The West Alabama Women’s Center in Tuscaloosa, Alabama serves people from all over South Central and occasionally other areas. An Alabama patient, Tamika (pseudonym), came to the clinic in 2021 to tell a story about the diverse challenges that black women face in a pro-life state and how the stigmatization of abortion affects reproductive health. finds out she’s pregnant and realizes she can’t be the parent her child deserves. She has no resources at all. Her decision to have an abortion was complex and out of control, which made it all the more important to consider it holistically.
A year later, Alabama no longer offers abortion services. Legislators wasted no time after Dobbs v. Jackson Women’s Health has decided to ban abortion entirely. However, the West Alabama Women’s Center still exists and provides other legitimate reproductive health services such as contraceptive services, abortion management, and prenatal care.
An exclusive excerpt from journalist Becky Andrews’ new book, No Choice: Destroying Roe v. Wade and Fighting for America’s Fundamental Rights, sheds light on the importance of the Alabama clinic to the health of women like Tamika. PublicAffairs, available Oct. 11) explores the past, present, and future of reproductive rights in the United States. Before the Supreme Court decided to reverse the landmark 1973 decision that legalized abortion at the federal level, at least 26 states were already living in a post-Row reality where access to abortion was severely restricted. Restrictions and only some privileges. Andrews told stories of local residents in those states who are still struggling to care for those most affected by the ruling. Activists and organizations are still fighting for safe and legal access to the basic right to health.
In Tuscaloosa, Alabama, the West Alabama Women’s Center sits among a group of modest businesses surrounding a moat of smoking asphalt. A faded brown brick house sits off the main road, sandwiched between a crisis pregnancy center and an insurance office. The clinic first opened in 1993, and the building smells of tiredness – I’m still here. At the moment, the weathered white telephone poles that run across the parking lot from the clinic are ready, but some protesters today did not press on them, waving and shouting to attract the attention of patients. The air is thick with rain that never happened, but it’s still possible. A rusty iron bench waits under an awning that shades the concrete path that leads to the steel door. Hazy fluorescent lamps poured from the steamed armored windows.
Inside, behind the reception desk, the last room on the left, and a corridor lined with examining rooms, a black woman who wants to have a baby sits on a plastic chair with her back straight and her legs crossed. Tamika has high cheekbones, a radiant complexion, and large, expressive eyes framed by fluffy lashes. For the date, she dressed comfortably: a black mask, black leggings, a black V-neck shirt and stylish burgundy Nike sneakers. The initial shock of her plight wore off, but the fact that this woman, so eager to become a mother, was having an abortion seemed like a cruel joke. It’s 2021, the last sparkling summer day in August. Hurricane Ida hit the Gulf Coast, causing flooding and downpours in Alabama, although everyone knew it was worse south of the water.
Rumors are circulating in Louisiana that overcrowded hospitals are in danger of evacuation as nurses manually pump ventilators to keep patients alive during power outages. With the Delta variant, the pandemic has escalated into a new wave, and people are beginning to realize that a vaccine does not mean a full return to normal, in part because the basic premise of getting vaccinated against a dangerous virus has become so politicized that most people reject it. Dampness mixed with fear. Tamika’s job ended in April 2020, a month after the pandemic began, and she has had no insurance since then, making it difficult for her to access contraceptives. When she feels she can provide stability for her children, she wants to be a mother in her own way – and in this chapter, her income is fickle, she’s uninsured, and the world is facing a seemingly endless pandemic. It. “It’s hard enough to have a baby when you’re financially stable and fully insured, but if you don’t, it’s a total ‘different level of stress,’” she said. “Not just stress when it’s a different ball.” game when you’re poor, black and pregnant, especially in the South.”
After a decade of misdiagnosis, an obstetrician an hour from Birmingham finally told Tamika that she had fibroids, and the wasted time had reduced her egg count. Before the pandemic, she was looking for a fertility specialist to explore her options. The visit itself was expensive, but her jaw dropped when the doctors told her how much it would cost to freeze her eggs. The number stayed with her all the time. $28,000. “Money is tight for everyone,” she said. “I don’t know anyone with $28,000 to spare, so I had to wait. I couldn’t afford it.”
The insurance she got at her old job through Blue Cross Blue Shield expired in May, and since then she’s tried everything she could think of to take birth control. She didn’t want to risk losing another egg, even if the chances of pregnancy seemed slim. If she can get pregnant, she hopes to meet the deadline and create the family of her dreams. She’s trying to get health care under the Affordable Care Act, but they want to assess her eligibility based on her previous year’s income because she’s no longer working, which doesn’t make sense. She was denied insurance. She considered paying out of pocket, but it would cost her $185 a month; without income, such spending would be unrealistic for her budget. She then contacted the health department – she called, left voice messages and sent emails, but all went unanswered while the pandemic escalated and a vaccine was still being developed. Going to the health department was risky; little was known about the coronavirus at the time, all she knew was that people were dying and she didn’t want to join them.
She also contacted Maude L. Whatley Health, a local community clinic, and was silenced again. The uncertainty of the pandemic has resulted in shortages of staff, support for patient care, and sporadic, unpredictable hours of operation. She then tried an online store – something like GoodRx – which at first seemed like it might work, but was deemed unacceptable when she revealed she was taking high blood pressure medication. “The healthcare system let me down,” she said.
Tamika found a breather at the West Alabama Women’s Center, which is owned by the local Yellowhammer Fund, and was able to help her pay. She said the care she received from them made her feel human again. “I thank God for this clinic,” she said, who considers herself lucky to live in Alabama, a city that still has abortion clinics, and not in a state like Mississippi. However, she didn’t have what she really wanted: stability, a life without the extreme fear of a global pandemic, resources to raise her children in a safe and healthy environment where she felt she could meet her every need. and her family. “I don’t know if I can get pregnant again.” Her words fell, cold and wet with sadness.
Of course, she was well aware of the danger of childbirth for black women in this country. The US has one of the highest maternal mortality rates in the developed world, with black women dying two to three times more often than white women. Her past experience with the healthcare system did not make her feel that her life and the lives of her loved ones mattered. Her ob/gyn ignored a close friend’s ectopic pregnancy, she complained of pain, and he accused her of trying to get drugs from him. Tamika was worried, so she sent her friend to a doctor in Birmingham, who confirmed that the pregnancy was ectopic, and sent her new patient to the operating room, except for a pregnancy that could have killed her. She also had to have her fallopian tubes removed. . During the operation, doctors discovered that the woman’s pancreas was also at risk of rupture. Another friend nearly died in childbirth after her baby went the wrong way and got stuck. According to her, doctors used forceps to pull him out, injuring his arm and causing a severe tear in the vagina. Her friend, who was bleeding heavily, said doctors told her they needed to “hurry up” – her shift was coming to an end and it was photo day at her son’s school. It is no coincidence that these stories haunt Tamika, they all involve black women and are consistent with her own experiences.
For many years, Tamika was forced to endure a period of pain that lasted several weeks, which left her dizzy and weak. The bleeding and spasms became unbearable in 2008 when she had just graduated from college and was not eligible for her parents’ continued insurance. Not knowing what else to do, she went to the health department, where she was told that finding the right method of contraception would help her body return to a normal menstrual cycle again. Over the years, she has alternated between different types of hormonal contraceptives. In vain, she increasingly felt like some kind of alien trying to convince people of a completely different civilization that she was in trouble and needed help. “I’m not asking for a miracle – I just don’t want you to put a Band-Aid on a bullet wound and send me out the door,” she said.
When she got her own insurance, she thought it might be the golden ticket to relief. At least she could go back to her doctor friend, the male gynecologist she saw when she passed her parents’ cover. One day, the pain and bleeding reached the point of losing consciousness, and she was rushed to the hospital, where she stayed for five days. There, doctors have their own ideas on how to fix it – by inserting an IUD. Even in a hospital, no one thinks about checking for fibroids, because approximately 26 million women between the ages of 15 and 50 have fibroids, and black women are two to three times more likely to have fibroids, as well as those that are benign. Tumors appeared at a younger age and were more numerous and severe than in white women. “Fibroids are widespread in my family: this is something that black women are more likely to inherit,” she said. “He was with my five cousins. He was with my grandmother.”
On the wall of Tamika’s uterus, she estimates, there is a fibroid the size of an orange. When the IUD was inserted, it stimulated and inflamed the fibroids, exacerbating the pain that spread throughout the body. She told her cousin what she was going through, who sent her to a fertility specialist in Birmingham, a black woman, who soon underwent an ultrasound and diagnosed Tamika. Within three months they were all removed. “She saved my life,” Tamika told me. “She brought me back to normal.” The expert who helped her wasn’t a magician – she was a black woman who knew what to look for because she knew other black women were suffering, and by those who could never fully understand the cost of living is considered weak. through pain.
The female body is the epitome of sexist medical assumptions shaped and affected by the stigma of abortion. A body with a uterus that has been neglected during illness is rooted in the past and is interpreted by the medical community as “hysterical” or considered weak because it has traditionally been male-dominated. The attitude that a woman’s body is defined by how men think it should function fuels the stigmatization of abortion and complicates the direct practice of basing reproductive health care on the needs and experiences of patients. In contrast to the ease of providing medical care and self-reported symptom testing, which may seem more achievable in other areas of medicine, those with wombs are met with skepticism and arrogance. Tamika speaks openly about her pain and looks for a solution, but her pain is not taken seriously. This pattern changed her reproductive life, her ability to have children of her own accord, and her future as a parent. Her basic human rights were violated. The stigmatization of abortion affects more than just abortion, it permeates every aspect of reproductive health and education. It is present in sex education, birth control practices and attitudes, routine gynecological care, prenatal and postnatal care and sterilization. Katsy Cook, an elderly Mohawk midwife, wrote: “Women are the first environment. We are the embodiment of Mother Earth. From women’s bodies flow generational relationships with society and the natural world. We use our body to nourish, maintain and build interconnected and interdependent relationships. Our ancestors said that the earth is our mother. Thus, we women are the earth.” Her words are wise and powerful; we are treated with such respect when we seek pampering.
Women of color like Tamika often face systemic racism and intergenerational trauma when they enter the medical profession with problems, in addition to the widespread suspicion that their gender deserved them. These ingredients create a potent poison that is sure to cause death as well as loss of life, as people whose bodies are biocoded as women cannot reach their full potential in life. Precisely because women’s bodies, especially those of pregnant women, are considered problematic because of their reproductive function, these avenues of activism are paved. In our culture, “we view pregnant people as suspicious and controlled,” said Rafa Kidwai, director of the If/When/How Legal Defense Fund, a reproductive justice nonprofit that fights the criminalization of pregnancy and abortion.
It starts young. Girls’ Generation is full of reproductive stereotypes and prejudices. From childhood, we were taught to play the role of mothers. Dolls are shoved into our hands, and our aspirations are shaped by what patriarchal forces believe is our highest mission: to have children and raise them to continue upholding a hierarchy that perpetuates sexism and racism. Some of us have learned in childhood to take care of our younger brothers and sisters with a motherly attitude, take care of the home, prepare meals for our family, and one day become the subconscious ministry of wives and mothers in the nuclear family. When the day comes when we bleed, we are told that we are no longer children, which is an important step towards motherhood. At the same time, we learn to fear our bodies and their terrifying powers. Until we are married, pregnancy is the second worst possibility. Abortion is the worst.
For women of color, there is a certain element of white supremacist control in the politics that governs their bodies. It’s hard to hear a story like Tamika’s and think that there’s nothing more optimistic than that all the doctors who saw her didn’t care about her at all. They couldn’t care less about her pain, her fertility, her ambition, her autonomy. She has no money, no insurance, no fair skin, no protectors but herself. Reproductive health is racial. Of course, the politicization of abortion affects all people with a uterus, but we cannot ignore the varying degrees and nuances of who gets what care and how. Black women are also accused of committing genocide against their own people by seeking help with abortion. Billboards sold in black neighborhoods to white anti-abortion groups pour water over them with twisted versions of anti-racist slogans such as “Black kids matter” and so on.
When she entered the Women’s Center of West Alabama for her first date, Tamika was greeted by “two gentlemen” whom she called generously. They yelled at her for her baby’s heartbeat, and she suppressed her anger but calmly rolled her eyes. “That’s good man, I know my baby has a heartbeat,” she said sarcastically. “I have a heartbeat. Black people who get killed on the street also have a heartbeat. And no one seems to care.” . Civil rights activist Angela Davis wrote, “When blacks and Hispanics had abortions en masse, they told stories not so much about wanting to avoid pregnancy, but about tragic social conditions that discouraged them from ‘The world brings new life.’
The stigma of abortion affects prenatal care, when the life of the fetus—desirable as it may be, is not part of the conversation—becomes more important to medical decision makers than the life of the mother. In postpartum care, that is, when it exists, its shadow appears in the everyday “melancholy” of postpartum depression, in our culture, in our culture, in the sacredness of the new mother. not someone who needs support – from partners, from the government, from the medical team. The child is born, the task of protecting life is completed. Completed.
There are also immediate barriers to abortion treatment. A young black woman named Jazmine I met in Huntsville told me that when her gynecologist confirmed her pregnancy last week, she told her abortions were illegal in Alabama. This is not true, and it is hard to believe that anyone who practices medicine would sincerely not understand this kind of thing. As a reporter covering reproductive health for more than six years, I have heard from people from all backgrounds that it makes it difficult or impossible to access abortion services when needed. Money has always been the biggest hurdle, especially when it comes to travel. Paid leave for their program and the possibility of any additional appointments required by the state due to waiting periods. Transportation, whether it’s because they share a car with several other family members, or because the bus routes in their city are unreliable, or they can’t afford gas, or they have to travel to another state for help . Parenthood, as at least 60% of abortion patients already have at least one child. The abusive partner deliberately impregnated them so that they could not leave once and for all. Blizzard. Appointment cancellations when a flight to an abortion provider is canceled preventing the provider from reaching the clinic. Patients accidentally ended up at the Crisis Pregnancy Center next door to the clinic, where they stayed so long that they missed appointments. Post-traumatic stress disorder. What does this mean for people seeking abortion assistance in a hostile state.
On the night I met Tamika, the clock was gradually approaching midnight. Tamika only asked to go through the emotional process of telling her story once, refusing to give me contact information to contact her, but I imagined her resting in a comfortable place while waiting for the medication to work and the pregnancy to pass. The Supreme Court has little time to consider a new Texas law that will take effect September 1 and ban abortion after six weeks of pregnancy. The law, which also encourages vigilance among anti-abortion citizens, includes a provision promising a $10,000 reward to any citizen (not necessarily a Texan) who reports that someone has “helped and assisted during the past six weeks “. subject to prosecution.
That day, I thought the court would intervene. The law is clearly unconstitutional and violates the three-month time frame set by Roy and Casey, the overburden standard. Moreover, they always interfere with government measures that blatantly ignore precedent.
Alone in a featureless Tuscaloosa hotel room, I lay in bed, tweeting over and over as I grew more and more worried. Midnight has come and gone. The law has been established.
Taken from NO CHOICE by Becky Andrews. © 2022 Kelly Andrews. Available from PublicAffairs, a division of Perseus Books, LLC, a subsidiary of Hachette Book Group, Inc., New York, USA. All rights reserved.
Post time: Sep-20-2022