Earlier this year, the Governor of Virginia developed a set of regulations under the guise of monitoring the quality of abortion care.  Sounds like a reasonable – even worthy – cause, right?  Don’t be fooled (or “trapped,” rather) by the rhetoric.  Targeted Regulation of Abortion Providers (or TRAP) is motivated by political agendas and religious dogma, not by genuine concerns for patient care and safety.  Abortion clinics, like all health centers, are already regulated by a variety of oversight agencies.  There is simply no legal or medical reason for treating abortion doctors differently than providers of other outpatient procedures of a similar nature and complexity.

The Virginia TRAP laws, set to take effect in January, are alarming for several reasons.

First, they were issued through an “emergency” administrative process as opposed to routine legislative procedures, thereby skirting most opportunities for public review and comment.  So… what’s the emergency?  Are women dying, experiencing high infection rates, or getting sick after abortions in Virginia?  Nope.

Note:  According to the Guttmacher Institute (among other sources):  “Abortion is one of the safest surgical procedures for women in the United States.  Fewer than 0.5% of women obtaining abortions experience a complication, and the risk of death associated with abortion is about one-tenth that associated with childbirth.”

Secondly, the medical expertise that was actually solicited was, ultimately, discounted.  Several members of the medical committee that advised the state about the regulations have indicated that the final version looks quite different from the one originally drafted.  In short, they said that the regulations went way too far.

Finally, and most significantly, the regulations treat abortion clinics as a type of hospital, thereby subjecting them to burdensome – and unnecessary – structural building requirements.  Typically, when such regulations are implemented, existing facilities are “grandfathered” in.  Not the case here – but not terribly surprising, since the Governor and his Attorney General have made no secret of their staunch opposition to abortion rights.

The draft regulations are nineteen pages long and reference numerous other statutes and regulations, which makes reading them – let alone fully comprehending their impact – a wild goose chase of sorts.  Let’s be clear:  regulation itself is fine – really!  I don’t think any abortion provider would dispute the need for some level of external oversight and guidelines.  But they must be reasonable and appropriate.  And by all – even objective – standards and criteria, these regulations are not.  As one doctor (sort of) joked:  “I can do open heart surgery in a place where I could not perform an abortion!”  The point is, we’d all be hard pressed to identify another area of medicine in which politicians are allowed to meddle in the actual content of practice in this way.

These are just the kinds of laws that the general public – no matter how pro-choice – overlooks.  From the outside, they seem relatively harmless.  In essence, they are back-door measures that enable anti-choice zealots to chip away at abortion access without ruffling too many feathers.  But these are the very laws that make abortion harder to get and more expensive.  They affect women indirectly – by penalizing those who provide the service.  And let’s be honest:  abortion providers already have it pretty tough – hounded by protestors, ostracized by the mainstream medical community, even threatened with physical harm.  So rather than basking in a warm holiday glow this week, a few dozen committed Virginia physicians and their dedicated staff will instead be worried about their jobs… and, ultimately, the women they serve – women who, right now, may have no idea that this is even happening. 

Note:  It’s worth pointing out that even before these burdensome regulations came into play, approximately 85% of Virginia counties had no abortion provider; 54% of Virginia women live in these counties.  Some clinic administrators estimate that all but a handful of Virginia’s twenty-some abortion providers will be unable to comply with the new regulations and will have to close up shop within the next two years.

Ironically, in the Governor’s recently-released budget, he all but eliminated funding for teen pregnancy prevention programs and for HIV prevention and treatment programs, but he added money for additional inspectors of abortion clinics.  Talk about trapped.  Sounds like a well-hatched plan to hold women and their families – especially the most vulnerable ones – hostage by “tying up” the very people who are there to help them.  The Governor and his cronies have a constituency to serve, but it sure as hell isn’t women seeking abortions.  And these regulations aren’t about ensuring the safety of abortion facilities, they are about closing them down — for good.

This week Mississippi voters will weigh in on a state constitutional amendment that defines legal personhood at fertilization. One New York Times writer described the initiative as a new tactic in the abortion fight, but as far as I can tell, there’s nothing terribly novel here. Anti-abortion groups long ago staked a polarizing claim in this debate by pitting the needs and rights of pregnant women against those of their embryos and fetuses. In doing so, they created the framework for an adversarial campaign between what they purport to be two entirely separate beings: selfish, irresponsible mother and innocent, unborn child. In reality, however, these two lives are inextricably linked, physically and otherwise.

Desired or not, pregnancy begins a relationship, and a woman must decide how to best manage that relationship – based not only on her own interests, but also on those of the potential child, her existing family and her larger community. Women alone carry this privilege and this burden, not because we are alone, but because our biological role cannot be shared or traded with men. For this very reason, a woman must have ultimate decision-making authority over the outcome of her pregnancy. Abortion opponents perhaps take solace in their view that women make impulsive and frivolous decisions about pregnancy, but this is a broad mischaracterization. Women do not abort because we devalue new life; to the contrary, we plan the size and spacing of our families out of respect for humanity, out of an understanding for the complexities and complications of our lives. Ending a pregnancy that is undesired and for which one is unprepared is in fact a very loving – even “motherly” – thing to do.

Our reproductive decisions are central to our individual identities, but they are also crucial to our group survival. In fact, maintaining control of our reproduction is one of the ways that we preserve the health and longevity of our human existence, for it allows us greater opportunity to create and maintain the ideal circumstances in which to conceive, bear and raise children (or not to, as the case may be). When our families thrive, so does our society. Ironically, limitations on our reproductive rights are not subject to the same scrutiny as other matters involving infringement of bodily integrity, even where actual children are concerned. For example, a parent cannot be forced to provide an organ or bone marrow to his or her child of any age, even if that act is necessary to save the child’s life. How, then, can we morally or legally justify compelling a woman to unwillingly donate her uterus – her body! – to the unborn? How can we even debate the personhood of a fetus, an embryo, a fertilized egg (!), if that categorization necessarily reduces a woman’s status to the equivalent of a vessel? Ain’t I a person, too?

The culture of shame and secrecy that has developed around abortion has enabled society to superficially isolate it as a separate and distinct act, void of any context and disconnected from the rest of our sexual and reproductive lives. But abortion is actually a very natural part of our biological cycle. A significant number of pregnancies (estimates range from 10-50%) end in spontaneous abortion, oftentimes before a woman even knows she’s pregnant. Even nature (or our Creator!?) understands that all pregnancies cannot and should not result in children. Abortion is as much a part of our social history as any other sexual or reproductive event. Women have sought and developed “organic” methods of abortion since the beginning of time – or at least long before the strict regulation and “medicalization” of the procedure and the ensuing cultural and political wars. An objective and compassionate understanding of the human condition includes a recognition of the rightful place of abortion along the continuum of experiences that make up our “childbearing” years. Sure, abortion is a tough issue – but so are many matters that we confront related to our intimate relationships and our reproductive health. That doesn’t make abortion wrong, evil or sinful – and it certainly doesn’t make it murder.

The only “new” thing about this ballot proposal is the backtracking of the debate’s starting line from conception to fertilization. This would outlaw not only abortion, but also certain birth control methods, and could create murderers out of miscarrying women and the doctors who help them. It’s such an extreme measure that even some “pro-life” leaders oppose it, and, if it passes, our (conservative) Supreme Court will undoubtedly strike it down. But the amendment itself is surely not the point. There will be months, years of litigation; there will be similar initiatives in other states, generating more opportunities for the spread of misinformation and abortion-related stigma; and there could be an immediate – albeit it temporary – negative impact on healthcare services for women. One supporter of Proposition 26 told Diane Rehm of NPR last week that “actually, it [the amendment] doesn’t change anything.” Even if, when all is said and done, that’s true, the collateral damage will have already been done. Just ask any woman struggling with an unplanned pregnancy: it changes everything.

Many have said it, but I’ll say it again:  NC HB 854 (aka Woman’s Right to Know Act) is a solution in search of a problem.  This bill assumes that women are impulsive and thoughtless when it comes to decisions about their families and their health.   Furthermore, it implies that abortion providers are nonchalant about their work and unconcerned with the realities of their patients.  These “allegations” are both unfounded and unfair.

The “purpose” of this Act is itself misleading:  “to require… the informed consent of a pregnant woman before an abortion….”  It insinuates that, without this law, women are having abortions performed on them without their consent!?  As a matter of course, all medical procedures require informed consent, and abortion is no different.  Healthcare professionals share a uniform understanding of informed consent that includes risks, benefits and alternatives; abortion providers are no different.  In fact, given the controversial shroud under which abortion providers work, no one is more concerned about adequate consent procedures than they – for the physical and emotional well-being of their clients, as well as for their own legal protection.

The authors and supporters of this bill are, in effect, using shame to discourage abortion.  But “guilting” women into having children is no more acceptable than “guilting” them not to.  Imagine arriving at your first prenatal visit, wrapped in the glow of your excitement at the knowledge of your soon-to-be child, to be presented with mandated, scripted information that includes things like 1) all possible complications of pregnancy and childbirth; 2) all known potential birth defects and infant illnesses; 3) the average amount of sleep loss following childbirth; 4) the total cost of raising a child; 5) the possible impact of child rearing on your career, your relationship and your sex life, etc.  “Now, before I show you this ultrasound, are you SURE you want to have a baby?  I am required to remind you that you can obtain a safe and legal abortion up to 20 weeks of pregnancy.  I can provide you with the names and contact information for several reputable abortion clinics in the area, if you like.”  While some or all of this information may be of value to you, a responsible and ethical healthcare provider would never assume that you want or need it, or force it upon you.  By the same token, the state cannot and should not assume that it knows best what information to provide to each individual woman seeking abortion services, or how and when to provide it.

The authors and supporters of this bill are, in effect, creating additional burdens and hardships in order to make abortion inaccessible.  The imposition of arbitrary timeframes – disguised as meaningful pauses for reflection – serve only as financial and logistical roadblocks for women involved in a precarious balancing act of childcare coverage, transportation arrangements and time off from work.  Adding time and steps to the process also increases the overall cost of providing services, resulting in higher fees for patients, and – potentially – in fewer available providers (as increasing costs and unreasonable regulations force some of them to throw in the towel altogether). 

The anti-abortion movement has been unsuccessful in garnering the support of the majority of Americans because, quite simply, Americans support a woman’s right to abortion as a viable alternative to unwanted pregnancy.  Given this reality, the anti-abortion contingency long ago changed its strategy to include back-door tactics like this one, camouflaged as harmless – even helpful — measures that ultimately impede women’s ability to obtain the kind of care they want, need and deserve.  Let’s call a spade a spade:  this bill is not about informing women.  Rather, it is a condescending and manipulative piece of legislation that seeks to restrict abortion by shaming women and complicating their lives.  I guess (the majority of) our legislators just think we are stupid, stupid, stupid.