I have spent much of my time in the past two weeks lobbying and protesting against a group of bills proposed by conservative republicans in the Virginia House and Senate. The journey has been grueling and energizing, celebratory and disapointing, and at virtually all times, marked by an increasing feeling of alarm at just how broken our legislative system really is.
The first bill entered into the Virginia House this year, by republicans who gained their seats via platforms based on jobs and the economy, was HB1, the "personhood" bill granting full rights under the law to fertilized human eggs / embryos / fetuses. There were also several other TRAP (targeted regulation of abortion provider) bills, including the most infamous, HB462. This bill mandates ultrasounds for women seeking abortion, which would require a transvaginal ultrasound for the majority of these women, since transabdominal ultrasound is generally unable to detect a fetal heartbeat in the first 10+ weeks of pregnancy. These laws, which strip women of their reproductive rights and dictate standard of care to physicians, made Virginia the laughingstock of the nation.
I have been honored to stand beside many intelligent, brave women and men this week and last week as we protested these bills outside the General Assembly, were present at committee meetings, encouraged activism via online and other interpersonal channels, and watched House and Senate proceedings from the galleries inside the Capitol. HB1 died in the Senate Education and Health committee. The House passed by HB1285, which seeks to make abortion unlawful after 20 weeks gestation for most pregnancies; an identical Senate bill, SB637, died in committee. SB484, the Senate version of the ultrasound bill, was withdrawn by its patron. This morning, the Senate Finance Committee passed by HB62 indefinitely; this bill would have repealed Medicaid coverage of abortion procedures in which the fetus had been shown to have physical or genetic abnormalities. 32 women requested this coverage in the past two years. The cost to the state is minimal when compared to the cost of continued medical care of the mother and baby and theraputic, early intervention, and special education services for the child. The bill would also result in women who could not afford the procedure being forced to carry these pregnancies to term, against their will. Despite comments from one senator who doubted that there would be a significant fiscal effect on the Commonwealth of requiring women to carry their children with disabilities to full term (ignoring the medical care and special services these children will require, and the support their families may require), the bill was still passed by indefinitely, which kills it for this year.
That left just one anti-woman, anti-civil-rights bill to defeat, and activists felt hopeful that it would die in the Senate today. Shortly before 2 pm, the Senate reconvened and shortly afterward, heard eight proposed amendments to HB 462 (the mandatory ultrasound bill). This bill had previously been amended by the house to soften the language, so that transvaginal ultrasounds would no longer be required to be performed, but are only required to be offered if a fetal heartbeat cannot be detected via transabdominal ultrasound. The physician is still required to perform a transabdominal ultrasound, required to make it viewable and audible to the pregnant woman, required to offer her the "opportunity" to view and hear it and receive a printed image, required to document whether or not she accepted these "opportunities", and required to keep a printout of the ultrasound image in the woman's chart for seven years. Governor McDonnell's "compromise" is anything but. It's still a TRAP law intended to make it more difficult for a woman to exercise her constitutional right to an abortion.
While watching the news and observing the House of Representatives from their gallery, I was saddened by the disrespect shown by right-wing conservatives for their fellow legislators (Del. Albo repeatedly evaded a question while insinuating that the questioner, a democrat, was some kind of idiot or harasser) and for women (see Del. Albo's story about his wife, accompanied by a porn soundtrack, and Santorum supporter Foster Friess' disgusting aspirin-between-the-knees contraceptive advice). I was alarmed by the excessive response of the police to a peaceful protest and annoyed by the dismissive, canned response of the police chief. I was frustrated by the unconstitutional, authoritarian rules of the Capitol grounds and the Senate and House galleries.
Yet somehow, I believed that logic and good old American freedom would prevail. I believed the word of my husband's business partner, Delegate O'Bannon, who said the bill would die in the Senate. I expected that Senator Saslaw's move to send the bill back to committee would be approved. It was not. What followed was a list of amendments offered by the democrats. Surely they would be accepted in a show of republican compromise, encouraged by a Governor with Vice Presidential aspirations, right?
Here are the amendments and their outcomes:
- Amendment 1: would prevent ultrasound being forcibly performed on a woman. Rejected 21-19
- Amendment 2: withdrawn by Senator Howell
- Amendment 3: exemption from ultrasound law for physician aware of genetic/chromosomal abnormality. Rejected 21-19
- Amendment 4: physician may enter note that the ultrasound was medically unnecessary, note remains in chart 7 years. Rejected 21-19
- Amendment 5: mandated insurance coverage of ultrasound. Tied 20-20, Lt. Governor voted nay, rejected.
- Amendment 6: exemption for women who lack sufficient funds to pay for mandatory ultrasound. Tied 20-20, Lt. Governor voted nay, rejected.
- Amendment 7: Commonwealth pays for the mandatory ultrasound; if the Commonwealth does not pay, the bill does not go into effect. Tied 20-20, Lt. Governor voted nay, rejected.
- Amendment 8: exemption for women whose pregnancy is the result of rape or incest, if and only if a police report was filed for said rape or incest. Passed by voice vote.
So, just to get this straight: the only time a woman can be exempt from this mandatory ultrasound is if her pregnancy is the result of a rape or incest AND she reported the crime to the police. If she cannot pay for the ultrasound, if she and her physician already know the gestational age of the fetus, if she and the physician know that the baby will be profoundly impaired or incompatible with life, if her physician deems the ultrasound medically unnecessary - these are all insufficient reasons for forgoing the ultrasound, in the judgment of 21 members of the Virginia Senate.
During discussion of Amendment 5, Senator Deeds pointed out the lack of funding for enforcement of this mandate. Senator Saslaw asked Senator Norment if he had ever, in his tenure, seen the legislature mandate a medical procedure. Norman evaded the question. Saslaw asked if Norman would consider this a mandate. Norman replied that he did not consider it abnormal. Again, an evasion.
Before the Senate voted on the amended bill, a number of democrats stood to present their arguments against it. The following quotes and paraphrased statements are from my notes:
Senator Northam, a democrat from Norfolk who is also a pediatric neurologist and the only physician in the Senate, questioned Senator Martin, who was presenting the bill, regarding whether Virginia code contains ANY other mandate of diagnostic procedure prior to a surgical procedure. Senator Martin couldn't answer the question. Senator Northam asked whether there were any other state-mandated diagnostic procedure. Again, Senator Martin could not answer the question. Northam then questioned why the legislature does not mandate specific procedures to other types of surgeons. As a side note, he added, "on the surface, this bill is about abortion," following up with the observation that if we want to decrease the incidence of abortions, we need to talk about education and access to both health care and contraception. (Study after study show increased use of contraception to decrease abortion rates, worldwide. Thanks to friend and Richmond family physician Mark Ryan for the links.)
Senator Northam stated, regarding HB462, "I consider that, as a physician, unethical." He discussed his years of training (four years of medical school, six years of post-graduate residency and fellowship), and the impact of this bill on a medical practice's ability to attract and hire new partners. Who would want to move to a state in which legislators dictate the standard of care to physicians? He indicated that the phrase "standard of care" is misused by Senators like Martin, and described the way that standard of care is established in medicine (hint: not by legislators). He concluded by declaring that the bill is not only unethical, but ridiculously unnecessary, proclaiming in exasperation, "I might as well do an ultrasound on this bottle of gatorade!"
Senator Edwards stated that the goal of the legislature is not to violate our individual dignity. He reminded the Senate that this bill violates the constitutional right of a woman to a simple, safe, legal procedure. He also pointed out that the language of the bill was contradictory. The title is "HB 462 Abortion; informed consent, shall undergo ultrasound imaging". The phrase "informed consent" indicates that a patient has the right to accept or refuse a procedure. The word "shall" indicates a mandate. How can one mandate that a patient undergo a procedure in order to obtain their informed consent for another procedure?
Senator Barker reminded the Senate that less than 1.5% of all abortions occur during the second trimester. The vast majority of abortions would occur before a transabdominal ultrasound could provide meaningful information to the physician or patient.
Senator McEachin (my representative) stated, "Senators, we don't know what we're doing...we should leave the practice of medicine to doctors...we have no business practicing medicine."
Senator Howell commented, "it reflects an attitude that is demeaning of women" and said that the bill carries the "presumption...that the doctors don't know what they do." She quipped that before the House amendment making the transvaginal ultrasound optional, the bill was state rape, and that now it's just state assault.
Senator Locke declared, "this legislation cannot be repaired or fixed; it must be defeated."
From a passionate, angry Senator Lucas, we heard, "desperate people do desperate things." She shared the sentiment expressed by so many pro-choice advocates through email and phone calls and visits this week, that the "arrogance of this body is an abomination." She shared her conviction that women denied access to abortion *will* seek illegal, unsafe ways to terminate their pregnancies, and insisted, "I would do whatever is necessary to keep you out of my business."
Senator Ebbin brought up the issue of incomplete miscarriage, and chided the bill's supporters, saying that it is "cruel to ask a woman to listen to a heartbeat that isn't there."
Finally, Senator Saslaw angrily advised the republican members of the Senate, "you might try voting the way you campaign," referring to campaign platforms based on smaller, less intrusive government, job creation, and fixing the economy.
...and after all this, the bill went to a vote, and 19 republicans and 2 democrats voted in favor of passing the bill. They voted in favor of the bill after hearing from a physician that it was medically unethical and unnecessary. The voted in favor of the bill after being reminded of the small-government values they claimed to have during their campaigns. They voted in favor of the bill in the face of a lack of evidence supporting the bill and evidence that contraception is what reduces abortion. They voted this way because they think it's necessary for "informed consent," even after being told that this is not actually what "informed consent" means. They voted this way even though no other medical procedure is mandated by law, and even though it disregards women's autonomy, and even though it will affect women living in poverty more than it affects affluent women, and even though thousands of women and men directly told them that THIS IS NOT OK.
This is not the government we want.
Here is the final breakdown of the vote:
Every Senator mentioned in this post is linked to his or her Senate information page. For those not listed, please refer to the Senate contact list. The bill will go back to the House for approval of its amended form; it is expected to pass and Governor McDonnell has said that he will sign the bill into law. Contact your delegates in the House. Call and write to the Governor. DO IT NOW. It is unfortunate that since HB1 died in committee, the number of pro-choice, pro-civil-rights advocates at the Capitol has waned. We cannot stop. HB462 matters NOW. And the bills that failed to make it to a vote this year will come back next year.
There will be a second silent protest this Saturday, March 3rd. I will be there. Will you? Show our legislators that this is NOT the American way to govern.
Every bill described above is linked to its legislative information page; read the bills, know what they say. THIS MATTERS. It's not just about women's rights, it's about human rights. It affects women and men, both through the direct results of these bills and also via the dangerous precedent they set regarding the dictation of medical practice by the Virginia legislature. So many women and men have come out to fight for freedom, but this work is exhausting and cannot be carried by them alone. This is YOUR life and YOUR country. Will you stand up to defend them?
