I heard it again today. Thank God, George Tiller, the doctor performing late term abortions in Kansas, was acquitted in the anti-choice witch hunt, but as the comments to the many articles reporting to the fact point out: George Tiller is one of only three doctors performing this procedure in the US today. Every pregnant woman, or woman who ever plans on getting pregnant, should be chilled by that news. Chances are, if you can afford your own OB/GYN, they'll perform a necessary late term abortion for gross fetal disability or life threatening pre-eclampsia, but if you are one of the millions of women who can't afford that private care or have no insurance, George Tiller and is like are your last hope.
So what can we do about it? There are at least two main approaches: we can find a way to train more doctors who will perform abortions, or we can pursue legal means to open up the field to other professions, possibly nurses and midwives. I think the prior option is far and away the best, since, lacking a wide variety of options, we want the best trained providers on our side that we can get. Clearly, the route to more doctors performing abortions and working in clinics is multi faceted. We're going to need to fight for legislation that mandates abortion training in med school, we're going to need to fight laws that allow Catholic hospitals to refuse to provide services, and, perhaps least obviously, we're going to need to lobby for an end to US policies that limit the number of doctors trained and the openings for those that get through med school in hospitals to train. The root of these policies is not improving healthcare for all, but raising the salaries of these doctors, and one of the many negative results is overtired residents working forty-eight hour shifts. All of these policies clearly fall under the purview of the healthcare reform the current administration is promising to put out there, so I suggest that we write our representatives to make these part of any healthcare reform bill. Best of all, ending the policy of limiting the number of doctors trained at all is not explicitly pro-choice (though it will certainly benefit us and everyone else), hence we can make a solid argument to pro-life representatives that otherwise wouldn't give us the time of day.
Outside of the lobbying sphere, if we're going to get more of our allies into med school, we're going to need to fund scholarships, provide internships in clinics, and work our butts off to get them past conservative admissions departments. We need to actively recruit women in pre-med programs into feminist campus organizations (and men, as well, but I think we'll have to accept that we're more likely to make headway with the women). And we need to find ways to keep our abortion providers safe, a perpetual problem.
As for lobbying to see nurses and midwives provide abortions, I don't see it happening in the US, but there is precedent outside of the US, particularly in the UK. A healthy midwife program in the US, as opposed to the ad hoc, state-by-state midwifery we have today, would greatly increase all American women's access to care, abortion included with adequate training. Abortion providing midwives may not be able to provide late term abortions, but if we could at least get RU-486 prescriptions from someone other than a pricey OB/GYN, many more women would have access to some form of abortion care than they currently have.
For that matter, we might lobby to see RU-486 OTC.
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This was an informative post. I only have one comment about RU-486: RU 486/misoprostol are not appropriate for over the counter usage. Patients need to be followed up and monitored with this treatment.
I think one of the biggest problems with doctor availability is the intimidation factor of the anti-choice movement. Has anyone had a chance to read "This Common Secret" by Susan Wicklund? She's a doctor who provides abortions, and her book details what she's gone through: her daughter needed a police escort to go to school, she had to wear disguises and bulletproof vests to get to work, sometimes she would even have to ride in the trunk of someone else's car to get to work safely, etc. The amount of intimidation and safety concerns and threats that these doctors go through is preposterous, and a lot of up-and-coming doctors are going to say, "I'm not going through that/ putting my family through that," and so forth.
I don't really know what can be done about it, though, but I think that's a huge reason that more doctors aren't willing to enter the field. I imagine many more people would be willing to do it if not for the fear of being killed just for going to work.
Slightly OT but I want to share my connection to George Tiller. My father coached his daughter in basketball. He told my dad that his father provided illegal abortions before Roe v. Wade. He was also shot twice by extreme anti-choicers.
Dr. George Tiller was shot and killed this morning...at his church. It's a sad day in Wichita.