Class and Poverty


BY JOSEPH RWAGATARE, 27 MARCH 2012

A girl walking from school. (File Photo) (Photo Courtesy Katy Gabel/AllAfrica)

Abortion is an emotive issue anywhere in the world. Few discussions about abortion are ever moderate. They often draw the most extreme, passionate, distorted and even unreasoned views. And so it has been in Rwanda in the last few days.

The debate here has been fueled by two things. First, is government’s intention to amend the law on abortion. This has been interpreted (erroneously as it turns out) to mean that government intends to legalise abortion. It is this misinterpretation of intention that has excited passions.

Now, Rwanda has some of the most enlightened economic and social legislation. But it has not yet got anywhere near legalising some of the more controversial and divisive issues like abortion. In some instances, it has tended to decriminalise them, while in others, it has sought to reduce sentences and allow for extenuating circumstances.

In the present debate, the latter seems to have been the intention. The amendment to the law seeks to reduce sentence given to offenders. As Mr Tharcisse Karugarama, the Minister of Justice, said in a BBC Kinyarwanda programme, Imvo ni Imvano on March 24, offenders should be helped to heal instead of being heavily punished.

Second, was the publication of figures of cases of abortion in Rwanda. It was reported that 60,000 abortions take place in the country every year. Most of these are unsafe, with 40 per cent leading to complications that require treatment.

The number of abortions is probably higher than this because most of them go unreported. We do not even know how many die or whose reproductive capacity is irreparably damaged.

This is the context of the current debate. Most of what I have seen has been wrong. For instance, in all the public discussions, nearly all participants have been men – usually, old men. Most of the men have been religious leaders. You cannot expect a balanced view from this limited group with strongly-held views on the topic.

First of all abortion directly affects women. They are the ones who make the decision whether to terminate a pregnancy or not. It’s their lives that are in danger. And they cannot be said to be less concerned about their pregnancy than the men who pontificate about the sanctity of life from the emotional safety of the pulpit or office. Where are the women? They are markedly absent from the debate. Their views on the subject or reasons that compel them to acts of desperation have not been heard.

Also, where are the voices of young people, who are likely to be entangled in the whole question?

I think it is a waste of time to talk about an issue and seek to prescribe measures regarding it when those directly affected are excluded from the conversation.

Secondly, the views of the men who are brought to discuss abortion are so well known; there is nothing new to learn from them. They cannot be expected to offer any other solutions. All men of the cloth, of whatever faith, are vehemently opposed to abortion. They will not even listen to circumstances where terminating a pregnancy may be the only way to save a life or the sanity of an individual. Can they feel the anguish of a mother taking such a drastic decision? Can they feel the pain – physical and psychological – that may have accompanied conception and continue to dog the woman? They can only take refuge from the real world behind a veneer of smug piety and condemn what they have never felt or are indeed incapable of feeling.

I heard someone from civil society condemn abortion in stronger terms than the bishops did. It was easy to tell where his organisation gets its funding from.

But we have to consider this question. Why do abortions continue to take place despite the legal, moral and religious injunctions? Clearly, there are serious issues to look into, and sanctimonious posturing simply won’t do. The debate should address these issues.

Also consider this. Some of the good men of the cloth are responsible for some unwanted pregnancies. And when the poor girl or woman tells the man of God about the pregnancy, he will either deny it or threaten her with divine retribution for daring to slander the servant of the Most High. He will then proceed to denounce loudly the immorality in our society. He will cry and lament the level of moral decadence.

Think about this as well. How many of the obviously well-to-do men discussing this subject have come up to offer help to starving or traumatised children and mothers – victims of rape, incest, coercion by those who have authority over them or some other form of abuse?

We cannot solve the complex question of abortion through hypocrisy, posturing or pious statements about the sanctity of life because this amounts to hiding our heads in the sand.

The debate is healthy, if it takes the right direction. And obviously it is a complex problem as there are serious ethical and legal issues to weigh. But the debate must not be stilted or left to a bunch of old men to determine. Let those who are most affected have their say.

Catholic Hospitals Expand, Religious Strings Attached

By 
Published: February 20, 2012

As Roman Catholic leaders and government officials clash over the proper role of religion and reproductive health, shifts in health care economics are magnifying the tension. Financially stronger Catholic-sponsored medical centers are increasingly joining with smaller secular hospitals, in some cases limiting access to treatments like contraceptionabortion and sterilization.

Catholic hospitals have a broad mission for medical care, says Sister Carol Keehan, president of the Catholic Health Association.

In Seattle, Swedish Health Services has offered elective abortions for decades. But the hospital agreed to stop when it joined forces this month with Providence Health & Services, one of the nation’s largest Catholic systems.

In late December, Gov. Steve Beshear of Kentucky turned down a bid by Catholic Health Initiatives, another large system, to merge with a public hospital in Louisville, in part because of concern that some women would have less access to contraceptive services.

And in Rockford, Ill., there is resistance to a plan by OSF HealthCare, run by the Sisters of the Third Order of St. Francis, to buy a hospital because of new restrictions that would require women to go elsewhere if they wanted atubal ligation after a Caesarean section.

About 20 such deals have been announced over the last three years, by one estimate, and experts expect more as stand-alone hospitals and smaller systems with no Catholic ties look to combine with larger and financially stronger institutions, in part because changes under the federal health care law are forcing all hospitals to become much more efficient.

There is already considerable tension between Catholic-run medical institutions and the Obama administration over insurance coverage for contraception for employees. The cultural divide over reproductive health is playing out on the campaign trail as candidates debate hot-button issues like abortion and contraception.

But while the growth of Catholic-run hospital networks is a testament to their long history and operational skill, local and state officials, doctors and advocates in many communities are concerned that some procedures that run counter to Catholic doctrine may no longer be available or will be much more limited. Some doctors fear they may not be able to do what’s best for patients, forced to wait to treat a woman who is miscarrying, for example, or to send arape victim elsewhere for an emergency contraceptive.

The restrictions at any given hospital may not be clear. “Women simply don’t know what they’re getting,” said Jill C. Morrison, senior counsel in health and reproductive rights at the National Women’s Law Center.

The confusion is likely to increase.

“We are starting to see what was rare in the past,” said Lisa Goldstein, who follows nonprofit hospitals for Moody’s Investors Service and predicts more such partnerships. The institutions themselves are grappling with how to remain true to Catholic doctrine and serve a broader community. About one-sixth of all patients were admitted to a Catholic hospital in 2010. In many smaller communities, the only hospital within miles is Catholic.

“That is a constant challenge,” said Sister Carol Keehan, president of the Catholic Health Association of the United States, which represents the nation’s roughly 600 Catholic hospitals. “It’s a challenge we take very seriously.”

Being a Catholic hospital means adhering to the church’s religious directives about care, Sister Carol said, but she says hospitals also see their mission much more broadly, including caring for those who are less fortunate and treating patients with respect.

At the Seton Healthcare Family in Texas, a unit of Ascension Health — the nation’s largest Catholic system and largest nonprofit system — officials say partnerships with struggling community hospitals are integral to their mission. Seton’s first partnership, in 1995, was to operate Brackenridge, a public hospital in Austin, because Seton was “not doing enough to care for the poor and vulnerable in central Texas,” said Charles J. Barnett, an Ascension executive.

In that case, Mr. Barnett says the system never agreed to provide services like elective abortions and sterilizations, and public officials and hospital administrators initially struggled to find a compromise. Although another system eventually offered sterilizations on a separate floor of the hospital, complete with a separate elevator, another hospital now provides those services.

One large system, Catholic Healthcare West in San Francisco, announced in January that it was severing its formal ties to the church to better work with hospitals that did not share its faith. The system, renamed Dignity Health, operates 25 Catholic hospitals, which will remain Catholic, and 15 non-Catholic hospitals. While none of Dignity’s hospitals will provide elective abortions or offer in vitro fertilization, the non-Catholic hospitals will not have to adhere to the church’s religious directives.

Dignity officials declined interview requests.

Even as Catholic Healthcare West, however, the system was not without controversy. One of its Catholic hospitals performed what it considered a life-saving abortion in 2009, but the local bishop in Phoenix disagreed, and the nun who allowed the procedure was excommunicated.

In many communities, like Rockford, the question is an intensely practical one: How will patients, particularly women, use services barred by the church? Because none of the city’s three hospitals perform elective abortions, the debate has largely focused on whether a woman who has a C-section can have her tubes tied afterward.

“It would just be an inconvenience to the patient and the physician, who has to make life-and-death decisions,” said Dr. Ronald Burmeister, a retired obstetrician in Rockford who is concerned about the merger.

The merger itself was prompted by the increasing need for hospitals to combine. Despite the federal government’s concern about possible antitrust implications, many believe the city can support just two hospitals. “Rockford needed a strategic partner,” said Andrew K. Bachrodt, a managing director for Kurt Salmon Associates, which advises nonprofit hospitals. OSF already owns a Rockford hospital, OSF Saint Anthony Medical Center.

OSF says Rockford needs fewer hospitals and wants to expand its network to better serve the area. “It’s all about how to deliver care, coordinated and efficient care,” said Robert C. Sehring, an executive at OSF.

OSF has already developed an arrangement in which affiliated doctors can prescribe birth control pills through a separate practice.

A woman who wanted a tubal ligation immediately after a C-section would be able to go to a competing hospital, if her insurance plan allowed. “It’s not like we’re eliminating female sterilization procedures,” said Kris L. Kieper, the chief executive of the YWCA in Rockford, who serves on an advisory committee for the OSF hospital there.

In Louisville, the debate focused on contraceptive services, like elective sterilizations, that had been provided by the University of Louisville Hospital, one member of a planned three-party merger that would have created a large statewide system. There was considerable uncertainty over whether University Hospital would be required to follow Catholic policies, according to a report by the Kentucky attorney general. Officials initially said the hospital would follow Catholic directives but then focused on certain procedures.

“While this evolving explanation may represent an accurate description of the proposed legal structure of the consolidation, it has cast a cloud of vagueness and skepticism over the issue in the public eye,” the report concluded.

Asking women to go across town to another hospital for services is not a solution, said Dr. Peter Hasselbacher, a retired university official who follows health policy in Kentucky. And while women in Louisville generally have a choice of hospitals, women in rural communities may not, he said, adding that many of Catholic Health Initiative’s Kentucky hospitals are the only hospital available.

Catholic Health says there was never a possibility that University Hospital would be allowed to perform services like elective sterilizations. “Our position around the ethical and religious directives never changed. How we communicated that evolved and changed over time,” said Paul Edgett, a senior vice president at the system.

Mr. Edgett says the system will consider future partnerships with non-Catholic hospitals, including University Hospital, as it seeks to position itself as a stronger system as health care evolves. “We all have to adopt and adapt,” he said. But, he added, “we’re not going to compromise our values in the process.”

www.rhrealitycheck.org/article/2012/02/13/unsafe-abortion-on-thailand-burma-border-perfect-storm

by Cari Siesttra, Ibis Reproductive Health

and Angel Foster, University of Ottawa & Ibis Reproductive Health

February 14, 2012 – 9:08am

Also see Anna Clark’s article about the lack of contraception access in Eastern Burma.

After decades of conflict and human rights abuses, reproductive health care in eastern Burma is among the worst in the world.  Millions of women still inside Burma as well as those who have fled to neighboring Thailand face a perfect storm of devastating health consequences from lack of access to family planning and safe, legal abortion.

In Burma, abortion is only legal to save the life of a pregnant woman.  And although abortion is legal in Thailand in some circumstances, women from Burma living in Thailand as refugees or migrants are generally unable to access safe abortion care.  As a result, unsafe abortion is a major contributor to maternal mortality and morbidity on both sides of the Thailand-Burma border.

Reproductive health efforts have been undertaken by non-governmental organizations and community-based organizations in this region for decades. However, these efforts are often fragmented and lack coordination.  In addition, few organizations address the issue of unsafe abortion beyond advocating for more family planning. In 2010-2011, a team of researchers from Ibis Reproductive Health and the Global Health Access Program conducted a comprehensive health assessment in order to understand abortion practices, harm to women, and ways to reduce the impact of unsafe abortion in this longstanding conflict setting.

Last week we formally released the report, Separated by borders, united in need. Our findings show a severe lack of access to family planning and considerable harm from unsafe abortion. Lack of health education and information contribute to high rates of unintended pregnancy, particularly among adolescents.  Women have difficulty accessing family planning services and organizations report lack of contraceptive supplies. There is widespread misinformation among health workers about the legal status of abortion and referrals for legal and safe services within Thailand are rare.  A lack of trained providers and restrictions on travel also prevent women from accessing safe, legal treatment.

As the world directs its attention to Burma and the possibilities for political change, it is important that we not forgot women and women’s health. The sixty-year civil conflict in Burma and has had a significant impact on reproductive health. As Burma embarks on its journey toward political reform, donor funds are likely to flood into the country.  We must remember to target some of those resources to women’s health so that women can fully participate in political and economic opportunities to come.

Russia has just defunded most abortions – a dangerous and discriminatory act that will harm vulnerable groups of women the most. If anyone is interested in arguments about why all abortions must be fully funded, here’s a piece written for the Canadian situation but much of it could apply anywhere: www.arcc-cdac.ca/action/why-abortion-must-be-funded.html

 

The Russian Health Ministry has cut the list of social grounds that allow women to have a free abortion, which leaves sexual assault as the only excuse for women to abort their pregnancy.

“A pregnancy which occurs after sexual assault, is a social reason for a woman to have an abortion,” the Health Ministry said in a statement.

Other social factors that would have qualified a woman for a free abortion were; if there was a court decision to relieve a woman of her parental rights, if a woman was in jail, or if a father became disabled or died during a woman’s pregnancy.

Among the medical factors that give Russian women the right for a free abortion are AIDS infection, oncology, an active form of tuberculosis, grave genetic diseases and other health problems threatening a woman’s life.

There are both state-run and commercial clinics that carry out abortions in Russia. The former offer free services in case a woman has social or medical factors that need to be taken into account, while the latter allow women to have an abortion even if they do not qualify for a free one.

Russia argues that abortion makes the ongoing demographic crisis in the country even worse. This kind of propaganda to distract from the governments responsibilities for social and economic problems can be found in more and more eastern european countries. Forcing especially poor women in having babies wont make the problem of poverty go away.

The parliament may soon pass a new anti-abortion bill that could limit access to abortion services and toughen criminal punishment for doctors who carry out illegalized abortions.

NEW YORK — The Women’s Media Center is deeply disappointed with the Susan G. Komen for the Cure Foundation’s decision to cease funding breast cancer prevention, education, and screenings at Planned Parenthood health centers. We urge our friends and supporters to join us by standing in solidarity with Planned Parenthood Federation of America and all of the women and families they serve to ensure that almost 750,000  women in rural, underserved, and low-income communities continue to receive comprehensive and accessible preventative care.

The Komen Foundation provides an important voice and services in the movement to find a cure for breast cancer.  We applaud them for this work but are troubled by the foundation’s public explanation that the decision to cease funding Planned Parenthood had nothing to do with abortion politics.

Since 2005, the National Right to Life Committee (NRLC) and STOPP (most recently known as the Society To Outlaw Planned Parenthood), have pushed a very public campaign aimed at ending Komen Foundation funding of Planned Parenthood services for breast cancer screening.  Dr. John Willke, a former President of the National Right to Life Committee has promoted a STOPP research report about the Komen Foundation support of Planned Parenthood (http://www.lifeissues.org/AbortionBreastcancer/komen/fact_sheet.pdf).  In October, 2011, Carol Tobias, the President of the National Right to Life Committee, wrote a column for Legatus Magazine that criticized the Komen Foundation with sentences like, “Komen’s support of the nation’s largest abortion provider is ironic in that, while Komen works to find a cure for breast cancer, Planned Parenthood is providing a “service” that contributes to the increase of breast cancer.”  [NOTE:  According to the National Cancer Institute at the National Institutes of Health, over 100 of the world’s leading experts have concluded that having an abortion or miscarriage does not increase a woman’s subsequent risk of developing breast cancer Summary Report: Early Reproductive Events and Breast Cancer Workshop]  

The National Right to Life Committee was originally created by the National Conference of Catholic Bishops and the President of the National Right to Life Committee has a platform and megaphone that extends far beyond the NRLC federation of 50 state right-to-life organizations and 3,000 local chapters nationwide.  In light of the public campaign against the Komen Foundation by the anti-choice movement, it is difficult to understand how the decision by the Komen Foundation is not related to abortion politics.

From a media perspective, the enormous outcry by women everywhere on Twitter, Facebook and blogs indicates the Foundation’s media team and leadership miscalculated the public’s reaction to their decision. Politico reports that in a video posted yesterday, Nancy Brinker, the founder and CEO of the Komen Foundation, said that the decision had been “mischaracterized” and that “the scurrilous accusations being hurled at this organization are profoundly hurtful.” (http://www.politico.com/news/stories/0212/72360.html)

The Women’s Media Center is a pro-choice organization and fully supports the movement to find a cure for breast cancer.

The Women’s Media Center urges the Susan G. Komen for the Cure Foundation to respond to press inquiries about the long-time anti-choice campaign for the Komen Foundation to stop funding Planned Parenthood to clarify that there was in fact no connection between a highly orchestrated anti-choice campaign and the decision of the Komen Foundation to end its support of Planned Parenthood for breast cancer prevention, education, and screenings.  The firestorm from this decision is not going to go away until the obvious links and questions are fully discussed.

Julie Burton, President
Women’s Media Center

www.thenation.com/article/165436/mexicos-anti-abortion-backlash?page=full

Mary Cuddehe

January 4, 2012   | 

This article was reported in partnership with the Investigative Fund at The Nation Institute.

Daniela Castro, a 21-year-old administrator for a Mexican children’s charity, got to the hospital just before dark. It was a warm, cloudless July night in 2010, and Daniela grabbed the arm of her boyfriend of three years, a handsome architecture student named Carlos Bautista. The two walked through the entrance confidently. If anything, they looked more like a pair of teen models than a couple of criminals. But Daniela was at the hospital that night because she had taken abortion pills that made her sick. Abortion is banned throughout Mexico, and authorities in her native Guanajuato, a mid-sized state in the center of Mexico with an ultraconservative reputation, like to enforce the law.

 

The state has opened at least 130 investigations into illegal abortions over the past decade, according to research by women’s rights groups, and fourteen people, including three men, have been criminally convicted. Given Mexico’s 2 percent national conviction rate during its most violent period since the revolution, that’s a successful ratio.

But Daniela did not have such numbers in her head when she told the attending physician her story. A few days earlier, she and Carlos had turned to Carlos’s mother for help. Of their parents, Norma Angelica Rodriguez, 41, was the most likely to be sympathetic. She had been a young mother herself, and she knew of a pharmacy in town that would sell Misoprostol—an over-the-counter ulcer drug that women take to induce labor—without asking a lot of questions. Rodriguez knew this because, like the estimated 875,000 Mexican women who have abortions every year, she had once needed the drug herself.

The doctor listened to Daniela, then slipped out of the room and made a call. Guanajuato hospitals are expected to report suspicious miscarriages just as they would a gunshot wound. It wasn’t long before a couple of officers arrived, followed by a lawyer from the district attorney’s office, who took out a note pad. “So, Daniela, how many people have you had sex with?” he asked, jotting down the answers. “And who gave you those pills?” That night, the DA opened an official probe into Daniela’s case. If convicted, both she and Carlos’s mother—though not Carlos—faced up to three years in prison.

* * *

Mexico has thirty-two states if you include Mexico City’s federal district, and until the spring of 2007, when Mexico City legalized it during the first twelve weeks of gestation, abortion was illegal in all of them. It was rarely prosecuted, though, and there were also legal exemptions. Every state had one for rape, and many to save the mother’s life; one state even had an exemption for economic hardship. Access, though, was another story. I once asked Rigoberto Velarde, the silver-haired state coordinator for Guanajuato’s Maternal Health Program, where a pregnant rape victim could get the procedure that was her legal right. Velarde drew back in his chair, widened his eyes and looked at me like I was crazy. “She can’t do that!” was his reply. Mexico’s abortion laws date back to the 1930s, and in the intervening decades two parallel systems have developed. Wealthy women could go to a private doctor or, since Roe v. Wade, travel to the United States. But any woman at the mercy of the public health system was pretty much on her own.

Mexico City’s legalization law, which required city hospitals to provide the service free, was the first in Mexico and one of few like it in Latin America (in many states the tide is turning in the other direction: in 2008 Nicaragua instituted a criminal prohibition on abortions, with no exemptions; in 2009 the Dominican Republic did the same). A month later, the National Human Rights Commission, whose director opposed the law, and the attorney general filed appeals with the Supreme Court, arguing that the law was unconstitutional. A long and closely watched debate roiled Mexico off and on for a year, until the justices finally voted to uphold the law, in August 2008. Abortion was now legal—and free—in the capital of one of the world’s most Catholic countries. It looked like a great victory for feminists.

* * *

Up until 2007 there had only been advances on abortion,” Elsa Conde, a former Mexico City legislator and the director of the National Alliance for the Right to Choose, one of the country’s leading abortion rights groups, told me in the summer of 2010. Advocates like Conde had spent decades chipping away at state-level bans. In 2004, for example, they got Baja California Sur to amend its rape exemption so that victims would actually be able to get legal surgeries at public hospitals; the following year the state reduced its maximum penalty to two years in jail. “But then we started seeing setbacks,” Conde went on. “And since October 2008, all we’ve seen is setback after setback after setback.” That year, lawmakers next door, in Baja California, passed a controversial fetal-rights constitutional amendment. While it did not technically change the existing rules—abortion could not become more illegal, after all—it codified one of the key goals of the US Christian right since Roe v. Wade: legally protected life beginning at “the moment of conception.” And an amendment is much harder to overturn than a law. By the end of 2009, fifteen more states had passed versions of this extreme ley anti-aborto.

The amendments were similar to a measure recently defeated in a Mississippi referendum but being prepared in other parts of the United States. In fact, the US “personhood” movement has been taking lessons from its neighbor to the south. In September Mexico’s Supreme Court rejected constitutional challenges to the ley anti-aborto in two states, providing a new spring of confidence for US anti-choicers. “This decision in Mexico provides proof that it is a viable strategy that is working in other places,” said Gualberto Garcia Jones, a legal analyst with Personhood USA. “If it had gone the other way, we would have seen pro-lifers say, If it can’t work in Mexico, it can’t work in the US.” Seventeen Mexican states—more than half the country—now have a fetal-rights amendment on the books. (Chihuahua has had one since 1994, and the seventeenth state, Tamaulipas, approved one in 2010.) This would be like the Mississippi ballot succeeding and then spreading to twenty-five states between now and the end of 2012.

The sweep was so fast and successful that no one had ever seen anything like it. Two of the three main national parties sponsored the amendments—President Felipe Calderón’s National Action Party (PAN) as well as the Institutional Revolutionary Party (PRI). Being anti-abortion was inherent in the PAN agenda, and the party’s state congressmen were strategizing about how to fight Mexico City’s legalization law at national meetings as early as the fall of 2007, according to a legislator who attended. (“Vicente Fox made ‘the Catholic look’ fashionable again,” Roberto Hernandez, a political analyst based in Mexico City, once told me.) The PRI’s participation was more of a departure from that party’s centrist foundations, and not all the rank and file were on board, but the PRI had been badly splintered since losing the presidency to the PAN in 2000, and the party core, perhaps sensing a change in the public mood and determined to take back the presidency in 2012, has supported the ley anti-aborto.

Catholic civic groups had done their part. Jorge Serrano, the skinny, flat-topped director of Pro-Vida, a prominent anti-abortion group based in Mexico City, became a fixture as he choreographed protests against the capital’s legalization law (one day a group of women who had had enough of his crusading showed up to taunt Serrano with a “rainstorm of thongs”—bunches of thong underwear stapled to their placards). The Mexican division of the Knights of Columbus got involved, too, mailing lawmakers plastic fetuses representing the various stages of gestation.

But as far as the feminist movement was concerned, the Catholic Church played the lead role. This was so widely believed, it was taken as fact. I was told more than once, for example, that Norberto Rivera, Mexico City’s archbishop, had hosted a fancy dinner for PAN governors and their wives during which he urged them to pass the ley anti-aborto as he pressed special rosaries from the pope into their hands. A PRI state congresswoman told me she had met a Vatican emissary who was traveling from state to state on a hush-hush lobbying mission. More recently, a bishop from Mexicali spurred the conspiracy mill when he implied that the pope had called the Supreme Court justices to influence their votes to support the ley. (The diocese declined to speak with The Nation.) But, as I learned one morning in the summer of 2010, a concentrated effort like this may not have been necessary.

That day I took a bus from Mexico City to Aguascalientes, a tiny, landlocked state in the heart of the country’s Bible Belt. Monica Delgado, the fresh-faced, preppy PAN congresswoman who drafted the Aguascalientes version of the ley, ushered me into her office in the Congressional building. There were different floors for the different parties, and the PAN floor was decorated with posters for an anti-abortion group called Vifac, whose motto is “We celebrate life.” Delgado explained that, like most PANistas, she was disturbed by the Supreme Court decision upholding Mexico City’s abortion-rights law and wanted to “bulletproof” her state against any progressive incursions. After she had finished drafting the amendment, Delgado said, she and the eight other PAN state lawmakers walked across the plaza to meet the local prelate. It sounded like the beginning of a joke: nine congressmen go to see a priest. But Delgado didn’t see anything funny or strange about the visit. The prelate had been nagging her and her colleagues in his weekly radio address, and the meeting was a “courtesy,” she said. “We had to go over and tell him, ‘It’s already been presented!’” Delgado’s proposal eventually stalled because of resistance from local feminist groups and one liberal PRI congresswoman who controlled a crucial committee. But with priests and politicians this close, it wasn’t hard to imagine the same scene playing to a different outcome in other states, regardless of any organized intervention by high-ranking clergy.

* * *

According to Diego Valadés, a legal scholar at the National Autonomous University of Mexico, state constitutional amendments nearly always take at least a couple of months to be approved. And yet when it came to fetal rights, lawmakers in most states where the ley anti-aborto passed managed to muscle it through in a matter of days. “There has never been anything like it; it was an almost synchronized series of events,” said Valadés. But like any work hastily composed, the ley was imperfect and seemed to place the IUD and in-vitro fertilization—not to mention exceptions to the abortion restrictions that were still on the books in many states—into a legal gray zone. “They say we protect life since conception—except for these causes that we already had,” said Fatima Juarez, a demographics expert at the Colegio de Mexico, in Mexico City. “How can you reconcile ‘We protect since conception’ and ‘You can [terminate a pregnancy] for economic reasons’? It’s illogical.” Now many fear that women who terminate a pregnancy for any reason can be prosecuted for infanticide.

Instead, state prosecutors dusted off the old abortion penal codes—most of which call for prison terms or fines—and opened investigations: ten in Veracruz, thirty in Puebla and thirty-one in Hidalgo. In 2009 in the southern state of Quintana Roo, a Mayan woman was wrongfully jailed for what turned out to be a spontaneous miscarriage, and in 2010 an 11-year-old girl who was raped and impregnated by her stepfather was denied an abortion because she was four months pregnant—one month past the allowable twelve weeks. The cases became a flashpoint in the national debate over abortion and the fairness of the ley, and when I called Elsa Conde again this past August, she described what she said was a mini-backlash to the backlash: four more states had strengthened access to abortion for rape victims. But Conde was quick to add that pro-choice advocates remain in a “position of defense.” “Basically,” she said, “we’re just trying to make sure no other states adopt the ley anti-aborto.”

In May 2009 the ley was approved with a two-thirds majority in Guanajuato. Just nine years earlier, the state congress had voted to eliminate the exemption for rape victims, but the governor was forced to veto it after a public outcry. In 2009 public school teachers staged a bonfire of middle school biology textbooks, and subsequent editions had some noteworthy changes in the chapter on sex: life now begins at the “moment of conception,” and virginity is “a treasure.”

But if one episode cemented Guanajuato’s conservative status, it came in the summer of 2010, when Centro Las Libres, a women’s health group in Guanajuato City, broke the news that seven women were in prison on a charge that amounted to infanticide—homicidio con razón de parentesco, or homicide of a family member—with a maximum penalty of twenty-nine years. Some had already spent more than six years in prison, so their sentences said more about the cruelty of the Mexican criminal justice system than the new ley anti-aborto. But the women became symbols of the dangerous consequences of criminalizing abortion and a focal point for the left in organizing against the ley. All the women said the fetuses they were accused of murdering were stillborn or miscarried. Yolanda Martínez, who says she didn’t even know she was pregnant, was alleged to have left a nearly full-term fetus to die in an outhouse. But police had first arrested her on suspicion of abandoning another infant—not hers, it turned out—found that day in a different part of town. Once she was in custody, her house was searched, and officers emerged with blankets that they claimed had held her dead newborn. Susana Dueñas says three experts declared the baby she was accused of killing a stillbirth, but the judge sided with a fourth opinion, of a doctor on the prosecutor’s payroll. After a media outcry, the state reduced the penalty for the type of homicide they had been charged under—from twenty-nine to eight years. In September 2010 all seven women were released for time served.

* * *

Las Libres is not the only women’s rights group in Guanajuato, but it is the most vocal. It was the unrelenting campaigning of Las Libres that was crucial in getting the seven women released, and when the New York Times ran a story about it, the group’s director, Veronica Cruz, appeared in the accompanying photo, protectively embracing one of the newly released women.

The first time I met Cruz was on an overcast morning in the summer of 2009. Forty years old, with a round face and light brown hair, she has the energy of a longtime activist. She is earnest but cynical. Inside the Las Libres headquarters on the outskirts of Guanajuato City, she introduced me to a petite woman dressed in white named Rosario. She was 20 and had recently completed a nine-month probation sentence. Her story was shocking to me at the time. She had taken abortion pills, fallen ill with nausea, gone to the hospital and been reported to the police. She said the staff had mistreated her, calling her names, completing the abortion surgically without anesthesia (which is standard) and allowing medical students into the room to take pictures with their cellphones. She paused and started to cry. About a month after the surgery, she said, she was lured out of her house in her slippers by men in an unmarked van and taken to jail in handcuffs. Her family borrowed the money to pay the $800 bond.

But it turns out that going to the hospital is a common way for Mexican women to get caught. According to the US-based Guttmacher Institute, a sexual and reproductive health and rights organization, the abortion-related hospitalization rate in Mexico is high—17 percent in 2006 (it is 0.3 percent in the United States). This is because so many abortions are clandestine, exposing women to physical as well as legal risks.

This past June I went back to Guanajuato to see Cruz. I found her curled up in a chair, gossiping with her sister, who helps run the office, and another volunteer. Cruz said that a couple of women had recently been arrested but that she wasn’t following their cases. “Honestly, it’s just too many to keep up with,” she said with a shrug. Daniela Castro’s was one of the last like it that Las Libres had pursued, so she picked up the phone to call her.

Daniela agreed to meet me at a cafe across from a large salmon-hued cathedral in the plaza of a nearby town. She looked carefree and summery in a floral A-line skirt and a fitted white T-shirt. But it was just a year before that Daniela woke up every morning worried that she was going to prison, and her life seemed to be falling apart. “My friends stopped talking to me, and they even wrote messages on my Facebook,” she said. Carlos quit the local university for a cheaper school two hours away so they could afford a private attorney, but he proved as useless as the public defender. For a while, they had no idea what to do. “We were thinking about running away to the United States—like wetbacks,” Daniela said, shaking her head. Las Libres heard about the case and connected Daniela with a group of pro bono lawyers from Mexico City who complained to the state Human Rights Commission. They argued that Daniela’s hospital interview was inadmissible because she hadn’t had a legal representative present. That small oversight seemed to be all that was needed: a few weeks later, Daniela’s case was closed for lack of evidence.

After we talked, Carlos and Daniela offered me a ride to the bus station. Carlos had been quiet most of the afternoon, but he suddenly chimed in as he was driving. “At the time there were all these kidnappings going on, all these people on the street kidnapping and murdering,” he said. “And yet we were the ones they had down at the prosecutor’s office.” Then he fell silent again, edging the truck around a corner.


Dec 12, 2011 12:00 AM EST

Jennie McCormack was arrested for terminating her pregnancy with an abortion pill. The case that could transform the reproduction wars.

The last thing on Jennie Linn McCormack’s mind when she realized she was pregnant was that she might, with a single telephone call, upend the vitriolic national debate on abortion.
All she thought about was how it would be impossible for her to take care of another baby. Surviving, barely, on the $250 of monthly child support for one of her three kids, the unemployed, unmarried 32-year-old also knew she didn’t have the more than $500 she’d need for the two-and-a-half-hour trip from her bare-bones rental in Pocatello, Idaho, to Salt Lake City, the closest city with a clinic willing to terminate a pregnancy. She had no computer, no car, no one to take care of her 2-year-old—and like Idaho, Utah had a waiting period for abortions, which meant she’d have to make two round trips. So early this past January, she made the call that may alter history and turn Jennie McCormack into Jane Roe’s unlikely successor: she asked her sister inMississippi to buy RU-486, the so-called abortion pill, over the Internet and send it to her. The cost: about $200.

“My mind just kept going back to my kids, how there was no way I could do that to them, no way I could make their lives even worse,” says McCormack, a petite blonde, as she nearly sinks between the cushions of her sofa, her eyes rimmed with tears. The man who had impregnated her had just been sent to jail for robbery; she did not feel comfortable reaching out to her mother—Mormon, like almost everyone in southeastern Idaho—for help.

McCormack, who thought she was about 12 weeks along, took the pills (the protocol involves two drugs, mifepristone and misoprostol) the afternoon they arrived. The drugs are FDA-approved only for ending early-stage pregnancies; McCormack had no complications, but the pregnancy turned out to be more advanced than she thought—perhaps between 18 and 21 weeks, experts later speculated—and the size of the fetus scared her. She didn’t know what to do—“I was paralyzed,” she says—so she put it in a box on her porch, and, terrified, called a friend. That friend then called his sister, who reported McCormack to the police.

Although RU-486 is legal and the fetus was not yet “viable” (that is, old enough to live outside the uterus), Idaho has a 1972 law—never before enforced—making it a crime punishable by five years in prison for a woman to induce her own abortion. The day after police arrested McCormack, her mug shot appeared above the fold in the local newspaper. “It’s hard to imagine the humiliation and fear,” says her lawyer, Richard Hearn, who is also a physician.

The case was dropped weeks later due to lack of evidence. Without solid proof, such as the envelope in which the pills came, her confession wasn’t enough to sustain the case. But prosecutors retained the right to re-file charges. In response, Hearn got a federal injunction to prevent any woman from being prosecuted under the state’s anti-abortion statute by the district attorney. He also filed a class-action suit against the state, claiming the statute is unconstitutional. But all that took nine months to play out, and McCormack lurched into depression and became a virtual shut-in.

“You’d have to know the climate here,” says Hearn, “to fully imagine the amount of pressure Jennie is under, how hostile people can be, how isolated she is.” Next week, motions will be heard in federal court to certify the suit as a class action. Last week, the prosecutor filed a motion to have Hearn’s injunction lifted. (The prosecutor’s office did not return calls seeking comment.)

The case has become a huge tangle for both sides of the abortion battle—state laws that put abortion beyond the reach of poor women are clashing with the global reach of the Internet. With Hearn ready to take his case to the Supreme Court, Jennie Linn McCormack may be above the fold for years to come.

“It’s a profoundly important case,” says Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania. “But it’s one that neither the pro-choice nor the pro-life people want to deal with. And that’s what makes it so crucial.”

It’s a bad case for both sides. The fact that McCormack kept a 4-month-old fetus frozen in the winter chill on her back porch is the sort of ghoulish image pro-choice activists try to avoid. For pro-life advocates, supporting her arrest would contradict a longstanding policy of targeting providers while holding women blameless. “It would require a massive change in direction if the anti-abortion movement now supported the criminal prosecution of women directly, which is why McCormack is troubling,” says Cynthia Gorney, a formerWashington Post reporter and the author of Articles of Faith: A Frontline History of the Abortion Wars. “It would violate everything they built the movement on.”

Neither right-to-life groups nor pro-choice organizations like Planned Parenthood and NARAL Pro-Choice America—usually quick to publicize such human stories as ammunition for their cause—have made public statements on McCormack’s case, and numerous calls to spokespeople on both sides of the issues went unreturned.

“McCormack puts them places that complicate the storyline. It’s the new frontier,” says Gorney, now a journalism professor. “Once you remove the providers, you have no one to picket or pressure. Abortifacient drugs and the Internet change the debate forever. ”

Despite the reticence of pro-choice groups to take up McCormack’s cause, it is exactly what they have been warning of for years: as clinics become inaccessible, poor women are more likely to take abortion into their own hands. In the era before Roe v. Wade, that meant back-room abortions; now it conjures images of a lonely woman in a small town at her keyboard Googling “abortion pill.” Hundreds of online merchants will send RU-486 without a prescription, according to Women on Web, an organization that sends the drugs to women in countries where abortion is illegal.

No one knows how many women in the U.S. have gotten the drugs this way, says Daniel Grossman, a physician who is a senior associate at Ibis Reproductive Health, a research and advocacy group in Cambridge, Mass. “[But] if women were not accessing them, these sites would not be proliferating.” Although the number of abortions nationally has dropped slightly in recent years, some 35 percent of American women will have one at some point in their lives.

The proliferation of sites providing the drugs coincides with the pro-life movement’s highly effective protests and attacks on physicians, clinics, and health-care groups that offer abortions. The number of Planned Parenthood affiliates has been cut in half since 1987, to fewer than 100. Almost 90 percent of counties in the U.S. and 98 percent of rural counties have no abortion services. Many clinics in states where local physicians are pressured not to perform abortions now fly in doctors from out of state to provide abortions, says Melanie Zurek, the executive director of the Abortion Access Project, a Boston-based group that offers training and support to doctors and health organizations.

While Medicaid coverage for abortions has long been outlawed, more than a dozen states now restrict private-insurance coverage of abortion. Texas cut funding for clinics that provide birth control, even if they don’t provide abortion services. A South Dakota bill that would have made women wait 72 hours before getting abortions was recently blocked by a federal judge. A bill in Ohio would ban abortion after a fetal heartbeat is detected, as early as six weeks after conception. In November, Mississippi voters narrowly rejected a referendum that would have defined “personhood” at the time of conception, a notion that would have made even certain types of birth control illegal. Legal scholars on both sides agree that such laws wouldn’t survive a constitutional challenge as long as Roe v. Wade stands. Which is precisely why some pro-life groups are championing them: their goal is to provoke challenges that go to the Supreme Court, which will, in their fever dream, strike Roe down.

This is, of course, the pro-choice movement’s greatest fear. Spooked by the recent strong challenge in Congress to federal funding for Planned Parenthood, pro-choicers are wary about mounting legal challenges to state restrictions, for fear those challenges would end up in front of an inhospitable Supreme Court.

For the clinics that remain, the use of abortion drugs, which require no equipment and far less training for physicians than surgical options, has quietly risen. More than 20 percent of all abortions in the U.S. are now “medical” abortions, according to the Guttmacher Institute, a nonprofit, nonpartisan research group. The drugs are more than 95 percent effective in ending pregnancies up until seven weeks, according to the FDA, and are considered the best method for ending very early pregnancies.

Later-term abortions like McCormack’s, even those done in a clinic, are the Achilles’ heel of the pro-choice movement. Although only 1 percent of abortions in the U.S. are done after 21 weeks (about 88 percent are performed within 12 weeks), anti-abortion advocates have made such procedures their prime target. Since the Supreme Court in 2007 upheld states’ rights to regulate late-term abortions, more than 35 states now have strengthened their prohibitions on clinics that performed the procedure.

Hearn, McCormack’s lawyer, is less wary about challenging statutes—and undaunted by the lack of public support from either camp. The pro-choice lobby “may not think this is a good time to bring something to the court because it’s so conservative,” he says, “but I say no case is perfect, and if not now, when?”

In addition to his challenge of the Idaho statute criminalizing self-induced abortion, he is targeting the state’s new “fetal pain” law, which is basically a clumsy end-run ban on late-term abortions. (Virtually all research on the subject shows that fetuses cannot distinguish pain until as late as the 30th week of gestation.) Four other states have recently passed similar laws, despite the fact that under Roe, abortions are legal until viability, which is around 25 weeks.

While the arguments fly, McCormack waits quietly in her small, dark apartment. A bedraggled bouquet of silk flowers hangs outside her front door along with a plaque that says “Welcome” in Spanish, French, and German. Even if her suit succeeds, there is no victory for her. She says she has “no friends at all, no one to talk to.” She knows no one who’s had an abortion, or at least no one who will admit it. “My mother, she’s Mormon, you know? She’s a proud person, and this is a terrible thing for her to have to look people in the eye.” After her picture appeared in the paper, McCormack got a part-time job at a dry cleaner, using another name, but people figured out who she was and stopped letting her bag up their clothes, so she quit. On a recent trip to a local state office to apply for aid, she was ignored for hours. “They made it clear what was happening,” she says. “For a while I just sat there, sort of amazed that they were just letting me sit there.” Eventually, she picked up her son and went home.

Even her attempts to bury her fetus have been thwarted. Hearn put in requests to the district attorney to have the remains released from the evidence locker, but no one has responded. “I never wanted to be someone public, to make a point,” McCormack says. “This isn’t a cause for me. I just didn’t know what to do. I did what I thought was right for my kids, that’s all.”

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