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From the desk of ... Dr. Willie Parker, Repro Health Watch

Going to Mississippi: If I Don't, Who Will?

August 14, 2012 | Reproductive Health

Dr. Willie Parker, MD, MPH, MSc

In referring to reproductive rights, military metaphors are often used to describe the dynamics between those who support and those who would constrain women. If abortion access is "war", then the state of Mississippi is the frontline, with the recent attempt of the state to implement requirements that abortions be performed by board certified/board eligible physicians in obstetrics and gynecology (OB-Gyn), and who hold hospital admitting privileges at a facility nearby. These regulations would shut down the remaining abortion clinic in the state, effectively denying women their constitutionally-protected right to abortion simply because they live in the state of Mississippi. Proponents of such an action argue that they are "protecting" the health of women, but the truth would suggest otherwise.

The late Senator Daniel Patrick Moynihan once said, "Everyone is entitled to his own opinion, but no one is entitled to his own facts." Reproductively speaking, the facts of Mississippi are: high teen and unintended pregnancy rates, high infant mortality, high maternal mortality, and astronomical poverty, accompanied by abortion access barriers of mandatory waiting periods, parental notification laws, biased state-mandated counseling, public scorn, and extremely aggressive protesters. These realities confront every woman in the state with an undesired pregnancy, or a wanted-but fatally flawed one. Their need for safe, compassionate, medical care, in this instance abortion, calls compellingly to anyone who would listen. We know world-wide that when abortion is legal and accessible, women remain healthy, and when it is not they die, often in populations with profiles similar to what I describe for Mississippi. Cognizant of this, I recently obtained a medical license and began travel to this great state to provide care. Now, invariably, I field two questions regarding that decision: why are you doing this, and what about your safety? I will address the second question first.

Agreeing with the notion that to know is to become responsible', my decision to become one of two physicians traveling to Mississippi to provide abortion care, largely due to doctors who live there quitting after being harassed, intimidated and ostracized, was prompted by my sense that women there experience the circumstances that make abortion necessary in the first place. These include limited access to or dysfunctional use of contraception, chaotic life circumstances, and serious health issues for a woman or the pregnancy that she carries. After growing increasingly uncomfortable turning women away who needed abortion due to my feeling religiously-conflicted about providing them during my first 12 years as an ob-gyn, a sermon by Dr. Martin Luther King challenged me to a deeper spiritual understanding where compassion moved me to action on behalf of my patients. Similar to the defining quality of the Good Samaritan in Dr. King's narrative of what made the Samaritan "good", where the Samaritan reversed the question of concern to care more about the well-being of the person needing help than about what might happen to him for stopping to do so, my concern about women when there are no abortion services became more important to me than what might happen to me for providing the services.

In response to a query of why I choose to help women in Mississippi, the fact is that the women most at risk to be harmed by the loss of abortion services there are Black and poor. Twenty percent of all Mississippians live below the Federal poverty line, but 48% of Blacks there do, making it the poorest state in the country, a fact that exacerbates if not causes the life circumstances that lead to abortion. This observation is not to racialize the impending loss of abortion access for all women in the state, but rather indicates that my personal commitment to address the provider shortage there stems in part from my lived experience of growing up as a poor Black child in the south (Alabama) and knowing first-hand the dire circumstances that converge to create desperation for women with unintended or fatally flawed pregnancies. During my clinic days there recently, I counseled a pregnant woman with 5 kids, the youngest who had just died a year ago from cancer, who indicated that she could not care for another child financially or emotionally. She, along with others had traveled from various distances in the state for their first state-mandated counseling visit ,or were returning for their procedure following a second trip from hours away, often complicated by childcare/work considerations and doubled travel costs. They typify the hardships that Mississippi women endure due to the present laws.

In an oversimplification of the decisions facing the women that I saw, those opposed to abortion often opine that "women can simply place a baby that they don't want for adoption". I submit that for Black women that decision is more complex. The foster care system in this country is filled with Black babies that no one adopts, 80% of children in foster care being African American. For black women the decision to continue an unplanned pregnancy becomes one of bearing a child and struggling to meet its basic needs, or to not bring it into the world at all, as opposed to having a baby to be placed in a system where no one wants it, the few high profile trans-racial adoptions by celebrities non-withstanding. Hence, the more complex reproductive dilemmas that the women in Mississippi face compelled me to meet their need, being a son of the South and sharing heritage with the people most vulnerable to policies that when enacted only exacerbate their suffering.

In closing, to the question of why I go to Mississippi, the answer is, I want for women there what I want for myself: a life of dignity, health, self-determination, and the opportunity to excel and contribute. We know that when women have access to abortion, contraception, and medically accurate sex education, they thrive. It should be no different for the women of Mississippi.

Willie J. Parker, MD, MPH, MSc is a board-certified obstetrician gynecologist who provides abortions. He serves on the board of Physicians for Reproductive Choice and Health (PRCH) and The Religious Coalition for Reproductive Choice (RCRC).


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