"Last I checked, we don’t have a rubber shortage in America. Look, when I was in college, we had a machine in the bathroom, you put 50 cents in and voila. So, yes, anyone who wants contraceptives can access them, but it’s an utter made-up nonsense issue,” Ted Cruz said at a campaign stop in Bettendorf, Iowa where he responded to accusations that Republican candidates are undermining access to contraceptives (http://abcnews.go.com/Politics/ted-cruz-birth-control-dont-rubber-shorta......).”

You know how you have your lines in the sand? Well my line in the sand is women’s reproductive rights and our right to bodily autonomy. I have noticed that if there is one thing that I simply refuse to hold my nose and vote on it is the right of women to control their own bodies. You take a position limiting that and we are enemies, not just people who do not disagree, but people with whom there is no going further. This holds for politicians, this holds for friends and family, this holds for strangers. Obstructing a woman’s decision on if, when and how many children she wants to have, putting limits to our decisions, making those decisions harder puts you in the enemy camp in my mind. Now, unlike anti-choice believers, I would never think of killing my enemies; but I will do everything in my limited power in the context of the capitalist and patriarchal societies we live in to send them back to the caves from which they emerged.

No one would ever question the right of a man to do what they want with their bodies and yet women still do not have complete control over their bodies and their reproductive decisions. Moreover, there is a race and class component to these choices that are two sides of the same coin. For working class women and women of colour, the issue was being allowed to have children – forced on contraceptives, used as guinea pigs to test contraceptives) and forced sterilisation. For white women with higher incomes and wealth, the issue historically was the right not to have children. For women, in general, it is the ability to decide if you want children (abortion, voluntary sterilisation, and fertility treatments), when you want them (this relates to contraceptives), and how many you want. These choices are not independent of the state, the Church, the culture in which you live, and your economic circumstances.

Anyone keeping track of the Presidential primaries in the United States cannot help but be struck by the level of misogyny and sexism among the candidates in the contest for the Republican nomination. All of the candidates running for the nomination have an anti-choice agenda – and that included Carly Fiorina. Even Donald Trump who used to hold a pro-choice position has switched sides. Their positions not only address abortion rights but attack Planned Parenthood and oppose the provision in Obamacare which ensures that birth control be available on health insurance plans.

While the Republicans have been in the anti-choice camp for quite a while, the level of sexism and misogyny in this batch of candidates is frightening.

On the other hand, in the only democratic debate in which abortion was addressed (Fox News of all sponsors), the replies of Democratic candidates were pro-choice if not identical. Bernie Sanders came out strongly in support of women’s reproductive rights arguing that governments do not have the right to tell women what to do with their bodies, opposing limit restrictions -- he previously had stated that he would repeal the Hyde Amendment in a statement on reproductive rights. Hillary Clinton also took a pro-choice stance (albeit a bit weaker than Sanders). Interestingly, she has also argued for attacking Hyde which was changed under Bill Clinton’s presidency from solely allowing abortion in the case of the life of the mother, adding rape and incest; so this is a shift in position. Her general position on abortion has been the “safe, legal, and rare” framework; in other words, keep it legal and safe, but make it rare. Interestingly, she has recently dropped the “rare” and that is an important tweak in a positive direction but she still holds that abortion as a moral issue and that conditions her beliefs. Moreover, she does recognise that restrictions can be placed on late-term abortions coming from her perspective of abortion being a moral issue rather than a medical choice determined by a woman. Neither candidate accepts the 20 week deadline (which violates Roe vs Wade) which is embodied in several pieces of anti-choice legislation passed in states.

Putting the discussion in the context of the attack on reproductive rights as a whole in the US is important as these discussions are clearly not isolated and are part and parcel of the general attack on women’s reproductive rights. These attacks are occurring due to legislation passed by states which restrict access to abortion rights and increase costs, attacks on Planned Parenthood and also partly due to the nature of private health care in the United States.

Attacks on Planned Parenthood

Planned Parenthood is sustaining several attacks against it. An organisation called Campaign for Medical Progress (CMP) released a series of videos purporting to show Planned Parenthood having a policy of selling tissue of aborted foetuses. This led to a series of investigations in several states in which no evidence of wrong-doing could be found and calls for defunding of the organisation federally and at state levels. So-called moderate Republican candidate John Kasich, the current governor of Ohio, has recently defunded Planned Parenthood and other Republican candidates have been advocating the same.

The defunding of Planned Parenthood is continuing irrespective of the fact that the so-called evidentiary videos by CMP in which the sale of foetal tissue and organs by Planned Parenthood was discussed were faked (and the heads of CMP are now facing prison).

The attack on Planned Parenthood became a literal physical assault on the 27th of November 2015 when Robert Dear Jr. entered the Colorado Springs Planned Parenthood clinic opening fire and killing 3 people and wounding 9 people. Following the attack, Dear clearly referred to the sale of baby parts. Dear faces charges of 1st degree murder. The Clinic has finally reopened its doors recently after being closed since the attack.

The defunding of Planned Parenthood in several states has serious consequences. Planned Parenthood not only provides abortions, but given the limited access to health insurance in the US is often the only provider for cancer screening (i.e., pap smears, breast cancer screening), provision of birth control and STD testing for women with low incomes. There is evidence from a study in the New England Journal of Medicine that in Texas the defunding of Planned Parenthood has impacted continuation of long-term birth control.

Catholic Church

At this time we are awaiting Supreme Court decisions that will impact both access to abortion rights (Texas HB2) and contraceptive availability on health insurance policies for employees by the Roman Catholic Archdiocese and Little Sisters of the Poor for purely religious groups and colleges and universities run by Churches.

Part of the issue in this challenge to the Affordable Care Act derives from an opt-out granted by President Obama allowing a conscientious objection clause addressing both access to abortion and contraceptives as part of health insurance. In terms of the employees of purely religious organisations, the issue is clearer as they often employ members of their church. However, in the case of colleges and universities, the issue is less clear as employees at all levels working for universities come from various religious beliefs and their reproductive rights are clearly being violated.

Unfortunately churches are not limiting their attack on women employees accessing birth control as part of their health insurance. The number of Catholic hospitals is growing in the US. They are bound by the Ethical and Religious Directives for Catholic Health Care Services written by the United States Conference of Catholic Bishops and they do not deviate from them.

These rules are impacting upon women accessing reproductive care by limiting access to birth control, voluntary sterilisation and abortion provision including waiting on D&Cs until infections set in. In Michigan, Mercy Health Partners has been accused of endangering the lives of 5 women by forcing them to undergo a prolonged miscarriage waiting on the development of infections endangering the lives of the mothers rather than do an immediate delivery. They simply followed the directives of the Church which meant that women having spontaneous abortions were forced to wait until the onset of infection rather quickly ending the miscarriage.

Continuing Legislation limiting access to abortion

A series of laws undermining women’s access to abortion have almost been continuous. Perhaps the most frustrating, and infuriating thing is the pretence that these laws are being put in place to “protect women’s health.”

These include laws trying to impact on the foetal viability clause In Roe v Wade; specifically there are attempts to put into place a 20 week limit for abortions (Roe is based on a trimester breakdown at 6 months allowing for life of the mother as cause afterwards). Additional regulations put in place relate to waiting periods, unnecessary intravaginal scans, parental consent, women being forced to listen to information about the dangers of abortion, and denial of certain procedures.

The West Virginia House of Representatives passed a law making it a felony for a doctor to do a “dismemberment abortions” (also known to the rest of the world as a Dilation and Evacuation procedure) unless the health of the mother is at risk. A D&E is a safe and common form of abortion procedure for 2nd trimester abortions. Similar bans of this type have been struck down by the courts in Kansas and Oklahoma. The Governor of West Virginia vetoed the legislation on the 10th of March and the Senate of WV overrode his veto on the 11th of March meaning that this ban will take effect in 90 days.

Another bill just passed by Indiana’s house and headed to the Governor actually requires that women who either spontaneously aborted or had an induced abortion be responsible for the disposal (burial or cremation) of the foetus, in addition to the usual nonsense about listening to foetal heart beats and viewing ultrasounds of the foetus. What is also present is the doctor “admitting privileges” at local hospitals that forms the heart of most recent legislations called TRAP laws.

Supreme Court on TRAP laws
TRAP laws increased following 2010 and consist of a series of laws which regulate abortions centres rather than abortion itself to limit access. At this point 24 states have legislation that employ TRAP provisions. These laws address the following:

Physicians doing abortions having admitting privileges in local hospitals
Abortion clinics having an agreement with a hospital to transfer women in case of an emergency
Abortion Clinics needing to be a certain distance from a hospital
Rooms where abortions are done up to ambulatory surgical level in hospitals
Clinic room sizes and corridor width are specified in places where abortions are occurring (http://www.guttmacher.org/statecenter/spibs/spib_TRAP.pdfwww.guttmacher.......).

The biggest threat to Roe v Wade and Doe v Bolton is an upcoming Supreme Court (SCOTUS) decision relating to Texas HB2 called Whole Women's Health vs Hellerstedt.

The decision specifically is addressing two provisions in HB2:

• One requires abortion clinics in the state to meet the same building standards as ambulatory surgical centres;

• The other requires abortion providers to have admitting privileges at local hospitals.

The impact of TRAP laws if Texas HB2 is not struck down: NY Times, 2/29/16

Given the danger to physicians providing abortion procedures (the case in Colorado Springs is merely the latest in a long line of violence against clinics, doctors and staff), in many states doctors come from outside the area and even outside the state to assist women in accessing their reproductive rights. As such, admitting privileges are very difficult to obtain and it means that the local hospital essentially can determine whether or not an abortion clinic can exist. The ambulatory surgical requirements are extremely expensive and unnecessarily given the nature of abortions done in clinics which are either medical or done in the first trimester. Both are extremely safe procedures and imposing this requirement would force centres to close. These provisions impose “undue burdens” on women due to the closure of centres that are unable to comply with the law as they will be forced to travel long distances and endure waiting times. For people that think this law is just about Texas, take a look at the map of the US, if Texas HB2 is deemed constitutional, it will affect every area in dark red in the picture in terms of women unable to access abortion rights. Louisiana and Mississippi’s laws are on hold pending this decision, but it will have wide impact across the US.

While the death of Justice Antonin Scalia has significantly changed the potential decision, it is not all clear sailing. The SCOTUS is now divided 4-4 conservatives to liberal judges (and several Republican leaders in the Senate and House are trying to prevent President Obama from appointing another judge).

If the court splits 4-4, the decision will be sent back to the lower courts that have upheld the Texas decision. If, on the other hand, Justice Kennedy manages to come to an agreement with the 4 liberal justices (resulting in a 5-3 decision); this can have a wide-ranging impact in the US. The upcoming SCOTUS decision on Texas HB2 will not only impact on Texas, it will impact on the 23 other states that have versions of this law. At the moment, a block was put on Louisiana’s application of their law (Act 620) by the Supreme Court which would have shut down all but two of the state’s abortion (2 out of 6 in the whole state) providers which may be a position sign. The application of the Texas Law is also under hold pending the SCOTUS decision, specifically the portion relating to ambulatory surgical centres which keeps some clinics open.

Oral Arguments in the case were held on March 2nd 2016. We are waiting for the SCOTUS decision which could in effect challenge both Doe and Roe and women’s reproductive rights significantly and essentially everything hinges on what Justice Kennedy thinks. Yes, once again women’s rights to their bodily autonomy are essentially being decided by 1 old white man.

Meanwhile, in 2015 over 700,000 people searched google to find out how to self-induce a miscarriage. The state with the highest searches was Mississippi which has one of the most restrictive and stringent anti-abortion laws.

I wished that this was unthinkable but honestly it was obvious; that is why women have been demanding bodily autonomy and their reproductive rights — that is why we are screaming “Not the Church! Not the State! Women Must Decide Their Fates!” I know that I am sick and tired of this crap (hell I have been for decades), so when will women’s bodily autonomy be recognised?!