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Missouri: A Case Study

The New York Times covered it a while back, but now Time Magazine has jumped on board to examine Missouri’s extreme limits on abortion rights — to the point where getting an abortion in Missouri is nearly impossible.

Consider, for example, the case of a 22-year-old unmarried woman we will call Lisa, who missed her period last November. Lisa, who was managing a restaurant, decided to have an abortion. Her timing could have been better. Just the month before, Springfield’s only abortion provider, which had been operating five days a week just 15 minutes from her home, closed its doors. “The environment here in Missouri is so hostile,” its administrator told the local paper. With four abortion doctors left in the state, compared with 10 as recently as 1996, Lisa’s closest alternative turned out to be the Planned Parenthood clinic in St. Louis, an eight-hour round trip by car. That meant Lisa, who has no car, not only had to ask a friend to drive her but also had to come up with an excuse for missing two days of work, because she was afraid to tell her boss the truth. Two weeks later, she had to make the trip again, for a follow-up exam that lasted about five minutes. She figures the whole episode–the clinic’s bill, the prescription for the abortion drug mifepristone, gasoline, food and incidentals–cost her a little more than $600. “It was all very frustrating,” Lisa told TIME a month after her abortion. “I only recently paid back everyone I borrowed money from.”

All that, for one of the most common surgical procedures in the United States.

This article illustrates how the right-wing assault on reproductive rights have, in many places, already made Roe practically useless.

Increasingly, the question of how difficult it is to get an abortion–and sometimes whether you can get one at all–depends on where you live and how much money you have. Last year state legislatures across the country passed 52 new laws restricting abortion, more than twice as many as in 2004.

Few states were more active than Missouri, where Republicans last year took control of the Governor’s mansion and both houses of the legislature for the first time in 84 years and thus strengthened the antiabortion majority in the statehouse in Jefferson City. Governor Matt Blunt even summoned the legislature into special session in September to pass bills that allow civil suits to be brought against anyone who helps a Missouri teen obtain an abortion without a parent’s consent and that require doctors who perform abortions to have privileges at a hospital within 30 miles of the clinic. Generally, only local doctors can get those, and abortion providers often do not live close to where they work. That was largely why the Springfield clinic closed. The Missouri legislature is back in session this month, and abortion-rights foes have another list of bills they hope to pass, including one that would protect pharmacists who refuse to fill prescriptions for morning-after pills from lawsuits and employer sanctions, give tax credits to centers that discourage pregnant women from having abortions, and require that pain relief be given to fetuses that are aborted after 20 weeks of pregnancy.

I feel compelled to point out the fact that these restrictions aren’t about trying to end abortion — if they were actually looking to end abortion, they’d be giving away contraception, offering comprehensive sexual health information and increasing aid to women with dependant children, so that more low-income women could actually afford to have children. Instead, they’re trying to allow pharmacists the “right” to deny women access to their own medications, and requiring doctors who perform a specific procedure to jump through all kinds of hoops that aren’t required of other medical professionals.

The reason for the declines is a matter of dispute. Economic growth, better contraception and safe-sex practices probably all contribute to the trend. But a 2004 study by researcher Michael J. New for the conservative Heritage Foundation found that states that have adopted laws regulating abortion experienced a larger decline than those that have not. Reductions are particularly steep, he found, in states that restricted the use of Medicaid funds to pay for poor women’s abortions and those that required pre-abortion counseling about fetal development and abortion risks. (Lisa complied with that rule by phone.)

While I’m hesitant to believe a “study” by the Heritage Foundation, this one makes good sense. Make abortions nearly impossible to have, and block poor women from affording them, and you’ll have a lower abortion rate. Or, you’ll get a higher second-trimester abortion rate.

Some of those who deal with women seeking abortions have different theories. “The restrictions may stop some, but we think things like the 24-hour waiting period and the reduction of the numbers of clinics do not reduce abortions. They increase later abortion,” says St. Louis–region Planned Parenthood CEO Paula Gianino, who has been at the organization for 15 years. While Missouri keeps no statistics that would back up that contention, a 2000 study by Guttmacher conducted in Mississippi found that the percentage of second-trimester abortions increased after the state adopted mandatory counseling and waiting periods in 1992

It isn’t exactly rocket science, is it? And these restrictions have a very real impact on the women they effect:

Hope counselor Zoila Rendon-Ochoa recently received a call from a St. Louis woman who spoke only Spanish and identified herself as an illegal Mexican immigrant working as a dishwasher in a restaurant kitchen. In her ninth week of pregnancy, she had left Mexico with no birth certificate; she had no driver’s license or other identification. “I can’t have this baby,” she pleaded. Recalls Rendon-Ochoa: “Before the law, we could have given her an abortion. She kept saying to me, ‘You can trust me. I’m 24,’ but we couldn’t prove it. She asked me, ‘Where do I go now?’ I couldn’t tell her. I would guess that she carried the baby to term.”

In another case at Hope, a 17-year-old high school student from St. Louis appeared with her boyfriend. She said she did not know where her mother or father was. She was told to get a judge’s order that would allow the abortion without parental consent. Another 17-year-old who was turned away said she would return after her birthday in several weeks, thus increasing the risk and expense of the procedure.

The beginning and the end of the article are obnoxious, with a good deal of editorializing from the author. But it does a decent job of detailing some of the barriers that women are up against.

In related news, South Dakota examines two bills that could determine the future of that state’s sex education, one issued by a right-wing Republican and the other by a conservative Democrat.

Rep. Roger Hunt, R-Brandon, introduced a bill Tuesday that says if a school offers a class in sex education, the instruction should focus on abstinence. The instruction also should not encourage, promote or provide instruction in the use of contraceptive drugs, devices or methods, according to the bill.

That’s smart. Just tell them, “Don’t have sex,” and don’t even mention that, at some point in their lives, most of them will probably use some form of contraception to prevent pregnancy, and it’s pretty important to use it correctly.

Sen. Stan Adelstein, D-Rapid City, filed a bill that would require schools to provide sex education that emphasizes abstinence but also includes material on contraceptives. The measure’s title says it would require balanced instruction on human sexuality.

…why, exactly, is this controversial?

Hunt said state law already calls for instruction in character development, including sexual abstinence, but districts can decide not to provide such instruction. He said HB1217 would clarify how sexual abstinence should be taught.

“It’s a matter of clarification because it would appear in some school districts there is a need for clarification,” Hunt said.

Students need to be told that abstinence is the only sure way to avoid pregnancy and sexually transmitted diseases, Hunt said. “I believe it’s important for young people to know you can eliminate any risk by sexual abstinence.”

Except that you can’t. Sorry. If you aren’t willing to discuss specific sexual behaviors, then the very word “abstinence” is meaningless. When I was in high school, most people I knew equated “abstience” with “virginity.” And if all you’re worried about is keeping your hymen intact, there are lots of sexual behaviors that you can engage in that can still transmit STIs. I remember doing an exercise in my high school sex education class where there were three signs posted in different corners of the room: “Yes,” “No,” and “Don’t Know/Opt Out.” The teacher would read out loud some sort of sexual or romantic behavior, and we were supposed to decide whether or not we thought that one could engage in that activity and still be abstinent. When you break it down into behaviors, it’s interesting to see how varying individual definitions of “abstinence” are — consider things like hand-holding, kissing, mutual masturbation, vaginal intercourse, oral sex, anal sex, using sex toys, fondling/petting, etc. Too many people, even sexual health educators (and especially, it seems, right-wing head-in-the-sand politicians) apparently think that everyone’s definition of “abstinence” matches their own, and it’s fine to use that word without defining it. It’s not, and it puts kids in phyiscal danger when we aren’t willing to have open and honest conversations with them about sexual health.

And I wonder if Sen. Hunt has heard of rape. Because all the abstinence in the world won’t protect you if that happens.

But just because Sen. Hunt apparently doesn’t think about rape survivors, you can’t say he doesn’t think about “sex crimes”:

The bill would require that students be told unlawful sexual activity could be punished as a crime, be told about biology and anatomy, emphasize the benefits of avoiding sex until married, and stress the need for discipline and self-control. Other required subjects would include information on AIDS and other sexually transmitted diseases and instruction on how to resist pressure to have sex.

Emphasis mine. What the hell kind of unlawful sexual activity is he talking about? Statutory rape? Or is the plan to just tell kids, “Unlawful sexual activity can land you in jail,” and let them assume that any sexual activity they engage in is illegal? Why do I suspect they’ll err on the side of lying and misleading these kids?


17 thoughts on Missouri: A Case Study

  1. i’m sorry to say that i live in missouri and yeah, this pisses me off. i’m fortunate to live in the little progressive bubble that is columbia, mo (gotta love college towns), but it’s scary outside of town. i’m just glad that my husband had a vasectomy. between the 2 of us we’ve got 8 kids. we would not consider another baby to be a blessing from god, that’s for damn sure.

    i live right down the street from a planned parenthood. i’ve been wondering how these new laws have affected them in terms of hospital privileges. since there are 3 big hospitals here in town, i’m hoping they’re ok.

    i keep trying to vote these fucktards out of office, but i’m outnumbered:(

    it suddenly occurs to me that perhaps there would be a need for something like NYC’s Safe Haven here in MO? I would be happy to host anyone who has to travel long distance for an abortion. like i said, it’s right down the street.

  2. WTF is up with this conservative idea of “self-control”? Why the fuck is that such a great moral choice?

    The only time “self-control” is necessary is to avoid dangering others, and if you individually do not feel the consequences are worth the actions. THAT’S IT. Other than that, all self-denial does is make you frustrated and fixated.

    A human being has a very normal desire for sex. There is not a good reason to indulge that desire (in moderation, of course) IF you understand the consequences, and you are not being pressured against your will.

    This “self-control”, self-denial thing is bullshit. There’s not a good reason to punish yourself.

  3. it suddenly occurs to me that perhaps there would be a need for something like NYC’s Safe Haven here in MO? I would be happy to host anyone who has to travel long distance for an abortion. like i said, it’s right down the street.

    Yeah, but unfortunately, the Columbia Planned Parenthood doesn’t provide abortions anymore. Otherwise, the “Lisa” featured in the Time article could have come to Columbia instead of traveling to St. Louis.

    But otherwise, I think the idea of a Safe Haven program for Missouri—something based in the St. Louis area—is sound.

  4. My husband and I recently moved to Columbia from the upper Midwest. One of the first things we saw was a semitruck with pictures of aborted fetuses on the side. Columbia is nice, but I’ve had to drive around some of the backwoodsy areas of MO for my research, and it’s scary as hell.

  5. This “self-control”, self-denial thing is bullshit. There’s not a good reason to punish yourself.

    Amen! I’m so tired of that stupid bullshit.

  6. Yeah! Hard work, moderation, self-control, responsibility – these are the memes of FASCISM, man!

    Fuck that noise. Pass me the bong.

  7. Yeah! Hard work, moderation, self-control, responsibility – these are the memes of FASCISM, man!

    Fuck that noise. Pass me the bong.

    For many women, it is an act of responsibility to limit your family to a managable size.

  8. Responsibility is how the MAN keeps us DOWN. Don’t bring your filthy propaganda lies in here, Jill.

    (Oh wait. This is your site. Never mind.)

  9. Robert, this meme that progressives are irresponsible and undisciplined is without foundation. I hold the billable hour records at my firm for week and month (and I guess day, though plenty of us have a bunch of 24-hour billable days). I’m a taxpayer, a registered voter, a homeowner, a teetotaler, and I’m on the board of a charity. Whoever this caricature you’re talking about is, I have not met him.

  10. Whoever this caricature you’re talking about is, I have not met him

    Well, of course not. You’re in the office 24 hours a day, at least according to your billing records. He would never come into a place containing so many establishment tools, man.

  11. Nobody who needs the threat of a big magic sky-man’s angry vengance to do the right thing actually has any “self-control.” The idea that self-control and moderation are somehow the province of the restrictive religious right and social conservatives is laughable. People who are told what to do by a magic book every waking hour don’t need self-control. People who realize we’re all essentially free, including, free to fuck things up royally, and yet don’t largely do it anyway, are the only people who can be said to have self-control.

  12. What really makes me go “What the freaking hell?” is all the bullshit about abstinance only education and the horsecrap about protecting self-righteous asshole pharmacists.

    My parents are both really anti-abortion. But they are also really really really pro-birth control. Even though they’re Catholic. Even though they had four kids (perhaps BECAUSE they had four kids … ). As far as I can tell, their attitude is basically “Do all you can to prevent getting pregnant if you don’t want to be, but once you are, you have to see it through.” I may not agree with it, but I can at least see some vague semblence of logic behind it, especially knowing that two of my siblings weren’t planned. But these abstinence only crazies make no damn sense to me at all.

  13. The idea that self-control and moderation are somehow the province of the restrictive religious right and social conservatives is laughable.

    True. Every human being is responsible for their own self-control, and should be expected to moderate their own behavior.

    People who are told what to do by a magic book every waking hour don’t need self-control.

    Following a philosophy articulated by someone else, in preference to following one’s own heart desires, seems to me to require a great deal of self-control.

  14. What I REALLY don’t understand is why it is anyone elses’s business how I live my life.

    I have finally reached menopause and boy howdy am I happy!!!

    I have NEVER wanted to have children although I like other people’s children well enough, as the saying goes.

    I started trying to get my tubes tied when I was 16 but no go because I was “too young to know what I was doing”.

    However, I kept trying. In my 20’s I heard “well we need to include your boyfriend in this discussion because he might sue us down the road if you decide you want children.” WTF???!!! My BOYFRIEND gets to decide what I do with my body?

    Then, the boyfriend sided with me and I heard “well, when you reach 35 if you haven’t had any children by then we will discuss it”.

    You guessed it…I reach 35 and said boyfriend was the husband by then. Again we hear “Well, you can’t really be sure that this is what you want. Your feelings may change. You still have time to have children.”

    I thought that maybe it was just the old male doctors giving me such a fuss so I did meet with women doctors hoping I could find someone who would treat me like I was an actual adult-type person who might actually have some insight into how I felt about motherhood. But to no avail.

    But I made it! No children and now the worry has passed!!!!!!

    Why can’t everyone just mind their own business instead of trying to force everyone else to live by their rules?

    You don’t like birth control? Don’t use it.

    You disapprove of abortion? Don’t have an abortion.

    But stay out of my life!

  15. Following a philosophy articulated by someone else, in preference to following one’s own heart desires, seems to me to require a great deal of self-control.

    No, it pretty much just requires fear.

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