24 January 2011

Abortion Rights: When Dollars Can Mean the Difference Between Life and Death

By Ellen Liu, Program Officer

What happens when poor women are denied access to safe abortions? Just ask folks in Pennsylvania, who are now dealing with the fallout from recent revelations of substandard, sometimes deadly, conditions at a "rogue" abortion clinic in West Philadelphia.

Kermit Gosnell, an unlicensed "doctor" who ran the Women's Medical Society for more than 30 years, is now charged in the death of at least one patient and seven newly born babies at his clinic, which largely serves low-income women and women of color. The abuses that Gosnell and his staff are accused of are nothing short of horrific -- and it's all but certain that anti-abortion forces will seize on them as support for the notion that abortion in this country should never be legal.

But as Daniel Denvir points out in an article now running simultaneously on RH Reality Check and AlterNet, abortion foes have once again got it entirely backwards. It's not abortion itself that is to blame for these lost lives and barbaric practices; rather, it's the policies advocated for by anti-abortion activists that bear the burden of guilt here -- particularly those that deny government funding for abortion -- because they too often "[force] women into... life-threatening situations."

Since the original adoption of the Hyde Amendment in 1976, the US government has been barred from using federal dollars to pay for abortions. That means that Medicaid, which provides health care to our nation's poor, cannot be used to cover abortion-related services -- forcing many poor women and women of color (who are disproportionately poor) who find themselves wanting to terminate their pregnancies to settle for the cheapest services available. The lack of government funding for abortion turns the question of reproductive health into a stark economic calculus: can you afford to pay for a safe, clean clinic? One whose doctor is licensed to perform the procedure you seek? Or must you rely on what your pocketbook allows -- which can sometimes amount to substandard, unregulated care, at the hands of practitioners who may or may not be qualified to do the work, and who may choose to cut corners to save costs where they can.

Though many states have stepped in to increase abortion access for poor women by using state dollars to fund Medicaid coverage, Pennsylvania, as Denvir notes, is one of 26 states that has done no such thing -- leaving its most vulnerable women, many of them in rural areas -- to fend for themselves. Women in 82 percent of Pennsylvania counties lack access to abortion clinics, at present, and even where they are available (in cities like Philadelphia), there's no debating that a woman's ability to pay has everything to do with the quality of care she is likely to receive.

Don't expect this situation to get better any time soon. As the New York Times pointed out late last week, conservatives in Congress, and at the state level, are already launching "aggressive campaigns" to limit abortions and women's access to them. From banning abortions earlier in pregnancy, to forcing women to view ultrasounds, to expanding the Hyde Amendment so that it would pertain to private insurance as well (see Daily Kos' piece on H.R. 3 or the Smith Bill), the results of midterm elections have provided conservatives with the perfect political opportunity to push through legislation that curtails women's access to abortions -- and endangers their lives. "This is the best climate for passing pro-life laws in years," Michael Gonidakis, executive director of Ohio Right to Life, told the Times. We wish we could say he was wrong.

While Congress and state legislatures continue to wrangle over just how far they can beat back Roe vs. Wade without an immediate Supreme Court challenge, every day, low-income women across the country face grueling decisions about their reproductive health -- decisions that often leave their very lives at risk. If we want fewer stories like the one coming out of West Philadelphia most recently, we ought to be doing everything we can to push back against conservative efforts to limit our reproductive choices. Removing federal restrictions to abortion funding would be one brave and long-overdue step in the direction of protecting the health of all of our nation's women; unfortunately, conservative leaders are highly unlikely to see the logic of that conviction.

Photo: By Elizabeth Rappaport. Migrant Health Promotion prenatal instruction, April 2008.

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