Patient POV Update: Immigration and Abortion News

I regret not posting here recently. It’s been a very busy time for me and I am following several issues that will make their way to this blog soon. I can’t give you a rank order of what’s most important, but I think there is a heck of a lot going on out there that warrants an in-depth look.

Immigrants with Mental Illness Need Rights to Counsel

US Homeland Security citizenship and immigrationImmigration is becoming a big issue (no surprise) since the Boston bombings.

The US Department of Homeland Security handles deportations. If you can,  grab a copy of this week’s New Yorker, I highly recommend reading: “The Deportation Machine.” It’s a horrifying story about what happens when a mentally ill person gets trapped by the Department of Homeland Security. In this case, the person was U.S. born! Authorities had good information and bad information, but whenever they uncovered good information, they wrote it off as being wrong.

On a related note, in California, a class action suit is underway that raises the issue that mentally ill immigrants should have access to counsel before they are hurdled into deportation. It’s a right that has been denied unfairly until now. The case may come to closure in the coming weeks.

Separating the Gosnell Case from Safe, Legal Abortions

Kermit A. Gosnell is a 72-year-old black doctor who performed abortions at  Women’s Medical Services, an abortion clinic in Philadelphia. Many women treated there were poor and black. Abortions were done late, many beyond the legal limit of 24 weeks for abortion in Pennsylvania.

It’s the one and only case that I’ve ever heard of since abortion became legalized in 1973 rife with charges of a doctor operating outside the law,  aborting viable infants long past legal gestational age for abortions in Pennsylvania, stockpiling infant parts in jars, filthy conditions, using unlicensed staff to do abortions, and practicing outside of the law. I am appalled by the conditions presented related to this case. However, it is noteworthy that the Judge cleared Gosnell of several charges earlier this week, as reported in the New York Times last night.

The case has been on my mind quite a bit. I was active in the movement to legalize abortion. and writing about this case requires attention to detail. The lurid details of the case revolt people, no matter what side of the abortion spectrum they are on.

Concerns I have about this case include the following:

  • that Gosnell is brought to justice;
  • that the media makes clear that Gosnell is a renegade, who based all accounts, operated outside the law, with no regard for safety.
  • that Gosnell does not resemble licensed abortion providers;
  • Legal abortions are extremely safe, far safer than childbirth;
  • Restrictive abortion laws do not serve the public’s health, but that make it unacceptably onerous for women to get timely abortions and clinics to operate economically.

I hope that the public and lawmakers put this case into proper perspective because it could unjustly continue policies that already have negatively affected access to timely abortions in many states.

I have serious concerns about the media handling of this story. My points are actually quite different from what you might have read. Expect to hear more from me on this in the coming weeks.

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We Need to Recognize Conscience
In Provision of Reproductive Services

The Obama Administration made a concession to Catholic leaders yesterday, bowing to conscience-based refusals to subsidize contraception coverage. At the same time, a compromise was struck enabling women who work for Catholic nonprofit institutions to use separate insurance plans independent from the church to obtain coverage for contraception at no out-of-pocket cost. The National Health Law Program stated: “Today’s announcement is largely a victory for women who have been fighting alongside health advocates for the past two years while employers threatened to deny women coverage for birth control in the courts and as lawmakers attacked and resisted implementation. No employer should be able to make personal decisions for their employees, including whether or when a woman is able to access birth control.”

However, the conscience-based contraception and abortion refusers are unlikely to let rulings like this stick. They promise to keep pressing for exemptions to providing reproductive services based on conscience.

But the Catholic Church does not have a monopoly on conscience. I neglected to cover an important New England Journal of Medicine Perspectives piece last fall, also overlooked by the mainstream press by Lisa H. Harris, MD, PhD.  Harris drew attention to recognizing conscience in abortion provision.

Harris pointed to “an ongoing false dichotomization of abortion and conscience, making it appear that all abortion opponents support legal protections of conscience and all supporters of abortion rights oppose such protections, with little nuance in either position.” What perpetuating this falsehood has done is permitted laws that fail to protect caregivers who are compelled by conscience to offer care, rather than refuse it, Harris argues.

Like many readers, I cannot believe that we are back to trying preserve the legalization of abortion and access to contraceptive care services. Day after day, roadblocks to reproductive care services are introduced, many claiming moral superiority, we need to underscore, as Harris and many others before her have done, that before the legalization of abortion, providers performed abortions “for reasons of conscience.”

Harris points out that before abortion was legal, many providers rallied to provide safe abortions to prevent women from dying from self-induced abortions and abortions provided by unskilled providers. This was a matter of conscience. Today, Harris explains, “abortion providers working within the law continue to describe their work in moral terms as “right and good and important” and articulate that the failure to offer abortion care generates a crisis of conscience.” It’s a moral imperative that underlies belief in “women’s reproductive autonomy as the linchpin of full personhood and self determination.”

On one hand, I am glad that the compromise yesterday ensures that women who work for religious organizations will be able to gain the same access to contraception as other women. However, I think we must continue to press for equitable access to contraception for all women. If we must work around conscience-based refusals, it is high time that we recognized conscience-based provision of reproductive care services.

No More Struggling to Find Co-Pay Dollars for Contraception!

Written by Keely Monroe, Raising Women’s Voices

This blog was originally posted for the What’s in it for Women? campaign. To learn more about the campaign and the wins women get from the new health law, please visit

Today is a day for millions of women like me to celebrate!

For the first time, our country is requiring all new health insurance plans to cover contraception – and do it without charging us co-pays and deductibles. It’s all because of the women’s preventive services provision of the new health care law (the Affordable Care Act). 

This is a big deal for me as a young woman who uses birth control because it hasn’t been the right time for me to become a mom. As a young professional living in Washington, DC, where the cost of living is high, I have found that the monthly co-pays for my contraceptives take a real bite out of my budget.

I am relieved and thankful that starting today, the health care law is going to begin to change all that for me and for all those women struggling to find co-pay dollars for care we can’t do without!

This new requirement will apply to coverage for a wide range of contraceptive methods – including birth control pills, IUDs and even tubal ligations that are popular with women in their 30s and 40s. It also covers the contraceptive counseling visit with your doctor to figure out which is the best method for you.

When will this great new coverage requirement go into effect for you? It applies to all new health insurance plans beginning today, but will go into effect with the beginning of your new “plan year.” So, student health plans, which generally start with the new school year in late August or early September, are likely to be the first to include this benefit. Other new plans may not incorporate the change until January, which is typically the start of health plan coverage years.

What about existing health insurance plans? They will have to comply with this requirement as soon as they make enough routine policy changes to be considered “new” under the health care law. It’s estimated that could take until 2014 for some existing plans. Call your health insurer or your employer’s human resources office to find out what you will get this great new coverage.

So this is what’s in it for women: Affordable contraception, well woman visitsimportant screenings and counseling for intimate partner violencecounseling for sexually transmitted diseases (including HIV), breastfeeding equipment and counseling and diabetes screening when you’re pregnant.

So thanks, health care law, for helping me and millions of women to stay healthy!

Raising Women’s Voices is a national initiative working to ensure the promise of health reform is fulfilled for women and our families. It is a collaboration of three national organizations: the Black Women’s Health Imperative, the National Women’s Health Network and the MergerWatch Project — and state-based women’s health organizations in 21 states.


At Last, Women’s Essential Health
Benefits Now In Health Reform

This is a great day for women’s health — and we need many more like these as we go forward. The day has come when health reform is actually helping women, giving women parity with men. I’ll be running a guest post directly in front of this today more in the spirit of this blog, from the patient’s point of view.

It’s ironic that this blog has taken up so much ink on prostate cancer recently, because I have been involved in pushing for women’s health for decades, before Roe v. Wade, home pregnancy tests, the HPV vaccine, and even HIV.

We really need to join forces to make sure that the #waronwomen is stopped in its tracks.

Abortion must remain legal without obstacles. The mandatory ultrasound, waiting periods, psych consults, need to stop. We need our contraception, and well woman visits.

We need to expose who is behind these regressive policies and get them out of our lives. Enuf said. Don’t sit still. Organize. Stay tuned for guest blog.