On the heels of two more states moving forward with passing measures to severely restrict women’s access to abortion, my mind is having trouble letting go of some of the most blatant double-talk I’ve seen in a while.
But first, a little background on the happenings this week.
On Thursday, the North Carolina House passed a bill that includes a 20 week ban, a requirement for all abortion providers to be licensed ambulatory surgical centers (which will likely close all but one clinic in the entire state), a prohibition on abortions for the reason of gender, curb abortion insurance coverage, and expand the ability of HCP’s to not participate in abortions on moral or ethical grounds.
Around midnight Friday night, the Texas senate passed House Bill 2, which requires doctors to have admitting privileges at nearby hospitals, allow abortions only in surgical centers, limit where and when women may take abortion-inducing pills and ban abortions after 20 weeks. Only five out of 42 existing abortion clinics meet the requirements to be a surgical center, and clinic owners say they can’t afford to upgrade or relocate.
ACOG speaks up for women
Leading up to the proceedings in Texas, ACOG released an open letter, titled, “Get out of Our Exam Rooms.” I have to tell you, I loved it. From the snarky-ness of the title to the logical and educated responses to the legislative nonsense it was a surprising in-your-face call to politicians to pull their hands out from where they have no business groping around.
But that euphoria was instantly mixed with confusion. Wait a minute, I thought. How is it that this organization is telling politicians that they have no place making health care decisions for women – that these choices should be between a woman and her care provider – while they simultaneously work to restrict women’s rights in birth? (See here for their deep investment in limiting a woman’s birthing rights in California.)
In quoting the major medical organizations’ position (American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Surgeons, and the American College of Physicians) in The New England Journal of Medicine, they assert:
“Legislators, regrettably, often propose new laws or regulations for political or other reasons unrelated to the scientific evidence and counter to the health care needs of patients. Legislative mandates to the practice of medicine do not allow for the infinite array of exceptions where the mandate may be unnecessary, inappropriate, or even harmful to an individual patient. …Lawmakers would also do well to remember that patient autonomy as well as individual needs, values, and preferences must be respected.”
Absolutely this is true. How is it, then, that ACOG holds a double standard for when it is okay for legislators to step in and impose non-evidence based restrictions on women’s health care – specifically when it comes to a woman’s right to choose when, where and how she gives birth? Why is it okay to trample on a woman’s autonomy where her birth choices are considered, but not where other areas of her reproductive health choices are concerned? Are these not inextricably linked? How do these values of autonomy and recognition of the importance of individualized care and choice not intersect?
“These proposed requirements … would only make it extremely difficult or impossible for most clinics … to stay open.”
Again, calling it like it is. These restrictions are about limiting a woman’s ability to access abortion under the guise of protecting women. And I can’t help but make the connection AGAIN to the issue of homebirth. In states like Delaware and California, the law requires midwives to be overseen by physicians. This is a staunch position that ACOG not only strongly supports, but expensively and tirelessly lobbies for on the legislative front. It puts forth a motivation of safety and continuity of care, but in actuality it ensures that no midwife would be able to practice, legally. As they know, the stipulation is unattainable due to physician’s liability insurance restrictions.
The result and motivator in both the abortion measure and midwifery legislation is the same – under the smoke and mirrors of making care “safe” for women, the true and ultimate investment in the stipulations is to restrict women’s ability to access care.
And, hold on, because this part’s my favorite:
“Women across this nation are completely capable of making their own medical decisions with their physicians, as they make many other important decisions every day for themselves, their families, and their businesses. Women do not need—or want—any government to make medical decisions for them.”
WORD. Thank you, ACOG. Though I think we can safely insert “care provider of our choosing,” which may or may not be a physician. Exciting to see that we have all arrived on the same page! I encourage the organizing groups in California to use ACOG’s own language, here, to support their cause in advocating for the removal of restrictive guidelines, and for insisting on maintaining women’s autonomy without governmental interference in ALL ASPECTS of reproductive health – including birth!