Self-care is not Selfishness

Christina M. Warden

As a counselor, I am always amazed at the strength and resilience of the people I am fortunate enough to talk with at The Hope Clinic for Women. Each of us has lived through so much; we each deal with obstacles that others do not know. We are each trying to do the best we can with what we have today. We each deserve respect, compassion, and support as we face life’s challenges. But there is something that comes up far more often in counseling sessions than I would prefer, a word that makes me wish I could pluck this poison thorn from people’s minds so it could no longer harm them. 
Too often people tell me that they’re concerned their decision to end a pregnancy is selfish. I think most would agree that part of being a responsible, caring person is to consider the people who are most impacted by our choices. But I see at least two big flaws in that self-condemnation. First, you are already taking into account the people in your life who are impacted. And second, there is one person who will be more impacted than anyone else by this pregnancy and what you do with it and that person is YOU. You are capable of knowing and anticipating your needs, as well as the needs of your current or potential future family. You are facing the reality of your everyday life circumstances and trying to make the best choice you can. People have abortions for many, many reasons and it is no one else’s place to judge those reasons.  
Typically, it is just untrue that the decision to have an abortion is selfish and the idea only distorts and complicates what can already be a complicated situation. There will always be people who have very strong feelings about your personal life choices, and some of them will act to influence those choices in ways that do not put your needs and wellbeing first. When they are very clever at doing this, it is called manipulation. Throughout human history, people with uteruses and vaginas have been forced and manipulated into doing with them what other people think we should do with them. Consequently, the courses of our lives have been shaped by these outside influences. This undue influence occurs in extreme and violent ways but also in everyday subtle ways, for example when we are given the message in a million forms that it is selfish to conduct our bodies and lives in ways that meet our personal needs and values. This is how we can be manipulated to believe that abortion is always a selfish choice. 
It is a cruel idea, and it ignores the often very serious self-searching and careful consideration that go into the choice to have an abortion. It ignores the diverse reasons that we can reach the conclusion that abortion is the best alternative. It ignores your say over what happens with your body and life. It ignores the ways this choice may enable you to be there for others in the future. It ignores the caring, compassion, and selfless efforts that you make in your everyday life, and what you are willing to do for the welfare of those most important in your life, including yourself. That is love, not selfishness. Self-care is not selfishness. 

Why I Am an Abortion Provider

Erin King, MD

I chose to become a doctor out of a desire to provide care to those who need it. But I cannot do my job until the Missouri legislature does theirs. I did my medical training and live in St. Louis. So why am I driving to Illinois every day to work? 

Like the many women who must leave Missouri to get an abortion, I leave Missouri to provide abortion care. My experience as an abortion provider in Granite City, across the river from St. Louis, gives me a unique perspective. Though Missouri and Illinois share a border, their policy approaches to reproductive healthcare lie far apart. 

With regards to abortion access, Illinois has outperformed Missouri for years. In 2011, 38 percent of Illinois women lived in a county with no abortion clinic, compared to a whopping 74 percent of women in Missouri. Missouri has only one abortion clinic for its 3 million women. Illinois, on the other hand, reported 26 clinics in 2011. 

I see patients every day who have come from Missouri. At least 38 percent of the 9,027 Missourians who received an abortion left the state to do so in 2012. And that was even before some of the harshest abortion restrictions in the country became law in the state. 

Faced with a mandatory 72-hour waiting period in Missouri, many patients tell me about the expenses associated with extra days off work, childcare fees, or extra travel and potential nights in a hotel. Some women have told me about the emotional trauma of Missouri’s mandatory counseling program, which provides medically inaccurate information and additional pressure against the procedure. Missouri has enacted countless “health” regulations on the one remaining abortion facility in the state — regulations that have no medical benefit for patients and significantly increase cost, paperwork, and barriers for Missouri abortion providers. Missouri even demands signed parental consent for minors obtaining an abortion when no consent is needed for any other reproductive health procedure in the state — including childbirth! 

It’s concerning to work right over the river from a state working so hard to restrict a legal and very safe surgery. Political scientists refer to the regulation of abortion as a “competitive” policy measure. This means that as heavily regulated states write restriction after restriction into their laws (Missouri legislators introduced 31 new regulations in spring 2016), it creates an influx of demand for the procedure in adjacent states. This spillover effect often incentivizes states to tighten their own sanctions, which has transformed vast regions of the United Stated into abortion deserts. 

Fortunately, so far, as anti-choice legislators in Missouri push a slew of restrictive abortion legislation, Illinois politicians have instead directed their energies towards funding pro-active family planning services. 

I’ve met thousands of women in my career as a gynecologist who have made many different, difficult choices about their reproductive healthcare. I strongly disagree with Missouri restrictions which undermine a woman’s personal autonomy and decision-making skills. Women are smart, responsible and can make their own well informed decisions. I will continue to drive across the Mississippi to work in a state that treats my patients with respect.

(First printed in the Riverfront Times June 27, 2016.)

It's time to reverse all TRAP laws

With the recent SCOTUS decision overturning HB2 in Texas, it is time to challenge all TRAP laws around the country.

TRAP stands for "Targeted Regulations of Abortion Providers" and it is an umbrella term for the hundreds of laws passed in the states that place onerous restrictions on doctors and clinics that offer abortion care. Legislators who propose these laws claim they are to protect women's health, but the Supreme Court found that rationale to be deceptive, and said these laws only serve to limit women's access to abortion.

The recent ruling applies specifically to two provisions in Texas law: that doctors providing abortion must have admitting privileges at local hospitals and that clinics be upgraded to surgical centers. The ruling means that these requirements are no longer allowed in Texas. But what about laws just like these that are already in place in other states?

The Guttmacher Institute published a report on TRAP laws on March 4, 2016. 24 states have TRAP laws. 22 have licensing regulations similar to ambulatory surgical centers. 21 require the clinic to have a relationship with a hospital for admitting purposes during an emergency.

Each of these 24 states must now face legal challenges to overturn these dangerous laws, and it will be up to the courts to strike them down, based upon the precedent established by SCOTUS. The Center for Reproductive Rights, whose attorneys won the Texas case, are moving forward swiftly to challenge state laws. Planned Parenthood has vowed to challenge the laws that have affected their clinics and doctors. 

Locally, Missouri saw several clinics close over the past two decades due to TRAP laws, ultimately leaving only one abortion provider in the whole state: the Planned Parentood clinic in St Louis. Three Missouri legislators are working to overturn the laws through the legislature. Sen. Jill Schupp, Sen. Jamalah Nashid, and Rep. Stacey Newman are filing bills that would rescind the earlier laws that are similar to the Texas laws.

Whether by legislative or judicial means, it is time to reverse these laws that have punished doctors, clinics, and women. SCOTUS is now on our side and we must move swiftly.

To learn more about TRAP laws, and to understand the role of the Hope Clinic for Women in providing for woman harmed by these laws, watch the documentary TRAPPED.