Girls and Young Women Will Suffer Most from Anti-abortion Madness

Reading Facebook posts these days has become an exercise in masochism for many of us. Daily horrific posts reveal various forms of violence against the least powerful among us.

Among the victims of such violence are young women and “emerging adult” females. A recent post referenced an eleven-year old girl in Ohio pregnant by rape. Given Ohio’s newly proposed anti-abortion legislation, she could be forced to carry the fetus to term. That’s nothing short of state-sanctioned child abuse. State after state, the same kind of cruelty could be repeated.

We have heard little about the full impact of Draconian measures aimed at overturning Roe v. Wade on women’s mental and physical health, but of this you can be sure: The impact will be more drastic the younger the girl or woman subjected to such measures.

It should be noted that research reveals having a safe, legal abortion does not pose mental health problems for women. According to Lucy Leriche, Vice President of Public Policy, Planned Parenthood of Northern New England, “over 95 percent of women who have had an abortion report feeling relief that outweighs any negative emotion they might have, even years later.”

In contrast, a statement last month by the Activism Caucus of the Association for Women in Psychology (AWP) makes clear the psychological damage that will be inflicted on girls (and women) from restrictions on their reproductive rights, none more so than the hideous laws Alabama and other states want to impose.

“Growing girls learn that in crucial, life-altering ways, the government has more control over their bodies than they do. This is important for many reasons, one of which is that a sense of control has been shown repeatedly in psychological research to be important to mental health and well-being,” write psychologists Paula J. Caplan and Joan Chrisler on behalf of the AWP. “Rape and incest are examples of extreme loss of control, and at least in some cases, making the decision to have an abortion after rape and incest are important parts of healing, which the Alabama law prohibits.”

Like domestic abuse and sexual assault, current proposed and passed laws are about power and control, and men’s fear of losing that power and control. The laws aim to remove any sense of agency from women, over their bodies and their lives. In their worst form, they are a manifestation of terrorism in which a women’s body is owned by the state, as it was in the chilling novel, The Handmaids Tale. Laws that attempt to incarcerate a woman for crossing state lines to have an abortion, laws that can send her or her physician to jail for life, laws that in the extreme could result in executing a woman for having an abortion reveal the pure evil underpinning these laws.

Let’s remember that the same men (and yes, some women) who want to torture girls and women in these ways are the same men (and women) who legislate against ensuring the health, safety, education, and well-being of the babies born of this unspeakable coercion, and who rabidly support capital punishment.

Even if these reactionary attempts to challenge women reproductive and human rights were to fail, “the blaming and shaming of girls and women who choose to use birth control measures or who choose to have abortions causes fear, self-doubt, low self-confidence, feelings of being unsafe, and beliefs that others consider [women and girls] unable to make major, or ethical decisions,” the AWP points out.

The truly heartbreaking thing is that once shamed, fearful, self-doubting, and depressed, it is almost impossible to regain a sense of personhood or control over one’s life. That kind of despair, in which it seems impossible to envision a way out, especially prevalent in the young, can easily lead to self-destructive behavior, including suicide.

Some years ago, when I worked in Romania on reproductive rights, I saw the damage done to girls, women, and children during the time of the dictator Ceausescu. His regime required all girls graduating from high school to undergo a pelvic exam to determine if she was pregnant. Every working woman was also subjected to monthly pelvic exams in their workplaces. These cruel practices were enforced to ensure that all pregnancies were carried to term. I saw the results of that grotesque policy in the Casa Copii – orphanages where unwanted babies were dumped. Many of the children were visibly impaired, physically and mentally. Others suffered in ways that can only be imagined. Very few of them, I’m certain, had any vision of a happy future. It was worse than Dickensian and it broke my heart.

What is happening in this country now is not far removed from the tragedies that have occurred because of pronatalist policies elsewhere. The lack of humanity, morality, and ethics inherent in such policies is stunning. It leaves one speechless. Incredulous. Furious. Grieving.

But it must not leave us silent.

We must march in unity, speak out vociferously, resist mightily, vote, and support the #SexStrike movement together. Most of all, we must refuse to sacrifice our young and our females on the alters of misogyny and in the chambers of violence. Our survival as sentient beings depends upon it.

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Elayne Clift writes about women, health and social justice issues from Saxtons River, Vt. www.elayne-clift.com

Women Beware! Birth Control, Abortion, and Your Healthcare Are at Risk

 

You’re a middle-class mom with two kids, a mortgage, a fragile marriage, and an elderly parent to care for when you find yourself pregnant. You’re a sexually active college student and because of a condom failure you’re pregnant. You’re pregnant with a wanted child when you learn your fetus has a serious anomaly and probably can’t survive outside the womb. You are a rural woman with limited income who gets routine healthcare at a Planned Parenthood now threatened with closure.

Variations on stories like these abound. For all kinds of women, and their advocates, they are terrifying, as federal and state legislators continue gunning for Planned Parenthood and vehemently resisting female autonomy, privacy, and decision-making.    

As a recent New York Times piece by the editorial board stated, “In its continuing assault on reproductive rights, the Trump Administration has issued potentially devastating changes to the nation’s nearly 50-year-old family planning program, Title X, which allows millions of women each year to afford contraception, cancer screenings, and other critical health services.”

To be clear, health clinics like Planned Parenthood have been barred from using federal funds for abortions, but they have been able to to offer non-federally funded abortions and other family planning services under one roof. Now the Department of Health and Human Services wants to make clinics that provide abortions navigate ridiculous regulations if they want to receive Title X funds. I mean ridiculous regs, like having separate entrances for abortion patients, or establishing an electronic health records system separate from their regular system. Providers will also be prohibited from making abortion referrals, or providing information that adheres to standards for “informed consent.”

In addition to threats at the federal level, more and more states are attempting to pass ridiculous anti-abortion laws, like requiring wider hallways or revamping janitor’s closets.

More Draconian is the unethical “domestic gag rule” that allows so-called “pro-life” staffers in Title X facilities to say a particular procedure doesn’t exist or to lie to patients about false risks of abortion.

As Dr. Leana Wen, the new president of Planned Parenthood, told The New York Times, “There will be many providers that will face an impossible decision: to participate in Title X and be forced to compromise their medical ethics, or to stop participating in that program,” a step that would lead to overwhelming demand for reproductive health care but not much in the way of supply to respond.

Since Roe v. Wade was decided in 1973, states have been constructing a maze of abortion laws that codify, regulate and limit whether, when and under want circumstances a woman can have an abortion, as the Guttmacher Institute points out. Major provisions to states laws, some on the books, other in litigation or defeated, include requiring that abortions be performed in a hospital or set gestational limits on abortion.

One example is the attempt to ban abortions when a faint heartbeat is detected, which can occur as early as six weeks, before a woman may know she is pregnant. Another is state restrictions on coverage of abortion in private insurance plans, and states allowing individual health care providers to refuse to participate in abortions. Some states mandate that a woman have counseling, including information on purported links between abortion and breast cancer, the ability of a fetus to feel pain, or long-term mental health consequences for the woman.

The Trump administration clearly wants to evict Planned Parenthood from the federal family planning program. It also hopes to ban abortion referrals. At the state level, early abortion bans called “heartbeat bills” are being proposed in several states. So far, five of them have advanced this legislation but every “heartbeat bill” passed to date has been overturned in state or federal court. With Judges Gorsuch and Kavanaugh on the Supreme Court, who know what will happen?

Five states have already passed preemptive “trigger laws” which would immediately ban abortion outright if Roe v. Wade is overturned.

Several abortion cases are currently in federal appeals courts or pending litigation in various states. Lawsuits are challenging such issues as required waiting periods, required ultrasounds, 15-week bans, admitting privileges, abortions for minors, and Medicaid coverage.

The situation, not only for women seeking their constitutional right to abortion, but for women – and men - seeking appropriate, quality, accessible, affordable reproductive health care ranging from preventive screening and contraception to treatment of sexually transmitted diseases, grows ever more dire as the Trump administration, and state legislators attempt to control what should be women’s private, personal decisions.

The irony is that rules rooted in anti-abortion (and anti-sex education) feelings threaten access to contraception, which prevents unwanted or unintended pregnancy and consequently increases health care costs in a nation where the cost of care is already skyrocketing.  Can anyone explain why that makes sense? 

More importantly, perhaps, can anyone fathom what would happen without Planned Parenthood?

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Elayne Clift writes about women, health, and social issues from Saxtons River, Vt.

www.elayne-clift.com

 

 

America's Rural Health Care Crisis Grows

Not long ago I received a call from my doctor’s receptionist. My long-time primary care physician and partner in healthcare decision-making was retiring her practice, she said, along with two other doctors in our small town. Together they would be leaving 4,000 patients to find care in a community where most physicians are not taking new patients because they are already overwhelmed by their caseload.

I felt especially troubled by the news since I don’t go to just any doctor, even if one is available. As a proactive health consumer, I research providers carefully because I want to work with someone with proven competence, a compassionate heart, and a philosophy of primary health care that supports my own. Finding a doc like that is not easy. It’s especially challenging when there are too few physicians available.

I also realized that I had become part of the troubling landscape of rural health care. I was suddenly caught up in a picture represented by facts and statistics like these: Disparities in access to healthcare for people who live in rural areas of America continue to widen. Recruiting physicians willing to work in isolated areas has also become more difficult, and is not helped by Donald Trump’s plans with respect to work visas and travel bans. Rural hospitals are closing at an alarming rate. In the past six years, 80 of them have closed and if the rate of closures holds, 25 percent of rural hospitals are predicted to close in less than a decade.

The number of doctors per 100,000 residents is 40 in rural areas compared to 53 in urban environments. That’s not counting specialists, where the comparison is 30 to 263. More than half of our counties have no practicing psychiatrist, psychologist or social worker while opioid-related addictions and overdoses are disproportionately higher in rural areas.

In addition, America’s rural population is older, makes less money, smokes more, is generally less healthy, and uses Medicaid more frequently.  Diabetes and coronary heart disease are more prevalent in rural areas and the death rates for rural white women have increased as much as 30 percent in recent years, reversing previous trends.

Studies published in the British Medical Journal recently revealed a severe lack of resources at rural hospitals, sparse staffing and limited access to specialist consultations and diagnostic tools. An attempt to reduce emergency department admissions for cost-cutting is also putting patients at risk.

The situation is complex and challenging due to economic factors, social differences, educational shortcomings, lack of understanding and political will among legislators, and the isolation of living in remote areas, according to the National Rural Health Association.

Some health care analysts and managers advocate for increased use of technology to help solve the growing problems in rural health care delivery, arguing that while technology won’t solve all the problems, it can make a discernable difference. For example, the Institute of Medicine believes that telemedicine can allow rural hospitals to “cut down on the time it takes rural patients to receive care, particularly specialty care.”

That’s all well and good, perhaps, when it comes to hospitals reducing costs and meeting their other needs. But where does it leave me, and other rural patients, when we’re sitting in our johnnies waiting to (literally) see our doctors?  Where is the comforting face-to-face communication and the physical observation so vital to a clinician’s assessment of a patient’s condition and emotional state? Where is the Q&A necessary for shared decision-making? I once left a practice because my doctor, who had previously looked me in the eye when we talked, listened carefully to what I said, and talked to me like a peer, suddenly couldn’t get his face out of his computer screen long enough to greet me when I entered the room.

As I search for a new doctor – the right doctor – in the coming days, I recognize that like many others, I have a big challenge ahead. For me that challenge goes beyond numbers - something the profession includes in discussions of “accessibility.” It involves trust, proven skills, two-way communication - often around intimate issues or possible critical life decisions - and mutual respect.

Such a partnership for health is not easy to find no matter where one lives. In rural America, it is becoming even more difficult. Patience and perseverance in selecting, hopefully, from a crop of good new physicians, may be just what the doctor – and this community -need to order.