[TRIGGER WARNING: vicious misogyny, senseless deaths of pregnant people, and extreme hostility to bodily autonomy, consent and agency.]
Oh dear, Kansas. What is to be done with you? You, along with your BFFs Oklahoma and Mississippi, lead the nation in having enacted since 2011 fourteen separate abortion restrictions each. These “pro-life” policies have a body count—and it is rapidly increasing. You see, states with more abortion restrictions also have skyrocketing maternal death rates:
Globally, only a few countries have seen a rise in the rate of maternal deaths in recent years. Those include Afghanistan, El Salvador, South Sudan and the United States of America.
Afghanistan, y’all. South Sudan.
While at one [time] the US had all but eliminated deaths associated with childbirth, things have changed in recent years, with maternal death rates climbing from 14.5 per 100,000 to 17.8 per 100,000 between 2007 and 2011. As of 2014, the number of women who die during pregnancy and childbirth in the US has risen to 28 deaths per 100,000.
According to my ladymath, that means the number of pregnancy- and birth-related deaths here has nearly doubled in the last four years.
For purposes of comparison, the maternal death rate in nearly all wealthy, developed nations is a single digit number. As of 2014, the US maternal death rate is 7 times higher than that of Austria, Finland, Iceland, Italy, Norway, Spain and Sweden, all nation’s which have a maternal mortality rate of just 4 deaths per 100,000.
The US maternal death rate is now 14 times higher than Israel’s—a country with very liberal access to abortion and a government that subsidies it. And here’s the real kicker: states with more abortion restrictions not only have higher maternal death rates, they also have higher infant and child death rates.
Anyway, apparently no longer content to share its embarrassing status with Mississippi and Oklahoma, Kansas is now enacting a law that will for all practical purposes prohibit all abortions after 14 weeks, by completely outlawing the safest and most effective surgical technique for abortions performed after that. The procedure is called dilatation and evacuation, or D&E for short. But not in Kansas, it isn’t. There, it is imaginatively called “dismemberment abortion,” defined in the statute by the use of “clamps, grasping forceps, tongs, scissors or similar instruments” to remove the contents of a uterus. (Read more about D&E here.)
Perhaps it’s worth remembering why abortions are delayed. Under the Roe framework, the procedure is generally legal up to the time of fetal viability, or about 24 weeks. The number one reason given for seeking abortions after 16 weeks is “did not recognize the pregnancy” (71%), followed by “difficulty making arrangements for abortion” (48%). That difficulty is by design: onerous and deceitful in-person counseling requirements, waiting periods, expensive and medically unnecessary transvaginal ultrasounds, draconian restrictions on public funding, and waves of clinic closings over vast swaths of the country have left many abortion seekers scrambling to gather funds, arrange for childcare, escape controlling families or abusive partners, and risking employment and social ostracism (or worse) in order to travel hundreds of miles to the nearest facility—sometimes twice. It’s also worth noting that poor women are disproportionally overrepresented among abortion-seekers, as are Blacks and Hispanics. That disproportionate impact is also by design: overwhelmingly lily-white lawmakers know that should the need arise, they and their partners can always jet up to Canada for a quick, safe procedure. (And don’t think for one second they would have any qualms about that.)
A D&E can be performed safely on an outpatient basis well into the second trimester, but medication abortions are generally only available up to about 9 weeks. This is not because medication abortions after this point are dangerous per se; although they may be more painful and have a higher risk of adverse events, they are relatively safe up to 24 weeks. The problem is that later medication abortions are inpatient procedures, requiring administration of precise doses at strict intervals over the course of multiple days. As you might imagine, this compounds that “difficulty making arrangements.” And that’s to say nothing of the added cost.
Based on model legislation drafted by the National Right to Life [sic] Committee, under this law a physician who performs a D&E is guilty of a class A misdemeanor; a second or subsequent conviction is a felony. The law also provides for civil damages against the physician. Either the person who has the D&E, a husband, or a parent if the patient is under 18 can sue the physician for:
(1) money damages for all injuries, psychological and physical, occasioned by the dismemberment abortion;
(2) statutory damages equal to three times the cost of the dismemberment abortion;
(3) injunctive relief; and
(4) reasonable attorney fees
Now at this point you would be forgiven for thinking these lawmakers are sadistic motherfuckers who need to to slither back into whatever cave or medieval era from whence they came, but no! In their wisdom and mercy, they provided an exception for medical emergencies! This means the D&E procedure is permitted in cases of imminent death or “substantial and irreversible physical impairment of a major bodily function.” You can ask Savita Halappanavar about how this policy works in practice OH WAIT NO YOU CAN’T BECAUSE SHE’S DEAD. Her doctors feared her impending death just wasn’t quite imminent enough to lawfully end her pregnancy. Oops.
There’s also another little caveat:
No condition shall be deemed a medical emergency if based on a claim or diagnosis that the woman will engage in conduct which would result in her death or in substantial and irreversible physical impairment of a major bodily function.
Translation: anyone who would commit suicide or maim themselves with a coat hanger rather than remain pregnant is, sadly, shit out of luck.
In an exclusive interview with the Palace, longtime activist and abortion doula-in-training Niki M said it sounded as though they were using an “argument from ew” to ban a perfectly safe procedure. When we inquired about possible alternatives to get around a D&E ban, Niki replied, “There’s inducing birth, but what sort of shitweasel would force someone to endure labor to expel a fetus? Oh wait. Nevermind.”
Loyal Readers™ will be unsurprised to learn that Kansas state senators will immediately be joining similar-minded colleagues in the Palace Abattoir, which houses our groundbreaking, life-saving involuntary organ extraction program for donors who feel so very strongly about forced organ donation by other people. Because of the specific provisions of SB95, we will be performing these extractions without regard to the safest and most effective surgical techniques, without regard to less painful and less risky alternatives or increased cost, and of course without the use of “clamps, grasping forceps, tongs, scissors or similar instruments.” Coat hangers will be the preferred surgical implement, although we fully expect our extraction teams to get creative. Perhaps knitting needles?
Extraction team in one of our state-of-the-art surgical suites.
SB95 has a companion bill pending in the lower house; with a 97-28 Republican majority it is expected to pass easily. The Governor, Sam Brownback (R-etrograde), is quite eager to sign it. So I’m just tossing all Kansas Republicans into the Abattoir, with the notable exception of Senator Vicki Schmidt, the only Republican to vote against SB95. However, because I am feeling unusually beneficent at the moment for some reason (???), I hereby magnanimously agree to release from Palace custody any Kansas Republican house member who votes against the bill.
Laura Gilkey, coordinator of Sarasota, Florida-based nonprofit The Safe Motherhood Quilt Project, said:
“Today’s mothers are twice as likely to die of pregnancy- or childbirth-related causes than their mothers were. There is no reason, given our vast resources, knowledge and technology, why we should be going backwards in this area.”
I beg to differ. There are indeed reasons. And a whole bunch of them are now locked up in the Palace Abattoir.