News from Washington State: Hope on the Abortion Front

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abortion access, abortion laws, in vitro fertilization, religious fundamentalism, Senator Patty Murray, veterans, Washington State

Anyone who is concerned about reproductive health issues has had plenty of bad news in the past few years. In Latin America and the Caribbean the menace of the Zika virus has caused governments to warn women against becoming pregnant, in most cases without loosening restrictive anti-abortion laws or providing increased contraceptive options. Despite problems of access, Guttmacher Institute scientists estimate that women of the region have about 6.5 million abortions per year (https://www.guttmacher.org). Most are illegal, many are performed under unsafe circumstances, and at least 750,000 women per year experience post-abortion complications.

In the U.S. more and more state legislatures have enacted so-called “TRAP” laws (targeted regulation of abortion providers) (http://www.reproductiverights.org/project/targeted-regulation-of-abortion-providers-trap) making it difficult if not impossible for many abortion providers to continue to offer the procedure. And Planned Parenthood clinics are under constant threat of losing state and federal funding despite the fact that most offer a full range of women’s health services (including cancer screening, in vitro fertilization, and sex education) that would not otherwise be accessible to women of scarce resources.

The U.S. is not a monolith, however. TRAP laws and other threats to women’s reproductive health do not affect all parts of the country equally. Take, for example, the Pacific Northwest. In 1991 voters in the state of Washington sent a clear message when they acted to limit Christian fundamentalists’ ability to curtail women’s abortion rights. By means of a direct popular vote, Washington residents enacted the Reproductive Privacy Act (RPA), which bars the state legislature from passing abortion restrictions, requires the state to finance abortions for poor women, and mandates that any public hospital that offers maternity services must also provide abortion services.

In 2015 the American Civil Liberties Union of Washington sued the Skagit County public hospital district on the grounds that Skagit County was referring women desiring abortions to Planned Parenthood clinics rather than offering the service themselves. The county claimed that their hospitals had no physicians willing to provide abortions and cited the RPA provision allowing individual doctors to opt out of doing abortions. But Skagit County Superior Court Judge Raquel Montoya-Lewis has ruled that the hospital district is required to find someone willing to provide abortions since they provide maternity services, and that the individual opt-out provision of the RPA cannot be employed at the county-wide level. The victory is a small one, of course, and it remains to be seen whether Skagit County will appeal the court decision. But at least the case has served to remind people in Washington State of the RPA and its provisions.

U.S Senator Patty Murray of Washington State

Another intriguing battle being waged right now concerns Washington Senator Patty Murray’s efforts to get the federal government to pay for reproductive assistance for injured U.S. veterans. For example, it would pay for in vitro fertilization for a couple who could not conceive in the normal way because of battle wounds (such as shrapnel in the uterus or testes). Her measure has passed the Senate, but is being obstructed in the House of Representatives. According to a June 22, 2016 editorial in The Seattle Times, opposition is being spearheaded by the conservative Family Research Council on the grounds that in vitro fertilization could result in the destruction of fertilized eggs (which is tantamount, in the eyes of Catholic and Protestant religious fundamentalists, to abortion). Senator Murray has noted the outrageous ironies of the situation: the U.S. claims that it is sending young people to the Mideast with the purpose of fighting Islamic religious fanatics who seek to impose their will on the population at large. But after U.S. soldiers are wounded in the course of that struggle they come home to fall victim to Christian zealots who impose their extremist views on the majority of Americans who do not share their fanaticism.

Zika and Abortion

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abortion, amniocentesis, contraception, El Salvador, gangs, religious fundamentalism, violence, Zika virus

The spread of the Zika virus is causing consternation and alarm in many countries. The symptoms of the mosquito-borne virus are generally quite mild, to the extent that many victims don’t even know that they are ill. Recently, however, it has become clear that, when contracted by women in the first trimester of pregnancy, Zika can cause birth defects such as microcephaly, brain damage, deafness, and paralysis. The World Health Organization has stated that as many as four million people in the Americas could be infected in 2016, and the U.S. Centers for Disease Control are cautioning pregnant women not to travel to certain countries in Latin America and the Caribbean where the virus outbreak is becoming severe.

The Central American country of El Salvador has been particularly hard hit, and the government has taken the unprecedented step of warning women not to become pregnant until 2018. This advice is bizarre. El Salvador is a poor country. Many women face barriers, both practical and cultural, to contraceptive use. Moreover, abortion — even when the fetus is known to be severely deformed — is illegal, and the punishments are severe.

The sign says “Stop Criminalizing Women.” The woman belongs to a protest movement in Chile, which, like El Salvador, has draconian laws that criminalize women who terminate their pregnancy. In both countries abortion is illegal under all circumstances, even if necessary to save the life of the woman. In El Salvador the exception that allowed abortion when the mother’s life is in danger was removed in 1998; in Chile it was removed under the military dictatorship in 1989.

An effective government strategy to combat the epidemic of birth defects would consist of three components: widespread sex education and cheap and easily available contraception; widely available prenatal screening for birth defects (amniocentesis); and safe, legal abortion. Since El Salvador has none of these, women in large numbers will inevitably get pregnant, and some will deliver babies with severe abnormalities.

Note that the government’s admonitions are not directed at men, as if they didn’t realize that men share responsibility for pregnancy. Rather, the clear implication is that women and women alone will be blamed for the expected public health catastrophe. A 25 January 2016 article in The New York Times about the Zika threat in El Salvador aptly describes the Salvadoran government’s pregnancy warning as “the equivalent of a Hail Mary pass that, to many here, only illustrates their government’s desperation.”

In this article the word “abortion” is conspicuous by its absence. This is a peculiar oversight by The New York Times, since the illegality of all abortion in El Salvador is one of the principal obstacles to an effective response to the public health crisis.

Also omitted from the coverage in The New York Times is any discussion of U.S. culpability for the deplorable situation in that country. During the years 1979-1992 the U.S. gave billions of dollars in financial and military aid to the right-wing government that committed large-scale atrocities during a civil war in which an estimated 80 thousand people died. After the war the huge quantity of weapons and the large number of demobilized and unemployed former soldiers set the stage for an epidemic of violent crime. In addition, in the mid-1990s the U.S. deported several thousand Salvadoran pandilleros (gang members, mainly from Southern California), who brought their criminal gangs back with them to El Salvador. Current estimates of the number of gang members in El Salvador (a country having 1/50 the population of the U.S.) range from 30 to 60 thousand. At present El Salvador has the highest homicide rate in the Americas.

The pandilleros are not the only U.S. export to cause havoc in El Salvador. Over the past two decades religious fundamentalist groups based in or funded from the U.S. have given rise to anti-abortion fanaticism on a level that was virtually unknown before. In 1994 the Kovalevskaia Fund (of which I am director) and the Salvadoran Women Doctors’ Association convened an international conference in San Salvador to discuss the medical consequences of illegally induced abortion. El Salvador’s Vice-Minister of Health attended, and topics included the use of herbal abortifacients and menstrual regulators by the indigenous peoples of El Salvador, the actions of RU-486, the efficiency of vacuum aspiration as an abortion technique, the work of South American abortion clinics and their education programs for midwives and obstetricians, and so on. There was a sprinkling of anti-abortion people among the 300 doctors and medical students in attendance, but discussions were wide-ranging and respectful. Yes, that is not a misprint. The abortion opponents in El Salvador listened to the discussions of these topics with interest and respect.

Now, however, such an event would be virtually impossible to organize because religious fundamentalists have become much more visible, violent, and well-funded than they were in the mid-1990s. Medical personnel are prevented from performing abortions even in cases of ectopic pregnancy or other life-threatening conditions. In such circumstances it is not surprising that the Salvadoran government fails to mention abortion in connection with the Zika crisis. That The New York Times fails to mention abortion in its own coverage is harder to explain.

Postscript (added 4 February 2016) Although the article on the response in El Salvador to the Zika virus did not mention abortion at all, a 3 February editorial in The New York Times did: “In Latin America, where many nations outlaw abortion, some governments have advised that pregnancies be delayed, which can create only greater anxiety for women who have sadly limited control over such decisions…. Immediate responses, like increasing access to birth control and abortion, face stiff legal and cultural resistance in the affected region.” The New York Times also carried an article “Surge of Zika Virus Has Brazilians Re-examining Strict Abortion Laws”.

Second postscript (added 8 February 2016) Today’s The New York Times has an excellent op-ed on the situation in Brazil by Debora Diniz, a professor of law at the University of Brasilia.