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Dear Senator Cantwell,
Thank you for being a champion for reproductive justice. In a just world, a woman would never make a choice about when, where or how to bear children because of what is covered by her insurance. She would not give birth to an unwanted child because an abortion costs more than she can afford. And she would not accept unnecessary routine interventions in a hospital that are paid for by her Medicaid when she would have preferred a cheaper physiologic birth with a midwife. You have shown time and again that you understand these issues, and in this you truly represent Washington state, where poor women can access Medicaid to pay for care with any licensed provider she chooses to see for her pregnancy, be it an abortion provider or a home-birth midwife. The language you championed in the Senate Finance Committee's healthcare bill which would require Medicaid to reimburse any licensed care provider working in a free-standing birth center is a step in the right direction for our nation, and I cannot thank you enough.
As you know, the House of Representatives has shown significantly less respect for women's health and reproductive justice. The Stupak abortion coverage ban is bad policy. Conservatives tout the importance of "patient choice" as an argument against any healthcare reform, but then they single out this one legal medical procedure and restrict women's abiltiy to choose to access that service. The Stupak ban does not maintain the status quo in regard to aboriton access. Rather, it would deny a woman the ability to purchase insurance covering abortion, even when that coverage will be provided soley from funds taken from women's own premiums rather than federal dollars. The Senate is our only hope for ensuring that this affront to women's self-determination does not become law. I know that you will fight as hard against Stupak-like language in the Senate healthcare bill as always do for women and families.
In August, I organized a meeting between a group of moms, dads and midwives and one of your staff members. We spoke about the importance of a real pulic option in healthcare reform, the specific challenges faced by women and young people in accessing comprehensive healthcare benefits, and the importance of midwifery care as part of a full range of reproductive health choices. Thank you for listening. Thank you for fighting for us.
God bless you,
Alison Cole Duren-Sutherland
Now consider the fetus. As a part of the pregnant woman's body, the fetus spends its gestation steeping in the chemical's of the woman's emotions. At first, the fetus is pretty rudimentary, but it becomes more complex throught pregnancy, to the point when labor begins and the fetus is an active participant in birth and bonding. And although I beleive that the fetus doesn't really have the technology to "think" or "feel" in the same way I do for most of the pregnancy, still, I cannot imagine that soaking in the mother's feelings would not have some effect on the development of the baby's feelings. In fact, the more I learn about pre- & perinatal psychology, the more pro-choice I become. If the fetus feels the mothers feelings, and in fact has their first expreinces of the world through the mother's feelings, and those feelings are negative toward the fetus itself, that seems generally pretty crappy for the person that fetus will become.
Of course, like any life experience, one can overcome the circumstances of one's gestation. But I see this as one more reason why women should not become mothers simply because they become pregnant. Choosing motherhood in one's own time and of one's own free will make the difficult task of sharing one's body with another being more joy and less invasion, and I truly believe that the baby born to a mother who loved and wanted it before or as soon as it existed has a better chance at feeling happy and at home in the world. I encourage all pregnant women planning to carry to term and give birth to practice "fetal love breaks," in which the woman sets aside time during her day, espcially when the day has been stressful, to tell her fetus how much it is loved. As the mom feels the love for her baby, the baby also feels that love.
Love is our birthright, and a baby who is tolerated rather than loved is, in my opinion, a tradgedy. I'm not saying all this to make women feel bad for having moments of frustration as they get another kick in the ribs at two o'clock in the morning. Perfection is unatainable, we will never do everything exactly right, we will always have fleeting moments of anger and resentment at our children all throughout their lives. But I think if a pregnant woman feels no love for her fetus, wants to be rid of her fetus, cannot imagine being able to mother the baby that the fetus will become, I think that if that woman wants to end her pregnancy, she should have every right to do so, because though she can hide those feelings from the world, she cannot hide them from her baby.
How long have I been making noise for healthcare reform? But I just can't feel like the House "reform" vote is a victory, though I know it is. But eliminating insurance coverage for abortion is NOT what I had been looking, hoping, and advocating for. Once again, the health of women is a political football. It is not about what's best for us, it's about political expediency, and that's just bullshit. The Stupak amendment is not about ensuring tax dollars don't pay for abortions -- the Capps amendment provided for that, along with the notorious Hyde amendment. It is about restricting women's access to healthcare.
Here's what our government says to women: Making an intimate personal choice to end a pregnancy? No insurance coverage. Want to give birth in the privacy of your own home with a midwife and minimize costly intervention? You may or may not be covered. Pressured into an unnecessary induction, epidural and cesarean because the ultrasound shows that the baby is big/small/whatever? Where's the checkbook? At least in
My tax dollars pay for military action I do not support, and anti-abortion people refuse to allow premiums paid by individual women to go toward abortion coverage within their health plan. Why is my concern for life less valid than theirs? Please defund the Pentagon before asking me to give up my autonomy. Women (& men) deserve the freedom to make our own best choices with dignity. Legal, covered abortion & homebirth for all women, now!
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Sex leads to pregnancy leads to childbirth. This, of course, is a huge oversimplification. It is possible to have lots of satisfying sex that doesn’t lead to pregnancy because a penis never goes into a vagina. It is possible to have chemical or mechanical problems of the reproductive system that make it impossible or unlikely for penis-in-vagina sex to produce pregnancy. People can also have penis-in-vagina sex but using any of a number of chemical, mechanical or physiological methods to prevent pregnancy (contraception). But, penis-in-vagina sex has been until very recently in human history the only way to make more humans, and it is only recently that it has been as simple (and difficult) as taking a medicine to prevent pregnancy.
When pregnancy occurs as a result of sex, it may not necessarily lead to childbirth. Genetically abnormal embryos often spontaneously abort, and one pregnancy out of five will end spontaneously before halfway through the pregnancy (20 weeks). Many women choose to end unwanted pregnancies through induced abortion, even in countries where abortion is illegal, clandestine, and dangerous because it is practiced outside the reach of evidence-based healthcare. Illegal abortion is a leading contributor to maternal mortality worldwide. In countries where abortion is legal, women have the choice to end an unwanted pregnancy with the help of a trusted healthcare professional and at little risk to their health or well-being. So, women can be pregnant without ever having given birth or having a child.
For most women who choose to get pregnant, sex gets them pregnant, though some use reproductive technology like insemination or in vitro fertilization to conceive. However, all unplanned pregnancies, which is about half of all pregnancies, occur because of penis-in-vagina sex. So, although it is a generalization, it is still generally true: sex leads to pregnancy leads to childbirth.
Knowledge is power. Sex ed helps us take charge of our sexual and reproductive health, and an important part of reproductive health is the part where you’re reproducing: conception, pregnancy and birth. Sexuality is affected by pregnancy, and childbirth is accomplished with the same hormones and muscular contractions as orgasm. Sex, pregnancy, and birth are biologically and physiologically linked. Childbirth ed is sex ed.
All animals are built to reproduce themselves, and we humans do it with sex, pregnancy, childbirth and breastfeeding. The pregnancy and birth of your child is your first act as a parent, and as parents you want to make the best choices you can for your children and family. By getting educated about the physiologic process of pregnancy, childbirth and breastfeeding, you set yourself up for a healthy reproductive life, and prepare yourself to be an informed consumer of the health-care you receive during pregnancy and childbirth. I want to bring childbirth ed to Scarleteen because when women and families are educated about birth it can be an empowering, transformative and even sexual experience in the life of a family.
__________________
Rachel,
I've worked in abortion care for six years now, and I want to thank you so much for your unflinching coverage of the murder of Kansas abortion provider and Christian grandfather George Tiller. There weren't really any other places in the media where I felt like someone care about the experience of clinic workers in the wake of such terrible violence. Thanks for "getting it" in a way that even my own partner, who is pro-choice because he knows it's none of his business, did not.
I am also really grateful for your coverage of health care reform. These days at the abortion clinic, I'm doing the health insurance billing, and this perspective on the health care system has made me a somewhat obsessive advocate for health care reform. Profit-driven insurance companies need to be reigned in. Only in the health care arena does the consumer not know what they will be responsible for paying until long after they have been provided with services, because insurance companies are not bound by the information they give to patients and doctor's offices about what will be covered.
The real reason I am writing to you right now, though, is because I think you might be able to "get it" on another issue that is sometimes invisible to the mainstream media, probably because, like abortion, it is a women's health issue. But it is also a health care reform issue, a public health issue, and a deficit reduction issue: midwifery care and out of hospital birth.
The US has abysmal maternal and infant mortality rates, while spending huge amounts of money on high-tech maternity care, most of which came into use before it's benefits had been rigorously demonstrated. Health care reform needs evidence-based birth care. Science is now beginning to back up leaving birth alone, and when women give birth with minimal intervention, the cost-savings is huge. That is why Certified Professional Midwives need to be a part of health care reform. If CPMs were federally recognized as eligible for reimbursement by Medicaid, poor women would have increased access to safe, evidence-based, low-cost care. In the midst of all the corporate advocacy happening in Washington, women from the MAMA Campaign and The Big Push for Midwives are trying to get the voices of women and families heard. I am writing to ask you to cover the movement for the full range of reproductive justice in health care reform.
The bottom line is that we need to reduce health care costs, or health care reform just won't work. Women who choose to prevent pregnancy when they are not prepared to be parents save money for their insurer (the state in the case of a public plan). Women who do not wish to be pregnant but are will save their insurer money by choosing abortion. Women who are carrying a pregnancy to term and wish to seek midwifery care in an out of hospital setting will save their insurer money because interventions will be reduced. Any reasonable insurer, while not mandating a woman to do any of these things, will provide her the coverage to do these things if she so chooses. By honoring a woman's own wisdom about her reproductive choices, insurers win as does the dignity of the woman, who is given every opportunity to control her reproductive destiny.
I am a huge fan and love listening to your show on my computer at work. Thanks for what you do.
Sincerely,
Alison Cole Duren-Sutheralnd
I have requested a meeting with you to discuss health care reform, but so far have been told that neither you or your staff have time to see me. I wanted to let you know that HEALTH CARE REFORM NEEDS TO HAPPEN FOR WOMEN.
THE CURRENT SYSTEM IS FAILING WOMEN AND FAMILES. As a student midwife, abortion-care worker, health care para-professional, medical insurance biller, and mom, I have first-hand experience with American medicine.
REFORM REQUIRES A PUBLIC OPTION. A not-for-profit public plan with clear billing instructions similar to Medicaid would reduce time wasted by doctors, patients and insurance companies arguing about coverage, leaving more resources for health care.
COST SAVINGS CAN BE REALIZED BY GIVING WOMEN A FULL RANGE OF REPRODUCTIVE CHOICE. I know that family planning and abortion rights are important to you, and I thank you for your work on these issues. Like women who choose contraception or abortion over carrying unwanted pregnancies, women who are carrying a pregnancy to term and wish to seek midwifery care in an out of hospital setting will save their insurer money, because the costs associated with a hospital birth will be substantially reduced. By honoring a woman's own wisdom about her reproductive choices, insurers win as does the dignity of the woman, who is given every opportunity to control her reproductive destiny.
In closing, I would request that you or your staff make time to talk to me and other moms about our experience with the health care system and why HEALTH CARE REFORM MUST HAPPEN NOW. We don't have a lot of money to spend lobbying legislators, but we believe the government can and must provide good health insurance, and we have ideas about how it can be done.
Thank you for all the work you do. May all your efforts be blessed.
Sincerley,
Alison Cole Duren-Sutherland
* I SUPPORT HEALTH INSURANCE THAT COVERS WOMEN MAKING THEIR OWN BEST CHOICES ABOUT REPRODUCTIVE HEALTH. Women who choose to prevent pregnancy when they are not prepared to be parents save money for their insurer (the state in the case of a public plan). Women who do not wish to be pregnant but are will save their insurer money by choosing abortion. Women who are carrying a pregnancy to term and wish to seek midwifery care in an out of hospital setting will save their insurer money because interventions will be reduced. Any reasonable insurer, while not mandating a woman to do any of these things, will provide her the coverage to do these things if she so chooses. By honoring a woman's own wisdom about her reproductive choices, insurers win as does the dignity of the woman, who is given every opportunity to control her reproductive destiny.
I have been so cynical lately about getting repro health coverage in a health care reform bill, specifically abortion access. I actually have more hope in the arena of homebirth midwifery. Reading some of the health reform coverage here has given me some hope, because the issue is reframed here as what it really is, an issue of the health of women. Thanks, RHRealityCheck.org. I will remember to stay vocal on the subject of aboriton access for poor women.
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This was the most major medical procedure I had ever had, and I was very nervous going in to it, but no one ever told me what to expect, what they were going to do to my body, what medicines I would be given, how I would feel afterwords. I ended up getting an infection, and having to return to the office, were I was seen by a different dentist who packed the holes in my gums with clove-soaked something that made me feel ill for days. The whole experience was disempowering, and as I said, I haven't been back to a dentist since.
At the time, I was a paramedical worker at a fabulous private women's health clinic, where I still work today, though in a different role. I spent my days there reviewing surgical informed consent forms with women seeking abortions. I would meticulously go through the steps of the procedure, unless a woman didn't want to hear what was going to happen, but either way I would review every possible complication of the procedure, give the woman statistics on how often those complications were likely to happen, and give her a chance to ask any questions she had about the procedure. When I went to get my wisdom teeth out, I expected something similar, and was shocked that it was nowhere to be found. How can anyone claim that I was provided with informed consent at that dentist's office? I knew I was getting my wisdom teeth out. That was it.
Soon after the wisdom teeth experience, I began working as a doula, supporting women and families during hospital births. There, I saw moms hooked up to external fetal monitor (EFM) belts as a matter of course. No one at the hospital mentioned to my clients that the monitors had never been shown to improve birth outcomes. No one mentioned that the monitors had been shown to increase cesarean section rates. No mom was ever given an informed consent form to sign authorizing the hospital to perform continuous EFM, or presented with the option of refusing the EFM all together.
Medicine pays lip service to informed consent, but ultimately our culture expects us to cede our power to our doctors. They are the experts, we are told, they know best. This is a problem in which we, as patients, are complicit. We need to get educated about our bodies and our health care, demand that our care providers give us complete information about our options, and make our own choices about how to promote our health. Ultimately, WE are our own primary care providers, as what we has a 24/7 impact on our health, while we may only see our doctors once or twice a year. One of the beauties of midwifery care is that it recognizes and promotes this vision of heath-care as client-centered.
I challenge every health care provider to provide the informed consent of two marginalized, but essential, areas of women's health care: abortion and midwifery.
Listen to women.
This, I believe is the key to good health-care policy when it comes to birth, abortion, contraception. To anyone who will never be able to be pregnant or give birth, I challenge you to listen. One benefit of the tragic death of Dr George Tiller is that it inspired many women to tell their stories of abortion. Women are also telling their stories about birth. We will not be able to set good policy or provide good care until we learn from the stories of women.
I have been encouraging everyone I know to share their helath care stories with their nationally elected representatives. I am greatful that great minds like midwife and anthropologist Melissa Cheyney are doing the work of collecting the stories of women to be a part of the shaping of health care policy.
Each women's story will be unique. Cesarean birth may be life-saving and empowering for one women, and traumatic for another. The same is true of abortion. A contraceptive method which is perfect for one woman will cause annoying side effects in another. When we listen to and synthesize women's stories, we see that empowering us to make the best choices for their own lives is the best foundation for health and well-being.
Throughout history, women's truths have been devalued. The common ground in the debate about women's reproductive health can only be found in the radical act of honoring the lived experience of women, and allowing policy decisions to reflect the reality of women's lives. Personally, I beleive that the human dignity of a grown woman is worthy of more more respect than that of a fertilized egg. I know that a woman's children almost certainly value her more than they would a zygote of a potential sibling. So let us listen to women. And women, let us share our stories. Let us educate eachother. Let us all be willing to learn.
Dear Senator Cantwell,
Thank you for all that you do for Washington State. I am writing today to let you know how important health care reform is to me, and give you a few points that I believe are essential to real reform of the health care system:
* A PUBLICLY-FINANCED HEALTH CARE OPTION IS VITAL. I work in insurance billing for a small medical practice, and it is ridiculous that private insurance companies make so much money off of trying to avoid paying for their member's health care. The system is too complicated to be understood by professionals like me, let alone health care consumers. I can only hope that a public option would provide clear, streamlined billing practices, as exists for Washington State Mediciad.
* WOMEN MUST BE ABLE TO ACCESS A FULL RANGE OF REPRODUCTIVE HEALTH CARE OPTIONS THROUGH PUBLIC HEALTH COVERAGE. This includes contraception, abortion, midwifery care and out-of-hospital birth. Providing coverage for all of these options will lead to significant cost-savings.
I encourage you to learn more about how Certified Professional Midwives and out-of-hospital birth reduce health care costs while optimizing outcomes. Please review the Milbank Report, found here: http://www.childbirthconnection.org/arti
*PROVIDING COVERAGE FOR WELLNESS-PROMOTING "ALTERNATIVE" AND "COMPLEMENTARY" CARE PROVIDERS WILL SAVE MONEY. Like midwives, practitioners like naturopaths, acupuncturists, massage-therapists, cranio-sacral therapists, etc provide alternatives to expensive drugs, surgeries, and hospital procedures.
Thank you for you service, and for reading this.
***
Emailed to the WA State Chapter of the American Medical Association in response to this bit of news:
I urge WA State Delegates to vote against the resolution which proposes to develop CPT (billing) codes to identify and label “non-compliant... Read More” patients at the American Medical Association’s (AMA) Annual Meeting next week. As a health care consumer, childbirth educator, and paramedical worker, I hope that Washington doctors understand that their patients are ultimately responsible for their own health-care decisions. Doctors need to be their patient's allies, not adversaries. This is especially important to me on issues of choosing a location and method of childbirth -- for pregnant women seeking quality care and good outcomes, “non-compliance” is often our only alternative to accepting care which is not evidence-based, such as mandatory repeat cesarean and continuous electronic fetal monitoring.
Thank you for your time.
First, some resources which inform or reinforce my personal beliefs on this matter:
National Advocates for Pregnant Women
from Guttmacher, which does scientific research on abortion:
"• Legal restrictions on abortion do not affect its incidence. For example, the abortion rate is 29 in Africa, where abortion is illegal in many circumstances in most countries, and it is 28 in Europe, where abortion is generally permitted on broad grounds. The lowest rates in the world are in Western and Northern Europe, where abortion is accessible with few restrictions. [1]
• Where abortion is legal and permitted on broad grounds, it is generally safe, and where it is illegal in many circumstances, it is often unsafe. For example, in South Africa, the incidence of infection resulting from abortion decreased by 52% after the abortion law was liberalized in 1996. [3]"
There's also a great NYT piece on maternal mortility due to unsafe abortion, but you have to sign up to access it.
Protestant Christians will find religious doctrine supporting the pro-choice perspective at the Religious Coalition for Reproductive Choice. If you dig around the site just a little, you can probably find the pro-choice perspective from any organized religion.
And here is what I have to say:
As part of this, I believe very strongly in the rights to self-determination, autonomy, and bodily integrity. I have no right to exert my will over the will of another with regard to what happens with their own being. This is why I believe that informed consent in health care and public health education are so important -- we need to be informed health-care consumers who take up our own power over our bodies, rather than abdicating our power to a health care provider who tells us what to do. This is why I am working toward midwifery -- birthing women and their babies need care that honors their unique humanity and wisdom instead of honoring routines, protocols and institutional guidelines. And this is why I believe that women choosing abortion deserve to be able to make that choice without danger, fear, or shame.
Whether or not I believe abortion is right, whether or not it is legal, women will still have abortions. Look around the world, where a significant percentage of maternal mortality is caused by illegal abortion. Living children will lose their mothers. Making abortion illegal again will not end abortion. Though you may be uncomfortable with the concept of abortion, please recognize that making abortion illegal does not end abortion. It only leads to criminalization of women and death.
No one would undertake such a dangerous choice as illegal abortion lightly, and yet it is undertaken because women know when they cannot mother one child more. In our country, where abortion is legal, opponents seek to create a similar climate of fear, shame and silence as though abortion were a crime; they call it "murder," which is a crime. I suppose that I am grateful that women only have to contend with shame when they choose abortion in the US, rather than shame and death. Abortion care workers, it seems, are the ones who have to worry about dying as a result of legal abortion. I wish that women and care providers could both approach abortion without shame or fear of death.
George Tiller said, "Trust women." Yes. Trust women to make the best choices for their own families Trust women to make their own private moral decisions. Trust that another individual might know their own life better than a stranger. Trust that your fellow humans make choices that seem just as absolutely right to them as your truths do to you -- and entertain the possibility that the values of another hold more truth in their own life than your values. In our own lives we live by our own truths. I would never try to force another person to have an abortion, just as I would never force another person to have an unwanted child. It is a dishonor to the humanity (and to the divinity) of another to enforce that your will be done in their life. Each of us deserves the dignity of self-determination, if we are choosing to continue a pregnancy and give birth, or if we are choosing to end an unwanted, unwelcome and/or unhealthy pregnancy.
Thanks for reading.
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- A woman carrying a planned and wanted pregnancy discovers during the last trimester that her fetus has an anomaly that is not compatible with life. Rather than endure the physical and emotional demands of carrying a living pregnancy to term that will not produce a living child, the woman chooses to end her pregnancy, grieving the loss of her loved and hoped-for child.
- A woman with an unwanted pregnancy who chooses abortion, but is unable to obtain one early in her pregnancy. Women could be delayed from obtaining first or second trimester abortions when they: are uneducated about their bodies and unaware of their pregnancy until much later than most women; do not experience or recognize typical symptoms of early pregnancy; are ashamed to admit that they are having sex outside of marriage and do not seek care of any kind until late in pregnancy; are past the legal cut-off for abortion in their own state by the time they arrange money, child-care, transportation, time off of work, etc. necessary to obtain an abortion; are using a birth-control method and thus do not suspect pregnancy until later.
- A pregnant woman who cannot continue her pregnancy because of a condition which crops up late in pregnancy which will lead to significant health issue, either a pregnancy-specific disorder, a new illness like cancer, or an exacerbated chronic health condition.
When I told him how upset I was about Dr Tiller's murder, my partner said, "That kind of thing hardly ever happens,certainly not any more." OK, fair enough. But it happened today. Today, someone was murdered for helping women exercise autonomy over their bodies, for helping women enact difficult choices, like the ones I discussed above. When last I looked at the news, we didn't know much about the killer; the police were looking for a white guy in a certain color car. Operation Rescue had condemned the attack. Yet I still say with confidence that Dr Tiller was murdered because he provides abortions. He had already survived an attempt on his life for that reason, back in the bad old days when "that kind of thing" happened a lot more often. And yet those people, one of whom killed Dr. Tiller, get to call themselves, and have gotten everyone else to call them, "pro-life." This is what fills me with despair. The fact that he was killed while he sat at church suggests to me that Dr Tiller was a religious person. I am a religious person. And I believe, and I imagine he believed, that the medical procedures he provided were not murder. I wish the person who killed him, and all the "pro-lifers" who hate us and shame women and picket with gory signs, could entertain the possibility that Dr Tiller and I are right about this, that they do not necessarily know better what God thinks about abortion than we do. I sincerely hope that the person who did this turns out to be what they call "criminally insane," but I doubt that they will be. I think they will be a mostly sane person who thought they knew what was on the mind of their God, and it was killing Dr Tiller.
Dear Murder, If God had wanted Dr Tiller dead, he would have done it himself. Shame on you for thinking you know better than God.
Would the Murderer say the same about those of us who choose or provide abortion: "If God had wanted that baby dead, he would have done it himself"? Well, Dr Tiller's life was not contained inside and totally dependent on another being who did not want him there. But I have been told that we will never be able to change eachother's minds. I have to accept that they think we are murderers and they will kill us for it. But I can't help myself. I want to talk to them. I want them to understand.
Dear Pro-Lifers: If you want me to respect your position, please first work to end war and the death penalty and poverty and health care disparities, and STOP SHOOTING PEOPLE.
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I guess they were too busy writing the article undermining women's choices to terminate a pregnancy. "Study Links Abortion and Preemies" (found here) has quite a title, but they're already backpedaling by the second sentence. The data is from 1959 to 1966. Roe v. Wade? 1973. So, yes, folks, if we're talking about data from a time where abortions were illegal (and we include miscarriages as "abortions," which the study also does) then, yes, we've got a study that links abortion and premature births. Please note: this study does not demonstrate a link between safe, legal abortion performed by a trained health care provider and ANYTHING. "Women need to be informed about these risks," says the researcher who penned the study. But the truth is, as Time points out, this study doesn't really say anything about risks to women who choose abortion today. Grr.
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