Why Clinics?

A reader has asked an important question: Why do we need abortion CLINICS, why not just go to a hospital or your doctor's office?

Here's the historical development. Abortion was illegal until it was nationally legalized by the Supreme Court in Roe v. Wade January 22nd, 1973. It was legal in three states prior to that, New York, California, and Colorado. There were always some doctors who did abortions on the sly, or who did a D&C for their patients (oops, I guess they were pregnant!). But it was risky and in the medical community there was a stigma both about the procedure and who got abortions, but also about breaking the law and risking losing your license or a jail term. There is a wonderful movie called "Dear Dr. Spencer" about a doc in a small town in Pennsylvania who operated an office for abortions openly, under cover, so to speak, but mostly it was really cloak and dagger stuff. Some doctors gave their patients an antibiotic and referred them to an abortionist, who might be a midwife, or an ex Army medic, or a funeral home director. Frequently the Mafia controlled access to abortion services.

When abortion became legal in NY, clinics were set up over night and they sometimes worked 7 days a week, 24 hours a day just to keep up with the demand as people travelled from all over the US. Early clinics were an interesting hybrid of medicine and politics. Some of the early advocates of legal abortion were feminists, clergy, and doctors, so they inserted some of that desire to let people talk about their sistuation into mandatory counseling. They also introduced an informed consent process, which meant that everyone needed to be told what was going to happen, what the risks were, what the alternatives were. This was an innovation at the time.

When the rest of the country started to provide abortion services, a mix of the same people, with some entrepreneurs, founded clinics based on the same strategy as any other specialty business: VOLUME. At that time there were still many doctors who performed abortions for their own patients, perhaps one or two a week, or even up to 10 a week, but there was that stigma attached to it, and most doctors realize that getting along in the community is very important to survival. But some people hate to go to hospitals because they can so easily lose their confidentiality or run into a hostile nurse or someone else who knows someone they know, for instance. Also, as larger practices started to form, for reasons of on call coverage, economy, and other factors, it was inevitable that one person in the practice would object to abortions. In larger cities it is still possible to find a private doctor who will do an abortion. (Like on ER the other night Dr. Coburn said, "Abby, I will help you whatever you decide.")

But that is rare, in large part due to the anti's. In the 80's anti abortion activists would call each doctor in town and pose as a patient, ask about ob care, and then ask about abortion. If they said they did that, they would start yelling and screaming at the nurse/receptionist. They picketed doctor's offices and hospitals and mostly it was just not worth it to do abortions in your office. If you wanted to continue to offer it, it was easier to work in a local clinic. More often, especially in smaller cities, you had to bring doctors in from out of town because no one locally would offer the service.

There are a lot of good things about the clinic model however, in spite of the isolation from mainstream medicine that many clinic experience. One is that people who work at clinics really get that pregnancy decisions are very complex and are usually good at understanding what their clients need. (Not always true, some clinics seem to adopt the stigma we are trying to change. I don't get why they are still in business...) Unfortunately, this frees people who just do obstetrics or birth control to miss part of the picture. Like every sub specialty, though, you can assemble a staff that really knows what they are doing, medically and emotionally. I remember talking to one doctor who worked in a hospital setting who said that it was nightmarish having to work with different nurses in the hospital who hated what he was doing or who would inadvertently hand him the wrong medicine because they were inexperienced.

And of course, there is the business part of the story. There is great economy of scale if you can bring all the right staff, resources, patients, and medical people to one session. Some Planned Parenthoods, for instance, schedule several visits for the convenience of staff and patients complain that they have to take off work or school, or find child care twice or three times.

I have given you the long answer. The short answer is stigma. Abortion clinics exist because those in the regular practice of medicine cannot withstand the heat or the stigma of providing abortions. In a society so divided about a subject, and with so much heat about the issue, you need people whose job it is to withstand the pressures, the negative attention, and who are not beholden to referral pressures in the medical community. If that same facility can evolve as an understanding place to go with a pregnancy crisis, then that's turning lemons into lemonade.

Thanks for the question.
--bon

Comments

[Me]

Jaqueline, as usual, has sidestepped the most serious questions her posts give rise to:

Where she gets off claiming she knows particular women will definitely abort in the future, and where she gets off assuming women are using birth control merely for casual sex.

She has sidestepped the issue of women using birth control in committed relationships and marriages. She has sidestepped the issue of the huge variety of hormonal birth control, all of which doesn't include the same risk factors.

She has sidestepped the issue that the risk factors she is so horrified by are actually far, far, far greater in women who aren't on the pill but who have lousy lifestyle habits.

The pill is also useful in perimenopausal women, or women who are experiencing seriously risky heavy bleeding during their periods. The pill lowers risk of ovarian cancer (ovulation increases risk of ovarian cancer - the longer Jacque goes without either the pill or pregnancy, the higher her risk of ovarian cancer).

Jacque/Jacqueline, you are an ideologue who sees the world in black and white, and who considers herself always right and everyone else always wrong. You have assumed things that are blatant lies about other people and presented them on this thread and on other threads as fact, and when this has been pointed out to you, you have brushed it all aside like it's no big deal.

You are dishonest. You are a liar. That pretty much says it all about you.

[Jacqueline]

LB98-

Why do we use the term innocent a lot? Well, because it's true. Unborn children aren't capable of malice or offenses. And although I'm anti-death penalty, I think it wise to point out the difference between innocent people killed by government sanction and guilty ones, because it appears that guilty people elicit more sympathies that the innocent do. So many take up the case of a guilty cold-blooded murderer on principle (as do I) but can not find principle to oppose the deaths of innocent pre-born people or simply do not wish to. I find that hipocritical and appalling.

Just so you know, I have never been to Bible college (although I do eat exclusively organic and dairy-free..Yay for Tofutti!). That being said, most protestant Christians do not oppose birth control so had I been to Bible college, that wouldn't explain my stance.

The original conversation was about birth control and abortion being liberating and promoting equality. They do neither. ( By the way that was 23 deaths from the patch, not latex. I was comparing men's risks to women's risks to demonstrate how inequitable they are). That is the issue. Analogies to shellfish allergies and other unhealthy drugs are irrelevant to the conversation, so why should I address them? The post was about birth control and abortion relative to women's health, not women's health in general.

But, as an aside, you mention the young girls that take the pill to regulate their periods and ease cramping. I had endometriosis when I was younger (14) and the GYN suggested the pill. Basically it a SIDE EFFECT is help for endo but you have to break other things in your body for that side effect. A healthy body ovulates for example. So instead of addressing the problem, you're jacking with what is healthy about you for the side effect of less pain elsewhere. I didn't know this at the time, so I took the pill and it was a nightmare, and I hope those pregnancy hormones didn't do damage to my sexually developing body. Luckily it was for a short time.

When my disease flared up again in my college years, I found out about the abortive aspects of the pill and refused to take it mainly because I didn't want to support a company that produces abortives. I instead decided to change my lifestyle. I cut out dietary causes (caffiene, dairy, refined sugar), ate flax products, etc and I don't have those issues anymore. No inflammation or cysts.

So those children that you suggest use the pill for those reasons, are risking blood clots and other health issues so that can have a 'regular period'. Unless you're trying to concieve, you don't need a regular period. And before you suggest that the pill fixes their bodies and makes them normal, if you never took your sugar pills, you'd NEVER have a period. So again, the pill is keeping them from being normal. As for the cramps, I had cramps so bad I was home from school with a heating bad. After I got off the pill, I got a pain pill for the crampy days instead of messing with my hormones further.

As for taking medication- I do, but sparingly and for need. The pill is not a need, so the benefits don't outweigh the damage/risks. After you take the pill, it often takes 6 months for the body to repair itself. Why traumatize your body like that? If your husband doesn't have a latex allergy or a spermicide allergy, why should all the responsibility and risk fall on you? Is that equal?

I hope I've addressed the questions you wanted me to.

[LB98]

>>>Not all women want children or should have children. True. I hope you never do have children.<<<

What an awful thing to say. For the camp that touts motherhood, pregnancy and the beauty of life for ALL, why would you hope she never experiences the joy and happiness of motherhood?

[LB98]

This message is for Jackie - for whom I have many questions after reading her posts.

I am a married woman with an infant son. I use birth control. After reading your views on BC and how it conveys to men that I am a sexual object only for their pleasure, I think my husband may disagree with your stance. Whilke he thinks of me as his little sex-kitten (the feeling is mutual), he also has a much higher regard and interest for my mind and soul, hence why he married me. I am on BC because we need to limit our family's size. Before I was married being on BC gave me the mind to know that *IF* I chose to have sex, I could do so with the knowledge that I would not get pregnant. It did not however, make me want to go out and sleep with dozens of men, which seems to confuse you thinking that promsicuity is an inherant side-effect of the pill. Nowhere on the packaging is there a warning that by taking the pill, it take over my mind and drop my inhibitions and sleep with as many men as possible. If you have scientific research, however, that proves otherwise, I would be fascinated to read it. Please provide a link to such info.

Secondly, I knew women who had been on the pill since their early teens because the pill regulated their menstrual cycles, and lessened severe cramping (that left them out of school otherwise). Were these girls taking the pill to cheapen themselves and become sex-objects for men? Do you think their mothers pimped out their daughters? Again, these girls didn't go out and sleep around either with random people because they knew they couldn't get pregnant. In fact, I believe most of them stayed virgins until their early 20s. They had the same, "I only want to sleep with someone who loves me and cherishes me" mindset as you.

You claim that condoms and other BC methods (other than the rhythm method) are dangerous to a woman's health because they affect her fertility and other body functions. Do you/have you taken any medication ever? When you have a headache, do you take any pain relief medication? Are you aware of the side effects of those medications too? If you're really worried about the side-effects of BC affecting your HEALTHY body, it would be logical for you to avoid ALL medicine, lest it tamper with your fertility and health. As a woman who had been on the pill for years, I can assure you that the pill did not impede my fertility. I became pregnant almost immediately after I stopped taking it (DH and I wanted a child).

You mentioned 23 people (women) have died from latex allergies from use of a condom. That is tragic. However, do you also have the same outrage at the people who sell peanuts, shellfish, strawberries and certain preservatives and flavor enhancers in food? Many more deaths have occured because of people inadvertently eating these items and going into shock from their allergies to them. As someone who is "pro-life" do these deaths bother you? Should they be outlawed? There could be pregnant women who are allergic to peanuts, and perhaps eat food contaminated with peanut oil who then miscarry or worse - die - killing the woman and z/e/f. Do FFL have an agenda to prevent these deaths?

You seem like a very strong-minded woman, and I imagine you like Sandra Dee - only vegan, organic and holding a degree from Bob Jones U.

I eagerly await your thought-provoking, non-judgemental, open-minded responses to my many questions.

[Me]

-- But sex causes babies, even with your magic pills sometimes, and I guarentee that if that happened you'd march to the clinic and have your child killed.--

And how could I have missed this other little gem?

More assumptions, Jacque?

Wow, you really love to assume things you can't possibly know about people you've never met.

But that's because you can't deal with real life. You can only deal with the strawmen and stereotypes you've got living in your head.

The only way you can deal with people who disagree with you is to completely dehumanize them in your mind.

In your mind, you are always right and women are exactly what you assume they are and you are the only person who counts, who is real.

How is this different from killing someone physically?

You have no way of knowing what anyone who finds themselves pregnant in any situatin will do.

There is no more guarantee that this person will abort an unexpected pregnancy than you will, yet you are publicly GUARANTEEING that she will. That's a hell of a crystal ball you've got there.

Again, every time you prolifers show up, you prove once again that you're dishonest, dehumanizing liars who deal in untruths and erroneous assumptions and mindless propaganda.

I can only ASSUME your two degrees are in a) idiocy and b) false assumptions.

People like you are why choice is safe in this country. Every time you open your mouths, you show the world that other life is the last thing in the world you're interested in.

[LB98]

I see anti-choicers throw around the term "innocent" life a lot. Would any of them, here, care to expand upon the opposite of "innocent" life and describe to me "guilty" life?

What makes a z/e/f "innocent"? How does the title "innocent" get assigned? What are the qualifiers?

[Me]

Birth control has zero to do with "a woman allowing herself to be a sex object for men". Allowing oneself to be a sex object for men is something that happens in your head.

Birth control is a tool. It can be used for ill or for good.

Family planning is responsible. Mindless breeding isn't.

Couples can choose together what form of birth control (from NFP to sterilization) is right FOR THEM.

That choice is not ever anyone else's business except the couple in question and people they CHOOSE to invite into the process (such as a medical professional).

No person can ever know for sure why a woman or a man uses birth control, and no person can ever know the depth of the relationship between a man and a woman in a relationship. Because they are planning their family differently from yours does not mean they are not committed and loyal to one another at all.

The truth about the more serious side-effects of hormonal birth control is that they are very rare and exacerbated by, hello, SMOKING!!! The same side-effects occur in women who are not on the pill, and they occur because those women smoke, or eat too much, or sit on their fat butts all day long and don't exercise.

A healthy, active woman with no pre-existing health conditions that might put her at risk for blood clotting or heart disease is not at any great risk at all by being on the pill.

Women who are not on the pill but who smoke, or who are overweight, or who don't get off their butts are actually at greater risk for those side effects (as well as other serious side effects) than healthy, active women on the pill.

So...Jacqueline, where's the outrage over that, eh? Why aren't you leading the rally against obesity and laziness? Since you're all about women's health and not poisoning an otherwise healthy, functioning body, and all? Why aren't you protesting the enslavement of bodies to fast food and slothful habits?

You paint a very two-dimensional picture of women who use hormonal birth control: to you, they're all single, working women who are just looking for quickie sex without commitment, and the men they have sex with are just pigs who want to use them.

That just isn't true.

And if you don't want to use hormonal birth control, don't. That's the whole point of choice. But don't accuse women who are of being things they're not.

As we've seen, you're pretty good at making dishonest, lying "assumptions" about people just so you can promote your agenda.

Why not try honesty instead?

Oh...yeah...you're "prolife"...you don't know how to do anything but lie.

[matt]

Do you think that Abortion Clinics should be exempt from standard medical regulations and oversight? If so, then why?

[Linda Flores]

I don't think that the point is to compare my personal life -- which is just that, personal -- with yours, or any other individual woman's.

I will say this: if Jacque is asserting that women who choose to have sex for reasons other than procreation are immoral and do not deserve to have children, and that sex where people make an effort to avoid conception is "mutual usury", well, that's a pretty ugly morality indeed.

[Jacqueline]

Linda-

You are a great pro-choicer in that you love to twist my words. I did not suggest a male conspiracy to use women, but I find it sad that you have no problems with being used because you're using them back, or as you put it, it's just your "sexuality."

I never said it's a conspiracy against women's health but since we're talking about equality, what exactly do men risk when they contracept besides a latex allergy? NOTHING. 23 women have died from complications of the patch. How many men have suffered condom complications? Doesn't seem quite equal, does it?

While I didn't imply that all women want loyalty and commitment when they have sex, I guess my self-esteem is higher than yours because I would expect loyalty and commitment with someone that can give me any range of diseases and could father my child (and having sex even with contraception, that COULD happen). I won't sleep with someone without loyalty and commitment.

"A woman who has no ability to control how many children she has, with whom she has those children, and when she has those children, is a slave to her body."

Okay, again, you say, something is wrong with a healthy fertile female body that can enslave. Are men enslaved to their bodies? No, it's just us poor poor women that need to jack with our bodies to be like men. That's equality?

And Feminists for Life is reprehensable to you because they dare say that women have a right to be respected just as they are, without making changes to their bodies. You suggest changing the body to gain equality- which is why my skin lightening analogy was so poignant, and probably why it pissed you off so much.

More with the twisting: You went off implying that I think that every woman should have 20 zillion children. I never implied that. I myself have no children, yet, as I had two degrees to finish and a career I'm focusing on. I think those are compelling reasons to supress your fertility but there are ways to do it without sacrificing your health and self-value. And when I talk about health, I'm not just talking about risks of contraception but other issues. Exactly how many STD's have you had (or have currently)?

Not all women want children or should have children. True. I hope you never do have children. Seems like your primary concern is having sex when you want with whom you want without consequence. "On your terms" you say. Not the best priorities to raise a child in and a bad influence for a daughter. "Here, take this pill. Then you'll be equal!"

I have no problems with your sexuality. I certainly wouldn't live that way but since you don't appear to have any morality in this area, you go on and have all the sex you want with anyone you want, on your terms...blah blah blah. Birth control is the best thing that ever happened to you, etc. And it's none of my business. But sex causes babies, even with your magic pills sometimes, and I guarentee that if that happened you'd march to the clinic and have your child killed. She should have rights too. That's equality.

[Jivin J]

Zygotic period cont.

"Embryonic period" (with quotation marks) gets 37,700 hits at Yahoo! compared to 31 for "zygotic period"

Many of the sites that use the phrase embryonic period use it to describe from fertilization on.

I also thought you might be interested in the article below

http://www.emedicine.com/radio/topic242.htm

[Jivin J]

Hi DP,
Thanks for getting back to me.

I didn't ask did he know "abortion" was the safest way, I asked how did he know "D and X" (which is what you said) - an abortion procedure a prolife doctor would have no experience with - was the safest way? I would even guess that most abortion providers don't know how to perform a D and X. It still makes no sense to me why someone would have ethical problems with removing a stillborn child. If the child is already dead then what's the ethical problem with removing him/her? It seems much more likely that he wasn't experienced with removing stillborn children but that also seems somewhat unlikely because having a stillborn child isn't that rare of an experience and I'm guessing most ob/gyns have had patients who've experienced this.

So if he probably didn't know how to do a D and X, why would he say it was the safest thing to do? I'm guessing that whoever explained the situation to you had some of their facts a bit skewed.

You originally said "second and third trimesters are performed because of fatal fetal anomolies, risk to maternal health, and, occasionally, in the early second trimester, because the woman couldn't get access earlier," - though interesting, none of the studies you've linked support your former claim, especially in the United States since all the studies were performed in foreign countries whose abortion laws differ from ours. But I guess it depends on how you define "health" with regards to the mother. If you define "health" as broadly as it is defined in Doe v. Bolton ("all factors - physical, emotional, psychological, familial, and the woman's age...") then anything could really be for "health" reasons.

The zygotic period? A yahoo search for "zygotic period" (including the quotation marks) gets a mere 31 hits. It doesn't seem to be a very standard phrase. Most standard definitions, at least that I've seen, indicate that a zygote is a one-celled organism. I've never seen any definition that says an embryo that is a hundred or more cells is also a zygote (but I'd be open to any evidence you might have from a standard source).

Your suggestions sound interesting but how would you study the embryo if you don't even know he's there? How do you look for embryos in menstrual products? Would the body of a dead embryo be able to tell us why he didn't implant? If they didn't implant would all of their cells stay together as a unified whole?

Also, if you were able to do everything that you've suggested, how would you save the embryos? How could you give something to a 5 day old embryo to make him more likely to implant, especially if you're not sure he's there? I guessing you could possibly give something to the mother to make her uterus more accepting to an embryo and I certainly be all in favor of that if such a thing were possible.

People in our country spend millions on IVF - if such a thing as you suggest were possible then why shouldn't millions be spent on that as well? Seems easier and safer (uterine core biopsies vs. hormone therapy and egg removal) for the woman if such a thing were possible?

Fairly large portions of newborn children die in some developing countries? Why not "screw cancer" research and save all those children?

[Linda Flores]

Aha, now the real ideology comes out ... thank you, Jacque, for putting it out on the table. Now yes, let's get into your Feminists for Life logic:

-- You say that birth control is a male conspiracy to allow men to use women's bodies for sex.

Are you for real?

The idea that women have sexuality, that they might want to engage in sex and have absolutely no desire to have children is completely supressed in that thinking -- and worse, viewed as unnatural.

Or this gem, paraphrasing what this male conspiracy of birth control must mean:
"My ability to have sex for fun should trump your health and well being." or is it, "I have no desire to show loyalty or commitment to you and having as child would insist upon it."

So according to your logic, that unhealthy birth control is a conspiracy against women's health -- since everyone knows a pregnancy is much heathier, emotionally and physically, and much much less risky than the birth control pill.
And you expect people to take such an argument seriously?

The second is even more telling -- because, of course, all women are looking for "loyalty and committment" every time they engage in sex, and were it not for that damned birth control, they could get it too! All they'd have to do to cement that loyalty and committment was to get pregnant!

Yeah, way liberated there.

Such sentences completely deny the reality that many people want to have many years of sexual relationships, and some of those people want children eventually, and some never want children at all, and some have not yet decided. Birth control and abortion allow that to be possible. Your logic calls that unnatural and oppressive to women.

A woman who has no ability to control how many children she has, with whom she has those children, and when she has those children, is a slave to her body. Ask women in countries where birth control is not available how much they feel able to enjoy sex given that they know that, like it or not, want it or not, they'll probably be pregnant at the end of it.

Oh, and then there's this:
"I think it sad that you would imply that there is something wrong with the female body that causes us to require pills or surgery to correct it."

And then you dare to liken birth control to skin lightening.

Because, of course, the ability of a woman's body to produce children is something that should never be suppressed, ever, and no "liberated" woman, as you define it, would seek to do such a thing. That's straight-up enslaving a woman to her fertility, and dressing it up in a sick quasi-empowerment language that doesn't try too hard to deny that no real woman would ever seek to suppress her fertility for anything.
Or, put another way, as I heard one FFL-type woman way, "birth control allows women to serve as sexual objects for men."
Actually, it does just the opposite -- it allows women to have their own sexuality, on their terms. And the logic of FFL and that position is that we should be baby-makers instead.

Sorry, no matter how anyone may claim to "feel" liberated when reduced to a baby machine, it ain't cutting it.

[DP]

"I'm not sure how science would help solve the problem of embryos failing to implant. How could you study something like that and find the problem? If you can't tell if an embryo is making her way to the uterus, how can one find out the reasons the embryo doesn't implant? I'm open to ideas if you have any."

Ok, now the fun one. It's extremely unlikely that the problem of failed implantation is insoluble. I have several ideas on how to study the problem of failed implantation. First, one would have to examine both the zygote (BTW: the zygotic period is from conception to the end of the second week; implantation usually occurs around 7-10 days after fertilization, so it is a zygote that implants...though you're right that it is up to several hundred relatively undifferentiated cells by that point) and the uterine environment. You'd want to know what cell surface molecules exist on both, what they do, and which ones are missing in the zygotes that fail to implant or on the uteri that chronically fail to allow implantation.

One could collect the menstral products of women not using birth control to look for zygotes that failed implantation and use discarded IVF concepti as controls. Confirm or disprove the hypothesis that most failed implantations occur because of chromosomal abnormalities via cytogenetics (I'd be very suprised if 50-80% of conceptions resulted in chrosomal abnormalities, but there's no way to tell without looking.) Gene chip both, RT-PCR and Western any differences, make a knock out mouse for anything that appears to be missing in the failed zygotes. Equally, one would want to look at uterine tissue. Uterine core biopsies are relatively non-invasive. Again, compare the uterine environment from women who chronically fail to implant verus those who have successful pregnancies...look for differences on the RNA and protein level. Compare with the results from the zygotes. Make some knock out mice. I'd probably concentrate on vascular factors and maybe platelet factors similar to those involved in metastasis, which might be considered essentially inappropriate implantation. Eventually, one could clone the molecules that seem most relevant, try to rescue the KO animals with it. If that worked, get it purified for human use and go to clinical trials.

So, you do realize that I just proposed several million dollars and several thousand person hours worth of research there, don't you? Without the inevitable setbacks and complications that arise once one starts doing the research. The NIH's budget shrank this year and currently includes no money for this purpose, at least as far as I know. There are, AFAIK, no private foundations set up to fund research into implantation failure. If you want this sort of work done, you'll need to pay for it, both as a taxpayer and as a charitable giver. Why aren't you and the pro-life movement doing so? If 50-80% of newborns were dying before they were 2 weeks old I'd be demanding that the NIH spend all it's money on finding out why and stopping it. Screw cancer, screw heart disease, a pandemic in babies gets priority. Even if I never planned to have another child. Why isn't the pro-life movement doing the same for what it considers to be approximately 10 day old children?

[DP]

OK, on to Jivin's second question, regarding how (or if) I know why late term abortions are done. I can give you a couple of references of studies of this question:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10456307&query_hl=1&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10426234&query_hl=5&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9141586&query_hl=5&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8040573&query_hl=5&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14634970&query_hl=5&itool=pubmed_docsum

I haven't been able to find any from the US, but given that most third trimester abortions in the US are done in Kansas and third trimester abortion is illegal in Kansas (as well as in most other states) except in cases of danger to the mother's health and fetal abnormalities incompatible with life, either the majority of third trimester abortions are done for those two reasons or the law is being broken with extreme regularity.

[DP]

Jiven: Sorry about not answering your post sooner, real life intervened. I'll try to address everything you mentioned.

How did my relative's (yes, I'm being intentionally vague out of paranoia that otherwise I might say something that would make her identifiable) doctor know that an abortion was the safest way to remove a dead second trimester fetus? He went to medical school: this is second year stuff. Maybe first year, if you think through the implications of physiology carefully. It's not safe to have hundreds of grams of necrotic tissue in a person's body, no matter what the tissue used to be. What I've always wondered (remember, I got the story about what happened second and, in some parts, third hand) is what possessed her OB to tell a patient that he wasn't going to comply with the standard of care? Was he looking to get sued? More likely he counted on there being no chance of a jury in west Texas handing out a malpractice verdict against someone for not performing an abortion, so he could ignore the standard with impunity. It seems likely to me that he did not say all this up front, but that it came out when she asked about options. On the other hand, some of these older OBs are really misogynists, so maybe he came out and told her he was going to risk her life unnecessarily. And you're right, he probably didn't know how to do the procedure, but the ethically correct thing to do in that situation would be for him to refer her to someone who did know how to do it and would do it. While I think being an OB who doesn't know how to do a D and E or D and X is like being a surgeon who doesn't know how to perform an appendectomy, I wouldn't have thought much the less of him if had refered her.

After writing the last post, it did occur to me that I was being too harsh. Only a minority of people who believe in the "pro-life" movement think that abortion to save the mother's life--especially in the presence of a dead fetus--is wrong. And, in case I gave the wrong impression, I don't think that all pro-lifers are evil either. I think they're wrong, on this issue, but not necessarily evil.

[Pandora]

Linda Flores wrote "Or, perhaps this way -- I challenge the pro-lifers to argue that women were more liberated when abortion and birth control were illegal."

Yes, I have had people decry the era pre-Roe, where women had to be sneaked off into maternity homes under cover of darkness. But now, thanks to Roe v Wade, we can sneak into abortion clinics where hopefully no one knows us.

[Pandora]

Linda Flores wrote "Or, perhaps this way -- I challenge the pro-lifers to argue that women were more liberated when abortion and birth control were illegal."

Yes, I have had people decry the era pre-Roe, where women had to be sneaked off into maternity homes under cover of darkness. But now, thanks to Roe v Wade, we can sneak into abortion clinics where hopefully no one knows us.

[Jacqueline]

Okay, Linda...Let's get into that.

As a woman, I'll go first.

When a man wants me to contracept by taking a pill/shot to make my fertile HEALTHY body unhealthy at the risk of other health issues (stroke, blood clot, etc), what is that man saying?

Is it perhaps, "I hate your body and it's ability to create life." or is it, "I want to use you for pleasure but not take any responsiblity for my actions or for YOU afterward," or is it "My ability to have sex for fun should trump your health and well being." or is it, "I have no desire to show loyalty or commitment to you and having as child would insist upon it." I don't find that empowering or liberating at all. I find that demeaning and mysogynistic. Because a woman might want to use a man back in the same way doesn't change what is being said. Both are just wrong. Mutual usury is still usury.

Now, when a woman says that she needs abortion to be liberated or equal, what is she saying?

Is it, "There is something inherently wrong with my feminity that must be surpressed." or is it, "I must have surgery to be equal with a man." or is it, "I hate my body because it's ability to create life is holding me back." or is it, "I'm irresponsible and want to take risks but not actually accept the consequences of those risks."

I think it sad that you would imply that there is something wrong with the female body that causes us to require pills or surgery to correct it. There is nothing wrong with a healthy fertile body that menstruates, ovulates, gives birth, lactates, etc. Those are signs of a healthy body, yet you insist on drugs and surgery to stop such things. That's not liberating, but oppression when you have to change your natural body to be 'equal'. Should blacks have just bleached their skin white to acheive equality? Likewise I shouldn't have to become like a man (unable to concieve) in order to be equal. That is so bigotted.

I feel quite liberated and equal and I have never killed my child through abortion nor have I taken hormones to jack with my fertility. If you were to study me next to a woman that contracepts/aborts, I'm sure you'd find that I'm as successful if not more so than she is. So is it really birth control and abortion that you can credit for your success when others are successful without it by making healthy lifestyle choices? Or do you just use it to make unhealthy ones because you want to?

Let's get into that.

[Linda Flores]

"The fact that a fetus is not a human being, and a woman is, does not matter.

Because it's not actually about "babies". The leaders of the pro-life movement, who rail against the "contraceptive mentality" (American Life League), who call contraception "disgusting" (Joseph Scheidler), who say that birth control is "harmful" (Rick Santorum, U.S. Senator), and who call on women to "Trust and obey" God's plan, even if that means having 20 children (Mary Pride) -- know perfectly well that it's about women's role in society that we're talking about. And abortion allows a woman to decide she wants to reject the role of motherhood. So does birth control.

And that's why these folks don't want women to have access to either one."

I posted the above because I think that pro-lifers do not want to touch this one --the question of what a woman's role in society is, and should be,and why eliminating a woman's right to abortion, and birth control not far behind that at all, is central to this vision for women. They remain silent on this because they don't want to admit that part of their vision is based on motherhood as the expected role of women, and as pregnancy as punishment for sex.

And no pro-lifer really wants to ruminate on what it feels to be a woman forced to be pregnant after she has decided she doesn't want to be -- what kind of violence that represents against her -- you know, the actual human being in this picture.

We keep getting suckered in on arguments that are not at the heart of the matter, like the number of conscience letters on file or other such stuff, or whether any of us in particular had an abortion or not. And no, Jacque, you do not get to get away with your "abortion is like child abuse" point:

"you must keep in mind when I 'impose my viewpoint' against child abuse and abortion, innocent children aren't killed. When you don't impose your viewpoint, they are."

Because, again, fetuses are not babies. An fetus that has been developing for eight weeks = not a baby, not a person.
A baby that was born eight weeks ago = a person.

Occupying the body of another, in development, completely enclosed within the uterus of a woman = not a human being.

Born, out in the world, has its own independent existence, not occupying anyone else's body = a human being.

Although, hey, when you're dealing with a movement full of people who think that the world was created in 6 days, I suppose you won't get too far when you try to argue about actual material reality.

So can it with the "innocent unborn babies" thing, if you're not willing to deal with science and reality as it actually is. (I'd be careful about making a general principle out of not dealing with reality, though -- could get you in trouble when dealing with sharp objects and speeding traffic. Or maybe y'all just suspend material reality when you're talking about abortion?)

So instead, let's actually talk what this is about -- the role of women in society, and why allowing women to have birth control, and abortions, is a terrifying thing for people like the ones I quoted above.

What is behind this "you had sex, now you must pay for it with a baby" position? (Or, more crudely put, the "she shouldn't have opened her legs" position)? Would any of us want to live a society where that was reflected in the law and politics? Cuz that's where we're headed, folks.

Or, perhaps this way -- I challenge the pro-lifers to argue that women were more liberated when abortion and birth control were illegal. And that we will be more equal and liberated when those things are made illegal once again. You could try pointing to model societies, if you could find one, where women are enjoying full equality despite not being able to engage in sex without fear of prgnancy.

Let's get into that.

[Diatryma]

Jacque, and Jivin at points: I think we're working from different starting points, and somewhat different arguments altogether. I've assumed that abortions will happen, that women who are pregnant will not want to give birth, that women will be sick, that ectopic pregancies will happen. Because abortions will happen, regardless of the legality thereof, I would rather they happen in safety and as much comfort as can be provided. Because women will lose children and need D&Cs, D&Xs (do please remember that partial-birth abortion is not a medical term), or induced miscarriages, I would rather the doctors who treat them be able to provide such care. I want my doctors to know what to do to take care of me.
I feel, with no evidence whatsoever, that a high number of abortions speaks of larger problems. But the way to decrease the number of abortions isn't to make them harder to get-- that leads to unsafe abortions. I support hospital abandonment incubators, birth control education and distribution, sex ed programs that have been shown to decrease the rate of teen pregancy (meaning not abstinence-only), and care for families, whatever their shape. I think these will decrease the number of abortions in a given period of time more effectively than criminalizing the procedure itself.
As for the interest of the potential offspring... I'm not sure how to answer that. I have not been convinced of the babyhood of an embryo; I've had too much developmental biology, I think. The analogy I typically work from is the organ donor: is it right that you be required to donate a kidney for someone you don't know? You might die from the operation, and they will die without it. The question isn't, "Is it right to donate your kidney?" but, "Is it right to force an unwilling donor to do so?" I would say no. The analogy isn't perfect, but it's the best I've come up with.

Jivin: the prolife position, like the prochoice one, is not a monolith. The doctor, as I see it, refused to learn, or at least perform, a procedure which could save a woman's life because it could also be used to end the life of a fetus. I know most prolife people are as upset by this as I am, or at least I hope they are-- but you don't get to say whether or not he was prolife. As the case was presented, his opinions on abortion caused harm to a woman who needn't have been harmed. While I am glad he didn't attempt anything he was not qualified to do, I wouldn't be comfortable with him treating me during pregnancy.

[missb, RN]

"What MisbRN didn't opine was blabermouth, invasion of HR privacy files, and generally reading the minds of others apparently without consent. Thus MisbphychicblabermouthprivacyinvaderRN!"

ummm...what??? I know which RNs have letters because we sit down and have big meetings about it whenever a termination case makes it to the floor. No one is "closeted" about it. At work, as here, people are very passionate about their beliefs (except the ones without letters, who are pro-choice but son't like takeing these invariably unpleasant cases--they are a little less passionate so they don't get caught). Yes, the law is conflicting. That's my point. The one you illustrated again. Thanks for clearing that up. I'm out of this argument, no matter what you serve for dinner. If it makes you feel better, you can tell yourself whatever you like to make it feel like you "served me". But really, I think you're a dolt with bad argumentative skills.

[Absentia]

I had an early second-trimester abortion in a hospital. I was lucky - my state allows second trimester abortions, and my OB was willing to perform it. Tests showed that the baby I was carrying had severe chromosome defects and, if born alive, would have a short life filled with pain. It truly astonishes me that anyone would claim I should have continued the pregnancy. I cannot imagine anyone claiming they have a right to decide what was best for me, my husband, and our very much wanted child. Yet people did - and do claim that. They seem to think that they can stand a safe distance away and denounce me and my choice. Except it was no one's choice to make but mine, with the assistance of my husband, my doctor, and my faith. I am very grateful that none of these morality police have any real effect on my life, and I most sincerely pray that women can continue to make the choices that are best for them and their own lives, rather than leaving it up to stranger.

[Jivin J]

Hi Diatryma,
How did the "prolife position" prevent the removal of the dead child? Since when does the prolife position say that it is morally wrong to remove a stillborn child?

I also have some doubts regarding DP's story. First, I would guess that a more logical reason that a prolife doctor wouldn't remove the child (especially with a D and X - aka partial-birth abortion) is that he wouldn't know how to do it. How would a prolife doctor (who has never performed an abortion) know how to perform a D and X (an abortion procedure that even most abortionists don't know how to perform)?

Second, why would a prolife OB say that the safest course for the woman would be to perform a procedure (D and X) he's probably never performed? How would he know it's the safest? It doesn't make any sense.

[Me]

And your coldness and disregard for other human beings comes across as unhindered as well, Jacque, and I think your lack of human feeling and your lack of regard and respect for the human beings you encounter speaks volumes more on just how prolife you really are.

You can't even see the people who are walking around in front of you as human beings.

How can you then expect others to see a tiny pregnancy that can't survive on it's own, that cannot speak, that cannot breathe, that has no face and no personality and no thoughts as a human being?

It's prolifers like you who can casually assume something about someone and then brush it off like it's no big deal who do the prolife movement the most harm.

If you want people to respect an unborn child, then maybe a good place to start would be to respect other people and not make terrible and dead wrong assumptions about them based on a handful of sketchy arm-chair pseudo-psychological propaganda.

If you can't see life and humanity in other people, then you have a hell of a nerve asking them to see life and humanity in something that doesn't look human or like life.