Category Archives: reproductive health

Lessons from the UU

I’ve been going to a Unitarian church for a few months now. When I decided I was going to homeschool Buddy I wanted him in a place where he would be around other children that was tolerant (of his special needs, of having an atheist mother, and of my children being multi-racial) and non-dogmatic. My husband had been taking them to mass, but his church really treats families horribly and there’s no sort of Sunday school. Also, even though I’ve never been Catholic, dealing with the Catholic church through my husband has been traumatizing enough that I fully understand why people call themselves Recovering Catholics and I don’t want to put my kids through that.

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Medical Abortions

This week, a tragic story about a couple who lost a wanted pregnancy went viral. Taylor Mahaffey went into labor just shy of twenty weeks of pregnancy. Let’s get a few facts straight. A fetus is not viable this young. The earliest a fetus can survive outside the womb is 22 weeks, and then there’s only a 10% chance, which goes up as the length of gestation increases. Another fact, Texas, where the couples lives, outlawed abortions after twenty weeks unless the mother’s life is at risk or the fetus has abnormalities incompatible with life, neither of which was the case for Ms. Mahaffey. This law was passed in 2013.

Best practice in this case, and what Ms. Mahaffey wanted because she did not want her baby to suffer, would be to induce labor. But, even though she was just shy of 20 weeks, the hospital did not want to run afoul of the law and sent her home. For three days she felt her child struggle within her. Then she started bleeding, but since there was still a fetal heartbeat, she was sent home. After four days and several trips in and out of the hospital her waters broke and she delivered her son stillborn.

I am appalled that Ms. Mahaffey’s life was put at risk for a fetus that had no chance of surviving. I am appalled that best medical practice was discarded for fear of legal repercussions. I am appalled that Ms. Mahaffey and her husband suffered for four days knowing that their wanted pregnancy was ending and that their agency in how to handle a tragic situation was stripped from them.

And I am appalled that, even though this is happening to other women across the country, pro-lifers continue to rationalize this away. Here are arguments that I see.

1. You should hope for a miracle/when I was in a similar situation, I waited for things to end naturally because that’s what our bodies intended to do and it worked out wonderfully. I see this one and variations a lot. And it makes me see red. If you are in that situation and want to pray for a miracle or let your body do it’s work naturally, great! That is YOUR medical choice. It is your body at risk, your choice to make. Here’s the thing. Letting our bodies work the way nature intended does not work so well for other people. Google Savita Halappanavar. Further, OTHER PEOPLE MAY WANT A DIFFERENT CHOICE! Other women may not want to risk medical complications when they are told their fetus is not viable. Other women may want to get it over with and move on. Other women may worry that their fetus is suffering, is being crushed by their womb, is struggling for no reason because there is no hope of survival and may want to end their suffering. People are different. How one person deals with a tragedy is different from how others deal with the same tragedy. If you want to stick a nonviable pregnancy out to the bitter end and pray for a miracle, great! That’s your right! But it is not right for you to tell other people what to do in a similar situation. Suppose the tables were turned and the woman’s life was always given top priority and women were forced to abort nonviable pregnancies (I am NOT advocating this, but suppose this were the case?) Now you understand what you are putting women through when you deny them the agency to make the best medical decisions they can for themselves. I cannot say it enough, these decisions need to be between a woman and her doctor.

2. This is about murdering babies, no one thinks about their suffering. No one wants to murder babies. People who make this argument tend to see pregnancy as black and white. And they also seem to believe it always results in healthy babies and mothers. But here’s the thing. Maternal mortality in the US is unacceptably high. And even when women survive, not all pregnancies result in healthy babies who survive. In this case, something that the article made clear, the Mahaffey’s fetus’s feet were dangling from her cervix for four days. Mahaffey describes him as “struggling” in the womb. She and her husband state they did not want him to suffer. They were thinking about their son’s suffering! It why they wanted to end the pregnancy. Once again, some people want to hope for a miracle, hope that the doctor is wrong, etc. Other people focus on the quality of life and do not think there is anything noble about suffering needlessly. And the former should not be able to dictate the medical decisions for the latter!

3. I don’t believe this story because a family member went through something similar and got good, compassionate care. I’m glad you had support during a tough time. However, this law was enacted in 2013, so very recently. Also, Texas is a huge state, so people are going to have different experiences depending on where in the country they are, the religious affiliation of the hospital they are at, their medical insurance, etc. Further, other women are coming forward across the US with similar stories.

Taylor Mahaffey suffered for four days, feeling her wanted son die within her, knowing that he was not going to survive. Her ability to control the medical decisions that impact her body was stolen from her. This is cruel. Her life was put at risk for a nonviable pregnancy. Best medical practice was put aside for fear of legal repercussions.

Pregnancy is a complex situation. It is a grey area. Women can die (and in Ireland, have died) by being denied the best medical care while pregnant for fear of being prosecuted by the law. Each pregnancy is unique. Each challenge is unique. And each family is unique. How each family faces adversity is unique. What is comforting to some families, such as bucket lists for the nonviable fetus, are torture for others, and vice versa. Some people value life at all costs, other people value the quality of life.

We need to acknowledge the harm these laws are causing. We have to acknowledge that different people are going to react different ways and find different thing comforting in a crisis. And we need to trust women and their doctors with their personal medical decisions. The clergy and politicians need to butt out.

Twisted Morality

Before modern times, a laboring woman faced three choices if the baby was unable to descend through her pelvis. A cranioctomy could be performed on the fetus, where a hole is drilled into its skull and it’s brain removed to allow the head to come out. The mother would live, the fetus would not. The second option was a c-section, which would undoubtedly be fatal to the mother as, before the invention of modern medical techniques, there was no way to suture the uterus to prevent her from bleeding out. The baby would live, the mother would not. Of course, the work around solution would be to perform a hysterectomy along with the c-section, which would both save the mother and the baby. But while this solution was know about, it was condemned by the Catholic Church.

The reason? It would enable couples to have non-procreative sex.

Yes, to prevent people have having non-procreative sex, the Catholic Church would have rather the mother died during childbirth. Better a woman should be dead than engaging in sex for non-procreative reasons!

And here is what I want to stress. The focus of the Catholic Church, conservative protestants and others in the so-called pro-life movement is not about the health and well being about the baby as they have spun it, it’s about people have sex for pleasure. If the pro-life movement was about preventing abortions, then they would be backing LARCs.

Haven’t heard about LARCs? These are otherwise known as Long Acting Reversible Contraceptives. Essentially birth control that lasts for years so you don’t have to worry about taking a pill every day or slipping on a condom that could break. These are also reversible so if you decide to have a baby, they can be removed and you can procreate at your leisure. And the failure rate is less than 1%. They are extremely reliable. Examples include the IUD and implants.

In Colorado, they were responsible for lowering the teen pregnancy rate by 40% in 6 years (and the abortion rate fell by 35%) GOP “pro-life” Republicans refused to continue funding this successful program, because “morality.”

It’s not just teens in Colorado. In the US, the rates of unintended pregnancy are at an all time low thanks to the IUD.

Birth control has achieved what years of abstinence programs and attacks on abortions have not, drastic drops in the rates of unintended pregnancies AND abortions. Birth control works. And all of the arguments I’ve seen against birth control are based on a person’s religious beliefs and that whole morality thing about fears of people having non-procreative sex.

Here’s the thing, this moral panic about people having non-procreative sex? Its getting in the way of implementing policies that are good for the health and well being of the nation. And unplanned pregnancy is a situation that is not good for anyone and which, despite the promoting of adoption, there is no perfect choice.

Recently the CDC got into a flap about the risk of alcohol use during pregnancy. Having worked with substance use and seen the effects of FASD first hand, as well as the tragic situation women who are addicted to opioids find themselves in when they get unexpectedly pregnant.Alcohol use is extremely detrimental to a developing fetus, and the worst time to drink is when most women don’t realize that they are even pregnant! This can cause severe mental retardation and a host of other complications. Women addicted to opioids who become pregnant are at an increased risk of miscarriage if they try to STOP using drugs, and therefore have to continue using drugs (hopefully while monitored by a doctor). Unfortunately, the baby is born addicted to opioids and has to go through detox. This is not a great first start in life: being born addicted to a drug, and spending weeks detoxing at a hospital and not a nurturing home. For women who have gone through this, it is agonizing.

I bring this up as an example of the value of having a planned pregnancy. When a woman chooses to get pregnant, she usually pays a lot of attention to her life choices, eliminating alcohol and other harmful substances from her diet.

Drug exposure is not the only thing we have to worry about. Zika has recently exploded as a public health crisis. Exposure to zika while pregnant is likely linked with microcephaly and Guillain-Bare syndrome and a host of other birth defects. There have been cases of zika in the US and my husband who works for the city government is privy to the measures that they are starting to take to prepare for it here in Texas. In fact, I’m dismayed that with this new public health crisis more isn’t being done to make sure women in those areas have access to LARCs, which, in the case of Texas, would mean not fighting Planned Parenthood and working with them to make sure women who wants LARCs have them! But, as we have defunded Planned Parenthood, pregnancy rates are up. Further, the Texas government was so unhappy with this report that they have attacked the researchers. Once again, concerns about moral indecency vs public health is what is influencing policy here, and when research flies in the face of morality, rather than changing our policies, we’re attacking the people doing the research.

I’m about finding solutions that work that protect the health and well being of women and enable them to bring healthy infants into this world. LARCs dramatically reduce the unplanned pregnancy rate, AND they dramatically reduce the abortion rate. They allow a woman to decide when she is ready to have a baby, and therefore allow her to make sure her environment and her body is health when she chooses to get pregnant. This increases the chance of healthy moms having healthy kids.

Fretting about “morality” is not doing anything for the health and well being of women and their babies. In fact, it is doing a lot of harm. This so-call morality is not morality, it is ultimately about control. This is about the church dictating when it is okay to have sex and when it is not.

My morality is about putting policies and resources in place to make sure every woman who wants one has access to LARCs. It’s better for women, it’s better for men, and it’s better for the babies.



Why We Need Planned Parenthood

“Do you know where I can get cheaper birth control pills?” she asked. “I can’t afford them at the local clinic.”

“Have you tried applying for Medicaid?” I asked. As I live in Texas, and our governor in his infinite idiocy refused the Medicaid expansions. So if this young woman lived in another state she would likely have access to Medicaid and free birth control. As she lived in Texas, though, this was not a guarantee.

“I tried, I was rejected.”

The nearest Planned Parenthood is over an hour away, a prohibitive distance for a lot of my clients. I explained this to her and she asked about the local crisis pregnancy center. I explained they do not provide medical services such as prescriptions for birth control. What I didn’t say was that the only thing they do is employ scare and shame tactics to sway women away from abortion.

I felt the frustration and anger I’ve been feeling all year. Earlier in the year I had several clients become pregnant at the same time (we joked about there being something in the water). All of them had wanted tubals after having their last child, but were refused for reasons that weren’t explained to them, even though one of them had five children. And though they had attempted to take care of their reproductive health, they were labeled irresponsible for getting pregnant. Even though none of them had planned their pregnancies they accepted them, even as they worried about supporting another child.

Usually a woman can get on pregnancy Medicaid quickly. At the time this happened the system was overwhelmed, and it took several months for them to get on Medicaid. A month is a long time when you’re pregnant. One, due to bureaucratic errors, had an even longer wait. Worse, she was starting to suspect something was wrong with the pregnancy. She looked ill, with a greyish tint to her skin. She was worried about gestational diabetes, something she nearly developed in a previous pregnancy.

But her Medicaid was delayed. And she lived too far away from Planned Parenthood to go in for a check up. The crisis pregnancy center couldn’t help her. She waited and waited, looking more and more ill each time I saw her. Her life, and the well being of her fetus was at risk because she could not get to a Planned Parenthood!

How in the hell is this pro-life?

Planned Parenthood provides a vital service for the community. The clients I see are impoverished. They qualify for foodstamps and other assistance. In the three years I have worked here I have NEVER seen a client have kids for the benefits. Like the group of clients I had at the beginning of the year most try to avoid becoming pregnant again, but due to a lack of access to reproductive healthcare, are unable to.

What I see is women wanting to get on birth control but being unable to afford it.

What I see is women having reproductive health crises and being unable to afford care for it.

What I see is women who are pregnant and unable to afford to see a doctor.

Texas is not expanding Medicaid. Planned Parenthood is under attack and there is nothing to support it in its absence. Where I work women do not have reliable access to reproductive heath care. And I see the harm of it. Every day.