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Wednesday, 8 May 2013

Leaving women with no options

Elizabeth Schulte discusses what's behind the horror stories from a Philadelphia trial.
The Women's Medical Society in PhiladelphiaThe Women's Medical Society in Philadelphia
THE RECENT murder trial of a Philadelphia abortion provider Kermit Gosnell revealed a nightmare story of unsanitary and dangerous medical conditions, where an immigrant woman died after being given an overdose of a narcotic.
This week, a jury is deliberating on the futures of Gosnell and four employees, who are charged with the deaths of four babies and a 41-year-old mother from Bhutan, as well as drug violations. Five more employees are charged with drug violations and conspiracy.
The religious right has tried to exploit this tragic story since it first was revealed in 2010, when federal authorities raided the Women's Medical Society clinic and began a grand-jury investigation. Hundreds of pages of reports documented filthy conditions, including reports of blood-soaked blankets and parts of fetuses littering the office.
Abortion opponents claim that babies were being killed during what they are calling "partial birth" abortions. However, what Gosnell is accused of doing--according to reports, forcing labor and delivery of premature infants, and then breaking their spines--has absolutely nothing to do with the actual late-term abortion procedure that women obtain from reputable abortion providers.
Abortions after 24 weeks of pregnancy are extremely rare, and they are almost always performed in dire situations, when the woman's life is in danger or fetus is deformed.
Opponents of abortion would like to paint the Philadelphia clinic as business as usual in women's clinics across the country--or what they call "abortuariums," where "babies" are "killed" on a daily basis.
But it isn't. The majority of abortions in the U.S. are performed in legitimate clinics that provide women with the safe health care that they need. According to Guttmacher Institute, about 90 percent of abortions occur before the end of the first trimester.
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WHATEVER THE outcome in the Philadelphia clinic trial, the bigger crime is that women seeking abortions were forced to endure these dangerous conditions in order to obtain them.
What would lead women to go to a clinic like Gosnell's in the first place? Because they saw no other option.
The Women's Medical Society clinic by and large provided services to women who didn't have the resources to obtain them elsewhere. Many of Gosnell's patients were immigrants.
Women like Karnamaya Mongar. During her testimony, Mongar's daughter explained that her mother went first went to a family clinic near their home in Virginia, but was refused care because she was already 16 weeks pregnant, and the clinic didn't perform abortions after 14 weeks. She was referred to another Virginia clinic, which sent her to a clinic in Washington--and from there, she was referred to Gosnell.
She died a day after received treatment at the Philadelphia clinic, prosecutors say from an overdose of Demerol administered by untrained staff members.
A 2011 Guttmacher Institute analysis of second-trimester abortions in the U.S. showed that most of the women who seek them are usually young and low-income, and would have preferred to have had an abortion earlier.
According to the grand jury investigation, Gosnell charged about 25 percent less than the average national price for a first-trimester abortion. For a second-trimester procedure, his fee was at least $1,000 less than the tiny number of facilities in the Northeast that perform them.
What should be on trial is the fact that some women had to turn to Gosnell at all. If the only choice for poor women of color is a dangerous procedure that could cost their lives, then they really have no choice at all.
It should be of little surprise that the site for this tragedy is Philadelphia, where poverty, racism and lack of access to health care go hand in hand. Some 25 percent of Philadelphia residents--43 percent of whom are Black--live below the federal poverty line, the highest percentage of the 10 largest U.S. cities.
Out of Pennsylvania's 67 counties, Philadelphia County ranks dead last in health outcomes, with some of highest rates of hypertension, cardiovascular disease and diabetes in the country.
Poor people have few avenues to quality health care and are less likely to be in the position to expect quality care. In the case of reproductive rights, this reality is even starker. As Charlotte Taft, director of the Abortion Care Network, pointed out at RH Reality Check:
One of the many prices women pay for the stigma attached to abortion is that they don't realize they have a right to medical skill, kindness and a clean attractive abortion facility, just as they do with any other health care.
If they are keeping secrets, they may not tell even other women about bad experiences--or good experiences. So each woman who is thinking about abortion is on her own. And they may not report substandard care to health authorities because they don't want to jeopardize their own confidentiality. Or they may not even realize that they deserve better.
This case is an important reminder of what conditions were like before the Roe v. Wade, the U.S. Supreme Court decision that made abortion legal in 1973. Untold numbers of women risked--and lost--their lives seeking to end unwanted pregnancies.
While all women suffered because of the ban on this important health procedure, poor women, disproportionately Blacks and Latinos--those who didn't have the resources to obtain safe abortions--were the most vulnerable to the dangers of back-alley abortionists.
Even after abortion was legal, it wasn't accessible to all women, as restrictions were placed on it immediately. The 1976 Hyde Amendment, which barred the use of Medicaid funds for abortions, for example, guaranteed that poor women with few resources could not afford safe and legal abortions.
If a clinic like Gosnell's exists, abortion opponents are to blame--because they are the ones who have stigmatized abortion and pushed women who want to obtain one into the shadows, where unscrupulous people can take advantage of them.
Laws restricting abortion, such as parental consent and mandatory waiting periods, make abortions more inaccessible--and make it more likely that women will have to resort to clinics like Gosnell's.
The right wing wants to use this as an opportunity to shut down clinics and pass more anti-choice laws--but for supporters of women's right to abortion, this is just another reason why we need more abortion providers and fewer restrictions.


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