Commentary Politics

Four Facts Nancy Pelosi—and All ‘Pro-Choice’ Democrats—Should Know About Abortion

Jodi Jacobson

House Minority Leader Nancy Pelosi could not articulate a vigorous, unapologetic, and evidence-based response on abortion to questions posed in an interview this week by Roll Call's Melinda Henneberger.

Just a week or so after Democratic National Committee Chairwoman Rep. Debbie Wasserman Schultz (D-FL) blamed voters for being “complacent” about abortion, House Minority Leader Nancy Pelosi illustrated why, despite being the nominally pro-choice party, Democrats continuously fail to lead on the issue of reproductive health care.

Pelosi could not articulate a vigorous, unapologetic, and evidence-based response on abortion to questions posed in an interview this week by Roll Call‘s Melinda Henneberger. In fact, Pelosi expressed discomfort with using the word “abortion,” underscoring how deeply abortion stigma has permeated the discourse of even the female leader of the Democratic Party, one of the most powerful women in the United States.

It is more than clear that abortion will continue to be politicized through the 2016 election and beyond. But Democrats persist in stumbling when asked about it. So here are some facts that any politician claiming to be pro-choice—and otherwise charged with protecting the interests, rights, and health of the voters who put them in office—must master and assert without apology.

Access to safe abortion care is fundamentally a matter of public health. In countries where access to abortion is limited either by law or in practice, women face high rates of maternal mortality and morbidity. In other words, they die and are injured, sometimes permanently, at far higher rates than in countries or regions where access to safe abortion care is guaranteed. This was indeed the case in the United States before Roe v. Wade.

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Today, according to conservative estimates, more than 300,000 women worldwide die each year from complications from pregnancy, childbirth, and unsafe abortion. That’s 830 women each and every day. These are women in their teens to their late 40s, who are most likely to be raising children and earning critical income for their families. Many times the number who die from unsafe abortion suffer long-term illness and disability instead.

In Uganda, for example, due to lack of access to contraception among other factors, more than four in ten births are unplanned, and women say they have far larger families than they want. In their struggle to have fewer children, they often resort to abortion. Abortion is, however, illegal in Uganda, and access to safe abortion is only available to the wealthy. Not surprisingly, Uganda has one of the world’s highest rates of maternal death, and estimates indicate that if rates of clandestine abortion continue, half of all women in Uganda will need treatment for complications of unsafe abortion at some point in their lives.

By contrast, as was the case for the United States, rates of maternal deaths and illnesses from unsafe abortion declined dramatically in both Nepal and in South Africa after those two countries legalized and increased access to abortion care.

The deaths of women should be reason enough to address the need for safe abortion, but families also suffer. When a mother dies, her children, especially those under 5, are more likely to suffer malnutrition, neglect, and death. As I first wrote more than 25 years ago, history has long shown that politically or religiously motivated laws will never eliminate abortion; they only make it more costly in terms of women’s health, and the health and well-being of their families. The fact of abortion as a public health issue should be the first talking point in any informed conversation led by pro-choice politicians.

Abortion is a matter of fundamental human rights. Every person on earth has the right to determine whether or not to become a parent, and when and with whom to have a child, although clearly too many people are as yet unable to exercise these rights.

Furthermore, the international community has long recognized the broader fundamental human rights of women. According to the 1993 Vienna Declaration on Human Rights:

The human rights of women and of the girl-child are an inalienable, integral and indivisible part of universal human rights. The full and equal participation of women in political, civil, economic, social and cultural life, at the national, regional and international levels, and the eradication of all forms of discrimination on grounds of sex are priority objectives of the international community.

Choice in childbearing, childbirth, and parenting are fundamental to women’s ability to make decisions about their participation in society, on their own terms. Women, however, cannot exercise these fundamental human rights without unfettered access to contraception and abortion. Yet too many governments, politicians, and religious leaders appear willing to abrogate access to these basic health interventions, ironically on the basis of a “pro-life” agenda—albeit one that ignores the value of women’s lives. Any politician who calls themselves pro-choice should understand the need to protect and promote the human rights of living, breathing women, and be able to articulate them.

Abortion is a fundamental economic issue. Access to both contraception and abortion play a major role in women’s economic lives. There have been innumerable academic studies carried out and policy papers written over the past several decades about the connections between access to abortion and women’s economic status throughout the world, and all of them come to the same conclusions: The ability to control reproduction is essential to women’s abilities to support themselves and their families, and is essential to long-term economic growth.

Having a child or children is a major lifetime economic investment for anyone; the U.S. Department of Agriculture has estimated that it now costs more than $245,000 to raise a child in this country, not including the costs of college tuition. A study by the Economic Policy Institute shows that child care alone outpaces the cost of rent in 500 of 618 municipalities examined. Given these and other considerations, such as low wages and the cost of health insurance, transportation, food, clothing, and other necessities, unintended pregnancy can throw a family into economic crisis. Studies show that most women seeking abortion are already struggling financially, cannot afford an additional child, or want to continue their education to create a better future for themselves and their families.

The Turnaway Study, a multi-faceted research project on abortion conducted by researchers at the University of California, San Francisco’s Advancing New Standards in Reproductive Health program, examined the relationship between abortion, reproductive control, and poverty, among other things. As noted in a policy brief by the Reproductive Health Technologies Project about the economics of abortion and women’s lives, the Turnaway Study found that women denied an abortion in the United States had three times greater odds of ending up below the federal poverty line two years later than did women in similar economic circumstances who were able to obtain an abortion, adjusting for any previous differences between the two groups.

Smaller family size and educational attainment are among two of the most critical factors in the economic success of families and communities. Women and their partners know what it means to bring a child into the world and what it takes to raise children, and only they are equipped to make decisions about whether they have the financial and emotional means to make that commitment. Access to abortion is therefore fundamentally about personal and family economics. Abortion is about what women want for their future, and the future of any children now and later.

Access to abortion also has wider social and economic implications. According to the World Health Organization’sSafe abortion care: the public health and human rights rationale:”

Safe abortion is cost saving. The cost to health systems of treating the complications of unsafe abortion is overwhelming, especially in poor countries. The overall average cost per case that governments incur is estimated (in 2006 US dollars) at US$ 114 for Africa and US$ 130 for Latin America. The economic costs of unsafe abortion to a country’s health system, however, go beyond the direct costs of providing post-abortion services. A recent study estimated an annual cost of US$ 23 million for treating minor complications from unsafe abortion at the primary health-care level; US$ 6 billion for treating post-abortion infertility; and US$ 200 million each year for the out-of-pocket expenses of individuals and households in sub-Saharan Africa for the treatment of post-abortion complications. In addition, US$ 930 million is the estimated annual expenditure by individuals and their societies for lost income from death or long-term disability due to chronic health consequences of unsafe abortion.

Unintended pregnancies also have other cost implications. Researchers at the Brookings Institute found that the United States spends $12 billion each year to cover medical care for women who experience unintended pregnancies and on infants who were conceived unintentionally.

In short, it is a fact that providing people with the means needed to make choices in childbearing is economically beneficial at all levels of society. In a country otherwise obsessed with individual economic choices, this should be a clear argument.

Abortion is an individual health issue. Yes, abortion is an individual health issue, related to but separate from its broader role in public health. Anyone who has had—or knows someone who has had—a difficult pregnancy, a miscarriage, an emergency c-section, a stillbirth, or any number of other complications is aware, pregnancy and childbirth can be wonderful and can be life-threatening, and the reality of either is a roll of the dice.

There are any number of contraindications for pregnancy that would result in the need for an abortion and any number of complications that can arise during a pregnancy, threatening the life or health of the pregnant person, the fetus, or both. The potential for very serious complications rises later in pregnancy, or after 20 weeks, the magic number alighted on by anti-choice zealots as somehow being a rational point after which abortion should be banned.

Any number of complications compromising the health of a pregnant person can occur, or fetal anomalies can be found, at or after 20 weeks of pregnancy, potentially causing even the most wanted pregnancy to go awry. Henneberger, now editor in chief at Roll Call, has frequently advocated for 20-week abortion bans, either not understanding or not caring that such a ban would dramatically limit access to medical care for untold numbers of women who face complications. Pelosi should have been able to more forcefully tell her why this is dangerous.

The United States is sliding backward on many fronts, including on access to contraception and abortion, two public health interventions for which the cost-benefit analyses are clear.

Politicians who claim to be pro-choice and raise money from citizens who support public health, human rights, and choice in childbearing must be able to articulate, embrace, and defend their positions. For too long, Democrats have come across as inept and apologetic when talking about abortion, even though the facts are clear and indisputable.

It’s time for this to stop.

News Politics

Anti-Choice Democrats: ‘Open The Big Tent’ for Us

Christine Grimaldi & Ally Boguhn

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America gathered Wednesday in Philadelphia during the party’s convention to honor Louisiana Gov. John Bel Edwards (D) for his anti-choice viewpoints, and to strategize ways to incorporate their policies into the party.

The group attributed Democratic losses at the state and federal level to the party’s increasing embrace of pro-choice politics. The best way for Democrats to reclaim seats in state houses, governors’ offices, and the U.S. Congress, they charged, is to “open the big tent” to candidates who oppose legal abortion care.

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America members repeatedly attempted to distance themselves from Republicans, reiterating their support for policies such as Medicaid expansion and paid maternity leave, which they believe could convince people to carry their pregnancies to term.

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Their strategy, however, could have been lifted directly from conservatives’ anti-choice playbook.

The group relies, in part, on data from Marist, a group associated with anti-choice polling, to suggest that many in the party side with them on abortion rights. Executive Director Kristen Day could not explain to Rewire why the group supports a 20-week abortion ban, while Janet Robert, president of the group’s board of directors, trotted out scientifically false claims about fetal pain

Day told Rewire that she is working with pro-choice Democrats, including Sen. Kirsten Gillibrand and Rep. Rosa DeLauro, both from New York, on paid maternity leave. Day said she met with DeLauro the day before the group’s event.

Day identifies with Democrats despite a platform that for the first time embraces the repeal of restrictions for federal funding of abortion care. 

“Those are my people,” she said.

Day claimed to have been “kicked out of the pro-life movement” for supporting the Affordable Care Act. She said Democrats for Life of America is “not opposed to contraception,” though the group filed an amicus brief in U.S. Supreme Court cases on contraception. 

Democrats for Life of America says it has important allies in the U.S. House of Representatives and the U.S. Senate. Sens. Joe Donnelly (IN), Joe Manchin (WV), and Rep. Dan Lipinski (IL), along with former Rep. Bart Stupak (MI), serve on the group’s board of advisors, according to literature distributed at the convention.

Another alleged ally, Sen. Bob Casey (D-PA), came up during Edwards’ speech. Edwards said he had discussed the award, named for Casey’s father, former Pennsylvania Gov. Robert P. Casey, the defendant in the landmark Supreme Court decision, Planned Parenthood v. Casey, which opened up a flood of state-level abortions restrictions as long as those anti-choice policies did not represent an “undue burden.”

“Last night I happened to have the opportunity to speak to Sen. Bob Casey, and I told him … I was in Philadelphia, receiving this award today named after his father,” Edwards said.

The Louisiana governor added that though it may not seem it, there are many more anti-choice Democrats like the two of them who aren’t comfortable coming forward about their views.

“I’m telling you there are many more people out there like us than you might imagine,” Edwards said. “But sometimes it’s easier for those folks who feel like we do on these issues to remain silent because they’re not going to  be questioned, and they’re not going to be receiving any criticism.”

During his speech, Edwards touted the way he has put his views as an anti-choice Democrat into practice in his home state. “I am a proud Democrat, and I am also very proudly pro-life,” Edwards told the small gathering.

Citing his support for Medicaid expansion in Louisiana—which went into effect July 1—Edwards claimed he had run on an otherwise “progressive” platform except for when it came to abortion rights, adding that his policies demonstrate that “there is a difference between being anti-abortion and being pro-life.”

Edwards later made clear that he was disappointed with news that Emily’s List President Stephanie Schriock, whose organization works to elect pro-choice women to office, was being considered to fill the position of party chair in light of Rep. Debbie Wasserman Schultz’s resignation.

“It wouldn’t” help elect anti-choice politicians to office, said Edwards when asked about it by a reporter. “I don’t want to be overly critical, I don’t know the person, I just know that the signal that would send to the country—and to Democrats such as myself—would just be another step in the opposite direction of being a big tent party [on abortion].” 

Edwards made no secret of his anti-choice viewpoints during his run for governor in 2015. While on the campaign trail, he released a 30-second ad highlighting his wife’s decision not to terminate her pregnancy after a doctor told the couple their daughter would have spina bifida.

He received a 100 percent rating from anti-choice organization Louisiana Right to Life while running for governor, based off a scorecard asking him questions such as, “Do you support the reversal of Roe v. Wade?”

Though the Democratic Party platform and nominee have voiced the party’s support for abortion rights, Edwards has forged ahead with signing numerous pieces of anti-choice legislation into law, including a ban on the commonly used dilation and evacuation (D and E) procedure, and an extension of the state’s abortion care waiting period from 24 hours to 72 hours.

News Law and Policy

Three Crisis Pregnancy Centers Served for Breaking California Law

Nicole Knight Shine

The notices of violation issued this month mark the first time authorities anywhere in the state are enforcing the seven-month-old Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act.

The Los Angeles City Attorney is warning three area fake clinics, commonly known as crisis pregnancy centers (CPCs), that they’re breaking a new state reproductive disclosure law and could face fines of $500 if they don’t comply.

The notices of violation issued this month mark the first time authorities anywhere in the state are enforcing the seven-month-old Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act, advocates and the state Attorney General’s office indicate.

The office of City Attorney Mike Feuer served the notices on July 15 and July 18 to two unlicensed and one licensed clinic, a representative from the office told Rewire. The Los Angeles area facilities are Harbor Pregnancy Help Center, Los Angeles Pregnancy Services, and Pregnancy Counseling Center.

The law requires the state’s licensed pregnancy-related centers to display a brief statement with a number to call for access to free and low-cost birth control and abortion care, and for unlicensed centers to disclose that they are not medical facilities.

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“Our investigation revealed,” one of the letters from the city attorney warns, “that your facility failed to post the required onsite notice anywhere at your facility and that your facility failed to distribute the required notice either through a printed document or digitally.”

The centers have 30 days from the date of the letter to comply or face a $500 fine for an initial offense and $1,000 for subsequent violations.

“I think this is the first instance of a city attorney or any other authority enforcing the FACT Act, and we really admire City Attorney Mike Feuer for taking the lead,” Amy Everitt, state director of NARAL Pro-Choice California, told Rewire on Wednesday.

Feuer in May unveiled a campaign to crack down on violators, announcing that his office was “not going to wait” amid reports that some jurisdictions had chosen not to enforce the law while five separate court challenges brought by multiple fake clinics are pending.

Federal and state courts have denied requests to temporarily block the law, although appeals are pending before U.S. Court of Appeals for the Ninth Circuit.

In April, Rebecca Plevin of the local NPR affiliate KPCC found that six of eight area fake clinics were defying the FACT Act.

Although firm numbers are hard to come by, around 25 fake clinics, or CPCs, operate in Los Angeles County, according to estimates from a representative of NARAL Pro-Choice California. There are upwards of 1,200 CPCs across the country, according to their own accounting.

Last week, Rewire paid visits to the three violators: Harbor Pregnancy Help Center, Los Angeles Pregnancy Services, and Pregnancy Counseling Center.

Christie Kwan, a nurse manager at Pregnancy Counseling Center, declined to discuss the clinic’s noncompliance, but described their opposition to the state law as a “First Amendment concern.”

All three centers referred questions to their legal counsel, Alliance Defending Freedom (ADF), an Arizona-based nonprofit and frequent defender of discriminatory “religious liberty” laws.

Matt Bowman, senior counsel with ADF, said in an email to Rewire that forcing faith-based clinics to “communicate messages or promote ideas they disagree with, especially on life-and-death issues like abortion,” violates their “core beliefs” and threatens their free speech rights.

“The First Amendment protects all Americans, including pro-life people, from being targeted by a government conspiring with pro-abortion activists,” Bowman said.

Rewire found that some clinics are following the law. Claris Health, which was contacted as part of Feuer’s enforcement campaign in May, includes the public notice with patient intake forms, where it’s translated into more than a dozen languages, CEO Talitha Phillips said in an email to Rewire.

Open Arms Pregnancy Center in the San Fernando Valley has posted the public notice in the waiting room.

“To us, it’s a non-issue,” Debi Harvey, the center’s executive director, told Rewire. “We don’t provide abortion, we’re an abortion-alternative organization, we’re very clear on that. But we educate on all options.”

Even so, reports of deceit by 91 percent of fake clinics surveyed by NARAL Pro-Choice California helped spur the passage of the FACT Act last October. Until recently, a person who Googled “abortion clinic” might be directed to a fake clinic, or CPC.

Oakland last week became the second U.S. city to ban false advertising by facilities that city leaders described as “fronts for anti-abortion activists.” San Francisco passed a similar ordinance in 2011.