a clinic director in Texas that was exactly what she saw happen.

Via Buzzfeed:

“In support of Congressman Todd Akin, I can attest that when I served as director of Planned Parenthood in Bryan, Texas, we often scared women into getting services they did not need – including abortion – so we could collect the fees,” Johnson said in a statement released to BuzzFeed on Wednesday by Akin’s campaign. “This included women who were not pregnant and women who were in the process of miscarrying.

The statement continued, “Anyone that would attack Congressman Todd Akin for his factual comments on the House floor in 2008 are misguided at best.”

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Performing a D&C on a woman who is miscarrying is of course common medical practice.  I should know—I had my own done in 2009 after I discovered I had lost the fetus weeks earlier and my body had never responded by going into labor. 

But the idea that abortions were performed on women who weren’t pregnant at all, now that is a totally different story. I had read many of Ms. Johnson’s interviews about her time at Planned Parenthood and the organization’s alleged zeal to up its abortion numbers or other plots to increase revenue, but hadn’t seen her claim the practice of pushing abortions on women who weren’t pregnant before.

I asked Ms. Johnson via email if she could clarify how abortions were performed on women who weren’t pregnant, and she was happy to explain:

I was, of course, a fan when I worked at Planned Parenthood. We often performed abortions on women who were nearing the end of their miscarriage. We would convince them it was necessary in order to collect the $400… since they were there anyway and we had already done an ultrasound. With these women, the fetal tissue had passed… we were basically just suctioning out a few cc’s of blood. Totally unnecessary for the patient, but necessary for our bottom line.

Although many reprodutive health professionals would be likely to consider miscarriage management like that to be fairly routine (and, as a woman who has been through the drawn out process of likely retained tissue that caused months of spontanious bleeding and an elevated hcg level, frankly, rather welcome), I was still more interested in the “not-pregnant” women, which Ms. Johnson explained further.

There were times where nothing was visualized in the uterus and we would perform the abortion anyway. Turned out the woman had an ectopic pregnancy. Once, the woman almost died in the ER from a ruptured tube. We paid her off to keep her quiet. That wasn’t the only time something like that happened. Planned Parenthood is not allowed to diagnose ectopic pregnancies, so many times abortions are performed on a non-pregnant uterus and the woman is sent home. Those were my personal experiences.

Ms. Johnson also mentioned the experiences of Carol Everett, the clinic worker in the 70’s who brought the “abortions on women who aren’t pregnant” concept to the religious right. I asked how likely it would be that such a thing occurs today, when pregnancy tests are available in every grocery store and gas station, and the vast majority of women go into a clinic already knowing whether or not they are pregnant.

That is true. But I have read in multiple places that 25 percent of women misread pregnancy tests. And I can tell you that we had women come in all the time who swore they had a negative test at home, but were indeed pregnant. I’m sure it was because of a misread… or possibly denial. Abortion clinics don’t perform pregnancy tests before performing abortions. And they certainly don’t draw quantitative beta HCG’s. So, I can see how the things that Carol Everett talked about could still happen today.

It is standard clinic procedure to do a follow-up pregnancy test to ensure that the patient is pregnant, and to narrow down whether she could have an ectopic pregnancy. I received a fact sheet from one clinic that had a list of factors to be considered if a pregnancy doesn’t show on an ultrasound that includes: 1) the patient is not actually pregnant 2) it’s too early to see anything or 3) the pregnancy is not actually located in the uterus, so it won’t be visible in an ultrasound. The suggested follow up is first to take another pregnancy test at the clinic, and, if it is positive, then wait seven to 14 days before returning for a second ultrasound. By that point, the pregnancy should be visible if it is in the uterus. The fact sheet also supplies the patient with warning signs to watch for should the pregnancy be ectopic, such as pain, dizziness or sudden weakness.

California provider Dr. Radha Lewis, MD, MS, a Physicians for Reproductive Choice and Health Fellow, disagreed with Ms. Johnson’s assertion that clinics don’t perform pregnancy tests, or will try to pressure women into unneeded procedures. “We give every women who comes in saying she is pregnant a pregnancy test, and if it is negative, we offer them birth control,” Dr. Lewis explained when I asked her the basic steps a woman would go through when getting an abortion.

What if the woman has miscarried already? Do clinics urge her to go ahead and get a D&C just in case?

“If a woman has a missed miscarriage we will present her with options,” said Dr. Lewis.  “She can either receive a D&C to complete it, or continue to wait, or we can give her medication to help the uterus contract to expel the tissue. If she is presenting symptoms such as continued bleeding, we would offer surgery in order to help her stop the blood loss and dizziness, just as an emergency room would do the same. This is the same choice provided to every woman across all clinics.”

Some will choose a D&C in order to simply move on, said Dr. Lewis. “She has other children, she is busy. She wants to get it over with and done.”

But force women to have an abortion when she was not actually pregnant? It simply doesn’t happen according to Dr. Lewis. “There are absolutely no instances of women having abortions performed on them when they are not pregnant and to say so is to assume that women are stupid and physicians unethical.”

News Health Systems

Complaint: Citing Catholic Rules, Doctor Turns Away Bleeding Woman With Dislodged IUD

Amy Littlefield

“It felt heartbreaking,” said Melanie Jones. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

Melanie Jones arrived for her doctor’s appointment bleeding and in pain. Jones, 28, who lives in the Chicago area, had slipped in her bathroom, and suspected the fall had dislodged her copper intrauterine device (IUD).

Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“I think my first feeling was shock,” Jones told Rewire in an interview. “I thought that eventually they were going to recognize that my health was the top priority.”

The doctor left Jones to confer with colleagues, before returning to confirm that her “hands [were] tied,” according to two complaints filed by the ACLU of Illinois. Not only could she not help her, the doctor said, but no one in Jones’ health insurance network could remove the IUD, because all of them followed similar restrictions. Mercy, like many Catholic providers, follows directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, tubal ligations, and contraception.

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Some Catholic providers may get around the rules by purporting to prescribe hormonal contraception for acne or heavy periods, rather than for birth control, but in the case of copper IUDs, there is no such pretext available.

“She told Ms. Jones that that process [of switching networks] would take her a month, and that she should feel fortunate because sometimes switching networks takes up to six months or even a year,” the ACLU of Illinois wrote in a pair of complaints filed in late June.

Jones hadn’t even realized her health-care network was Catholic.

Mercy has about nine off-site locations in the Chicago area, including the Dearborn Station office Jones visited, said Eric Rhodes, senior vice president of administrative and professional services. It is part of Trinity Health, one of the largest Catholic health systems in the country.

The ACLU and ACLU of Michigan sued Trinity last year for its “repeated and systematic failure to provide women suffering pregnancy complications with appropriate emergency abortions as required by federal law.” The lawsuit was dismissed but the ACLU has asked for reconsideration.

In a written statement to Rewire, Mercy said, “Generally, our protocol in caring for a woman with a dislodged or troublesome IUD is to offer to remove it.”

Rhodes said Mercy was reviewing its education process on Catholic directives for physicians and residents.

“That act [of removing an IUD] in itself does not violate the directives,” Marty Folan, Mercy’s director of mission integration, told Rewire.

The number of acute care hospitals that are Catholic owned or affiliated has grown by 22 percent over the past 15 years, according to MergerWatch, with one in every six acute care hospital beds now in a Catholic owned or affiliated facility. Women in such hospitals have been turned away while miscarrying and denied tubal ligations.

“We think that people should be aware that they may face limitations on the kind of care they can receive when they go to the doctor based on religious restrictions,” said Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, in a phone interview with Rewire. “It’s really important that the public understand that this is going on and it is going on in a widespread fashion so that people can take whatever steps they need to do to protect themselves.”

Jones left her doctor’s office, still in pain and bleeding. Her options were limited. She couldn’t afford a $1,000 trip to the emergency room, and an urgent care facility was out of the question since her Blue Cross Blue Shield of Illinois insurance policy would only cover treatment within her network—and she had just been told that her entire network followed Catholic restrictions.

Jones, on the advice of a friend, contacted the ACLU of Illinois. Attorneys there advised Jones to call her insurance company and demand they expedite her network change. After five hours of phone calls, Jones was able to see a doctor who removed her IUD, five days after her initial appointment and almost two weeks after she fell in the bathroom.

Before the IUD was removed, Jones suffered from cramps she compared to those she felt after the IUD was first placed, severe enough that she medicated herself to cope with the pain.

She experienced another feeling after being turned away: stigma.

“It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

The ACLU of Illinois has filed two complaints in Jones’ case: one before the Illinois Department of Human Rights and another with the U.S. Department of Health and Human Services Office for Civil Rights under the anti-discrimination provision of the Affordable Care Act. Chaiten said it’s clear Jones was discriminated against because of her gender.

“We don’t know what Mercy’s policies are, but I would find it hard to believe that if there were a man who was suffering complications from a vasectomy and came to the emergency room, that they would turn him away,” Chaiten said. “This the equivalent of that, right, this is a woman who had an IUD, and because they couldn’t pretend the purpose of the IUD was something other than pregnancy prevention, they told her, ‘We can’t help you.’”

 

Tell us your story. Have religious restrictions affected your ability to access health care? Email stories@rewire.news

News Human Rights

What’s Driving Women’s Skyrocketing Incarceration Rates?

Michelle D. Anderson

Eighty-two percent of the women in jails nationwide find themselves there for nonviolent offenses, including property, drug, and public order offenses.

Local court and law enforcement systems in small counties throughout the United States are increasingly using jails to warehouse underserved Black and Latina women.

The Vera Institute of Justice, a national policy and research organization, and the John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge initiative, released a study last week showing that the number of women in jails based in communities with 250,000 residents or fewer in 2014 had grown 31-fold since 1970, when most county jails lacked a single woman resident.

By comparison, the number of women in jails nationwide had jumped 14-fold since 1970. Historically, jails were designed to hold people not yet convicted of a crime or people serving terms of one year or less, but they are increasingly housing poor women who can’t afford bail.

Eighty-two percent of the women in jails nationwide find themselves there for nonviolent offenses, including property, drug, and public order offenses.

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Overlooked: Women and Jails in an Era of Reform,” calls attention to jail incarceration rates for women in small counties, where rates increased from 79 per 100,000 women to 140 per 100,000 women, compared to large counties, where rates dropped from 76 to 71 per 100,000 women.

The near 50-page report further highlights that families of color, who are already disproportionately affected by economic injustice, poor access to health care, and lack of access to affordable housing, were most negatively affected by the epidemic.

An overwhelming percentage of women in jail, the study showed, were more likely to be survivors of violence and trauma, and have alarming rates of mental illness and substance use problems.

“Overlooked” concluded that jails should be used a last resort to manage women deemed dangerous to others or considered a flight risk.

Elizabeth Swavola, a co-author of “Overlooked” and a senior program associate at the Vera Institute, told Rewire that smaller regions tend to lack resources to address underlying societal factors that often lead women into the jail system.

County officials often draft budgets mainly dedicated to running local jails and law enforcement and can’t or don’t allocate funds for behavioral, employment, and educational programs that could strengthen underserved women and their families.

“Smaller counties become dependent on the jail to deal with the issues,” Swavola said, adding that current trends among women deserves far more inquiry than it has received.

Fred Patrick, director of the Center on Sentencing and Corrections at the Vera Institute, said in “Overlooked” that the study underscored the need for more data that could contribute to “evidence-based analysis and policymaking.”

“Overlooked” relies on several studies and reports, including a previous Vera Institute study on jail misuse, FBI statistics, and Rewire’s investigation on incarcerated women, which examined addiction, parental rights, and reproductive issues.

“Overlooked” authors highlight the “unique” challenges and disadvantages women face in jails.

Women-specific issues include strained access to menstrual hygiene products, abortion care, and contraceptive care, postpartum separation, and shackling, which can harm the pregnant person and fetus by applying “dangerous levels of pressure, and restriction of circulation and fetal movement.”

And while women are more likely to fare better in pre-trail proceedings and receive low bail amounts, the study authors said they are more likely to leave the jail system in worse condition because they are more economically disadvantaged.

The report noted that 60 percent of women housed in jails lacked full-time employment prior to their arrest compared to 40 percent of men. Nearly half of all single Black and Latina women have zero or negative net wealth, “Overlooked” authors said.

This means that costs associated with their arrest and release—such as nonrefundable fees charged by bail bond companies and electronic monitoring fees incurred by women released on pretrial supervision—coupled with cash bail, can devastate women and their families, trapping them in jail or even leading them back to correctional institutions following their release.

For example, the authors noted that 36 percent of women detained in a pretrial unit in Massachusetts in 2012 were there because they could not afford bail amounts of less than $500.

The “Overlooked” report highlighted that women in jails are more likely to be mothers, usually leading single-parent households and ultimately facing serious threats to their parental rights.

“That stress affects the entire family and community,” Swavola said.

Citing a Corrections Today study focused on Cook County, Illinois, the authors said incarcerated women with children in foster care were less likely to be reunited with their children than non-incarcerated women with children in foster care.

The sexual abuse and mental health issues faced by women in jails often contribute to further trauma, the authors noted, because women are subjected to body searches and supervision from male prison employees.

“Their experience hurts their prospects of recovering from that,” Swavola said.

And the way survivors might respond to perceived sexual threats—by fighting or attempting to escape—can lead to punishment, especially when jail leaders cannot detect or properly respond to trauma, Swavola and her peers said.

The authors recommend jurisdictions develop gender-responsive policies and other solutions that can help keep women out of jails.

In New York City, police take people arrested for certain non-felony offenses to a precinct, where they receive a desk appearance ticket, or DAT, along with instructions “to appear in court at a later date rather than remaining in custody.”

Andrea James, founder of Families for Justice As Healing and a leader within the National Council For Incarcerated and Formerly Incarcerated Women and Girls, said in an interview with Rewire that solutions must go beyond allowing women to escape police custody and return home to communities that are often fragmented, unhealthy, and dangerous.

Underserved women, James said, need access to healing, transformative environments. She cited as an example the Brookview House, which helps women overcome addiction, untreated trauma, and homelessness.

James, who has advocated against the criminalization of drug use and prostitution, as well as the injustices faced by those in poverty, said the problem of jail misuse could benefit from the insight of real experts on the issue: women and girls who have been incarcerated.

These women and youth, she said, could help researchers better understand the “experiences that brought them to the bunk.”

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