Last week, news broke that outspoken OB-GYN and abortion advocate Dr. Diane Horvath-Cosper has filed a federal civil rights complaint against the MedStar Washington Hospital Center in Washington, D.C., where she is completing a two-year Family Planning Fellowship. She alleges her employer broke the law by forbidding her from publicly speaking about abortion at the risk of losing her job.
On its face, this case may appear to be a localized, isolated incident. But for pro-choice activists and supporters, it represents much more than a passionate doctor pitted against her employer. This is about abortion stigma and the need to affirm and normalize abortion’s role in basic health care—something that’s infinitely harder to achieve when providers are silenced.
In her complaint, Horvath-Cosper argues that the imposed “gag order” discriminates against her pro-choice principles. Her case hinges on the Church Amendment, a Roe v. Wade-era conscience clause that bans federally funded institutions from discriminating against doctors “because of … religious beliefs or moral convictions respecting sterilization procedures or abortions.” The law is typically used to shield medical personnel who refuse to participate in the provision of abortion care, but Horvath-Cosper’s counsel asserts the law is also intended to protect doctors who perform them.
For their part, according to the complaint, MedStar Washington hospital officials claimed the silencing was motivated by safety concerns following the deadly attack on a Colorado Springs Planned Parenthood this past November. However, the hospital has yet to institute robust security measures, such as physical security recommendations as per the National Abortion Federation, according to the New York Times. This leads me to believe its real motivation has to do with stigma, not safety.
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Abortion stigma is everywhere you look: in the media, throughout state legislatures, and outside clinics. It’s largely responsible for proliferating the myth that abortion care is not a form of basic health care (when it is, in fact a commonplace procedure for millions of American women) and for its demonization in public discourse. What’s more, it fuels anti-choice violence—something Horvath-Cosper knows all too well (she’s previously written about what it’s like living in fear of your life simply for providing compassionate abortion care to patients who need it).
Make no mistake about it: Stigma is a pervasive form of gender discrimination that aims to silence providers and punish women for seeking abortions. It is something no other medical specialty contends with. And it is at the heart of this case. Stigma has effectively made free speech and doctor/patient safety mutually exclusive ideals, like a dysfunctional Venn diagram in which the circles exist next to each other, but never overlap.
It’s worth noting that this divisive segregation didn’t happen in a vacuum; two very powerful social contexts have paved the way for Horvath-Cosper’s complaint. In the past year, anti-choice violence, hate speech, and online harassment flourished in the wake of heavily edited and misleading videos attacking Planned Parenthood—all of which are direct products of abortion stigma. In response, the pro-choice community embraced and promoted abortion as a social good. From the popular #ShoutYourAbortion social media campaign to the 1 in 3 Campaign’s Abortion Speakout, activists of all ages and backgrounds have sought to reframe the reproductive rights conversation.
But a conversation can’t happen when silence—the preferred tool of anti-choice bullies—is wielded in the very establishments that provide abortion care. When a hospital’s medical director tells his family planning fellow that the hospital does “not want to put a Kmart blue light special on the fact that we provide abortions,” the message is clear: Abortion is morally repugnant and an unsuitable medical procedure, unworthy of discussion. It’s likewise clear that anti-choice rhetoric and ideology have seeped into the places they least belong, and are being replicated.
Silencing providers does not protect anyone. It only fuels stigma and undercuts the pro-choice community’s efforts to promote and protect reproductive health care. It’s a vicious cycle that doesn’t stand a chance of being broken unless brave advocates like Dr. Horvath-Cosper are allowed to speak the truth.