A Tale of Two Books

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abortion, abortion restrictions, anti-abortion movement, Crisis Pregnancy Centers, misleading advice, obstacles to abortion, TRAP laws

Recently, I reviewed two books for a librarians’ journal. Although both examine the experiences of U.S. women who wish to terminate undesired pregnancies, the two books couldn’t be more different. Obstacle Course: The Everyday Struggle to Get an Abortion in America, by David S. Cohen and Carole Joffe, is as straightforward as its title. Using first-person accounts by abortion providers, clinic volunteers, reproductive rights activists, and women seeking abortion, the authors chronicle the difficulties that confront women in most parts of the country: a distressing tangle of TRAP laws, long waiting periods, harassment by anti-abortion protesters, and state-mandated falsehoods that physicians must deliver to their patients before an abortion. These obstacles—which of course disproportionately affect women of color, rural women, and the poor—make accessing abortion far more time-consuming, expensive, risky and stressful than it needs to be (and certainly far more difficult than it is in any other industrialized country).

Cohen and Joffe don’t just focus on the negative, however. They also describe the situation in areas of the U.S. where abortion access is routine. In these places reproductive health clinics are not subject to TRAP laws, women seeking abortions are rarely harassed or stigmatized, and state financial assistance is available. Also, in some states early abortion is possible via telemedicine, and in a few jurisdictions abortion by means of medication can be overseen by physicians’ assistants or nurse practitioners. Obstacle Course is readable, nuanced, and comprehensive; if I were still teaching, I would happily assign it to undergraduates.

The second book, The Pro-Life Pregnancy Help Movement: Serving Women or Saving Babies, by Laura Hussey, has a title that immediately reveals the author’s anti-abortion bias (“pro-life” and “saving babies”). Hussey frankly admits her early involvement in anti-abortion activism and her belief that human life begins at conception. Given her own anti-abortion advocacy, it is not surprising that Hussey’s treatment of the crisis pregnancy centers (CPCs) is admiring and uncritical. Because the CPCs have received negative press for their deceptive practices and intimidation techniques used against women seeking abortion, they have been rebranded by their supporters as “pregnancy help centers.” Hussey not only accepts the rebranding, but styles the women she surveys as benevolent, religiously-motivated “social reformers” whose opposition to abortion stems from their deep desire to serve women.

In Hussey’s account, CPC personnel distance themselves from the more extreme wings of the anti-abortion movement. Interviewees claim, for example, that they avoid what they euphemistically term “sidewalk counseling” but which personnel and patients at abortion clinics see as traumatizing harassment. CPC employees also claim that their work is non-political, and that they have nothing to do with lobbying for TRAP laws, mandatory pre-abortion viewing of ultrasounds and anti-abortion videos, and other barriers to abortion access so ably chronicled in Obstacle Course. (By the way, Karissa Haugeberg paints a very different picture of the women of the CPCs and their support for and in some cases participation in violent anti-abortion activities; see my review of her Women Against Abortion in this earlier post.)

There are numerous questionable aspects of Hussey’s laudatory treatment of the CPCs. To my mind, most damning is her refusal to take a stand on the junk “science” that the CPCs disseminate to their clients. CPCs routinely claim that abortions cause breast cancer, are more dangerous than carrying a pregnancy to term, negatively affect women’s long term mental and physical health, and so on.

These false claims have been refuted by professional bodies ranging from the World Health Organization to the American College of Obstetricians and Gynecologists. Yet Hussey portrays the CPC propaganda as having equivalent weight to those refutations. This stance is inexcusable. By spreading medical misinformation, the CPCs give the lie to their claims to be serving the interests of women.

 

Tansy, St. John’s Wort, and Mint—Oh My! Misleading Herbal Advice to Women

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herbalists, mint, misleading advice, St. John's Wort, tansy

Tansy (from http://gardenology.org)

On the first day of my Women as Healers class in January 2013 an older student appeared shocked (and slightly scornful) because I did not recognize the name of someone she called “a renowned woman herbalist and healer.” I replied that there are so many women herbalists and healers with a large internet presence that there was no way that I could be familiar with them all. The student insisted that this woman was one of the best and knew enormous amounts of information about herbal remedies and tonics; she would forward the link to me so that I could judge for myself. A couple of days later I followed the link she sent and wandered through the delights of the website. In many ways it was impressive indeed: gorgeous photographs, empowering feminist phrases, and a nice piece on how to recognize early minor stroke signs. There was, however, a glaring red flag that appeared on the first page I perused. Namely, the healer waxed eloquent about the efficacy of “St. Joan’s wort” (known to most people as St. John’s wort or Hypericum perforatum) as a tonic and cure for the winter blues. She did not, however, note any counterindications or caveats in her recommendation.

Now St. John’s wort is a pervasive–and in some areas invasive–species, and so has found its way into the pharmacopoeia of many cultures, most often as a mood regulator or herbal anti-depressant. However–and this is extremely important–it is also known by many peoples as a uterine stimulant, that is, a substance that induces uterine contractions or brings on the menses. Consequently, if the reason why a person is depressed is because she cannot conceive, St. John’s wort is emphatically not a good thing to take. Moreover, the estrogenic properties of St. John’s wort can interfere with the action of modern contraceptives and even certain psychotropics. Yet this in many ways informative website (and countless others of the same ilk) says little or nothing about the possible side effects and dangers of the herbs it recommends.

In my teaching as well as in my research for Sex and Herbs and Birth Control, I have encountered a distressingly large number of similar examples. Some herbalists tout Queen Anne’s lace as a diet drink, though many women from Appalachia to Rajasthan know it as a contraceptive. Some commentators recommend spearmint or pennyroyal or catmint tea as a digestive aid, yet say nothing about the emmenagogic (menses-inducing) properties of many members of the mint family. Tansy (pictured above) is mentioned as an herbal insecticide or natural dyeing agent. But the use of the herb as an abortifacient is passed over in silence, as is the fact that tansy oil–as well as the oils of pennyroyal, juniper/savin, sage, and parsley/apiol, among others–can be lethal if injested.

Part of the problem is that in the U.S., allopathic medical professionals spent much of the 19th and early 20th centuries assiduously distancing themselves from older healing specialties such as herbalism and midwifery. Thus, on the one hand, herbalists rarely have sufficient scientific knowledge of the preparations they recommend to issue adequate warnings. On the other hand, allopathic physicians in the U.S. rarely know enough about naturopathic remedies to give useful advice about side effects of herbs or their possible interactions with other drugs their patients might be taking. An additional problem is that herbal preparations are classified as supplements and are not subject to Food and Drug Administration regulation, so scientific studies of herb-pharmaceutical interactions are pretty much non-existent.

The difficulties caused by this lack of regulation and the ignorance of both herbalists and allopaths in the U.S. do not necessarily arise in other countries. Cubans, for example, in part because of the continued economic embargo by the U.S., have needed to cultivate local herbal alternatives to expensive imported drugs. Modern pharmaceuticals and herbal remedies are combined in Cuban medical practice. Family doctors on the island are expected to be familiar with a whole range of substances they can recommend to their patients, and are thus more likely to be able to give the warnings that I have found conspicuously absent on herbal websites in the U.S.