Suffering Under Liberty and the Reproductive Health Policies of North Carolina

Guest post by Brittney Cobb, Charlotte Dominguez, and Andi DeRoin.  The authors are first-year social work graduate students at North Carolina State University. Along with completing advanced generalist practice education, they are advocating for policy change at the state level and fighting for social justice, equity, and a healthy community.

Reproductive health justice is vast, yet abortion seems to always be at the forefront of America’s consciousness. Over the past year, North Carolina conservatives have launched a new political offensive to limit health care access, legislate reproductive decisions, and disregard the bodily integrity of half the population. Though attacks like this are happening across the country, the recent legislative actions of North Carolina officials strike close to home for us North Carolina State University social work graduate students as we prepare to enter the career field.

Despite protests that SB 353 could further restrict access to abortion, and reminders that such action went against his campaign promises, Governor McCrory signed Senate Bill 353 into law on July 29th 2013.  Under this law, 1) medical providers in North Carolina have the right to refuse to perform abortions (despite already being able to do so), 2) sex-selective abortions are banned (despite having no evidence of prevalence), 3) providers must be present for an entire surgical abortion procedure or the administration of the first pill to induce a chemical abortion (despite no evidence of adverse safety or health effects), 4) the Department of Health and Human Services (DHHS) must write and enforce new rules for health clinics, which could include new ambulatory care standards and 5) motor vehicle operators are responsible when colliding with motorcycles they do not see.  Yes, you read that correctly– our legislators stuck limiting health care regulations onto a motorcycle-safety bill.

Redundant legislation and foggy rhetoric do not ensure women’s safety, nor do they prevent harsh interpretation from restricting access to abortion. Opponents of the bill fear the new regulations could potentially force health clinics to close their doors if they cannot meet the new standards.  National and State medical groups attest that the guidelines clinics currently run under are sufficient, and enforcing new regulations are unnecessary.  The effects of these new DHHS rules are inciting community uproar and concern.  Negative reaction from the bill comes from what we believe are the true motives of those who pushed for it to be signed into law.

To put it bluntly, those with a uterus will suffer under SB 353, but communities which rely on clinics for comprehensive health care will suffer the most. If clinics are forced to close under the new DHHS rules, many marginalized populations (which already have limited access to health care) will become even more pushed aside–by NC legislators. Without availability to those clinics, marginalized women will lose access to reproductive health care which could result in increased unwanted pregnancy and no safe access to abortions. Their reproductive livelihoods are being threatened by policies put in place that limit their access to these clinics.

It seems that the main moral value driving this policy is the right to life, while a woman’s right to bodily autonomy drives opposition.  The heart of the reproductive health debate seems to involve where priority is placed: on the unborn, or on the pregnant female.  Senate Bill 353 does not deny the right to abortion, but it infers a proposition to end them. For those who support a woman’s right to have complete control of her reproductive health, arguments such as these do not overshadow the existing life of a mother.

Abortion and reproductive health care providers, as well as individual advocates across the state, have made their voices heard both during and after the consideration and passage of SB 353. Though there is inspiration from past movements related to such ingrained and divided social justice issues, nothing seems to adequately prepare us for today’s fight.  The only seemingly viable option is to attempt to network with other states; together we can comprehensively and independently lobby lawmakers.  As reproductive rights are dismantled, we can harness the resulting disgust and outrage, empower all individuals to stand up for personal liberty and bodily integrity, and influence our state, our region, and our country.

Know the Facts About Motorcycle Vagina Law & TRAP

Targeted Regulations of Abortion Providers (known as TRAP laws) are part of a coordinated, national effort to limit reproductive freedom and chip away at access to reproductive health care by any and all means necessary.

What is a TRAP law? TRAP laws single out facilities that provide abortion care and impose on them medically unnecessary, politically motivated regulations that don’t apply to other health care centers. TRAP laws are designed to force women’s health care centers to close and make abortion care more difficult and expensive to obtain.

What do TRAP laws look like? There are three main types of TRAP laws:

  • Licensing laws that require women’s health centers, but no other comparable facilities or offices, to obtain and maintain a license and to adhere to other types of regulations regarding physical building requirements, staffing and procedures.
  • Laws that require women’s health centers to act as Ambulatory Surgical Centers (ASCs). ASCs are “mini-hospitals” where medical professional perform a wide range of out-patient surgeries. Obtaining an ASC license can require physical reconstruction of facilities and other changes that may be too expensive for many providers.
  • Laws that require doctors providing abortion care to obtain special agreements with hospitals, often in the form of admitting privileges or transfer agreements. These are essentially business agreements between hospital and doctors that are not medically necessary but can often be very difficult, if not impossible, to obtain. The American Congress of Obstetricians and Gynecologists (ACOG) opposes admitting privileges and transfer agreements and instead recommends providers establish a plan to ensure prompt emergency services if a complication occurs and a mechanism for transferring patients who require emergency treatment.[1]

Wait. Does North Carolina already have TRAP laws? Yes! Women’s health centers in North Carolina are already subject to dozens of regulations that do not apply to other healthcare providers. For example, elevators in clinics must be large enough to accommodate a stretcher, hallways must be 60 inches wide, and all doors must be at least 3 feet wide.

What is SB 353? SB 353 is legislation that was passed by extremists in the NC General Assembly and signed into law by Gov. McCrory in July 2013.  The law creates sweeping and egregious restrictions on access to comprehensive reproductive healthcare.

Is SB 353 a TRAP law? Yes. The most dangerous aspect of the law is the fact that it gives The Department of Health and Human Services (officials appointed by the Governor) the power to make new regulations for women’s health centers.  If anti-choice politicians get their way, instead of increasing health and safety, these restrictions will likely make safe and legal abortion care more difficult to obtain for women and families.

What can I do about it? You can spread the word about the impact these bad regulations will have on women’s health. Make sure your friends and neighbors know the facts:

  • Women’s health care centers are gateways to well-woman care. Women’s health centers offer a wide range of essential women’s health services, including cancer screenings, annual check-ups for reproductive health, and pap smears. First-trimester abortion care is only a small portion of the reproductive health care offered at women’s health care centers, but TRAP regulations impact their ability to provide care to all patients–thousands of NC women–not just those seeking abortion care.
  • Women’s health centers in North Carolina are highly regulated by state and federal safety regulations. Women’s health centers are already subject to numerous TRAP regulations. Additionally, they follow the same regulations as other physicians’ offices and facilities providing services like dentistry, oral surgery, and colonoscopies.
  • Abortion is incredibly safe. Abortion is one of the safest and most common medical procedures in the United State. The most respected doctors in our state and in the nation believe that there is no need for further regulation of women’s health centers.

[1] For more information on types of TRAP laws, visit the Center for Reproductive Rights on-line at http://reproductiverights.org/en/project/targeted-regulation-of-abortion-providers-trap.

McCrory is beginning to show his true colors.

Last Thursday, Governor McCrory was in Roanoke, VA, campaigning for Ken Cuccinelli, the republican candidate for Governor of Virginia. “By choosing to campaign for Cuccinelli, McCrory is showing his true colors. Cuccinelli is one of the most extreme opponents of women’s reproductive health care in this country, he has explicitly admitted that his goal is to ‘end abortion in America,’ and has compared abortion to slavery,” said Suzanne Buckley, Executive Director of NARAL Pro-Choice North Carolina.

“McCrory and Cuccinelli actually have a lot in common. As attorney general, Ken Cuccinelli made taking away the reproductive rights of Virginia women his top priority. This past summer, McCrory signed the most restrictive anti-choice law we’ve seen in over four decades,” said Buckley. “And when it’s convenient, both men try to hide their anti-choice politics,” she continued. “The good news is that women are watching, and whether they live in Virginia or North Carolina, they are not going to be fooled by lying politicians like McCrory or Cuccinelli,” she concluded.

cuccinelli-surrogates-draft

Everything you need to know about today’s DHHS meeting.

Today, the Joint Legislative Oversight Committee on Health and Human Services will hold a public meeting with the NC Department of Health and Human Service.  The meeting will feature members from both the NC House and Senate as well as representatives from DHHS, including Secretary Wos. Wos will be on hand to answer questions on a wide-range of topics from problems with the Medicaid billing system to controversies over staff salaries and severance packages.  Based on what we’ve seen from Governor McCrory and DHHS so far this year, there is very little “health” care going on in the department, and a lot of political maneuvering

North Carolina’s Department of Health and Human Services (DHHS) is having an identity crisis. Each day brings more alarming news about DHHS—abrupt resignations, politically-motivated hires, massive raises for inexperienced staffers.  DHHS is a large and critical state agency. With an $18.3 billion budget, the agency is responsible for ensuring the health, safety and well-being of all North Carolinians, and—as of October 1—for proposing medically appropriate regulations for abortion providers under new legislation recently passed by the General Assembly.

In a move that shows more cronyism than concern about North Carolinians’ health, Margaret “Mardy” Peal was recently hired as Senior Planner for the agency.  Peal has no recent health policy experience, but did recently serve on the board of directors of an anti-choice organization. To be specific, Peal served on the board of a CPC with an explicitly political anti-choice policy. Why would DHHS hire an ideologue opposed to the very procedures the agency oversees?

Besides the obvious antipathy to matters of health—especially women’s reproductive health—this hire seems to represent another embarrassing misstep from the administration following a legislative session rife with surreptitious parliamentary tactics and broken promises from the governor. If McCrory and DHHS truly care about women’s health, it’s time to put politics aside.  This is about more than reproductive rights; this is about basic good governance.

Here’s to hoping that today’s meeting brings some much needed transparency to one of the state government’s most critical agencies.

Listen in to the afternoon portion of the meeting here and follow us on Twitter @NARALNC for live-updates and breaking news.

Four Moments of Grace from Wednesday’s Protest

Guest Post by NARAL Pro-Choice NC Volunteer Alice Wilder

I ran up the steps of the capitol, around the building and was met with a rush of pink and purple. My first instinct was to cry- being in the physical presence of activists felt like exhaling. Seeing the crowd was the first of many emotional moments at the Wednesday protest. SB 365 is horrifying, if passed, it would eliminate all but one abortion providers in North Carolina. It’s the Red Wedding of anti-choice legislation. Considering the stakes at this protest, you’d think it might be somber and angry- but that wasn’t my experience. Sure, there was anger, but I came away feeling immense love for NC pro-choicers. It’s difficult to sum up the energy of the protest, but here are some moments where I felt that love.

1. Watching how quickly everything came into place

I went to dinner with a friend, and by the time I came home around 7:30 my Twitter feed was filled with news of this bill. In no time, plans were being made. By 8:00 there was a Facebook event. Carpools were being organized.

2. Those in other states spreading the word

I follow many activists on Twitter, and I’ve gotten used to seeing them Tweet about Texas and Ohio. They’re probably pretty exhausted (what a week it’s been!) and it was wonderful to see solidarity from activists all over the country.

3. The young families

Our line of grass in front of the House was filled to the brim with children of all ages. Many played in the grass or sat on their mother’s hips as the protest went on. Older ones shouted along as we chanted. In front of me at one moment was a young mom with two toddlers on her hips, a boy and a girl. They were visibly tired, it was near the end of a long, hot morning. We made eye contact. “My mom took me to protests when I was their age” I told her. She smiled back, “so did mine.” And there she was, teaching her kids about democracy, leading by example. It was so beautiful to see so many generations of activism in one place.

4. Solidarity even in silence

My friend Rachel and I ventured up to the outside of the gallery to watch the proceedings. It was eerie to be so close to legislators trying to make laws controlling my body- but an honor to be near the senators defending our right to choice. Those activists in the gallery were not allowed to make any noise or hand motions. It was a shock to go from outside, where we were yelling ourselves hoarse to inside, where yelling would almost definitely invite arrest. As I neared the glass to get a glimpse of the senators, I saw two people holding hands in silence. It was a moving expression of  solidarity in a space intended to oppress citizens.