Access Denied

When Mary Burns (not her real name) discovered she was pregnant, she was afraid to tell her mother. She knew that if her stepfather found out, he would "beat me within an inch of my life." She was only 16, and there was no room to raise a child in her parents' trailer.

Burns wanted an abortion, but was shocked by the few choices she had. In South Carolina, where she lives, minors are required to get the written consent of one parent before they can have the procedure. South Carolina does offer a judicial bypass, but this option was moot because no judge in the state would hear her case. The clock was ticking. Abortions can be legally performed in South Carolina up to the sixth month of pregnancy, but no clinic in the state will perform an abortion after the first three months. By the time Burns traveled to Atlanta, secured an out-of-state judicial bypass and set up an appointment, she was almost 20 weeks pregnant, raising both the cost and the risks.

Paying for an abortion is not usually a problem for middle- and upper-class women. For teen-agers like Burns, however, a lack of financial resources, parental consent laws, and the scarcity of clinics and cooperative judges make abortion nearly inaccessible. And that's not all: According to legislation that passed the House of Representatives last year, Burns' boyfriend and his grandmother could be prosecuted for transporting her across the state line to get an abortion. The so-called Child Custody Protection Act would make it a crime for anyone other than a parent to assist a young woman in getting an out-of-state abortion if she has not fulfilled her home state's parental notification requirement.

Even though Roe v. Wade is still intact, women across the country are realizing that their access to abortion has diminished. Legislation is stacking up to block young, poor and rural women from obtaining abortions. Anti-choice groups long ago identified providers as the "weak link" to abortion rights, and launched a stealth attack on doctors and clinic staff through the courts and Congress. Mark Crutcher's influential 1992 underground manual, Firestorm: A Guerrilla Strategy for a Pro-life America, lays out strategies to sabotage and harass doctors and women through what he calls "guerrilla legislation": passing "pro-life laws" and promoting malpractice litigation against abortion doctors. Crutcher envisions "an America where abortion may indeed be perfectly legal, but no one can get one."

To this end, Crutcher founded the Denton, Texas-based Life Dynamics, which sends out direct mail to 450,000 providers and 30,000 medical students nationwide. The mailers include fake business cards and posters titled "Serving Your Baby Killer's Needs," emblazoned with a provider's photo, name and address. They also publish graphic books of crude, racist jokes that make abortion providers "the laughing stock of the medical community." Crutcher also helped form a law firm to litigate abortion malpractice cases; the firm has recruited 600 lawyers and 500 expert witnesses to help make malpractice suits commonplace.

Due to the work of such anti-choice groups, guerrilla legislation is thriving. In the past six years, 157 federal anti-choice bills were proposed in Congress and all but 24 passed (most were later vetoed). In that period, more than 400 anti-choice measures were introduced in state legislatures, an increase of 300 percent since 1995. So-called "partial-birth abortion" bans passed in more than 30 states before the Supreme Court declared them unconstitutional last spring.

At the state level, access to abortion has been restricted in countless ways. Thirty states have laws requiring clinic personnel to read to their patients graphic, government-produced scripts that promote childbearing before they can schedule an abortion. In 32 states, young women must obtain the consent of one or both parents before they can have an abortion. Many states also impose mandatory waiting periods, requiring a woman to wait from eight to 72 hours between her first appointment and the abortion procedure. The American Medical Association has concluded that waiting periods "increase the gestational age at which the induced pregnancy termination occurs, thereby also increasing the risk associated with the procedure." According to the Alan Guttmacher Institute, a reproductive-rights research organization, during the first five months of Mississippi's waiting period law, the number of abortions dropped 22 percent.

Conservative politicians have made abortions even less accessible for poor women. Since 1976, the Hyde Amendment (named for Illinois Rep. Henry Hyde) has banned the use of federal funds for covering abortions for women on Medicaid. Only 15 states and the District of Columbia provide funding for poor women to obtain abortions. The cost of a first or second trimester outpatient abortion ranges from $200 to $400, but later abortions are much more complicated and usually cost thousands of dollars.

Rhona Johnson (not her real name) of Lewisville, Texas was 26 weeks pregnant when the fetus she was carrying was diagnosed with spina bifida and hydrocephalus, spinal and neural conditions that usually lead to permanent brain damage. Doctors told her the fetus would either die in utero or live less than a year. Giving birth would have required major surgery, risking Johnson's own life.

Johnson learned that only two doctors in the country were qualified to perform the type of late-term abortion she needed. Her insurance did not cover the procedure, so she and her husband scraped and borrowed to come up with the $4,000 needed for the abortion and for travel expenses to Dr. George Tiller's clinic in Wichita, Kansas. Tiller's clinic is a prime target of the anti-choice movement: In 1993, he was shot and wounded by an anti-abortion extremist. "They told us there would be protesters," Johnson says, "but there were crowds videotaping me and calling me a murderer."

Johnson's experience outside the clinic was so horrific, and her experience inside so positive, that she became staunchly pro-choice. "People don't want to talk about sex or its consequences," she adds, "but the saddest part is that pro-lifers do not trust women to make their own decisions."

Meanwhile, violence and legal intimidation have fueled a dramatic drop in the number of doctors and clinics. Over the past seven years, seven abortion doctors and clinic workers have been murdered and 12 others injured in attacks by anti-abortion terrorists in North America. Threats of bioterrorism, primarily anthrax hoaxes, and other forms of harassment continue to disrupt clinics. Eighty-four percent of counties nationwide have no abortion provider.

Another Firestorm-inspired tactic is putting abortion providers out of business by not renewing leases, placing onerous regulations on abortion facilities, or seeking to bankrupt providers through malpractice charges. In the case of Florida abortion provider Dr. James Pendergraft, such tactics have translated into serious federal charges against him. Pendergraft, a highly credentialed African-American doctor, publicly advertises that he performs late-term abortions. He practices in five clinics in a state where two doctors have been murdered and wears a bulletproof vest on his rounds. Three years ago Pendergraft tried to open a facility in the conservative central Florida city of Ocala (where the last abortion clinic was destroyed by arson in 1989), and was informed in a letter from the chairman of the Marion County Board of Commissioners that he was not welcome there. Pendergraft ignored the letter and opened the clinic. But his patients and staff received constant threats of violence and were besieged with protesters. He was denied permission by the city to hire off-duty police officers as security guards. In 1998, Pendergraft won an injunction against the city in federal court, on the grounds that Ocala and Marion County failed to protect the clinic from harassment.

But Pendergraft's problems continued. In June, during the injunction negotiations, Pendergraft was indicted for attempted extortion of the county. The charge stems from an alleged conversation between Pendergraft and his attorney about settling the case. Pendergraft and his supporters claim he is innocent and that the charges are just another attempt to keep him from offering abortion services. His trial begins on December 11; he faces a possible 30 years in prison, loss of his medical license and a fine of more than $1 million. Even if Pendergraft wins, the time and money he has spent defending himself have sapped much-needed resources from his medical practice, which some say is the real goal of the case.

Pro-choice advocates emphasize that they have been forced on the defensive in response to legislation proposed by the right, and that the threat is not going away. "Most people don't believe that it is possible to overturn Roe, but it certainly is," says Vicki Saporta, executive director of the National Abortion Federation. "And we need to be very concerned that the Justice Department under a Republican administration will not discourage violence against abortion providers."

Several campaigns have been launched recently to improve the reproductive options of all women. The Campaign for Access and Reproductive Equity, for instance, is alerting the public to legislation that undermines the reproductive health of young women, low-income women and women of color. Another group, Medical Students for Choice, aims to reverse the stigma against abortion providers and increase their numbers. The group now has more than 4,000 members on 100 college campuses. If only half of them include abortion services when they enter private practice, the number of abortion providers nationwide would double.

Pro-choice activist Rosemary Candelario believes the movement could learn a little about aggressive organizing from the right. "We need to return to the radical roots of activism," she says, "and force politicians to work on our issues."

Miranda Kennedy is research editor at Ms. magazine and a reporter at WBAI, New York's Pacifica radio station.

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