Belly Tales

The Diary of a New Midwife

New hope for South Dakota

Filed under: Choice, Feminism, Politics, Women's Health — The Midwife at 2:53 pm on Saturday, October 25, 2008

As reported by the Daily Kos, a rigorous new poll shows that Measure 11, South Dakota’s latest attempt to ban abortion, might not pass as easily as everyone originally thought.  South Dakota’s initial attempt to ban abortion in 2006 was defeated by 56% to 44%, mainly because the bill included no exceptions for victims of rape and incest, or provisions for the mother’s health.  Now, in 2008, these exceptions have been inserted into the wording of the referendum, but as the Daily Kos points out, these provisions are largely superficial, and offer no real practical exceptions.  The general idea was that as soon as this wording was inserted, the South Dakota abortion ban would pass by a landslide, but thanks to a hard, uphill battle waged mainly by the South Dakota Campaign for Healthy Families, the latest polls show that Measure 11 might be shot down again, just like its 2006 counterpart.  According to the poll, if the vote were today, 44% would vote No, and 42% would vote Yes.  Which is really exciting, encouraging news, although the race is too close for comfort.

Even so, none of this changes the fact that women trying to access reproductive health care in South Dakota face a really tough challenge.  There is only one clinic in South Dakota which performs abortions, and they are done by a rotating staff of doctors who are flown in from neighboring states.  And again, as the Daily Kos has pointed out, the hoops that women in SD have to jump through before actually having the procedure done are incredibly daunting:

The woman must receive state-mandated “counseling.”

The woman must wait at least 24 hours after the state-mandated “counseling” before procedure may be provided.

If the patient is a minor, a parent or guardian of the patient must be notified.

The doctor must offer the woman an opportunity to view a sonogram, and must then record any responses in her permanent medical records.

The doctor must deliver a government-dictated script to women designed to intimidate her and discourage her decision. The mandatory language includes statements of fact which are contrary to all available medical research.

Usually by the time a woman is sitting across from me (a midwife) for her initial prenatal visit, she’s already made up her mind to keep her baby.  But every now and then I come across a woman who’s still conflicted, and we usually have a frank and very difficult discussion about whether she really wants this pregnancy or not, and everything that keeping this pregnancy entails.  This is a hard decision to make in a hospital like mine, sitting across from a provider like me who is resoundingly pro-choice, and is not at all judgemental or discouraging of the woman’s thoughts or decision.  These women are often young, alone, and already scared and intimidated, but if they really don’t feel like they can keep this pregnancy (for whatever reason–and we do talk about the reasons, but only to make sure that she’s thought everything through), I gently refer them to the termination of pregnancy clinic, with compassion and support.  No one is judging them.  Judgement is the LAST thing you should find in your health care provider’s office.

Now, imagine this were South Dakota.  Imagine how much harder it would be to make such a decision if I were legally required to read these women a script containing statements which are medically false and which do nothing but make the woman feel even more intimidated and guilty about her decision.  If I were forced by state regulations to make it very clear that I think abortion is a terrible idea, it would take a very staunch woman indeed to be able to stand up to something like that (and this is not because I’m so terribly persuasive, but only because the power of the white coat is astounding: people automatically trust you a little bit more and believe you’re speaking the truth, just because you’ve got a white coat on.  If you tell them that they need to eat more iron-rich foods because they’re anemic, they generally listen to you.  If you tell them that what they’re doing is wrong, they listen to you too).  And then, to top it off, I’d have to offer these women a sonogram, just so they can see that heart beating some more, and feel even more like a monster for doing what they feel they have to do.  The cruelty of it makes my skin crawl.

In any case, the reproductive rights of the women of South Dakota hang in the balance (and by proxy, the women of the rest of this country too, because if this referendum passes in South Dakota, it’s just opening the door for every other state).  And do not be fooled: the inclusion of exceptions into the wording of the bill in no way changes the fact that this referendum will basically make all abortions in South Dakota illegal, because there is absolutely no practical way to carry out these exceptions, and no doctor willing to test it.  So, what can we do about it?  We can donate money to the South Dakota Campaign for Healthy Families, and we can…(to put a rather neo-conservative spin on it)…pray.

3 Comments »

Comment by Ritsumei

October 25, 2008 @ 6:05 pm

I can’t speak to the medical accuracy of the statement, but the rest of it doesn’t sound so bad to me, actually. Women have choice - but they exercise that choice as much in the act of having sex as they do in the act of deciding to end another life. Exemptions for rape ect. address that lack of choice. Why is it horrible to ask people to take responsibility for the consequences of their actions BEFORE another innocent life is on the line?? Why is the only choice that counts, the only choice that really allows “reproductive freedom,” a choice to kill?

Comment by The Midwife

October 25, 2008 @ 11:39 pm

The problem, in this case, is that there are no true exceptions for women who’ve been raped or who have medical contraindications against having a baby. There are no South Dakotan doctors who will perform an abortion, and there is no doctor in South Dakota willing to stake his livelihood and his license on trying to test this referendum. So essentially, if this referendum passes, abortion will be illegal in South Dakota, period.

Again, quoting the Daily Kos, look what a woman would have to go through to prove that she was raped and satisfy the demands of the law under this referendum:

“Under the ban, even a woman pregnant because she was violently raped can obtain an abortion only if she or her doctor immediately report the rape and, subsequent to the abortion procedure, submit a “buccal or other biological sample from the woman, and a tissue sample from the remains of the embryo or fetus, each sufficient to perform forensic DNA analysis” to law enforcement. In other words, in order to obtain medical care, a woman who has just been violated needs to provide the police with her DNA. So that they can, conceivably, investigate if she’s lying.”

What a terible burden of proof to lay at the feet of a woman who’s just been brutally traumatized, and doesn’t want to have to bear the results of that trauma for the rest of her life! Similarly, the provision for medical exception is so vague that it will never be a useful tool:

“Likewise, a woman seeking an abortion because of an imminent threat to her health has little recourse. The “health exception” touted by anti-choicers is fantastically vague, clearly does not cover certain serious threats to the well-being of women which can be caused by pregnancy [oh, say...like severe preeclampsia?], and provides no safe harbor to physicians. Doctors facing ten years in prison if they violate the ban will be loath to test the health exception provision.”

These exceptions are thrown into the bill only to try to sugarcoat the totalitarianism of it.

You’re right: sex IS a choice, and under ideal circumstances, it happens in a loving, supportive realtionship with the intent of making a baby. But life is messy and complicated, and an incontrovertible aspect of life on this planet is the fact that there are thousands…millions…of unplanned pregnancies each year. People may have sex while using birth control (i.e. taking responsibility for their decision to have sex), but birth control is never 100%, and can sometimes fail. Or sometimes people just have accidents, like a married 46 year old woman with 4 grown children who’s now pregnant again, and feels it in her bones that she just doesn’t have it in her to raise another child.

Accidents happen, but children should never be brought into this world unwanted. Every child that’s born should be born into a family that wants him or her, and is prepared to raise and nurture that child. If a woman becomes accidentally pregnant, I don’t feel like she should be forced to have and raise a child she doesn’t want. And sure, adoption is an option, but again, the red tape and severe lack of resources makes this a difficult choice to pursue, and many women don’t even know how to initiate it. It’s not like there’s an adoption agency on every corner willing to take every unwanted child into it’s loving arms. The system is overburdened, resources are scarce, the wait times are unbelievable, and growing up in foster care can sometimes be a very damaging environment to children (sometimes…this is not to say that there aren’t amazing, loving, fabulous foster parents out there!).

I’m not pro-abortion, I am pro-CHOICE. I am by no means suggesting that all women who accidentally become pregnant should have an abortion. Many women decide that they can and should keep the baby, and that they have the love and resources necessary to raise and support the child, and in that case, their accident becomes a blessing. So that is the other side of the choice, and not every choice made is a choice to kill. But the key to choice is that it is the woman’s CHOICE. As a supporter of choice, I firmly believe that I can’t make this decision for anyone else other than myself. I haven’t walked a mile in the shoes of the woman who chooses to keep her baby against unbearable odds, or the woman who feels like she absolutely, under no circumstances, can have and raise a child, for whatever reasons. I feel like I can’t make that decision for them, and therefore I can’t judge other people’s decisions, and that’s why I believe in choice. Women need to have this choice so that they can judge for themselves. Isn’t that in the bible too? Judge not lest ye be judged?

Making abortion illegal removes that choice, and basically says that women are not fit to make their own decisions and judgements regarding their own bodies. If this referendum is passed, the law will say: you will have this baby, whether you want it or not. The law doesn’t have to walk in that woman’s shoes, and it doesn’t have to figure out how to feed or clothe that baby, or how to love a baby that wasn’t wanted. The law just says it’s illegal, period. Unfortunately, women aren’t going to suddenly stop having accidents just because abortion is suddenly illegal. The only thing that will change is that instead of having abortions in clean facilities with medically-trained staff, they will be taking pills and poisoning their bodies and using coat hangers. That’s why I want abortion to remain legal in this country. Not so that more woman will have abortions, but to prevent desperate women from doing desperate things.

And in the meantime, as a midwife I am doing everything I can to teach women about their bodies, to teach them about safe sex, to educate them about birth control and their options and to prescribe birth control so that there are fewer accidents, and most importantly, to listen to them without judgement and to accept their decisions without judgement. To me, that’s one of the most important aspects of being a health care provider, and that’s why the Department of Health and Human Services latest regulation on conscious choice has really gotten under my skin…but I’ll save that for a seperate post.

Comment by Ritsumei

October 26, 2008 @ 9:38 pm

First of all, thank you for your sane response! I was a little nervous, disagreeing. Sometimes it’s hard to find someone who disagrees but is still able to carry on a civil conversation. But I always learn so much when it does happen!

I agree, the limitations on this particular bill sound troubling. Particularly the retaliation against doctors who, it sounds like, are acting in good faith that they are working within the law. This troubles even me, and I am firmly against abortion in almost all cases (rape and Mom’s health being the big exceptions). I agree, that is a terrible burden to place on a woman who’s just been savaged. There are clearly some serious problems with this piece of legislation as you have explained it.

One thing that I struggle with in regards to abortion is the questions of liberty vs. life. As I have done my best to be a responsible voter in this election I’ve come to realize that we are no where as free as we think we are and our federal government is something of a bloated tick. It’s grown way past the size that it was intended by the framers. This bothers me immensely. When you cherish freedom for yourself you have to recognize that others will use their freedoms in ways you find offensive. And their freedom is still just as precious as your own. Any less than that and that precious freedom slips away little by little.

On the other hand, there is no doubt in my mind that a child is a child is a child. The decision to abort a pregnancy is a decision to end a life. A helpless, innocent life. And so often this is ignored or denied by those who insist that abortion is necessary for choice. Killing a newborn is punishable by law. I don’t know of anyone (other than Mr. Obama, but as you say that’s another conversation) that is for killing a newborn. It’s morally wrong, no matter how you approach it. I just don’t see a lot of difference between the new-born and the pre-born.

The adoption issues are interesting. If the same resources that go into making abortion easily available went into making adoption easily available I think that a lot of the obstacles that you talk about would evaporate. If Planned Parenthood would do more than just pay lip-service to alternatives other than abortion (and I’ve looked at their statistics), it would be a huge start.

At the same time, I find the argument that adoption is not available, not workable, to be disingenuous. I suffer from infertility due to PCOS. It took us 8 years to achieve a winning pregnancy, for a variety of reasons. In that time one of the things that we did was look very seriously at adoption. For infants, which is what we’re talking about here, there are more adoptive parents than infants. The problems that you talk about with foster care, wait times, ect., seemed to mostly apply to the older kids. It’s much harder to find a good adoptive home for an older child. But infants, the parents wait in line. If one wishes to avoid the public systems then I know that the Catholic church, the Lutherans, and the Mormons all have adoption services. I’m Mormon myself, so I know the most about LDS Social Services. I believe that the birth mothers have a great deal of control over the process, up to and including choosing the adoptive parents. I also believe that pretty much all the states have a period of time where the birth mother can change her mind about going through with the adoption. Sometimes even after the child has been placed with the new family. That’s why we didn’t go too far with the idea of domestic adoption: we weren’t willing to risk loosing a baby that we’d already accepted into our family & hearts. How much of the “unavailability” of adoption services comes from the knee-jerk reaction of providers offering abortion and glossing over adoption? Sure, adoption is more work. But at the end of the 9 months you’ve saved a life and added immeasurable joy to a family.

I think that my feelings about adoption are nicely summed up by some lyrics from one of Michael McLean’s songs:

“But then, the gift is given,
There’s a phone call straight from heaven.
There’s a child that’s nearly due
That a young girl’s giving you.
She gives more than just one life
When she makes of this man and wife
A father and a mother.
When she gives the gift
We could not give each other.”

He’s got another one celebrating birth mothers, but this one has always resonated more strongly with me. The reasons should be pretty obvious.

With the infertility numbers that we have, the idea that adoption isn’t a viable option seems ludicrous. I’ve mourned strangers aborted babies nearly as strongly as I mourned my own loss when I had an early miscarriage. They CHOSE to stop being pregnant. I would have given anything to finish for them!

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