Dozing off last night, I caught the headline on the New York Times’ webpage announcing the health care bill had passed in the House. Sweet dreams are made of this, right? Well, I woke find the health care glass isn’t entirely half-full. What it took to get conservative Democrats on board was taking abortion from not only the public option but from any private insurers receiving any public funding. Flashback to the Reagan era… except this bill passed despite the Democratic President in office being pro-abortion rights, and with a Democratic majority in both houses. I can’t decide whether those defending what happened to abortion this weekend can be rightly called defenders of the bill or apologists to half their constituents (women).

For example, last night, Jan Schakowsky, D-Ill., detailed numerous other benefits for women in the bill, including free medical preventive services and better prescription drug coverage under Medicare, before she concluded, "Women need health care reform." Of course women need health care reform. Women need all those services Schakowsky mentions—and women of childbearing age need coverage for abortion. (Risking a snide remark here, I will add that we learned from the recent forays into abstinence-only sex education an important truth: that advocating for abstinence, which is indeed the only surefire method of pregnancy prevention, does not work).

In the New York Times, Representative Rosa DeLauro, Democrat of Connecticut, is quoted: “Abortion is a matter of conscience on both sides of the debate. This amendment takes away that same freedom of conscience from America’s women. It prohibits them from access to an abortion even if they pay for it with their own money. It invades women’s personal decisions.”

News coverage in the Times and other outlets describes abortion rights supporters in the House “holding their noses” and voting in favor of health care reform, because the larger issue—health care—was so critical to push forth. (No argument from me that universal coverage and a public option are critical). The Times article explains that the Democrats, having suffered lost majorities for over a decade, were mainly left represented by the party’s more liberal members during that period, and as Democrats have regained their majority, theirs has become a larger and more diverse set of representatives. Despite public support for abortion rights having grown, the fact that more viewpoints are represented within the party changes how Democrats, writ large, relate to abortion rights. The logical conclusion from last night: that the “big tent” version of the Democratic party can’t prevail when threatened by the Bishops’—flagrantly not separating Church and State—vow to bring the issue to every Church if coverage for abortions remained in the health care reform bill.

Okay, but how bad is it? Cecile Richards, President of Planned Parenthood, released a statement just after the vote: “The Stupak/Pitts amendment would restrict women’s access to abortion coverage in the private health insurance market, undermining the ability of women to purchase private health plans that cover abortion, even if they pay for most of the premiums with their own money. This amendment reaches much further than the Hyde Amendment, which has prohibited public funding of abortion in most instances since 1977.”

Given that public funds for abortion services have been unavailable for decades now, grassroots efforts have been at work for a long time now, essentially scrambling to fill the gaps. There are over 100 local abortion funds—these groups provide “loans” (read, generally gifts) to low-income women so that they can pay for services—across the country. The National Network of Abortion Funds (NNAF) works to coordinate these many advocates into a stronger voice for abortion rights and especially highlighting the issue of abortion access.

Collectively, the funds provide over $3 million to more than 20,000 women each year. It’s hard to imagine how the need for funds would spike if private insurance ceased to cover abortion services (by definition, people don’t tend to budget for their unplanned pregnancies or planned pregnancies that may unexpectedly require termination; what’s more abortion providers demand full payment up front).

Access goes well beyond funding. How many actual providers of abortions practice, and how far must women travel to obtain services? How many legal hoops do women have to climb through to be granted access abortion services: parental consent or notification laws, spousal consent or notification laws, mandatory waiting periods or mandatory “counseling?” And how many medical providers in training are learning how to perform abortions?


If there’s a critical message it’s that access really does count. I learned this at seventeen, when I became pregnant during that brief (how clichéd, yes) window of a couple of weeks between becoming sexually active and walking through the doors of Planned Parenthood to obtain birth control. While this happened what seems now a very long time ago, I can still remember that I didn’t get birth control before becoming sexually active because I was in some denial about doing so and I can also still remember that there was (in 1981) federal funding for the abortion because I was under 18. Ready access counted in myriad ways: for one thing, by not having to worry about money, I truly could make the decision myself. While, fortunately, I did reach out to my mother, I could do so for emotional support and on my own timetable; I didn’t have to tell her, I got to choose to tell her. For another thing, at Planned Parenthood, I was handed a brochure—accordion fold—with a long list of places where I could obtain abortion services.

At that time, mechanisms were in place for women to have agency over this decision; this is not the case any longer and if both the potential for public funding along with private insurance coverage for abortion services go, it’ll be even less possible for women necessarily to make this decision for themselves.

The watering down of language by the abortion rights’ movement from being pro-abortion rights or pro-women’s equality to “pro-choice” was a tepid response to the anti-abortion movement’s hijacking of the word (and concept of) “life,” as in fetus equals person, as in “pro-life.” I’ve spent years reiterating that women’s lives are lives worth talking about when advocating for abortion rights. A woman’s equality relies upon her being able to determine what to do with her pregnancy, whether bidden or unexpected.

Years ago (1988), Katha Pollitt wrote about how the decision to have a child is a much bigger one than the decision to terminate a pregnancy, because children are such an awesome responsibility. Between seventeen and my mid-forties, I’ve had babies, I’ve had abortions and I’ve adopted a child. I would not presume to speak for Caroline, who gave birth to Saskia, however, I can say this with certainty; having a baby was no small event in Caroline’s life. Having a baby is a big deal, period.

My feminism went from bud to blossom after that first, unplanned pregnancy. First off, how amazing it was to know I could have a baby (I am woman, hear me roar). And how remarkably lucky I was to be able to say not now, not until I grow up, not until I complete my education and find a partner I choose to have children with… How incredible that there were protections in place to ensure that my dreams counted equally to man’s for his life. Because what was also clear perched unceremoniously at various toilets, sick, was that my fertile, female body determined my life’s path, unless I was given the chance to make choices about when and whether to become a parent.

The place my mind went upon hearing of this deeply important component of women’s health care being put on the legislative and political chopping block was to a bathroom, to a woman—not a poor woman, necessarily, not even a single woman necessarily—a woman who isn’t planning to have a baby at this time and who does not feel her circumstances (by which I mean everything from emotionally to financially to whatever else) authentically support her to have a child at this time. She was staring a pregnancy test stick (cost, about ten bucks). I didn’t have to hear her, because I could read her lips: f*&^. I want for any woman whose response mirrors that one to have a choice, just like I want for any woman whose response is to jump up and down in glee at that moment to feel she has that choice, too. Regardless of a line on a stick, I want every woman to have a sense of her future being hers. And that’s why, understanding as I’m trying to be of the whole health care reform picture, I’m gazing at an imagined stick and trying to will the whole picture to look different.