Taking Stock: Some Choice Reflections at the Year End


The end of the year is a special time. Some of us make a slew of year-end contributions; others make New Year’s resolutions. We think back and we think forward. My thoughts as the year ends turn to the greatest challenge facing abortion-rights supporters: the absence of adequate federal, state and personal financial support for women who have chosen to have abortions and simply don’t have the money. I am struck by the almost absolute apathy of most of the movement when it comes to this pressing concern.

When we look back, we are critical of the movement of the mid-seventies which chose to focus its attention on rallying the troops about a less-than-real challenge to Roe’s constitutionality rather than on the first and most significant blow to Roe: the 1980 Harris v. McRae Supreme Court decision which ruled that neither the states nor the federal government were obliged to pay for abortions through various funding mechanisms.

Efforts to overturn the Hyde Amendment as well as state laws prohibiting the use of state money for abortions have consistently taken a back seat to efforts designed to secure adolescent access to abortion services and fight waiting periods, phony informed consent laws and restrictions on later term abortions and on specific types of medical procedures.

Restoration of funding for low-income and poor women has never been the centerpiece of the choice agenda and it is still not at the top of the movement’s public wish list. While the movement rallied around funding issues during this year’s battle over health care reform and the draconian restrictions on the use of a single penny of government or government-approved insurance plans being spent on abortion, passions have abated.

Research and policy groups with the notable exception of Ibis Reproductive Health and the Guttmacher Institute seem to have no programs related to public funding; prochoice legislative leaders at the state and federal level discourage advocates who raise the issue firmly refusing to introduce any measures to restore funding. And our President, having made clear during the health care debate that we have a “tradition” of not using government funds for abortion is silent.

In fact one can rarely read an article or speech by any leader in the movement or go to the websites of choice organizations and see the Hyde Amendment mentioned. Check it out yourself. I just did and was very disappointed.

In March, the National Organization for Women (NOW) announced an emergency campaign to repeal Hyde. I don’t know what they did, but I just went through all the action items on the lengthy web site list and Hyde wasn’t there. I was asked to sign a Reproductive Freedom pledge that mentioned everything from not using the word “prolife” to being a clinic escort, but no mention of repealing Hyde.

We all know the stats: 25 percent or so of women on Medicaid who would choose abortions end up having babies instead, most in poverty with little chance of getting out of it. Some women who don’t raise the money for a first trimester abortion end up with second trimester procedures, either borrowing the money or getting some help from the various abortion funds around the country whose volunteers are the unsung heroes of our movement – and when was the last time you saw one of these funds given some big prochoice award?  

What are we going to do about this sorry state of affairs? What indeed can we do? We act as if we are helpless in this matter. We are victim of our belief that the only way to change things is by electing the right people to public office or through legislation.  But the fact is that there is a lot we could do to ensure that women who can’t afford abortions get them – right inside our own movement.  Here are a dozen action steps we can all take:

You can donate to abortion funds around the country at the National Network of Abortion Funds. Right now your donation will be matched dollar for dollar.

1.     First and foremost contribute at the local level to your local independent abortion fund or at a local clinic. Every choice advocate should be a regular contributor to an abortion fund.

2.     Become a volunteer at the fund and let your local provider know that you will provide transport, lodging and emotional support for a woman who needs it who comes for an abortion.

3.     If you are a doctor who performs abortions, perform more of them for free – or if you do none for free, start doing them.  In the old days, the standard was that for every ten abortions, a doctor was asked to do one for free.

4.     If you are an abortion clinic, up the number of abortions you do for free or start living by the one in ten model.

5.     Clinics should make a commitment to not turning away any woman who is more than ten weeks pregnant and has not raised the money for abortion. Critical to this is the adoption of policies that allow women to make payments over time. We simply cannot accept the argument “women won’t pay after they leave the clinic.”

6.     Before you contribute to a reproductive health clinic or escort, find out what their policy is on free or reduced fee abortions, and lend your support to the ones that do the most for poor women.

7.     Reproductive justice and choice organizations should raise money to pay for abortions for women who cannot afford them. Every organization that does direct mail should do one mailing a year to its list seeking contributions to be used in their entirety for abortions.

8.     Staff at reproductive choice organizations could collectively contribute to abortion funds with the Executive Directors and Board members taking the lead.

9.     Every Foundation that funds in the field should allocate some portion of their giving to abortions for poor women. We constantly hear that donors want deliverables; they want their money to result in something tangible. What could be more tangible than providing an abortion for woman who cannot afford it? You might actually change her life.

10.  On the political level. Never make a speech in which you do not mention the immorality of denying government funds for abortion. Consistently advocate for repeal of the Hyde Amendment, for funding for federal workers and for women in the military on your home page.

11.  On the electoral level, contribute no funds to candidates who do not actively work to restore state or federal funds for abortion.

12.  After you give to your local abortion fund, give again.

It is a special time of year, we see around us a country in crisis, joblessness, increasing poverty, homelessness, horrible public education, great sadness and suffering. We talk about shared sacrifice and we know the personal is political. We criticize those opposed to abortion as caring only about the unborn. Can we call upon ourselves to care for women who simply do not have the resources for the abortion they need?           

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  • pegjohnston

    Yes, to putting the issue of women in need front and center, and consistently articulated. Yes, to urging pro choice people to contribute to abortion funds.

     

    It seems to me that providers (and I am one) already contribute a lot to keeping the cost of abortion affordable. 1. Prices for abortions have been amazingly contained over the last 50 years, in spite of medical inflation. Someone calculated the fee that would be charged if we had kept pace with the rest of medicine at over $1000 for a first trimester abortion, as opposed to the existing average of $350-500.

    And, providers routinely accept less from some insurance plans, offer discounts, and write off bad debts. Many clinics I know have created a special fund for those in need which is an improvement over asking staff to contribute a few bucks a piece, which is what used to happen.

    I estimate just in my small clinic that we give away somewhere between $66,000 and $143,000 a year in free or discounted services.

    I just want us to be careful about playing into the myths of the anti abortion movement who stereotype abortion providers as greedy, rich, and heartless when the truth is many small independent clinics are all too close to the edge of bankruptcy.