Sunday, January 18, 2015

Women's medical rights continue to lose ground — or do they?

Posted By on Sun, Jan 18, 2015 at 8:04 AM

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The annual protest march against abortion will be held at the state Capitol today and virtually every Republican politician of any stature will be jostling to be photographed at the front of the pack and then speaking on the Capitol steps.

The march and participation of dominant politicians reflect the conventional wisdom: Abortion, though it remains a legal, constitutional right, is overwhelmingly opposed in Arkansas.

Actually. No. Every credible poll continues to show a desire on the part of the majority to keep abortion as a legal alternative, though with varying degrees of support for measures aimed at limiting it. The 2014 Arkansas Poll, for example, which did a great job predicting election outcomes, found that 40 percent of voters in the poll favored laws making it harder to get an abortion, while 12 percent wanted the laws to be eased and 38 percent said they favored no change in existing law. Some 12 percent didn't answer. That's a majority to leave things as they are, or make abortion more easily available.

A rally in favor of reproductive rights is scheduled at 1 p.m. Jan. 24. There ARE people who support medical autonomy for women in Arkansas. Counting crowd turnout is a meaningless representation. Be sure the marchers today will include people whose families have turned to abortion in difficult circumstances and don't regret the decision.

News from North Carolina indicates even Republicans in some states recognize the desire for keeping the abortion option available. They are politicians who think the GOP fixation on social issues — include marriage equality in this number — obscures issues more important to young people. Education, jobs, health. And alienates them.

From North Carolina, via Huffington Post:

A group of Republican congresswomen led by Rep. Renee Ellmers (R-N.C.) is expressing concerns about an anti-abortion bill that was expected to have overwhelming GOP support in Congress, National Journal reported on Friday.

The bill would ban abortions after 20 weeks of pregnancy, except in cases of rape, incest or when the woman's life is in danger. Congress will vote on the legislation next Thursday, the 42nd anniversary of the Supreme Court's landmark 1973 Roe v. Wade decision. The decision protects a woman's right to have an abortion up until the point that the fetus would be viable outside the womb, around 22 to 24 weeks.

Ellmers reportedly told her Republican colleagues in a closed-door meeting on Tuesday that she is concerned the bill would alienate young voters, who she suggested are turned off by the Republican Party's crusade against legal abortion.

"I have urged leadership to reconsider bringing it up next week … We got into trouble last year, and I think we need to be careful again; we need to be smart about how we're moving forward," Ellmers told National Journal. "The first vote we take, or the second vote, or the fifth vote, shouldn't be on an issue where we know that millennials — social issues just aren't as important [to them]."

Politico reports that six GOP congresswomen, including Ellmers, also expressed concerns that the rape exception in the bill is too narrow because it only would only apply to women who have filed police reports. 

But that's North Carolina. Arkansas already has an unconstitutional 20-week abortion ban, just waiting for the right plaintiff to challenge it (somebody with a dreadful fetal abnormality who's denied the ability to deal with it by Arkansas law passed over Gov. Mike Beebe's veto.) Our bill at least doesn't have a "real rape" provision that shames people away from seeking abortion by requiring a police report to qualify. (Remember, husbands can force sex on unwilling wives who'd fear or face huge obstacles in seeking to prosecute.)

The larger Republican majority plans more efforts to bring a de facto if not de jure end to abortion in Arkansas. First in the bill box this year is the bill described as a preventative against "telemedicine" abortions in Arkansas. Despite misinformed reporting from Republican bloggers, the procedure is used almost nowhere in the U.S. It's not being done in Arkansas. An effort in Iowa was outlawed, though it remains in use pending a court appeal. Too bad it's not widely available. It provides a means for women far removed from major medical centers to end a pregnancy in its earliest stages without multiple, expensive trips far from their homes. Telemedicine is widely accepted otherwise, just not for women seeking an abortion.

Reporting, by both right-wing bloggers and local media, have talked about "abortionists" "unborn babies" and "performing abortions" in talking about the ability of ending a pregnancy with the help of a doctor talking to a woman by TV hookup.

I thought it might be useful to talk in more detail about the procedure being targeted here. It is not coincidental, I don't believe, that a drug abortion is offered by Planned Parenthood at its clinics. And I'm not sure there's not a deeper motive to the bill than merely requiring that a doctor be physically present in a room when the first part of this procedure — taking a pill — is performed.

A woman who believes she's pregnant visits a clinic. If she's pregnant, the law requires an ultrasound. It determines the gestation of the pregnancy. The woman may look at the ultrasound and receive a picture of it. The woman talks to a counselor about options, including parenting. If a woman decides to end the pregnancy, she meets a doctor. But first, she must wait 24 hours.

On the return visit, the woman talks with the doctor. He describes the medical regimen. It's given only to those no more than eight weeks and 6 days after their last menstrual period. If the woman is confident about her decision, she takes a Mifepristone pill. The woman then leaves with another medication, Misoprostol, to be taken by mouth within 48 hours. Together, the pills induce a miscarriage in most cases. 

The clinic schedules a follow up visit for the woman in two weeks. The clinic is also reachable for consultation by phone around the clock.

Insurance doesn't cover this service. Insurance pays only for birth control pills that are also a part of comprehensive health services offered by Planned Parenthood, which the anti-abortion forces want to run out of business. With readily available birth control pills and comprehensive sex education, the need for abortions would be drastically reduced.

The procedure, yes, is an abortion, as is a spontaneous miscarriage. It is not surgery. It comes at the very earliest stage of pregnancy, months before a fetus is viable. It requires administration of a pill and is safer than pregnancy carried to term.

The sponsors of the anti-telemedicine legislation — which might be a backdoor attempt to further restrict pharmaceutical abortions — patronize wornen by suggesting they are uninformed and alone and taking risks by taking these pills.

This isn't a back alley, hotel room procedure. It's a procedure that includes at least three visits to a health clinic and consultations with doctors and counselors, who also remain on call. Most women seeking to end an unwanted pregnancy also have support systems of their own. She is not alone when she goes to a clinic to receive a pill to end a pregnancy. The drugs, as many have noted, are also available through means outside the clinic process. Better that a woman see doctors and counselors, even by TV, than to practice medicine themselves without consultation and drugs purchased by Internet.

Those are some inconvenient facts. They won't disturb those who believe conception brings an end to woman's autonomy, even for a rape victim 24 hours after an assault. Many hold this belief based on faith, a faith that in many cases also believes women should not have contraceptive pills to prevent ever coming to this difficult decision. I write today merely to say those with different beliefs — a majority, if a quiet one, according to polling — are not alone.

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