This Is Woman's Work with Nicole Kalil - 152 / The Necessity Of Choice with Jacqueline Ayers

Episode Date: August 23, 2023

Women’s right to choose has been in question throughout history… getting to choose who and if you marry, what you wear, what’s appropriate and not, whether or not you can work, what you can do for a living, the right to open your own bank account, to vote, to consent, and if and when you give birth. I am very aware I’m going to piss some people off, and this is too big, too important for me to worry about that. We’re going to talk about the necessity of women’s right to CHOOSE. I’ve invited Jacqueline AIyers, senior vice president of policy, organizing, and campaigns at Planned Parenthood Federation of America to join us. She leads the strategic direction of the federation’s legislative affairs, global advocacy, and federal and state policy teams. Previously, she has served as legislative director for the National Urban League, was a legislative aide in the U.S. House of Representatives covering health, education, and judiciary issues, and is licensed to practice law in the state of Indiana. All that to say this: we’re covering this topic with someone who can bring knowledge, experience, and real information to the table. CHOICE. If that’s not the hill we’re willing to die on, I don’t know what is. And I don’t care how you do it, I just care that you stand for it. Not just YOUR choices, or the choices you like, but the right for each woman, for each person to have agency and ownership of the one thing we should always have COMPLETE control over: our bodies. Resources: To get information about the status in your state around abortion access visit bansoff.org   text ACCESS to 22422 Resource: https://www.abortionfinder.org/  Get involved: plannedparenthood.org To join Nicole’s pod (to get all the inside scoops, free stuff, and the occasional rant), click here

Hi friends, I'm popping in quickly to share two things. First, a reminder that August 26 is National Women's Equality Day, which commemorates women securing the right to vote in the United States and encourages us to continuously work to gain full rights and privileges, public or private, legal or institutional, which is one of the many reasons I'm doing an episode on women's right to choose today. And second, to give a content warning as we're going to be talking about abortion. And if this topic is triggering or traumatic for you in any way, I invite you to opt out and join us next week. Okay, now we can dive into our episode. I am Nicole Kalil, and if you've tuned into This Is Woman's Work on a regular enough basis, you know that I often ask myself the question, is this the hill I want to die on? As a way of deciding if something is worth my energy, the risk, or a fight. As someone who gets really heated about far too many things, I've learned that asking myself this

question helps me to put things into perspective and make better choices about how much of my time and emotions I want to invest in something or in someone. I've also shared a couple of things along the way where the answer is yes, this is the hill I'm willing to die on. Ideally not actually die, but there are people who have died and will die for the topic we're covering today. Yes, choice is the hill I'm willing to die on for a few reasons. First, I understand the power of choice. I believe, in fact, that it's the most important and powerful gift, tool, and opportunity any of us have. Our choices determine what we do in our life, who we do it with, how we show up, and how we respond. Of course, I have to acknowledge

that not everyone is afforded the same access, privilege, and opportunity from which to make choices from. And also, nobody can control everything that happens in life, and yet our power lies in our ability to choose. Women's right to choose has been in question throughout history. Getting to choose who you marry, what you wear, what's appropriate and not, whether or not you can work, what you can do for a living, the right to open your own bank account, to vote, to consent, and if and when you give birth. Today, we're going to get right into the heart of the matter, women's right to choose. I'm very aware that this is going to piss some people off, and this is too big and too

important for me to worry about that there are many feelings many beliefs many strong opinions and many arguments both for and against women's right to choose to have an abortion so let me be clear and upfront about mine I have been wildly fortunate to never have had to make this choice, not because I'm smarter or more virtuous than anyone else, but because I got lucky. Like the vast majority of women I know, regardless of their beliefs about abortion, I had premarital sex, unsafe sex, sex I regretted with people I regretted, and I just got lucky. I do, however, know women who have had to make this choice. Some chose to carry to term and raise their babies. Some chose adoption and some abortion. And I can tell you that it was a hard and difficult choice for every single one of them.

And some of them do have regrets, while many don't, regardless of what their choice was. And I'm grateful every day that they were able to make their choice. But we can all share stories and anecdotes. We can all find information that serves our narrative. We can argue about fetuses and babies, morality and reality, danger to women's health and lives, and whatever God you believe in, and why men aren't forced to raise children and cover half of medical expenses incurred during pregnancy. But here's the thing for me. It's about our right to choose. In no other situation that I know of can someone be forced to donate their bodies to someone or something else. People die on transplant lists every day, even though there are people walking around with

healthy body parts and organs, and we can't force them to give them up to save a life. How we can't even force a dead person to donate their organs. They have to choose it. The idea that women would have less right to choose than a corpse is never going to be okay with me. Nobody should ever have the right to use a woman's body against her will. That's it. That's where I land. And if you're anything like me, you're probably feeling a combination of furious and helpless. So I've invited Jacqueline Ayers, Senior Vice President of Policy, Organizing, and Campaigns at Planned Parenthood Federation of America to join us today. She leads the strategic direction of the Federation's legislative affairs, global advocacy, and federal and state policy teams. Previously, she has served as

Legislative Director of the National Urban League, was a legislative aide in the U.S. House of Representatives covering health, education, and judiciary issues, and is licensed to practice law in the state of Indiana. All that to say this, we're covering this topic with someone who can bring knowledge, experience, and real information to the table, not just a person with personal opinions who's ranting ridiculous shit all over the internet. So Jacqueline, thank you first for the incredible work you do and the courage you have in doing it. And also for joining me today. Before we dive in at the power and necessity of women's right to choose, I have to ask if you can share a little bit about the work of Planned Parenthood, because I believe it's been misrepresented and misunderstood

by many. So what is the mission of the organization and what is the work you're actually doing? Thanks so much, Nicole. Such an important topic at an important time. So I want to thank you for having me on. Planned Parenthood is often misrepresented or misunderstood, but I do think it's important to note one in four women in this country will have been to a Planned Parenthood in their lifetime. So whether it was you, it's likely someone you know. Planned Parenthood health centers across this country are the nation's leading provider and

advocate of high quality, affordable health care. The largest provider of sex education in this country. Each health center provides a robust spectrum of sexual and reproductive health care for over 2 million people every year, and that does include access to abortion. And so our organizations across the country work to make sure that patients have care, compassion, without respect, without judgment, that it is the health care that they are getting, that they are choosing. And in my day-to-day work, what I do is work on advocating for the policies that allow and create the conditions, both at the state and federal level, for the Planned Parenthood affiliates to provide health care. So, Jacqueline, I am one of those one in four women. I went to Planned Parenthood in my teenage years and in my twenties, and I am to this

day forever grateful that I was able to have that and have that ability to walk into a place and feel safe and not judged. So again, thank you for your work. So I want to switch to asking why you believe that ownership and agency. And when I say you, I might mean you personally, but maybe more you as this global entity, why you believe ownership and agency over your own body is both imperative and critical to healthcare. Having the freedom to make the best choices about your health and including reproductive health is something that is so deeply personal.

The best decisions for your life, deciding when to start a family or not, when to pursue your education, what types of job choices you're going to make, all of these personal decisions have to remain personal. And I think for women, we know that our ability to control our reproductive freedom, it means that we get to make more of these choices. Instead, we find ourselves, I think, in a moment since the overturn of Roe a year ago, we're hearing story after story of people not just being denied access to care, but at the end of the day, having politicians make the decision to take away their choice, even if their life is at stake, even if they're being forced to carry a pregnancy against their will. Too many people in this post-Roe world are having their basic autonomy taken away. So that's what we want to

keep fighting more is to make sure that everybody, particularly politicians who can be hostile to reproductive health care, know that we're not going to make any compromise on people's ability to have that bodily autonomy. Yeah, I couldn't agree more. And it's infuriating to me. And I do see some progress in this space. But when we say politicians, more often than not, we mean old white men. And for them to have any insight, any experience, any ability to make that choice for us is both mind blowing to me and infuriating. Totally. And just completely out of line with where their constituents are.

It's just not what poll after poll tells us. The majority of people, in fact, 80% of people want to see people have access to the reproductive freedom, including abortion access. And so when we have elected officials who are doing exactly the opposite, it's really important that people know where their elected official stands, because too many of them right now are allowed to go against one of the wishes of the majority. Thank you for pointing that out, because that's, again, infuriating and also confusing. Okay. I want to talk about the fact that there are many arguments for and against the freedom of choice and people feel as strongly about their beliefs as I do about mine. Why do you believe that choice is a necessary right for women?

At the end of the day, this is truly about questions of freedom, making sure that people have bodily autonomy, making sure that you can have access to birth control options, STI screenings, are. But, you know, overall, I can't think of another issue where we would accept our medical decisions being decided by anyone else. is something that is not going to be accepted. And we looked at the true lived experiences of people even before the Dobbs decision. Unfortunately, far too long, whether it's women of color, Black and Brown women, low-income folks, immigrants have been having their choices and their medical decisions taken away, mostly because of misinformed policies that are not truly supportive of people's access to care. So we definitely want to make sure that it's restoring the choice, but we're also making sure it's available for everyone. And there are big consequences if that choice and when that choice is taken away from us. So, you know, can you give us either some data, information, experiences of how the overturning of Roe versus Wade is actually

impacting all women, regardless of whether or not they need to have an abortion or choose to have an abortion? What does this mean for us? What are the consequences? Yeah, I mentioned that we're really starting to hear some anecdotal stories. And I think as unfortunately this continues to go on, we're going to see more qualitative data as well. But we already know that what people are facing is that when you have less providers, it's not just going to impact access to abortion. It's going to be access to a variety of methods, treatments. And we want that decision again, to be made by providers, your access to, to be able to achieve your family planning goals, whether that's your specified type of birth control, again, getting sex education information for young people, if that's abortion bans.

When we have all of these continued restrictions, we're seeing less and less providers provide care. We're also starting to see, unfortunately, more people who have told us that their rights have been stripped. We are, to date, 20 states have eliminated all or some access. And there is a study from WeCount. So this is not our data, but WeCount put out a report recently that shows just since July of 2022 to March 2023, so almost a year since the Dobbs decision came down, more than 25,000 people were unable to get an abortion from a provider. Wait times have been increased. They're seeing, unfortunately, people who, again, never thought they were going to need

access to an abortion, but do need miscarriage management being turned away in hospitals. And so we're finding ourselves in a moment of complete chaos and confusion. It's causing a lot of issues for patients, providers, the health center staff, and, you know, really continuing to put people's lives at risk. So I think we have to keep highlighting it. And storytelling is so important. All the Planned Parenthood patients and supporters who come forward telling their stories, because that's how we're going to really understand what's going on in these states where bans are existing. So a couple follow-up questions, I think in states of chaos, extremism can come out. So there are lots of people who are saying

like women will die if this rate is taken away. Is that factual or is that extremist? Well, I think if you are having people delay what is time-sensitive care, if you're turning people away from emergency rooms, we've heard awful stories coming out of Texas now of people who have very much wanted pregnancies, but unfortunately, due to complications, are showing up in emergency rooms and being told, actually, we need to contact our lawyers before we can see you. We think you should go home, wait until you get sepsis, and then come back when we actually have to do life-saving care. So it is irresponsible that the choices to keep these bans mean that people are going without care. And I think, yes, we're going to see that this results in people really being harmed. I think it's also notable that the majority of these states who have abortion bans are the same states that haven't done things like expand Medicaid, have high maternal mortality rates. So if you're choosing to have a child or choosing not to have a child, unfortunately,

the healthcare system in these states are not actually helping people stay or get healthy overall. And so it's an entire healthcare system that's really being decimated with these bans. Okay. Then another question is, do these policies actually impact the amount of abortions that are happening. And my lens is, even if you read like historical, abortions have always existed. This is something that women have done forever. And there of course was a period of time prior to Roe versus Wade. Now we have this period of time where it's been overturned. Are women actually having less abortions or are they just doing it in a less safe way? We have a few data points. We're going to continue to learn more. So first,

I referenced the Society of Family Planning put out the We Count report. That report names 43,000 people. It has stated that abortion bans have been creating health care services that are out of reach for them. And we know that where abortion is legal, that means that states are not able to compensate for other states where the bans are in place. So, you know, you can't go from having access in the majority of states to having access in less and continue to see the same number of patients. So it is certainly a challenge right now. We know that patients sometimes are waiting up to 23 days to get an appointment. And so, you know, we've seen real increase in the complexity of patient journeys and having to navigate this new system. So we are seeing much more increase for referrals. A lot of that is people who are getting referred to out of state. And we know that sometimes it's not a

choice for people to take time off work, to get childcare, to travel long distances, to have access to the transportation. So that means that there are increasingly people who are going without. And the last thing I would say for people who now that people can access things like medication abortion, but we just haven't seen data yet on telling us what the numbers are around people who are choosing to self-manage. Okay. So there's a lot of feelings, opinions. This is just one of those topics that if you want to get people arguing, you bring it up, right? So what are the biggest myths or downright lies that we're being told that just don't align with the facts about abortion, women's healthcare, women's right to

choose? What are the things that you see that infuriate you because they just don't line up with the data and the experience. I don't want to repeat falsehoods, but I will say a biggest myth is that, as you noted, this is a cultural issue, that it's only a morality issue. For so many families, this is a kitchen table economic issue. The choice to expand your family or not is truly an economic issue. And that's something that everybody has to deal with. I want to borrow a line from our reproductive justice colleagues who often say everybody loves someone who has had an abortion. And so people who are putting out myths or untrue facts or flat out lies about where public opinion on this, I think are really the ones who are doing the worst damage because

it doesn't allow us to be fully transparent about the fact that we all know somebody who's had an abortion, whether they, they've told us or not. And so we really have to work on reducing the stigma and talking about it, storytelling, being able to stand up for these rights and access our ways to push back on the and do some of that myth busting. But the bottom line, I think, is that we know that people should be able to make decisions over their own lives. And that misinformation, harassment, the things that we have seen since the Dobbs decision, both online and at health centers is a very active opposition who are taking up a lot of space, driving what it myths and misinformation. But I think the best way to push back against all

that stigma is to stick to the facts, follow the work of actual providers, not the ill-informed folks. And again, listen to your friends and family who, for many people, this is an economic issue. I'm so glad that you said that because that rings true for me. Everyone knows someone they love that's had an abortion, whether they know it or not, that is a truth. So what I want to talk about a little bit is how a tactic that is often used is labeling or creating an other. When we talk about things like this, we bring to mind an image and there's trying to sell a little bit of an image of a woman who gets an abortion. And you said this, it's somebody who's immoral or, you know, doesn't care or is using it as

birth control, whatever. There are all these things. What do we need to know about women who are having abortions? Friends at the Guttmacher Institute, which is an institute that studies sexual reproductive health care data, tell us that we know that people who are seeking abortions are obtained a lot of times by people who already have kids. Fifty-nine percent of people who are accessing abortion already have children. So again, they're making this choice about their family size. We know that almost half of people having abortions are living below the federal poverty line. I think just reinforcing again that we don't have the systems

that allow people to continue expanding their family if they're not able to access care. And we know that the vast majority of women having abortions are in their 20s. So the abortion patient survey data that Guttmacher puts out every year tells us that the experiences are varied and the reasons that people have abortions are very, very personable. And we know that the other side of that is it's getting much more difficult to safely have children in the United States. The CDC tells us that USA is one of the most dangerous wealthy countries to be pregnant, particularly for Black women. And so we're seeing that the way the policies and healthcare systems are being set up are squeezing people from both sides, that you're not supported to get your access to abortion if that is your

choice. And our systems are not set up to support people who in fact do want to expand their families. So that's an interesting data point that you bring up there. And one I was curious about, obviously I have my personal beliefs and I feel like the United States is great in so many ways. And obviously, you know, first world country, and there's so many things in our history to be proud of and so many things not to be proud of. And ultimately, it's just mind blowing to me that we live in this country and it's starting to feel like we just don't care about women or women are the second class citizens. And then there's, of course, there's still third class and fourth class and all of that to ask, how does the U.S. compare? You talked about pregnancies, but how does the U.S. compare to other first world countries when it comes to health care for women and abortions for women? We know that when it comes just particularly since the pandemic, we know that there's been a vast increase in STI testing. We know anecdotally through our health centers, people are increasingly finding difficulty

in locating gender affirmingirming care for our LGBTQIA friends. I mentioned the data on maternal health, but if we just look at, say, contraception in particular, it really continues to be a major concern for people. We know that in the Supreme Court decision in Dobbs, Justice Thomas wrote about how maybe we should be revisiting decisions around birth control. So, you know, we see a lot of potential for future concerns when we don't believe they're just going to stop at abortion access. But it could very much, in fact, be birth control where we know that there is a Fifth Circuit court in the state of Texas that is coming after mifepristone, which is the most commonly used form of medication abortion.

And we are going to continue to take away funding for federal family planning program and including for Planned Parenthood. And so the landscape right now is just extremely difficult for people to get access to an OBGYN. Unfortunately, we know that if you look at states like Georgia, 60 percent of the counties do not have access to an OBGYN. So just for your annual exam, people are having delayed time in being able to get access to sexual reproductive health care. And so, you know, I think our health care providers or staff or volunteers, you know, we're continuing to not just stand by and watch this real human toll and risks being put forward, but also making sure that we're continuing to raise awareness and advocate for real change that we know we need to see if we want to start to see the trend of that data

go in the opposite direction. Okay. I have one other talking point that gets brought up a lot. It's this idea of just put your child up for adoption or, you know, the idea that if, if women don't have the right to choose, don't have access to abortion, we're going to have a lot more children in the world where for one reason or another, the mother may not be ready, equipped, or able to care for them. And there's this sort of like adoption and foster care may fix the problem. And every woman I know who fosters or family that I know who fosters or is trying to adopt a kid, the amount of time expense, it's probably about as hard as it should be for us to have children, you know, to do something that important. But this idea that, you know, that is even a remote possibility that all these unwanted pregnancies could turn into children who are adopted and fostered. So all of that to ask what happens to children if we remove women's right to choose or to not have forced pregnancies and birth of unwanted children. We actually do know a couple of things about this. Obviously, we want people first and foremost to be able to

make their choice and choose what they feel is right for their family. We know that because of lack of expanded Medicaid, limited family planning dollars, not everybody has access to be able to prevent an unintentional pregnancy. And I mentioned the closures of hospitals and difficulty getting in with healthcare providers. But forcing people to have children to take on additional economic responsibilities that they otherwise would not have chosen does create further financial insecurity

that impacts children, it impacts women and entire families. A few years back, there's something called the Turnaway Study that showed children who are parents already have at the time they seek abortion, they already have children, but they show actually worse child development if their mother is denied an abortion. So for the children they have, continuing to expand their family when they didn't want to can create some worse child development compared to children who are a mother who is able to receive sure that people are able to have to think about these decisions on a very personal level. And so if it's your reproductive freedom absolutely includes your right to parent, however you see fit. And it also has to include the right not to parent if that is your decision. And so really overall,

what we should be aiming for is abortion justice that lets people be able to have the reproductive freedom and economic freedoms that they would really want without having to do this in the public debate with elected officials who are writing policies that don't support people to think about the greatest impact for themselves and their children. Okay, Jacqueline, I want to ask one final question, and that is, what are the ways,

both big and small, that we can get into action and fight for this very personal and necessary right to choose. We invite everybody to join Planned Parenthood in that fight. We'll make sure that in the health centers, we're doing everything we can to protect sexual reproductive health care, get people the resources. And to learn the latest, people could visit banzoff.org to get access to information about the status in your state of abortion access, but also what you can do to support health centers, abortion funds, share your stories, all of that information and how to plug in is at banzoff.org. Okay. We're going to put banzoff.org in show notes, as well as plannedparenthood.org. They have a get involved page that I would invite you to visit and we'll include a text number that you can access and

everything else in show notes. So please feel free to check all of that out. And I would just ask whatever is the right way for you to get into action, get into action. Jacqueline, thank you so much for having this really important conversation with me and for bringing your expertise and knowledge. And most importantly, I said at the beginning for your courage and care and the work that you all are doing. Thank you so much. Thank you so much, Nicole. Okay. I'm not sure that anyone who is anti-abortion will still be listening, but for anyone that doesn't agree

with anything that was said today, I say this. I respect your right to choose. If abortion is wrong or a sin for you, then don't do it. And I'd rail just as strongly against anyone who tried to attack your right to choose your personal beliefs or your religion. I'm frankly disturbed by the unadulterated arrogance we demonstrate when we believe we know what other people should be choosing. Making the right and best choices in and for

our own lives is challenging enough. Stop pretending you have the answers for everyone else and stop pretending that arrogance doesn't have consequences, especially for women who haven't been afforded the same level of options and choices as you have. And frankly, we all know and love women who have had abortions. If you don't, it doesn't make you morally righteous and makes you a woman that other women don't trust with their secrets or their hard choices. Being a woman that other women can trust is something I've committed my life to, and I hope you will too. I've said before that when I say this is woman's work, the this is whatever feels true and right for you. So here's the big

reveal. This has always been another word for your ability to choose. Choose your passion, your purpose, your people, your reactions, your responses, your beliefs, your relationships, your career, your education, your risks, your investments, your kindness, your growth, your confidence, who, when, and how you have sex, and if and when you give birth. Those choices and so many more. That is the this in This is woman's work. Choice. And if that's not the hill we're willing to die on, I don't know what is. So I don't care how you do it. I just care that you stand for it. Not just your choices or the choices you like, but the right for each woman

to choose, for each person to have agency and ownership over the one thing we should always have complete control over, our bodies. Choice is and always will be woman's work.