Why Is It Still So Hard For People To Say The Word ‘Abortion’?

You’re forgiven if you didn’t realize this was National Women’s Health Week. The Office on Women’s Health (a subset of the U.S. Department of Health and Human Services) has the week after Mother’s Day set aside to promote awareness and encourage us to seek out basic, and often lifesaving, medical care. Scanning the list of 107 “health topics” and finding no mention of abortion despite all the sub-sections for pregnancy, this hardly feels like a comprehensive campaign.

The Office on Women’s Health is hardly the only entity to shy away from the word abortion, though it is particularly disappointing. With a supposedly pro-choice president and a (hopefully) impartial Health and Human Services department, I had expected, at least, a euphemistic reference to a common, safe procedure that has been a necessity for human beings for as long as pregnancy has existed.

In this era where those charged with dictating standards for health and care refuse to acknowledge abortion, the role of public advocate has fallen on the shoulders of those who provide reproductive healthcare — a role which requires risking their lives as well as their jobs.

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Dr. Diane J. Horvath-Cosper has refused to abide by her employer’s demand that she stop talking about abortion. She works in Washington D.C., where residents are prohibited by Congress members they didn’t elect from using their tax dollars to provide abortion care to Medicaid recipients. Considering the silence around a procedure performed on one in three Americans who can become pregnant, it’s not hard to imagine why she thinks talking about abortion is so important; one is left wondering instead why a hospital would disagree.

As NARAL Pro-Choice America said in their statement supporting Dr. Horvath-Cosper:

“If MedStar Washington Hospital Center is truly ‘dedicated to delivering exceptional patient first healthcare,’ they should actually put patients first and stop contributing to the stigma they face if seeking an abortion.”

MedStar imposed the “gag order” on Dr. Horvath-Cosper’s public advocacy work in December for supposed security reasons, citing the November 27 shooting at the Colorado Springs Planned Parenthood. Chief Medical Officer Dr. Gregory Argyros said he he didn’t “want to put a K-Mart blue light special on the fact that we provide abortions.”

The National Women’s Law Center (NWLC) has filed suit on her behalf, claiming MedStar has violated the Church Amendments of the Federal Health Care Conscience Protection Statutes. The Church Amendments are most often cited when anti-abortion medical staff raise objections to being part of related care, but according to the NWLC suit, the legislative history and wording of the amendments make it clear that the right to a moral stance is protected for those whose moral convictions oblige them to be vocal supporters of abortion.

The complaint reads, in part:

“Dr. Horvath-Cosper requests that the Office for Civil Rights (“OCR”) investigate MedStar and require that it end the discriminatory practice of placing broad content-based speech restrictions on its abortion providers or other health personnel on the topic of abortion while not restricting the speech of similarly situated physicians and stop discriminating against those whose moral convictions compel them to speak out about abortion.”

When Dr. Horvath-Cosper’s counsel tried to negotiate prior to taking legal action, she was reportedly told that “if she wished to speak about abortion, she should relinquish her fellowship and leave.”

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While the fear of targeting is not unwarranted, it is the scarcity of abortion providers — not the vocal advocacy of a brave few like Dr. Horvath-Cosper — that has put anything resembling a flashing blue light over the facilities that offer those services. Between 2011 and 2015, 288 anti-abortion laws were passed at the state level — many designed to force clinics to close due to expensive and/or impossible provisions like those currently being fought before the Supreme Court by Whole Woman’s Health.

According to the National Abortion Federation, 88% of all U.S. counties have “no identifiable abortion provider” — a stat that inflates to 97% in non-metropolitan areas. Abortion providers themselves are concerned about the shortage exacerbated by the attitude of medical schools around the country toward the care they provide. Despite how common abortion continues to be, fewer than half of ob-gyn residency programs include first trimester abortion as a routine part of training, about one-third offer it as elective only, and 7% provide no abortion training at all.

When there are so few clinics and even fewer hospitals offering abortion care, spotlighting them is easy. In the states that do not allow all advanced practice clinicians — e.g. nurse practitioners and others who routinely prescribe other medications — to offer even medication abortion care, those who wish to target providers can even track which days those legally able to administer abortion care are on site. When the limited number of facilities are further limited to certain days of the week based around a doctor’s availability, anti-abortion picketers and extremists can schedule their activities and threats effectively.

NAF found a spike in threats and violence following the doctored videos from the Center for Medical Progress last year. Calls to clinics have included messages threatening to “…pull a Columbine and wipe everyone out…” and implying coordinated efforts like “We will kill all [hospital] abortion doctors…” And, as covered by Jessica Mason Pieklo at Rewire, there is an entire summer of abortion violence trials slated for this summer, kicked off by the courts finding the admitted Colorado Springs Planned Parenthood shooter Robert Lewis Dear Jr. legally incompetent.

The incompetency hearing was particularly disturbing because the ruling simultaneously brushes off the extremist views that lead to 179 counts, including murder and attempted murder, and legitimizes those views as based in political and religious beliefs that are protected by the First Amendment.

Pieklo explains:

“All the evidence of Dear’s planning, of his specific targeting of Planned Parenthood, of Dear’s insistence he have a platform in the form of a criminal trial — by ruling Dear incompetent to stand trial because of his ‘political delusions,’ Judge Martinez overlooks Dear’s very real but sincerely held religious belief that abortion is a moral wrong that has no legal justification.”

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Anti-abortion groups can use these rulings and quote the Declaration of Independence all they want to foster the idea that we’re a pro-life country. The truth is that we are largely libertarian or progressive people when it comes to the availability of abortion care. All of this fear, all of this secrecy, all of this stigma — it persists despite the evidence that abortion is a public good that an overwhelming percentage of Americans think should be legal, available, and funded.

Polling from last summer that details popular opinion on abortion is hardly breaking news, but word hasn’t gotten around to the politicians who are calling for yet another audit of Planned Parenthood, promising unnecessary investigations into AmeriCorps, and campaigning on appointing anti-abortion justices to the Supreme Court.

According to polling including all ages and political backgrounds, a full 86% of voters agree (including 68% who strongly agree) with the statement, “however we feel about abortion, politicians should not be allowed to deny a woman’s health coverage because she is poor.”

So why does our president in the last days of his tenure continue to avoid the word “abortion?” This year’s White House statement commemorating the Roe v. Wade decision to decriminalize abortion manages to wield all the euphemisms to avoid saying it:

Today, we mark the 43rd anniversary of the Supreme Court ruling in Roe v. Wade, which affirmed a woman’s freedom to make her own choices about her body and her health. The decision supports the broader principle that the government should not intrude on private decisions made between a woman and her doctor. As we commemorate this day, we also redouble our commitment to protecting these constitutional rights, including protecting a woman’s access to safe, affordable health care and her right to reproductive freedom from efforts to undermine or overturn them. In America, every single one of us deserves the rights, freedoms, and opportunities to fulfill our dreams.

And why have democratic debate moderators failed to #AskAboutAbortion despite an online campaign demanding they do so? Both remaining candidates made history early on by vocally condemning the Hyde Amendment’s four-decades of discrimination against anyone insured by a federally funded program like Medicaid and one would think the networks would be going after candidates on issues they presume are volatile and divisive. More than a year into the primary election, however, only at the Fox News town hall has abortion been mentioned by a host or moderator.

Last month, Hillary called out the moderators on CNN:

“We’ve not had one question about a woman’s right to make her own decisions about reproductive health care, not one question,” Clinton said. “And in the meantime we have states, governors doing everything they can to restrict women’s rights. We have a presidential candidate by the name of Donald Trump saying that women should be punished and we are never asked about this.”

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Systematic silencing by those who should be promoting full-spectrum healthcare, the corporate media, and our elected officials are in stark contrast to the grassroots movement to end stigma and create a culture where abortion is again considered a routine part of medicine. Campaigns like #ShoutYourAbortion, the #AbortionPositive tour, and the documentary play “Remarkably Normal” are building support that compliments the advocacy of physicians like Dr. Horvath-Cosper. Perhaps by the next National Women’s Health Week, the word abortion will at least be part of the discussion again.

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Lead Illustration: Truthout.org / Jared Rodriguez

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