Stigma, Cost Leads Texas Women To Seek Abortion Drugs in Mexico
August 27, 2010 — Several recent studies suggest that U.S. women are increasingly seeking methods for self-induced abortions instead of visiting legal clinics that have become "embattled, increasingly costly and geographically inaccessible," The Nation reports. The article profiles a woman from Brownsville, Texas, to illustrate a common experience among women in the state's Rio Grande Valley, where women, seeking to avoid social stigma and unable to afford medical care, travel to Mexico for cheap drugs to end their pregnancies. An ongoing Guttmacher Institute study shows that 79% of women who attempt self-induced abortions are from the U.S., with the women spread across 20 states.
Mexican pharmacies -- often located just over the U.S.-Mexico border -- are known for carrying cheap and accessible abortion drugs, such as the ulcer medication misoprostol, which is prescribed with mifepristone for legal medical abortion in the U.S. When taken correctly, misoprostol on its own will produce a miscarriage 80% to 85% of the time.
Dan Grossman of Ibis Reproductive Health, who has studied the topic of self-induced abortion, said, "I think our findings suggest that there are still significant barriers to abortion care in the United States," including the "high cost of abortion care -- and in most states Medicaid cannot be used to cover abortion care." A bottle of misoprostol in a Mexican pharmacy can cost $87 to $167, while an uninsured woman in Texas can pay $450 to more than $900 for an abortion. According to Guttmacher, 75% of women who have an abortion say they cannot afford a child, and 42% of women who obtain the procedure have incomes below the federal poverty level.
According to New York Times columnist Nicholas Kristof, misoprostol is "beginning to revolutionize abortion around the world, especially in poor countries," because of its low cost and widespread availability and because of its use for treating postpartum hemorrhage. Rebecca Gomperts, founder of the global reproductive health services provider Women on Waves, noted that misoprostol can be taken privately in a woman's home, which "creates autonomy." Gomperts added, "The fact that (women) can just take a medication is huge, because they don't have to depend on someone else doing something to their bodies."
In areas like the Rio Grande Valley, such autonomy is necessary to avoid the stigma of visiting an abortion clinic. According to The Nation, for women who choose misoprostol, it is "far easier to be able to say 'miscarriage,'" to explain the end of a pregnancy "than to admit to an abortion." Although there are clinics in the area and the procedure is legal, "a trip to the abortion clinic amounts to a damnable transgression" for many women, who sometimes are unaware that the procedure is legal, The Nation reports. Terri Lievanos, a former education coordinator for Planned Parenthood of Brownsville, Texas, said that U.S.-born women "come in here and say, 'Wait a second, abortion is legal?' They've only heard it discussed in a negative way." Gloria Feldt, former president of the Planned Parenthood Federation of America, said, "What we're dealing with now is 35 years of women being very publicly shamed by anti-choice protestors," adding, "Underground abortion is one of the consequences."
Although the anonymous nature of self-induced abortion makes it difficult to determine exact figures, The Nation reports that it is "hardly a new phenomenon." Lester Minto, who works at an abortion clinic in Harlingen, Texas, said that about 20% of his patients have used misoprostol before coming to him, which "tells me there are many more who are using it who don't need to come to me" (Tillman, The Nation, 8/26).
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Richmond-Times Dispatch Reporter Explains Significance of Va. AG's Opinion on Abortion Clinic Regulation
Aug. 27, 2010 — On NPR's "Tell Me More," Richmond Times-Dispatch political reporter and columnist Jeff Schapiro discussed Virginia Attorney General Ken Cuccinelli's (R) recent advisory legal opinion concluding that the state Board of Health has the authority to regulate abortion clinics.
Schapiro noted that Cuccinelli is "echoing a view expressed by his predecessor" -- current Gov. Bob McDonnell (R) -- "that [abortion clinics] are, in effect, hospitals, and that the standards by which they operate should be hospital-like." The Democrat-controlled state House has rejected legislative attempts to impose such regulations. Schapiro said the release of the legal opinion means that in Virginia, "the shift in the abortion debate is from the legal to the regulatory and administrative."
Although the Board of Health has the power regulate the clinics, most of the board's members are Democratic appointees, and many have expressed reservations about enacting Cuccinelli's recommendations, according to Schapiro. The board has not regulated abortion clinics since the 1980s. "It would be left up largely to the governor ... to ask the Board of Health to enact these regulations," Schapiro continued, adding that "one could anticipate a struggle" between the board and the governor's office.
Abortion clinics say that adopting the hospital-like regulations would be "extraordinarily expensive and in effect put them out of business," according to Schapiro. The clinics also argue "that what this is all about [is trying] to make abortion as difficult as possible to obtain in Virginia," he said. If the changes take effect and the clinics close, "this would have the effect of making it very difficult for a number of women to [obtain abortions], of which there are about 25,000 abortions in Virginia annually" (Keyes, "Tell Me More," NPR, 8/25).
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Neb. Judges Take Action on Antiabortion Law, Request To Restore Prenatal Services
Aug. 27, 2010 — In Nebraska, a federal judge recently approved an agreement to block a law that would have required extensive screenings for women seeking abortions, while a county judge denied a request to restore prenatal care services for low-income women. Summaries appear below.
~ Screening law: On Tuesday, a federal judge approved an agreement between Nebraska Attorney General Jon Bruning (R) and Planned Parenthood of the Heartland that permanently blocks a law (LB 594) that would have required women seeking abortions to first undergo extensive physical and mental health screenings, the AP/KETV reports. Bruning's office announced last week that it would not defend the law in court because the judge indicated the law likely would be ruled unconstitutional. Planned Parenthood of the Heartland has argued that the law would be difficult to comply with and require doctors to give women irrelevant information (AP/KETV, 8/26).
~ Prenatal care: On Wednesday, Lancaster County District Judge Karen Flowers rejected a request to immediately restore eligibility for state-funded prenatal services for low-income women, the Omaha World-Herald reports. The Legislature earlier this year declined to restore the funding to provide prenatal coverage for at least 1,500 women, many of whom are undocumented immigrants, after initially cutting the funding in 2009. Gov. Dave Heineman (R) and others who supported the cuts argued that state money should not go toward services for undocumented immigrants. Medical and antiabortion-rights groups presented moral and financial arguments to support providing preventive care for pregnant women. The Nebraska Appleseed Center for Law in the Public Interest, an advocacy group for low-income populations, has filed a lawsuit challenging the eligibility cuts. Flowers said she has questions to ask before considering the suit, which will continue despite Wednesday's ruling (Hammel, Omaha World-Herald, 8/26).
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'Friday Night Lights' Reflects Reality of U.S. Abortion Debate, The Nation Opinion Piece Says
August 27, 2010 — In portraying a teenage character's decision to have an abortion, the NBC show "Friday Night Lights" "tackled the very forces that have so effectively stifled discussion of abortion as a viable option for women, both on TV and real life," Center for Reproductive Rights President Nancy Northup writes in an opinion piece in The Nation. The decision to have an abortion is "rarely made on television or film nowadays, even though abortion is a common and legal medical procedure that one-third of American women decide is the right choice for them," Northup adds.
In the "Friday Night Lights" storyline, a high school sophomore named Becky Sproles seeks the advice of her principal, Tami Taylor, about an unintended pregnancy. The principal first tells her about adoption agencies and support services, Northup writes, noting that "[o]nly when Becky asks about abortion does Tami tell her she can 'direct her to the literature on that.'" Nonetheless, Tami is forced to transfer to another school after she refuses to apologize for providing the information.
The antiabortion-rights characters in the show want "exactly what their real-life counterparts want: to deny women any information that could help them obtain an abortion and to prevent them from getting one," Northup writes. Because they have been unable to overturn Roe v. Wade, abortion-rights opponents have "resorted to pushing laws that severely limit women's access to abortion, especially at the state level," she explains, adding that the restrictions "are either intended to dissuade women from getting an abortion ... or they're designed to make it so expensive or cumbersome for clinics to provide services that the facilities shut down." Antiabortion-rights advocates and policymakers "have a right to express their views," but they "cross the line" when they pass legislation designed to "manipulate information that women receive from healthcare professionals about their pregnancies and options for abortion," Northup argues.
Northup writes, "We would not tolerate being deprived of critical information in other important areas of our lives. Yet when it comes to whether to continue a pregnancy -- a decision that profoundly affects every aspect of a woman's being -- ignorance and deception have become acceptable, or even politically safer, than accurate and supportive information and understanding." This is "unsurprising" because "when even information about abortion becomes the object of legislative control and anti-choice reprisals, fear and silence inevitably prevail," she states. "It is a chilling effect we can see in both our popular culture and our political debates, where anti-choice rhetoric dominates and pro-choice lawmakers must tiptoe around the issue or risk heated attacks on their character," Northup says.
She continues that "Friday Night Lights'" "willingness to depict [the teen character's] abortion as the right choice for her is truly an exhilarating breath of fresh air." However, "it is not enough" because "[e]ach and every one of us needs to break the silence and stand up for all the Beckys and Tamis of the world, and demand that our laws as well as our TV shows reflect and respect the reality of women's lives," Northup concludes (Northup, The Nation, 8/26).
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Higher Rates of Depression Found Among Low-Income New Mothers, Study Says
Aug. 27, 2010 — More than 50% of infants in poverty are raised by mothers with mild to severe depression, which could contribute to problems in parenting and child development, according to a study by the Washington, D.C.-based Urban Institute, the Washington Post reports. Depression is "not uncommon" for women with infants in all income brackets; overall, 41% of women reported symptoms of depression and 7% reported severe symptoms, the Post reports.
The study was based on nationally representative data from a federal education survey of 14,000 children born in 2001. The women were interviewed when their infants were nine months old. Low-income participants were predominantly in their early 20s, with more than 50% younger than 24. The severe depression group was 44% white, 30% black and 21% Hispanic and had a greater risk for substance abuse and domestic violence than low-income mothers who were not depressed.
The researchers found that one in nine infants in poverty had a mother with severe depression, and that 87% of them were breastfed for four months or less. The American Academy of Pediatrics recommends that infants be breastfed at least through the first year. According to the researchers, at least 70% of women with depression need professional help, but only 30% of women in the study reported speaking to a professional during the year before the survey.
There are several underutilized or unnoticed opportunities to reach out to low-income new mothers who are depressed, including through social services programs such as food stamps and the Special Supplemental Nutrition Program for Women, Infants and Children. The report noted that the federal health reform law (PL 111-148) will expand health insurance to many uninsured women in this group and increase home-visiting programs for new parents (St. George, Washington Post, 8/26).
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Blogs Comment on Women's Suffrage Anniversary, Military Abortion Ban, Other Topics
August 27, 2010 — The following summarizes selected women's health-related blog entries.
~ "Stem Cells, Politics and the Law," Michael Tomasky, The Guardian's "Michael Tomasky's Blog": The main issue in this week's embryonic stem cell ruling is "the direct connection between a ruling like this ... and the way the GOP plays politics in the U.S. Senate," according to columnist Tomasky. Judge Royce Lamberth initially threw out the case, but it was appealed and returned to a panel of three conservative judges on the District of Columbia circuit, who decided that it should move forward, according to Tomasky. Lamberth then reversed his decision. Tomasky asks, "Why did this question go to three conservatives?" He writes, "Part of the reason may be that Obama has not filled two vacancies on the D.C. Circuit." However, "everyone who knows anything knows that whatever appointments he'd tried to make would now be languishing in the circle of hell known as the senatorial hold," Tomasky states. This week's decision "is where GOP Senate obstructionism isn't just about politics and actively hurts the republic," Tomasky continues, concluding that "as far as Republicans are concerned, this decision ... is precisely where their obstructionism pays dividends and is why they do it" (Tomasky, "Michael Tomasky's Blog," The Guardian, 8/27).
~ "Virginia Uses Pretense of Public Health To Shut Down Abortion Providers," Pema Levy, Change.org's "Women's Rights": "Since becoming [Virginia] attorney general in January, [Ken] Cuccinelli (R) has launched a tireless, yet largely unsuccessful, culture-war offensive," most recently by releasing an opinion that the state Board of Health has the authority to regulate abortion clinics, Levy writes. "There are a few ironies in the current situation," she continues. First, proponents of Cuccinelli's opinion "use terms like 'equality' and 'women's life and health', lauding [it] as a victory for women's safety," she says. However, "abortions are very safe in the United States, and the surest way to make them unsafe is to make them harder to get," Levy writes. She continues, "Rather than protect women, Cuccinelli and his cohorts' antiabortion activism would abandon women to unsafe abortion providers." The second irony "is the argument that abortion should receive equal treatment when it comes to regulated medical procedures," Levy states, adding, "In fact, the medical establishment has shunned abortion providers" (Levy, "Women's Rights," Change.org, 8/26).
~ "Waiting for Equality," Deborah Vagins, American Civil Liberties Union's "Blog of Rights": The 90th anniversary of the 19th Amendment -- which gave women the right to vote -- "serves as a reminder that although women have won political rights, we must still work to achieve economic rights," Vagins, legislative counsel for ACLU, writes. The U.S. is "on the verge of securing monumental rights for women," with the Paycheck Fairness Act (S 182) "poised for passage in the Senate," according to Vagins. The bill would "update and strengthen the Equal Pay Act" and "provide workers with tools they need to help close the wage gap," Vagins writes. The bill passed the House in 2009 with "overwhelmin[g]" support, and it is backed by President Obama, Vice President Biden and more than 40 co-sponsors in the Senate, she adds. Vagins continues that the Paycheck Fairness Act is "the next milestone in the fight for equal rights, and the Senate must act now so that women today and for generations to come can bring home the pay they rightfully earn" (Vagins, "Blog of Rights," American Civil Liberties Union, 8/26).
~ "Lift the Military Ban on Abortion Once and for All," Brandann Hill-Mann, Change.org's "Women's Rights": A recent report from the Guttmacher Institute shows "that the current ban on allowing women access [to] abortions in military facilities overseas -- even with their own money -- is absurd," Hill-Mann writes. She continues that this is a "hypocritical policy, insisting that women put on a uniform or support a man who does, giving their lives to defend a country that allows other women access to a legal and protected medical procedure that is denied them while ordered to another country." The Burris amendment included in the Senate Defense Authorization Bill (S 3280) "would fix all that" and "ensure that military women would have access to the highest quality of care available to military personnel and their families," Hill-Mann writes. She concludes, "It is vital to speak up and let lawmakers know that uniformed women and civilian dependents deserve all medical care" (Hill-Mann, "Women's Rights," Change.org, 8/24).
~ "A Stem Cell Shock," Russell Korobkin, Huffington Post blogs: In challenging the legality of the Obama administration's embryonic stem cell research guidelines, Judge Royce Lamberth makes a "spectacular leap of logic" by "conclud[ing] that any research that bears a relationship to research ineligible for federal fund is part of the same 'project' and therefore also ineligible," according to Korobkin, an author. Such logic "would equate research on acorns with research on oak trees, research on milk with research on cows and research on air with research on oxygen," Korobkin continues. He notes that the Clinton, George W. Bush and Obama administrations have all interpreted the Dickey-Wicker Amendment -- which bars the use of federal funds for research that destroys embryos -- "to mean that government funds cannot support the creation of embryonic stem cell lines, ... but that there is no statutory bar to funding scientists who use the resulting stem cell lines as tools in the search for cures." According to Korobkin, the "key is to remember the Dickey-Wicker is an appropriations rule that concerns only what type of projects may receive federal financial support, not what projects are legally permissible." He adds, "The relevant question, therefore, is for what purpose the requested federal money would be used?" He argues, "If the money will be used for any other purpose, the grant is legally permissible" (Korobkin, Huffington Post, 8/27).
~ "WashPo Makes Amends on Cuccinelli Fail, Sort Of," Jodi Jacobson, RH Reality Check: Jacobson discusses the Washington Post article on Tuesday that "fail[ed] to provide the facts in response to assertions by anti-choicers" that Virginia Attorney General Ken Cuccinelli (R) was acting "to restrict women's access to abortion care [in order] to 'protect' their health and well-being." Jacobson writes, "Cuccinelli's claims to be concerned about the health and safety of women are false and misleading," adding, "Yet the Post repeatedly quoted anti-choice supporters and members of both the far right in the Virginia Legislature and on Cuccinelli's staff espousing their 'concern for women.'" However, in an editorial published on Wednesday, the Post "indirectly call[ed] itself out by actually citing medical evidence," Jacobson continues. She writes that although it "is a laudable step," the Post "needs to go much further." According to Jacobson, "The Post has developed a habit, running from poor coverage of the failures of prevention policies under the President's Emergency Plan for AIDS Relief to coverage of abortion care, of giving ideologues equal space and equal credibility on sexual and reproductive health issues, even when they skew the evidence or ignore it altogether." Jacobson writes, "To retain its once-lauded credibility on providing facts, the Post needs to run a front-page article examining the actual science and medical evidence on abortion and contraception and stop trying to placate or provide free advertising for the ... fundamentalist political agenda" (Jacobson, RH Reality Check, 8/25).
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