Abortion Rates


Congressional-sealCongress began the 2015 session proposing more anti-abortion legislation, keeping in step with legislators at the state level doing the same. Abortion rights have been chipped away so continuously, many of us have come to expect more, no matter how ludicrous.

The proposed laws calling for intrusive, expensive, and uncomfortable (even painful)  transvaginal ultrasounds and mandated scripted information containing unscientific , inaccurate or incorrect information to abortion patients serve no purpose but to promote anti-abortion propaganda and delay access to abortion services.  Some proposals are truly bizarre. An addendum to legislation in North Carolina that passed in 2013 is currently being pushed by some politicians to “…[establish] governing and quality assurance boards and [designate] a chief executive to handle day-to-day operations…”  Exactly what will an additional layer of bureaucracy in a medical practice accomplish for women’s health?

restrictions-2011-2013_smWhen asked to describe the benefits of these laws, the answers are generally the same and women generally have reactions of disbelief to their claims:

Women need to be “properly” informed. Once they are provided the right information, they will be less likely to have an abortion. Uh, yeah, even we women know that we really just do not know what we are doing when it comes to pregnancy, abortion, or other decisions involving our reproductive lives. Yep. We women need the wisdom and personal, often religious, convictions of politicians before we can feel confidence in our decision. We should not trust ourselves or our medical care providers.

It protects women’s health. Abortion is such a dangerous procedure with two victims – the pregnant mom is scarred for life and her child is killed. Can you please just give specifics about how it actually protects women? Are you saying that childbirth is safer or, really, be honest, are you just trying to put another barrier in place to stop women from choosing to have an abortion? Or, are you thinking illegal abortion would be better somehow?

We care about women and children. Oh, I know, I know…you will eventually convince me to give birth whether I am a healthy young woman, a 46-year-old woman with four children and no desire for more, a woman with chronic health conditions, a 13-year-old unprepared for pregnancy and parenting, an 11-year-old pregnant as a result of repeated sexual molestation from a male relative, or any other woman in any other circumstance. You care so much that you will promise to support me spiritually, emotionally, and financially until my offspring become adults. Oh, wait…I forgot, most of you actually stop supporting women once we give birth, once the fetus becomes a child.

preg patientsIf we assume for a moment that those who support abortion restrictions are sincere in their claims that they believe women should be properly informed, that the laws protect women’s health, and that they care about women and children, then they should also support other reproductive healthcare-related proposals that have the same goal in mind. If the premise of restrictive abortion laws is really about informing and protecting women, then laws must be developed to ensure that all women who get pregnant and plan to give birth are aware of the risks involved. All medical practices that have pregnant women as patients must arrange for structural modifications to their facilities to ensure women and the government that they can properly respond to medical emergencies that might arise. The medical providers of pregnant women must also be required to make specific, politically dictated statements about the range of risks involved in pregnancy and childbirth although, unlike the “abortion information,” statements can be based on empirical data and medical facts.

acogResearch by Elizabeth G. Raymond, MD, MPH and David A. Grimes, MD and published in the American College of Obstetrician and Gynecology’s Obstetrics & Gynecology (February 2012), concluded, “Legal induced abortion is markedly safer than childbirth. The risk of death associated with childbirth is approximately 14 times higher than that with abortion. Similarly, the overall morbidity associated with childbirth exceeds that with abortion.”  (Full PDF article available at no charge through embedded link.) While I am not interested in shattering the joy of women learning of a wanted positive pregnancy test, fair is fair. There are risks associated with pregnancy and childbearing for which women should receive appropriate medical information. Given the political and religious propaganda out there, the chances are that a lot of women think that pregnancy and childbirth are safe. If women cannot be respected as able to independently make decisions about abortion, how can we possibly believe them able to make decisions concerning pregnancy and childbirth?

In addition to pregnancy and childbearing putting women at a higher risk of death than abortion, there are numerous risk factors that require medical attention and monitoring, including prior to conception. Rh incompatibility, kidney disease, diabetes, polycystic ovary syndrome, and autoimmune diseases are among the many conditions that can dramatically complicate the health of pregnant women and their babies. Age and lifestyle are other factors that obstetricians must consider during preconception consultations and prenatal treatment practices. The latest blow to pregnant women and fetal wellbeing is research concerning the influence of the time interval between the delivery of the first baby and conception of the second.  “[A]n interval of less than 12 months causes an increased risk for severe preterm birth in women who already suffered preterm birth in their first pregnancy” was the primary finding of the research, which will be presented this week at the Society of Maternal-Fetal Medicine’s annual meeting.

Obesity is one of the most common risk factors for women in developed countries. According to research published in Science Daily (July 2010), “The heavier the woman, the higher the risk of induced preterm birth before 37 weeks, with very obese women at 70% greater risk than normal weight women.  Overweight or obese women also had a higher risk of early preterm birth (before 32 or 33 weeks). Again, the heavier the woman, the higher the risk of early preterm birth, with very obese women at 82% greater risk than normal weight women.”

CDC pregnancy-related-death-2010_600pxAll proposed Pregnancy and Childbearing Risk Awareness legislation should reach far to include all possible complications – just as restrictive abortion legislation underscores improbable complications such as a perforated uterus or death. For example, maternal mortality is on the rise in the United States, with roughly 18 out of 100,000 women dying from pregnancy-related complications in 2013; between 1998 and 2005, the figure was much lower, with roughly eight deaths per 100,000 pregnant women. In 2011, the Center for Disease Control reported 17.8 deaths per
100,000 pregnant women, noting also significant racial disparities with a rate of 12.5 per 100,000 white women and 42.8 per 100.000 black women. The death rate from abortion is one for every one million abortions performed at eight weeks or less, one for every 29,000 abortions performed at 16 to 20 weeks gestation, and one for every 11,000 abortions performed at 21 weeks or later. Obviously, far more women die due to pregnancy-related complications than abortion complications, even at the later stages of gestation. It is only appropriate to ensure that women have the correct information so that they can decide if they really want to be pregnant and if motherhood is actually worth such possible health concerns.

Those of us who believe that reproductive justice is critical to achieving social and economic equality for women know that women can and do think for themselves in every sphere of life and most especially their reproductive lives. We also make many household and relationship decisions, not to mention educational and career decisions. We do not need politicians, pastors, or “sidewalk counselors” to help us make informed, personal decisions nor do we need them to create laws to try to impose their views on us. If they feel they must be a part of our reproductive lives, they should go about it fairly and provide complete and accurate information on abortion and pregnancy.

GodJudgeGaysABIt’s instructive for those who eschew their history lessons (or conveniently forget their history lessons), because they are condemned to repeat it. The prediction that God will judge America over abortion (and homosexuality) is pitiful because it ignores past God-will-get-you predictions from past religionists. Let’s not forget that the Shakers thought the world would be over in 1792, while the Jehovah’s Witnesses pegged various years between 1914 and 1994 as an end date. Joseph Smith, founder of the Mormon church, who told church leaders in 1835 that his conversation with God revealed that Jesus would return within the next 56 years to begin the End Times. Or in 1980, televangelist and Christian Coalition founder Pat Robertson telling his 700 Club TV show “I guarantee you by the end of 1982 there is going to be a judgment on the world.” What these doomsday predictions have in common is fear-mongering foisted upon the gullible.

 This recent God-will-get-you prediction also ignores America’s history of exploitation, pillaging, maiming and killing native Americans and their land, the enslaving, maiming, and killing of millions of Africans, the support of foreign regimes that raped and killed millions, and the corrupt leaders in our own government and military who killed their own, who notoriously engaged in medical experiments on our poor black brothers and nuclear experiments on unknowing populations and who neglected the millions who are needy, oppressed, hungry, poor, sick, and homeless. And, guess what? God did not judge America. It’s still open for business. It remains fully immersed in the basic constitutional principles of freedom, individualism and unobstructed commerce, principles embraced by God-fearing, family-values oriented Republicans.Screen Shot 2012-12-13 at 6.57.54 AM

So when antiabortion crusaders post their dire prediction about God judging America, it’s an opportunity to remember yet another history lesson. Since biblical times, the prophecy of Armageddon, where it was alleged that God would destroy the armies of the Antichrist, is as ordinary as dirt, as quotidian as germs and as dangerous as cold oatmeal.

To get to the root of such a dystopian perspective, one need only open religious tracts to understand the machinations of (mostly) men with a proclivity toward the dramatic, men who are positioned as thought leaders in the prolife culture. Take Fr. Frank Pavone who cherry picks from old and new testaments to push his Priests for Life celebrity life. From his web site, in a section titled “Life is Victorious over Death,” (an anti-science statement if there ever was one), Pavone explains, “Abortion is death. Christ came to conquer death, and therefore abortion.” Note that his fractured syllogism does not cite any biblical text because there is no mention of abortion anywhere in the bible. But to authenticate his logic, he attaches a random biblical citation “I have come that they may have life, and have it to the full” (John 10:10) as if this adds clarity and confirmation of its righteousness.

Visit Flip Benham’s tracts (Operation Save America) for an even more dramaturgical response to abortion. Like Pavone, Benham “unashamedly takes up the cause of the preborn” using the “Cross of Christ” as their strategy (whatever the Hell that means). But rather than proclaim that God will judge America, Flip and his followers believe they ARE the heart and voice of God to solve the problem of abortion through “The Cross of Christ.” Knowing how literal these folks can be, it’s worrisome to imagine that the crucifixion is better theater than Pavone’s blather.

Joe Scheidler’s Pro-Life Action League shares Flip Benham’s affinity for the theatricality of public demonstrations in his Culture of Death performances. Recalling the twisted, disfigured and bloody body of Christ hung on a cross or the depraved killings in which bodies were stacked like cordwood during the Holocaust as teachable moments, Scheidler translates these two grotesque moments in time using images of mangled fetuses hung on signs and posters in his Face the Truth shows. And, quite naturally, their signs create opportunities for them to be on camera wherever they set up their traveling circus.

Calling abortion a national atrocity, as Scheidler does, ignores the sanctity of women’s lives and the choices they make. Calling the 9-11 tragedy God’s judgment and revenge for America’s slaughter of 45 million children, as Benham does, ignores the agency of the men who flew the planes into the buildings, those who supported them and all associated global politics including the Bush administration. Benham’s comments also ignore the rights and wishes of women. And in stating that a when a prisoner is put to death, he is afforded more dignity than the dignity a fetus deserves, Pavone is absolutely discounting the dignity of the woman who is carrying the fetus.

Recall, for a moment, the absurd expression that guns don’t kill people—people using guns kill people. Most rational citizens understand this about guns. Most understand that life and death by guns is more complicated than some bumper sticker expression. So when antiabortion crusaders like Benham, Scheidler and Pavone (and their followers) fabricate such prophecies about abortion and about God’s judgment, aren’t they really saying something more complicated like railing against women and their providers? Like the inert quality of a gun, abortion is a procedure without agency. Abortion cannot be accomplished without human agency. So to say God will judge America for abortion makes no sense unless we unpack what these crusaders most likely mean.GodYouHateImage

In an anti abortion Wikipedia under the “Condemnations and Predictions” category, the entry might read: “God will judge America over Abortion” is a slogan adopted by pro life conservative, evangelical Christians, both Protestant and Catholic, as an abbreviated dystopian version of reality and an alternative to the longer version: “We God-fearing Christians, who don’t believe in the evils of contraception or abortion or unruly American women, want you to know that God will judge abortion-minded women and all abortion providers. It is from our faith that we must inform you that you are the incarnation of evil and that you are condemned to eternity in Hell if you are in any way affiliated with the sins of murdering unborn children.”

Bottom line: It’s not God’s judgment. It’s the anti abortion folks’ judgment on women.

The Wichita Divide

Hyperbole.

I always liked that word, although it was years before I understood its meaning.  And, of course, like most Americans I always mispronounced it by saying “Hyper Bowl.”

Speaking of…yesterday, a friend of mine told me about yet another book on abortion called “The Wichita Divide: The Murder of Dr. George Tiller and the Battle over Abortion” by one Stephen Singular.  I will admit right up front that I have not read the book in its entirety and probably never will.   Immersed in the issue for years, I never read any of the books about abortion except – to be honest – to go to the index to see if I was mentioned.

So, I may be totally misrepresenting Mr. Singular’s thesis but the gist is that the city of Wichita and the state of Kansas are now hotbeds in the battle over abortion rights.  Actually, he refers to these spots as the hosts in a new “war.”  Other authors and columnists also commonly refer to the current state of the battle over abortion rights as a “war.”

Hyperbole.

I will admit that there may have been some semblance of a “war” in the 1980’s and 1990’s when abortion clinics were being bombed and abortion doctors were being stalked, threatened, attacked and killed.  It was domestic terrorism, pure and simple – and I was in the middle of it.  But I put the word “war” in quotes because, to me, a war is when two sides are engaged in the battle.  In that case, the bombs were being planted and the shots were being fired by one side only.  Yes, to be fair, the attacks were coming from a violent fringe of the anti-abortion movement, but it was a one-sided assault nonetheless.   We never shot back.

But, to define today’s situation in Wichita or the nation as a “war” is laughable.  Nationally, although there are some exceptions, the average abortion clinic no longer has to deal with anti-abortion protestors.  If they do, it’s usually a handful of octogenarians who barely have enough energy to yell “Don’t Kill Your Baby!”   After taking their morning medication, these “warriors” will grab their twenty year old sign, take the bus out to the clinic and, depending on the weather, stand out front in a pathetic effort to “save babies.”  Of course, the

y rarely succeed.  It’s actually a sorry scene compared to years ago when anti-abortion groups like Operation Rescue could conger up hundreds of people at a moment’s notice to block access to a clinic.  Protestors were regularly arrested and sent to jail.  On the other hand, I’ll bet you that not more than 10 people have been arrested in the last few years for blocking access to an abortion clinic.  At the same time, folks like Randall Terry, the founder of Operation Rescue, Joe Scheidler and Pat Mahoney have virtually disappeared.  In fact, here is a question for you:   can you name one national anti-abortion leader?

On the other side of the coin, the abortion clinic escort movement, which helped many women get through the crowds of pro-lifers, has also virtually disappeared.  Of course, that is good news in that there is no great need for these courageous folks who volunteered their time to help women obtain an abortion.

I have no doubt that another doctor will ultimately get killed, a clinic will be vandalized, and some staffer will one night get a death threat.  But – and I don’t mean to sound cavalier about this – this is part of the territory.  When a person signs up to work in an abortion clinic, they understand the risks.  It’s the same for a firefighter or a policeman.

But, despite the occasional incident carried out by some bored pro-lifer, for the life of me I cannot fathom how anyone can suggest that there is some kind of “war” in Wichita or anywhere else over the abortion issue.    It might sell a book or two, but it’s a totally silly suggestion.

Hyperbole.

Dr. Finkel

After a while, we simply referred to him as “Finkel.”

I am referring to Doctor Brian Finkel who for many years owned an abortion facility in Phoenix, Arizona. He was an outspoken Ob-Gyn who performed abortions with a gun on his hip. He was one of the few doctors who would talk openly and honestly about his work. Check that, he never saw a microphone or television camera that he didn’t love. And today he is serving time in a county jail for sexually assaulting and molesting a number of his abortion patients. He will probably be there for the rest of his life.

I can’t remember when I first heard of Doctor Finkel, but I think it was when he called our office to inquire about how he could join the National Coalition of Abortion Providers. At that point, we had only three staff people, including me, so it was impossible to run a complete check to determine if he was a good doctor who was running a respectable clinic. Still, I did call a few people on my board but no one had ever heard of him. When I called him to talk about membership, I was impressed by his candor and his articulateness. And, truth be told, he was one of the funniest guys I had ever met.

We ultimately allowed him to join. What appealed to me was Finkel’s willingness to talk about his work. Around that time, the anti-abortion violence was really hitting the fan and our doctors were running in the opposite direction. They were either quitting their job altogether or at least going underground. But I needed doctors to talk, to share with the world their horror stories, to testify before the Congress, to tell the real story. And Finkel, who employed a professional speech writer, fit that bill.

Shortly after he joined NCAP, I visited him at this clinic. It was one of the more beautiful facilities I had ever seen, all decorated in a southwest motif. I quickly learned that he had an Elvis fixation, as his walls were adorned with all sorts of pictures and tapestries featuring The King. Indeed, Finkel referred to himself as “The Elvis of the Pelvis.” In person, I started to get a different perspective. He was rather short with his staff, often referring to them as “honey” or “sugar lips.” And in private conversations, he would regularly refer to “the bitches” who needed abortions. When he had to go into the surgery room, he would say he was going to “the vaginal vault.” He would refer to the “niggers” or “spics” who “didn’t know how to keep their legs closed.” The invectives flowed so smoothly out of his mouth that it stunned me to the point where at first I literally could not respond. I would ultimately admonish him and he would cool it for a while. Of course, being a total slob did not disqualify him from performing abortions and, again, I needed a doctor who had the balls to speak to the American public. I was very torn.

In 1994 NCAP decided to hold a press conference in Washington D.C. to urge the (Clinton) Administration to help protect abortion providers from the terrorism that was raging across the country and, with a gulp, I invited Finkel. He was a big hit. That night, our event was the first story on each of the network news shows and Finkel was the star because he was smart enough to know about props. At one point, he bent down behind his podium and held up his bullet proof vest to the cameras. “Mr. President, I need protection. I am just an Ob-Gyn in Phoenix Arizona, not an American ranger in Mogodishu.” After that, Finkel became a star. He and I were both on Good Morning America a few days after John Salvi killed several abortion clinic workers in Boston. He debated everyone, he was even on the Howard Stern show.

Behind the scenes, however, he kept telling me that the local District Attorney was out to “get him.” He even asked me to talk to the D.A., which I didn’t do. That’s because deep down I started to suspect that Finkel was a little wackier than I really thought. Then, in September 2001 everything hit the fan. That’s when a woman told a Phoenix newspaper that after undergoing an abortion in Finkel’s clinic she had woken up from sedation to find the doctor lying against her with his hands on her breasts. In the weeks and months that followed, more than 100 women reported similar allegations against Finkel to the Maricopa County Attorney’s Office, which charged him with more than 60 counts of sexual misconduct involving 35 different women and he was convicted on most of those charges. Finkel called me asking me to intervene on his behalf but I couldn’t do it. Of course, I couldn’t prove anything but I had just seen or heard too much over the years. To this day, I wonder if there was anything I could have done to prevent those women from being harmed.

Today, on Father’s Day, I get a letter from Finkel adorned with lots of wild doodling and numerous exclamation points. He tells me how he was “railroaded” and how “justice will soon be served.” His only remaining option is the U.S. Supreme Court. So Finkel, who is now in his sixties and has about 20 years on his sentence left, will probably die in prison.

Good riddance.

Candidate's Speech

The candidate walks into the jam-packed auditorium at Calvin Coolidge High School.  The district he seeks to represent has elected both Republicans and Democrats.  The residents are independent thinkers who are very serious about the social issues of the day.  As the candidate strides up to the podium, he looks over the crowd and sees a number of pro-life and pro-choice signs.  It seems evenly divided.  Personally, the candidate believes abortion should be legal but has some concerns about its usage.  He is truly in the middle somewhere.  But the conventional wisdom says that the candidate should just put their lot into one of the camps and stick with that position.  This candidate is different and tonight his goal is to defy that conventional wisdom by appealing to the activists on both sides:

Good evening, ladies and gentlemen.  I’ve been asked to give you my views on the abortion issue tonight.  Generally it is not an assignment that the average candidate looks forward to but I guess I’m a little different.  I’ve actually been excited about this prospect.

Let me start by saying that I respect those of you who are pro-life and those of you who are pro-choice.  This is probably the most controversial issue of our time and I honestly believe that all of you are well- intentioned.   Unfortunately, the media loves to focus on the negative, so they will cover the extremists on both sides.  That is not fair because I firmly believe that the average activist comes from a good place, has deep- seeded convictions and is not shy about expressing them.  Indeed, I applaud you all for standing up for what you believe.

Now, I’m gonna be straight with you.  I’m not the typical politician who tries to have it both ways.  You deserve to know where I stand.

I believe abortion must remain legal in this country.  To me, it is a matter of a woman’s health.  I am a great student of history and, as everyone knows, before abortion was legalized in this country, many women were dying from botched, unsafe back alley abortions or were being severely harmed.   We can all quibble about how many women we’re talking about but, for me, the numbers don’t matter.   Women will always seek out abortions and, if that is the case, then I prefer they be safe.

At the same time, however, I think the pro-choice folks need to fess up.  Abortion is a form of killing.  A woman sitting in the abortion clinic waiting room has something – and you can decide what you want to call that something – in her body.  It is something that, if not aborted, will ultimately become a child.  It is a living organism.  Indeed, if it was a wanted pregnancy, we would be calling it a “baby” from day one.  Then, when the woman leaves the clinic, that organism is no longer alive.  To me, that is “killing.”  It’s a sad process, one that no one wants to experience.   It’s a very sad fact of life.

Sides of the Issue

But here’s the good news.  The number of abortions in this country is decreasing.  It’s hard to say what is causing that trend, but I would like to give credit to both sides of the issue.  For example, the pro-choice folks like to emphasize birth control education.  The pro-lifers hope to “protect” women by pointing out how some women ultimately regret their abortions.  Whatever the reason, the number is going down and that is a good thing.

Now, although I support abortion, I am very concerned that some women might be getting later terms abortions for less than compelling reasons.   That’s why I would support banning third trimester abortions unless the woman’s life was endangered or if there was a possibility of her experiencing severe health consequences.   I don’t think a woman should have an abortion at that stage for some less-than-serious reason.

I will add that I can support the work of so-called crisis pregnancy centers as long as they are totally candid up front about their opposition to abortion.  If a woman clearly understands that she is basically going into a pro-life center andshe still wants to talk to them, then go for it.  I have no problem with that.   In addition, I will vigorously support the right of pro-life activists to protest in front of a clinic.   That is the essence of the First Amendment.

Although I support legal abortion, I am torn about the use of taxpayer’s dollars for abortions.   I understand how the pro-lifers don’t want their tax dollars used to fund something that they find morally objectionable and they have all the right in the world to try to pass laws restricting the use of those dollars.  Indeed, in my earlier days I supported efforts to de-fund the Vietnam War.   On the other hand, I am troubled by the thought of a woman on welfare with four children not being able to use her Medicaid card for an abortion because it means we all will be paying more money to help her raise yet another (unwanted) child.    It’s a tough one for me and I would like to sit down with representatives on both sides of that issue.

Abortion is not a black and white issue to me.  It is very, very complicated.  In the meantime, however, if I am elected to Congress I will work hard to make it easier for couples to adopt, I will support using federal dollars for contraceptives.   I will support any educational effort that has the same goal as we all do – to eliminate the need for abortion in this country.  I ask you all to consider supporting me.  I support legal abortion but I will work as hard as anybody to eliminate the need for it.

Thank you very much.

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