Analysis Media

‘Philomena’ Reminds Us That the ‘Baby Scoop Era’ Affected Millions

Kathryn Joyce

The Oscar-nominated film Philomena tells the tale of an Irish Catholic mother separated from her son by one of Ireland's infamous 20th century Magdalene Laundries. But this adoption system wasn't limited to mid-century Ireland; there are millions of Philomenas out there.

“We all knew what it meant when a big car arrived,” says Philomena Lee, the namesake character of the Oscar-nominated film Philomena (starring Judi Dench), which tells the tale of an Irish Catholic mother separated from her son by one of Ireland’s infamous 20th century Magdalene Laundries. The laundries were convents-cum-reformatories where unwed pregnant women (or girls caught having sex, or girls who were raped, or girls just thought to be promiscuous), were sent to atone for their sins—usually through hard labor, washing laundry sent in from neighboring villages. They were also de facto adoption agencies, as Catholics from Ireland, but more often the United States, came to adopt the children delivered by pregnant Magdalenes.

What the big car meant, in Philomena’s case, was that an American doctor and his wife had come to adopt her son, Anthony. Like other children born in the convent, Anthony was labeled an orphan, abandoned by his mother, who, though she lived in close proximity to him in the convent, was only allowed to see him an hour a day. Like most other mothers in the laundry, Philomena had to watch as her son was delivered into strangers’ hands, while she remained to work in the convent to pay off her debt for being taken in: four years of labor in lieu of a £100 fee she couldn’t afford. Fifty years later, a modern generation of nuns, wearing friendly cardigans and pouring tea, offered Philomena sympathy, but no information on Anthony’s whereabouts, while residents of the local town whispered that the nuns burned documents to obscure how they’d “sold all those babies to America.”

This is the set-up that sends Philomena, along with world-weary journalist Martin Sixsmith, to America, to search out traces of her son. After they realize early on that he has died—a casualty of the AIDS crisis—the movie’s drama deals with how Philomena faces her grief, her worries that her son had forgotten or resented her, and her pained loyalty to the Catholic Church that oversaw their separation. Philomena, who in the movie and in real life remains a devout Catholic, ceaselessly defended the nuns who imprisoned her and the system they upheld, couching each tentative request for information with assurances that she doesn’t blame the church, and refusing that she was coerced. “I could have never given him a life like this,” she says, reflecting on the comparative opulence of her son’s upper-middle-class life in the United States.

At the end of the movie, Philomena encounters an unrepentant old-school nun who vehemently defends the adoptions—and her subsequent lies to both mother and son—as the just rewards for sex outside marriage. Martin becomes furious, but Philomena forgives, chastising the journalist for his “exhausting” anger.

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Many would read this moral as a particularly Christian message. In any case, it’s one of forgiveness and acceptance. Although the abuses Philomena represented are far tamer than the sadistic cruelty depicted in the 2002 film The Magdalene Sisters, when Philomena was released late last fall, New York Post reviewer Kyle Smith nonetheless panned it as “another hateful and boring attack on Catholics.” Shifting into an anti-abortion argument in a second piece on the movie, written in response to filmmaker Harvey Weinstein’s rebuttal of the review, Smith sneered at the suggestion that the adoptions at the Magdalene Laundries were anything but altruistic. “We all know how cruel it was for the mid-century Catholic Church to provide shelter for scorned women written off as dead by their families, help them give birth to their children and place the adoptees in loving homes,” he wrote. In an open comment to the real Philomena Lee, Smith reminds her that, in the movie, her character avows that the choice to relinquish was hers.

If anything, far from being an anti-Catholic film, Philomena may stray too far in the direction of letting bygones be bygones, and in suggesting forgiveness for a system—both religious and societal—that penalized women who got caught having sex with one of the harshest penalties imaginable: losing their children. (In fact, the emphasis on forgiveness may be poetic license: In the nonfiction book the movie is based on, Martin Sixsmith’s The Lost Child of Philomena Lee, Sixsmith writes that when she learned about the nuns’ obstruction of her and her son’s efforts to connect, the real-life Philomena was angry.)

But a more significant failing of Smith’s review, and his sarcastic follow-up, is his apparently total blindness to the historical reality that Philomena is based on. Not only was the adoption system of the Magdalene Laundries far from benevolent, it was far from limited to mid-century Ireland. The fact is, there are millions of Philomenas.

The “Baby Scoop Era”

Between the 1940s and 1973, when abortion was illegal and single motherhood taboo, unmarried women who became pregnant faced few, punishing options: a shotgun wedding to the father, an illegal abortion that could result in maiming or death, a pariah’s life as a single parent, or “going away,” to one of hundreds of homes for unwed mothers for the duration of their pregnancy, to relinquish their babies for adoption and return home as though nothing had happened. Overwhelmingly, women chose—or were forced to choose—the latter.

It’s a time that in the United States is often referred to as the “Baby Scoop Era,” and during it some estimates hold that a full fifth of all children born to never-married white women relinquished their infants for adoption. For women sent to maternity homes, that number rose to 80 percent, comprising anywhere from 1.5 million to 6 million women.

While, at least in the movie, Philomena maintained that she was never coerced into relinquishing her son, for many U.S. birth mothers or first mothers (preferred terms vary) who are now in their 50s, 60s, or older, the pressure they encountered at maternity homes was harsh and unapologetic. Severe isolation was normal, as was withholding information from women about their pregnancies and impending labor. Maternity home residents were forbidden visits with friends, family, or the fathers of their children, and weren’t allowed to receive letters or phone calls. They were sometimes dropped off at hospitals to labor alone, separate from married mothers, sometimes without pain medication, and pushed to sign relinquishment papers while they were still drugged or recovering from labor. Many were told to deny that they knew the fathers of their children, deliberately misled about their right to keep their babies or about services that could help them, and frequently refused a chance to hold their children after birth. Some had their babies taken while they were sedated or were told that the babies had been stillborn, but were never shown their bodies.

“They wanted to keep us scared to death,” said Karen Wilson-Buterbaugh, the 65-year-old founder of the Baby Scoop Era Research Initiative, which compiles documents from the period. “They didn’t want us to be repeats. It was so traumatizing that many mothers don’t remember the births.”

As a 17-year-old unwed expectant mother, Wilson-Buterbaugh was placed by her Catholic family in a Washington, D.C.-area maternity home in 1966. Women sent there were expected to work for their keep, and there were locks on the doors of the floors housing women considered flight risks. To Wilson-Buterbaugh, the differences between the U.S. maternity homes and the Magdalene Laundries are few. In the United States, widely available baby formula allowed infants to be adopted almost immediately, rather than staying with breastfeeding mothers, and U.S. women were sent home quickly, to return to their lives as “born-again virgins,” unlike their Irish counterparts, who were penalized with further years of debt-bondage. But for many, the sense of lifelong loss is the same.

Lee Campbell, the founder, in 1976, of the pioneering organization Concerned United Birthparents (CUB), the first support group for mothers and fathers whose children were adopted, emphasized how catastrophic that loss could be. Many mothers who relinquished children suffered symptoms of post-traumatic stress disorder (PTSD), and some even experienced grief that researchers found to be more intense than the pain of women whose children died—their pain compounded by a paralyzing lack of resolution, as they wondered for years what happened to their child. Some mothers say the grief was so overwhelming that they couldn’t bring themselves to recognize their loss until years or decades later.

“Birthmothers were like members of a 1978 religious sect in Jonestown who followed their leaders’ command to drink Kool-Aid that had been laced with cyanide,” writes Campbell, in a CUB review of Philomena. “I admit that for ten years, I obediently drank from my own PTSD chalice of Kool-Aid. When its potency began to wane and my PTSD erupted in full, as textbooks say it will after eight to ten years, I started CUB.”

The problems didn’t stop with the end of the Baby Scoop Era in 1973, though the tactics became, in some ways, subtler. For my 2013 book The Child Catchers: Rescue, Trafficking, and the New Gospel of Adoption, I interviewed other mothers who relinquished children for adoption in the mid-80s in Catholic maternity homes, where they were threatened with lawsuits if they backed out of planned adoptions. I interviewed more mothers who’d relinquished in the 2000s, after being sent to modern evangelical maternity homes that coached young Christians to believe that relinquishing would bring God’s blessing.

The problems didn’t stop at U.S. borders either. Similar adoption programs occurred in other countries, particularly Commonwealth nations. However, some of these nations have begun to acknowledge their mistakes. In Canada, several churches have undertaken archival digs to determine what role they may have played in coercive adoptions. In Australia, the advocacy of Baby Scoop Era mothers resulted last year in a national apology from the prime minister for forced adoptions, modeled on the country’s previous apologies for human rights abuses—including forcible adoptions—of indigenous people.

The American Philomenas

For the New York Post’s Kyle Smith, this is apparently unknown history, papered over with the assumption that more adoptions are good, and therefore maternity homes that facilitate more adoptions are good. That’s not a big surprise, but even likely allies seem unaware of the connections between Philomena’s quest and the experiences of millions of U.S. women. Last week, Sen. Claire McCaskill (D-MO) partnered with the real Philomena Lee to call on Ireland to open its adoption records and grapple with its past (a call reflected in a recent petition aimed at the Catholic Church). U.S. birth mothers/first mothers have started a Facebook group called “We Are the American Philomenas,” and they share a sense of bafflement that most people are unaware of how common their story is.

“It’s just beyond our comprehension that they can’t connect those dots, especially after all the efforts we’ve made,” Wilson-Buterbaugh says. “There are millions of Philomenas out there, from just about every country. We’re just flabbergasted that people aren’t figuring this out.”

Like a number of Baby Scoop Era mothers I spoke to, Wilson-Buterbaugh worries that their stories may die with them. CUB’s Lee Campbell worries that, with fading media interest in their stories and a lack of outside support, “CUB’s growl has faded to a mew,” while problems in domestic adoption persist.

This fall, I sat in a room full of mothers at CUB’s annual retreat—women who had relinquished children for adoption ten, 20, or 40 years before. It was a room moved easily to tears, as panel after panel included personal testimonies from women who, decades later, were still hoping to reconnect with their now-adult children, or who had found their children and reunited, only to have them later pull away, overwhelmed by the weight of emotion. No matter how many years they were removed from that loss, the women I met still mourned. And many were still angry.

Representing that anger might have perhaps made Philomena a less palatable film for many mainstream viewers, but as the Post’s review suggests, even a modicum of anger over the sacrosanct institution of adoption can prompt blinding defensiveness.

I thought of this moment when I read that review, imagining that there was no way someone could sit in the midst of that much collective grief and come away to claim that what happened to these women was charity, or remotely a choice. And I thought about it again when I later watched Philomena myself, in a matinee screening in an outer borough of New York, where two women in their 60s remained in their seats, staring at the credits, long after the theater had emptied.

Commentary Sexual Health

‘Not the Enemy, But the Answer’: Elevating the Voices of Black Women Living With HIV

Dazon Dixon Diallo

National HIV Testing Day is June 27. But for longtime advocates, ensuring that the women most affected by the epidemic can get and influence care and policy is the work of many years.

I met Juanita Williams in the mid-1980s. She was the first client at SisterLove, the then-new Atlanta nonprofit I founded for women living with AIDS.

June 27 is National HIV Testing Day, and many women will be tested during the observance. But when I met Williams, HIV was a growing reality in our communities, and women were not even recognized as a population at risk for HIV at that time.

This lack of understanding was reflected in women’s experiences when seeking care. Williams’ attempt to get a tubal ligation had been met with fear, ignorance, and hostility from a medical team who informed her she had AIDS. Not only did they refuse to provide her the medical procedure, the hospital staff promptly ushered her down the back staircase and out the door. Williams was left without information or counseling for what was devastating news.

A Black woman who grew up in Syracuse, New York, she had moved to her family’s home state of South Carolina. Her first major decision after her diagnosis was to leave South Carolina and move to Atlanta, where she believed she would get better treatment and support. She was right, and still, it wasn’t easy—not then and not now. Even today, Williams says, “Positive people are not taken seriously, and positive women are taken even less seriously. People think positive people are way down on the totem pole.”

As communities across the United States observe National HIV Testing Day and emphasize taking control of our health and lives, women’s voices are an essential but still neglected part of the conversation. The experiences of Black women living with HIV, within the broader context of their sexual and reproductive health, highlight the need to address systemic health disparities and the promise of a powerful movement at the intersection of sexual and reproductive justice.

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The urgency of adopting an intersectional approach to sexual and reproductive health comes to light when considering the disproportionate impact of HIV on women of color. Black women account for 69 percent of all HIV diagnoses among women in the South. Advocates also acknowledge the history of biomedical and reproductive oppression that Black women have suffered throughout American history, including forced pregnancy and childrearing during slavery to forced sterilization afterward. Keeping these matters in mind helps us understand how the HIV epidemic is a matter of sexual and reproductive justice.

Taking seriously the perspectives of women such as Williams would amplify our collective efforts to eradicate HIV’s impacts while elevating women’s health, dignity, and agency. This is especially pressing for women living with HIV who experience the greatest disparities and access barriers to the broad spectrum of reproductive health, including contraception and abortion.

The policy context has created additional barriers to advancing the reproductive health of women living with HIV. For example, the 2015 National HIV AIDS Strategy Update neglected to mention family planning or reproductive health services as arenas for providing HIV prevention care. Yet, in many instances, a reproductive health clinic is a woman’s primary or only point of access to health care in a given year. Providing HIV prevention and care in family planning clinics is a way to provide a space where women can expect to receive guidance about their risk of exposure to HIV.

As advocates for women living with HIV, we at SisterLove are committed to ensuring that human rights values are at the center of social change efforts to protect and advance the sexual and reproductive health and rights of women and their families. We work to transform the policy frame to one that asserts women’s agency to make decisions that are best for themselves and their loved ones. We draw strength from the resilience and determination of the women we serve.

Several years after becoming deeply involved with SisterLove, Williams became an advocate for her own reproductive health and began speaking out on behalf of other Black women living with HIV. She eventually became a trainer, counselor, and health outreach worker.

Later, in 2004, Williams was the only woman living with HIV invited to be a main speaker at the historic March for Women’s Lives in Washington, D.C. She is a mother, grandmother, and great-grandmother who has returned to South Carolina, where she teaches other women living with HIV about sexual and reproductive justice and human rights. Williams uses her own story and strength to help other women find theirs.

“Give [women living with HIV] a voice and a platform for that voice,” she has said. “Give a safe place to let their voices be heard and validate them …. We need positive women’s voices to continue to fight the stigma. How do we do that? We tell our stories and reflect each other. I am not the enemy, I am the answer.”

Advocates need strength as we work at many critical intersections where the lives of women and girls are shaped. We cannot address HIV and AIDS without access to contraception and abortion care; health and pay equity; recognition of domestic and gender-based violence; and the end of HIV criminalization. And as advocates for sexual and reproductive health in our communities, SisterLove is working alongside our sisters to support National HIV Testing Day and ensure all people have the information, tools, and agency to take control of their health.

Elevating the health and dignity of people living with HIV calls for special attention to the epidemic’s implications for women of color and Black women, particularly those within marginalized communities and in the Deep South. The voices and leadership of the most affected women and people living with HIV are essential to making our efforts more relevant and powerful. Together, we can advance the long-term vision for sexual and reproductive justice while working to eradicate HIV for all people.

Culture & Conversation Media

TRAP Laws and the Abortion ‘Crisis’: A Conversation With Award-Winning Filmmaker Dawn Porter

Tina Vasquez

Recently, Porter spoke with Rewire about the inaccurate framing of abortion as a “moral” issue and the conditions that have created the current crisis facing providers and patients alike. Her film will air nationally on PBS’ Independent Lens Monday.

Dawn Porter’s documentary TRAPPED focuses on the targeted regulation of abortion providers (TRAP) laws designed to close clinics. But, as Porter told Rewire in a phone interview, TRAPPED is also about “normal people,” the providers and clinic staff who have been demonized due to their insistence that women should have access to abortion and their willingness to offer that basic health-care service.

Between 2010 and 2015, state legislators adopted some 288 laws regulating abortion care, subjecting providers and patients to restrictions not imposed on their counterparts in other medical specialties.

In Alabama, where most of the film takes place, abortion providers are fighting to keep their clinics open in the face of countlessand often arbitrary—regulations, including a requirement that the grass outside the facilities be a certain length and one mandating abortions be performed in far more “institutional” and expensive facilities than are medically necessary.

The U.S. Supreme Court is expected to issue a ruling this month on a Texas case regarding the constitutionality of some TRAP laws: Whole Woman’s Health v. Hellerstedt. The lawsuit challenges two provisions in HB 2: the admitting privileges requirement applied to Whole Woman’s Health in McAllen, Texas, and Reproductive Services in El Paso, Texas, as well as the requirement that every abortion clinic in the state meet the same building requirements as ambulatory surgical centers. It is within this context that Porter’s film will air nationally on PBS’ Independent Lens Monday.

Recently, the award-winning filmmaker spoke with Rewire about the Supreme Court case, the inaccurate framing of abortion as a “moral” issue, and the conditions that have created the current crisis facing providers and patients alike.

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Rewire: What has changed for the clinicians featured in TRAPPED since the documentary premiered at the Sundance Film Festival in January?

Dawn Porter: Now, in Alabama, the legislature has passed a law banning clinics within 2,000 feet of a school. There’s a lot of frustration because the clinicians abide by the laws, and then more are put in place that makes it almost impossible to operate.

Everyone has been really focused on Dalton Johnson’s clinic [the Alabama Women’s Center for Reproductive Alternatives] because the clinic he moved to was across the street from a school, but the law has also affected Gloria [Gray, the director of the West Alabama Women’s Center in Tuscaloosa, Alabama]and that’s not something a lot of us initially realized. She’s afraid this will shut her down for good. I would say this has been a very hard blow for her. I think Dalton was perhaps more prepared for it. He will fight the law.

The good news is that it’s not like either of these clinics will close tomorrow; this gets decided when they go back for relicensing at the end of the year. Right now, they’re in the middle of legal proceedings.

Of course, we’re all also awaiting the Supreme Court decision on Whole Woman’s Health. There’s a lot of uncertainty and anxiety right now, for these clinic owners in particular, but for all clinic owners [nationwide] really.

Rewire: Let’s talk about that. Later this month, the Supreme Court is expected to issue its ruling on that caseEven if the Supreme Court rules that these laws are unconstitutional, do you think the case will change the environment around reproductive rights?

DP: It really depends on how the Court writes the decision. There may be no case in which it’s more important for the Court to have a comprehensive decision. It’s a multiheaded hydra. There’s always something that can close a clinic, so it’s crucially important that this Court rules that nothing can hinder a woman’s right to choose. It’s important that this Court makes it clear that all sham laws are unconstitutional.

Rewire: We know abortion providers have been killed and clinics have been bombed. When filming, did you have safety concerns for those involved?

DP: Definitely. The people who resort to violence in their anti-choice activities areI guess the most charitable way to describe itunpredictable. I think the difficult thing is you can’t anticipate what an irrational person will do. We took the safety of everyone very seriously. With Dr. Willie Parker [one of two doctors in the entire state of Mississippi providing abortions], for example, we wouldn’t publicize if he’d be present at a screening of the film. We never discussed who would appear at a screening. It’s always in the back of your mind that there are people who feel so strongly about this they would resort to violence. Dr. Parker said he’s aware of the risks, but he can’t let them control his life.

We filmed over the course of a few years, and honestly it took me a while to even ask about safety. In one of our last interviews, I asked Dr. Parker about safety and it was a very emotional interview for both of us. Later during editing, there was the shooting at the Colorado clinic and I called him in a panic and asked if he wanted me to take our interview out of the film. He said no, adding, “I can’t let irrational terrorists control my life.” I think everybody who does this work understands what’s at risk.

Rewire: It seems Texas has become ground zero for the fight for abortion access and because of that, the struggles in states like Alabama can get lost in the shuffle. Why did you choose to focus on Alabama?

DP: I met Dr. Parker when he was working in Mississippi. The first meeting I did with him was in December 2012 and he told me that Alabama had three clinics and that no one was talking about it. He introduced me to the clinic owners and it was clear that through them, the entire story of abortion access—or the denial of itcould be told. The clinic owners were all working together; they were all trying to figure out what to do legally so they could continue operating. I thought Alabama was unexplored, but also the clinic owners were so amazing.

To tell you the truth, I tried to avoid Texas for a long time. If you follow these issues around reproductive rights closely, and I do, you can sort of feel like, “Uh, everyone knows about Texas.” But, actually, a lot of people don’t know about Texas. I had this view that everyone knew what was going on, but I realized I was very insulated in this world. I started with Texas relatively late, but decided to explore it because we were following the lawyers with the Center for Reproductive Rights and they were saying one of their cases would likely go to the Supreme Court, and Whole Woman’s Health was most likely. They, of course, were right.

When you’re making a film, you’re emerged in a world and you have to take a step back and think about what people really know, not what you think they know or assume they know.

Rewire: In TRAPPED, you spliced in footage of protests from the 1970s, which made me think about how far we’ve come since Roe v. Wade. Sometimes it feels like we’ve come very far, other times it feels like nothing has changed. Why do you think abortion is such a contentious topic?

DP: I don’t think it’s actually that contentious, to tell you the truth. I think there is a very vocal minority who are extreme. If you poll them, most Americans are pro-choice and believe in the right to abortion in at least some circumstances. Most people are not “100 percent, no abortion” all the time. People who are, are very vocal. I think this is really a matter of having people who aren’t anti-choice be vocal about their beliefs.

Abortion is not the number one social issue. It was pretty quiet for years, but we’ve seen the rise of the Tea Party and conservative Republicans heavily influencing policy. The conservative agenda has been elevated and given a larger platform.

We need to change public thinking about this. Part of that conversation is destigmatizing abortion and not couching it in a shameful way or qualifying it. Abortion is very common; many, many women have them. Three in ten U.S. women have had an abortion before the age of 45. I think that part of the work that needs to be done is around stigma and asking why are we stigmatizing this. What is the agenda around this?

Evangelicals have done a great job of making it seem like this is an issue of morality, and it’s just not. To me, honestly, it doesn’t matter if you’re pro-choice or anti-choice. Everyone is entitled to their own opinions and beliefs. I can respect different opinions, but I can’t respect someone who tries to subvert the political process. People with power and influence who tamper with the political process to impose their beliefs on other people—I really can’t respect that.

Rewire: There are a lot of entry points for conversations about abortion access. What brought you to focus on TRAP laws?

DP: People often discuss abortion in terms of morality, but that’s not what we should be talking about. The reason why these laws have been so effective is because they successfully harm the least powerful of the group they’re targeting. Who’s getting picked on, who’s suffering the most? Women of color, people who are low-income, people who don’t have health insurance. There’s something so unjust about how these laws are disproportionately affecting these populations, and that really bothered me. I’m certainly interested in abortion as a topic, but I’m also interested in politics and power and how those things take shape to hurt the most vulnerable.

Rewire: In TRAPPED, we get to see a very personal side of all the clinicians and providers. One clinician discusses having to be away from her six children all of the time because she’s always at the clinic. We get to see Dr. Willie Parker at church with his family. And it was amazing to learn that the remaining providers in Alabama are friends who regularly eat dinner together. Was it intentional to humanize providers in a way we don’t usually get to see?

DP: Absolutely. The anti-choice side has successfully painted the picture of an abortion provider as this really shady, sinister person. I spent three years embedded in these clinics, and that couldn’t be further from what I saw. These are passionate, brave people, but they’re also very normal people. They’re not superheroes or super villains. They’re just normal people. It’s not that they don’t think about what they’re doing; they’re just very resilient and courageous in a way that makes me very proud. I wanted people to see that.

Rewire: Honestly before watching TRAPPED, I never thought about the personal toll that pressure takes on providers. Dalton Johnson used his retirement funds in order to continue providing abortion care. In several scenes, we see an emotional Gloria Gray struggling with whether or not to keep fighting these laws. Do you think people generally understand what it’s costing providers—financially and emotionally—to continue operating?

DP: I don’t think a lot of us think about that. People like Dalton are saying, “I would rather cash out my retirement than give in to you people.” We should not be asking people to make that kind of sacrifice. That should not be happening.

We also don’t spend enough time thinking about or talking about all of the things that have happened to create the conditions we’re now dealing with. It’s like a perfect storm. Medical schools are not training abortion providers, and the abortion providers that are around are getting older and retiring. Of course laws keep getting passed that make it more and more difficult to run a clinic. In this kind of environment, can you really blame people for not wanting to be providers? Especially when there’s the added pressure of having to take not just your own safety into account, but the safety of your family.

Anti-choice people target the children of abortion providers. They target them at home. This is a hard job if you want to have a life. I mean that literally too—if you literally want to have your life.

This is why so few go into this field. As the number of providers in some states continues to get eliminated, the burden left on those standing is exponentially greater.

The reason why we have a crisis around abortion care is not just laws, but because we have so few physicians. There are all of these factors that have come together, and we didn’t even get to cover all of it in the documentary, including the fact that Medicaid doesn’t cover abortion [under federal law. Seventeen states, however, use state funds to cover abortion care for Medicaid recipients.] A lot of this is the result of conservative lobbying. People have to be aware of all the pressures providers are under and understand that we didn’t get to this point of crisis accidentally.

Rewire: It can feel hopeless, at least to me. What gives you hope when it comes to this unrelenting battle for reproductive rights in this country?

DP: I don’t feel hopeless at all. I feel like it’s really important to be aware and vigilant and connect these dots. I wanted to help people understand the complications and the challenges providers are up against.

These providers have done their part, and now it’s time for the rest of us to do ours. People can vote. Vote for people who prioritize providing education and medical care, rather than people who spend all of their time legislating an abortion clinic. Alabama is in a huge fiscal crisis. The education system is a mess. The Medicaid system is a mess, and the whole Alabama state legislature worked on a bill that would affect a couple of abortion clinics. Voters need to decide if that’s OK. I think this is all very hard, but it’s not at all hopeless.