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Wednesday, May 9, 2012

Waiting periods, Ultrasounds, and Crisis Pregnancy Centers: Shame, Disgrace and Punishment

The War on Women, and the war against choice in particular, have employed four powerful tools that some pro-choice individuals don't seem to think are important or wrong.  Mandatory ultrasounds, mandatory waiting periods, mandated physician supervision of medical (pill) abortion and "Crisis Pregnancy Centers" are all ways the anti-choice movement has tried to mislead the public into thinking they want women to make an informed decision about their pregnancy or make abortion safer, when their true motivation is simply to keep women with unwanted pregnancies from aborting, regardless of the cost.

Mandatory ultrasounds sound so innocent.  After all, shouldn't women know exactly what they are deciding against?  Doesn't looking at the embryo/fetus on the screen mean she has to think about it more? Isn't more information always a good thing?

Well, this is certainly what they want us to think.  In truth, we are living in the age of information.  Anyone who wants to know exactly what the fetus looks like, at any given stage, can look it up online in greater detail, with better pictures and descriptions, than can be had at an ultrasound.  Even without the ultrasound mandate, a woman could ALWAYS request an ultrasound to see what is going on inside her, even if she was going in for an abortion.  So, this is not facilitating more information.  Instead, it is an attempt to make the woman feel bad about her choice, a choice any woman in that situation agonizes over, analyzes, and typically researches before coming to a conclusion about what would be best for her, in her particular situation.

Showing her "the baby" and reading her a description of its functioning organs and abilities at the present stage of development, is all about trying to change her mind and make her feel ashamed of her choice.  The fact that this is not an option we're forcing doctors to offer, but rather a part of the procedure we're forcing women to be subjected to, says it all.  Women know what's going on, and they're out to make sure we feel terrible about making a choice we already didn't want to have to make.

Mandatory waiting periods are also a barrier to allowing women to retain their dignity and make their decisions without harassment.  Even a 24-hour waiting period is ridiculous.  The premise is that women need this time to make certain that they are firm in their decision to abort.  If that was really what lawmakers wanted, they would allow women to phone the doctor or clinic 24 hours ahead to start their waiting period at home.  No one could argue with the idea that a woman should have some time to think it over, right?

Actually, I would disagree with even a waiting period at home.  This polarizing political issue has become such a public spectacle, I seriously doubt anyone is unaware of it and what it entails.  Moreover, just about any woman I've ever talked to has at least thought about the "what ifs" of an unplanned pregnancy.  To assume that women need to be made to essentially "sit in time out and think about our actions" is to treat us as second class citizens and children.

Ultimately, the greatest argument against mandatory waiting periods is a medical one.  Time is crucial when a woman chooses to terminate her pregnancy.  The earlier she terminates, the less likely it is complications will arise and the cheaper it will be.  There is a fine line between the time when a woman is eligible to have a medical (pill) abortion, and a surgical one.  If she's too far along for a medical abortion, there is a fine line between whether she's eligible for the easier, cheaper, dilation and curettage (D&C,) or the more costly and harder to obtain dilation and evacuation (D&E.)  More doctors can help a woman in need of a medical abortion than of a D&C.  There are FAR more D&C providers than D&E ones.  Furthermore, the cost escalates as time passes.

But it's just 24 hours, right?  How much difference can one day make?  In the hypothetical, one day would, admittedly, make little difference in most circumstances.   But in the real world, most clinics cannot see you on the day you call to make an appointment, or even the next day.  So, if it takes a week to make that first appointment, then the next available appointment isn't for another week or so, this poor woman has added 2 weeks to her pregnancy.  It's not unreasonable to think that this timeline may have limited her options.

What about the mandate that doctors supervise their patients taking the first pill dose in a medical abortion?  Surely this is ethical and right?  I mean, we're just making sure the woman asking for the abortion is actually the one getting it.  It's important that she isn't taking the pills to another woman who hasn't seen a doctor (and one who is attempting to circumvent all the legal roadblocks to abortion set up by the anti-choice lobbyists.)

I'll agree whole-heartedly that it is best, in most circumstances, that a woman see a physician for her abortion.  This ensures that she is receiving the correct treatment in the safest possible environment, and that she will be immediately attended to in case of complications.  However, we need to understand that we live in the real world, where it can be very difficult to get an appointment at a busy doctor's office.  Doctors who would consider writing a prescription for a medical abortion might reconsider if they know they are going to have to schedule for a longer appointment (or two, in the case of states with mandatory waiting periods,) rather than simply writing a script.  If there's also a mandatory ultrasound, this further complicates things, making a doctor even more reluctant to provide this service for women.  The pool of abortion providers continues to get smaller and smaller.

The worst thing to happen to the pro-choice movement is the wave of "Crisis Pregnancy Centers," which now outnumber freestanding abortion clinics by 5:1.  The Crisis Pregnancy Center is a religious-based, anti-choice "clinic," usually set up with an ultrasound machine, designed to trick pregnant women into thinking they are going to an abortion clinic.  Instead they enter a place set up to look like a cozy, inviting room to comfort women through this difficult time.  They are offered free pregnancy tests and ultrasounds, while bloody videos of dismembered fetuses and botched abortions play in the waiting area.  The literature they provide is all anti-choice propaganda, and most of it is misinformation to further their agenda.  They are told things like abortions have been linked to an increased risk for breast cancer or that an abortion could kill you or permanently damage your fertility.  The former has been proven false and the latter is true in the same way that saying crossing the street could kill you is true.  Yes, it could, but the odds of it happening are so infinitesimal that they are negligible.  Those pamphlets certainly don't explain that carrying a pregnancy to term is far more dangerous than aborting.  They also tell their unsuspecting victims that condoms generally don't work and they tell their marks that most women experience so-called "post-abortion syndrome" after an abortion.  This "syndrome," by the way, is not recognized by either the American Psychiatric Association or the American Psychological Association.

The people who work there are coached on how to dodge certain questions like, "Do you do abortions here?" or "How can I keep this from happening again?"  They also play fast and loose with telling women how far along they are.  See, there are two ways to date a pregnancy, and both are valid.  You can date a pregnancy from the time of conception, which is usually about 2-3 weeks after the woman's last menstrual period, or you can date it from the date of her last menstrual period.  Since VERY few women know their date of conception, but almost all of them know when they were last bleeding, most doctors use the date of their last menstrual period for dating purposes.  So, in a way, a fetus can be both 9 and 11 weeks old simultaneously.

Why does this matter?  Because if a woman likely to have an abortion is told at a Crisis Pregnancy Center that she is two weeks less pregnant than she actually is by her last menstrual period, she might assume she has more time to think about terminating her pregnancy and therefore miss her state's legal cutoff, end up being unable to afford a more expensive procedure, or need a more involved and harder to obtain abortion.  On the other hand, sometimes they tell women they are more pregnant than they are if they think showing them a larger fetus "doll" might sway them.  So as not to lie, they tell them, "Looks like you're 9 weeks pregnant" (from last menstrual period.)  "Here is what a 9 week fetus looks like" (shows the woman a fetus that is 9 weeks from conception.)  See, they're not lying.  They're just not being entirely honest.

Here is a short video of an undercover exposure of a Crisis Pregnancy Center in New York City:

Now that you understand how ludicrous "Crisis Pregnancy Centers" are as proponents of women's health, you can see that the idea of sending women to one of these places for "pre-abortion counseling" is insane, incredibly offensive, and infuriating.  But that's exactly what has been proposed in South Dakota and a few other states.

I'd advise anyone interested in this fight to watch the documentary 12th & Delaware.  It's about an abortion clinic across the street from a "Crisis Pregnancy Center" and what goes on inside each.  I'd also appreciate support to prevent taxpayer dollars from going to fund these religious institutions.  I've started a petition here:!/petition/end-non-profit-status-and-tax-dollars-funding-religious-anti-choice-crisis-pregnancy-centers/pQBWZkZs

The truth of the matter is that chipping away at our freedom to choose is easier and more effective than directly challenging Roe v. Wade.  Understanding that the anti-choice movement's "reasonable regulations" are not reasonable at all in the real world, rather than simply in the abstract, and knowing that they are not motivated by an intent to protect or inform women, but rather by a ridiculous desire to restrict abortion further, is important.


  1. Quick question for you:
    With less and less doctors performing abortions these days, are you in favor of MAKING and FORCING doctors perform abortions when their religious beliefs are against abortion?

    Just curious where you draw that line. I don't support the idea that a pregnant woman or government has the right force a doctor to perform a procedure that he/she believes is morally (religious) wrong.

  2. No, of course doctors who are morally opposed to abortion should not be forced to preform them, although I do think that if this idea makes them squeamish they should look into something other than obstetrics and gynecology. I do think, for the sake of preserving women's health, that all Emergency Rooms and Urgent Care Facilities should be legally required to have a doctor on staff or on call who can preform emergency abortions for any gestational age. I also think that pharmacists should not be allowed to use their "moral objections" to refuse to fill a prescription. I think those people need to find a new line of work if they have a problem with this. A doctor can be a fine ob/gyn who does not perform abortions, but a pharmacist who refuses to help fill prescriptions is not doing their job, especially since they are not actually preforming an abortion themselves.

    I draw the line at limiting access. I think a lot more doctors would be open to helping women in need of early, medical abortions if they knew they could simply determine gestation and then prescribe the combination of pills. I think it should be legal to allow a nurse practitioner or RN to then explain the pill combination, side effects, and dosing instructions to the patient. This would allow more doctors to help more women, alleviate some of the scheduling issues with freestanding abortion clinics, and allow women an alternative to wading through the protestors in front of the clinics so that they can quietly visit their own doctor and take care of their problem with their own, trusted ob/gyn whom they've known for years.

    Great comment and question, Michele. Thanks for reading my blog!