Newsflash: It's Not Unusual To Measure Pregnancy From Two Weeks Prior To Conception

The following is a cross-post from RHRealityCheck.org
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Dear Everyone,
Please stop referring to Arizona's new abortion ban as the "Pregnancy Begins Two Weeks Before Conception Act."  It's an ill-informed statement and makes us all look like we don't know what we're talking about.  Plus, it focuses on the wrong aspects of the bill.

First of all, from a health care standpoint, pregnancy is nearly always measured from two weeks prior to when implantation (the physiological beginning of pregnancy) actually occurs.  All clinicians - doctors, midwives, the good folks at your local Planned Parenthood - measure pregnancy not from how long a person has actually been pregnant, but from their last menstrual period (LMP), which falls about two weeks prior to implantation.  This is partly because we don't always know exactly when a person actually became pregnant, but mostly because it's far more accurate to measure a person's unique gestation rate by her cycle. 

In other words, if I was pregnant and had my last menstrual period on July 23, I would be classified as "six weeks pregnant" even though I've probably only been pregnant for about four.  This is not unusual, and all clinics that provide abortions measure your pregnancy this way.

Now, let's instead focus on the real problems with this bill.  The ban on abortions after the 20th week LMP (18 weeks gestation, for those of you playing along at home) is an arbitrary marker backed up by the idea that fetuses feel pain after this point (there in fact is no evidence to support this claim).  My own state of North Carolina has had this ban in place for years, as do Alabama, Louisiana, Kansas, Idaho, Indiana, Nebraska, and Oklahoma. The Arizona bill also requires women to have an ultrasound 24 hours to having an abortion, requires clinics that provide abortions to be held to higher standards than most other outpatient surgical facilities, and states that providers must have admitting privileges in local hospitals (again not something that is generally required of practitioners operating in other kinds of outpatient surgical centers).  In other words, the Arizona bill is a major attack on abortion access, not just a bill that challenges our understanding of gestational measurement.

So really, instead of calling it the "Pregnancy Begins Two Weeks Before Conception Act," I'd like to suggest the following alternatives:

• The "Let's All Use Bunk Science To Legislate When A Fetus Feels Pain" Act
• The "Arbitrary Guidelines On Gestational Restrictions For Abortion" Act
• The "Women Are Incapable Of Making Their Own Decisions" Act
• The "State-Sanctioned Rape" Act (to borrow from the Virginia bill passed earlier this year)
• The "Let's Place So Many Restrictions On Who Can Provide Abortions That No One Can" Act

The above suggestions don't necessarily roll off the tongue, and to be sure they don't make for decent soundbites either.  But they would keep this whole mess from becoming known as the "Pro-Choice People Don't Know Anything About Pregnancy" debacle. 

Your Friendly Full-Spectrum Doula,
Lauren

Why Birthing Rights Matter to the Pro-Choice Movement

In the more abortion-focused circles of the pro-choice movement, birthing rights often go undiscussed.  My mentions of home birth rights specifically have brought varying responses, from supportive to ambivalent to outright hostile ("Well that is not safe!"). 

But let's be clear about something.  Reproductive justice means that everyone has complete control over if, when, where, how, and with whom they bring a child into the world.  It means that people have accurate, unbiased access to information regarding all facets of their reproductive lives, from contraception to pregnancy options, from practices surrounding birth to parental rights. It means that our choices are not constrained by politics, financial barriers, or social pressure.  In other words, how can the right to give birth at home - safely and legally - not be on a reproductive justice advocate's radar?

I mention this because we in North Carolina are enduring yet another vicious attack on the rights of pregnant and childbearing individuals.  Women seeking home births may have the legal right to do so, but just like the women seeking abortion care, these laws do nothing to protect access.  As far as home birth attendants go, our state only recognizes certified nurse midwives (CNMs), and in order for these phenomenal women to legally attend births, they must be supervised by an MD currently licensed to practice obstetrics in the state.  As you can imagine, physicians that will supervise homebirth CNMs are few and far between, and this week one of them was advised (under threats of sanction) that he cannot sign off on CNMs who are not under his direct employment.  Even though the law does not dictate these terms, the medical board's sanction left seven of our eleven home birth CNMs without a licensing MD, and countless women without a care provider.

The research is abundantly clear: when labor is progressing normally, a woman under the care of a trained midwife is as safe giving birth at home as she would be under the care of an obstetrician in a hospital.

Anti-abortion birth advocates are already taking a hypocritical stance on the matter as they decry abortion rights while asking why women's reproductive decisions are limited.  I've been biting my tongue while reading the Facebook comments of fellow birth professionals all week.  One such statement went, "It is legal to have an abortion but a woman can't choose to have a home birth with a midwife! This is crazy!"  Another, "A mother can kill her baby in all three trimesters but can't give birth at home.  The government is nuts."  [Fact-Check Sidebar: North Carolina restricts abortion access after the 20th week of pregnancy (hardly "all three trimesters"); additionally, this ruling didn't come from the government, it came from the NC Board of Medicine, an agency independent from the state's governing body.]  These ramblings are usually followed by the contradictory co-opting of pro-choice language, ripe with phrases like "right to choose" and "my body, my choice."

The abortion rift amongst birth advocates is really nothing new.  After all, to simply be an advocate for varying birthing options does not encompass any official position on the politics of pregnancy itself.  Birth advocates come to the work for a variety of reasons, while it certainly seems odd to me that a person could support the "right to choose" in one pregnancy outcome but not another, the social stigma surrounding abortion means that this rift is bound to exist. 

That home birth rights are not at the forefront of the reproductive justice movement, on the other hand, is beyond me.  The struggles are just too similar.  Every time someone points out that women might have to cross state lines to access a home birth midwife, I think of the women who still - in the year 2012 - have to seek abortion care in a state with fewer restrictions or more providers.  When we worry that women will have to give birth with midwives who operate illegally (or go unassisted), I think of the women who risked their lives going to see illegal abortion providers with no public credentials, or the women who simply did it themselves.  Medicaid and many private insurers restrict access to home birth midwives just like they restrict access to abortion, making both more or less a privilege to those with the means to pay out of pocket. 

Reproductive justice advocates who are involved in birthing rights see both - the right to an abortion and the right to give birth at home - as the same struggle.  We understand that any assault on reproductive freedom comes from a system of patriarchal self-interest that sees women not as autonomous beings, but as objects to be regulated and "fixed."  We know that any women who choose home birth have done their research and don't need "warnings" from government institutions, just like women seeking abortions don't need the ideological jargon in "Right To Know" legislation.  We know that women and their families are capable of making the best possible decisions regarding the births of their children, and we seek to create a world where access, stigma, and social pressure don't sway these decisions.  In other words, we live up to the full spectrum of our ideology... we Trust Women.

I call on the reproductive justice movement to make birthing rights a part of their pro-choice consciousness.  If we are to create a world that ensures sexual and reproductive well-being for all women and girls, no struggle to protect our choices or desires can go unsupported.

A Matter of Context

Trigger Warning: pregnancy loss

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I believe I'm going to remember last week as the week of miscarriages.  Really, though, it was just the two.

The first was good news, the second not so much.  The two together provided a stark reminder that the emotions surrounding pregnancy loss are completely relative. 

The first happened to a woman who had contacted Spectrum.  She had become pregnant accidentally and had scheduled an abortion procedure around 5 or 6 weeks LMP.  Having been raised what she called "Uber-Catholic," having an abortion was, to her, the killing of a human being.  But she had no choice.  You hear this scenario played out pretty often when you work with people experiencing pregnancy loss.  Intellectually, the embryo is just that: an embryo.  But when you're supporting a person who has been raised in a certain faith or ideology, there's always this deep-seeded idea that they will be killing a human being.  What the general public needs to know is that, most times, they will still have the abortion.  No amount of belief that the embryo is human, no amount of guilt or shame they feel from their childhood upbringing, and no state-mandated scare tactics can sway them from that choice.  They will terminate the pregnancy.  The difference is, they will have more emotional trouble dealing with it.  That's where I come in.

I spent a number of hours speaking on the phone with this woman over the course of a week.  She came to trust me as a truly non-judgmental ear that didn't shame her for choosing abortion but also wouldn't correct her when she said "baby" or "kill."  She became fixated on the idea that she would feel better about the whole situation if she experienced a spontaneous abortion (the medical term for miscarriage) instead of having it induced.  I don't know whether or not she did something to herself to self-terminate (she mentioned having read the parsley + vitamin C "trick" on the internet), but regardless, she did indeed end up having a miscarriage.  The news came from her voice with absolute joy.  She truly felt like the Universe, God, or what have you worked with her to bring about the event, and in the end she was able to have the kind of pregnancy loss she could not only deal with, but be happy about.

The second miscarriage of last week happened, sadly, to one of my birth clients.  She was 18 weeks pregnant, and without sharing too much of her personal information here, I can tell you that this event was earth-shattering for her and her family.  After hearing the news, I spent the better part of the next couple of days in a kind of withdrawn daze.  The pain she must have been experiencing was unimaginable to me.  After all, 18 weeks is pretty far along: you've become attached to the idea of having a baby.  You may have even thought up some names, or even started to buy clothes.  You've already told everyone that you're pregnant.  As if the loss itself isn't enough to deal with, the fetus and other products of conception are not likely to pass on their own, meaning you'll possibly need a D&C and/or labor induction.  Your pregnancy - once this enigmatic idea of a baby - actually looks like a baby at this point... a very small baby, but a baby nonetheless. Worse still, losing a pregnancy after 16 weeks means your milk is likely to come in once your progesterone levels drop.  In other words, full breasts and empty arms.  It's really more than I care to imagine.

I have heard (mostly young) pro-choice folks scoff at the notion of having a memorial for a miscarried embryo or fetus.  Hell, I might have done it myself in my teen years; after all, if a fetus is not a baby, then you didn't lose a baby.  But listen to enough people who have lost wanted pregnancies - whether to miscarriage, stillbirth, anomaly, etc - and your opinions mature astronomically.  They are no longer as black-and-white as they were when you were a red-faced college freshman shouting at antichoice protestors in front of your local Planned Parenthood, and while you remain as staunchly pro-choice as ever, the entire idea of pregnancy loss is tangled up in a billion shades of gray. 

That's really why "the abortion war" is so damn polarizing.  Social issues are best understood and dealt with when they can be easily boiled down to a black-and-white dichotomy.  But really, no social issue whatsoever can be simplified to that end.  We try, but we fail, and in our wake we do a grave disservice to those most affected by that issue.

The antichoice camp is able to rally huge amounts of support simply because their side really does take the black-and-white approach: their arguments are one-liners and emotion-grabbing images, and they make great headlines.  The prochoice movement fails by merely trying to echo these tactics.  Our arguments are full of holes when restricted to the same style of one-liners and headlines, easily refuted when we don't get into the complexities of pregnancy and women's lives.  Our messages will not be received if we merely keep screaming them louder and louder, and we will not ever attain true reproductive justice until we begin to acknowledge that all pregnancy outcomes - birth, abortion, miscarriage, stillbirth - mean nothing without the context that surrounds them.

Just look at my two clients... one had a miscarriage, and it was wonderful.  The other had a miscarriage, and it was the worst thing possible.

Moments in the Life of a Doula

Very Little Known Fact: May is International Doula Month.  2012 marks my third May as a doula, and let's just say the past few years have been nothing short of inspirational. 

I'm on call for my tenth birth.  Number ten!  Two and a half years ago I never thought I'd get here... my dedication to women's health has never been enough, and I fast learned that it's very hard to "get known" as a birth worker, especially when you've never had any babies yourself.  Still, the clients I have worked for have hired me for my presence, my energy.  And as I get more experience, more mamas are realizing that it's energy, not personal experience as a laboring person, that really matters.

Today I'm thinking about all the babies I have had the privilege to watch come into the world: Lundyn, Sara, Quinn, Aaron, Micha, Madison, Gershom, Amelia, and Sullivan.  All born to totally badass mamas with incredibly unique and wonderful birthing experiences. 

Thinking about these nine phenomenal experiences, I ran through my "stats".  Some prospective clients like to know, for example, your clients' epidural rate, though unlike your care provider's cesarean rate, a doula's epidural rate really hinges more on the way the birth progresses itself and not the actual doula.  Or so I tell myself.  But still, I'm proud of my stats.  In my nine births, I have had:

• Three boys, six girls.
• Three mamas who chose to have an epidural.
• Three mamas induced with Pitocin.
• One cesarean birth.
• Two mamas delivered at Forsyth Medical Center, one at Women's Birth and Wellness Center, and six at Women's Hospital.
• The fastest labor was an hour and a half.
• The longest was well over 20 hours.
• My favorite midwife thus far was Kate Layman, CNM at the birth center.  My least favorite was one of the faculty midwives at Women's who, fortunately, was only on for three more hours after my mama was admitted. 
• My favorite obstetrician was Dr. Grewal, my least favorite a tie between Dr. Marshall and whoever the guy was at Forsyth back in September (not worth remembering). 
• I've really loved all the nurses, but my favorite remains the pediatric nurse at Women's Hospital who helped the mama and I convince the father that circumcision has no real medical benefit.

Like any doula, I've experienced the absolute best of human love, compassion, and forgiveness simply by being there in the room.  I've heard mamas and their partners say ridiculously funny shit, sharing a good laugh between tough contractions.  I've also witnessed families make difficult decisions, seen women break down and sob when their birth plans have gone awry.  Fortunately, my birth clients have all gone on to deliver beautiful, healthy babies despite these roadblocks.  I have many favorite moments that straddle these two extremes... to name a few:

• My greatest learning moment came to me in birth number four.  The mama had been having one back-labor contraction on top of the other for a solid 90 minutes.  It had been seven hours since her last vaginal exam, at which time she was 5cm dilated.  When her contractions "stopped," I told her she was probably complete and would be feeling the urge to push soon.  After an hour of continued back pain and no urge to push, the nurse checked her and found that she was 6cm, at most.  As the baby was being born later that day (after an epidural, a nice long nap, and a marathon pushing phase), I saw that he was asyncletic.  Immediately my education flooded the forefront of my mind... it all made sense: the slow progression, the "fake" transition, the lengthy 2nd stage, even the week of prodromal labor. All textbook signs of an asyncletic presentation.  It was in this experience that I re-learned to NEVER estimate the laboring person's progress, that it's not the doula's job no matter how "clear" it seems to be at the time.
• While DONA would surely frown on this, I've been taught a few midwifery skills by midwives who needed an extra hand.  When a birth center midwife was busy stitching up a mama with a 4th degree tear, she asked me to do the fundal massage.  I'd never done it before, but she told me where to place my hand, what to do, and how hard to do it.  While it certainly went against my "doula instincts" to massage so hard, I now feel like I would be able to do hemorrhage control if I'm ever the only person present who knew how to do it.  Another midwife, during a very long 2nd stage at the hospital, gave me a refresher course in how to catch a baby if I ever had a mama deliver on the side of the road.  DONA teaches a little bit about that, but since we're really not "supposed" to do anything medical, they keep it brief.
• There's a popular one-liner amongst birth professionals about the difference between a doula and a midwife: "Midwives catch babies, doulas catch dads."  While I scoff at the obvious couple-centrism, I actually have caught a dad before.  Seeing how he was an ex-Army medic and current paramedic, no one really thought he'd have a problem with witnessing the birth.  However, the sleep deprivation, low blood sugar, and pure adrenalin of "oh my god I'm becoming a father" formed the perfect storm, and while everyone else was watching his baby crown, he was boarding the express train to the floor.  I caught him, this easily 200-pound man, inches above the ground.  Even Dr. Grewal turned from her obstetric duties to congratulate me on my quick reflexes, and hey, it bought the baby's cord some time!
• Speaking of umbilical cords, I once saw a "true knot" in one, which was awesome. The midwife and I shared a moment of "oh wow awesome!" while the new parents were admiring the new baby.  Because we're birth nerds like that.
• Some of my favorite parents have been the ones who "talk back" to care providers that aren't honoring their wishes.  At a rapid (unmedicated) birth last September, the doctor was trying to tell the woman to push when she didn't yet feel the urge.  Any decent research on an unmedicated 2nd stage will tell you this is a waste of energy, but the doctor obviously had a golf game to get to, so he continued to berate her, saying she "wasn't going to have a baby by just laying there and resting."  At this moment, she looked at him and said, "Shut the hell up, I'll push when I damn well feel like it."  Obviously the urge to push came, and within minutes she was holding her baby girl.  My favorite part about that birth was the dad talking shit about the doctor while he was on the other side of the curtain... whoops!

My favorite moments, however, are present at every single birth: the energy you can almost touch, the families being born, the immense joy in the room.  It's really indescribable, and words just cannot do justice to the experience of being present for the birth of a baby.

On another note, I also spent some time this week being the "phone doula" for a woman who was planning an abortion.  I was reminded of how similar the work is even if the outcome is obviously very different (I've discussed this before).  I gave advice, self-care suggestions, and basically was just there to listen and understand.  Without providing too much specific information about her case, I can tell her that her outlook on abortion is far different from mine.  Which is to say, she's never considered herself prochoice or "pro-life."  She was raised what she called "Super Catholic" and honestly thought she would be killing a human being.  But she was having the abortion anyway because it was her only real option.

By the end of our conversations prior to her appointment, she felt good about the choice she was making.  She had more clarity in her values, she was forgiving herself, and couldn't stop thanking me for being there for her without leading, assuming, judging, etc.

Just like at births.

I've been jokingly labeled as a "truly full-spectrum" doula by friends.  Bad Day Doula, Relationship Doula, Sleep Deprivation Doula, Headache Doula... I may end up being my mom's Hip Replacement Doula by the end of the summer.  What it comes down to isn't some certification, or even training... it comes down to who I am as a person, what I am willing to do for people, and the way I treat them.  The training informs the actions we take in response to our instincts, but someone can't simply be trained to be the kind of person a doula is.

Oh hell, I'm rambling.  I'll just let Boromir break it down for you.  Happy International Doula Month, all!!

Pro-Life vs. Anti-Choice: What are abortion restrictions really all about?

A piece at RH Reality Check begins, "Restrictions on abortions just don’t work in that they don’t result in the desired outcome.  This is the predictable, yet bold, conclusion of a report to be presented at the United Nations on Monday, October 24th by Anand Grover, a UN-appointed independent expert on health."  The article goes on to discuss such restrictions in a global context, adding in quotes from the author's friends about women who have "too many" abortions.

I have to take issue, however, with the lack of discussion regarding what, exactly, abortion restrictions are really all about.

To be sure, a large portion of mainstream anti-abortion people probably do just want abortion rates to fall.  While these people still don't seem to want to hear arguments for better access to contraception and sexuality education, they do indeed just see abortion as an evil procedure that should be stopped.  I know this because I have a handful of anti-abortion ("pro-life") friends with whom I have been able to have civil, intelligent conversations.  Neither party has ever come away from these conversations with a total change of opinion, but I'd like to think we have - at the very least - obtained a slightly better understanding of why the other person thinks the way they do.  Such an outcome is hardly going to turn the tides of "The Abortion War" any time soon, but I can't help but think it's a step in the right direction.

Thing is, these "pro-life" friends of mine aren't exactly at the forefront of the anti-choice movement.  They don't set the agendas, and they certainly aren't in the driver's seat.  Many don't even follow the larger anti-choice movement: they're simply anti-abortion in their own right, which is why I am able to call them friends.

The anti-choice movement, on the other hand, has never been and never will be about simply reducing the number of abortions.  These people lead the way, set the tone for how all anti-abortion arguments will be made.  They are increasingly radical and dangerous, pulling more "moderately" anti-abortion people with them.  They use violence, threats, and harassment.  They spin bad research to make pseudo-scientific arguments poised as fact, exploit the vulnerability of people who have had abortions, and write large checks to make sure lawmakers put their desires first.

For these people, the agenda is far more dangerous: relegating female-bodied individuals to hapless incubators, reinforcing a culture of male dominance, enforcing social injustice that intersects every aspect of humanity (race, class, sexual orientation, gender identity, etc)... this is their game.  And as leaders of everything anti-abortion, they have the weight to pull more moderate "pro-lifers" with them.  We see their militant tactics infiltrate the mainstream political climate as "personhood amendments" and funding cuts to preventative health care become the norm. 

Make no mistakes: it is true that abortion restrictions do absolutely nothing to reduce the number of abortions in the U.S. or anywhere else in the world.  But we need to be constantly critiquing the motives behind most of these restrictions.  Far from some sort of altruistic ideology, the anti-choice movement is not-so-gently reshaping the way women (and all female-bodied individuals) are seen, heard, and allowed to live.

The Follow-Up

Today I received a birth announcement from a mama whose birth I attended last month.  It was such a beautiful card, featuring two pictures of the adorable baby girl that I had been privileged to see enter the world just six weeks earlier.  I am on call for another birth now, and have been for almost two weeks.  I hate being on call.  There is something about my mind that is never quite settled, and every on call session, I start to wonder why on earth I chose this path.

Then, of course, the mama goes into labor and I get to watch it all over again: a woman's inner strength shining through her as she brings into the world a new tiny lifeform.  There's blood.  There's sweat.  There's usually some tears.  It's amazing, and each time I kick myself for questioning my love for this work, no matter how fleeting the thought was. 

My favorite thing, honestly, is running into the family at a later date.  Sometimes they contact you with an accompanying photo, the baby that had been a mere six pounds now pulling up and taking practice steps.  Sometimes you just run into each other in the grocery store or at a yoga class.  It's all wonderful, and such a great feeling to know that they thought of you as an important part of their birth experience.

Last month I also supported a woman through an abortion.  Since we are not yet ok'ed by the clinic, I can't say I was her "doula," but I did my best with what I had: we had several conversations over the phone, I drove her to the clinic, I held her hand as she completed her paperwork, and after it was over, I drove her back home and left her with self-care instructions to go along with the instructions she had received at the clinic. 

This was a very wanted abortion, at least as wanted as it could be considering its need arose from a very unwanted pregnancy.  It was not sought due to financial restrictions, fetal anomoly, or an abusive relationship.  This woman had simply become pregnant accidentally.  She was young and not ready to be a mother.  By the time we left the clinic, all the anxiety I had read in her voice in the days prior were gone.  We barely even talked about the abortion on the half-hour drive back to town, except that she had used the breathing techniques I suggested and they worked really well.  We talked about what she was studying in college, how she was hoping to feel upbeat enough to go to a party that evening, and how she was planning on spending her summer break.  Back at her house, she hugged me and thanked me for being there for her, and I told her to give us a ring if she needed to talk about anything later on.  I haven't heard from her since.

The difference between birth doula'ing and abortion doula'ing may seem immense, but it's really the same kind of work.  You discuss options, make sure the person you're supporting can make informed decisions, support them through whatever decision they make, and are there for them every step of the way (except during the abortion procedure, for security reasons).  The major difference is, obviously, the outcome.  I could sit down and write an email to any one of my birth clients, and I'm sure I would later recieve not only an update, but a link to a Picasa album as well.  When I emailed my abortion patient the next day, just to see how she was feeling, I never heard back.  Which is fine.  And I'm sure if I did run into her at the grocery store, we would chat and things would be cheerful.  But of course, there would be very little ooh-ing and awe-ing over how not pregnant she was the way I would ooh and awe over my birth clients' babies ("Oh, he's gotten so big!"  "Oh wow, you look great!" etc). 

This makes abortion doula work rewarding in a completely different way.  At the end of the day, you don't get announcements in the mail about how not-pregnant your client is.  They don't send you pictures of their flat belly or write you telling you how not being pregnant is going for them.  From what more experienced abortion doulas have told me, you usually don't hear anything from them ever again.  Statistically, you're not even likely to get a request for a post-abortion resource. 

When you're supporting someone through an abortion, the moment that you actually connect is very fleeting.  But that's really the beauty of it.  My abortion patient told me that she was happy I was able to drive her, because her friends would have had expectations of how she should act/feel/react.  I, on the other hand, had no expectations for her: to her, I was a kind stranger with a good ear.  What I was for her was exactly what she needed, and I suppose that in and of itself is plenty for me. 

The Importance of Clinic Defense

Note: The following was first published at ChoiceUSA's Choice Words.
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Every Saturday morning, a dedicated group of volunteers arrives outside of the Louisville EMW Surgical Center, Kentucky's only abortion clinic. On the surface, their job is simple: accompany the clinic's patients from their cars to the clinic doors. But considering the crowds of invasive protesters doing everything in their power to block people from entering the clinic, a day in the life of a clinic escort is anything but simple.

After having possibly driven hours the morning of an abortion, this is what Kentucky's abortion patients can expect to encounter upon arrival:


They call themselves "sidewalk counselors," many of which are from the crisis pregnancy center across the street. Some wear orange jackets similar to those worn by the escorts to further confuse and ambush folks trying to enter the clinic. The ACLU has said that the EMW Surgical Center encounters some of the largest, most aggressive anti-abortion protests in the country.

Further south, the NC-based antichoice group Operation Save America regularly targets Family Reproductive Health, a Charlotte clinic known by many to be one of the most caring, compassionate clinics in the state.


The man depicted in the above video, Flip Benham, was found guilty of stalking a doctor last November and given 1 year probation. The ruling hasn't stopped Benham's followers from appearing week after week to shout over the clinic's gate in his place. Clinic defender and activist Scott Trent describes OSA as "one of the most reactionary, bigoted Christian Fascist groups in the country." Despite the very dedicated group of defenders that show up in the wee hours every week, the harassment continues. "They regularly climb the tree on the border of the property to shout at women going into the clinic, block the driveway in flagrant violation of the FACE Act," Trent tells me, adding that local police regularly neglect to enforce the federal law.

During one of the weeks I was able to make the 90-mile trek to Charlotte, a representative from an area mom's group approached me with a contact sheet. "As a group, we're neither pro-choice nor pro-life," she told me, but they oppose Operation Save America because of their tactics. She was referring to the giant posters depicting aborted fetuses and embryonic remains, saying that as moms, they don't want their young children exposed to such gruesome images. Additionally, she continued, "One of our moms has had multiple miscarriages, several have had abortions, and the posters trigger panic attacks." The moms group is working on a project where folks can hold signs warning oncoming traffic that there are graphic images ahead, then point folks in the direction of a detour.

I could go on about the importance of clinic defense, how activists in both small and large numbers sacrifice their time and their safety to uphold the right to choose. It shouldn't have to be this way, but this is the reality we live in. And while the Feds and local law enforcement alike could be doing more to enforce the FACE Act, defenders put themselves on the line to pick up where the police do not (or cannot) step in.

End Note: This summer, Operation Rescue is revitalizing the "Summer of Mercy" event that led to increasingly violent action against the slain Dr. Tiller in Wichita 20 years ago. This time they're targeting Dr. Carhart at his new Germantown, MD location. If you are able, hook in with local organizations, contact folks organizing defense projects to keep this clinic safe and open. The Summer of Mercy event 20 years ago involved human blockages of clinic entrances, massive arrests, violence, and profound harassment of those receiving much-needed needed care.

The Run Around

The collective was formed, the funds raised, and the training scheduled.  All the Spectrum Doula Collective needed, then, was a clinic to work in. 

There enlies the problem.  Although there are many abortion providers in the central-NC area, very few are willing to open their doors to our version of doula support.  One clinic manager in particular told one of our members that they "don't bring in outsiders to do [their] jobs." 

I cannot get upset by the obvious anxiety clinic workers feel when approached by someone who is, let's face it, an outsider.  Decades of threats, picketing, harassment, vandalism, anthrax attacks, bombings, arson, and shootings have shaped the way the American abortion clinic has to operate by necessity.  They can't just open up their doors to each request for volunteers: to do so could very well open a clinic up to all kinds of infiltration, breach of client confidentiality, or worse.  It makes sense that medical care providers in general would be uneasy about perfect strangers entering their most confidential areas, and the nature of abortion itself compounds these worries astronomically. 

However, I can't shake this idea that the abortion doula would be "doing the jobs" of clinic workers.  This is something that birth doulas have to face when working in a hospital environment.  Though my personal experience working with hospital staff has been overwhelmingly positive, there is a kind of unresolved idea that doulas accompany women who don't believe they would otherwise be taken care of.  Some labor and delivery nurses harbor contempt for the doula, as if the doula is there to "correct" whatever care the nurse is there to provide.  Though the duties of the labor and delivery nurse are completely out of the doula's scope of practice, this remains one of the most common myths about doulas.  (This is not to say there aren't some "bad eggs" out there who mess with the Pitocin drip, adjust and read fetal heart monitors, even perform vaginal exams!  This is indeed not the job of the doula, and any doula who performs such a task indeed be censured by her certifying organization.)

There's something to be said for the fact that both clinics that have seemed receptive to our project proposal are manged by those with a history in labor and delivery.  These are people who have worked with doulas before, and they have both had good things to say about the profession.  If only they could let their colleagues in other clinics know what we do and do not do!

Even if we did make it abundantly clear what the abortion doula does and does not do, however, I believe we would still be getting some amount of push-back from clinicians.  After all, what are we implying by offering emotional support to their clients?  Are we saying they don't do enough of it themselves?  Are we charging them with being unsympathetic?  Most of all, are we co-opting the belief of the anti-choice camp that abortion will always be an emotionally-trying experience??

Granted nothing is further from the truth.  Our core values state that we respect and value the protection of clinics and their staff members.  We have not (and will not) ever suggest that any clinic has failed to provide quality care to its patients without witnessing it firsthand.  However, even the woman who is most confident in the abilities of her obstetrician/midwife and nursing staff might desire the non-medical support of a birth doula.  Such would not be an indictment of her care provider's failure; on the contrary, this woman might simply desire something that doctors, midwives, and nurses are either not trained or unable to provide.  This is hardly a charge of neglect or bad health care: many families see birth as a process that, while decidedly medical in some respects, can run more smoothly when a trained support person accompanies the entire labor period. 

I hope we can convey to our community's clinics that volunteer abortion doulas can enhance, not replace, the care given by providers and staff members.  It truly takes a spectrum of expertise to work with the average abortion patient: there's the first contact, the options counselor, the nurses, the doctor, and anyone who provides comfort and after-care instructions in recovery.  Adding a volunteer who is specifically trained to provide support and nothing but support can only enhance the work provided by the team of clinicians.  Additionally, the unfortunate fact that many clinics in this country are under-staffed and over-worked means that the average clinic worker can only provide so much support to each individual patient.  This is not a charge of their ability to provide such support, however; it is a charge against those who have made one of the most common surgical procedures performed in the U.S. into an event riddled with silence, stigma, and shame.  And I guess really, that's the whole problem.

Beyond Roe

Thoughts on the Roe v. Wade anniversary, 1/22/11.

In the world before Roe, women fronted hundreds of dollars for a perfect stranger (maybe a doctor, maybe not) to terminate their pregnancies.  They risked their lives to secure such a service, never knowing if the provider had proper training, if the abortion would work, or if they would end up bleeding to death in a hotel room.  Some women entered the makeshift "procedure room" only to be raped and left behind, still pregnant and hundreds of dollars poorer.  Still others, those who could not afford even the sketchiest of abortions, took matters into their own hands, ingesting toxic chemicals and using sharp metal instruments such as the now-emblematic coat hanger.  In some areas, groups like the Jane Collective and Judson Memorial Church helped to link women with legitimate (albeit illegal) providers who were known to be safe.  Women who could work it out traveled to Chicago and New York City, respectively, to utilize such services.

The attacks on legal abortion started almost immediately after the procedure was legalized nationwide in 1973, and these attacks continue today.  While we fight with everything we have to preserve Roe, we mustn't forget that the Supreme Court ruling itself never really guaranteed the most important detail: access.

Today, lower income women occupy a complex place: while they are statistically less likely to have access to contraception and are therefore more likely to experience an unintended pregnancy, legislative barriers such as the 1977 Hyde Amendment mean that their access to abortion is severely diminished.  While Medicaid will front the $8000+ bill for basic prenatal care and hospital birth costs, our medical system remains unwilling to offer women the several hundred dollars for an abortion.  These restrictions are upheld by "fiscal conservatives" who ramble on about lower-income women, predominately women of color, being a "drain on society" while simultaneously restricting key prevention options.  Anti-choice groups, inseparable from their "fiscal conservative" friends, claim abortion clinics target women of color specifically as part of some sort of eugenics conspiracy, all the while doing nothing to increase reproductive autonomy in lower-income communities.

Congress reaffirmed the federal ban on abortion funding in last year's "Patient Protection and Affordable Care Act," which, if repealed, will be replaced by even stricter guidelines on abortion coverage.  This does not, of course, curb the rates of abortion in America.  Women will sacrifice groceries, electricity, even rent money to save up for an abortion, and the more time this takes, the more invasive and expensive the procedure will become; reproductive rights advocates refer to this as "chasing the fee."

It's not just financial barriers that limit accessibility.  According to NARAL Pro-Choice America, 87% of U.S. counties currently lack an abortion provider, and with good reason: why would a doctor want to provide a service that could very well lead to attacks by violent anti-choice groups? 88% of US-based abortion clinics have reported at least one form of harassment by anti-choice forces, and nearly one in five clinics has received at least one bomb threat.  And with more restrictive legislative barriers being passed each year, it's no wonder so many clinics are forced to close their doors forever.  Some states, such as North Dakota or Nebraska, have only one or two clinics serving the entire region.  These clinics are generally over-booked, under-funded, and under-staffed, placing very unfortunate compromises on the quality of individual care that a woman may receive.  Many women who have had abortions in these areas compare it to being moved through an assembly line.  Women who must travel great lengths to secure an abortion appointment must take more time off from work and possibly pay high childcare bills for the kids they already have.

There is, then, a whole class of women who will not be able to secure a legal abortion at all, even though they technically have the legal right to do so.  For these women, it's like Roe never happened.  Many procure misoprostol, a drug which, when taken with mifeprex, can terminate an early pregnancy safely, provided the woman is under the care of a physician.  Taken alone and without the supervision of a medical care provider, however, the results can be devastating. 

Still others will not induce abortions with pills received from sketchy international pharmacies.  Some women will indeed find a surgical abortion provider for cheap.  However, if not properly informed they could end up in the hands of someone like Dr. Kermit Gosnell, a man who was recently charged with murder for the deaths of one woman and seven newborn babies at a rogue "clinic" in West Philadelphia.  Gosnell was in fact not a licensed abortion provider, and the stories coming from his now-closed "clinic" are horrific.  Still, women went to him.  And why wouldn't they?  Gosnell was the cheapest game in town, located right in the neighborhood for many lower-income women who needed an affordable abortion.  Indeed, the Gosnell case is a stark reminder that, for many women, the days of back-alley butcheries are for from behind us.

If abortion services were not so stigmatized, if the procedure itself was not so mystified and fraught with silence and shame, and if financial and geographical access were not so profoundly limited, no one would ever visit a place like Gosnell's back-alley butchery.  We cannot simply shun the Gosnell case, recount statistics about the safety practices of licensed abortion facilities, and parade around with images of nicely done-up clinics where private-pay clients receive decent care.  Not, at least, without asking ourselves why Gosnell was in business in the first place.  Monster or not, Gosnell was providing a service that many women obviously needed, and it is up to every one of us to work beyond the limits of Roe to ensure, for each and every woman and girl, complete autonomy over our bodies, our sexualities, and our lives.

Taking CPC Awareness to the Streets

The following was first published as a ChoiceActivism submission at ChoiceUSA's ChoiceWords blog.
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Anti-choice crisis pregnancy centers continue to pose an affront to informed choice in our country. Outnumbering real abortion clinics 2-1 nationwide, CPCs often advertise themselves as abortion providers or places where women can obtain unbiased information about their reproductive options. They are known for misleading women with bunk statistics about a purported link between abortion and breast cancer/infertility/depression and for effectively delaying a woman's decision past the point where she would be able to choose a medical, non-invasive abortion procedure. While disclosure requirement efforts by activists in Baltimore, MD, Austin, TX, and New York, NY would help to stave off confusion, a group of grassroots activists in Greensboro, NC are taking public awareness into their own hands.

Organized by simple word-of-mouth, monthly demonstrations take place in front of the Greensboro Pregnancy Care Center, an affiliate of CareNet. They hold signs reading, "FAKE CLINIC," "Honk 4 Choice," and others in order to educate passing cars about the Pregnancy Care Center. They do not engage with people going in and out of the center. The participants are students, workers, and retirees. What brings them together each month is their continued concern over the information given out by the CPC.

During an appointment, a staff member at the center told a UNCG student that abortion is linked to higher instances of breast cancer, a claim that has been continually repudiated by the National Cancer Institute, the American Cancer Society, the American College of Obstetricians and Gynecologists, and others. When I personally called the center to inquire about emergency contraception (they call it simply the "morning after pill"), the woman on the phone told me I would have to make an appointment, and that the next available appointment was in three days. Had I really needed emergency contraception, this would have put me past the point where the drug would have been effective, possibly leading to an unintended pregnancy and possibly an abortion. What's more, the woman on the phone never told me the center did not carry the medication.

It's not just personal experiences that led to concern over this particular CPC's operation. While they recently added a disclaimer that they do not provide or refer for abortions, their website continues to claim that they offer "accurate information about all pregnancy options." Or do they? Under "Abortion Education," they claim that medical abortion ("abortion by pill") can only be used up to seven weeks since the last menstrual period (LMP), when in fact it is effective and prescribed up to nine weeks LMP. Another page ("Morning After Pill") claims that emergency contraception can cause "an early abortion," which is not only a medically inaccurate claim, but could dissuade a woman who is morally opposed to abortion from taking steps that could prevent pregnancy in the first place.

Until these centers are held accountable for the misinformation they provide, policy-based activism and grassroots activism alike will continue. The concerned citizens of Greensboro, NC are no exception. From a press statement:

We hope to alert women to seek help for their pregnancies or suspected pregnancies at proper clinics and OB-GYN offices. As advocates of the pro-choice movement we believe that every woman deserves the right to be informed about every option (abortion, motherhood, adoption) truthfully and without coercion or intimidation.

Doing the right thing is tricky.

I'm getting flak for issuing an apology where an apology was due.  I guess no one said doing the right thing was easy?

Here's what happened: I had heard that there was a crisis pregnancy center in Asheville called "Asheville Pregnancy Support Services," or APSS.  I received a negative testimonial about the place about two months ago, so I listed it as a deceptive health center.  Such a listing prompted a man to picket the center, the way we do in Greensboro at the Pregnancy Care Center.

Two days later, I received an email from the owner of FemCare, Western NC's only abortion clinic.  She told me that she had heard from APSS's CEO that there was a picketer who said he was affiliated with CPCwatch.org, so she followed the breadcrumbs to me.  What she wanted me to know, however, is that APSS is not a deceptive health center.  It is run by pro-life women, but they do not do any biased options counseling, their ultrasounds are conducted by medical professionals (RNs, mostly), and they don't use false research and scare tactics to dissuade women from choosing abortion.  Basically, they help women who are carrying to term.

After confirming that I had, in fact, been contacted by FemCare's owner, I took a closer look at the testimonial we received about APSS.  I realized that it was a pretty generic CPC experience, which is likely why I just believed it outright.  Upon closer inspection, I found that the IP address used to send the testimonial (via the website's contact form) was from Iowa, and the email address provided is no longer in use.  Somebody was toying with me, either get a center listed or to prove that CPC Watch doesn't take care in fact-checking our sources.  I take full responsibility for the latter.

I had to check my biases.  Just because a center is staffed by pro-life individuals doesn't mean that they are offering bad counseling or biased information.  I wrote the CEO of APSS, issued a public apology on our blog, and 24 hours later I had received a large amount of inflammatory emails, but this time from pro-choicers.

I've been struggling with whether or not I should even respond to these messages.  I don't think it's wrong to apologize to an anti when an anti deserves an apology; surly, providing false or misleading information about a pregnancy center is no better than CPCs dolling out false and misleading information about abortion clinics.  Our supporters didn't feel that way.  I got more than one message that included something akin to "fuck 'em all" regarding pregnancy centers that don't provide abortions.  Another accused me of being "one more spineless liberal who is going to let what little momentum we have slip away," as apparently I'm "bending to the will of the antis" and "will concede everything in the name of 'common ground.'"  Ouch.

My question is, why do pregnancy centers have to provide, or even refer for, abortions?  From what I've seen, APSS is 100% open about what they do and do not refer for.  I have little issue with their operation, especially after conversing with Western NC's only abortion doctor. I don't think any center has to provide or refer for abortions.  So long as they're not undermining choice by giving out false or misleading information, not using scare tactics to dissuade women from making informed choices, not making women convert to Christianity to "earn" baby supplies, and not harassing them, I don't have a problem with the place existing.  Hell, my local Planned Parenthood clinic doesn't provide abortions, are we gonna picket them?

Admitting my mistake has had little to no effect on the picketer, who is, for lack of a better term, batshit crazy.  He refuses to believe there's nothing deceptive about APSS and told me outright that the fact that they don't link the abortion clinic from their website means they "deserve" to be picketed.  He also refuses to just take his picketing elsewhere, as apparently Asheville is "pro-choice turf" and therefore APSS has no right to exist.  

Coordinating projects like this can really be a double-edged sword.  I fully support a woman's right to carry a pregnancy to term (duh), even if abortion seems like the best option given her situation.  We can go back and forth all day long about how her decision is tainted with the biases inherent in a patriarchal system, whether or not she's wrong about an embryo being a sentient life form, or what we would do in her situation (think about the debate surrounding Juno here).  But at the end of the day, we want women to make the most informed choice they can, and after that we need to support it.  Isn't that what "pro-choice" is supposed to mean, after all?

Something to think about

I like looking at reproductive issues in a holistic, family-centered way, but unfortunately this doesn't always do the situation justice.  Many women face unintended and challenging pregnancies alone, and they take care of it alone.  Contrary to popular belief, the woman-as-island idea is not a feminist one; feminism was founded on sisterhood, community, and cooperation.  I partially blame American individualism for what I see as a huge step back for modern feminism: the idea that women ought to be self-sufficient, overly individualistic, and not ask anything from anybody.  We as a society lack positive messages about needing to rely on someone else, unless of course it's a sort of traditional, patriarchal reliance like we see in heterocentric marriage.  Women (and men) who take advantage of public assistance have the stigma of being "freeloaders" and a drain on society.  Even on a personal level, many women feel the need to remain stoic and not ask anything from anybody, including friends and family.

I think it's the fear of being labeled a freeloader that gets women, especially women of color who have a long history of being labeled "Welfare Queens," to the point where they do not ask for help from anybody, no matter how trying the situation.  Maybe some women just feel like they can't bother others with what they've always been taught are "trivial" problems, even if it takes every ounce of personal strength to face the situation on their own.

But I've gotten way off topic.  I read an entry on Every Saturday Morning's blog that made me think:

who's fight is this?

When approached by the CPC harasser, the man really puts the situation in perspective: "If God sends me to hell for doing my duty to my family, then so be it. I’ll suffer forever as long as my family is safe and taken care of."

So much of what we do as reproductive justice advocates is directly for  women who are facing difficult and confusing decisions. And often that's the way we see it because that's all we see, as many women go through these things alone. But a more holistic approach is something I can definitely get behind: while we continue to do what we do first and foremost for women and girls, so often we are also doing it for the men in their lives and possibly even their children. Often, what we do is not just for the women but for their families.

Something to think about. 

Antis misrepresent Planned Parenthood data, as usual

The following was first published at ChoiceUSA.
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Just another day in the life of an anti-choice wingnut: the American Life League and Jill Stanek are both reporting that, according to 2008 data, Planned Parenthood does little more than offer abortion services.

While the American Life League takes measures to state (albeit vaguely) that they are only reporting on Planned Parenthood's services to pregnant women, Jill Stanek makes no such effort. In her piece, Planned Parenthood: Abortion virtually only service, Stanek presents several pie and bar graphs to display the discrepancy between pregnant women who receive abortions at Planned Parenthood clinics and pregnant women who receive prenatal care and adoption referrals, adding smugly, "You may need a magnifying glass to spot the adoption and prenatal care bars."

I wonder why that could be? Maybe because Planned Parenthood clinics are virtually the only abortion providers in many communities. They are not adoption agencies and they don't claim to be, nor are many clinics capable of providing prenatal care. Rampant survey bias here, and it clearly suggests something that the anti-choicers just can't seem to get their heads around: women aren't stupid. Think about it. If I'm pregnant and am planning a birth, I'm calling a midwife or an obstetric practice. If I'm pregnant and thinking about adoption, I'm calling an adoption agency. If I'm pregnant and considering abortion, well, I'm most certainly calling an abortion clinic! This "stunning revelation" by the American Life League only proves what we already knew: that many Planned Parenthood clinics provide abortions.

More interesting is the reality of the data that ALL and Jill Stanek are "reporting" on. The official report, a fact sheet on services provided by Planned Parenthood affiliate clinics in 2008, reveals much more than how many women received pregnancy-related services at Planned Parenthood clinics. In 2008:

• 35% of medical services went to providing contraception to men and women.
• 34% of medical services went to STI/STD testing and treatment.
• 17% of medical services went to cancer screening and prevention.
• 10% of medical services went to other women's health services, such as pregnancy tests, prenatal care, midlife health care, and infertility treatment.
• 3% of medical services went to abortion procedures.

The other 1% involves primary care, adoption referrals, and additional service. Additionally, Planned Parenthood clinics regularly provide non-medical services to the community, including education, support, and outreach. In other words, ALL and Jill Stanek are running with grossly misrepresented data. Never mind that the largest chunk of Planned Parenthood's medical services go directly towards preventing the need for abortion in the first place; no, that fact doesn't adequately fit the agenda of the antis, and it certainly doesn't help them paint a picture of a Planned Parenthood that only exists to profit off of women's abortions.

In all fairness, the American Life League report does address the other services, but only to highlight the fact that Planned Parenthood has seen an uptick in abortion services and a downturn in preventative care clients:

"Despite the increase in abortion, Planned Parenthood showed a decline in a number of other areas, including a drop of four percent (almost 100,000 visits) in its primary customer base – female birth control customers ... The latest Planned Parenthood data are in keeping with the testimony of former Planned Parenthood clinic director Abby Johnson, who has publically [sic] testified that Planned Parenthood is intentionally trying to increase its abortion business."

Once again, the American Life League proves it has little expertise in the interpretation of survey data. Failing to recognize cause and effect, ALL jumps to the unfounded conclusion that the data indicates that Planned Parenthood has some underlying agenda to get women pregnant and lure them into the clinics for abortions. Such conclusions suggest that ALL might be lacking in the social awareness department and are woefully unaware of the economic downturn that became severe during the very year this data was taken.

In September of 2009, the Guttmacher Institute reported that about half of women surveyed said they are delaying getting pregnant or limiting the number of children they have due to economic concerns. The report, A Real-Time Look at the Impact of the Recession on Women’s Family Planning and Pregnancy Decisions, did report that more women were being careful with their birth control, which does not adequately explain why Planned Parenthood would see a downturn in female contraception patients. However, 12% of women said they were thinking of switching to long-term contraceptives such as the IUD to cut costs.  This would mean fewer visits to their providing clinic. Additionally, 18% of women on the pill reported inconsistent use as a means to save money; this could easily lead to an increased need for abortion, not to mention fewer clinic visits to procure contraception. The report also suggests that many women might be struggling to access contraception:

"Twenty-three percent of surveyed women report having a harder time paying for birth control than in the past ... Nearly one out of four women report having put off a gynecological or birth control visit to save money in the past year ... Forty-two percent of employed women agree with the following statement: 'With the economy the way it is, I worry more about taking time off from work to visit a doctor or clinic.'"

But again, if you're an anti, it's probably just easier (and convenient) to blame the evil abortion chain. Reality has never been a strong suit for their camp, after all.  But, while we're playing with graphs:

You "might need a magnifying glass" to see the Stanek bar.

Safe Surrender laws continue to fail, women still shamed from receiving care

This morning, the staff at the Winston-Salem Planned Parenthood arrived at work to find a suspicious storage container outside the clinic.  Not taking any chances, they phoned police for a security scan.  When police arrived, they found a deceased newborn baby girl inside the storage container.

Planned Parenthood released this statement:

This morning our Planned Parenthood staff found an unidentified storage bin outside the health center and immediately called police. We are fully cooperating with law enforcement as they conduct their investigation. Our hearts and prayers go out to all involved in this tragic situation.

I shutter to think what might have led someone to leave an infant to die outside of a vacant clinic.  But I can imagine.

We live in a climate where women are shamed on just about every reproductive front: shamed for using contraception, shamed for getting pregnant, shamed for choosing abortion, shamed for choosing adoption, and shamed for becoming single mothers. Safe Surrender laws do not adequately remedy the many occurrences of women giving birth in secret and leaving a child to "hopefully be found."

I am not allowing myself to believe that some anti left a dead baby outside of a Planned Parenthood clinic, though it did briefly cross my mind.  I truly believe a frightened woman gave birth and left her daughter near the clinic in hopes that she would be found and cared for.  Or just found and dealt with.  Instances of women giving birth in secret then leaving their children to hopefully be found are not all that rare.  But make no mistakes: instead of demonizing the women who endure the agony of unassisted childbirth and immediate abandonment, we should be demonizing the endless shame cycle that each and every reproductively-capable person experiences on some level, regardless of the choices she makes.

There is no excuse for denying women access to any reproductive health care that she deems right for her. When they feel like they have no choice, many women take drastic measures, often alone and unattended, and the results can be devastating. I find it significant that the mother chose to leave her baby outside of a clinical organization that works tirelessly to combat the epidemic of her situation.  But again, it was sadly too late for her.

Concord man charged in clinic violence plot

According to the News and Record, Justin Carl Moose of Concord, NC has been charged by federal authorities for providing information meant to aid in the bombing of a North Carolina abortion clinic. 

Moose is a supporter (at least) of the extremist organization Operation Save America.  When OSA held a national event in Charlotte this past July, I went to Family Reproductive Health to successfully hold off the antis and defend the clinic.  It was there that I first encountered the man who goes by "Moose."  He was one of the more aggressive protesters.  Several times, he ran from across the street directly at the clinic's gate as if he meant to run straight through.  At the last moment, he stopped, turned to all of us defenders with our cameras rolling, yelled that we were pathetic, and went back to his fellow demonstrators.  He did this at least three times before a Charlotte police officer told him he would be arrested if he did not stop.

Moose currently makes all of his information available on Facebook, which is where the initial complaint originated.  According to the complaint, he is being charged with "violating Title 18, United States Code, Section 842(p)(2)(B), Distribution of Information Relating to Explosives, Destructive Devices, and Weapons of Mass Destruction."  If convicted, he faces up to 20 years in prison up to $250,000 in fines.

Throughout his Facebook page, Moose alleges that he is a "freedom fighter" with little to no disregard for the law.  This is interesting because he also rants on and on about Islam, jihad, and acting against organized terrorism.  I guess it only counts as terrorism if it's based in a system of beliefs that are different from one's own?  Most troublesome, however, are his interests and "likes."  An admitted "right wing extremist," Moose is a "fan" of the Army of God, a radical fringe organization that supports and condones the murder of abortion providers and boasts such members as Eric Rudolph and Paul Hill.  He is also a fan of a group called "Pardon Scott Roeder," referring to the man who shot and killed Dr. George Tiller last year. 

In his bio section, Moose lays out exactly where he stands: "End abortion by any means necessary and at any cost ... Save a life, shoot an abortionist." An August 23 post reads:

"To all the feds watching me: You can't stop what is in motion.  Even if you bring me in, my men will continue their mission.  Furthermore, I will not go peacefully.  Do you really want another Waco?"

One wonders if he did, in fact, go peacefully when he was detained on Tuesday.  

An August 2 post links viewers to a website that contains information about the addresses of abortion clinics and their employees (some including the employees' home addresses) with the instructions, "Do with it what you wish."  The remainder of his page is a smattering of anti-Islam rants, Islamaphobic jokes and jibes, and links to gun and ammo websites, one reading, "Check out the flamethrower ammo!"  An August 24 post reads:

"I ask of all my associates this September 11 to not go out and burn a koran [sic].  Who not go out and burn a mosque!  That'll show those camel humpers who's boss!"

An August 3 post links readers to a how-to website on TATP explosives, complete with Moose's own specific advice on using TATP to manufacture a bomb.  Another links to Ted Kaczynski's manifesto, with fellow radicals singing his praises ("Kaczynski has a brilliant mind in my personal opinion").  One from August 18 glorifies the murder of Dr. Tiller and reads, "Make a bomb and light the fuse, another Hero in the news.  The monster dead, with whole in head.  His end was made and babies were saved," again followed by praises from fellow antis.  Unfortunately, I don't believe his cheering section will also be investigated.

Moose is scheduled for a detention hearing in Greensboro, NC on September 13 at 2:30pm.  My guess?  Look for an influx of antis in our neighborhood very soon.

Be careful out there, everyone, especially those of you who work directly in women's health.  Trust women!

Updated: 9/10/10 at 5:00pm

Moose's Facebook page has been taken offline, either by law enforcement, a family member, or Facebook itself.  I know that law enforcement sometimes removes internet content that they plan on using to argue a case, but Moose was also in obvious violation of Facebook's Terms of Use. 

Dr. Carhart: Who Do You Want to Decide?

Today, RH Reality Check featured a piece by Dr. LeRoy Carhart, one of two American physicians currently offering later-term abortions, regarding the Hyde Amendment:

‎"As a physician who has been providing abortions for decades, I can tell you that the issue of abortion doesn't exist in black and white; it's all shades of gray. When it comes to the issue of later abortion, arbitrary lines are just that, arbitrary. But not only are these limits irresponsible, they are dangerous. Restricting a woman's right to obtain an abortion at any stage in her pregnancy is an outright siege of her body by the state."

Dr. Carhart is one of my favorite people.  He risks his life daily to provide a controversial yet vital service to women and their families.  He endures threats on his life, his clinic, and his practice.  And through it all, he still has the energy to be an outspoken supporter of reproductive freedom. 

Read through the piece, if you will.  In it, you will find account after account of women who desperately needed Dr. Carhart's help.  These women and their families have sold family heirlooms, pawned their cars, and gone into tremendous debt just to be able to have an abortion; ironically enough, the delay caused by them "chasing the fee" meant that they had to travel even further distances and pay hundreds of dollars extra for a more invasive later-term abortion.  In some cases, Dr. Carhart recounts, many women who finally arrived at his Nebraska clinic weren't able to legally have the abortion because the pregnancy was not life-threatening and the fetus was viable. He wrestles with the complex moments where a woman is overjoyed to find her fetus carried significant defects, because it means she could legally terminate the pregnancy.  You can see why he has such a firm grasp on the complexity of the issue.

If the anti-choicers truly cared about not terminating a pregnancy after the arbitrary points where they push restrictive legislation, they would be 100% against the Hyde Amendment.  But they don't.  They don't care if a fetus is 2mm or 5 inches.  They don't care if it's still in its embryonic stage or if it's around 20 weeks gestation.  They use the graphic images of later-term abortions because it makes a better point than the microscopic product of pregnancies terminated earlier on.  The legislation to restrict the later-term procedures are just an entry point, an excuse to dig their fingers underneath the rock of legal abortion so they can overturn it altogether.  The same goes for mandatory delays, biased counseling, and TRAP laws. 

The antis have little (if any) interest in the human aspects of abortion.  And I'm not talking about "when does a fetus become a human," and I'm certainly not talking about their belief that embryos deserve personhood status.  The antis like to play pretend that they're "compassionate," that they don't want women to undergo abortions because they think it will "hurt" them.  They have precious little compassion for these women, which is why their version of "supporting the woman" involves shouting desperate pleas while following them between the parking lot and the clinic entrance.  Or why they have to misconstrue research and make up mental disorders to disuade women from making an informed choice.

It's not the woman they're concerned about, it's her role as an autonomous human being.  They don't want her to have that.  If they did, they wouldn't have the knee-jerk reaction to engage in manipulative "counseling" when they hear the stories like the ones shared by Dr. Carhart.  They would realize that, often, dealing with an unplanned pregnancy has no winning solution.  They would allow themselves to separate the value of the fetus from the value of its carrier.  But they don't.  Because they don't trust women.

The campaign against Dr. Carhart has been nothing short of genius.  Like his late colleague Dr. George Tiller, Carhart's name has been smeared, his practice slandered, and his livelihood dismantled.  The antis have painted a highly pervasive picture of LeRoy Carhart, one that is not at all representative if you speak to the women and families who have been helped under his care.  Unfortunately for them, Dr. Carhart is not one to sit back and take it. 

Call It What You Will

The following is a ChoiceUSA cross-post.
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In her 2008 book Abortion and Life, author and activist Jennifer Baumgardner recounts a situation that led her to take a more critical approach to the language surrounding abortion:

"I had my own moment of truth during my fifth month of pregnancy ... I was speaking to a group of Barnard College's Students for choice when I referred to that object in one's uterus when one is pregnant as a 'baby.'

"A nurse practitioner who was speaking after me interrupted: 'Fetus, you mean. You said baby, but it's a fetus.'

"'Oh, right,' I stammered, blushing. 'Oops.' I felt foolish, caught in an ignorant mistake. Later, though, I realized that I had always thought of my pregnancy as carrying a baby -- that was the word I wanted to use -- and I was forcing myself to say 'fetus' out of fear. If I said 'baby,' that meant I wasn't pro-choice, or with the program, or knowledgeable."

As is usually the case, I found myself nodding fiercely while reading Baumgardner's take on the situation.  She was pregnant herself, thought of her fetus as a baby, and was completely caught off guard when she was basically accused of anti-choice pandering because of a simple word choice.  Now obviously, context might have dictated that "fetus" was a better word for Baumgardner to use in this scenario, but her point stands: why does it matter?

I don't think anyone could question Baumgardner's merit as a pro-choice activist.  After all she's done for reproductive freedom (and the feminist movement at large), the NP's correction of her language was probably less of an accusation about her beliefs and more of a clarification on what she was talking about.  But again we must ask, why does it matter what she chooses to call her own pregnancy?

As a birth doula, I don't use the term "fetus" unless I'm using it as part of  a technical term like "fetal heart monitoring" or "fetal position."  (Unless, of course, I happened to be working for a woman who used that term herself, but honestly, when have you ever heard of a pregnant woman calling her someday-baby a "fetus?")  It's not my job to make a political case out of one family's situation, so why would I go out of my way to use a clinical term when I'm not a clinician?  I can imagine how that would sound: "We can get the fetus into a better position for birth if we move this way."  "You're doing wonderfully, you'll be meeting your fetus in no time!"  "Lovely work, mama, just let that fetus descend through the pelvis."  Technically, this language is accurate, but think of how cold and distant it would sound to an expectant mother!

In referring to her own body, Jennifer Baumgardner has every right to call her pregnancy what she wants to call it.  If we're pro-choice, shouldn't we embrace that decision as well?  We all know it's a "fetus" or an "embryo" (depending on the stage of pregnancy).  That's not the point.  The point is, if women have the right to own their bodies, they have the right to call it what they will.  Correcting a pregnant woman when she calls it a "baby" is no better than the antis forcing the terms "life" and "baby" down the throats of vulnerable women when they're considering abortion.  Sure, we may have the medical terms on our side, but the pro-choice fight isn't just a fight for medical science, it's a fight for people and for self-realization.  The right to realize oneself as a mother at the moment of implantation is as important as the right to never realize oneself as a mother at all.

It is understandable that many advocates for choice might be turned off by anyone using a non-technical term for a pregnancy.  After all, such language has become a staple of our movement.  "It's an embryo, it's a fetus, etc."  These short statements provide concise counter-arguments in moments where you aren't likely to delve into the big, deep questions about fetal life and its value versus the life and will of its carrier.  In a wholly political context, terms like "embryo" and "fetus" are technically accurate and therefore kosher. But for individual cases where a woman's pregnancy comes up in conversation, choice advocates should remain open to co-opting the language of the woman, viewing the pregnancy as she views it, and allowing her to choose for herself what it is she's carrying in her belly.

Where I Stand on Abortion

Central North Carolina will hopefully soon be graced with a training by The Doula Project of NYC.  This is of course pending the go-ahead from one or two hospitals and clinics that would welcome the women of the Spectrum Doula Collective into their doors.  Part of TDP's training for abortion and miscarriage doulas involves a "values clarification workshop."  What could that mean, you might ask, since obviously any abortion doula would be pro-choice.

One thing I've learned in speaking with a variety of people on the ever-controversial topic of "the A word" is that being pro-choice doesn't always carry the kind of in-depth understanding of one's own position.  Pro-choice people come in all types.  I've met folks who are staunchly pro-choice but swear up and down that they would never have an abortion themselves.  I've met people who are pro-choice in that they don't believe it's any of their (or the government's) business what women do with their own bodies; for this reason, they choose to abstain from any political or social action for reproductive rights.

Values are different than stance.  One's political convictions don't always match personal beliefs.  I am pro-choice, but it wasn't until the last year or so when I began turning those beliefs inward to ask what I feel about abortion myself.

I consider myself fortunate to have never experienced an unintended pregnancy.  While I can say with confidence that I probably would have had an abortion had I become pregnant when I was in my late teens/early twenties, today I have no idea what I would do if I found out that I was pregnant.  I am at such a different point in my life, and while financially speaking I'm not in the most comfortable place, I am in a great relationship with someone who loves and respects me, I have a college degree, I own my house, and I'm on track to develop a new career that would be pretty forgiving of a baby suddenly joining the picture.  I wish my position was that of every woman... I understand that the choices women make when faced with an unintended pregnancy are directly influenced by their circumstance, their values, their relationship status, and their goals.  I think there would be a time in almost every woman's life where becoming pregnant would have warranted, at the very least, considering the option of abortion.  With that in mind, being 100% against abortion simply doesn't make sense to me.  All women are different, each has a story, and their feelings are always valid.

I think it comes down to trusting women.  That has become my mantra as of late, since I find it provides a concise argument for keeping all reproductive options accessible.  While I appreciate the unapologetic cries of "Abortion On Demand And Without Apology" from highly political advocates, I find that the pro-choice movement at large could always use one of these values clarification workshops to take ourselves past our concise slogans and get into the real nitty-gritty of what it is we're fighting for on the personal level.  Hasn't that always been the argument, that abortion is a personal decision?  Values surrounding abortion aren't fun to delve into, they don't make good protest signs, and they're not nearly as cut-and-dry as terms like pro-choice/pro-life.  But for the sake of our movement and the thousands of women and families who depend on our continued efforts to keep all options open, processing one's own values is imparative. 

I say I trust women.  What does that mean?  In short, it means I believe people are capable of making their own decisions.  Now obviously we sometimes even have to fight for women to receive accurate information (as is the case with crisis pregnancy center awareness), so there's a political battle even there.  But from a personal standpoint, what does it mean to trust?

• I trust that, with access to comprehensive and unbiased information, all pregnant people are capable of choosing the best path for themselves.  This includes teenagers who can become pregnant but for some reason often cannot access abortion without a parent's consent.
• I trust a pregnant person's feelings about abortion.  This includes the desire to not have an abortion even if society dictates that it would be the "correct" or "best" thing to do.  It also includes those who are staunchly against abortion on a political level but have them themselves because they find they have no other option.  A woman who chooses to not have an abortion even though she may be young, unemployed, single, or in a bad relationship is not proving anything about abortion at large; her choice does not make abortion inherently wrong, and her personal life does not have to be co-opted for someone else's political agenda.
• I trust people's emotions surrounding their abortion: relief, guilt, shame, sadness, joy, ambivilance, anger, empathy, regret, confidence, fear, etc.  I know what the surveys say, about relief being #1.  But that hardly means this is the only emotion that is valid, or even that women don't feel emotions in addition to relief.  We can go all day on whether or not negative feelings about abortion are due to man-made stigma or if women under-report sadness.  What it comes down to is, women experience a range of emotions, usually not all negative or all positive, and each and every one is valid for her situation.  Understanding this is essential to our movement's success in ensuring each woman truly has a choice; it is not the same as "selling out."
• I know that saying things like "it was just a blob of cells" is the least helpful thing someone can say to a woman experiencing sadness after an abortion (or miscarriage).  Questioning her feelings displays a lack of trust and is not going to make those feelings go away.  Women also do not need to hear your political convictions on abortion if she hasn't asked for them.  It is possible to be pro-choice and at the same time create space for the expression of negative emotions about abortion; in fact, it is required to be truly pro-choice.
• I know that each woman is unique and that unintended pregnancy is sometimes a lose-lose situation.  It may be that no single reproductive option is 100% right for her, no matter how obvious the right answer may seem to an onlooker.  I trust that women can be confused about what to do about an unintended pregnancy without becoming a case study for the antis.  
• I trust that every pregnant person will invite her partner/parents/friends/options counselor into her decision if she feels that it will be helpful.  Until she does, it's none of anyone's business what she does.  This goes for teenagers, women whose boyfriends are pushing for the abortion, women who are not terminating a pregnancy conceived from rape or sexual assault, women whose boyfriends are pushing against the abortion, etc.  If she made the choice, it is valid.
• Lastly, I trust that 99% of people who work at abortion clinics are doing it for the right reasons.  Contrary to what you might have heard, abortion clinics do not usually profit greatly from providing abortions; they usually lose money on the procedure to keep it accessible.  There are some bad eggs out there, I while I believe clinics that do not maintain high standards of care should indeed either improve or be shut down, I believe the real magnitude of the problem lies in the over-worked/under-staffed/under-funded nature of the American abortion clinic, a situation that is a direct result of continued stigma.  

So there it is.