War on Women
In 1980, Dwinna Barker was a divorced mother in Amarillo who had just lost one of her two young children to Reyes syndrome. She had also been laid off from a well-paid job.
“After two months of unemployment, I was lucky to find work with Bell Helicopter in the Fort Worth area, which I badly needed. … I was desperate with all the unpaid medical bills and another small child and no help whatsoever,” she said. Her insurance had expired just days before her daughter was diagnosed with Reyes, a nearly always fatal disease that attacks the brains and livers of children, but whose cause is unknown.
She took the “lowest job on the totem pole” at Bell, but at least it included health insurance.
Within a few months, Barker began bleeding vaginally “all the time,” she said, and suffered severe pelvic pain. She went to a gynecologist in the Bell insurance program who treated her with multiple antibiotics for several months, diagnosing her with gonorrhea even though he had not done any cultures. “I was not getting better, and I could not take more time off work. I was desperate,” she said.
A friend recommended she go to Planned Parenthood. “I didn’t even know what they did.” She got her first exam there for $6. “I couldn’t believe it,” she said.
The doctor at the reproductive health clinic gave her a complete exam, including cultures, and called her back within a few days. There was no sign of gonorrhea but something much worse.
“I had uterine cancer,” she said. “They gave me the name of a surgeon and told me to see him ASAP.” Barker had an emergency hysterectomy.
“Amazingly, I was diagnosed in time, before the cancer had spread,” she said. “I was very lucky. The gynecologist I had been going to had just taken my insurance money in exchange for terrible care, but that happens all over this country every day, especially to the poor. I’ve never heard of it happening at Planned Parenthood.
“As far as I’m concerned, Planned Parenthood saved my life, and it has saved the lives of many, many others,” she said.
The idea of conservatives trying to de-fund Planned Parenthood is outrageous, she said. “It would be a real tragedy to cheat women who cannot afford expensive medical care out of this wonderful option for excellent care that everyone can afford. … How can anyone think that would be the right thing to do?”
Barker’s question is one that thousands of outraged women around the country are asking, as conservative lawmakers, Catholic bishops, Republican presidential hopefuls, and right-wing radio hosts push for drastic changes in law and policy — in Texas and other states as well as in Washington — that would deny women access to contraception and reproductive health programs, including screening for breast, uterine, and ovarian cancer.
Women in Texas and around the country are calling the attacks on women’s health a “war on women” and a “regression to the Victorian era.” They are rising up in considerable strength to fight back, from older organizations such as the National Organization for Women, the Feminist Majority, and the Center for Reproductive Rights to newer groups such as HERvotes, a coalition made up of 51 feminist groups “coming together for Elections 2012,” to work on issues from health to the economy, according to organizer Kathy Bonk.
And this time, as the recent blow-up over the Komen Foundation’s defunding of Planned Parenthood proved, they are using social media to help them organize at the speed of a Twitter post.
The extent — and in some cases the vicious nature — of the attacks on women’s healthcare are breathtaking. Republicans in the U.S. House of Representatives have floated a bill that would deny health insurance coverage to all women — 30 percent or more of the women in this country — who have ever had an abortion.
The Republican budget plan would remove all funding for the 40-year-old Title X family-planning program that provides five million women with access to contraception and family-planning services at local clinics. The program, which in the past has had strong bipartisan support, is credited with reducing teen pregnancies and abortions and saving $4 for every dollar it costs.
A few weeks ago, Foster Friess, a billionaire supporter of Republican presidential hopeful Rick Santorum, told Andrea Mitchell on MSNBC that in his day “gals” used aspirin as birth control — “They just put one between their knees.” The attempt at humor left the veteran newswoman speechless.
Then there was the attack by radio talk show host and Republican consultant Rush Limbaugh on female law student Sandra Fluke, whom he called a “slut” and a “prostitute” because she testified before a congressional hearing about the need for contraceptives to be available to college students without co-pays. Limbaugh eventually was pressured to apologize — but not before he stooped so low as to call for Fluke to send him videos of her having sex so he could get something for the money that he as a taxpayer was spending for her contraceptives.
Women’s groups overnight began a campaign to boycott Limbaugh’s advertisers. As of Tuesday, nine advertisers had pulled their ads, two radio stations had dropped his program, and Fluke had gotten a call from President Barack Obama congratulating her for her courage.
In Texas, the state’s highly successful Medicaid Women’s Health Program (WHP) will shut down March 14 due to a measure advocated by Gov. Rick Perry and passed by the Republican-dominated Texas Legislature. The measure cuts state and federal funds to the program if any of the money goes to female health providers for basic medical services, if that provider also performs abortions such as Planned Parenthood does — even though none of the money, by law, is used for abortion services.
And the state’s sonogram law, considered to be among the most draconian in the country, has already gone into effect. It requires women to have an invasive and painful sonogram 24 hours before an abortion,
State Sen. Wendy Davis of Fort Worth said that, based on the number of calls her office is getting, she believes such attacks are going to have a dramatic impact on the upcoming presidential election, to the benefit of President Obama and the Democratic Party.
“The outcry is extreme, from Democratic and Republican women alike,” she said.
Local Republican Party officials did not return phone calls seeking comment.
Davis recounted a story by former Republican Lt. Gov. Bill Ratliff, talking about the Mothers Against Drunk Driving group and their success in forcing drastic changes in state law.
“ When Mama Bear gets mad, change occurs,” Davis quoted Ratliff as saying.
And right now, she said, “Mama Bear is mad.”
When the seven-year-old Medicaid Women’s Health Program shuts down in Texas next week, Davis said, about 200,000 women will lose access to basic reproductive healthcare, from cancer screenings such as the one that saved Barker’s life to contraception services.
Davis said the legislature has also taken 66 percent of funding away from the state’s family-planning budget, a separate program paid for with state tax dollars as well as money that “flows through” from the federal government. Those cuts will drop more than 200,000 women from that program, raising the numbers of women in Texas who have lost their health safety net to nearly half a million.
The WHP program is closing because the state’s health commissioners are about to begin enforcing a new regulation inserted into an omnibus health bill sponsored last year by Republican State Sen. Jane Nelson and signed by Perry that prevents any state money from going to otherwise qualified healthcare providers that are affiliated with abortion clinics.
The clause was added even though abortion clinics receive no funds from the Medicaid program, said Davis, who voted against it. She called the measure a direct attack on Planned Parenthood, the 75-year-old family-planning organization that has become the evil poster child for those who want to ban abortions in this country.
In a statement, Planned Parenthood of Texas called the moves “sabotage” of an “incredibly important program.”
Kelly Hart, communications director for Planned Parenthood of North Texas said that about 44 percent of the women enrolled in WHP use a Planned Parenthood clinic as their primary healthcare provider. However, she emphasized, “No federal funds go to the abortion providers. None.”
WHP is a Medicaid-waiver program established in 2005 by the George W. Bush administration to help poor women between the ages of 18 and 45, who otherwise would not qualify for Medicaid, get reproductive healthcare at little to no cost. The federal government picks up 90 percent of the bill, leaving the states to cover only 10 percent.
The services covered include screenings for breast, uterine, and cervical cancers and for diabetes; annual exams; testing for sexually transmitted diseases; and birth control.
Both Hart and Davis said the program has not only kept women healthy and cut down on abortions but has also saved Texas taxpayers more than $42 million a year by preventing unwanted pregnancies — since about half of all pregnancy care in Texas is paid for by Medicaid. Last year, Medicaid coverage for prenatal care, labor, and delivery cost the state an estimated $2.7 billion. “That cost will go up dramatically,” Davis said, “and so will the number of abortions.”
The Obama administration has told Texas officials that the rule is unconstitutional and a violation of federal law because it restricts the rights of patients to go to the doctor or clinic of their choice. If Texas adopted the rule, the Obama administration said, the state, by law, would lose its federal funding.
Perry justified the action as necessary to protect the “unborn.” Nelson said it is a “state’s rights” issue, laying the blame on the Obama administration that she said “has no authority to dictate which Texas providers can participate in our Medicaid program.”
What it all means, Davis said, is that the lives of hundreds of thousands of low-income women across the state will be put at risk as they will no longer have access to mammograms, Pap smears, the pill, or treatments for sexually transmitted diseases, among a host of other “well-woman” services the clinics provide.
In addition, Nelson’s so-called “health reform bill” cut back state funding for the family-planning program mentioned above from $100 million two years ago to $38 million for the next two years, Davis said.
That cutback, Davis said, has already been responsible for the closing of 22 family-planning clinics statewide, most of them run by Planned Parenthood. The hardest-hit area has been South Texas, she said, where the only healthcare available to most women was provided via the WHP clinics run by Planned Parenthood and another nonprofit, Community Action of Central Texas Inc.
Out of 13 clinics once operating in the vast region, only two remain, she said. In some rural areas of West Texas, Planned Parenthood is the only provider of reproductive health services for women.
Davis called the cutbacks a fraud perpetrated by politicians who are using abortion to appeal to the “right-wing ideological base” of the Republican Party. “If what they want is to reduce abortions, why take contraceptive care away?” she said.
“The women who are left without other types of healthcare will find it in the emergency rooms and the public hospitals such as John Peter Smith, and the taxpayers will pay,” Davis said. “It doesn’t make sense from a moral perspective or a fiscal perspective.”
“I do not know if the program can be saved,” Hart wrote in an e-mail to Fort Worth Weekly. “We would hope that the legislative leadership will rethink this disastrous decision and return to the current program structure. Women’s health should not be politicized.”
However, in an e-mail statement to the Weekly, Nelson shifted the blame for the program’s demise to the federal government.
Interruption of care provided by the WHP program “will have a devastating impact on the health of Texas women,” she said, but “the blame will lie squarely on the shoulders of the federal government, which has no authority to dictate which Texas providers can participate in our Medicaid program.
“Our state policy has been in place since 2005 as prescribed by the Texas Legislature and is only now being enforced by our Health and Human Services,” she wrote. “This is yet another intrusion into state’s rights, and I am disappointed that the administration would jeopardize women’s health to score political points with the extreme left.”
In an editorial sent to news outlets on March 1, Perry also laid the blame on the president’s shoulders and admitted the fight was over abortion.
“We will continue to fight back against all manner of federal encroachment into our lives and any and all efforts to destroy or dilute the protections we’ve put in place for our unborn,” he wrote.
In the meantime, Hart and her colleagues are busy raising money for a patient-assistance fund to help blunt the impact of the changes. “Our costs for services are already discounted, but we now have a fund for those patients who will be affected by the loss of this program. We will do everything we can to continue providing care for our patients,” she said.
Planned Parenthood offers abortions — legal in this country since 1973 — at a handful of its 800 clinics around the country, at no cost to taxpayers. In fact, Hart pointed out that the family planning and basic well-woman’s healthcare its clinics provide “prevent unwanted pregnancies which reduces the need for abortions.” In Fort Worth, of the six Planned Parenthood clinics scattered throughout the city that offer reproductive health services, only one performs abortions. (That clinic also offers vasectomies, performing 94 last year. There have been no protests about that service from those who want to ban abortions and contraceptives, Hart said.)
Amy Hagstrom Miller, president of Whole Women’s Health, an Austin abortion provider with a clinic in Fort Worth, said she believes the anti-abortion groups’ efforts ultimately will be futile. “Women will do whatever it takes to terminate a pregnancy when they know in their hearts … that it’s not time for them to bring a life into this world,” she said. “They always have, and they always will.”
But since Roe v. Wade, the landmark Supreme Court decision that made abortion legal, women have not had to rely on the dangerous methods of the past — such as drinking lye, using coat hangers or scissors, or going to back-alley abortionists where they often bled to death, died later from infection, or were left so damaged internally that they were never able to conceive again.
It was usually the poor and young women afraid to tell their parents they were pregnant who suffered; rich women could always go to Mexico, said Linda LaBeau, a Fort Worth nurse who worked in one of the first clinics in the country to offer abortions following the Supreme Court decision. “We were a pioneering clinic,” she said in a recent interview. “We had women from all walks of life. But now I fear we’re going to wind up back where we were before the pill, before Roe v. Wade.”
That is what makes the effort to defund women’s health programs so egregious, she said. “This is an attack on poor women’s reproductive freedoms and the health of their children.”
Texas’ sonogram bill, passed during the last legislative session and signed by Perry as an “emergency,” is now being followed by the state’s abortion providers, albeit under protest. “We don’t like it, but we are following the law to the letter,” Hart said.
The law — and similar ones in several other states — mandates that a woman seeking an abortion must first undergo either a “jelly-on-the-belly” sonogram, which isn’t invasive, or a transvaginal sonogram, which is. The latter — one that some women have described as “very painful” — involves inserting a 10-inch probe deep into the vagina in order to record sound-wave pictures of the fetus. The transvaginal sonogram is mandated for very early pregnancies, which is the case in most abortions, said Miller, whose company operates clinics in six cities around the country.
Terry O’Neill, head of NOW, called the sonogram law “state-sponsored rape.”
Melissa Harris-Perry, Tulane professor and MSNBC news commentator, put it even more bluntly: “Your governor wants to get up in your vagina and take pictures,” she said, when Perry signed the bill.
The law mandates that the patient’s doctor describe what the woman is seeing in detail and play the sound of the fetal heartbeat if there is one. (The woman does have the option to not look and to cover her ears as some women reportedly have done. Her doctor, however, must continue to recite the state-mandated script.) Then the woman must go home and wait 24 hours before coming back for the abortion. — unless she lives more than 100 miles away. In that case she simply has to wait two hours. Adding insult to injury, the woman must pay for the added procedure. There is no provision in the bill for funds to help offset the added cost.
Miller said many of her patients are working mothers who must take time off from work and find someone to care for their other children. “We have patients from West Texas who may live just short of that 100-mile radius, and they must spend two or more days on the road or stay in a motel here while they wait.” Even those who live close will miss two days of work, she said.
Miller’s clinics have been adhering to the new law since October, she said. “Yet, not one women has decided not to terminate her pregnancy based on the sonogram,” she said.
“My patients know they must follow the law, and they do,” she said. “But they are upset about it.” She called abortion a wrenching personal decision “that the state should not have any involvement in.”
Fees are approximately $350 for the procedure and follow-up care. Donor funds are available to help low-income women, she said. No tax dollars are involved.
Miller said her clinic performs 50 to 60 abortions a week here. Evangelical religious protesters are a regular part of the day, “and their numbers seem to be increasing,” she said. “We have a lot of volunteers, including Medical Students for Choice, who escort the women into the clinic.”
The New York City-based Center for Reproductive Rights filed a class- action lawsuit last year challenging the constitutionality of the Texas sonogram law on behalf of Texas doctors who are also “representing the rights of their patients,” said the center’s senior staff lawyer, Julie Rikelman.
The Texas law is “one of the most extreme” in the country, she said. “It is a terrible position for doctors to be put in” because it forces them to do a procedure that is not medically necessary while taking away their right to make that decision on behalf of their patient, she said.
In August, U.S. District Judge Sam Sparks of San Antonio ruled that the law is unconstitutional and a violation of the First Amendment rights of physicians, forcing them to “advance an ideological agenda with which they may not agree, regardless of any medical necessity and irrespective of whether the pregnant women wish to listen.”
He granted a temporary injunction halting its implementation until the case could be heard on its merits. However, the ruling was quickly overturned by a three-judge panel of the U. S. Fifth Circuit Court of Appeals, one of the most conservative appellate courts in the country according to Rikelman.
In what Rikelman described as a “very unusual ruling,” the appeals court judges also wrote that any appeal of their order must be heard by the “very same three judges who overturned Judge Sparks. … That doesn’t give us much hope that an appeal [of the injunctive order] will be any different.”
A federal judge in North Carolina recently ordered an injunction against a similar law there, citing a violation of the First Amendment. The center is encouraged by that ruling, Rikelman said, but has not made a decision on what their next move should be in the Texas case.
On the national stage, Republican presidential candidate Rick Santorum has been preaching for months about the evils of contraceptives and his support of the states’ right to ban them.
Obama stirred the ire of the Catholic bishops, along with that of Santorum and his rivals for the Republican presidential nomination, when he ruled that, under his Affordable Health Care Act, Catholic institutions such as universities and hospitals, must provide non-Catholic employees with access to no-co-pay contraception through their health insurance. The Catholic Church views artificial contraception as a sin, even though polls show that a majority of Catholics practice some form of birth control.
However, the Obama administration declared that even Catholic employers, outside of direct church operations, must abide by labor laws that require equal access to benefits for all employees. In a compromise with the bishops, Obama declared that the insurance provider, not the Catholic institution, must pay for those employees’ contraceptive coverage.
Pat Svacina, communications director for the Catholic Diocese of Fort Worth, said that there are no large Catholic institutions in the city such as a hospital or a university that would fall under the ruling. Local Catholic schools and the Catholic Charities agency are considered to be “arms of the diocese,” he said, and therefore are not required to provide coverage for contraceptives.
At the federal level, a proposed amendment to a highway funding bill was proposed by Sen. Roy Blunt of Missouri last week that would have expanded the “religious liberty” exemption for Catholics into a broad range of exemptions for any employer who might object to various medical procedures on “moral” grounds, such as HIV/AIDS testing, blood transfusions, cervical cancer screening, contraception, mammograms, and even maternity care.
Senate Majority Leader Harry Reid objected, saying it was a distraction from the underlying legislation, forcing the Senate to table the amendment. Feminists claimed a major victory, after groups like the National Abortion Rights Action League mounted a campaign to stop it.
Such amendments “are just the first of what we expect to be many similar attacks,” aimed at stopping abortions, NARAL president Nancy Keenan told MSNBC news. “We have to recognize these attacks for what they are — blatant attempts to redefine religious liberty as the ability to impose one’s religious beliefs and convictions on other people.”
U.S. Rep. Mike Pence, a Republican from Indiana, recently tacked an amendment onto the budget bill that would bar any federal financing of Planned Parenthood because the nonprofit family- planning service offers abortions at some of its clinics — even though no federal funds are used to pay for abortions.
The resolution would also deny funding for international family-planning organizations and reproductive healthcare, reinstituting a controversial order imposed by George W. Bush but lifted by Obama when he took office. (Obama has also rescinded Bush’s order to grant legal protections to health providers who refuse to perform abortions, refuse to offer emergency contraception to rape victims, or refuse to fill prescriptions for contraceptives.)
House Republicans introduced the bill to deny health coverage to any woman who has had an abortion and the budget plan to delete the Title X family planning program. And another House bill would allow hospitals receiving federal funds to refuse to terminate a pregnancy even when it is necessary to save the life of the mother.
Planned Parenthood has provided basic reproductive health care to one in five American women at least once in their lifetimes, according to the nonprofit’s website. Even more significant, its founder, family-planning advocate Margaret Sanger, was the primary mover in the 1950s behind the development of “the pill,” the little oral contraceptive that arguably has done more to liberate women than any other scientific breakthrough of the last century.
Cindy Fountain of Cleburne said birth control pills have been critical to her health.
“The type I take, which is an old-style generic, was prescribed for me to help control my menstrual periods. I went for several years in my mid to late 40s with out-of-control periods — not knowing when they were going to start, tons of bleeding,” she said. She even became anemic at one point. She was about to have to undergo surgery, she said, when her doctor finally prescribed the birth control pills that solved the problem.
Now, she said, “I am just waiting for menopause. But if it weren’t for this pill, I would have probably had a hysterectomy.”
Birth control has allowed women to manage their reproductive health needs, plan the size of their families, and as Lynn Parramore wrote recently in an essay on conservative men’s fear of irrelevance, “reliably earn a living, thus rendering men economically unnecessary.”
Such liberation seems to have scared the bejeebers out of some men who yearn for a return to a time when “gender roles were strictly defined — and when men did the defining,” Parramore wrote.
In the South Texas city of Victoria, the Women’s Donor Network, which focuses on women’s reproductive health, has signed up as a member of HERvotes (Health and Economic Rights), a recently formed coalition of 51 women’s organizations.
According to Margery Engel Loeb of the Donor Network, the coalition will work to mobilize women voters this year to work against the “right-wing conservative attacks” on contraception and other key gains that women made in the last century. In Texas, the coalition is also working to overturn the decision to defund the Women’s Health Program.
Loeb, 63, a progressive activist in South Texas for most of her adult life, said that the diverse groups already committed to HERvotes range from the Black Women’s Health Imperative to NOW to the National Conference of Puerto Rican Women to the General Coalition of Women’s Clubs.
Those groups have come together, she said, over the issues of women’s health and access to birth control, including the Affordable Health Care Act. In August, Loeb said, “a ton of policies benefiting women’s health will be mandated” under that law. Services ranging from Pap smears to maternity care to contraception will have to be covered in insurance policies, she said, without increasing the premiums, as the old system allowed. And insurers will no longer be able to turn women down for coverage on the basis of “pre-existing conditions” such as pregnancy or spousal abuse.
“It is an important beginning,” Loeb said.
She said studies show that once women — and men — understand what the act really does, they usually embrace it. Loeb intends to make those benefits known, she said, by campaigning around the state — and she wishes more women would join in that work.
Loeb said she’s disappointed that Texas women have not “mobilized and organized” as Virginia women have done over the broad attacks on women’s health issues and the sonogram bill in particular.
In Virginia, she said, relentless protests over that state’s bill influenced legislators to remove provisions that would have required the transvaginal sonograms and to add a provision making the tests optional for victims of rape and incest.
“We are committed to broadening the debate over women’s issues from that of abortion to the broader issues of women’s health,” Loeb said. Men always try to make the debate on women’s health focus on abortion alone, she said, but “it is so much more than that.”