Right to lose: How anti-abortionists are winning

Even in California, reproductive rights aren’t safe. Learn why the state’s most vulnerable women are more at risk than ever

Samara Azam-Yu is co-director of ACCESS Women’s Health Justice in Oakland, which helps women surmount barriers to sexual and reproductive health care.

Samara Azam-Yu is co-director of ACCESS Women’s Health Justice in Oakland, which helps women surmount barriers to sexual and reproductive health care.

Photo by William Leung

It’s Day 23 of the 40 Days for Life campaign, and director Susan Money is showing off her collection of plastic fetuses.

In a black velvet case she keeps close, she cradles three finger-sized models of babes in utero. A nearby crate holds three more “Touch of Life”-brand figurines.

It doesn’t matter that a fertilized human egg resembles more glop than form at the early stages that these carefully crafted dolls are meant to depict. To this group of activists, muttering prayers outside of the Women’s Health Specialists clinic in Sacramento, opinion can be molded like untempered plastic.

“Basically, we’re here showing the love of God,” says Money, a devout Catholic with cotton-white hair and a soft trill.

God may be her co-pilot, but it’s conservative lawmakers Money should thank for advancing her crusade.

More than 40 years after the U.S. Supreme Court recognized a woman’s right to choose, that right is being challenged in great swaths of the country. California remains a progressive holdout, but that doesn’t mean it’s a reproductive-rights utopia. It’s more like an outpost, where the barriers are nuanced and disproportionately insurmountable to the state’s impoverished and socially vulnerable. California isn’t exempt from potential encroachment if a Republican reclaims the White House next year, either.

“The anti-choice campaign has really stepped up their shaming,” says Amy Everitt, state director of NARAL Pro-Choice California. “Today, abortion care is really hard to access.”

The tide started turning against reproductive autonomy following another Supreme Court decision 23 years ago. In Planned Parenthood v. Casey, the court yielded states broad discretion to restrict access to abortion. States didn’t hesitate, cobbling together what the Guttmacher Institute, a nonprofit organization that aims to promote reproductive health through birth control, marvels is a “latticework of abortion law.”

In July, a Davis-bred activist elevated the fight to the national stage. Videos produced by David Daleiden’s anti-abortion group, the Center for Medical Progress, insinuated dirty dealings between the Planned Parenthood Federation of America and biomedical companies that collect fetal tissue for medical research, including one in Placerville (see sidebar, page 15). No wrongdoing was uncovered, despite four—and counting—GOP-led congressional investigations, including the most recent, held in September.

But no matter. Those are just facts. And facts don’t hold up against dollhouse provocations.

Founded in 2007, 40 Days doesn’t traffic in graphic images or lob Molotov cocktails through clinic windows. Money says the campaign aims to evoke a softer tone, even though its solution is just as final: Abortions should be illegal, even in cases of incest or rape. Outside Women’s Health, she and her faithful crew nest that message in hymns and prayers, toys and smiles.

A gold sedan bounces over the lumpy entrance. Before Money can hold out her flier, a voice from inside shouts, “I’m keeping my baby!”

“Super duper!” Money exclaims.

Why shouldn’t she be happy? Her side is winning.

Crisis centers of conscience

Lynn and her boyfriend found out she was pregnant in a Target store bathroom in Rancho Cordova.

Then 19, she says this feeling came over her amid the fluorescent lights and popcorn-seasoned air. She just knew. The couple beelined to the pharmacy, purchased a couple of home pregnancy kits and took them straight to the lavatory. Minutes later, Lynn stared at the blue plus sign wondering what to do next. If she shut one eye, it looked like a fork in the road.

That was approximately 12 years ago. At the time, she was working at a restaurant, but without health insurance. Her boyfriend didn’t want the baby. Neither, she decided, did she.

“It was scary,” Lynn says now. “I was obviously kind of in shock.”

(“Lynn” is her middle name. Like other women in this story, she agreed to speak to SN&R about her abortion on the condition that her full or real name not be used.)

At home, Lynn’s younger sister split open a phone book and found a place in Sacramento that advertised free pregnancy tests.

It didn’t turn out like they expected.

Once inside, Lynn was asked to repeat the low-fi pee test she had done at Target. That made her suspicious. Then she was led to a small room, where an older woman invoked God and pressed her to have the child.

That shut her down.

“I kind of felt cornered,” she says, “because I knew I didn’t want to have a baby.”

Lynn didn’t realize it at the time, but she had wandered into the orbit of so-called crisis pregnancy centers.

These bait-and-switch fronts for anti-abortion activists look like full-service medical clinics, but aren’t. Most aren’t licensed by the California Department of Public Health, and, though they may advertise free pregnancy or STD tests, that oftentimes translates to pee sticks and referrals.

“They have only one goal—to stop women from accessing abortions,” Everitt says.

NARAL tested that hypothesis with a yearlong investigation. What its members encountered during 49 in-person visits, Everitt says, were people who dressed like doctors but behaved like anti-abortion activists.

In the majority of cases, NARAL says, women were incorrectly told that abortion increases the risk of breast cancer, infertility, miscarriage and depression. Staff at these places also tried scaring women away from contraceptive use with similarly dubious claims.

The influence of such crisis centers extends outside their walls.

According to a national survey of clinic violence that the Feminist Majority Foundation published last year, medical clinics that were located near crisis-pregnancy centers reported more than double the rates of violence and harassment than clinics that weren’t.

It’s these centers that Money and her fellow volunteers advertise while standing outside of Women’s Health in Sacramento, at a legally mandated distance and under the watchful eyes of a clinic escort and sheriff’s deputy. Near the top of her list, printed on pink fliers, is the Alternatives Pregnancy Center on Howe Avenue, which is where Lynn believes she went.

Among the services advertised on APC’s website are free pregnancy tests, ultrasounds and “Biblically based” counseling for people who regret getting an abortion. In a recently added parenthetical, the site states, “Alternatives does not provide or refer for abortion.” The postscript might have been inspired by new legislation.

When he signed Assembly Bill 775 in October, California Gov. Jerry Brown targeted the centers’ false advertising by requiring that they be upfront about what they do—and don’t—provide. The Reproductive FACT Act, as it’s called, is the first of its kind in the nation, and is poised to affect more than 170 crisis-pregnancy centers around the state beginning in January, according to NARAL.

That is, as long as the legislation survives a legal challenge.

Attorneys from the Sacramento-based Pacific Justice Institute last month sought an injunction in federal court on behalf of two religion-based centers, in Marysville and Redding.

Plaintiffs’ attorney Kevin Snider called AB 775 “an existential threat to pro-life clinics” in a phone interview. “You’re telling pro-life clinics to refer women and girls to places where they can get free and cheap abortions. That’s preposterous on its face.”

A spokeswoman for Attorney General Kamala Harris, who co-sponsored the legislation, promised to “vigorously defend the state law in court.”

When asked about the Reproductive FACT Act, Money almost does something that seems uncharacteristic for her—swear: “It’s a piece of,” she says, falling silent.

For Lynn, however, the legislation would have spared her an unwanted lecture. “They did kind of corner me and put kind of a guilty conscience in me that abortion wasn’t an option if I wanted a relationship with God,” she recalls.

Whatever ends up happening in court, the rise of crisis-pregnancy centers reveals something about the anti-abortion movement’s approach in California: Here, the most effective attack is the indirect one.

‘Two steps forward, one step back’

Megan didn’t learn she was pregnant again until well into her second trimester. The 21-year-old Santa Cruz woman had given up a newborn baby for adoption less than two months earlier and was still recovering from labor when her boyfriend sexually assaulted her.

It was a dark time and getting darker.

“He would force me to have sex with him, which is the only reason I got pregnant so quickly,” she wrote in an email to SN&R. “I couldn’t go through another adoption, but I also knew that I couldn’t take care of a child.”

Megan was 16 weeks along when she discovered the pregnancy. That put her in a small and increasingly ghettoized subgroup of women who seek abortions.

As of November 1, a dozen states had gestational age limits in place to prevent most abortions for women who are more than 20 weeks pregnant, according to the Guttmacher Institute.

A federal ban on later-term abortions is also one of the top legislative priorities for the Susan B. Anthony List, a pro-life political lobby, and has elicited support from the cream of the Republican presidential crop, including frontrunners Ben Carson, Marco Rubio and Donald Trump.

But the data on women who terminate pregnancies after 20 weeks reveals a fragmented system that blocks abortion access at the front end, and then vilifies the women who eventually soldier through.

By the time she discovered her pregnancy, Megan knew she was running out of time. None of the local providers would perform a second-trimester abortion. The one clinic she was referred to was 30 miles outside of town, which meant she had to arrange—and raise money for—travel and lodging, along with the actual procedure.

“Since I was working for minimum wage with no savings and an insurance policy that wouldn’t cover an abortion, I had to pull the money together before I could schedule the appointment,” she explained.

Megan’s experience took place in 1992. But, in some ways, it’s more common today.

Rana E. Barar, center, is project director of the Advancing New Standards in Reproductive Health program at UC San Francisco’s Bixby Center for Global Reproductive Health. The center just completed a seven-year survey of abortion seekers that is producing surprising new findings.

Photo by Cindy Chew

Samara Azam-Yu is co-director of ACCESS Women’s Health Justice in Oakland. Over the past eight years, she says, callers to the help line have gone from describing single-issue barriers, like prohibitive costs or distances, to “all of the above” quagmires similar to Megan’s experience.

“The poverty rate is a real problem in California,” Azam-Yu says. “There are definitely people traveling every day for care,” some for hundreds of miles. “As someone in the movement, it can be hard to think it’s not two steps forward, one step back.”

While the state only prohibits abortions of viable fetuses that don’t pose health risks to the mothers, individual hospitals can deny abortions on religious grounds. That’s becoming a larger issue as Catholic hospitals gobble up more of the health-system marketplace, says Phyllida Burlingame, the reproductive justice policy director at the American Civil Liberties Union of Northern California.

Still, only 5 percent of abortions take place in a hospital or private physician’s office, Guttmacher data says. The vast majority occur in clinics, whose staff members can choose to impose restrictions beyond what the law requires. When they do, it’s often due to the availability of trained physicians and facility regulations.

But Azam-Yu says clinics aren’t immune to pressures both economic and political, especially in rural or conservative counties with limited support.

The obstacles can manifest in subtle, agonizing ways. A clinic that’s suddenly closed its doors. Or shortened its gestational eligibility. Or stopped accepting Medi-Cal. Or doesn’t provide general sedation. Or rejects anyone with a “high-risk” pregnancy, which can mean women who are obese, have asthma or had an earlier caesarian birth.

It just happens such factors are more common among women who are poorer and geographically isolated than they are the general female population.

“It’s really heartbreaking when you hear the barriers that people are dealing with,” she says. “If you’re stretched thin, the outcomes are really the same.”

Other states have it even worse.

According to Guttmacher, 42 states presently allow health institutions to deny abortion care, 38 have parental notification laws, 35 restrict private or state insurance from covering abortion and 28 employ waiting periods. Along with proliferating gestational limits, such policies can create a fait accompli: Stall women from accessing reproductive care early in their pregnancies so that by the time they do, it’s too late.

Today, abortion restrictions force more than 4,000 U.S. women to carry unwanted pregnancies to term every year, according to new data from UC San Francisco’s Advancing New Standards in Reproductive Health project, which completed a seven-year survey of abortion-seekers earlier this year. They also compel an unknown number of women to risk health and freedom by taking matters into their own hands.

“Abortion doesn’t go away,” says ANSIRH project director Rana E. Barar. “It happens … in varying degrees of safety.”

For Megan, a former foster child of limited means with a menacing partner, it was the right decision. She was able to get her abortion at 20 weeks.Not everyone can say the same.

Turning back the clock on Roe v. Wade

One month after she was raped by her employer, Katharina mustered the courage to return to his South Sacramento office and demand money for an abortion.

The man ran a copier business that took up one half of a building suite on Fulton Avenue. Aside from Katharina’s brief employ there—she was hired one day, assaulted the next and quit two days later—he was the only person in that large, gray space.

“I said, ’I’m pregnant. I need money for an abortion,’” Katharina recalls of the brief meeting. He told her to come back a couple of days later for the money. When she did, the place was cleared out. The renters next door said the man moved to another state.

That was November 1967, roughly six years before the Supreme Court struck down state-by-state prohibitions against abortion. The procedure was illegal in California, too, but that didn’t matter to the 20-year-old Katharina, a broke single mother to a 3-year-old boy. For her, there were two options: Terminate the pregnancy or die trying.

“I would have killed myself, I wouldn’t have had that child,” she says.

This might sound like ancient history from a less-evolved time, but it’s not. For Ben Carson and groups like 40 Days for Life and Californians for Life, it’s a glimpse into the future.

“[Abortion] isn’t illegal yet—and I say yet,” says Wynette Sills of Californians for Life. “You have to change hearts and minds first before you change the law.”

But the law has already changed across much of the country, despite Gallup polls that show more Americans consider themselves pro-choice than pro-life.

And there are warning signs that Katharina’s story is happening today.

A Guttmacher policy review cited “at least half a dozen” cases in which women were prosecuted after they attempted to abort pregnancies using illegally obtained abortifacient drugs. It happened to a South Carolina woman in 2004, a Massachusetts woman in 2007, a Pennsylvania woman who obtained the drugs for her daughter in 2013 and a Georgia woman this year.

Women suspected of lying about their miscarriages were also charged, including an Indiana woman sentenced to 20 years in prison earlier this year.

After her attacker fled town, Katharina tossed herself from countertops, off tables and high stairs, hoping to miscarry. She ingested quinine tablets and whiskey on the advice of an older woman. When that didn’t work, she asked her sister to insert a sewing needle into her womb, to see if they could force the issue. But the pain was too great.

When she finally terminated her pregnancy, she labored alone in a doublewide trailer in South Carolina. A man she never met had stuffed gauze into her uterus to induce an unnatural birth. Hours later, when it was time, she passed the tissue in a toilet and flushed without looking.

Nearly 50 years later, in a suburban Folsom cafe, Katharina considers the lengths she and other women of her era went to assert control over their bodies. She contracted a severe tubal infection, but counts herself lucky. “My story still turned out good in the end,” she says. “But there were women who went into the back alley and died.”

She speaks in the past tense, as if that time is over.

But it’s not. In 2009, a 17-year-old Utah girl paid a man $150 to beat her into a miscarriage when she couldn’t access abortion care due to the state’s strict policies.

For her desperation, the girl was charged in juvenile court with solicitation to commit murder.

The right choice

Draped in a pink frock and trading perforated tickets for cash, Kim Borden stands at the doorway to a back alley that’s quickly losing the light. Outside, a handful of her associates keep their eyes peeled for passersby with lost expressions.

This resistance is easy to miss.

It’s early evening at Pre-Flite Lounge, a speakeasy-style bar located in a nondescript alley wedged between J and K streets on the 10th Street side of the block. On this late-September weekday, the bar has been overtaken by a fundraiser for a local affiliate of Planned Parenthood, the beleaguered health entity that was plunged into a fabricated crisis over its handling of aborted fetal tissue.

The optics are fitting. With God supposedly on their side, the opponents of choice have pushed women into the back alley once again.

Congressman Ami Bera doesn’t get it. Reached by phone, the Democratic representative from California is among the legislators who have, thus far, turned back repeated attempts to strip Planned Parenthood of financial support from two federal programs—Medicaid and the Title X Family Planning Program. Congressional Democrats currently have a backup goalie in President Barack Obama, who promises to veto any legislation that withdraws funding. But he’s not long for his office, and Republican presidential aspirants have made no bones about wanting to reverse that support.

“For years, you’ve seen it at the state level,” Bera says of attempts to dismantle reproductive rights. “In addition to fully defunding Planned Parenthood, I think they’re [Republicans] looking for other ways.”

To Bera, this is a departure from the Republicans of old, of the ’60s and ’70s, who understood that helping women plan for families wasn’t a bad thing. “To me, it’s an issue of individual rights,” he says. “We should not be limiting this access, but talking about expanding it.”

California is one of the only states to actually do that. In 2013, the state legislature deputized nurse practitioners and other trained clinicians to perform first-trimester abortions, which is expected to cut delays, especially in rural counties.

“It was a really significant statement by California in terms of our commitment to reproductive health care,” the ACLU’s Burlingame says. “What we really see is California leading the nation.”

But how long can it hold its own?

In solidarity with other cities around the nation, Borden says she co-organized September 29’s Midtown Pink Out “because Planned Parenthood has done something for each of us for the better part of our lives.”

It’s where Lynn went after her surprise run-in with a pushy pro-lifer. Unlike her visit to the crisis center, she says Planned Parenthood staff gave her a blood test confirming her pregnancy and walked her through all of her options. After thinking it over for a few days, she opted for a medication abortion—an effective cocktail of mifepristone and misoprostol that accounted for 23 percent of nonhospital abortions in 2011, a Guttmacher policy review found.

“My experience with Planned Parenthood was very positive,” she says. She’ll even voice that publicly now, whenever someone bad-mouths the health-care provider within earshot: “I had a very pleasant experience with Planned Parenthood when I got my abortion.”

Happy endings are more common than abortion opponents want the public to think.

According to the UCSF survey, women who obtained abortions were healthier in the short term and better off socioeconomically than those who were forced to carry unwanted pregnancies to term—and less likely to remain in abusive or undesired relationships.

“The reasons that women give for having an abortion are very prescient,” says Barar, who piloted the Turnaway Study with lead researcher Diana Greene Foster. “There are very tangible effects [of having a child] and women know what these effects are going to be.”

The study found out something else, Barar says: Of the women who obtained abortions, 95 percent said it was the right choice, and did so when asked multiple times over the ensuing five years of the survey.

The seven women who shared their stories with SN&R belong to that majority.

“I have two beautiful children and an amazing grandson,” says Megan, now 44. “I don’t believe that I would have any of them if I had made a different decision. My son that I gave up for adoption wouldn’t be who he is. So I don’t regret my decisions.”

It’s not something that gets stated out loud often, even though approximately one in three women will terminate at least one pregnancy by the time she’s 45.

When two women recently tried to embolden others to share their abortion stories on Twitter, their hashtag, #ShoutYourAbortion, was nearly co-opted by antagonists declaring vitriol and threats.

The ugliness reinforced an old pattern: There are many people who talk about women getting an abortion, but not many women who feel safe sharing those stories themselves. That’s one shame among many to NARAL director Everitt.

“We would do well to start talking and [understanding] women who do access abortion care,” she says, “because it’s all of us.”