Commentary Abortion

Your Right to Abortion Care Is in Danger—No Matter Where You Live

Katie Klabusich

Since the Supreme Court gave people in the United States the legal right to abortion care with Roe v. Wade 42 years ago, residents of historically “safe” states have too frequently taken our access to reproductive rights for granted.

Read more stories commemorating the 42nd anniversary of Roe v. Wade here.

Since the Supreme Court gave people in the United States the legal right to abortion care with Roe v. Wade 42 years ago, residents of historically “safe” states have too frequently taken our access to reproductive health care for granted. As someone who has lived in the blue states of Illinois, Maryland, New York, and now California, I’ve seen the pervasive assumption by those who identify as pro-choice that candidates on the left will prioritize access to abortion care—and that we need to do nothing more than dutifully pull the lever for them each November.

This is simply not the case. It’s time we in blue states engaged en masse to demand bold, proactively pro-choice talking points on the campaign trail and in platforms from our would-be legislators and direct action from current office-holders. We should be aggressive about storytelling to end stigma, changing culture by posting our lived experiences on our social media networks, and normalizing abortion care so others in our networks also expect and demand access. If we do not curb our complacency, we risk the complete curtailing of our rights.

Those of us born around or after 1973 often have little, if any, personal connection to the time of abortion prohibition. We assume that although individual legislatures might propose, and even pass, bills restricting our rights, they’ll never get away with it in the long term. After all, we think, that’s what the court system is for! To protect us from extremist legislators and their fits of fancy! We rely on the courts because the media typically refers to Roe as the presiding law without including the effects of Planned Parenthood v. Casey, Gonzales v. Carhart, or other successful measures that have chipped away at our ability to obtain abortion care over the past few decades.

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Week one of the 114th Congress should have gotten everyone’s attention. With the reintroduction of the “Pain Capable Unborn Child Protection Act,” which would ban abortion after 20 weeks in all states, the GOP-led House of Representatives declared its top priority for the session: the contents of Americans’ wombs. The following day, not to be outdone by his pseudoscience-obsessed colleagues Reps. Trent Franks (R-AZ) and Marsha Blackburn (R-TN), Sen. David Vitter (R-LA) picked up the anti-choice baton by proposing four abortion-restricting laws. Vitter’s bills would see Planned Parenthood completely stripped of federal funding (a fight that led to the last government shutdown), outlaw the non-problem of sex-selective abortion, require admitting privileges for all providers, and allow doctors and nurses to refuse abortion care even in life-threatening situations.

These restrictions would endanger abortion access in every state: red, purple, and blue.

Currently, we have a presidential veto to fall back on. With primaries less than a year away and a new administration around the corner, however, that safeguard is not ensured. We can’t wait for that uncertain outcome to urge our elected and would-be legislators to make reproductive health care a priority.

And for those of us in progressives areas, our rallying cry must not simply be, “Please don’t let those restrictions creep across our state’s border!” It’s not just unconscionable for us blue-staters to breathe sighs of relief, confident that our access to safe, legal abortion care will hold as we watch it crumble for our neighbors in red and purple states; blue state access has been slowly and quietly eroded as well. If you’ve been one of those people waiting for restrictions to affect you before engaging, consider this your call to enlist: Your state is not safe, and your rights are not guaranteed.

This year, the Guttmacher Institute deemed more than half the states in the nation to be “hostile” to abortion care. Twenty-four prohibit Affordable Care Act (ACA) health insurance plans from covering abortion, most with only extreme exceptions such as in cases of rape or incest. Eighty-seven percent of U.S. counties have no abortion provider. None of these anti-choice environments are limited to red states.

In fact, in a recently released report card on reproductive rights and health from the international nonprofit group the Population Institute, only 17 states managed a rating of B- or above, based on a combination of factors that include affordability, implementation of comprehensive sex education, and access to clinics and emergency contraception. We should not look at the report card itself as a comprehensive depiction of the health-care access situation in the United States; after all, those of us living in the four A-rated states—California, New Mexico, Oregon, and Washington—can and do face significant barriers to abortion care. My newly adopted home of California, with its vast social safety net and recently enacted abortion provider-expanding law, still only offers care in 55 percent of its counties. My ACA plan through Blue Shield of California may have recently updated its policy to remove the words “medically necessary” from the abortion provision, but I’m still going to fork over substantial travel costs in order to use the coverage I pay for if I move to a rural area. This means none of us can afford to thank our lucky stars and call it a day. People are already being left behind in the “A” states—with more in jeopardy if we don’t safeguard against restrictions enacted on a national level.

In fact, the only reason we aren’t worse off nationally is the implementation of the ACA’s contraception mandate, which greatly improved prevention across the country. When it comes to the Population Institute’s report card, the ACA should have led to drastically higher marks, but thanks to the 231 laws enacted at the state level over the past four years, we’re barely clinging to our C grade overall. And we’re in serious jeopardy of backsliding.

So those of us in blue states with friendly representatives and the rare, but not yet extinct, pro-choice champion must make a habit of letting our legislators know we oppose coverage bans like the Hyde Amendment. When Congress debates a federal budget, Hyde will be reintroduced—as it is every year—in order to prevent Medicaid funds from being used to provide low-income Americans with safe, necessary abortion care. Furthermore, we must also press them to stand against TRAP (targeted regulation of abortion provider) laws that would make it even more difficult for patients to realistically access care. Legislators from conservative districts will seek to continue the tradition of punishing the poor, so we need to embolden our blue state reps by writing, tweeting, and signing petitions asking them to speak for us as well as for those whose representatives work against their interests.

Roe should have been more than a court decision; it should have cemented the right to safe, legal abortion care for all. That is not the case. As of 2012, just 15 percent of Americans said they required a candidate to agree with them on choice—but far more than that will be directly affected by the decisions their candidates make on their behalf. The time to ramp up our stigma-fighting, legislator-lobbying, and capitol-protesting is right now. Legislators in the state houses and in Washington need to hear loud and clear that bodily autonomy isn’t something we take for granted and that we expect them, no matter the ZIP code of their constituency, to affirm our right to decide what happens in our doctors’ offices.

Become part of the storytelling movement—something anyone can do in any state. Speak out against red-state-shaming and lift up the activists fighting uphill battles in their extremist state legislatures. And find out the state of access in your ZIP codes: Are there clinics? If so, do they need support, volunteers, or advocates? What’s the policy on sex ed in your school district? The full slate of positive reproductive health-care policies gets a massive lift when complacently pro-choice blue state residents get off the sidelines.

Take this week’s recognition of Roe and run with it. Use the anniversary as an excuse not just to demand proactive policies from your legislators, but also to discuss abortion and the reality of access in your networks. Then keep at it as though your bodily autonomy depends on it. Because, no matter where you live, it does.

News Abortion

Anti-Choice Leader to Remove Himself From Medical Board Case in Ohio

Michelle D. Anderson

In a letter to the State of Ohio Medical Board, representatives from nine groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Anti-choice leader Mike Gonidakis said Monday that he would remove himself from deciding a complaint against a local abortion provider after several groups asked that he resign as president of the State of Ohio Medical Board.

The Associated Press first reported news of Gonidakis’ decision, which came after several pro-choice groups said he should step down from the medical board because he had a conflict of interest in the pending complaint.

The complaint, filed by Dayton Right to Life on August 3, alleged that three abortion providers working at Women’s Med Center in Dayton violated state law and forced an abortion on a patient that was incapable of withdrawing her consent due to a drug overdose.

Ohio Right to Life issued a news release the same day Dayton Right to Life filed its complaint, featuring a quotation from its executive director saying that local pro-choice advocates forfeit “whatever tinge of credibility” it had if it refused to condemn what allegedly happened at Women’s Med Center.

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Gonidakis, the president of Ohio Right to Life, had then forwarded a copy of the news release to ProgressOhio Executive Director Sandy Theis with a note saying, “Sandy…. Will you finally repudiate the industry for which you so proudly support? So much for ‘women’s health’. So sad.”

On Friday, ProgressOhio, along with eight other groupsDoctors for Health Care Solutions, Common Cause Ohio, the Ohio National Organization for Women, Innovation Ohio, the Ohio House Democratic Women’s Caucus, the National Council of Jewish Women, Democratic Voices of Ohio, and Ohio Voice—responded to Gonidakis’ public and private commentary by writing a letter to the medical board asking that he resign.

In the letter, representatives from those groups shared comments made by Gonidakis and said he lacked the objectivity required to remain a member of the medical board. The letter’s undersigned said the board should take whatever steps necessary to force Gonidakis’ resignation if he failed to resign.

Contacted for comment, the medical board did not respond by press time.

The Ohio Medical Board protects the public by licensing and regulating physicians and other health-care professionals in part by reviewing complaints such as the one filed by Dayton Right to Life.

The decision-making body includes three non-physician consumer members and nine physicians who serve five-year terms when fully staffed. Currently, 11 citizens serve on the board.

Gonidakis, appointed in 2012 by Ohio Gov. John Kasich, is a consumer member of the board and lacks medical training.

Theis told Rewire in a telephone interview that the letter’s undersigned did not include groups like NARAL Pro-Choice and Planned Parenthood in its effort to highlight the conflict with Gonidakis.

“We wanted it to be about ethics” and not about abortion politics, Theis explained to Rewire.

Theis said Gonidakis had publicly condemned three licensed doctors from Women’s Med Center without engaging the providers or hearing the facts about the alleged incident.

“He put his point out there on Main Street having only heard the view of Dayton Right to Life,” Theis said. “In court, a judge who does something like that would have been thrown off the bench.”

Arthur Lavin, co-chairman of Doctors for Health Care Solutions, told the Associated Press the medical board should be free from politics.

Theis said ProgressOhio also exercised its right to file a complaint with the Ohio Ethics Commission to have Gonidakis removed because Theis had first-hand knowledge of his ethical wrongdoing.

The 29-page complaint, obtained by Rewire, details Gonidakis’ association with anti-choice groups and includes a copy of the email he sent to Theis.

Common Cause Ohio was the only group that co-signed the letter that is decidedly not pro-choice. A policy analyst from the nonpartisan organization told the Columbus Dispatch that Common Cause was not for or against abortion, but had signed the letter because a clear conflict of interest exists on the state’s medical board.

Commentary Contraception

Hillary Clinton Played a Critical Role in Making Emergency Contraception More Accessible

Susan Wood

Today, women are able to access emergency contraception, a safe, second-chance option for preventing unintended pregnancy in a timely manner without a prescription. Clinton helped make this happen, and I can tell the story from having watched it unfold.

In the midst of election-year talk and debates about political controversies, we often forget examples of candidates’ past leadership. But we must not overlook the ways in which Hillary Clinton demonstrated her commitment to women’s health before she became the Democratic presidential nominee. In early 2008, I wrote the following article for Rewirewhich has been lightly edited—from my perspective as a former official at the U.S. Food and Drug Administration (FDA) about the critical role that Clinton, then a senator, had played in making the emergency contraception method Plan B available over the counter. She demanded that reproductive health benefits and the best available science drive decisions at the FDA, not politics. She challenged the Bush administration and pushed the Democratic-controlled Senate to protect the FDA’s decision making from political interference in order to help women get access to EC.

Since that time, Plan B and other emergency contraception pills have become fully over the counter with no age or ID requirements. Despite all the controversy, women at risk of unintended pregnancy finally can get timely access to another method of contraception if they need it—such as in cases of condom failure or sexual assault. By 2010, according to National Center for Health Statistics data, 11 percent of all sexually experienced women ages 15 to 44 had ever used EC, compared with only 4 percent in 2002. Indeed, nearly one-quarter of all women ages 20 to 24 had used emergency contraception by 2010.

As I stated in 2008, “All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.”

Now, there are new emergency contraceptive pills (Ella) available by prescription, women have access to insurance coverage of contraception without cost-sharing, and there is progress in making some regular contraceptive pills available over the counter, without prescription. Yet extreme calls for defunding Planned Parenthood, the costs and lack of coverage of over-the-counter EC, and refusals by some pharmacies to stock emergency contraception clearly demonstrate that politicization of science and limits to our access to contraception remain a serious problem.

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Today, women are able to access emergency contraception, a safe, second chance option for preventing unintended pregnancy in a timely manner without a prescription. Sen. Hillary Clinton (D-NY) helped make this happen, and I can tell the story from having watched it unfold.

Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told. On August 31, 2005 I resigned my position as assistant commissioner for women’s health at the Food and Drug Administration (FDA) because the agency was not allowed to make its decisions based on the science or in the best interests of the public’s health. While my resignation was widely covered by the media, it would have been a hollow gesture were there not leaders in Congress who stepped in and demanded more accountability from the FDA.

I have been working to improve health care for women and families in the United States for nearly 20 years. In 2000, I became the director of women’s health for the FDA. I was rather quietly doing my job when the debate began in 2003 over whether or not emergency contraception should be provided over the counter (OTC). As a scientist, I knew the facts showed that this medication, which can be used after a rape or other emergency situations, prevents an unwanted pregnancy. It does not cause an abortion, but can help prevent the need for one. But it only works if used within 72 hours, and sooner is even better. Since it is completely safe, and many women find it impossible to get a doctor’s appointment within two to three days, making emergency contraception available to women without a prescription was simply the right thing to do. As an FDA employee, I knew it should have been a routine approval within the agency.

Plan B emergency contraception is just like birth control pills—it is not the “abortion pill,” RU-486, and most people in the United States don’t think access to safe and effective contraception is controversial. Sadly, in Congress and in the White House, there are many people who do oppose birth control. And although this may surprise you, this false “controversy” not only has affected emergency contraception, but also caused the recent dramatic increase in the cost of birth control pills on college campuses, and limited family planning services across the country.  The reality is that having more options for contraception helps each of us make our own decisions in planning our families and preventing unwanted pregnancies. This is something we can all agree on.

Meanwhile, inside the walls of the FDA in 2003 and 2004, the Bush administration continued to throw roadblocks at efforts to approve emergency contraception over the counter. When this struggle became public, I was struck by the leadership that Hillary Clinton displayed. She used the tools of a U.S. senator and fought ardently to preserve the FDA’s independent scientific decision-making authority. Many other senators and congressmen agreed, but she was the one who took the lead, saying she simply wanted the FDA to be able to make decisions based on its public health mission and on the medical evidence.

When it became clear that FDA scientists would continue to be overruled for non-scientific reasons, I resigned in protest in late 2005. I was interviewed by news media for months and traveled around the country hoping that many would stand up and demand that FDA do its job properly. But, although it can help, all the media in the world can’t make Congress or a president do the right thing.

Sen. Clinton made the difference. The FDA suddenly announced it would approve emergency contraception for use without a prescription for women ages 18 and older—one day before FDA officials were to face a determined Sen. Clinton and her colleague Sen. Murray (D-WA) at a Senate hearing in 2006. No one was more surprised than I was. All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.

Sometimes these success stories get lost in the “horse-race stories” about political campaigns and the exposes of taxpayer-funded bridges to nowhere, and who said what to whom. This story of emergency contraception at the FDA is just one story of many. Sen. Clinton saw a problem that affected people’s lives. She then stood up to the challenge and worked to solve it.

The challenges we face in health care, our economy, global climate change, and issues of war and peace, need to be tackled with experience, skills and the commitment to using the best available science and evidence to make the best possible policy.  This will benefit us all.

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