Thursday, August 20, 2009

The Abortion Evangelist

LeRoy Carhart is determined to train as many late-term-abortion providers as possible—or the practice just might die with him.

Full Article
By Sarah Kliff | NEWSWEEK
Published Aug 15, 2009
From the magazine issue dated Aug 31, 2009

Leroy Carhart was at his abortion clinic near Omaha when he got the phone call. It was Sunday morning, a little after 10, and the doctor was in surgery. He felt his cell phone vibrate. Carhart ignored it, finishing the abortion before checking his phone. The number for George Tiller's head nurse in Wichita, Kans., flashed on the screen. The timing was unusual; Carhart didn't often hear from Tiller on Sunday mornings. He thought it might have to do with a patient, maybe an emergency. But when Carhart called back, Tiller's nurse was crying. "George is dead," she told him through sobs, relaying the news that Tiller, the late-term-abortion provider, had been fatally shot at his Lutheran church.

Carhart was scheduled to work in Tiller's clinic the next day; he was one of three abortion doctors who took turns assisting there. His car was already packed for the five-hour drive from Omaha to Wichita he'd made every third Sunday for the past five years. Carhart decided he would still go, to see Tiller's family and help figure out what would happen to the clinic. But first he would see the patients at hand. His waiting room, after all, was full of women who'd crossed state lines and waited hours to see him. "I didn't have any time to sit here and feel sorry for myself," says Carhart. He hung up the phone, went back into the operating room, performed another abortion. By day's end, he had seen a dozen women.

Carhart knows there are people who want him dead, too. A few days after Tiller's murder, Carhart's daughter received a late-night phone call saying her parents too had been killed. His clinic got suspicious letters, one with white powder. It's been like this since Carhart started performing abortions in the late 1980s. On the same day Nebraska passed a parental-notification law in 1991, his farm burned down, killing 17 horses, a cat, and a dog (the local fire department was unable to determine the fire's cause). The next day his clinic received a letter justifying the murder of abortion providers. His -clinic's sidewalks have been smeared with manure. Protesters sometimes stalk him in airports. The threats, the violence, now the assassination of his close friend—all of it has left Carhart undaunted, and the billboard-size sign over his parking garage still reads, in foot-high block letters, ABORTION & CONTRACEPTION CLINIC OF NEBRASKA. "They're at war with us," says Carhart of the anti--abortion activist who killed Tiller. "We have to realize this isn't a difference of opinions. We need to fight back."

What makes Carhart such a target isn't just that he performs abortions—about 1,800 doctors do so today—but that he is among the very few still willing to do so late into pregnancy. Only 1.3 percent of abortions happen after the 21st week of pregnancy, according to the Centers for Disease Control. But those procedures have become the focus of intense debate. To pro-choicers they are tragic stories of late-discovered anomalies, with heroic doctors terminating a fetus that wouldn't survive long after birth. To pro-lifers they are morality tales that best prove the point about all abortion. "I don't support any abortions, but I think third-trimester abortions are particularly abhorrent," says Nebraska's attorney general, Jon Bruning, who has publicly called Carhart "one sick individual" and vowed to act on any evidence that would warrant an investigation. In the third trimester, Bruning says, abortion is "not only morally abhorrent but visually and physically abhorrent. You have a child with arms and legs."

A public-opinion poll in May found 68 percent of Americans support Roe v. Wade's comprehensive protection of elective, first-trimester abortion. But the farther along a pregnancy gets and with each biological milestone a fetus passes, the numbers drop and Americans become more cautious and conflicted. Around 24 weeks, when the fetus is likely viable outside the womb, the right to terminate becomes most controversial and abortion least accessible. Roe recognized the unique status of late-term abortions and gave states the power to restrict or disallow abortion when the fetus is viable (with an exception for "the preservation of the life or health of the mother").

Past viability, no doctor will terminate a pregnancy without a compelling reason. But what is a compelling reason, and who decides? Some would count a serious fetal abnormality, mental or physical; others would not. What if the baby has a 50 percent chance of surviving outside the womb? A 30 percent chance? While most of us navigate these questions in theory, Carhart deals with them in practice. At Tiller's clinic, he saw a rape victim in the third trimester of pregnancy. Every time she felt the baby move, she said, it brought back the rape all over again. She'd made three suicide attempts. Carhart performed her abortion. "If a woman is going to kill herself, then I think you have to look at it for her health," he says. The day before Tiller's death, a woman came into Carhart's Nebraska clinic 28 weeks along. Carhart asked her what she would do if she had to carry the baby to term. "She didn't say she was going to kill herself," he says. "She said she would put it up [for adoption]." He turned her away.

Carhart has a few firm lines; he won't, for example, do elective abortions past 24 weeks, because the fetus is likely viable. "It just makes sense to me," says Carhart. "After a certain point in time, the fetus is viable and we have to look at it differently than if it were not viable." And at 24 weeks, many studies show a fetus's chance of survival to be above 50 percent. Any earlier and the survival rate is lower; at 22 weeks it's less than 10 percent. But Carhart admits that such clear guidelines rarely present themselves. "There are times when abortion is the right answer," he says. "There are times when abortion is not the right answer. I hope I get it right."

Monday, August 3, 2009

Italy approves RU-486 abortion pill

Philadelphia Inquirer

August 1, 2009
The long-debated move drew Vatican warnings of excommunication for doctors and patients.

By Alessandra Rizzo

Associated Press
ROME - Italy has approved the use of the abortion drug RU-486, capping years of debate and defying opposition from the Vatican, which warned of immediate excommunication for doctors prescribing the pill and for women who use it.

The pill is already available in a number of European countries. Its approval by Italy's drug-regulation authorities was praised by women's groups and abortion-rights organizations, which say the pill will provide women with an additional, noninvasive procedure.

It drew the immediate protest of the Catholic Church, which opposes abortion and contraception.

"That's not how you alleviate human suffering, that's not how you help women, that's not how you help mankind," Monsignor Elio Sgreccia, a senior church bioethicist, said yesterday.

The Italian Drug Agency ruled after a meeting that ended late Thursday that the drug, which terminates pregnancy by causing the embryo to detach from the uterine wall, cannot be sold in pharmacies; it can be administered only by doctors in a hospital.

The agency said in a statement that the pill can be taken only up to the seventh week of pregnancy - not up to the ninth, as is the case in other countries. Women who used the pill between the seventh and the ninth week of pregnancy incurred more risks and had often needed surgery, it said.

The decision is expected to go into effect in about two months, the agency said.

In a nod to the ethical implications associated with the decision and the controversy surrounding it, the agency noted that "the task of protecting the well-being of citizens . . . must take precedence over personal convictions."

The 4-1 vote at the agency's executive branch comes about two years after it started looking at the issue. The pill became available in some parts of Italy on an experimental basis in 2006.

For the Catholic Church, the decision was the latest defeat in its efforts to ban or restrict abortion in the nation that hosts the Vatican.

Italy legalized abortion on demand through the end of the third month of pregnancy in 1978, after a long battle between secular forces and the church. Abortion after three months is allowed when the pregnancy is deemed a grave danger to the woman's mental or physical health.

Three years later, Italians voted in a referendum to keep the law, again defying a church-backed campaign.

Archbishop Rino Fisichella, who heads the Vatican's Pontifical Academy for Life, issued a condemnation of abortion and the RU-486 pill in a front-page article in the Vatican newspaper L'Osservatore Romano yesterday. He said the church cannot passively sit back, and insisted the ethical implications of the pill could not be overlooked.

"An embryo is not a bunch of cells," Fisichella wrote. "It's real and full human life. Suppressing it is a responsibility nobody can take without fully knowing the consequences."

There were about 121,000 abortions on demand in Italy in 2008, according to figures provided by Italy's health authorities. That number was down 48 percent from 1982 - the year when the number peaked after the referendum upholding the abortion law - and down 4 percent compared with the previous year.

Critics of RU-486 say that taking a pill might reverse that trend because it would make interrupting a pregnancy easier.

Tuesday, July 7, 2009

Confronting Our Ambivalence: The Need for Second-Trimester Abortion Advocacy

by Susan Yanow

Abortion continues to be one of the most politically contentious and divisive issues in the United States. In attempts to reframe the issue, many prochoice groups are prioritizing messages of “prevention” and “reducing the need for abortion.” These frames mirror public sentiment that abortion should be “safe, legal and rare,” but are problematic. While it is critically important to increase access to comprehensive sexuality education and contraception, these frames may be used to support those who seek to impose increased restrictions on abortion access. Our messages must embrace the reality that women will always need contraception and abortion services, that these services need to be more accessible and that they need to be available throughout pregnancy.

Since abortion was legalized in 1973, the right to abortion has been eroded through laws that create barriers to care. Second-trimester abortion is particularly vulnerable. Opinion polls show that only a quarter of the public agrees that abortion should be legal in the second trimester. Intense public debate over so-called “partial-birth abortion” has inserted graphic descriptions, often misleading, of later abortion into the public arena. The widespread availability of high-resolution ultrasonography, which brings vivid images of fetal development into the public eye, adds fuel to the debate. News stories about very premature infants being “kept alive” through medical intervention call into question for some the definition of “viability.”

As a movement, we have not engaged fully in the debate over later abortions, aware that we do not have public support or compelling ways of talking about the women who need these services. Some prochoice writers, such as William Saletan, have even questioned the wisdom of continuing to fight for later abortions, arguing that efforts should be focused on securing first trimester abortions. (Washington Post, March 5, 2006) This position threatens the reproductive rights of the thousands of women every year who need second-trimester abortion services, and reflects a lack of knowledge about who these women are and why they do not seek abortion care earlier.

Too many conversations about second trimester abortion start defensively with the statement, “Of course, most abortions take place in the first trimester.” However, approximately 55,000 women in the US obtain abortions at 16 weeks or later every year. This is not new; women have consistently needed access to later abortions. The distribution of abortions by gestational age has remained fairly constant since 1983 with approximately 88 percent of abortions occurring before 13 weeks, six percent occurring between 13 and 15 weeks, four percent occurring between 16 and 20weeks and one percent occurring after 21 weeks.

Who are these women? The women who seek later abortions are disproportionately young women, low-income women and women of color who often face numerous delays in obtaining services that contribute to the later gestational ages at which they present for care. Of the abortions provided to white women, 11.5 percent occur after 12 weeks compared to 13.1 percent of abortions to African Americans. A Guttmacher Institute study found that adolescents took a week longer to suspect a pregnancy than adults.

While women who detect severe fetal abnormalities in the second trimester have been the “face” of advocacy for later abortions, in fact they represent a minority of the women who need this service. Two recent studies of why women obtain abortions in the second trimester suggest that late detection of pregnancy, cost and access barriers, and difficulty making a decision, all play a role in the use of second-trimester abortion. Fifty-eight percent of women reported that they would have liked to have had the abortion earlier, but faced barriers. These barriers include a shortage of second-trimester abortion providers, the cost of a second-trimester abortion (which is covered by Medicaid in only 17 states), referral issues and low public support for women who seek later abortions.

A Shortage of Providers

While the shortage of abortion providers outside of urban areas in the US is widely acknowledged, there is an acute shortage of clinicians trained and willing to provide abortions after twelve weeks for non maternal and fetal indicators. According to a survey of abortion providers conducted by the Guttmacher Institute, approximately 60 percent of abortion-providing facilities offer abortion services after 14 weeks, and only 33 percent of the facilities offer abortions at 20 weeks. Only 24percent of the facilities offer abortions at 21 weeks and beyond. Five states lack a provider performing abortions after 12 weeks for non-maternal or fetal indications, ten states lack a provider performing abortions after 15 weeks of pregnancy and 22 do not have a provider offering abortions after 20 weeks. Consequently, access to second-trimester abortion care is severely limited for women living in those states. Getting an accurate referral, making travel and child-care arrangements, and raising the extra money needed to travel, sometimes including plane fares and overnight stays can cause substantial delays in women getting the abortions they seek.

Some states have passed burdensome requirements that restrict providers. For example, in 2003 in Texas, there were 3,066 post-16 week abortions performed. In 2004 the Texas legislature passed a law that abortions after 16 weeks can only be provided in surgicenters, which are extraordinarily expensive to construct. In 2004, there were only 403 post-16 week abortions provided in Texas.

Costs of Second-Trimester Abortion

The cost of second-trimester abortion, which can include travel, accommodations, lost wages and child care, continues to be a barrier and cause of delay for many women, in spite of the ongoing efforts of the 100 grassroots abortion funds affiliated with the National Network of Abortion Funds (NNAF) and other funding resources. Fees for second-trimester abortion vary depending on gestational age and location, and range from $600 to $3,000. If the procedure is done in a hospital rather than a freestanding clinic or surgical center, the fee can be even higher.

The Hyde Amendment (first passed in 1976 and reauthorized every year since) prohibits the use of federal funds to pay for abortions except for cases of rape, incest or life endangerment. Only 17 states allow the use of state funds for abortions outside of these three narrow circumstances. Additionally, 12 states restrict abortion coverage in insurance plans for public employees, and five states restrict insurance coverage of abortion in private insurance plans. Three quarters of the women receiving outpatient abortions pay for the procedure with their own funds.

Insurance carriers and Medicaid (in the 17 states where Medicaid covers abortions) reimburse second-trimester abortions at a rate that does not cover the costs. Additionally, many malpractice policies increase rates for post-16 week abortions, with another increase at 19-20 weeks. The cost of providing later abortions and poor reimbursement provide a disincentive for clinics and hospitals to provide second-trimester services.

Inaccurate Referrals

Inaccurate referrals can contribute to many of the delays imposed on women seeking abortion services. If a woman calls the clinic closest to her, they may schedule an appointment for the following week without adequately screening her. When she arrives, she may learn that she is above the clinic’s gestational age or be above their weight limit. Many organizations refer only to other providers within their membership systems rather than to the closest appropriate provider. Most states do not have comprehensive guides available to assist in good referrals to the nearest and most appropriate provider.

Currently, there are a number of referral sources for women seeking abortions, but each is limited. Planned Parenthood and the National Abortion Federation maintain only listings of their members. The various abortion funds often only have information about the clinics that are geographically most proximate, and must do extensive research with each caller to find appropriate referrals for women needing later procedures. The lack of a comprehensive referral network means that women are often delayed needlessly, or must travel further than necessary.

Low Public Support for Women and Providers

“You are 16 weeks pregnant and you want an abortion? Why did you wait so long?”

Despite the ongoing need for second-trimester abortion services, public support for abortions after the first trimester is very low. In addition to the visibility of later pregnancies, many members of the public have themselves experienced pregnancy at this stage and have uniquely personal experiences with fetal movement. This experience leads some to ask, “How can a woman who experiences fetal movement still opt for an abortion?” There is little understanding that many women end up in the second trimester of an unwanted pregnancy due to barriers and delays, while other women can only make the decision to have an abortion when they are in the second trimester. Some women need more time to wrestle with the decision—for example, they may be against abortion while at the same time knowing that they cannot possibly become a parent at this point in their lives—and this deep ambivalence delays their decision. Other women have desired pregnancies and then find themselves in a changed situation, either medically or socially (a partner becomes abusive or leaves, a job loss, a hurricane that destroys her home, a cancer diagnosis), which necessitates an abortion, despite the initial desire to keep the pregnancy and have a child.

Additionally, the general public and many medical professionals do not recognize or honor the work of abortion providers. The public image of a second-trimester abortion provider is a negative one, fueled by antichoice rhetoric and sensationalist stories after rare complications occur. In order to protect their safety and the privacy of their families, physicians who perform later abortions often do not discuss their work in any public forum. As abortions are primarily done in freestanding clinics, the procedure and those who provide it are often marginalized by colleagues in mainstream medicine.

Developing a Solution

While there is good data on the multiple reasons women delay seeking abortions and the obstacles they face, we don’t know why the second-trimester abortion rate has remained steady and which barriers, if removed, would result in women accessing services earlier. For example, would free pregnancy tests result in earlier detection and earlier decision making around abortion? What would the impact of comprehensive sexuality education be on women’s recognition of pregnancy symptoms? There is a clear need for more quantitative and qualitative research on women who seek second-trimester abortions, and more collaborative strategies to increase abortion access.

In 2007, recognizing this need for a coordinated effort by the reproductive health, rights and justice communities, Advancing New Standards in Reproductive Health (ANSIRH), a program of the University of California San Francisco, launched the National Strategic Initiative to Secure and Expand Second-Trimester Abortion to develop strategies to increase second-trimester abortion services and support those who offer this service. This initiative has evolved into the Second Trimester Access Network, a collaboration that includes leadership from many prochoice organizations and seeks to promote work across the field on second-trimester issues. The mission of the network is to thoroughly understand all aspects of second-trimester abortion and support member groups in removing barriers that delay a woman’s access to abortion, while recognizing that some women will always need abortions late in the second trimester for a myriad of complicated reasons.

The Initiative and the Network have identified some initial strategies to removing barriers to women’s access to second-trimester abortion.

Increase Training and Services

Acquiring the skills needed to provide second-trimester abortions requires experienced trainers and a sufficient volume of patients, both during the training experience and afterwards to maintain skills. Possible solutions include establishing regional hubs that would provide a sufficient volume of procedures to train all types of clinicians (doctors, advanced practice clinicians, registered nurses), or expanding the training capacity and increasing the gestational age at some current sites that provide later abortions. It is also important to recognize that training is only a first step. Once trained, providers need support to overcome obstacles to practice, including building public and clinical support for their practice.

Second-trimester abortion services are unevenly distributed. While many states have no providers of second-trimester abortions, some urban areas have a wealth of resources (for example, in the Greater Boston area there are eight facilities that offer abortion after 16 weeks.) For first trimester abortion, it is reasonable that no woman should have to travel further than the nearest primary care provider. However, second-trimester abortions require a different set of skills and different types of facilities. How many providers are needed? How far is it reasonable to expect a woman to travel for a later abortion? Research is needed to gather detailed information on current providers (including whether they are in solo practice, retirement plans, etc.), develop a model for a rational geographic distribution of services and explore the potential of providing incentives for trainees to provide abortions in underserved areas to expand services beyond where they are currently located.

Provide Funding for Abortion and All Reproductive Health Care

The Hyde Amendment, which bans Federal Medicaid coverage of abortions, is blatantly unjust and must be repealed. A strong coalition to repeal the Hyde Amendment exists (Hyde: 30 Years is Enough!) and activity within the coalition is increasing as new possibilities are seen with the change of power in Washington. In the interim, legal and advocacy strategies must be developed in each state to ensure a fair reimbursement rate to providers. In states with coverage only for rape survivors or danger to a woman’s health, advocates must ensure that at least these exceptional cases are covered.

However, the repeal of the Hyde Amendment is only a first step. Health-care reform of some kind is coming. Advocates must make sure that health-care reform efforts at both the state and federal levels include coverage of comprehensive reproductive health services. Several coalitions, including Raising Women’s Voices for the Healthcare We Need, are working for health-care reform that explicitly includes coverage of abortion care.

Provide Accurate, Timely Referrals

There is a clear need for a comprehensive referral resource that includes information on gestational limits for each provider, weight restrictions if any, cost schedules and other services (e.g. translation services). The resource should also provide funding assistance if a woman is facing economic challenges, be regularly updated and accessible to all possible referral sources. The National Network of Abortion Funds (NNAF) is currently collecting information from its member funds to begin compiling this resource.

Develop a Multifaceted Communications Strategy

The general public is unaware or misinformed about the reasons that women seek abortion in the second trimester. The complicated issues that lead women to make this decision must be shared with the public in a sympathetic light to increase political support for second-trimester abortion care. To create messages that resonate with different communities, we must engage those who work most closely with young women, rural women and women of color. The strategy must destigmatize abortion, incorporate respect for women and providers and avoid the devaluation of any groups, including disabled people, in the development of messaging. We must find ways to clarify that our goal is to prevent unwanted pregnancy, not to prevent abortions.

A first step is to begin with ourselves. Within our organizations and across our movement, we must clarify our values and remind ourselves that a definition of reproductive justice must include all women with unintended pregnancies, regardless of gestational age. Prevention will not eradicate the need for second-trimester abortion. Instead of using the frame of “prevention,” we must begin to advocate for abortion “as early as possible, as late as necessary.”

Susan Yanow, MSW, is a long-time reproductive rights activist and founding executive director of the Abortion Access Project.

Friday, July 3, 2009

Changes at TCHP Blog

Hello regular, new and future readers of The Coathanger Project Blog. I’m Lisa. I’ll be here pitching in with blogs, updates on the state of the Reproductive Justice/Pro-choice movement, stories that are related to abortion legislation, feminism, women’s issues and a lot that is pertinent to thinking, caring, and passionate people like you. I’m also hoping to have guest contributors, fiction, poetry, short films – anything to make visiting us here at TCHP Blog interesting, elevating, motivating and inspiring so that you can in turn spread that information, energy and action to the culture around you. So really not much will change, just more hands in the kitchen! Feel free to contact us here if you’ve got anything to say—or if you want to contribute or for whatever! Don't worry, Angie's still with us and will contribute-- she's working on spreading the awesome-ness that is TCHP film (if you want her or the film to happen at your space, please don't hesitate to let us know!) and is working on something new!

Monday, June 22, 2009

Right-Wing Extremists Threaten Women's Rights All Over the World


In the weeks following the assassination of Wichita abortion provider Dr. George Tiller, it was perhaps too much to hope that antiabortion organizations and activists would reflect on, and even temper, their movement’s rhetoric. Instead, the halfhearted denunciations of violence issued by groups like the National Right to Life Committee and Operation Rescue were all too quickly followed by a return to offensive characterizations not only of abortion, but of abortion providers.

While the most harmful expressions of antiabortion violence are playing out here in the United States, the vigorous export of the rhetoric, tactics and ideology of the movement is creating a similar hostile environment for abortion providers and for women seeking abortions in other countries. Legal attacks and harassment against clinics, women and providers in countries where women risk their lives to end a pregnancy are increasing, largely tolerated by governments who are reluctant to confront powerful religious leaders.

In many ways the U.S. antiabortion movement is succeeding in recreating the intimidating American model abroad. Take, for example, the 2007 police raid on a family planning clinic in Brazil, which was eerily reminiscent of the raids on Dr. Tiller’s clinic in Wichita. In both cases, the private medical records of thousands of women were confiscated and searched for evidence of illegal abortions. Prosecutors felt that the possibility that any of them might have had an illegal abortion far outweighed their right to keep their medical records private.

Similar attitudes can be seen at the national level where conservative antiabortion legislators recently submitted a proposal to the Brazilian Congress seeking to define abortion as a “heinous crime.” This came just months after their caucus, the Parliamentary Front in Defense of Life, pushed for the approval of a congressional committee dedicated to investigating illegal abortions and the black market sale of abortive drugs “in order to implement the law to the fullest extent.” If found guilty, women who undergo illegal abortions could receive one-to-three years imprisonment, and physicians up to 20 years.

Even where abortion is legal, activists are applying the same tactics of intimidation seen here in United States. Last year the Mexico City legislature approved a progressive reproductive health bill allowing abortion for up to twelve weeks. A legal appeal (supported by the country’s Catholic hierarchy) quickly followed but was denied by the Mexican Supreme Court. Antiabortion activists sprung into full attack mode, protesting clinics wielding massive posters of bloodied, mangled full-term babies who they claimed were the victims of abortion. They continue to film, intimidate and harass women entering clinics for legal services, begging them not to get an abortion.

With the exception of a few countries, most nations in the world allow abortion for at least some indications. Still, abortion stigma is so culturally pervasive that many women do not use legal facilities to terminate their unwanted pregnancies but instead self-induce under dangerous conditions. Because of the stigma, governments have little incentive to ensure that legal services are available and many doctors are unaware that women have the right to request legal abortions in their hospitals and clinics. Instead, antiabortion organizations use their political influence and dangerous rhetoric to punish and endanger women.

In this country we can observe in the wake of Tiller’s murder a certain reinvigoration of the antichoice movement. Rather than stepping back to evaluate how they contribute to hostility toward women and providers, the anti-abortion movement is continuing to stick to its message. The repeated refrain is that they don’t condone Tiller’s killing but that, after all, he “murdered unborn children.”

Human Life International (HLI), a Virginia-based organization that claims it is “the largest prolife movement of Catholic orientation in the world,” is a perfect example of this global approach. They are clearly not ready to tamp down on its war of words. Indeed, their public statement following Tiller’s murder offers no apology:

George Tiller, the mass murderer of Wichita, Kansas is dead. “Those who live by the sword, die by the sword,” said the Lord… Can killing a mass murderer be considered “justifiable homicide”? The short answer to this is “no,” but it is not always apparent why HLI provides financial and material support to affiliates around the world to pressure governments to reject liberalizing abortion laws, while simultaneously creating a cultural climate that stigmatizes abortion and the women who get them. Its activities are focused on the developing world where abortion is already legally restricted (including in Mexico and Brazil), and where women often risk their lives to end an unwanted pregnancy.

Given the history of U.S. antichoice organizations working to recreate the hostile social environment around abortion abroad, is it just a matter of time before a Scott Roeder appears in South Africa or India?

Tuesday, June 9, 2009

Tiller's Clinic to Close Permanently


The Witchita, Kan., abortion clinic run by murdered doctor George Tiller will be closed permanently, the Tiller family announced Tuesday as Rep. Louise Slaughter, D-N.Y., offered a House resolution honoring the slain abortion provider.

Tiller opened the Women's Health Care Services, Inc., in the 1970s and it served as one of three clinics in the country that performed controversial second- and third-term abortions.

"Notice is being given today to all concerned that the Tiller family is ceasing operation of the clinic and any involvement by family members in any other similar clinic," Tiller family attorneys Lee Thompson and Dan Monnat said in a statement.

"We are proud of the service and courage shown by our husband and father and know that women's health care needs have been met because of his dedication and service. That is a legacy that will never die. The family will honor Dr. Tiller's memory through private charitable activities," the attorneys said.

Tiller, who in March was acquitted on 19 misdemeanor charges related to his practice, was fatally shot while serving as an usher in his church on May 31. The murder drew a flood of denunciations from President Obama along with liberal and conservative lawmakers and abortion rights groups and abortion foes.

Attorney General Eric Holder ordered the U.S. Marshals' service to "increase security for a number of individuals and facilities" although officials provided no specifics.

Scott Roeder, 51, was taken into custody for the crime.

On Tuesday, Slaughter offered a resolution condemning Tiller's murder on behalf of 80 co-sponsors. The resolution noted the increased acts of violence taking place in places of worship, and called for condolences to the Tiller family and a recommitment to tolerance.

Monday, June 8, 2009

Why I Am An Abortion Doctor by Dr. Gary Romalis

Why I am an abortion doctor

'I can take a woman, in the biggest trouble she has ever experienced in her life, and by performing a five-minute operation, in comfort and dignity, I can give her back her life'

By: Dr. Garson Romalis, © Garson Romalis
Published: Monday, February 04, 2008

What follows are remarks delivered by Canadian abortion doctor Garson Romalis on Jan. 25, at the University of Toronto Law School's Symposium to Mark the 20th Anniversary of R. vs. Morgentaler


I am honoured to be speaking today, and honored to call Henry Morgentaler my friend.

I have been an abortion provider since 1972. Why do I do abortions, and why do I continue to do abortions, despite two murder attempts?

The first time I started to think about abortion was in 1960, when I was in secondyear medical school. I was assigned the case of a young woman who had died of a septic abortion. She had aborted herself using slippery elm bark.

I had never heard of slippery elm. A buddy and I went down to skid row, and without too much difficulty, purchased some slippery elm bark to use as a visual aid in our presentation. Slippery elm is not sterile, and frequently contains spores of the bacteria that cause gas gangrene. It is called slippery elm because, when it gets wet, it feels slippery. This makes it easier to slide slender pieces through the cervix where they absorb water, expand, dilate the cervix, produce infection and induce abortion. The young woman in our case developed an overwhelming infection. At autopsy she had multiple abscesses throughout her body, in her brain, lungs, liver and abdomen.

I have never forgotten that case.

After I graduated from University of British Columbia medical school in 1962, I went to Chicago, where I served my internship and Ob/Gyn residency at Cook County Hospital. At that time, Cook County had about 3,000 beds, and served a mainly indigent population. If you were really sick, or really poor, or both, Cook County was where you went.

The first month of my internship was spent on Ward 41, the septic obstetrics ward. Yes, it's hard to believe now, but in those days, they had one ward dedicated exclusively to septic complications of pregnancy.

About 90% of the patients were there with complications of septic abortion. The ward had about 40 beds, in addition to extra beds which lined the halls. Each day we admitted between 10-30 septic abortion patients. We had about one death a month, usually from septic shock associated with hemorrhage.

I will never forget the 17-year-old girl lying on a stretcher with 6 feet of small bowel protruding from her vagina. She survived.

I will never forget the jaundiced woman in liver and kidney failure, in septic shock, with very severe anemia, whose life we were unable to save.

Today, in Canada and the U.S., septic shock from illegal abortion is virtually never seen. Like smallpox, it is a "disappeared disease."

I had originally been drawn to obstetrics and gynecology because I loved delivering babies. Abortion was illegal when I trained, so I did not learn how to do abortions in my residency, although I had more than my share of experience looking after illegal abortion complications.

In 1972, a couple of years after the law on abortion was liberalized, I began the practise of obstetrics and gynecology, and joined a three-man group in Vancouver. My practice partners and I believed strongly that a woman should be able to decide for herself if and when to have a baby. We were frequently asked to look after women who needed termination of pregnancy. Although I had done virtually no terminations in my training, I soon learned how. I also learned just how much demand there was for abortion services.

Providing abortion services can be quite stressful. Usually, an unplanned, unwanted pregnancy is the worst trouble the patient has ever been in in her entire life.

I remember one 18-year-old patient who desperately wanted an abortion, but felt she could not confide in her mother, who was a nurse in another Vancouver area hospital. She impressed on me how important it was that her termination remain a secret from her family. In those years, parental consent was required if the patient was less than 19 years old. I obtained the required second opinion from a colleague, and performed an abortion on her.

About two weeks, later I received a phone call from her mother. She asked me directly "Did you do an abortion on my daughter?" Visions of legal suit passed through my mind as I tried to think of how to answer her question. I decided to answer directly and truthfully. I answered with trepidation, "Yes, I did" and started to make mental preparations to call my lawyer. The mother replied: "Thank you, Doctor. Thank God there are people like you around."

Like many of my colleagues, I had been the subject of antiabortion picketing, particularly in the 1980s. I did not like having my office and home picketed, or nails thrown into my driveway, but viewed these picketers as a nuisance, exercising their right of free speech. Being in Canada, I felt I did not have to worry about my physical security.

I had been a medical doctor for 32 years when I was shot at 7:10 a.m., Nov. 8, 1994. For over half my life, I had been providing obstetrical and gynecological care, including abortions. It is still hard for me to understand how someone could think I should be killed for helping women get safe abortions.

I had a very severe gun shot wound to my left thigh. My thigh bone was fractured, large blood vessels severed, and a large amount of my thigh muscles destroyed. I almost died several times from blood loss and multiple other complications. After about two years of physical and emotional rehabilitation, with a great deal of support from my family and the medical community, I was able to resume work on a part-time basis. I was no longer able to deliver babies or perform major gynecological surgery. I had to take security measures, but I continued to work as a gynecologist, including providing abortion services. My life had changed, but my views on choice remained unchanged, and I was continuing to enjoy practicing medicine. I told people that I was shot in the thigh, not in my sense of humour.

Six years after the shooting, on July 11, 2000, shortly after entering the clinic where I had my private office, a young man approached me. There was nothing unusual about his appearance until he suddenly got a vicious look on his face, stabbed me in the left flank area and then ran away.

This could have been a lethal injury, but fortunately no vital organs were seriously involved, and after six days of hospital observation I was able to return home. The physical implications were minor, but the security implications were major. After two murder attempts, all my security advisors concurred that I was at increased risk for another attack.

My family and I had to have some serious discussions about my future. The National Abortion Federation provided me with a very experienced personal security consultant. He moved into our home and lived with us for three days, talked with us, assessed my personality, visited the places that I worked in and gave me security advice. In those three days, he got to know me well. After he finished his evaluation, when I was dropping him off at the airport, his departing words to me were "Gary, you have to go back to work."

About two months after the stabbing, I returned to the practise of medicine, but with added security measures. Since the year 2000, I have restricted my practise exclusively to abortion provision.

These acts of terrorist violence have affected virtually every aspect of my and my family's life. Our lives have changed forever. I must live with security measures that I never dreamed about when I was learning how to deliver babies.

Let me tell you about an abortion patient I looked after recently. She was 18 years old, and 18-19 weeks pregnant. She came from a very strict, religious family. She was an only daughter, and had several brothers. She was East Indian Hindu and her boyfriend was East Indian Muslim, which did not please her parents. She told me if her parents found out she was pregnant she would be disowned and kicked out of the family home. She also told me that her brothers would murder her boyfriend, and I believed her. About an hour after her operation I and my nurse saw her and her boyfriend walking out of the clinic hand in hand, and I said to my nurse, "Look at that. We saved two lives today."

I love my work. I get enormous personal and professional satisfaction out of helping people, and that includes providing safe, comfortable, abortions. The people that I work with are extraordinary, and we all feel that we are doing important work, making a real difference in peoples' lives.

I can take an anxious woman, who is in the biggest trouble she has ever experiences in her life, and by performing a five-minute operation, in comfort and dignity, I can give her back her life.

After an abortion operation, patients frequently say "Thank You Doctor." But abortion is the only operation I know of where they also sometimes say "Thank you for what you do."

I want to tell you one last story that I think epitomizes the satisfaction I get from my privileged work. Some years ago I spoke to a class of University of British Columbia medical students. As I left the classroom, a student followed me out. She said: "Dr. Romalis, you won't remember me, but you did an abortion on me in 1992. I am a secondyear medical student now, and if it weren't for you I wouldn't be here now."

Sunday, May 31, 2009

Saddest News.

New York Times

WICHITA, Kan. — Authorities said they had a suspect in custody Sunday afternoon in the shooting death of George Tiller, a Wichita doctor who was one of the few doctors in the nation to perform late-term abortions.

Dr. Tiller, who had long been a lightning rod for controversy over the issue of abortion and had survived a shooting more than a decade ago, was shot inside his church here on Sunday morning, the authorities said. Dr. Tiller, 67, was shot with a handgun inside the lobby of his longtime church, Reformation Lutheran Church on the city’s East Side, just after 10 a.m. (Central Time). The service had started minutes earlier.

Dr. Tiller, who had performed abortions since the 1970s, had long been a lightning rod for controversy over the issue of abortion, particularly in Kansas, where abortion opponents regularly protested outside his clinic and sometimes his home and church. In 1993, he was shot in both arms by an abortion opponent but recovered.

Dr. Tiller had also been the subject of many efforts at prosecution, including a citizen-initiated grand jury investigation. In the latest such effort, in March, Dr. Tiller was acquitted of charges that he had performed late-term abortions that violated state law.

Shortly after Sunday’s shooting, police said they were searching for a man who had fled in a powder blue Taurus. By mid-afternoon, they said someone had been taken into custody, but offered no additional details.

“This is going to be a larger search than maybe just Wichita,” said Brent Allred, a police captain, who said that the FBI and state police had been called to the scene. Few parishioners remained at the church, a modern, red brick facility that seats about 500 people. Police cars surrounded the building.

Troy Newman, president of Operation Rescue, an anti-abortion group that has led opposition to Dr. Tiller’s methods, denounced the killing on Sunday, as did other national groups opposed to abortion. “Our prayers go out to his family and the thousands of people this will impact,” Mr. Newman said in a telephone interview from his home in Wichita.

“Operation Rescue has worked tirelessly on peaceful, non-violent measures to bring him to justice through the legal system, the legislative system,” Mr. Newman said. “I’m a tireless advocate and spokesman for the pre-born children who are dying in clinics everyday. Mr. Tiller was an abortionist. But this wasn’t personal. We are pro life, and this act was antithetical to what we believe.”

Leaders of national abortion rights organizations, meanwhile, expressed outrage. Some described Dr. Tiller as one of the only doctors in the nation who performed third-trimester abortions when the life or health of a mother was at stake, and said that his death would make it even harder for women in such circumstances to end their pregnancies.

“Dr. Tiller was a fearless, passionate defender of women’s reproductive health and rights,” said Nancy Northup, president of the Center for Reproductive Rights, based in New York, which had worked on a legal case related to Dr. Tiller. “It’s time that this nation stop demonizing these doctors, and start honoring them.”

At St. George Orthodox Christian Church, next door to Dr. Tiller’s church, members said they had often been concerned about being so close to a church that often was the scene of protests because of Dr. Tiller’s presence. Dr. Tiller had attended the church for a long time, they said, and had contributed significantly to construction of the current facility, which was built in about 1996.

“This is a God-fearing community,” said Mickey Cohlmia, who was at services at the neighboring church on Sunday morning and said she was horrified that such a thing had happened in Wichita, a city of about 358,000 in southern Kansas. “How does this scar everybody in his church?”

Tuesday, May 26, 2009

Favorite New Blog: The Abortioneers

The Abortioneers is a fantastic new blog (created January 2009) about the ins and outs and ups and downs of direct service in the field of abortion care. It contains a variety of voices expressing the multi-faceted vicissitudes of the contemporary prochoice/direct care experience. It's at the top of The Coat Hanger Project's favorite blogs list - check it out!!!

UN Committee Concludes That Abortion Law in Northern Ireland Should Be Amended

Safe and Legal Abortion Rights in Ireland
Tuesday 27 May 2009

UN Committee concludes that abortion law in Northern Ireland should be amended

For the third time in ten years, another United Nations human rights monitoring body has recommended that the abortion law in Northern Ireland should be amended and better protection afforded to women’s human rights. The United Nations Committee on Economic, Social and Cultural Rights, the monitoring body of the Convention on Economic, Social and Cultural Rights met in Geneva on the 12 and 13 of May 2009, to examine the UK and Northern Ireland government. In its concluding observations, the Committee recommended that the abortion law in Northern Ireland should be brought into line with the rest of the UK.

It stated:
“The Committee calls upon the State party to amend the abortion law of Northern Ireland to bring it in line with the 1967 Abortion Act with a view to preventing clandestine and unsafe abortions in cases of rape, incest or foetal abnormality.”

Reacting to the Committee’s recommendations, Dr Audrey Simpson, fpa Director Northern Ireland said:
“Once again the ongoing discrimination of Northern Ireland women has been acknowledged in Europe. It is totally unacceptable for the UK Government and the Northern Ireland Assembly to continue to ignore UN human rights monitoring bodies. It is a blatant disregard for women’s human rights in relation to their reproductive health.”

Response to Obama’s speech at Notre Dame on "common ground" and abortion
By Sunsara Taylor

In the weeks leading up to Barack Obama’s delivery of the commencement address at the University of Notre Dame, the national eye was drawn once again to the question of women’s right to abortion. Anti-abortion Catholics and Christian fundamentalists, many of whom have been at the heart of some of the most violent tactics against doctors, women and clinics, descended on the campus. They trespassed. They got arrested. They put up billboards. More than 70 bishops condemned Notre Dame’s decision.

However, on March 17, when graduation day finally arrived, Obama received a standing ovation upon entrance, a glowing introduction from the Catholic president of the university, and repeated cheers as he spoke.

In his speech, Obama called for “fair-minded words” on both sides of the abortion issue. He called on people to express their differences but not to demonize those who think differently than themselves. He called for “common ground” and pointed to where he felt this could be found, as well as some of the challenges he sees in achieving it.

To many, these were reasonable words. To many, the response to him by the overwhelming majority of the student body—together with a significant number of prominent Catholic figures—represents motion in a positive direction.

But, when Obama speaks of “common ground” on abortion, he is not standing on some neutral “middle ground”—he is accepting the terms of the anti-abortion movement and adapting aspects of a pro-choice position into that framework while gutting the heart of the abortion-rights position. In so doing, he is legitimizing and strengthening a viciously anti-woman program while both abandoning the much needed fight to expand access to abortion and birth control and giving up the moral and ideological basis on which the pro-choice position stands.

Much of what is wrong with Obama’s approach is concentrated in a few key sentences of Obama’s speech, where he speaks directly to the question of abortion:

“Maybe we won’t agree on abortion, but we can still agree that this is a heart-wrenching decision for any woman to make, with both moral and spiritual dimensions. So let’s work together to reduce the number of women seeking abortions by reducing unintended pregnancies, and making adoptions more available, and providing care and support for women who do carry their child to term.”

First, and very importantly, abortion is not a “heart-wrenching decision for any woman to make.” A great many women are not conflicted at all about their abortions. Many feel relief and even joy at having their lives and their futures more fully back in their control.

This is as it should be. The simple fact is that a fetus is not a baby, it is a subordinate part of a woman’s body. A woman has no moral obligation to carry a fetus to term simply because she gets pregnant. And a woman who chooses at whatever point and for whatever reason to terminate a pregnancy, should feel fine about doing so and should be able to.

When it comes to abortion, there really is only one moral question: Will women be free to determine their own lives, including whether and when they will bear children, or will women be subjugated to patriarchal male authority and forced to breed against their will?

By denying the experience of the many women who feel positively about their abortions, Obama is undermining the legitimacy of this response and reinforcing all the many voices in society that tell women they should feel heart-wrenched for terminating a pregnancy.

As for the fact that many women do feel conflicted or even deeply guilty about getting an abortion, this doesn’t prove that abortion is a morally complex issue any more than the fact that many women feel guilty or ashamed after being raped makes rape a morally complex issue.

To understand where these feelings of guilt come from, where they do exist, it is necessary to pull back the lens from the individual woman to see the larger culture and forces shaping their responses.

Women have been told—for centuries in every major religion and almost every culture—that the most meaningful thing they will ever do is bear children. Women are conditioned—and expected—to plan their lives around when they will have children, and, once they do, to evaluate every major decision from the framework of how it will affect their children. Women who do not subordinate their own dreams and aspirations to the raising of their children are openly considered selfish and routinely demonized.

On top of this, there have been decades of relentless ideological assault on abortion that has been orchestrated from the highest levels of government and power. Women have been told that they are “murderers” if they choose to abort—by Christian fundamentalists at the doors of women’s clinics across the country, by talking heads on the major media and by blockbuster movies and TV dramas that invariably portray abortion, at “best,” as a desperate and regrettable act. Women have been told there is something wrong with them if they don’t feel guilty.

All this conditions the guilt that women feel, where that is part of their experience. But none of this means that there is anything about abortion that women should feel guilty about.

From here, Obama moves forward, stating that “common ground” can be found by working “together to reduce the number of women seeking abortions” and to “reduce unintended pregnancies.”

But, as I wrote previously, “To talk today of reducing the number of abortions is to talk about strengthening the chains on women. The goal should NOT be to reduce the number of abortions. The goal should be to break down the barriers that still exist in every sphere of society to women’s full and equal participation as emancipated human beings. In this society, right now, that means there will be—and therefore should be—more abortions.

“This is because there are many, many women who want abortions who are unable to get them due to the tremendous legal, social and economic obstacles that have been put in their way. These obstacles include parental notification laws, mandatory waiting periods, anti-abortion fake clinics that disorient and delay women, the fact that 84% of counties have no abortion providers at all, and countless other cruel and humiliating restrictions.”

Right now, as you read, real women’s lives are being foreclosed and degraded due to lack of accessible abortion services.

As for reducing unintended pregnancies, it would be truly wonderful if all young people received frank and scientific education about their bodies, their sexuality, and how to form healthy and mutually respectful emotional and physical relationships. It would be truly wonderful if birth control were widely and easily available and its use was popularized. This would be the best and most effective way to reduce unintended pregnancies. However, this is not something that the forces behind the “pro-life” movement will agree to. The same biblical scripture that drives these forces to try to force women to carry every pregnancy to term, also drives them to oppose birth control. There is not a single “pro-life” organization that supports birth control.

At its core and from its inception the “pro-life” movement has been driven by the biblical mandate that women must leave it up to god to decide how many children they have. This mandate is rooted in the Christian mythology of “original sin” and its repercussions.

As the Bible tells it, “god” created man (Adam) first, and then made a woman (Eve) out of his rib. These two lived in innocent bliss in the “Garden of Eden” until a serpent tempted Eve and Eve tempted Adam to eat the “forbidden fruit.” For this “original sin,” Adam and Eve were cast out of paradise and ever since—so the myth goes—mankind has had an evil nature which has led to all the horrors humankind has inflicted on each other ever since.

Flowing from this—and central to the “right-to-life” movement—a special additional curse is put on women. Right there, in Genesis, the “Lord” is quoted as saying to women, “I will greatly increase your pains in childbearing; with pain you will give birth to children. Your desire will be for your husband, and he will rule over you.” Later, the Bible articulates that women can only redeem themselves by submitting to men and bearing children: “For Adam was formed first, then Eve; and Adam was not deceived, but the woman was deceived and became a transgressor. Yet she will be saved through childbearing, providing they continue in faith and love and holiness, with modesty.” (1 Timothy 2: 13-15)

There can be no “common ground” with this view, even in the aim of preventing unwanted pregnancies. And, by seeking to find “common ground” here, Obama is just moving the ball further down the court towards enforced motherhood; he is leading pro-choice people away from the fight that needs to be waged for abortion while at the same time setting the stage for another losing battle around sex education and birth control.

What’s perhaps even more outrageous is the fact that Obama—rather than challenging the mandate embedded within the “original sin” mythology that women become obedient breeders—himself cites and legitimates this farcical and very harmful myth. Earlier in his speech, Obama offers a non-explanation as to why “common ground” is often hard to find between, among others, “the soldier and the lawyer” who “both love this country with equal passion, and yet reach very different conclusions on the specific steps needed to protect us from harm” and between “the gay activist and the evangelical pastor” who “both deplore the ravages of HIV/AIDS, but find themselves unable to bridge the cultural divide that might unite their efforts.” He says, “part of the problem, of course, lies in the imperfections of men—our selfishness, our pride, our stubbornness, our acquisitiveness, our insecurities, our egos; all the cruelties large and small that those of us in the Christian tradition understand to be rooted in original sin.”

No. “Common ground” is not hard to find because we demonize those who are fighting to subjugate women, those carrying out torture and war crimes against detainees, or those who want to deny fundamental rights to gay people. “Common ground” is not difficult to find because we have big egos or are too prideful or insecure.

“Common ground” is difficult to find because those who uphold women’s right to abortion are coming from a point of view that is completely antagonistic to those who are trying to take away this right. In the same way, those who condemn torture are coming from a view that is antagonistic to justifying, covering up and continuing that torture. And those who recognize the basic rights and humanity of gay people as well as the need for real education about safe sex are coming from a view that is completely antagonistic to the biblical motivation that sees any sex outside of procreation as an abomination.

As I stated earlier, there is no such thing as a “neutral middle ground” between antagonistic positions. Even the illusion of “common ground” can only be achieved when one side capitulates to the terms of the other side. This is exactly what Obama has done.

When it comes to abortion, the “common ground” Obama is putting forward is one where everyone accepts the notion that there is something morally wrong with abortion and where the legitimacy and the very existence of women who are perfectly okay with their abortions is erased. At a time when abortion is very hard to access for a great many women and the freedom to abort is undermined by the mountain of guilt and shame that is heaped on women for even considering this option, Obama’s “common ground” is one which abandons the fight for abortion access and retreats instead to a rear-guard battle to reduce unintended pregnancies without ever even mentioning birth control.

Finally, Obama tips his hat entirely to the anti-abortion position when he says we can unite to “provide care and support for women who do carry their child to term.” Here, in one phrase he accepts the unscientific, anti-abortion rhetoric that refers to fetuses as children. Flowing from this, a woman who chooses to terminate is killing her “child.”

In many ways, the approach Obama has taken to abortion—and what he mapped out in his speech—could prove even more dangerous to women’s rights and women’s lives than the religious fascists who were gathered at the gate. This is because Obama is dragging along many women and men who ought to know better—who, if there were outright attacks on the legality of abortion very well might be up in arms, but who are being lullabied to sleep by Obama’s calm and reasonable tone as he barters away women’s fundamental rights.

It is imperative that people see this speech, and Obama’s position overall, for what it truly is. It is not a reasonable middle ground, but a step-by-step waltz into a world with fewer and fewer rights for women and less and less ground to stand on to resist. It is urgent that people bring forward a new framework: one that values the lives of women above fetuses, one that sees the positive value in women being enabled to live full social lives including by controlling their own reproduction, one that recognizes that this is good for society as a whole.

Mexico Anti-Abortion Laws On The Rise

Huffington Post
MEXICO CITY, May 22 (IPS) - In the last 13 months, 12 of Mexico's 32 states have approved amendments to their state constitutions defining a fertilised human egg as a person with a right to legal protection, and seven other state parliaments are taking steps in the same direction.

Non-governmental organisations (NGOs) say it is a massive conservative reaction to a law decriminalising abortion up to 12 weeks' gestation that went into force in the Mexican capital in April 2007.

The law was upheld in August 2008 by the Supreme Court, which ruled that it did not violate the Mexican constitution.

Behind the wave of reforms of state constitutions, according to critics, is a pact between the hierarchy of the Mexican Catholic Church and the leadership of the most traditional political parties to curb social movements advocating the legalisation of abortion.

"I have no direct evidence, but we have repeatedly heard allegations" that such a pact exists, María Mejía, head of Catholics for the Right to Decide (CDD), told IPS.

According to María Luisa Sánchez, director of the Information Group on Reproductive Choice (GIRE), what is happening is a kind of "revenge" on the part of conservative groups. "These reforms are absurd and put women at risk," she told IPS.

The states where constitutions have been reformed are governed by President Felipe Calderón's conservative National Action Party (PAN) or by the Institutional Revolutionary Party (PRI), which ruled Mexico for seven decades.

The amendments of the state constitutions have not, so far, been accompanied by changes to the regional criminal codes, which for the most part allow abortion in the case of rape or danger to the mother's life.

But the possibility remains that the criminal codes will be brought into line with the constitutional reforms, Mejía said.

Mexico is a federal nation in which each state has its own constitution and criminal code, although these cannot run counter to the national constitution and criminal code.

In this country of over 107 million people, an estimated 880,000 abortions are carried out annually, according to a study presented in 2008 by the Colegio de México, the Mexico office of the Population Council and the Guttmacher Institute in the United States.

The study found that an average of 33 abortions a year are performed for every 1,000 women between the ages of 15 and 44. This figure is higher than the average reported for developing countries, which is 29 abortions a year per 1,000 women of reproductive age.

Most abortions are performed clandestinely, even in cases where they are legal, because the authorities and public health centres put up such barriers that the right to therapeutic abortion under certain circumstances becomes non-existent.

A PAN lawmaker for the central state of Querétaro, Fernando Urbiola, told IPS that the recent reforms of the state constitutions "are simply due to the need to be consistent with the principle of defending human life, which begins at conception."

In Querétaro, which is governed by the PAN, Urbiola chairs the Commission on the Family in the state parliament, and is promoting a modification of the state constitution so that it will protect the fertilised egg from the time of conception. The change could be approved before the end of the year.

Urbiola argues that "unborn children" urgently need legal protection, on a par with any other person, until death. In his view, the wave of reforms will also close the door to euthanasia and recognise men's right to keep alive the eggs they fertilise.

GIRE's Sánchez said that her group is coordinating a series of demonstrations with women's movements in the various states, to urge the Supreme Court to rule on the wave of constitutional changes in the states.

"We hope that the Supreme Court will take up the issue again and give more weight to the right of women to decide about their lives and bodies. The Court must hold another debate and ratify its earlier ruling," said Sánchez.

In the August 2008 ruling, in response to a lawsuit arguing that the decriminalisation of abortion in the capital, governed by the leftwing Democratic Revolution Party (PRD), was unconstitutional, the Supreme Court ruled that the law did not violate the constitution.

The Supreme Court verdict was repudiated by the hierarchy of the Catholic Church and other conservative sectors.

However, the Calderón administration accepted the decision, although it had previously demanded, through the Attorney-General's Office, that the Mexico City law be repealed.

Now GIRE is asking the Attorney-General's Office to take up the issue again, this time to bring a suit before the Supreme Court alleging the unconstitutionality of the reforms against abortion approved by the states.

According to Mexican law, the Supreme Court deals with cases at the request of the Attorney-General's Office or the state National Human Rights Commission, or on its own initiative.

Mejía, of Catholics for the Right to Decide, also wants the Supreme Court to deal with the issue, but she recognised that this is very unlikely to happen in the short or medium term.

Since April 2007, when abortion in the first three months of pregnancy was decriminalised in Mexico City, just over 20,000 women have exercised this right in public health centres. Nearly 80 percent of them were from the capital.

According to official statistics, 47 percent of the women who requested an abortion in Mexico City were between the ages of 18 and 24, and 21 percent were aged 25 to 29. Nearly seven percent were under 18, and the remainder were over 30.

The great majority of the women who had abortions said they were Catholic, like 90 percent of Mexicans.

Mejía and Sánchez both said that it is illogical for only some women in Mexico to have the right to an abortion, and called for the same rights to be available for all women.

Furthermore, they both said that abortion should be removed from the criminal codes and should be dealt with instead as a public health issue.

No woman is happy to make the decision to have an abortion and no woman seeks an abortion for pleasure, which is "something conservatives just don't understand," and that is why they close the doors to women and their rights, and even worse, threaten them with imprisonment, Mejía said.

The state criminal codes lay down different penalties for women who have abortions, except for victims of rape or when the mother's life is endangered. In some cases, foetal malformation is also accepted as a legal reason for abortion.

In the state of Veracruz, for example, abortion carries a prison sentence of six months to four years; in Jalisco it is four months to one year, in Guanajuato from six months to three years, and in Baja California Sur from two months to two years.

Studies indicate that clandestine abortions are the fourth or fifth cause of death among Mexican women, and that obtaining permission for an abortion is complicated and, in many cases, impossible.

After the August 2008 Supreme Court resolution, GIRE legal adviser Pedro Morales called on state legislators to move from "prohibitive and punitive regimes on abortion to permissive laws compatible with the fundamental rights of women."

Instead, 12 states moved in the opposite direction and made it even more difficult to get a legal abortion, and another seven states may soon follow suit.

Monday, January 26, 2009

BBC News: Obama Overturns Global Gag Rule (with video)

BBC News

US President Barack Obama has lifted a ban on federal funding for foreign family planning agencies that promote or give information about abortion.

The US is one of the biggest supporters of family planning programmes globally, but former president George W Bush blocked funds for abortion services.

Powerful anti-abortion groups in the US have criticised the lifting of the ban.

But aid agencies welcomed the move, saying it would promote women's health, especially in developing countries.

A White House spokesman said Mr Obama signed the executive order without asking for coverage by the media late on Friday afternoon.

The issue of abortion services remains controversial in the US, pitting pro-life conservative groups against more liberal, pro-choice Americans who back a woman's right to choose whether or not to have an abortion.

The BBC's Richard Lister in Washington says this may be why President Obama signed the order with so little fanfare.

Highly contentious

Organisations that had pressed Mr Obama to make the abortion-ban change were jubilant.

They called the funding ban the "gag rule" because it cuts funds to groups that advocate or lobby for the lifting of abortion restrictions.

The Planned Parenthood Federation of America hailed the president for "lifting the stranglehold on women's health across the globe with the stroke of a pen."

"No longer will health care providers be forced to choose between receiving family planning funding and restricting the health care services they provide to women," the organization said in a statement.

But anti-abortion groups were quick to criticise the reversal of the funding ban.

"President Obama not long ago told the American people that he would support policies to reduce abortions, but today he is effectively guaranteeing more abortions by funding groups that promote abortion as a method of population control," said Douglas Johnson, legislative director of the National Right to Life Committee.

A 1973 decision by the US Supreme Court legalised abortion.

A Gallup poll conducted last year showed that 54% of Americans think abortion should be allowed under certain circumstances, 28% believe it should be legal under any circumstances, while 17% back a total ban.

See-saw issue

The policy has become a see-saw issue between Republican and Democratic administrations.

Former President Bill Clinton, a Democrat, repealed the policy when he took office in 1993 and George W Bush reinstated it in 2001.

The ruling is also known as the Mexico City Policy, because it was first introduced at a UN conference there in 1984 by former Republican President Ronald Reagan.

In a move related to the lifting of the abortion rule, Mr Obama is also expected to restore funding to the UN Population Fund (UNFPA) in the next budget, the AP news agency reported.

The Bush administration contended that the fund's work in China supported a Chinese family planning policy of coercive abortion and involuntary sterilisation, claims the UNFPA has vehemently denied.

In a separate move earlier on Friday, US regulators cleared the way for the world's first study on human embryonic stem cell therapy.

While the decision of the US Food and Drug Administration is independent of White House control, Mr Obama is widely expected to adopt a more pragmatic and science-oriented approach to stem cell research.