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Peggy Romberg, the Director of Texas Family Planning Association was our guest speaker. Mrs. Romberg discussed the history of the fight for reproductive choice in the U.S. and Texas, and the current threats to the pro-choice cause. Mrs. Joe Love Nelson, the Director of Planned Parenthood of Lubbock, was also in attendance.INTRODUCTION
LAWS
ABORTION VS. MEDICINE
CHALLENGES TO ABORTION
MORAL AND ETHICAL ISSUES
MYTHS
TEEN ISSUES
INTRODUCTION
When I married Matt's dad, almost 38 years ago, his mother, when we became engaged, gave us a book on birth control, and I would say to you that in the Fall of 1961 that was a very popular book at the dormitory of the University of Texas. In fact, I believe that it was nearly worn out by the time I got to read it because it was so interesting. Things were quite different then and all issues about sexuality and about reproductive health care were kept pretty quiet.
As Matt said, I sort of got involved as a Planned Parenthood Board member and volunteer and I think one of the things I learned from that experience … is that the world is not like my little warm moisture in every case. It is quite, quite different [in] that people and women particularly live in circumstances and relationships that are not exactly like the ones that I was familiar with, and that was a big, big education process for me. I worked with Sarah Weddington to try, and attended a conference, and change the abortion laws in Texas before the Roe vs. Wade case was argued before the courts. So, there were attempts to try and change that. I wanted to mention one thing because the actual law - abortion statute - that was on the books originated in the late 1800s and was … in the Texas Penal Code because they wanted to protect women from bad health care and from dangerous health care, and it had nothing to do with potential fetus or potential baby or whatever. It had to do with protecting women's health. Since that Roe vs. Wade decision that struck the Texas Abortion statute and those nation wide that were in conflict with the majority decision we've seen perhaps as many as 200 bills introduced, and that is why Sarah Weddington called me in February of 1973 and said, "Can you come help lobby?" And I said, "What do you mean, we just won a Supreme Court case?" She said, "I have seven bills on my desk again." So, 200 bills, amendments, and what we call "writers" (amendments to the appropriations' bills) - we've had that many since 1973, all related to this issue. back to the top
LAWS
Somebody mentioned that they didn't really know the laws in the state - I guess Lori - in the state of Texas and I'm just going to give you a thumbnail summary of what the laws in the state of Texas are. First, only a physician - a licensed physician - could provide abortion care, and in providing that care must adhere to all the other parts of the medical practice act regarding informed consent: telling the patient what the procedure is, what the risks of the procedures are, complications [and] what to recognize so that in providing abortion care the physicians must always inform the woman and be sure she's making an informed consent to the procedure. I mention this because the opposition often says that this is not the case and doesn't happen and no one has to tell the women anything.
The second statute that is on the Texas books is that no can be forced to perform an abortion… Nurses can not be forced to assist, doctors can not be forced to provide care and neither can anyone be discriminated against for participating in abortion procedure including in hiring practices. So, if this nurse say worked at a reproductive health care center where they provide abortions on Saturdays, they could not discriminate against her in other employment that she might seek at like a Catholic hospital would be a classic example.
We also have requirements that anyone - clinics, doctors, everyone - has to report a certain amount of statistical information about every abortion performed, including the age of the patient, the number of weeks of gestational age, just a whole raft of things that they put out. Then every year the State Department of Health gives you a list of the statistics regarding abortion for that year. That was a way of also keeping up with any deaths that relate to abortion in our state. They also, in that same year that we passed reporting, required clinics that provide abortions to be licensed by State of Texas, inspected by the State of Texas and adhere to a certain group of standards which include quality assurance, all sorts of things. The Health Department comes in unannounced and inspects and investigates any complaints against that facility.
We also in Texas statute have a prohibition during the 3rd trimester, abortions may not performed [during the 3rd trimester] except to protect the health of the woman or if there is a severe and irreversible abnormality of the fetus. We also have a statute that requires licensed facilities to display and provide patients a 1-800 number to contact the Department of Health regarding any complaints that are substantiated against that facility. These facilities must also display their license number on any of their materials where they note that they provide abortion care so that their license is in clear view.
We also as of last year, and actually beginning January 1st of this year is implementation, we have a requirement that parents be notified if their minor child is seeking an abortion. There is a bypass procedure. If the minor does not want to notify her parents or have her parents notified she may go to court and prove that she is mature enough … and sufficiently well informed to consent to the treatment, or that it would be dangerous to her both physically and emotionally to tell her parents, or that notification would be dangerous for her. So, there are exceptions, and we are just getting out toes wet in this and I would be happy to talk to any of you about how this is working but I will just summarize by saying just a little bit later in my presentation about some of the scary things that are happening.
And then the last thing we have is a statute that requires physician's offices that provide abortion to be licensed by the Department of Health. The law suit has been filed and that particular statute is enjoined at this point and will have to go through the court process to see if they can actually enforce that because they don't go into doctor's offices and make spot inspections if doctors are providing a lot of other outpatient surgical procedures in their offices. So this is sort of a new area for Texas and is certainly something we thought wasn't going to happen, nor TMA or Texas Association of OB/GYNs. No one really expected this to happen.
One of the things that has sort of evolved in the process … are crisis pregnancy centers or Care-Net centers. These are anti-abortion centers that advertise that they'll help you and do pregnancy testing and they will help and that they will help pregnant women. I will say that they have improved a tiny little bit over time because back in the '80s they actually were found guilty of deceptive trade practices and advertising in the yellow pages under abortion when they in fact did not provide abortion. They now must list themselves as abortion alternatives in the state of Texas. Ninety percent of them do not have medical staff present. Their approach [is] to do a pregnancy test, not unlike the home pregnancy test though they can order and use the actual test used by physicians, I believe. [They also try] and have the young women watch pretty graphic, gory films to try and persuade them not to have an abortion. I can give you episodes of what has happened, and years ago we actually had people showing up at Planned Parenthood of Austin who were pregnant well past any possibility of termination who were actually helped by some of these centers to a certain point and then told that this wasn't working out. Actually, even finding a family to take the young woman in and then at 5 months telling her, you know, "I'm sorry, this isn't working out." That has stopped, and in all fairness I need to tell you that that has stopped because enough bad publicity of that type of care and unfair practice was something they wanted to correct. back to the top
ABORTION VS. MEDICINE
One of the things that has been hard for me and I'm sure for a lot of people in the medical field, be they nurses, physicians or other health care professions, is that the opposition to choice have had a great deal of success in isolating abortion from other medical care. Somehow the rules are different. Doctors have to be watched more closely if they're providing abortions. In some places they require that abortions be performed in ambulatory surgical centers which would mean that they would cost instead of $300 to $400 they would cost $1700. So, there are all these areas where this procedure is sort of isolated totally. back to the top
CHALLENGES TO ABORTION
I think we have a lot of challenges before us, and I wanted to talk just a little bit about some of those. One of the most noticeable is we have fewer and fewer physicians that are providing care - a serious dearth in physicians. This is for a lot of reasons. One, I think about half of the medical schools in the state of Texas offer abortion training as an elective, and the others there is no way in those facilities to secure their training. So that's one thing. We also, and this is probably the saddest for me because I've been involved in this movement for so long, and that is that a lot of the doctors that had such a passion to protecting choice and providing this care to women in crisis - such a passion for doing that- are retiring and dying. These physicians were the ones that were so strongly pro-choice because they dealt with the results of illegal abortions in our country. They're the ones … that used to have ER rotation duty, so matter what your field of practice was, unlike "ER" on TV today, you did your duty as spending 6 weeks a year, or 6 evenings a year, or something, being the physician on duty in an emergency room. So it is these doctors who saw the red blanket cases, young women dying from hemorrhage, from infection. In fact, abortion was the leading cause of maternal death in our country before the Roe vs. Wade decision - the leading cause of death. It's interesting because if you ever have the opportunity to meet physicians who were practicing before 1973, it's really interesting because there is that commitment that is hard to imagine in the field of abortion care today because they are retiring and moving on. But they are committed. They get it, they understand, they are care takers of women and health professionals that are there for women, and they don't to go back to the bad old days.
I think another challenge we have is getting the people that really belief that this is an individual choice to speak out socially and publicly and to actually vote of this issue. Believe me, we have the fight on our hands just in the medical community of hospitals, doctors, etc., that the legislators are twenty years behind, catching up to where popular opinion is, and they are very frightened because they have to run for election every 2 to 4 years and this has become such a political issue.
Let me just briefly say … that it has been our experience that the opposition resorts to a lot of distortions and non-truths… Of course one of the reasons there is a dearth of physicians is because of intimidation and harassment, threats of violence and actual violence that is perpetrated against physicians. I have personal friends who provide abortion care who have had their home picketed, lives threatened, children harassed at school, who have had their wives called up all time of the night [with] babies crying on the [other] end of the phone - the stories could go on and on, which makes your card just another example of what we've seen. Organized religions, the Roman Catholic Church, fundamentalist Christian groups and what I call religious political extremists, interestingly enough, if you look at whole gamut at the groups that are anti-choice, who will see a huge proportion of Anglo males who are in leadership positions. I could give you a whole speech another day on the issues of control and the control of women, but I think this is another topic…
The other thing we see from the opposition is attacks on family planning funding, family planning services and family planning providers. Joe Love Nelson and her board members that are here are familiar with pickets outside because there organization, which doesn't provide abortion, but speak out to keep abortion safe and legal in this country and in this state, they are harassed, and essentially their patients are coming in to get birth control and their annual physical exam are harassed. Also, they attack family planning funding of anything that I want, they don't want. Sort of like they wait to see if I'm for sex education or if I'm for the children's health insurer initiative because they're going to try and take care of not letting any money go to family planning. They are automatically against all of the things we are for, even things such as parenting education for kids that are in public schools. It's really interesting that they would attack family planning and Planned Parenthood specifically, because if you think about it for a moment you'll know that the only program around that prevents abortion and prevents the need for abortion is to avoid unintended pregnancies through family planning. This is the only place. And family planning clinics are pro-choice because they, like me, sat in those rooms and listened to the stories of women and they support women's health care, they believe women should have access to health care and reproductive health care is absolutely critical to the health and well being of women ages 14, unfortunately, and younger, … to women aged 54 … back to the top
MORAL AND ETHICAL ISSUES
The anti-choice position is one taken from personal beliefs, personal religious beliefs, [such as] when personhood begins, when ensoulment takes place. Let me say that it's all over the map on this issue - what people believe. But that's their position, and I will say to each of you that it is their right to have that position, to express that position and to make choices in their own lives based on that position. I would defend their rights. I have been in the position of trying to defend a young woman who was under age 18 right, with her parents who wanted her to have an abortion, and she did not want it. We fought as hard to protect that young woman's right to not terminate her pregnancy as we do for the other young women who want to terminate their pregnancies. The rub I have with the opposition, and as I say they have the right to make their own choices in their own lives and families, but the rub is when their rights come head to head with the rights that I have and that others have. That's the rub. The real rub is that in a free society you have to allow people individual choices, and we don't want to see laws and blockading access to clinics to other people, hindering availability through all sorts of efforts: harassment of physicians so that they'll opt out of abortion care as a part of their practice. You have to realize that the goal of these folks is to eliminate all abortions for everyone no matter what the reason. They have essentially started attacking on the most vulnerable areas where they can have some success. We used to rely on the U.S. Supreme Court. It was the biggest shock to me, when dealing with the Hyde Amendment which prohibited abortion funding for Medicaid women - women who depend on federal funds for ALL of their care - I thought, "They'll never do this. We'll win, we'll win." That was sort of the wake up call for me when they said the federal government said that we're not paying for this service. The most vulnerable of our society, the poorest of poor, and in Texas to be Medicaid eligible you're living at 17% of poverty, which for a family of four is less than $3000 per year. So those women have no choice at all. They can't find $300 … $300 on an income of $3000, there is no hope for these women, and, once again, they are also condemned for being pregnant in the first place - they should have known better, they shouldn't be sexually active - all of these things come to rest on the shoulders and backs of really poor, really entrapped women that have no care. A country that is founded on the premise of religious freedom certainly has to allow people to make these decisions on their own. I come to you and say that I'm a person of faith, and I belief that abortion is and can be a moral and ethical choice that women make. I also believe that only the pregnant women can make [that decision] - only she walks in her shoes, only she knows what her life circumstances are - and she has to be free to make that choice. And she is capable of making that choice. There is a lot of stuff that if you read through the lines that say women are not capable of making such a serious choice. back to the top
MYTHS
Now I'll just talk a little bit about myths, and this comes down to what the opposition says and what is really the fact. That all religious persons and churches oppose abortion, all Christians oppose abortions, and anyone of faith opposes abortion. I even had this experience in a study group that Matt's dad and I are in which we read various religious books and then have conversations on Sunday nights about them where the woman was confessing that this was not a real Christian attitude but she felt that if a child wasn't wanted that the woman should be able to terminate the pregnancy. Of course that caused, as Matt would guess, me to levitate out of my chair and state that was just not true. The myth is that all religious folks and religions oppose, and this is not the case. We have very strongly pro-choice denominations, including the United Methodist Church, the Episcopal Church, the United Church of Christ - not the Southern Church of Christ -- this is like First Christian Church, the American Baptist Association, not the Southern Baptists. In fact, the people that work for the Southern Baptist Association used to lobby with me against bad abortion bills until the Southern Baptist Convention was taken over by more extremists, and they called me and said that this is not the way most Baptists feel and we really feel badly about it. The Presbyterian Church of America, the Jewish Unitarian, the YWCA, and there is a large group of Catholics for choice that are very active. I've left materials for Matt about that organization because they really, really do a lot of work.
Another myth is that abortion is unsafe. Just so you know, according to the Council on Scientific Affairs of the AMA, mortality from legal abortions is ten times lower than maternal deaths in live births. (From the American College of OB/GYNs: appendectomy, childbirth, and tonsillectomy all have higher moralities than abortion.) Abortion is safe. It's safe in Texas and safe in the country. Texas fatalities from legal abortions are lower than the national average even. I say this all the time to Texas legislators because they're slow learners and because they never listen to me.
[Another myth is that] abortion causes breast cancer. Have any of you heard that? Great psychological and emotional illness? I'm leaving with Matt a whole stack of statements on breast cancer and abortion where people are refuting the claim. There was a study, or two, I think just one, that found a higher incidence of breast cancer in women who had a termination. But, as the scientists tell me, they failed to factor out the issue of women having a full term pregnancy by the time they're 30. They know that there is an increase in breast cancer if women have not had a full term pregnancy by 30, so they didn't cross this reference. I'm leaving statements by the American Cancer Society, the National Cancer Institute, the National Breast Cancer coalition and others, and lots of information about the fact that abortion does not cause breast cancer.
[Another myth is that] abortion will cause emotional and psychological problems. I'm leaving two articles behind, one from the American Psychiatric Association and the American Psychological Association, which have studied abortion received and abortion denied and have found no increase in emotional or psychological regrets/problems following the termination of a pregnancy. Now, I'll tell you that that doesn't mean that one individual doesn't have this, and that is why I believe strongly in good counseling. The other thing that was kind of interesting, I don't know if you remember … C. Everett Koup, the Surgeon General under President Reagan's administration who did not want him to find nor did he particularly want to find, when he did an extensive study on the potential emotional consequences of terminating a pregnancy, he couldn't find them. He could find nothing that was statistically significant in that area. In spite of that, of course, the Texas Supreme Court thinks you can.
One of the other myths is this whole issue of partial birth abortions, and I could spend a whole hour on that so I won't. Let me just tell you that was probably one of the most brilliant public relations campaigns from the opposition that I've ever seen before. One … you can not find it anywhere in any text called partial birth abortion as a procedure. But they did an incredible campaign talking about a very graphic procedure that really doesn't happen as such. They showed a Gerber baby, looking at least 3 months old in drawings and graphic terminology and created a whole campaign that even had our friendliest members of congress calling us and saying, "Oh my God, what's this? Tell me we don't have to defend this." In reality, it was really slick, because the definition in that bill and the bills that have been introduced across these states are so vague and so all encompassing that it isn't talking about this procedure that they've made up - it is all abortions except those that would be Mifepristone which is an oral medication. Anytime that you enter the woman's body in the vagina to terminate a pregnancy, doctors who read that and lawyers who read that say, "That's all abortions." And that's why courts have thrown it out in 11, I believe, of the 12 states where they've passed these laws they have been enjoined immediately because they are too vague and they fly in the face of Roe vs. Wade. Again, their goal is to eliminate as many abortions as you can. back to the top
TEEN ISSUES
A little bit more about teens, because I think this is a really tough issue. I've had three children - two daughters. I know that is a tough bullet because I fortunately reached my opinion before my daughters reached puberty. I used to say, "Remember, these positions you have are based on good sound facts, figures and safety." So that's why you have to bite the bullet as a parent because it's hard. You look at your daughter and certainly you want to know if she's considering surgery, an abortion, whatever. Secondly, you look at your daughter and you say, "I want to help her. I want to be there for her." And that's a valid position. I need to tell you that 75% of kids bring a parent with them when they come, and that number is huge the younger the kid is. So it's your sixteen and seventeen year olds that are not, or kids that are coming and saying, "I can't. You don't understand what my life is like. You don't understand." We had a case go to the Texas Supreme Court this last week where the minor told the judge that her older sister was thrown out of the house and never seen again when she told the parents she was pregnant at seventeen. And here she is, pregnant and seventeen. Yet the judges were denying her a judicial bypass saying that she hasn't really convinced them enough that the same thing would happen to her. I guess the parents were to suppose to have learned a lesson by never seeing this other child again. These things happen and kids are not always in great situations. Even worse than that is the fear that they have if they told their parents and it's huge for upper middle class kids like ours. They've been taught to solve their own problems, taught to be responsible for their actions. These are the kids that are more, I think, likely to try and figure out a way not to involve a parent. In Texas one of the considerations we had is that we had a study conducted by a professor in medical school in Mexico that 800 women die from abortions per month in Mexico where abortion is illegal but readily available. And at least some Texas teenagers, we fear, were going to cross that border and try to seek care rather than have their parents find out that they were ever pregnant or sexually active. We know of two deaths, and there are probably others, but we know of two because one was a criminal case. A thirteen-year-old child who had been sexually abused by her father for years tried to go and terminate a pregnancy and they told that she had to get his permission. So she went to talk to her father, and he was so upset that while she was sleeping he shot and killed her. So that's a criminal case and we know about that.
The other case is Becky Bell, and I think some of you probably have heard of Becky. I've been privileged to know both of her parents and have her mother stay in my home. Becky was a seventeen year old Indiana girl who's parents did not like her boyfriend at all, probably for good reasons. You know all of us look at some of our kids girlfriends and boyfriends and say, "Umm, I don't know." But they didn't like him, and she was pregnant and she was scared. She went to Planned Parenthood. They said that you have to notify your parents or get their permission. She said, "I can't. You don't understand. They don't even want me going out with this guy." So they made arrangements to send her to Kentucky, across the state border, and helped her get an appointment. We don't know what happened, but she didn't go. Instead she found a way to get an illegal abortion. She never told her parents what was wrong with her as she continued to get sicker and sicker, and in fact, as she was dying in the hospital, she said, "I'm sorry." They had no idea, and the results from the autopsy showed that she died from a massive infection and pneumonia because of an illegal abortion. Those parents thought, when Indiana passed the parental consent law, "This is great. This is good stuff. Now Becky will have to come to us." Now they travel across the country saying, "Those laws kill young people. We thought it would help Becky and help us, and in fact it killed her." Now, we know about this case because they are willing to step forward and say that her life has to count for something. And I've watched them talk to Senators one on one and to Lieutenant Governors one on one, or two on one, and believe me we've seen movement on the part of some of these folks who have previously agreed to oppose this legislation by hearing their story.
So, it isn't easy, and as I mentioned, we are in the midst of implementing the Parental Consent Bill in Texas. I told you about the one case, but there are a couple of others I want to tell you about before we wrap up. One woman from Houston has had six court hearings. The trial judge denied her … the appellate level refused to let her … the Supreme Court sent her back to the trial Judge, he again denied her, the appellate court denied her, and finally the Supreme Court just gave her permission. We've had in Midland all the cases where a minor has sought a judicial bypass have been denied. One because the doctor wasn't in the courtroom with her, which is not part of the statute at all. Fortunately the appellate court in El Paso has overruled. We have had in Houston where a judge has tried to name someone from a crisis pregnancy center as guardian … for the young woman and the court has said that can't happen now. And believe me, we have no idea what is happening in rural Texas because we have 254 counties in the State of Texas and abortion is available in only 16 of those counties. So there is a vast area of small towns and medium sized towns where there is no facility or no provider and we have no idea what is happening to these young women. I can assure you that most of them are not getting what they need as far as counseling and medical attention.
I'll end by saying that one of the greatest fears I have is that we will not have doctors to provide care, we will not have places and that this procedure will become more and more isolated from women's health. One of the things I think that was good in my life personally was when I left the Texas Abortions Rights Action League and the organization that proceeded it and came to Texas Family Planning because it fit reproductive rights and access to abortion in the whole realm of women's health care, which is where I think it belongs. I would urge, even if you do not agree with me and would not choose abortion in your own lives or recommend it to your loved ones, that you recognize the difference of opinion on this and the importance of keeping abortion safe and legal for the rest of the world and that you not try and pass laws that govern individual rights for these women. back to the top