NEWS & LETTERS, September-October 2010
Toll of abortion wars
Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us, by Carole E. Joffe (Boston: Beacon Press, 2010)
Carole Joffe for the past 30 years interviewed abortion providers and observed their interactions with patients. She states that far-right fanatics have a disproportionate impact and that abortion has become a "stigma." Women are afraid to reveal that they had one, and doctors are afraid to let other doctors know that they have even had training in providing them. For a doctor, the presence or absence of support, especially from other doctors, can make or break their decision to provide abortion services. The stigma makes abortion a controversial subject even in pop culture. It stems from the U.S. stigmatization of serious discussions about sexuality which exists alongside its commercial exploitation. As a result, politicians are able to get away with proposing legislation against abortion, even in cases involving the woman's health or life.
Many people feel that laws putting dangerous restrictions on abortion are "moderate." These include TRAP laws (Targeted Regulation of Abortion Providers), which impose requirements going far beyond those imposed on other medical practices. Informed consent laws require doctors to lie to patients about the effects of abortion. Joffe also describes the disturbing results of restrictions on teenagers.
WOMEN SUFFER WITHOUT ABORTION ACCESS
Clinic personnel and patients have to deal with physical attacks and harassment from fanatics, causing clinics to spend money on security measures instead of healthcare.
Joffe tells enraging emergency room stories of women whose wanted, late-term pregnancies endangered their lives. Their doctors had to plead, argue, manipulate, or transfer them to other hospitals to get abortions. Lack of access to contraception causes higher rates of abortion among poor women, even though it is also more difficult for them to access abortion. Fanatics have used these higher abortion rates to claim that abortion clinics have a racist conspiracy to target women of color and the poor. Escalating a vicious circle, they use these lies to attempt to cut government funding for abortion and other reproductive health services including contraception.
European countries that make contraception and abortion available, and sometimes even free, have lower rates of unintended pregnancy and abortion. They also often have national healthcare and childcare, lower infant mortality rates, paid parental leave, and government subsidies for parents.
VISION OF REPRODUCTIVE JUSTICE
Americans must consider abortion as "one part of a larger mosaic of reproductive rights and services, as women's health advocates in the 1970s understood." Joffe describes the organizations Sistersong and National Advocates for Pregnant Women that continue this vision. These are part of the reproductive justice movement, led by women of color who consider the right not to have a child as part of a broader struggle including the right to parent children and control birthing options. Some reproductive clinics include counseling to help teenagers decide what they want sexually so they can have healthy relationships. Joffe also says abortions can be normalized by allowing hospitals and primary care doctors to perform them. This would also help to erode the simplistic stigma by exposing more people to the fact that every woman is in a unique situation and has unique feelings regarding abortion and her reproductive health in general.
This book explains the origins of obstacles to abortion as a pervasive social stigma created by a fanatical fringe movement and shows how we can improve public health by destigmatizing abortion and sexuality.
--Adele
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