Dr. Amy Whitaker joins panel discussion on abortion care

Dr. Amy Whitaker joined IL Congresswoman Jan Schakowsky on Monday, September 21 at Personal PAC for a panel discussion about issues surrounding choice. Illinois appellate judge Laura Liu moderated the panel.

Dr. Whitaker spoke about her passion for abortion care. She also described the situations our patients are in as well as the barriers that doctors face in providing abortion care.

To learn more about PersonalPAC, check out the hashtag #‎GetPersonalWithPersonalPAC‬ on Facebook and Twitter.

Congresswoman Jan Schakwosky and Dr. Amy Whitaker

Appellate Judge Laura Liu moderates the panel

Ci3’s Lee Hasselbacher Quoted in “Guardian” Article

Lee Hasselbacher

Image courtesy of Lee Hasselbacher

Lee Hasselbacher, JD, policy coordinator for Ci3 and the University of Chicago Section of Family Planning & Contraceptive Research, was quoted in a January 15 article on abortion rights, published in The Guardian. 

In the article, entitled “Restricting abortion high on the agenda for Republican-controlled Congress,” Hasselbacher expressed concern that individuals think of abortion as separate from women’s reproductive healthcare, and optimism that this attitude is changing.

Read the full article.

“Vessel”: A documentary and a movement

The new documentary “Vessel” leaves the audience inspired, furious, and perhaps above all, gobsmacked with the profile of Dr. Rebecca Gomperts, a Dutch abortion provider and all around revolutionary. Gomperts first gained notoriety in 1999, when she created a mobile clinic aboard a ship and sailed to countries where abortion remains illegal. She aimed to reduce the number of unsafe abortions and unwanted pregnancies by providing sexual health services, including early medical abortions, in international waters. Because the ship flew under the flag and laws of its home country, The Netherlands, the team could provide mifepristone* and misoprostol** (the medicines, when taken together, cause an abortion) to women within the first 12 weeks of a pregnancy.

Dr. Rebecca Gomperts aboard the ship as it arrives in Spain (image courtesy of vesselthefilm.com)

Dr. Rebecca Gomperts aboard the ship as it arrives in Spain (image courtesy of vesselthefilm.com)

The documentary highlights the gumption and resources needed to create such a novel (and enviable) social enterprise. When the ship finally takes to sea under the moniker Women on Waves, protesters and media await them at the shore. At nearly every port, authorities and politicians ensured that the ship struggled to dock, stay, and allow local women to board. Yet, as word got out of the ship’s arrival, the team received hundreds of phone calls requesting appointments and information.

The first half of the film follows the ship’s journeys and the mission of relaying the message that medical abortion with misoprostol (with or without mifepristone) gives women the possibility to safely do medical abortions themselves. This option needed a platform, and so Women on Waves transitioned from the open sea to focusing on empowering women how to do a medical abortion by distributing information through the internet, stealth advertising, and by supporting the creation of safe abortion telephone hotlines. If women could not come to the ship, thought Gomperts, she would directly deliver them the pills.

The latter half of the film follows what arose from this experience: Women on Web. Women had already figured out that taking misoprostol, available as an ulcer medication, could induce a miscarriage. Misoprostol was known for being safe, but women around the world kept asking: How do we get it?

So, along with the website, Gomperts and her team launched campaigns around the world—in Portugal, Ecuador, Morocco, and more—where they advertised the information hotline and how women could procure a safe abortion. One scene in the film plays out like a heist as the team schemes to raise a banner advertising their contact number from a statue of the Virgin Mary. Throughout, the calls for help kept coming, as did the backlash.

But Gomperts did not let backlash, or the fear of any such judgment or consequence, hold her back.

Image courtesy of vesselthefilm.com

Image courtesy of vesselthefilm.com

One of the biggest takeaways from “Vessel”, besides the impressive central character, is how much fun the team appeared to be having on the boat and on the ground when planning covert advertisement campaigns. It was a refreshing reminder that empowerment should be enjoyable. Helping women receive normal medical care should feel good.

Although not explored directly in the film, Dr. Gomperts refuses to work with and in the United States. In previous interviews, she explains why she does not mail pills to women in the United States. We know all too well that although abortion has been legal in the United States since 1973, women’s access to abortion is constantly restricted by the political and religious right via TRAP laws and other legislation.

Gomperts puts the onus on us—advocates in the United States—to push for legislative change and until then, to provide medical care any way possible. She challenges women’s groups to find reliable sources for misoprostol pills and to refer women or deliver to women in order to administer safely at home. She does not want to endanger her own work, and so she calls out the abortion rights groups in the United States to rise up to the challenge of our time.

Gomperts maintained throughout the film that her work is not a personal mission, but a response to a need. She never intended to be an activist, but a doctor who alleviated suffering.

To wit, when grilled by the media about her personal life (“Have you ever had an abortion?”) she  replies,

“Are you going to ask somebody working for Amnesty International if they’ve been tortured, no, come on, this is about whether or not women have basic human rights” […] “you cannot force any women to go through an unwanted pregnancy… it’s a humiliation, it’s a torture for them.”

Although she did not intend to be an activist or an anecdote, Dr. Gomperts is an ally worth emulating. She saw a need, and set out to meet that need. “Vessel” is essential viewing for abortion rights workers in the United States. May we address the needs we see and meet them, so that when women need an abortion, they do not have to rely upon obscure interventions, but upon equal, affordable, basic healthcare systems already in place.

Thank you to The Nightingale Cinema in Chicago for hosting the screening. See where else the film is screening here or watch on Video on Demand platforms or iTunes now!

*Also known as Mifeprex; RU-486

**Also known as Cytotec

Coercion and Reproductive Justice

An essential piece of the reproductive justice and sexual rights movement is the right of all women to make reproductive choices free from coercion.

According to the Guttmacher Institute, coercion in any form is wrong and compromises choice. Coercion violates women’s right to decide freely if and when to have a child and the right to have the government respect her decision.

The Guttmacher report condemns coercion in the form of U.S. state legislatures passing increasingly restrictive abortion restrictions to keep women from ending an unwanted pregnancy. Parental notification or consent, mandatory waiting periods, and inaccurate and biased counseling exist under the guise of “preventing coerced abortion”. Rather, these TRAP laws aim not so much to inform women about the abortion procedure, as to dissuade them from choosing an abortion in the first place.

Increasingly, these laws prevent women from making decisions about how and when to give birth, posing a risk to all pregnant women, including those who want to stay pregnant.

Roe v. Wade gave women the right to choose abortion. Roe v. Wade also gave women the right not to choose abortion.

In the United States, a dark history of forced sterilization and present day controversies about the rights of the disabled remind us that as much as women have a freedom to abortion, if she chooses to continue a pregnancy, she has the equal right to do so.

Coerced abortion occurs in many forms. In January 2014, a Florida man was sentenced  to nearly 14 years in prison for tricking his pregnant girlfriend into taking Cytotec, a brand-name version of misoprostol, which causes miscarriage. Further complicating the issue, he was initially charged with first-degree murder under the Unborn Victims of Violence Act, punishable by life in prison, but he pleaded guilty to lesser charges of product tampering. The fetus was estimated to be at seven weeks.

In 2013 in Texas, a pregnant 16 year old girl claimed her parents were pressuring her to have an abortion when she wanted to continue the pregnancy and get married. When the pregnancy was confirmed, the teenager’s father allegedly became angry and insisted that she have an abortion and it was his decision.  Texas is one of the states that requires parental or judicial permission for a minor to obtain abortion; in this case, the minor had to obtain judicial permission not to have an abortion.

Coerced abortion compromises reproductive justice and often results from broader issues such as domestic and sexual violence, birth control access and tampering, economic disadvantage, education expectations, and religious convictions. Abortion is not the problem. The prevention of choice is the problem.

Jcr_my_body_my_choice

New Section research promotes parent–daughter communication about abortion before pregnancy occurs

parent_daughters

Press Release

Published: 13 October 2014

 

Discussing sexuality and reproductive health is a complex issue for parents and their daughters. Parents often feel ill-prepared to initiate these talks, and their daughters often fear a negative reaction or perceive judgment for their sexual activity. Yet, numerous studies have shown that, in general, parent-daughter communication leads to positive sexual health outcomes with regards to pregnancy and STI/HIV prevention.

New Section research, published online ahead of print in the Journal of Adolescent Health, discusses the role and potential impact of parent-daughter communication about abortion among non-pregnant adolescents. These conversations, the authors suggest, may decrease pregnancies and abortion and obviate the need for forced communication.

Currently, 38 states legislate communication between abortion-seeking minors and their parents via Parental Involvement (PI) laws, which require minors 18 years old and under to notify or obtain consent from a parent(s) or guardian before obtaining an abortion. PI supporters argue that these laws promote communication and provide young women with family support. PI opponents maintain that forced communication during the time of crisis can harm young women and delay treatment, increasing the medical risk of a procedure. Furthermore, studies show that most adolescents voluntarily involve parents in their decisions about pregnancy resolution, especially when they anticipate support.

Our qualitative study found that only 43 percent of nonpregnant African-American adolescent females had ever discussed abortion with a parent. Almost half were sexually active, and the vast majority stated they would voluntarily tell a parent of an abortion decision “as soon as possible” or “within one to two weeks.” However, nearly 20 percent acknowledged risk and expressed fears of hurt, punishment, and eviction if their parent learned about an abortion.

The study identified several correlates of parent-daughter communication about abortion. Parents who had had talked about other sexual health topics (e.g. birth control and STIs) were more likely to have discussed abortion with their daughter. If daughters perceived parental acceptance of sexual activity, they were more likely to have an abortion communication. A mother’s experience with teenage pregnancy was positively associated with abortion communication, although the study did not assess the positive or negative quality of the communication. Of concern, sexually active adolescents were less likely to communicate about abortion.

Ultimately, this study found that rather than mandating communication at the time of abortion, policies should focus on general parent-daughter communication about sexual health. Policies that force communication at the time of abortion appear misplaced.

Read the full article here.

Reference

Sisco K, Martins S, Kavanaugh E, Gilliam M. Parent-Daughter Communication About Abortion Among Nonpregnant African-American Adolescent Females. Journal of Adolescent Health. Published online ahead of print September 27, 2014: DOI: 10.1016/j.jadohealth.2014.07.010

 

Section study finds young women involve a parent in abortion when they anticipate support

‘Cause it’s like, ‘man what are they going to think’ and ‘are they going to hate me for this?’ That is what goes through your mind.

When a young woman seeks to terminate a pregnancy, how does she decide whether to talk to a parent? A recent study from the Section of Family Planning and Contraceptive Research at the University of Chicago found that pregnant teens will turn to parents and adults who are engaged in their lives and who will offer support, regardless of her decision. Young women will avoid talking with parents who are less involved or may try to prevent them from seeking care.

The study, recently published online ahead of print in the American Journal of Public Health, explored the factors young women under age 18 consider when deciding to involve a parent. Researchers conducted interviews with 30 minors seeking abortion in Illinois, prior to implementation of a parental notice law in 2013. Currently, there are 38 states with laws requiring a parent provide consent or receive notification before a minor can access abortion.

Image courtesy of the Illinois Caucus for Adolescent Health (icah.org)

Image courtesy of the Illinois Caucus for Adolescent Health (icah.org)

“There’s a commonly accepted idea that teens will try to hide their pregnancy or abortion decision. However, pregnant young women actually do turn to parents in the majority of cases. In our study, 70% of the young women involved a parent or guardian. They thought carefully about which parents and adults in their lives they could turn to for help in making their decision,” said Lee Hasselbacher, policy researcher at the Section of Family Planning.

While each young woman’s family circumstance was different, there were several common motivations for involving a parent. Factors in favor included close and supportive relationships, need for help with logistics like travel or payment, or experiences that made discovery of the pregnancy seem inevitable.

I mean, I wouldn’t normally tell my dad but it came to a point where I needed another $50 for the abortion to be done and so I relied on daddy.

Minors expressed a range of motivations for not telling a parent about their abortion as well. Some teens worried that if their parent learned of their decision, it would dramatically change their relationship or feared it would even lead to anger or harm. Young women also discussed the lack of a relationship or presence as a reason they did not want to involve a parent.

To me that [disclosing pregnancy and abortion] would start a whole lot of drama and right now um, our relationship is like- is kind of on good terms but it’s not so for me telling her this um, I think it like would go back down the drain.

One of the strongest findings was that among those young women who did not involve either parent, most were concerned that one or both parents would directly interfere with their decision to get an abortion.

She just told me, like, it’s not right… and she told me like, if I did get pregnant, like, she told me she wouldn’t let me have one. She said it’s my responsibility.

“This study reveals the complicated lives of pregnant young women and suggests that young women, not policymakers, are the ones best able to identify those people in their lives who can help them deal with a pregnancy. This study reinforces the need to listen to these young women and support policies that encourage family communication long before a pregnancy or abortion decision,” said Dr. Melissa Gilliam, Chief of the Section of Family Planning and Contraceptive Research and author on the study.

Reference

Hasselbacher LA, Dekleva A, Tristan S, Gilliam ML. Factors Influencing Parental Involvement Among Minors Seeking an Abortion: A Qualitative Study. Am J Public Health. Published online ahead of print September 11, 2014: e1-e5. Doi:10.2105/AJPH.2014.302116.

Press

Jersey Tribune

Medical Xpress

Science Daily

Science Newsline

 

 

New study recommends doula support during abortion procedures

image from exhaleprovoice.orgMany women choose to have a doula–a lay support person–present during their labor process. A doula’s support has been connected to maternal and child health benefits such as pain control, shorter labor, decreased rates of cesarean delivery, and breastfeeding assistance. In full-spectrum reproductive health care, doulas can provide support for women during not only labor and delivery, but also for a variety of reproductive experiences, including miscarriage, adoption, and abortion.

While each of these reproductive experiences has unique physical and emotional challenges, a doula’s role is consistent: be a source of emotional, physical, and social support.

Section faculty Dr. Julie Chor researches the effect and role of doulas in abortion care. Her most recent publication, co-authored with Dr. Melissa Gilliam and Dr. Brandon Hill, appeared in the June 2014 online edition of the American Journal of Obstetrics and Gynecology.

In this study, Dr. Chor hypothesized that women having a first trimester abortion with doula support would have significantly less pain than women randomized to usual care.

She found that the although the majority of women who had an abortion were satisfied with the procedure, doula support did not statistically impact recalled pain. However, 96.2% of women who received doula support recommended that doula support be routinely used during procedures and 60.4% expressed interest in training to become a doula. Additionally, more than 70% of women who did not receive doula support said they would have wanted someone present to provide support during their procedure.

Furthermore, women receiving doula support were less likely to require additional clinic support resources. Doula support, Chor suggests, may address patient psychosocial needs.

Dr. Chor’s findings are relevant and timely, as volunteer abortion doula groups are organizing across the country and increasingly being used in clinics.

Click here to read more of Dr. Chor’s research on expanding the role of doulas into abortion care.

Abortion & Reproductive Health Care for Incarcerated Women

orange-is-the-new-black-01Orange is the New Black returned for a second season to Netflix last Friday and continued a major plot line involving a pregnant inmate and the father of her baby, who happens to be a guard in the prison. What started as a secret romance escalated quickly due to the difficulties pregnant women face while behind bars. Legally speaking, a sexual relationship between an inmate and prison official can never be considered consensual and so the characters hatched a series of plans about how to deal with the pregnancy. Could she secretly terminate the pregnancy without anyone finding out? Could she continue the pregnancy and receive adequate health care? Could she hide the pregnancy and the true father? What happens when she goes into labor? What punishment(s) will the couple endure for their actions?

While the TV show mixes fact and fiction, it does honestly depict the reality of what happens when a woman becomes pregnant in prison or enters prison already pregnant. In addition to this ongoing pregnancy plot line, in the first season an inmate entered prison pregnant, went into labor and delivered in a hospital, and was separated from her baby shortly afterwards and returned to prison. Between six and 10 percent of women are already pregnant when admitted to a prison or jail and they can become pregnant during private visits with partners, home visits, while in work release programs, or as a result of sexual assault [ACOG]. Studies also show that approximately 14 percent of girls are pregnant when they arrive to juvenile detention.

In recognition of the prevalence of these realities, the Section published a policy brief on Abortion & Reproductive Health Care for Incarcerated Women. Although our brief focuses on Illinois policies and programs, incarcerated women in state and federal facilities across the United States face myriad barriers to receiving reproductive heath care, including abortion services. Despite having the constitutional right to have an abortion (as guaranteed under Roe v Wade), accessing the procedure while incarcerated presents many challenges, including facilities’ ad hoc responses to abortion requests and the logistics and challenges of organizing transportation and payment.

The brief also discusses the practice of shackling, prison nursery programs, and policy reforms needed to address the gendered needs of women prisoners.

Although Orange is the New Black errs on the dramatic side of storytelling, it does provide an overdue platform for discussing the basic human rights of incarcerated women who have the same rights as civilians to make decisions about their own bodies.

The Women’s Health Protection Act of 2013

In honor of International Women’s Month, the Ci3/Section blog is proud to present a series of posts from its staff, supporters and constituents. Below, Section project assistant Sara Newton writes about the Women’s Health Protection Act of 2013.

As part of  International Women’s Month, this series of blog posts not only celebrate women’s achievements, but also remind us that the battle for equality is not finished. It’s 2014, and women are still paid less than their male counterparts, are still disproportionally represented in business and political leadership positions, and despite the passing of Roe v. Wade 41 years ago, women still face harmful and unnecessary barriers to receiving medical care. The Women’s Health Protection Act aims to defend all women’s right to basic sexual healthcare in a social climate that constantly politicizes women’s health and bodies. This chipping away of a woman’s constitutional right to decide if and when to have a child is one of our unfinished battles.

According to the Guttmacher Institute, more abortion access restrictions have passed between 2011 and 2013 than in the entire previous decade. This means that 56 percent of women–more than half of the female population in the United States–now live in states considered hostile to their health and rights.

GuttmacherMap

Image: guttmacher.org

Anti-choice politicians and lobbying groups continue to pass bills that curtail the constitutional guarantees of Roe v. Wade. Even though a state cannot prevent a woman from having an abortion before the fetus is viable outside the womb (20 to 24 weeks), state legislatures have found ways to make it increasingly difficult, if not impossible, to access abortion services. These bills have misnomers of “protecting women’s health” with the true objective of preventing abortion access. This strategy has led to the closing of clinics nationwide, forcing providers to obtain(elusive) hospital-admitting privileges, forcing women to view ultrasounds, requiring biased and inaccurate counseling, expecting women to find the time and money to attend multiple appointments and observe waiting periods, and arbitrary clinic reconstructions.

In response to these ploys, in November 2013, Democrat Senators and Representatives led by Senator Richard Blumenthal (D-Conn.) introduced the Women’s Health Protection Act of 2013 (WHPA), which would prohibit states from passing Targeted Regulation of Abortion Providers (TRAP) laws.

If enacted, WHPA would preempt state efforts to enact measures like heartbeat bills and fetal pain legislation by requiring states to first meaningfully prove that these regulations do protect women’s health as they claim. According to the WHPA, any legitimate connection has yet to be proved as TRAP laws “…do not advance the safety of abortion services and do nothing to protect women’s health. Also, these restrictions interfere with women’s personal and private medical decisions, make access to abortion more difficult and costly, and even make it impossible for some women to obtain those services.”

WHPA notes that closing clinics not only prevents accessing safe and legal abortion, but further prevents women from accessing basic sexual and reproductive healthcare, “including contraceptive services, which reduce unintended pregnancies and thus abortions, and screenings for cervical cancer and sexually transmitted infections. These harms fall especially heavily on low-income women, women of color, and women living in rural and other medically underserved areas.”

WHPA also includes language that prevents regulating abortion providers differently from providers of “other medically comparable procedures” or requiring abortion facilities to meet standards not required of “facilities where medically comparable procedures are performed.”

WHPA highlights what pro-choice advocates and abortion providers already know: TRAP laws do nothing to protect women’s health, rather they are purposefully burdensome to women and only increase her waiting time, cost, and health risks. These restrictions do not rely on scientific or medical studies, nor do they prevent abortion. A recent study found that 98.4 percent of  women who saw their ultrasound still chose to have an abortion. Closing clinics only drives women to seek unsafe or self-induced abortions, as has been seen in Texas, where some of the most restrictive legislation has passed.

It is unlikely that the WHPA bill will pass the GOP-controlled House. But as January 22 marked the 41st anniversary of Roe v. Wade, which confirmed every woman’s constitutional right to make medical decisions without interference, it is a timely reminder to support the ongoing fight for reproductive justice.

Tell Congress to enact WHPA by taking action here.

Sara Newton received her BA in Writing from Indiana Wesleyan University and her MA in Development Studies from University of Melbourne, Australia. Before joining the Section staff full-time, she volunteered with the Policy program for several months, and has been a regular contributor to the Ci3/Section blog.

Upcoming Events: “How to Survive a Plague” and “After Tiller”

We are proud to announce the following upcoming events. Please share with your Chicago contemporaries.

Friday, January 17 – How to Survive a Plague Screening and Panel

How to Survive a Plague

Image: moviedearest.blogspot.com

Section of Family Planning chief and Ci3 Founder and Director, Dr. Melissa Gilliam, will be a panelist at a screening of the award-winning film How to Survive a PlagueThe event will take place Friday, January 17, at 6 p.m. at the Reva and David Logan Center for the Arts (915 E. 60th St). Admission is free.

How to Survive a Plague chronicles how AIDS went from a death sentence to a survivable diagnosis. The film has been hailed by The New York Times as a “moving and meticulous documentary about AIDS activism in the late 80’s nad early 90’s” and won Best Documentary at the 2012 Gotham Independent Film Awards.

Admission is free. Seating is on a first-come, first-served basis and RSVP’s are appreciated. Click here for more information and reservations.

Wednesday, January 22 – After Tiller Screening and Discussion with Filmmaker Martha Shane

After Tiller

Image: aftertillermovie.com

Ci3 is proud to co-sponsor an on-campus screening and discussion of After Tiller, on Wednesday, January 22, from 5-7:30 p.m. at the University of Chicago’s International House (Assembly Hall, 1414 E. 59th St).

RSVP on Facebook

Following the screening, a panel discussion will be held featuring After Tiller filmmaker Martha Shane. The film is an intimate exploration of the highly controversial issue of third-trimester abortions in the wake of Dr. George Tiller’s 2009 assassination. Click here to learn more about After Tiller.