Junk science makes for catchy headlines and hashtags. Who could honestly be expected to resist highlighting phrases like "reversible abortion" when given the chance, even if such a narrow scope happens to overshadow the bigger, more important picture.
Arizona's SB 1318 , signed into law as the legislature was closing out its session, garnered all the attention recently for requiring doctors to lie to their patients seeking medication abortion by telling them that "should they change their mind after taking the first pill of a chemical abortion, it may be possible to reverse the effects, but time is of the essence."
Debunking is fun - like being let in on a secret or uncovering a truth. But the current singular focus on the fantastic is obscuring an alarming reality: 2015 is setting a record pace for state-level abortion restrictions.
It turns out, not taking the second pill - the misoprostol that follows a day or two after the dose of mifepristone - gives a patient roughly the same chance of carrying to term as the faux treatment in the Arizona law that is now firmly affixed to the state Dept of Health Services website. One sentence can confirm what most rational people hearing a phrase like "reversible abortion" already knew: It's not real and no amount of wishing or hoping from abortion foes can make it so.
In the meantime, while everyone was pointing to the shiny, outlandish "informed consent" provision, the original and much more devastating purpose of SB 1318 - to completely eliminate insurance coverage for abortion - took effect. Insurance is just so boring, though! Except to the people who can't afford care without it, or for the rape victim who shouldn't have had to plan ahead to terminate an unwanted pregnancy.
All these "boring" restrictions have that unspoken caveat hanging in the air, as they're waved off with a yawn: "... except to the people who can't afford care."
Laws and policies that trade away people's rights always disproportionately affect the already marginalized and underrepresented groups - i.e. the poor, people of color, LGBTQ people, youth, the undocumented, and, especially with abortion access, residents of rural areas. Using the rights of the voiceless as politically convenient bargaining chips isn't new; this is simply a crisis moment when it comes to abortion access, and it's being ignored for the sake of the absurd headline opportunity.
Debunking is fun - like being let in on a secret or uncovering a truth. But the current singular focus on the fantastic is obscuring an alarming reality: 2015 is setting a record pace for state-level abortion restrictions. Without eye-catching provisions that fit easily in news chyrons, this wave of "boring" provisions threatens to reduce access to full-scale reproductive health care in this country to a mere memory.
Past the Emergency Point on Provision
We shouldn't need extraordinary circumstances or catch phrases to care about ordinary people who need access to care that could make or break the trajectory of their lives. When only 12 percent of counties even have a provider, we are past the emergency point where every single restrictive law costs people their right to bodily autonomy. And the restrictive laws keep coming.
According to the reproductive health researchers at Guttmacher Institute, 332 anti-abortion provisions were introduced in 43 states just in the first quarter of this year. One of the most alarming trends is the deliberate grouping of certain laws targeting abortion providers, or TRAP laws, which combine to create a burden of urgency for patients.
From Guttmacher's state trends report :
"Many of the new abortion restrictions enacted this year would either limit the use of medication abortion (Arkansas and Idaho) or ban abortion at 20 weeks post-fertilization (West Virginia), a disturbing combination of attempts to curtail access in both the early and later months of pregnancy, potentially leaving women with fewer options and a greatly reduced time frame to get the care they need."
Super red Arkansas tops the national leaderboard with six anti-abortion bills thus far, but with restrictions pending in 43 states, blue and purple coastal legislators are absolutely participating in the systematic elimination of abortion care. New waiting periods - which imply patients aren't smart enough or know themselves well enough to decide what they need - add time, stress and expense along with reinforcing stigma. Parental notification laws, which often require minors to get the permission of their abuser or abuser's family member, are popular in 2015, despite the story of a 10-year-old rape victim in Wisconsin who's being forced to carry to term after her grandmother failed to provide medical care before she entered her sixth month.
Despite the United Nations declaring access to reproductive health care - including abortion - to be a human right, citizens of the United States have no affirmative guarantee to that right.
"Pro-life" groups that have been unable to ban abortion outright in their states or terrorize providers into quitting for their own safety are having luck banning specific procedures like Dilation and Evacuation (D&E), which is used to terminate second trimester pregnancies and to treat incomplete miscarriages. Kansas and Oklahoma bills prohibiting D&E have been signed into law, with Missouri and South Carolina fighting for third place.
Regulating the minutiae of managing a full-spectrum, reproductive health-care practice is all the rage this year as well: Twenty-one states have 43 pending provisions to micromanage everything from disposal procedures to admitting privileges for providers who offer medication abortion. And, as is now the new normal, gestation bans prohibiting abortion past 20 weeks have been introduced in seven states. Whether the residents of those states will be lucky enough to have exceptions for the life/health of the pregnant person and/or exceptions for rape and incest remains to be seen.
Negotiating a Minefield
With every new restriction, a barrier to care is created. Despite the United Nations declaring access to reproductive health care - including abortion - to be a human right, citizens of the United States have no affirmative guarantee to that right. What they are guaranteed is a minefield fewer and fewer can navigate on their own - especially when the expense is piled on top of the stress. To find their way, more and more people are turning to the hotlines of the National Network of Abortion Funds (NNAF) - a coalition of grassroots, volunteer-driven organizations that works to bridge the gaps created by the patchwork of human-rights-violating, anti-abortion laws. Lindsay Rodriguez, NNAF communications manager, says the need is increasing as hurdles often impose greater costs.
"When you factor in unnecessary practices, like mandatory waiting periods, ultrasounds that cost extra, closing clinics, strict regulation on dispensing abortion pills, and increased wait times for appointments, many are having to wait longer, and so the actual abortion procedure can cost more," she said.
"On top of that, many people getting abortions have to navigate real financial difficulties around getting to those appointments: hotels, unpaid time off work when you need the extra money even more - or even having to quit your job to get to multiple appointments, child care, travel expenses. All of these add up to the auxiliary costs of abortion, pushing it out of the range of many people altogether."
Vicki Saporta, President and CEO of the National Abortion Federation (NAF), told Truthout their hotline staff has been busy as well helping often angry, frustrated patients overcome barriers in pursuit of basic medical care.
"Patients often feel deceived and upset when they are forced to hear medical misinformation or view an ultrasound against their wishes."
"After the law [HB2 ] passed in Texas, we heard from patients who were unable to access care locally that would have been available just the week before," said Saporta. "This is very frustrating for women who now often have to travel great distances to access the abortion care they need."
On top of the distances and expense, often patients must be told false "facts" that can leave them confused about risks. The providers do what they can to mitigate the so-called "informed consent " laws requiring doctors to give their patients such incorrect "information" on the reversibility of abortion, the risk of breast cancer and the prevalence of "abortion regret."
"We need to hold our elected officials accountable for putting their own ideological agendas ahead of women's lives and health."
"Our providers must comply with the law, and they explain to patients that unnecessary hurdles like waiting periods and misinformation are mandated by politically motivated laws," said Saporta. "Patients often feel deceived and upset when they are forced to hear medical misinformation or view an ultrasound against their wishes."
Despite the challenges, Saporta remains positive, pointing to proactive laws like the provider expansion enacted in California last year and the Comprehensive Women's Health Bill introduced this year in Oregon. She encourages people to see the big picture to stem the tide of anti-choice laws:
"It's important for people to understand the motivation behind these laws and the effect they will have on the lives and health of women. We need to hold our elected officials accountable for putting their own ideological agendas ahead of women's lives and health."
Rodriguez sees reason to be hopeful as well.
"We do … see an increase in people talking about the Hyde Amendment [which prohibits Medicaid from covering abortion], in media covering it, and in the push to repeal it and offer comprehensive health care; I would say that's directly in response to work NNAF and member funds have done for years."
In addition to pushing for coverage ban repeals and assisting individuals in immediate need on the ground, NNAF members also utilize their annual Bowl-a-Thon fundraiser to break down stigma and build awareness about barriers to abortion care.
"[H]undreds of people raise money from thousands of donors each year," said Rodriguez. "Every time that happens, there are new conversations happening around the inequity of funding bans, the racism and classism of the laws, and there's new people being brought on board with our mission."
Asking people to donate is one thing; getting them directly involved in the cause with other passionate people creates an ever-expanding pool of energized reproductive health-care advocates.
"[The Bowl-a-Thon] allows people across the country, purely as volunteers, who may be frustrated in so many ways by the state of reproductive rights in our country, to stand up and say they believe in equal abortion access for all, and they're going to do something about it," said Rodriguez.
With so much to do, Rodriguez sees a space for "larger connectivity" and also celebrating "local and incremental victories because it gives us a vision of what's possible."
"There's not always a lot to celebrate in our world, as we see these rights chipped away to a pre-Roe era, where abortion was only for a selective few who had the financial resources," said Rodriguez. "But one thing worth celebrating is the incredible network of funds fighting back with all their might. There are so many people devoting their lives to the cause of real justice; we're powerful together, and we're going to win."