A day at the Philadelphia Women’s Center: How staff navigate state restrictions to provide compassionate abortion care

By Julie Zaebst, Senior Policy Advocate, ACLU of Pennsylvania

On a recent day in March, a group of our staff was glued to our phones in anticipation of the Georgia state House vote on a draconian anti-abortion bill. The bill would ban abortion at six weeks gestation — a stage before most people even know they are pregnant. But as this circus was unfolding in Georgia, we were also preparing to spend the day at the Philadelphia Women’s Center, getting an inside look at what it actually means to provide abortion care under the current regime of restrictions and red tape in Pennsylvania.

The Philadelphia Women’s Center is an independent abortion provider that has been providing first- and second-trimester care for more than 45 years. Every day, their staff arrives at work prepared to navigate byzantine laws and regulations that were designed to make their jobs of providing safe, compassionate, and timely abortion care difficult. But despite the politically motivated restrictions, they’ve developed systems to make the experience as seamless as possible for patients.

By the time patients arrive for their appointment, they have already cleared countless hurdles. First, they must locate a provider and get themselves to the office. With more than 85% of counties in Pennsylvania lacking an abortion provider, this is no small feat. The number and locations of abortion providers is not a reflection of the need for care; rather, it is a reflection of the challenges of opening and operating a clinic, a task made more difficult by restrictions the state imposes only on abortion providers and not on other similar healthcare providers.

Of course, patients must arrange time off from school or work for their appointment. For low-income folks, this may mean a day without pay that their family counts on for survival. The majority of patients are already parents, so securing affordable childcare is often another obstacle that they face.

State law imposes a mandatory delay on patients: at least 24 hours before their procedure, they must receive state-directed counseling from a provider. The Philadelphia Women’s Center offers a couple of options to make this process as least burdensome as possible to patients. But if a patient misses their counseling session and they can’t reschedule quickly enough to satisfy the waiting period, they have to cancel their procedure and restart the scheduling process.

Perhaps the biggest barrier of all is the ban on insurance coverage of abortion care. During our visit, we had the chance to read patients’ entries in journals that the center provides in their waiting room. Many of them shared that their decision to get an abortion was driven by financial circumstances — they simply couldn’t afford to raise a child (or, in many cases, another child). According to a study by Guttmacher Institute, 75 percent of the people who received abortion care in 2014 were low-income.

Still, PWC staff must break the news to most of their patients that their insurance will not cover their procedure because state and federal law prohibit Medicaid from covering abortion care in most circumstances.*

Because most patients who are insured through Medicaid must pay out of pocket, some may wind up “chasing the fee,” as one staff member explained to us. A patient may take a few weeks to scrape together the money needed, only to find out that the cost of care has increased because they are now further along in their pregnancy — so they have to go back to the drawing board.

A patient must navigate all these barriers before they even arrive at the center for their procedure. And for some patients, the hurdles are even higher: for incarcerated folks, for instance, or for young people, who must obtain consent from a parent or get a judicial bypass.

When they arrive, patients will likely be greeted by anti-abortion protesters outside the clinic — but also by escorts, who help them make their way inside safely. There, staff will welcome them and prepare them for their procedure.

What we observed during our visit were dedicated, compassionate medical providers doing what they were trained and committed to doing: providing healthcare. The only difference we saw between the Philadelphia Women’s Center and any other healthcare facility? Doctors and patients — those who know best — face politically motivated restrictions and interference.

The Federal Government Steps Up to Protect Survivors of Domestic Abuse From Eviction

By Sandra Park, Senior Staff Attorney, ACLU Women’s Rights Project

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Tonya Lee* and her two children had been living in their Maryland apartment complex for five years when her boyfriend became enraged during an argument and stabbed her and her older son. After the police arrested him, her landlord sent her a notice: They were evicting her because of the violence. Her lease included a standard provision authorizing eviction of tenants when there is criminal activity in their homes.

Domestic violence survivors shouldn’t face eviction just because the crime takes place in their home. The ACLU has been advocating for 15 years to establish survivors’ rights to stay in their homes after reporting domestic violence and sexual assault. Those rights are now a reality for millions of people across the country.

Today I was part of a forum with Department of Housing and Urban Development Secretary Julian Castro at which he announced three housing reforms that will help protect victims like Tonya from losing their homes. Speaking at the National Coalition Against Domestic Violence conference in Chandler, Arizona, Castro announced new regulations from HUD that guarantee survivors of domestic violence, sexual assault, dating violence, and stalking protection from eviction from federally funded housing. The regulations, which carry out housing rights created by the Violence Against Women Act (VAWA), apply to privately owned affordable housing developed with tax credits, public housing, and Section 8 housing. The regulations also state that housing providers must develop policies that offer emergency transfer options for survivors who need to move to another location for safety reasons.

Survivors also often confront local nuisance, or crime-free, ordinances. These ordinances exist around the country and penalize tenants for calling 911 for criminal activity at their home, even when they are the victims. For example, Nancy Markham was nearly kicked out of her Surprise, Arizona, home after calling the police for protection from domestic violence. There was a city ordinance that treated 911 calls as “nuisances” that could lead to eviction.

After advocacy by the ACLU and our partners, HUD issued new guidance explaining that local nuisance ordinances can violate the Fair Housing Act because they so often penalize domestic violence victims who call 911. The guidance calls on cities to get rid of such ordinances to promote fair housing for domestic violence and other crime victims.

HUD also finalized regulations that for the first time explain how the Fair Housing Act prohibits sexual, racial, and other forms of harassment in housing. Such protections are vital to prevent the experiences of women like Yolanda Boswell, whose real estate manager repeatedly offered to reduce her rent in exchange for sex. When she refused, he raised her rent and threatened to evict her. We later learned that he similarly harassed several other women. Just as employers can be held accountable for harassment in the workplace, the regulations spell out how property owners and landlords are responsible when they fail to address harassment committed by their agents.

The ACLU represented Tonya, Nancy, and Yolanda as they successfully fought housing discrimination. But millions of people have faced the loss of their housing because they are victims of domestic and sexual violence. They may feel trapped and endure further violence to avoid homelessness.

PEOPLE SHOULD BE SAFE IN THEIR OWN HOMES

KEEP THEM SAFEThese latest housing reforms bring us one step closer to a world where everyone’s home is a sanctuary. Survivors of violence cannot truly be free without being able to obtain and keep safe housing. And the right to fair housing must not only include having a roof over one’s head, but also living free from violence and abuse.

*Tonya Lee is a pseudonym.

This blog is cross-posted on the ACLU’s blog Speak Freely.

Her Story: Let’s Celebrate Women’s Privacy

By Janice Arellano, Larry Frankel Legislative Fellow, ACLU of Pennsylvania

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Janice Arrellano

“The emphasis must be not on the right to abortion, but on the right to privacy and reproductive control.” –Justice Ruth Bader Ginsberg, Apr. 1974

The reflection and celebration of women’s advancement in the United States is not only attributed to the progress on Capitol Hill, but also in the arts, education, media, and popular culture. Women are dominating the discourse and driving critical messages of respecting women’s decisions with their bodies and stories both in popular media and in our everyday lives. Some of the people I have recently admired outside of the political or legal spheres in this regard are Laverne Cox, Janet Mock, Sheryl Sandberg, Lupita Nyong’o, and, dare I say, House of Cards’ character Claire Underwood.

It is the year 2014, and there is much to commemorate during this Women’s History Month. Various pieces of legislation have been enacted over the past few decades, namely the Equal Pay Act of 1963, the Pregnancy Discrimination Act of 1979, the Family and Medical Leave Act of 1993, the Violence Against Women Act of 1994, and the break time for nursing mothers provision of the Patient Protection and Affordable Care Act in 2010. However, at the state level, particularly in Pennsylvania, there seems to be a need for a women’s rights refresher course for many state legislators. This can be a month to look back in reverence, or, for many women, it can also be a time to look ahead with trepidation.

As the third Frankel Fellow for the ACLU of Pennsylvania and the first female to serve in that capacity, it has been quite an experience reading proposed bills from a woman’s standpoint and learning how often this viewpoint is undercut, even inside our state’s capitol. Just in the past few weeks, during Women’s History Month, I have witnessed one piece of legislation that was heading in the right direction for women’s rights but has recently been sidetracked by an amendment. Without going beyond the scope of this article, that bill (HB 1796) was meant to protect domestic violence victims, who are predominantly women, from municipal ordinances that penalize individuals who make too many emergency calls to law enforcement. It was a laudable piece of legislation, but an amendment was recently added that would ban local workplace leave policies designed to protect many crime victims puts HB 1796’s passage in jeopardy.

Proposed legislation: An adoptee given access to original birth certificate without birth mother’s consent

This past Tuesday, I observed a hearing on House Bill 162 before the Pennsylvania Senate Committee on Youth and Aging. This bill considers an adult adoptee’s right to access his or her original birth certificate/record without the birth parent’s consent. In most cases, the birth parent likely listed on the certificate is the birth mother. The sponsor of the bill provided very compelling testimony demonstrating the need to know his mother’s name, where he was born, and any medical and genealogical information critical to his complete history and confirming his identity. An adoptee and adoptive mothers testified as well. Throughout the hearing, all I could think about was whose consent, body, and privacy was kept silent. I wondered how the women who want to keep their anonymity to preserve their well-being and also to move past a very difficult, emotional, and personal moment to place a child for adoption would think of this bill.

A representative from the Pennsylvania Catholic Conference testified that many women choose to place their children for adoption because the baby was conceived through a violent act, such as rape, incest, or other exploitative means.

This proposed legislation would significantly undermine the privacy rights of the mother and possibly bring about a history that a woman wants to keep in the past. Pennsylvania law already respects the importance of an adult adoptee’s access to the medical, genealogical, and social history of their birth parents, information that is helpful to understanding many aspects of a person’s future health and social decisions.

HB 162 would create true conflicts between the adoptee’s need to know his or her biological parents and the biological parents’ desire for privacy. Allowing the release of identifying information without the consent of the parties involved would alter past jurisprudence and interpretations of existing adoption confidentiality statutes and the intentions of legislators who created such statutes.

RELATED LINKS:

House Bill 1796 | ACLUPA HB 1796

House Bill 162 | ACLUPA HB 126

Catholic Conference page on HB 162