Thoughts on the 41st Anniversary of Roe v. Wade

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Growing up, January 22 was not a day I thought of as any different from other days in January. However, as I learned more about the history of reproductive health politics in the United States, this day has transformed into both a celebration and a yearly opportunity to reaffirm my vision of the kind of health care provider I want to be.

Today, on the 41st anniversary of the Roe v. Wade case that legalized abortion in the US, I’m thinking about all the recent hype around the Korean “Baby Boxes.” In theory, they provide a way for “desperate young mothers” who “can’t” parent their infants to “safely” and anonymously give away their children. I’m thinking about what the sanctioning of anonymous abandonment means for the very fabric of Korean society. What does it mean for the human rights and dignity of Korean children, who are suddenly cut off from their families, their birth story, their medical history, and if adopted, their cultural lineage?

As a Korean-American adoptee, I think every day about my birth mother, who became pregnant with me against her will.  I wonder how much of her pregnancy, the continuation of her pregnancy, and the process of my adoption felt like a “choice” to her. What options were truly available to her? What would she have done if she had had access to the kind of contraception and family planning care that I believe is a human right? How might her life–and mine–have been different if single-parenting in Korea were a real choice, not a guaranteed sentence to a life-time of stigma and shame?

It should go without saying that I am grateful for my life. Yet at the same time I am deeply troubled by the fact that given what I know of Korean history and politics, it is highly unlikely that my birth mother felt any kind of true agency or empowerment in her decision-making around her pregnancy.

Today I stand with the many unwed Korean mothers, Korean adoptees, activists and leaders in Korea who are voicing their concerns with the Baby Boxes and working to offer real support for all parents, not just those that fit the mold of “appropriate” parents.

I stand with those who refuse to pit abortion and adoption against each other as moral opposites. Adoption is not a more “noble” decision than abortion, nor is abortion immoral. They are simply two of the possible three outcomes of a pregnancy.

I stand with all the leaders in the adult adoptee community who are advocating for more ethical practices in the domestic and international adoption industry.

I stand with the courageous health care providers–the nurses, nurse-practitioners, nurse-midwives, physician’s assistants and physicians who provide compassionate, supportive abortion care every day. I aspire to be among them in the future.

I stand with all the people of the world who have experienced a pregnancy–intended or not–who have felt judged, stigmatized, or ashamed for the way they feel about their pregnancy.

As a Korean-American adoptee, future nurse-midwife, and reproductive justice advocate, I affirm my commitment to be a leader in the realm of full-spectrum reproductive health care. There is so much at stake. We need all of us to create the kind of world that supports all families, regardless of who they are, how much money they have, or what others think of them.

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[Friday Wrap Up]: 30

So many articles this week! Some of the highlights: exciting news for APC’s in California, one woman’s experience of a later-term abortion, new trends in prenatal screening, a call to action to end the shameful shackling of laboring patients in prisons, and an awesome, awesome story about transgender parenting from Canada. Read on!

California Expands Abortion Access!

Gov. Jerry Brown on Wednesday expanded access to abortion in California, signing a bill to allow nurse practitioners, midwives and physician assistants to perform a common type of the procedure, an aspiration abortion, during the first trimester.

Oregon, Montana, Vermont and New Hampshire allow nurse practitioners to perform such abortions, which use a tube and suction, while several other states, including California, permit nonphysicians to provide drugs to terminate pregnancy.

But the new California law goes further, allowing a wider range of nonphysician practitioners to perform surgical abortions. While other states have passed a tide of laws restricting abortion access, California has gone against the political tide.

It Happened to Me: My Late-Term Abortion Was a Nightmare, But It Didn’t Have to Be

Stories like this break my heart…and make me angry. As an aspiring abortion provider, I can’t fathom how anyone involved in abortion care would let personal judgment get in the way of providing compassionate care for their patients, especially in situations like this. I want to believe that all health care providers bring good intentions to their work…but experiences like this remind me that we have a long ways to go.

Was I expecting too much, some special treatment because I wanted my baby, because I felt like my situation was particularly emotionally fraught? Maybe I expected the clinic to feel sorry for me, and they treated me like any other woman having a “regular” abortion. Except no abortion is a “regular” abortion, and no woman having an abortion should be treated with suspicion and disrespect. Every woman having an abortion for any reason deserves a little kindness and warmth. It could make a world of difference.

Breakthroughs in Prenatal Screening

“Breakthroughs”…but with a lot of nearly impossible ethical dilemmas to ponder. I so admire the work of thoughtful genetic counselors–it’s not an easy job and the growing number of tests makes this one of the more dynamic professions in health care today. Unfortunately, this article doesn’t really delve into the ethical questions of what it means to have more testing available, however, it does touch on some of the financial aspects of testing–which really, is another ethical dilemma of its own.

In the nearly four decades since amniocentesis became widely accepted, new techniques have gradually improved the safety and accuracy of prenatal diagnosis. Prenatal tests for more than 800 genetic disorders have been developed. And the number of women who must undergo amniocentesis or C.V.S. has been greatly reduced.

We Need to Stop Shackling Women in Prison–Now

The headline says it all.

One of the first women who shared her story with Birthing Behind Bars was Linda Rosa. She learned that she was pregnant with twins after entering jail in 2008. Linda Rosa recalled being shackled each time she was taken to see the doctor: “They used to shackle my hands and my legs. I would have to walk with the shackles on my legs, which would leave cuts on the back of my ankles.” Linda had to undergo a C-section and was shackled while recovering in the hospital. She recalled having stitches and staples from her c-section and shackles on her wrists and ankles when she visited her newborn babies in the ICU. “Everywhere I had to go, I had to wear shackles,” she said.

Transgender Pregnancy: The last frontier in assisted reproductive technology

Loved. This. SO. Much. We need to hear more stories like this. It’s so important.

It took nine rounds of intrauterine insemination for Heller to become pregnant. The first four experiences at a Montreal fertility clinic had been quick and impersonal. But their fifth try was worse than usual. The doctor rushed in, never said hello or gave his name, never looked at the women. He asked “insemination?” and they said “yes.” He was quick and rough, Heller recalled, and she bled afterward, something she’d never experienced. He left the lamp on between her legs as he rushed out of the room, they say.

PRENDA: Why should a midwife care?

Earlier this week, Miriam Yeung, ED of the National Asian Pacific American Women’s Forum wrote on RH Reality about HR 3541.

HR 3541, the Prenatal Nondiscrimination Act (PRENDA) will be put to a vote in the House. PRENDA would ban abortions sought based on the sex of a fetus, threaten doctors with up to five years in prison for performing such a procedure, and even require doctors and nurses to report women whom they suspect are seeking an abortion for these reasons. While the bill is cloaked in the language of civil rights for women, this bill is a wolf in sheep’s clothing. Rather than lifting the status of women, this bill is nothing more than another hypocritical attempt to ban abortions in this country – this time using Asian women as the excuse.

This is essentially just one more bill that is distracting us from the real issues at hand.  As Miriam points out, sex selection is a major concern…but a top-down bill is not going to change that. The real change is a cultural one, and that has to come from within.

So why should a midwife care?  Because the real issue here is not whether sex-selective abortions are happening.  The real issue is how Asian-American women face disparities in access and quality of care that lead to poorer health outcomes:

Nearly 18 percent of Asian Americans and 24 percent of Native Hawaiians are uninsured while only 12 percent of the non-Hispanic, non-elderly white population is without insurance. Over 29 percent of Asian American and Pacific Islander women have not had a mammogram for the past two years, and over 24 percent have not had a Pap Test in three years. We do not need another obstacle. This bill exacerbates disparities by further restricting access to comprehensive health care services and penalizing health care providers who serve women from our community.

Take the time to contact your representative and let them know you want them to focus on the real issues of health disparities.  The vote has been changed from today to tomorrow, there’s still time. I’ll be doing the same.

Update: The bill was rejected on Thursday, 246 to 168. Choice quote to keep us motivated to oppose such measures?

“I don’t support abortion for gender selection,” said Representative Diana DeGette, Democrat of Colorado and an opponent of the legislation. “I don’t know anyone who does. Maybe that’s because there is no problem in this country of abortion for gender selection.”