The Last Abortion Clinic: Whistling Past the Graveyard

There’s a lot of talk these days about what might happen if Roe falls, and most opinion seems to be roughly divided into two camps.  A sizable contingent feels confident that the Republicans need Roe more than Democrats do, both because it’s the most reliable way of energizing their base, and because they fear the voter backlash that would surely follow its loss.  Almost as many people seem to believe that Democrats should shut up about the issue of abortion and let it go, because all it’s good for is losing elections.  Their reasoning goes that even if Roe was struck, abortion rights would revert to the states and because — as some preciously naive poster commented a few days ago — “Americans are liberal and pro-choice,” women would still keep access to safe and legal abortion care.  

Both those opinions are wrong — for some women, even today, literally dead wrong.  Should you still cling to either of those cherished illusions, PBS Frontline‘s The Last Abortion Clinic and numerous abortion providers will tell you that you’re only whistling past the graveyard.
Fifteen years later, Walter Dellinger‘s 1990 analysis sounds like prophecy.

[Harvard professor Mary Ann] Glendon suggests that Roe v. Wade “insulated the pregnant woman from the larger society” and that it precluded humane statutory initiatives and supportive communitarian approaches to the problem of abortion and unwanted pregnancy. Nothing in Roe v. Wade, however, precluded a woman from choosing to consult her parents, spouse, minister or supportive friends about her decision; nothing in Roe precluded government from reducing the number of abortions by making more effective birth control widely available; nothing in Roe v. Wade precluded the community from providing the financial support that would make it easier for more women to choose to have more children. What Roe foreclosed was not communitarianism, but compulsion.

Now, in 2005, even with Roe still nominally alive, a mounting wave of TRAP legislation is making compulsion our national norm.  This year’s state-level legislative sessions imposed a near-record number of laws imposing new restrictions on a woman’s access to abortion or contraception.

Since January, governors have signed several dozen antiabortion measures ranging from parental consent requirements to an outright ban looming in South Dakota.  Not since 1999, when a wave of laws banning late-term abortions swept the legislatures, have states imposed so many and so varied a menu of regulations on reproductive health care.

West Virginia and Florida approved legislation recognizing a pre-viable fetus, or embryo, as an independent victim of homicide. And in Missouri, Gov. Matt Blunt (R) has summoned lawmakers into special session Sept. 6 to consider three antiabortion proposals. (Note: One of these has already forced the closing of the only clinic within 160 miles of Springfield, MO)

While national leaders in the abortion debate focus on the upcoming [Supreme Court] nomination hearings grass-roots activists have been changing the legal landscape one state at a time. In most cases, the antiabortion forces have prevailed, adding restrictions on when and where women can get contraceptive services and abortions, and how physicians provide them.

Antiabortion activists say they have pursued a two-pronged approach that aimed to reduce the number of abortions immediately through new restrictions and build a foundation of lower court cases designed to get the high court to eventually reverse the landmark 1973 Roe v. Wade decision making the procedure legal.
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South Dakota has been among the most active states, passing five new laws, including a “trigger” law that would impose an immediate abortion ban after any Supreme Court ruling overturning Roe v. Wade.  
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In its new informed-consent law, South Dakota requires physicians to tell women seeking an abortion about the “existing relationship between a pregnant woman and her unborn child,” and that all abortions “terminate the life of a whole, separate, unique living human being.

What World Magazine‘s “Christian Views” applauds as the “clinic-killer” tactics of Pro-Life Mississippi have raised state-enforced compulsion there to a holy imperative and made it official government policy.          

The last abortion-providing clinic in Mississippi is the Jackson Women’s Health Organization.  PBS producer Raney Aronson and a team from Frontline spent two months finding out how that has happened, and how your own state could be next.  Wherever you are, it’s comforting to think “it can’t happen here,” but I can virtually promise you that at some level, it already has begun.

This November, the Supreme Court will take up its first major abortion case in five years: Ayotte v. Planned Parenthood of Northern New England. This case will come before a changed court. But for Betty Thompson, a former abortion clinic director in Jackson, Mississippi, the concern is less about Ayotte and more that Roe v. Wade is simply becoming irrelevant as states pass hundreds of abortion regulations across the United States. “[Pro-life groups] are going to chip away at Roe v. Wade until the law is on the books, but nobody will be able to access the service,” she tells FRONTLINE. According to one abortion provider in the South, who prefers to remain anonymous: “The assault on abortion rights is very clever. It’s very smart. And we are losing.”
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Americans United for Life considers Mississippi an example for the nation. In fact, the organization’s motto is “Changing Law to Protect Human Life, State by State.” “Mississippi has an impressive track record,” AUL senior legal counsel Clarke Forsythe tells FRONTLINE. “Our goal is to see that other states pass the type of legislation that Mississippi has passed over the past decade, and we see a lot of legislative activity. Legislators and governors across the country in many different states are looking at the same type of common sense legislation that Mississippi has passed.”

Mississippi isn’t the only state where women are tithing their health and safety to the religious right.  Even in the major metropolitan area of Dallas, “moral values” TRAP laws are driving women and teenage girls into deep and dangerous waters.  Two or three women a week finally make their way to our clinic only after having tried everything from self-injecting multiple vials of Methergine, to ingesting up to 30 tabs of Cytotec (10 times the therapeutic dose when used as the stage-two drug in medical abortion), to taking or doing just about anything else you can think of, including punching their abdomens purple.  Some of the women who try to abort themselves are from countries where abortion is illegal, and they already “know” and accept that abortion is dangerous.

Flea markets and bazaars here do a thriving business in drugs to “make your period come,” and in low-income neighborhoods everybody knows “a lady down the street who can help you out.”  All of this has become so prevalent in the Spanish-speaking community that when a woman calls to ask about fees, I feel her out a little and ask if the cost will prevent or delay her having her abortion. If she says yes or even seems to hesitate, then we contact the Lilith Fund or Texas Equal Access, so that if she’s alone and has no one to help her she won’t do something dangerous or have to prostitute herself to get the money.  That happens a lot, too, since our Texas TRAP laws and more restrictive state regulation took effect last year.  They were diabolically designed and crafted to cost providers dearly and thereby increase the cost of providing abortion care, and they do exactly that.  

And the teenagers who can’t tell their parents are a whole ‘nother story. They think that they can drink bleach to have a miscarriage. They pay their best friend’s boyfriend to punch them in the stomach every day after school for days on end. They get on the internet and read about how abortions are performed, and call to find out what kind of tube they can use at home.  Jane’s Due Process literally saves lives in this state, but I live in fear of the day that I can’t keep one of those kids on the line long enough to make her believe that there’s a safe way out.  

And I can virtually promise you that when one of them carries out her pitiful, desperate plan and ends up in an ER, nobody talks about it.  Only a few weeks ago, an OB/GYN resident at a major Dallas hospital told me about the women who come bleeding into their ER, but she won’t tell anybody else, and it’s hard to blame her. I can’t imagine a quicker road to professional perdition for a hospital physician in Dallas, Texas in 2005 than stirring up a public ruckus about abortion — unless it’s getting caught performing one.

The people who imposed our TRAP laws here are the people in charge, and they like things just the way they are — quiet as a church mouse. That’s why Rick Perry had mega-evangelist Rod Parsley at his elbow when he signed the Texas parental consent law that made abortion providing physicians eligible for the death penalty… in a Ft. Worth church.  

But it could be worse. What follows is information received just a couple of days ago from a friend who is an abortion provider in yet another southern state, as we discussed the Frontline program and the increase in illegal abortion caused by TRAP laws.  This comes from a woman for whom I have unbounded respect and admiration, someone who saw “abortion wards” up close and personal before 1973 and who has dedicated herself to providing women with a high quality of abortion care ever since.

Our local university medical hospital tells me they see 12-20 patients per year already who have either self-induced or had illegal abortions.  Some make it, some don’t. These are underage and/or poor women mostly and a few daughters of pro-life families who can’t be seen entering a clinic or going against what their parents believe.  So we’re already living with this at that level and know it will increase when Roe falls.  As a matter of fact I’ve already been approached to help them organize an ‘abortion ward’ — like in the old days — as they know their caseload will mushroom.  

[I] don’t think this is unique to our area or news. The local hospital I referred to is unfortunately publicly funded and we’re in a solid repug state so I imagine they’re afraid of losing funding if this info is confirmed.  Also the very doctors who treat these women are afraid of losing their contracts and there’s always the ‘privacy’ excuse.  

I know other ‘private’ docs and hospitals are experiencing the same but just like in pre-Roe days, mum’s the word.  Most people don’t even realize  hospitals had abortion wards before Roe. Just like what’s happening today, it simply wasn’t talked about openly.

We deal occasionally with a patient who’s attempted to self-induce (through use of caustic douching or ingestion – most common being taking an entire bottle of quinidine tabs chased with castor oil).  When the quinidine dosers call, we get involved with getting them to E.R. before their cardiac rhythm is interrupted — then if the pregnancy continues, we provide abortion care at little or no charge — as patients are usually poor; however some are underage, in which cases we shepherd them through the judicial bypass procedure — sometimes both.

In this culture I don’t know of a woman who’s been through this (or her family) who could ‘go public’ as they would be shunned in the community, lose job, lose children, etc.

Shades of Margaret Atwood’s “Handmaids Tale”.

[W]e’re already dealing with it to some degree here and certainly know what to do if there are complications from legal abortion — but this is a whole other aspect I haven’t had to deal with in years and with my outrage over losing this right for women, I know I’m not detached and objective (nor do I intend to be).  …

To know now how safe and simple this care is and deal with the fallout from criminalization (knowing that those injuries and infections were totally avoidable — except for the religious right, ignorant, backward, etc., etc., etc.), going back to holding women in my arms while they die a totally preventable death is not something I aspire to and not sure I can hold up to it.

This isn’t some specter of a future horror that might or might not ever come to pass. This is the United States of America right now, and repressive state-level laws “regulating” abortion are already compelling women — as always, primarily poor women of color and teenage girls — to resort to the same dangerous and sometimes deadly methods of illegal abortion that kill thousands of women in the Third World every year.  

If you aren’t already horrified, there’s no hope for you.  Don’t even try to imagine how much worse it would be if Roe fell. And maybe no one could hold up to the reality of it, or would — if they knew.  But until Frontline went to Mississippi and Louisiana, nobody except people like us was talking about what already has been going on for some time.  

And where’s that guaranteed political backlash?  It’s nowhere, the same place it would be without Roe. If nobody is talking about it now, in this time and space of relative freedom, who would dare to make a public issue of nonexistent abortion rights in places where abortion had become a crime?

OK, the timing’s lousy. Tuesday is election night, and we all have races to watch. But the polls will have closed before “The Last Abortion Clinic” begins, and nothing else you do then will change even a single vote.  Watch this program, learn the details of what not enough people know, and then let’s all come back and talk together about what we can do — and must do — to keep women safe and free.  If you won’t be home at the regular broadcast time, you can even see it via streaming video from the PBS site.

Or don’t watch it, and try not to think about what a desperate woman somewhere in the United States of America in 2005 will feel forced to do tonight.  Just push it right out of your mind.

“Forget it, Jake. It’s Chinatown.”

And on your way home, don’t forget to whistle when you pass the graveyard.