WP_Post Object
(
    [ID] => 6921
    [post_author] => 15
    [post_date] => 2024-06-24 12:23:28
    [post_date_gmt] => 2024-06-24 12:23:28
    [post_content] => 

Two years after Roe v. Wade was overturned, an honest assessment of how things could get worse.

Nine months before the 2016 presidential election, I declared in an op-ed that if a Republican were to win in November, Trump would be “the best-case scenario for American women, not the worst.” Having covered politics and abortion rights for years, I’d been wrong in my predictions before—but never quite as spectacularly as I was about that.

It’s not that I thought the plainly misogynistic Trump would be good for women, but rather that Senators Ted Cruz and Marco Rubio—two of the highest-profile GOP alternatives to Trump at the time—would be worse. I wasn’t alone in thinking so: That February, a left-leaning columnist for Glamour had labeled Trump the “Best Republican Presidential Candidate on Women's Health Issues” because he was noncommittal on abortion and had taken less extreme positions overall than other Republicans in the race. Trump was and remains amoral and unprincipled, but, at the time, he was considered somewhat of a wild card, whereas Cruz and Rubio were running as ideologues with carefully cultivated right-wing brands. Both wanted to force women to carry their rapists’ babies to term, and Cruz vowed to prosecute Planned Parenthood if elected president. I was surprised that Trump—who was pro-choice for years and never cared about abortion, except as a means of shoring up support from the religious Right—turned out to be the most ruthlessly effective of the three at rolling back women’s rights nationwide.

Two election cycles later, I’m relieved that that op-ed was never published. But being so wrong about the former president taught me an important lesson: What Trump believes, says, or avoids saying has little bearing on what he does—and countless people will suffer as a result of his whims. He is a creature of impulse, guided by an outsized ego and often sharp political instincts. Barring some unforeseeable and extraordinary event, he will be his party’s nominee in November. But what matters far more than “who” leads the GOP ticket is how life would change for abortion seekers with a Republican in the White House next year.

We already know the consequences of anti-abortion laws and policies because we’ve been witnessing them for years, more commonly but not exclusively in red states. Thanks to our shockingly inadequate healthcare system, millions of pregnant people are already suffering—and not just those who need abortions. States with the cruelest abortion bans have the highest maternal and infant mortality rates in the country: Give birth in Alabama, for example, and you are more than four times as likely to die during or shortly afterward than you would be in California. In states like Idaho, Missouri, and Texas, abortion is a felony in nearly all circumstances; and with Roe overturned, healthcare providers across the country must now weigh their responsibilities to their patients against the risk of being sued, stripped of their medical licenses, or jailed—a choice with deadly consequences for patients. A 2022 survey of medical students found that a majority, around 58 percent, were unlikely or very unlikely to apply to residencies in states that restrict abortion, meaning we’re on the brink of a serious shortage of qualified OB/GYNs in the states where they’re needed the most. We’ve already seen the consequences of this play out: A January New Yorker story posed the question, “Did an Abortion Ban Cost a Young Texas Woman Her Life?”—and, as the author’s extensive reporting makes clear, the answer is a resounding “Yes.” Yeniifer Alvarez-Estrada Glick, the young woman in question, died while pregnant in 2022. After trying and failing to save Glick’s life, a doctor attempted to deliver her baby prematurely via C-section. The baby died, too.

Glick’s health problems, coupled with the poor care she received as a low-income, uninsured, undocumented Mexican woman in a small rural town in Texas, all contributed to her death. But according to the four outside experts The New Yorker asked to review her medical file, doctors likely could have saved her life by explaining how risky it was to continue her pregnancy and, if she wanted one, performing an abortion. Texas’ cruel abortion law made them afraid to do so.

If a Republican wins the presidency in November, the landscape will be even bleaker. While Congress is unlikely to pass federal legislation banning abortion nationwide, a Republican presidential administration wouldn’t need a law to accomplish that goal. As with the repeal of Roe, anti-abortion activists have been laying the groundwork for a backdoor ban for decades. And while Trump recently claimed that he would not support a federal abortion ban (a stance he’s likely to waffle on), anti-abortion activists don’t need him to. Below are the three main strategies they are pursuing—despite stiffening opposition from a passionate but fragmented pro-choice movement—to make a national ban a reality:

  • A Republican HHS Secretary could override the FDA’s approval of mifepristone, one of the two drugs most often used to induce abortion. Mifepristone was first approved by the Food and Drug Administration (FDA) in 2000; but in 2022, anti-abortion activists, hoping to curb access to the drug, filed a lawsuit challenging the FDA’s approach to regulating it. The Supreme Court’s June ruling in that case preserved access to mifepristone for now, but left the door open to further challenges down the road. And the next president’s Health and Human Services (HHS) Secretary could still override the FDA’s approval of the drug, effectively ending what has become the most common method of abortion nationwide.
  • An anti-abortion administration could resurrect the Comstock Act. Comstock is a 150-year-old anti-obscenity law which prohibits using the mail to send or receive “obscene” items, potentially including anything that could be used to perform an abortion. Under the Telecommunications Act of 1996, Comstock applies to the internet, as well, meaning that even discussing abortion online could lead to up to five years in prison, $250,000 in fines, or both. Medical abortions performed via telemedicine, wherein providers consult with patients online and send the necessary pills by mail, are just as safe and effective as those performed in person; but Comstock would prevent doctors from sending the pills at all, severing a lifeline connecting women in red states and remote, rural areas to needed care. (Between April 2022 and August 2022, around 4 percent of total recorded abortions in the U.S. were performed via telemedicine; as of May 2024, that figure had risen to 19 percent.) Because Comstock is a federal law, it would most likely invalidate state laws, which means a Republican Department of Justice could federally prosecute doctors and drug companies nationwide. It could also shut down all U.S. abortion clinics by barring them from receiving any abortion-related materials via mail.     
  • An anti-abortion Republican president could reinstate the global gag rule. The rule bars foreign nongovernmental organizations (NGOs) from using any funds, including non-U.S. government funds, to provide abortion services, information, counseling, referrals, or advocacy, effectively forcing NGOs outside of the U.S. to choose between receiving U.S. global health assistance and providing comprehensive healthcare. It has largely been in place under Republican administrations since 1984, but the Trump administration expanded it to apply to an unprecedented range of agencies and public health programs, many of which serve poor women in rural areas. When women desperate to end a pregnancy are kept in the dark about their options, they have more abortions, not fewer—and many end up dead or seriously injured as a result. The International Women’s Health Coalition wrote in a 2019 report that the rule “contributes to arbitrary deaths by impeding the provision of life-saving care.” Marie Stopes International, one of the largest global family planning organizations, estimated in 2017 that Trump’s expanded gag rule would increase abortions in Nigeria by 660,000 over four years, and that 10,000 women would die as a result. Precise figures are difficult to come by, but it’s clear that women have, as predicted, died as a consequence of this cruel and pointless policy. (Healthcare providers also expect the repeal of Roe to continue harming women worldwide.)

Whether or not the above scenarios come to pass—and there is little doubt that, if a Republican wins the White House in November, the last one will—the harm already caused by state abortion bans shows that a national ban would be an unmitigated disaster. Nor would it stop people from getting abortions. Women end pregnancies for a myriad of reasons, some more common than others. They do so whether it is safe, legal, and accepted, or dangerous, criminal, and condemned. And they do it whether or not their parents, lovers, spouses, friends, neighbors, religious leaders, strangers, or elected officials approve. The only difference is how many will get the quality care they need, and how many will suffer and die.

Forcing a person to carry a pregnancy to term and give birth against their will is a brutal act under any circumstances. But in a country like the U.S., with its threadbare social safety net and policies that vary wildly by state and region, it often means forcing them into poverty, as well. As Bryce Covert explained in 2023, “The states that have banned abortion are the same ones that do the least to help pregnant people and new parents make ends meet.” Most states with abortion bans offer little help to pregnant workers; none guarantee any control over work schedules, paid family leave, or paid sick days. When Lationna Halbert of West Jackson, Mississippi, found herself unexpectedly pregnant in 2022, she told In These Times, she cried and cried. She was earning just $8.50 per hour and already had a four-year-old son. She and her partner were not ready for another baby, nor could they afford to raise one. When Roe was overturned, an abortion ban automatically went into effect in Mississippi, shutting down the state’s last remaining clinic. By the time Halbert realized she was pregnant, it was too late: She couldn’t afford to travel to another state to get an abortion, and it was impossible to get one safely and legally in Mississippi. She delivered her second baby in a hospital with no hot water.

As I have written for The Conversationalist before, the same officials who worked so tirelessly to      overturn Roe have also fiercely resisted using public funds to help vulnerable women like Halbert. This is because the same politicians who romanticized her fetus have nothing but contempt for Halbert herself, and for all the other people—who are, not coincidentally, mostly women—being forced to have babies they do not want and cannot provide for. That contempt is matched only by their sociopathic indifference to the children who make it out of the womb—the kind who already exist, only to be routinely denied housing, healthcare, and basic nourishment by their state governments. (Nor do these politicians have any empathy for living, breathing children facing crisis pregnancies of their own.)

If pregnant women are the primary and intended victims of U.S. abortion policy, which is rooted in a desire to control and punish them, their children, partners, and families are collateral damage. It is bad for babies to be unwanted; bad for already existing children to be deprived of needed resources; and bad for the couple experiencing an unexpected pregnancy to be forced to have a baby that one or neither wants. It is delusional and insulting to pretend otherwise. Anti-abortion zealots’ cozy fantasies of domestic fulfillment have nothing to do with the daily lives of women forced into motherhood.

Even under a Democratic administration, women are already being investigated, prosecuted, and punished for various pregnancy outcomes, including miscarriages. In 2023, Brittany Watts, a 33-year-old Black woman in Ohio whose water broke prematurely, leading to a miscarriage, was charged with abuse of a corpse—a felony punishable by up to one year in prison and a $2,500 fine. Doctors told Watts her fetus was nonviable, and she spent a total of 19 hours in a local hospital over the course of two days, begging for supervised medical help. Concerned about the potential legal ramifications, the hospital repeatedly delayed her care. Watts ultimately gave up and miscarried alone in her bathroom. When she returned to the hospital for follow-up care, a nurse rubbed her back and told her everything would be okay—then called the police at the behest of the hospital's risk management team. As Watts was lying in the hospital recovering, police searched her home, seized her toilet, and broke it apart to retrieve the remains of her fetus as “evidence.” Watts’ charge was dismissed after a grand jury declined to indict her: Her prosecution was meant to shame and punish her, not protect her fetus. But prosecutors have always been more inclined to target women of color, immigrants, and/or poor women in these types of cases—because it’s easier to win against someone who can’t fight back. Watts’ experience also specifically demonstrates how little our healthcare system values the health and well-being of Black women, who are three times more likely than white women to die from a pregnancy-related cause.

One of the bitterest ironies of conservative reasoning on abortion is that, followed to its logical conclusion, it will impede tens of thousands of people who desperately want to become parents or expand their families from doing so. When the Alabama Supreme Court ruled in February that embryos created through in vitro fertilization (IVF) are children, three of the state’s IVF providers suspended their services, fearing legal repercussions. (Alabama voters in a longtime Republican stronghold were so alarmed that they elected a pro-abortion rights Democrat to Congress a few weeks later.) A number of prominent Republicans, including Trump, have since affirmed their support for IVF, but that hasn’t stopped many of them from co-sponsoring the Life at Conception Act, a piece of federal legislation that would ban nearly all abortions nationwide and does not include a carveout for IVF. Nor has it stopped those same Republicans from blocking a recent bill that would have protected the procedure. Leaders of the nation’s largest Protestant denomination, Southern Baptists, have recently voted to condemn the use of IVF, as well.

While Republicans’ support of openly fascist and deeply unpopular abortion policies has become a political liability for the GOP, it’s simultaneously become a human nightmare for the rest of us. Trump’s failed attempt to contain the political fallout from Arizona’s recent revival of an 1864 ban is an object lesson in locking the barn door after the horse has bolted. If abortion is the same as infanticide, as most anti-abortion activists insist that it is, then no person seeking one would be exempt from prosecution, whether you’re 9 years old and a man rapes you, 11 years old and your grandfather rapes you, 12 years old and a man rapes you, 33 and desperate to end your pregnancy, 33 and suicidal, a married mother who doesn’t want another child, or unexpectedly pregnant at 45. Even white, married, heterosexual moms are not exempt. The state of Texas recently forced lifelong Texan Kate Cox to travel out of state for an abortion she needed to protect her life and fertility. Cox, a married mother of two who wants more kids, was told that her third pregnancy was nonviable: The fetus was unlikely to survive, and the best-case scenario was that she might give birth to a baby who would live in anguish for a week or less. Alternatively, she could experience a life-threatening uterine rupture and need a C-section and/or a hysterectomy, potentially losing the ability to have more children in the future. Forced sterilization, which is one outcome Texas’ barbaric denial of care could have imposed on Cox had she lacked the means to travel out of state, is internationally recognized as a human rights crime. No wonder she fled.

It’s a sad truth that things can always get worse, even for relatively privileged Americans. Until it did, many legal experts considered it highly unlikely that the Supreme Court would overturn Roe, upending nearly 50 years of precedent and stripping American women of a right guaranteed to us for half a century. But many U.S. residents, particularly in rural areas and throughout the South and Midwest, have been living under de facto abortion bans for at least the last decade. A right is only guaranteed when it can be freely and easily exercised by all; for many U.S. residents, the cost of abortion—the procedure itself, the travel, the lodging, the childcare costs, the ability to request and take time away from paid work—is too high. One in five U.S. women must travel more than 40 miles one way to access care; in some rural areas, that distance is 300 miles or more. Under a national abortion ban, the situation will only grow more dire. People have taken and will continue to take risks that range from reasonable but frightening (crossing the border to buy pills from a pharmacy in Mexico) to desperate and potentially fatal (shooting themselves in the stomach). Denying care to women who need it permanently alters their lives, most often not for the better.

There is no reason to believe that the proudly anti-democratic GOP will uphold democratic norms or respect the popular will, and little reason to trust the Democratic Party, which has, in recent years, canceled elections, failed to defend abortion rights, and repeatedly defied its own voters. But focusing on how abortion politics are hurting the GOP or improving Biden’s chances misses the point. Like miscarriage, abortion stops an embryo or a fetus from becoming a baby. Restricting it tortures women, children, and families and rips holes in communities. Policies that harm actual, living people must be stopped, and those who promote them held to account. Voting is one fragile, inadequate tool. With so many lives at stake, we’ll need more.

[post_title] => The Reality of a National Abortion Ban [post_excerpt] => Two years after Roe v. Wade was overturned, an honest assessment of how things could get worse. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => national-abortion-ban-republican-gop-president-election-roe-v-wade-womens-rights-united-states-policy [to_ping] => [pinged] => [post_modified] => 2024-08-28 21:11:27 [post_modified_gmt] => 2024-08-28 21:11:27 [post_content_filtered] => [post_parent] => 0 [guid] => https://conversationalist.org/?p=6921 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw )
A collage with a black background and flashes of deep blue. In the top left corner, a fragment of a black and white photo of a woman seemingly naked, her hand to her mouth. In the right bottom corner, a black and white photo of a surgery room. The black running through the center conveys a rip between the two.

The Reality of a National Abortion Ban

WP_Post Object
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    [ID] => 5810
    [post_author] => 15
    [post_date] => 2023-04-19 00:32:53
    [post_date_gmt] => 2023-04-19 00:32:53
    [post_content] => 

The first question we ask about complex chronic illnesses shouldn't be whether or not they're real.

Over the last few months, the question of whether long Covid is real has been the subject of lengthy examinations from publications across the political spectrum. These articles are often ambiguous in their conclusions, giving equal weight to the legitimacy of the condition while simultaneously attempting to debunk it.

As anyone who has it will tell you, long Covid is very real, but if you’ve been reading these articles purporting to explore LC’s reality or unreality—questioning if society has it “wrong”—you might think that it is not, or that the people who have it (and illnesses like it) do not have a physical ailment at all, but instead a mental health one. While it’s not surprising that more right-leaning publications have engaged in long Covid denialism, the trend of left-leaning legacy publications like New York Magazine and the New Republic doing something similar is, to me, cause for concern. As a disabled, nonbinary feminist who has dedicated a large chunk of their career to exploring the tangled issues of gender, chronic pain/illness, and the society-wide disbelief of these illnesses, I think the insistence on showing “bo­­th sides” of long Covid is a slippery slope.

“Skepticism” of complex chronic illnesses is nothing new. I and many other chronically ill people have seen “skepticism” of our disabilities play out in media, amongst the general public, and in the medical field plenty of times before. Diseases such as multiple sclerosis (MS), rheumatoid arthritis, and ulcers were all thought to be psychosomatic at one time. In more modern times, chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), fibromyalgia, Postural orthostatic tachycardia syndrome (POTS), and many other chronic illnesses and pain conditions have been explained away as mysterious, and therefore Maybe Not Real, too.

Yet time and time again, it’s been shown that they are. After a CFS/ME outbreak occurred in Incline Village, Nevada in the mid-1980s, proving that the illness was seriously impacting patients, the Centers for Disease Control (CDC) pledged $12.9 million to research the condition, only to then quietly move the money they had earmarked to other departments. Meanwhile, CFS/ME remains just as pervasive today: Many long Covid patients have ended up with CFS/ME after battling acute Covid, in addition to experiencing a host of other debilitating, multi-systemic symptoms

As a person who has had lifelong health problems of varying severity, when I first heard about CFS/ME as a high school student, my immediate thought was that it sounded awful. Being tired all of the time and having to deal with muscle pain, cognitive issues, poor sleep, and post-exertional malaise (symptoms getting worse after a patient exerts themselves) sounded like a version of Hell on Earth. It’s not that I didn’t think becoming chronically ill could happen to me—because if I’ve learned one thing as a person with multiple health problems, it’s that your health is not under your complete control, no matter how much willpower you think you have. Rather, even then, I understood that extending a crumb of empathy to people whose health conditions seem weird or mysterious or exaggerated to you is not fucking rocket science.

Just a few years later, however, I would learn not everyone feels the same. When I was a 19 year-old college student, I began experiencing extreme fatigue and muscle pain in my back, neck, legs, and shoulders for no apparent reason one day. It never went away, and I spent over a year trying to figure out what was happening to me. Shortly after my 21st birthday in 2007, I was diagnosed with fibromyalgia by a rheumatologist. It would be another year before fibromyalgia had its media tipping point, but I became familiar with the stereotypes very quickly, mostly via internet comments and a few real-life unsolicited opinions. The people who get it (mostly women, as the gender ratio is very skewed), according to commentors online, tend to be middle-aged or older. They are fat and eat the wrong foods. They’re lazy. They just want prescription drugs. They are mentally ill. They aren’t utilizing positive thinking effectively enough to get better. They just need to exercise more. They are brainwashed by Big Pharma TV ads into thinking they are sick—this one courtesy of popular women’s website Jezebel.

Several of these stereotypes have been projected onto people of all genders with various disabilities, but there’s something about “mysterious” diseases with no single cause that tends to push ableism and sexism to the front—again, most likely because they disproportionately affect women. Unsurprisingly and likely because of this, fibromyalgia tends to be subjected to the “hysteria” argument, too: Per an (in)famous New York Times article titled “Drug approved. Is disease real?” about the fibromyalgia medication Lyrica, “The more these patients are around the medical establishment, the sicker they get.” I am left wondering how soon an “expert” will make a similar argument about long Covid.

Such both-sides claptrap when it comes to illnesses that medical science hasn’t “solved” yet is a thing that some media outlets like to do in the interest of “balance,” and it has been going on for a long time—longer than I have been alive, in some cases. But giving equal weight to opposing perspectives that are not, in fact, equal does not make sense. What, exactly, is the rationale for treating debilitating chronic illnesses, new and old, and those conditions’ reality for millions of people as a neat little thought experiment?

Because I’ve been writing about these issues—and living with them as a chronically ill person—for a long time, I suspect that the answer is multi-faceted. A lack of empathy is one facet; it does not escape my notice that most high-profile articles questioning the “realness” of complex, multi-system chronic illnesses are written by journalists who do not have these health conditions themselves. It also does not escape my notice that it has almost exclusively been chronically ill people, ME/CFS patients, and the journalists, writers, and medical professionals who work with ME/CFS and long Covid patients to call out NYMag, the New Republic, and other publications on bad journalism related to long Covid so far.

But another facet is the broader, ableist pattern of doubting chronically ill people in general, especially those debilitated by contested illnesses. It’s easier to not see ableism, or take it seriously as a mode of oppression, if you don’t deal with it every day. Much like it’s easier to say Well, if I had long Covid, I would just think more positively or If I had CFS/ME, I would at least TRY graded exercise therapy (GET) and cognitive behavioral therapy (CBT) to get better (even though both have been debunked) when you’re not actually going through it. Medical and everyday sexism, too, is another ingredient in this crappy metaphorical pie—doubting and dismissing women and other people who are not cis men who say that yes, they are in debilitating pain, that their fatigue crushes them 24/7, that they really are sick, has been a huge part of how chronic illness has been talked about in the U.S. for decades. Would you be surprised to learn that, like many of these illnesses, long Covid also has a gender discrepancy? Maybe I’m just cynical, but I was not.

Believing people of all genders when it comes to their experiences—of their own bodies—should be an obvious starting point when it comes to long Covid and other post-viral or “mysterious” chronic illnesses. Just because medical science hasn’t discovered the answers to long Covid, CFS/ME, fibromyalgia, and other chronic illnesses so far does not mean that there are not answers—nor does it definitively mean that these illnesses are psychosomatic. As we’ve seen, disbelieving people about their experiences of their own bodies is deeply entrenched in American culture—especially if those bodies are outside of the norm of cisgender, non-disabled, white, thin, young, and male. The long Covid coverage that’s been highly publicized in this current moment is only continuing this callous tradition of doubting, dismissing, and socially gaslighting chronically ill people as they are—yet again—shoved to the margins. It is time for the media, the government, other institutions, and the non-disabled public to do better.

[post_title] => Long Covid Skepticism is a Slippery Slope [post_excerpt] => The first question we ask about complex chronic illnesses shouldn't be whether or not they're real. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => long-covid-cfsme-fibromyalgia-skepticism-chronic-illness-media-both-sides [to_ping] => [pinged] => [post_modified] => 2024-08-28 21:14:01 [post_modified_gmt] => 2024-08-28 21:14:01 [post_content_filtered] => [post_parent] => 0 [guid] => https://conversationalist.org/?p=5810 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw )
An illustration of a larger figure contorted and in motion, bending over and arms spread, legs buckling. The person is featureless in the face, smooth and curved. Two smaller figures are grabbing and pulling at the larger figure, one grabbing at its wrist, and the other at its calf. We can just barely perceive an orb of light rising from behind the shoulders of the larger figure. The entire illustration is bathed in dark purple.

Long Covid Skepticism is a Slippery Slope