State of Sexual and Reproductive Health and Rights: 2019 Year in Review

This year, states around the country passed 6-week abortion bans, critical cases on reproductive health and rights and LGBTQ rights reached the Supreme Court, targeted regulation of abortion provider (TRAP) laws have passed through statehouses around the country, and violence and harassment outside clinics have risen. Lauren Rankin, freelance writer and clinic escort, sits down to talk with us about the ups and downs of reproductive health in 2019.

While states have attempted to pass restrictive abortion legislation many times in the past, this the U.S. this year saw an uptick in 6-week abortion bans. Georgia, Mississippi, and Ohio passed 6-week abortion bans in early 2019, (and Missouri passed an 8-week ban) even though Roe v. Wade mandates that abortion cannot be banned before fetal viability. While Planned Parenthood v. Casey stated states could restrict abortion, they could not place an “undue burden” on patients. In May, Alabama passed a complete and total ban on abortion that made performing an abortion punishable by up to 99 years in prison. These clearly unconstitutional bills are passed with the goal of rising to the Supreme Court and challenging and eventually overturning Roe. *Note: None of these bills have gone into effect.

6-week bans across the U.S. have set the standard for restrictions high enough that many other pieces of obstructive legislation passed this year has flown under the radar. This includes targeted regulation of abortion provider (TRAP) laws that require abortion providers to have admitting privileges to a hospital. Other states have passed bills that require doctors to wrongly inform their patients that a medication abortion can be reversed if the patient changes their mind, and that an ectopic pregnancy can be re-implanted in the uterus. “Abortion reversal” has not been proven to be medically possible, and has in fact endangered people that have participated in “abortion reversal” studies.

Clinics have also experienced a rise in harassment, violence, and protesting in the past year. Clinics have faced homicidal violence, bomb threats, arson, and more. Many people stand outside abortion clinics every day protest at patients and staff. Because of restrictions that have been passed, many clinics have cut down hours or closed down. As these clinics close, protesters know exactly what locations to go to.

The Title X “domestic gag rule” has been under attack all year. Title X is the only and largest federal health program for reproductive health care and serves about 4 million low income, underinsured or uninsured populations every year. The gag rule prevents clinics from providing, referring for, or counseling on abortion care if they want to receive their annual funding from Title X.

Meanwhile, the Department of Health and Human Services have proposed religious refusal rules that allow healthcare providers to refuse care based on a “religious or moral objection.” This rule obviously disproportionately impacts LGBTQ+ folks, women, people of color, those seeking reproductive health care, young people, and more. In the Supreme Court this year, the confirmation of conservative justices Brett Kavanaugh and Neil Gorsuch has been ominous for the future of reproductive health and rights.

Links from this episode

Lauren Rankin on Twitter
Title X Is Under Attack
The Trump Pence Administration has Forced Planned Parenthood out of Title X
National Abortion Federation
National Network of Abortion Providers

Transcript

Jennie: Welcome to rePROs Fight Back a podcast on all things repro. I'm your host Jennie Wetter. In each episode, I'll be taking you to the front lines of the escalating fight over our sexual and reproductive health and rights at home and abroad. Each episode, I will be speaking with leaders who are fighting to protect our reproductive health and rights to ensure that no one's reproductive health depends on where they live. It's time for repros to fight back.

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Jennie: Hi everyone and welcome to this week's episode of ReprosFightBack. And if you're listening to this episode when it comes out, happy New Year's. I hope everybody has a wonderful and safe New Year’s Eve tonight. So I thought before we started this week's episode, I would take a minute and talk a little bit about, this has been a really long year, a long decade with all of the attacks on reproductive health and rights. It has just been long and everybody's tired and sometimes we're struggling. And so I thought it would be worth it to take a minute and talk about what I've been doing to focus on me and my self-care, and to hope that this gives you a chance to sit and think about doing what you need to do to figure out how to take care of yourself, to not drain yourself. Because this is a long fight and it's going to be ongoing. And it's important that we are being kind to each other and taking care of ourselves. So one of the things I've had to do more traveling than usual is the last two years, and that's exhausting in and of itself. I tried to make sure to build in self-care and doing what I need to do to take care of me on those trips. I'm inherently an introvert, so having to go and talk to a bunch of new people is particularly draining on me. I have always found a way on trips to do little things to take care of myself. And so some of that is things like last year I had to go to a conference where I was going to have to talk to people for four days in San Diego. And so I was lucky enough to be able to sneak out two days early and meet my best friend and go to Harry Potter world. And it was just really fun way to unwind before what was going to be for me, a really draining week of having to stand at a booth and talk to people for four days, which it's fun. It was a is to talk about the podcast and talk about everything that's happening. It's just physically exhausting for me and it's little things, just finding little ad-ons to trips, whether it was when I was in Vancouver, I took a day after the conference to go whale watching to just like get away from everything and not deal with work. You know, I think one of my favorite ones this year was I had a conference that was in Orlando and I was lucky enough to have a good friend who loves Disney and have her come meet me. And I went and did Disney like for the first time as an adult and it was so much fun that I think I'm going to do it again next year. It was just good to just disconnect from everything and be with people who recharge me instead of drain me and that has been really important. And for everyday things…four years ago I adopted two kittens and so they have been an important part of my self-care of having them at home and it's just nice to have them and they're silly and it's just something to the unwind with at night. I also really tried to leave work at work and I know reproductive health rights and justice, it follows you everywhere because it's life and so I just really try to not look at my emails when I get home. I really have made a point of…I don't watch cable news, I don't. I really try to just leave it all behind and not stress about it 24/7 as much as I can and I'm privileged in that I can do that.

Not everybody can do that. Again, I'm an introvert, so a lot of my things that recharge me are things that I do alone. I'm a big reader. That is to me is really relaxing and engages my brain on things that aren't work. And I read a lot. And then one of the other things I really do is I started knitting when I was in grad school and found that was a great way to get some of that extra nervous energy out. You know, when you get stressed you kind of, I get at least a little jittery and like I kind of internalize my stress and my stomach gets upset. I just need an outlet. And knitting was a really good one. It kept my hands busy, it kept me doing things and enabled me to like, watch TV or a movie or something and also be doing something with my hands and my brain that was engaging. And then the last thing that I have been doing is I had everybody recommending to me to watch the Great British Baking Show, which has been amazing and I love watching it, but also inspired me to start baking. And I started baking bread. And to me that's just been really relaxing and a stress reliever. So you know, it's been about finding the thing that works for you. So your things may not be my things. But these, the things that I have found that have really helped me try and let go of all of the stress that can value around. And you know, so much of this stuff, I get so angry when I'm at work fighting on all of these issues and I just need things that are going to calm and center me. And you know, every once in a while I'll notice that it's starting to build up. I'll not be sleeping well or you know, any number of other ways, start doing things like really grinding my teeth or something. And I have to find things that help. Sometimes I'll do meditation, which is also really helps kind of with the calming. So you know, in new year it's a time to sit and remember that we need to take care of ourselves and find the things that work for you to promote self-care and everybody has their thing and, and everybody is, is different. You know, take the time to do the things you need to do to take care of yourself. Because this is a long fight. We're going to be fighting this for a long time and we can't have everybody burning out. And I hope you find the things that work for you and the new year. So with that I'm going to turn it over to an amazing conversation I had with Lauren Rankin. She is a total badass and you should absolutely be following her on social media and reading her pieces when you can. She is amazing and I can't wait for you all to hear our conversation.

Jennie: Hi y'all. I am so excited for today's guest. First of all, if you're not following her on Twitter, you better be because she is amazing. Lauren Rankin is a freelance writer and a badass clinic escorts and just amazing. So make sure to follow her on Twitter. She's @Laurenarankin, but she's also, like I said, a freelance writer so you can see her pieces all over the place and hopefully maybe having a book sometime in the future. Hi Lauren, thanks for being here.

Lauren: Thank you so much for having me, Jennie. It's a true thrill. I am so excited.

Jennie: So this is coming out on new year's Eve. So happy new year. It’s a lighthearted episode y'all. But it's a good time to look back at all of the shit that has happened this year.

Lauren: Yeah, for sure.

Jennie: So I think one of the biggest things that happened this year is the slew of six week abortion bans or as the horrible people like to call them “heartbeat bills.”

Lauren: My favorite. Jennie: Yeah, maybe let's start there.

Lauren: So yes. So what you're talking about, what they call “heartbeat bans” is basically this idea of just nonsense, junk science that you can detect a fetal heartbeat at six weeks, which, okay, sure. And that therefore means that is a life, and a person and a human. The first few states started doing this in March, if you can remember back in March long ago, it feels like a really long time ago. But Georgia was right out the gate, and Ohio passed six week bans banning abortion at six weeks. Most people don't even know they're pregnant at that point. And basically we in the movement referred to them as near total abortion bans, which is what they're meant to do. Roe v. Wade, you know, TBT to Roe v. Wade mandates that states cannot restrict abortion before the point of fetal viability, which newsflash is not at six weeks. But you know, the follow-up case, Planned Parenthood v. Casey in 1992 reaffirmed that, but said states could restrict abortion but not place an undue burden. These do that. So we saw Georgia pass one, we saw Ohio pass one, Mississippi passed one, and then Alabama decided to outdo everyone in May and passed a complete and total ban on abortion that made performing an abortion punishable by up to 99 years in prison. And really all of these bills are designed to do one thing, which is force the Supreme Court to finally hear a case and overturn Roe v. Wade. They're all unconstitutional. The creators of the bills admit that themselves explicitly. And I think what really ended up happening that was a real shame is there was a lot of attention on these bills as there should be. They're horrifying. They're frightening, they're draconian, they have no place in society. But what we're missing as these bills work their way through the court system as they have none of them have gone into effect, is that they're actually a whole bunch of other abortion restrictions that are happening at the same time. And these bills move the goalpost so far to the right, that all of these other bills that we, I'm sure we're going to get to have sort of become even more invisible than they were before. And whether or not the Supreme Court actually overturns Roe v. Wade in the end and one of these one or all of these bans are allowed to go into effect, it won't really matter if a lot of these other restrictions are allowed to go into effect. And that seems pretty likely at this point.

Jennie: Yeah. And so that is absolutely true. The other thing that also really was hard for people is you would hear these six-week bans are passed and people thought they couldn't go get abortion.

Lauren: Yes, exactly. And it's so important to note…abortion is still legal. Yes. In all 50 states. Yes, none of these bans are in effect. I was talking when I was writing about Alabama's ban, I was talking to people at abortion funds and clinic workers and they were saying that people are calling up panicked, horrified that their appointments are gone, that they can't get an abortion in the state. None of that is true. Four states passed six week bans and Missouri passed an eight week ban and Alabama passed a total ban. None, not one of those bans currently is in effect and abortion is legal in every single state. There are abortion clinics open in every single state and you can get one. It might be difficult to access for a whole host of other reasons, but if you are pregnant and you need abortion, no matter where you are, go to National Abortion Federation and you can find a clinic in your state. It's open. They are servicing people. You cannot be denied an abortion.

Jennie: Yeah, absolutely. You've mentioned that there's a lot of other restrictions that have kind of flown under the radar but could have a big impact on people's ability to access reproductive health and I think that just makes me think back to like we here with you know the new justices on the court, the fear that Roe is going to be overturned and that's the focus and not thinking about all of these things that are already happening that make row meaningless on the ground completely.

Lauren: You know, this is not just the end of this year. This is the end of a decade and the end of the most disastrous decade this country has seen for abortion rights since it was legalized nationwide, you know, nearly 47 years ago and it's been a concerted effort over the entirety of this decade. I believe it's something like 500 abortion restrictions have been signed into law and many of those seem really benign. They seem like not that big of a deal. Like well I guess waiting for two days, like, okay, whatever you want to like take the time as if people who finally get to an abortion clinic, having to scrape up money and get a car and all that shit haven't actually thought about it up until that point….

Jennie: But this like pushes them all of a sudden, “Oh, I can't get them medication abortion anymore. I need surgical abortion. Oh no, now I need to save even more money.:

Lauren: Yes, it's paternalistic and it's designed not only to make abortion more difficult to access, but more stigmatizing and shameful to access. And those bills, a lot of them have not gone anywhere. They haven't gone challenged, know mandatory waiting periods are the law and more than two dozen states in this country. And there's no one challenging those in court. And that's because I think rightfully at this point, advocates and legal organizations realize that those fights aren't necessarily winnable because our court system has been so radically restructured. But in the meantime, on the ground, that just means that patients are struggling even more. And abortion is even more stigmatized and difficult to get while everyone is talking about “we have to save Roe.” Roe has been pretty much meaningless for millions of people, especially over the last 10 years, but since the Hyde Amendment became law in 1976 who cares if Roe v. Wade is a law of the land?

Jennie: If you can't get an abortion, it's useless.

Lauren: Absolutely. You know, affordability is a huge factor and it's not just being able to pay for it. You know, with these waiting periods or clinics closing, it's like these all play together. Clinic is further away. You have to take more time off work, find childcare for longer. You may have to go twice now and not only that, but if you're able to get to a clinic, then you're going to be met with a bunch of people screaming at you and your face that you're a murderer, that you're going to hell that you or worshiping Satan, that you are a baby butcher or you're going to have people screaming at you with a camera in your face telling you you're going to go to hell. You've done all of this to get to that point and then you might have to do that twice or three times, depending on how many times you have to go back to that clinic. Every single level. It is near logistically impossible to get an abortion and that is the entire point. You mentioned I was a clinic escort. I've been one for six years and I'm in New Jersey, which is a pretty liberal state and we still see some of the most egregious, horrific harassment of people, mostly men, I must say cisgender men ,screaming at you. You know, it's not just a matter of all of the legislation you're battling with a dwindling number of clinics. It becomes easier for protesters to target a fewer number of clinics and make it even harder once you get there. It’s this toxic atmosphere that has really gotten worse and worse. Like you said, as the decade has gone on, it's just keeps escalating. Think back to like 2009 if you can. Folks, if you can remember, President Obama had just been inaugurated, you know, we were battling for the Affordable Care Act and at that point I think most people probably felt pretty comfortable at least about where abortion rights stood. The Supreme Court a few years earlier had a loud, really stupid ban, which what's called the partial birth abortion ban, which is dumb, a ban on a certain type of procedure to become law and stay the law. But other than that, it didn't really seem like anything serious was going to happen. And in 2010 the Tea Party swept not just into the federal government but into state legislatures. We are now 10 years later, 10 years beyond that point, are dealing with the ramifications of that at the federal level. That movement failed in a lot of ways in the states. [inaudible] passed with flying colors, voting rights restrictions, abortion restrictions. That movement has led us to this crisis point and this myopic focus on saving Roe v. Wade has allowed people who generally are very supportive of abortion rights to have this erosion happen under their own noses. And we have to stop talking about that. We also have to stop just asking our presidential candidates, “would you like, do you support Roe v. Wade? No shit. That is the bare minimum. What else are you going to do? What are you actually going to do? Are you going to end the Hyde Amendment? Are you going tp end the Helms Amendment? What are you going to do? Are you going to repeal the domestic gag rule, the global gag rule? I want to know concrete things from you. And we're allowing abortion to become simply one landmark ruling when it is so much more than that.

Jennie: Yeah, and again, it goes back to the reasonableness of the things that we let slide. You know, coming up, there's going to be the Supreme Court case looking at Louisiana's TRAP law that is just like the TRAP law that was struck down before. But there are things that when you tried to explain them to people, it takes a minute, right?

Lauren: Oh, it does. Yeah. No. [Sarcastically] Obviously abortion providers should have admitting privileges at a local hospital… or an ambulatory surgical center. I have found the easiest way to do this is to compare abortion provision with another healthcare procedure. Okay, so you have to get knee surgery. That sucks. Sorry for you. It's a pain in the ass. Also, complications from knee surgery are more dangerous than complications from abortion. You're welcome. You have to get a knee surgery. Your doctor takes you in, has to have whatever. This same kind of law would require your knee surgeon to be able to admit you to a hospital. That does not mean that you can go to the hospital. You can go to the hospital whenever for whatever. Your doctor can refer you anywhere at any time. To have admitting privileges means you are a staff member of that hospital. Does your outpatient knee surgeon need to be a staff member at a hospital in order to give you knee surgery? No. That's absurd. It's the same thing with abortion. Your abortion provider just not need to have admitted privileges for you to go to the hospital. If there's a complication that's called what we already have that works, that's unnecessary. What it's designed to do, is put a hospital in a really compromising position, and I should also point out in the last 20 years, public hospitals have eroded significantly. The majority of hospitals in this country are Catholic. Catholic hospitals are anti-choice. They oppose abortion and they have literal doctrine that does that. They are not going to provide admitting privileges to an abortion provider. So what you've done there, it's forced that hospital, it's either go against the significant lobby or its own code of conduct. They provide this doctor as a basic staff member or that clinic has to close and what happens is the clinic closes the Supreme Court in 2016 with Justice Anthony Kennedy who was no liberal lion. I don't know where this idea came from, said that is unconstitutional, that you are using a framework that this is for women's health. When it's not, it's meant to close clinics and it's going to, it already did in Texas. The Louisiana law is exactly the same and anyone who thinks that the Supreme Court taking this case up is good news-- I'm sorry. You're foolhardy. Yes. We don't know what's going to happen. Oral arguments will happen in March of next year, four years after oral arguments happened in Whole Woman's Health. This core is hugely different. Gorsuch is on the court and Brett Kavanaugh, who by the way remains a rapist. Just going to put that out there. Sorry for your listeners who don't agree. I don't know why you're listening to this podcast. You know we have a Supreme Court that not only is poised but has been born and bred to finally do this thing of gut abortion access. And I don't think John Roberts would necessarily sign his name to overturning Roe v. Wade in law, but this could be absolutely catastrophic. So yes, TRAP laws are difficult to explain. They're nebulous and…abortion is legal, abortion is illegal, but fundamentally it's the same thing at the bottom line. And the risk is so severe here that if we don't pay attention, it's going to be gone. So unfortunately…

Jennie: …that was really light. Happy new year y'all. So six-week bans and TRAP laws unfortunately are not the only shenanigans they have been getting up to. There's two and I'm going to put them together even though they're very different, but they're very related in the just absolute anti-science bullshit. “Abortion reversal” bills and the bills that we're starting to see now that say you can “re-implant” an ectopic pregnancy and that's fine.

Lauren: I mean, so a lot of this underwrites, you're actually right to put the two of them together because it's part of the same sort of junk science framework that is underwritten so much of what the anti-choice movement has done legislatively for years. They did it with 20 week bans where they were like fetal personhood, like a fetus can feel pain, which do you ever, I don't know if you guys remember a few years ago a Texas lawmaker said that he saw a picture of a fetus that looked like he was masturbating. Yes. This is… I'm not making this up, please go Google it. I feel like you can't make the show up because it is so wild and every doctor everywhere was like, that's not a thing that a fetus does. But you know all of these things are based on junk science and medical lies. So what splits them up for a second? Number one, “abortion reversal.” No, that is not a thing. So there are two kinds of abortions. You can have a surgical abortion, which most people assume is an abortion. But in the first trimester, the most common form of abortion now is medication abortion. It's two pills. Misoprostol and Mifepristone and I don't know whose genius idea this was, but someone was like, you know what? What if we could reverse an abortion like we're in back to the future or something. So they, this concept that halfway through you take one pill. Then if you all of a sudden decide, I don't want to do this, you can take progesterone to reverse your abortion. So a study very recently had a clinical trial had to stop before it concluded [anything about abortion reversal] because there were such grave and dangerous health risks to the 40 women who were enrolled in it. This is not scientific thing. You cannot do this. This is not a thing that happens. You cannot reverse your abortion and you know what? People don't want to, if somebody wants to, if somebody feels regret over their abortion --and that does exist. There are people who feel, because it's like any other thing in your life, a complicated, complex choice. I am moving to another state. I'm excited to move. I also have lots of conflicting feelings about that. Does that mean that I necessarily don't want to do that? No. You shouldn't be allowed to pass a law [to stop me]. But abortion is really just the same thing. It's a, it's a gray area of human existence. This idea that we're pedaling not just junk science, but harmful medical practice that could hurt somebody in order to further stigmatize this procedure is absurd. And it's already the law in several states that doctors have to tell you, you know, you could reverse your abortion halfway through. Doctors have to tell you a lot of things that are lies. They have to tell you… there's so many of them. Abortion causes breast cancer. No, it doesn't. Abortion can cause lowered fertility. No, it doesn't. Doctors are required in many states to tell you these things against their own medical judgment. And for a doctor to tell you, “you could reverse your abortion” is directly not only a violation of the Hippocratic Oath that they take, but could put your life at risk. And yet I have no doubt that anti-choice legislators, an act of this will continue to move forward with this thing. I see it outside the clinic too. It's not just laws. There are pamphlets that are being passed out. And here's a quick little anecdote. I'm a clinic escort and there's a crisis pregnancy center, which is a fake anti-abortion health center right across the street. And we have people who work there in addition to the men who scream. And one woman, I've sort of, I don't know, I've developed a little rapport with her. If you're listening, what up? I'm not going to use your name, but she, one day, she's an actual nurse, she's the only medical professional who works there. And she came up to me and she was like, I'm really upset and I need to talk to someone. And I was like, okay, tell me what's going on. She showed me this pamphlet that she was supposed to give out to patients that was about abortion reversal and she's like, I know this isn't real. I know this isn't real information. So she called the number on the pamphlet and it was staffed by, I don't know, some Catholic charity or something. And they told her all of these horrific, awful things that she knew wasn't medically accurate. And she said, I cannot continue to hand this out. And I'm thinking, then why do you work here? Why do you work here? And I tried to help her see that in a really gentle way. You know, she's a woman of color. She needs, she needs a job, but the anti-choice movement, prey on that kind of disinformation. It preys on people who are marginalized and pedal you dangerous lies. In the end, she wouldn't actually hand out the pamphlet. She threw them all away, which I appreciated. But when even people in your own movement are like, this is going to hurt somebody, that's the reality that we're facing. And abortion reversal is not going anywhere. It's just not. Ectopic pregnancy was, here's a fun thing… Ohio man, they just, they never quit. They never do quit. So a few years ago, you may remember that Ohio had a six week ban. And were they the first? They were the first and at the last second, John Kasich. God, can you remember that guy? Kasich… I don't know how to pronounce your name because you're an anti-choice asshole. So John Kasich swooped in as the moderate hero he is and said, I'm not going to sign the six week ban. You know what I will do? I'll sign the 20-week ban. Ohio is like classic with this Trojan reasonableness, right? It's a little like, well, there is this horrible thing we could do. We could have done this really horrible thing. We'll only do the halfway less work entirely. Its goalpost moving and they're doing it right now. Again. So Ohio has now a total abortion ban that is somehow worse than Alabama’s. It's shocking to me that that's even possible. That makes abortion murder, abortion, murder and aggravated abortion murder. So it's just, I mean it's honestly mental and patients may actually be able to be criminalized under the law. It's very murky and unclear, but providers could actually possibly face the death penalty for providing an abortion. It's also unclear because fun fact, these people are not great at writing laws and it's really long to write 723 pages or something like that, which you know, I love to read, but no thank you. But it also, Ohio has done this before and they're doing it again. I don't know where they got this idea. I genuinely don't. And if somebody out there knows, please tell me on Twitter because I want to know where they got this from. But this idea that you can “reimplant” an ectopic pregnancy, which is and you know not inside where it should be into, right? People die from ectopic pregnancies, people, people die from them. They are life threatening and this is not something that any physician does says can be done or should be done. It could actually fucking kill you. And this Ohio law may mandate that. Now here is the important thing to remember. This bill is likely not going to become law. You know what's on the heels of that bill, kids—an abortion reversal bill. That is what they are trying to do. They are trying to pass this bill and the Trojan horse is this horrific total ban that everyone is horrified by, which rightfully so, that's bananas. But what they're trying to do is put that up, have everyone attack that and then sneak this bill in the back. The bill that we also know now is entirely unscientifically true and this is what these legislators continue to do. They cannot stand on science; they cannot stand on public support. They cannot stand on actual genuine legal precedent. So they have to find all of these hi-jinks and they continue to do it seamlessly. It's unreal. It's amazing how successful they are at doing this and we fall for it every time and we're falling for it now with Ohio.

Jennie: Yeah. Oh God. I, sorry, just sorry y'all. This is going to be really dark episode. Do you want to talk about abortion or harassment at clinics.

Lauren: Yeah, I think I'm so glad you asked that because I think that a lot of what we focus on when we talk about abortion in the U.S. is the political fight. You know there's an election coming up, states still passing all these laws and that's what you and I have talked about this whole time. But there's a whole other fight that's happening in this issue that most people don't see. And that's actually at the dwindling number of clinics.

Jennie: Did you know my origin story starts with being invited to go protest at a clinic in Madison? So I went to Catholic school K-8…

Lauren: Oh, I have to hear this right now.

Jennie: Okay, sorry. Everybody's already heard this. I went to Catholic school and when I was in like, I don't know, fifth grade, I think I had someone I went to school with ask me to go to Madison with her to save babies and I was like, “yeah, no, that sounds amazing.” Well I like, you know, go home and I'm like, “mom, mom, so-and-so asked me to go to Madison with her to save babies!” And she's like, huh? She's like, “okay, let's, let's sit down and talk about it.” She doesn't say, “no, you're not doing that,” but she does it so much better. She's like, “okay, well have you thought about if a woman is going through” and I'm saying woman, cause that's definitely the conversation that was had in like the eighties maybe nineties. It was definitely, “have you thought about it? This person is going through that or if this person is going through this” and didn't tell me what to think. And then at the end she was like, “okay, do you still want to go? Because if you want to go you can go.” And I was like, no, that'd be terrible. And so yes, my work in this field can be traced back to a very pro-life person who is still a very pro-life person, like really conservative. She gave me the spark back in the day. So thanks. Yeah, if you're listening to this-- solid job.

Lauren: Yeah. I mean what you're talking about there is there's so many different layers to this and there's so many different players in harassment. Since 2016 since Trump's election clinics have reported a dramatic rise in harassment, aggression, and even acts of violence against the clinic. The last murder at an abortion clinic was in 2015 and Colorado Springs at a Planned Parenthood, but clinics have been, there've been arsons, there have been bombs. There've been all sorts of things that have happened since then, but even on a less overtly horrific level every day at clinics, especially on Saturdays, there are hoards of people outside who are holding up signs, pictures of doctored, gruesome baby photos, holding megaphones and screaming shit. You would not believe at people and this is happening in your state. People I don't, wherever you are, if you live in New York, it's happening here. If you live in New Jersey, it's happening there. If you live in California, if you live in Illinois, it's definitely happening there. It's happening all over the place and what this does is create this climate of fear and tension and terror outside of clinics. It’s not just clinic patients, clinic staff, clinic escorts, not just owners have to deal with, but everyone in the community at the clinic where I volunteer, our clinic is next door to a pizzeria.Yeah, they moved in after, well after us. I don't really know why, but Hey Sophia, that's the name of the pizzeria. Go check them out and they are grappling with the reality of people screaming in front of their place and it galvanizes community members when they actually see what's happening, when they actually see a lot of these people identify as women, so patients who aren't necessarily women, but like some of these people are really young and dealing with a lot of shit and they're walking through just a mass of people who were screaming horrible things at them. No matter what you believe about abortion, I think most people can agree that we shouldn't make people feel like shit for making a choice and it's really only going to get worse, especially as more restrictions are allowed to go into effect. If the Supreme Court sides rules in Louisiana that admitting privileges are totally fine and totally legal. The number of clinics are going to completely shrink. And even in pro-choice states, there's going to be even more of an influx of pressure in patients on those clinics, which means protesters know exactly where to go to make your life a living hell. And I've been doing it for six years and in some ways it stays the same. And in some ways it's getting worse. It's draining and exhausting. And also really inspiring that like not just that people do this work and they show up and like put on a vest and volunteer their time, but the patients honestly are just like, I'm going to do this thing. You don't know what it took for them to get there. They're going to do it anyway. They're going to walk through a gauntlet of angry people to go do this thing that they probably had to save up for days, for weeks, for months in order to do. And that's amazing. That is a testament to the human spirit and that's why I think it's important to keep doing stuff like this and why I keep doing it.

Jennie: Yeah, no, I think that's amazing. And I'm so glad that there are people that are doing it and I feel for the providers who have to deal with that every day going to work.

Lauren: Yeah. It's not even just going to work for them. Like these people protest at their houses, at the schools for their kids go, you know, it's every single element of their life is under serious threat and duress because they're doctors and that's bullshit.

Jennie: So unfortunately abortion itself is not the only thing that has been under attack this year.

Lauren: Oh really? Shocking. Jennie: So one of the things it started, it was proposed last year, so probably a lot more of the coverage then but has gone into effect is the domestic gag rule around Title X. Most of it has gone into effect this year. Some of the middle finish going into effect next year.

Lauren: Yep. And that's really going to impact people's… I know clinics are doing as much as they can to be able to ensure that patients can still get affordable birth control, but it could have a real impact on low income people trying to access a STI services, birth control, and such. Yeah, so the domestic gag rule, which is a name that those of us in the community sort of used to call this horrific rule out of the Department of Health and Human Services. Basically it's what conservatives have been trying to do for years, which is boot Planned Parenthood and other abortion providing reproductive health centers out of Title X—which, if you haven't heard of it or you don't know about it, but you probably have benefited from it or someone you know has is the largest and only federal health program for reproductive health care. It serves I think about 4 million people a year and these people are low income, under-insured without insurance entirely because those people still exist--what up Medicare for All-- and now is significant portion of those health services maybe unavailable to people who need them the most. What the domestic gag rule does is basically say you cannot provide abortions or talk about abortion or counsel on abortion or refer for abortion if you want to receive Title X funding. So not only is it deliberately meant to attack Planned Parenthood and other abortion providing reproductive health centers, but it might actually end up giving that money to CPCs and other organizations that are anti-choice, not medically staffed and not based in science, don't actually even provide, had been no intention of providing. Absolutely none. Most don't. But what I think the other provision I wrote about this at Teen Vogue earlier this year, when the rule came out, it's not just that it actually forces those organizations to have separate entrances for abortion and for all the other health care services. First of all, a separate entrance is like the most overtly stigmatizing bullshit thing you could possibly do. And it's just absolutely fucking insane. But it also makes it so much easier to target abortion patients for harassment. You know exactly what door they are going in. You don't even have to bother with all the other people who are doing things that maybe you don't care as much about. Although to be honest, people who oppose abortion also oppose birth control and generally hate gay, queer and trans people. So it's designed to be punish on every level. And I was actually pretty surprised when an appeals court upheld it. I was pretty shocked. I thought, I mean I figured the Supreme Court would allow it to stand, but it is, it is the rule and it's why it's even more important now that we have elected leadership that reflects the values that we have. We need someone in every level of political office who believes and supporting access to reproductive healthcare on every level. And this is unfortunately where we stand on this and we'll see where it takes us. But it's an insidious regulation that is meant to hurt those who are already marginalized the most. I mean the good-ish news is it is still working through the court systems. It is just in effect while it is doing that. So it could still go away, but the fastest way for it to go away is if it were to a new person were to get rid of said regulation.

Jennie: Totally. So there is that. And another thing we haven't talked about yet is so many good things coming out of HHS. Like they really need a real bucket of fun over there.

Lauren: Yeah. It's really an area where I feel like Mike Pence has really just dug in and just gone shot his best life. So one of the other things is the refusal rules that have been proposed at HHS too. I mean there's so many of them, but basically say you can be refuse healthcare basically because of who you are. Yeah. That's literally it. It's no secret that Mike Pence has a legislative history of discriminating against LGBTQ people and this administration has been [inaudible] in a lot of ways too. Queer, trans and lesbian and gay folks. But this regulation basically allows providers to say, I don't want to serve you because of this. It's like the bullshit with the cake. Like, yeah, you know what? I don't want to like make you a cake because you're gay. First of all, Jesus Christ, don't you want to make money on your stupid cake? But it's basically extending that and therefore for anyone, LGBTQ people are already like among the most marginalized, especially trans folks in this country, especially trans women of color. And this is institutionalizing. Yeah. Medical discrimination, and even if this administration is to go away at the beginning of 2021 that kind of emboldening of entitlement and discrimination is not something that just goes away with it. It's not something that just goes away with a vote. You've basically told bigoted providers that they can do whatever they want. If they don't want to help you because you're a trans person, they don't have to. Okay. Yeah. It's absurd. And that when we allow that to happen to any community, it can spread to all, but it's, especially for trans people who are facing violence, trans women of color have some of the highest rates of homicide in this country. Violence against them is so ubiquitous that we don't even blink when it happens and we're saying to that community of people, I don't give a shit. I don't give a shit. What happens to you? Somebody can say, yeah, I, I see you're bleeding in the street. I don't care. That's a violation of the Hippocratic Oath. It's a violation of your constitutional right to life, liberty, and the pursuit of happiness. It’s a deliberate attempt to cast these people as subhuman and I don't honestly see what other end there is to it then telling people that they don't matter.

Jennie: So that is a sampling of all of the shit that has been going on in this last year. So maybe we'll look at some of the things that are coming. So we already kind of touched on SCOTUS so I don't know that we need to spend a ton of time on that, but just… this case matters. It definitely does. And we'll also get the decision on the, the LGBTQ cases that were already argued.

Lauren: So in those matters, yes, this administration has remade the courts for a lifetime in a way that's deeply harmful but, and courts do matter in do matter. And I don't want to make anyone out there think that they don't-- you showing up on March 4th, 2020 when they're oral arguments ready to yell and support abortion rights is important and we need your body out there if you are able to do that. It's not just that though. And let's not lose sight here of the courts may hand a series of deafening defeats. We may lose a lot of cases. It's likely that we will, we have been set up to fail. There is still power in local in grassroots efforts and abortion happened before Roe v. Wade and it will happen long after it. Trans people are still alive and in the world before this decade when they really, I mean it was a boom and visibility for that community but you watch pose and like I remember like those amazing people in Paris is burning in ballroom culture in the eighties black, trans and queer people who were still living their lives and trying to get just fucking survive… that's not going anywhere either. I think the next decade is going to have to be a real reckoning with-- I'm 34 I have not lived in a time before legal abortion and I have not lived in a time when the Supreme Court was at least overtly adverse to my general wellbeing and interests. I'm a white cis woman, so I'm pretty privileged, but I think liberal and progressive people for too long have sort of relied on the court to just sort of be a buffer. That time is over people. It hasn't been like that for most of American history and it certainly hasn't been like that for black and brown people, for queer and trans people and mostly for women. It has not been that we cannot continue to look to the courts to save us. We're going to have to do it ourselves and there's already a significant network of support on a grassroots level that exists that we're going to have to rely on and the time has sort of come for us to stop saying like, I wonder how the court will rule and the time is now for us to say, what am I going to do?

Jennie: Well, I feel like that leads us perfectly into one of the next things you wanted to talk about, which is self-managed abortion.

Lauren: Yes. Self-managed abortion is huge. So with medication abortion, you've made first trimester abortions, so much less invasive, more private, more manageable. The way that it happens now in most clinics is you take the first pill at the clinic with your provider and then you go home and you take the second one, but it doesn't have to be that way and you can manage your abortion on your own at home. People, women and pregnant people around the world have been doing this for years, especially in countries where abortion is restricted heavily or criminalized, there are support lines that people can call and get who approved guidance on taking medication to terminate their pregnancy at home. You know, abortion clinics, we're a thing that emerged in the early seventies before Roe v. Wade as sort of a standard of care and quality. That was the whole point. These places specialized in performing abortions. They could do it well, they could do it safely and they could do it quickly. The time for abortion clinics may be coming to an end, at least on a national level. There will always be places that will be hubs and if you have an abortion after 12 weeks, you have to have a surgical abortion. You cannot and you should not try to use medication abortion for that. Please don't. If you are pregnant after 12 weeks medication, abortion is not an option for you. Find a clinic and we will always need clinics, but these pills put the power to control your own body in your own hands for the first 12 weeks of your pregnancy and we're going to have to start as a movement, having a very serious real conversation about how to make self-managed abortion not only accessible, safe and equitable, but to fight efforts to criminalize it because that is what is going to happen. It has already happened. We've seen it with women like Purvi Patel… It's going to happen. People are going to terminate their pregnancies and people, especially women of color, are going to be targeted for criminalization, but it could also be a huge opening and access to quality care for people, especially in rural areas that cannot get to a clinic that have to drive 200, 300 miles to get to a clinic that's unfeasible and it's going to get harder.

Jennie: I think there are some really exciting work happening around self-managed abortion. I'm excited to see where that movement goes. Y

Lauren: Yeah, no, I think that is exciting. It is a different world from when Roe first was put in place.

Jennie: Right. You're talking much more dangerous options then than you are now.

Lauren: Totally, and that's not to say that there aren't risks with self-managed abortion there totally. Are there risks with anything that you take? Any medication you take comes with the risk. If you manage your own abortion that if something does go wrong, you can go to the hospital and you won't risk your doctor, your nurse, someone who works there calling the cops on you and that we can't insure right now. And that's something that needs to be a huge legal effort moving forward that you are able to manage your abortion at home and then if something does go wrong like it would for maybe any other thing, but you have an allergic reaction to some other medication that you can go to the doctor and if you, if this does happen to you and you go to the doctor, tell them you're having a miscarriage, tell them you are having a miscarriage. You do not have to say why you took that medication. You don't, it's the same medication for miscarriage and for inducing an abortion. So just a hot tip for any of you out there. You do not have to do that. You do not have to self-criminalize.

Jennie: Okay. I think one of the other things that we wanted to talk about looking forward is that there are some things that the states are doing, some amendments that are in the offing for 2020 because it's an election year.

Lauren: Yeah. I just wanted to flag, I want to flag that for people that it's not just a of the laws that state legislators are passing. Your state may have an amendment. Louisiana next year has an amendment that would rewrite the state constitution to affirm that there is no constitutional right to an abortion in the state. Kansas has a very similar law. Our amendment, excuse me, that's on the ballot and voters get a chance to weigh in. You know, Kansas just had the Supreme Court rule that abortion is a constitutional right, so this would be a voter amendment sort of combat that which would tangle that up in court. But your state may have a ballot initiative that isn't about banning abortion entirely. It might be restrictive. Everyone should take a look in 2020 take a look at what your ballot is. What does your ballot say? Is there anything about abortion on it? Is there anything about fetal life? Is there anything about pregnancy? And it's not just states like Kansas and Louisiana, there's one in New York that I don't think will actually make it onto the ballot because it depends on a certain number of signatures. But this is sort of the wave of the future now where it's not just legislation that's being passed but sort of trying to do with like a little smoke and mirrors gig with voters. So please, please, please read your ballots. People please do. I mean no matter what it's about, but this is a movement that's happening now. It's been happening for a few years, but it's gaining momentum and it could seriously curtail abortion or other reproductive rights in your state.

Jennie: Lauren, I could talk to you for hours and I'm sure everybody would love to listen. Maybe we should wrap it up. So I always like to end with what can people do. So what can listeners do to take action on any or all of these things?

Lauren: There's so much that everyone can do. It's so important that we don't lose sight of what we can do. It feels like we're powerless and we're basically meant to believe that we're powerless. We are not clinic. Escorting is not for everybody. That is, it's, it's a really intense experience but if you're interested in volunteering as a clinic, escort, contact your local clinic. If you don't know what your local clinic is, the National Abortion Federation has a rundown of every single registered abortion clinic. This does not include CPCs and contact information. Reach out to your clinic, ask them if they have clinic escorts, if they need it, if there's a training program that you want to get involved in, if that is not your bag, if that's too much for you, we still need your money. We're in capitalism. Yeah, I know it sucks people. I'm sorry but we are in it and we need your money and I would encourage everyone listening. Planned Parenthood is great. The ACLU is great. The Center for Rproductive Rights is great. But the people who need your money right now are at the grassroots level and at the local level. The National Network of Abortion Funds is a great place to start. And I would, they have, so I don't know if you guys know, Ihope, I'm assuming you do, but abortion funds are amazing groups that provide financial and logistical support to people who are trying to access an abortion, find an abortion fund that speaks to you. Maybe it's in your community, maybe it's in a state that's really highly criminalized. Like the Mississippi Reproductive Freedom Fund run by Lori Bertrand Roberts. It's the only fund in the state. Find one. And even if it's just like $10 a month, that means something. It's a huge, huge way to signal that you support someone or you know, donate to the Abortion Care Network, which is the group of the largest independent abortion providers in the country. Planned Parenthood might be the largest abortion provider, but the majority of abortions in this country are performed at independent clinics. And they don't--they lack the structural support the Planned Parenthood does. They need your help, they need your money, they need your support. And lastly, I'm not going to say any sort of lobbying or like calling your legislator. That's okay. Fricking given, you know like call your legislator all the time. I have Chuck Schumer on like auto dial at this point. I'm pretty sure his office is sick of my ass and they should be, they should be calling…

Jennie: I mean for those of you who have senators, I am unfortunately one of the disenfranchised…

Lauren:…you are. Yes. So I always extra appreciate when people take the time to call the senators that they have constantly Chuck Schumer and Gillibrand. But I would actually encourage you to think about talking to someone in your life you have not talked to before about this issue. You know what Jennie mentioned, like your story with your mom. What your mom did there for you was a lot of emotional labor. Yeah, it's worth doing for your kid. But that kind of conversation can actually be a model for how people can talk to other people in their life about abortion… These terms are actually pretty meaningless for the reality and the nuance of this issue. If it can just be asking someone what they think about this thing, “Hey, did you know about this law?” Did you know about this bill? Or even using the word abortion, abortion, abortion, abortion. People do not use that word. Use it. It is a word that is worth using. And the last thing I would say is there are so many people who are doing this work on the ground who feel burnt out and tired and exhausted. It's been a long time. I'm superbly privileged among them. You sending like a little card or something to your local abortion clinic and saying like, thank you for what you do driving by. If you see like protesters at a clinic and you see clinic escorts drive by, rolled down your window and be like, thank you for what you're doing to the clinic escorts. Even saying thank you is such a hugely meaningful thing and for me abortion is not a political issue. It's a humanity issue. It's a dignity issue. I think we can all extend a little grace and gratitude to each other. It goes a long way and if you are able to do that around abortion, that is battling abortion stigma and that's an amazing thing.

Jennie: Absolutely. Lauren, thank you so much for doing that.

Lauren: Thank you. This was so fun. Thank you.

Jennie: Okay. I hope you all enjoyed the conversation as much as I did. I could've talked to Lauren for forever. It was so much fun. I hope everybody has a wonderful new year and that we find ways to recharge and be ready for this fight and keep fighting. So enjoy. I will speak to you all in our next episode in two weeks. Do you want to tell me what self care you've been doing, what works for you? If you have comments on the episode or a topic that you would love us to talk about, please always feel free to reach out. And we'll see you on our next episode of RePROs Fight Back. For more information, including show notes from this episode and previous episodes, please visit our website at reprosfightback.com. You can also find us on Facebook and Twitter at RePROs Fight Back, or on Instagram at reprosfb. If you like our show, please help others find it by sharing it with your friends and subscribing, rating and reviewing us on iTunes. Thanks for listening.

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