Culture

No, There Isn’t a Self-Induced Abortion Crisis

For the past year, author and former Google data scientist Seth Stephens-Davidowitz has been making the media rounds. His research—and his book, Everybody Lies—uses big data to uncover behaviors and attitudes that Americans wouldn’t normally admit to. Some of the findings are fun (including tips for how to get a second date) and some feel depressingly self-evident (Americans are pretty racist), but none have caused the level of progressive panic as  Stephens-Davidowitz’s research on abortion. Using data tracked from Google searches, he concludes that abortion restrictions have led to “a hidden demand for self-induced abortion reminiscent of the era before Roe v. Wade.”

This inference is alarming and it has garnered significant press, including articles in Vox and The New York Times. However, there’s a basic misunderstanding at the core of the research that could harm women’s access to comprehensive reproductive health care—particularly affordable and safe abortions.

Stephens-Davidowitz’s research mistakenly conflates “self-induced abortion” with “illegal abortion,” though the two terms apply to two very different procedures. A self-induced abortion is simply an abortion that can be conducted within the comfort of one’s home. That includes medical abortions, also referred to as the “abortion pill,” which can be used to end early-term pregnancies. An illegal abortion, on the other hand, is often what we think of as a “coat hanger abortion”—it’s one of the risky procedures women undergo when other options (such as self-induced medication abortions) are not available.

Self-induced abortions are safe and fairly common.

Self-induced abortions are safe and fairly common: They accounted for 31 percent of all nonhospital abortions in 2014. “People choose to self-induce for a variety of reasons,” said Jill Adams, founding executive director of the Center on Reproductive Rights and Justice at Berkeley Law. “The flexibility of conducting the procedure at home on one’s own timeline is paramount, and self-induced abortion can be significantly cheaper than surgical abortion.”

But misinformation about self-induced abortion, namely that using the abortion pill is a dangerous practice, could ultimately make it harder to access. Anti-choice advocates and legislators have seized on this type of misinformation in the past, most notably through TRAP lawsTargeted Regulation of Abortion Providers, or TRAP laws, are specific legal requirements for abortion providers that are different (and more difficult to comply with) than the requirements for other medical practices. Examples include specifying specific hallway widths, staffing requirements, or admitting privileges. that require medically unnecessary updates to clinics that provide abortions as an indirect way to reduce abortions.

If that happens, it will hit women with few other options the hardest. Medical abortion is particularly crucial for people who would otherwise struggle to access reproductive health care, including people living in rural areas and women of color. Rural patients face clear physical barriers: 31 percent of women living in rural areas traveled more than 100 miles to access abortion services, and an additional 43 percent traveled between 50 and 100 miles. For women of color, who often suffer from a variety of barriers to abortion—such as financial instability, limited access to a broad range of providers, and distance from clinics—medication abortion can be the most cost-effective and low-risk abortion procedure.

These searches could simply be an increase in medically accurate information.

There’s a chance that the searches Stephens-Davidowitz reports could simply represent an increase in medically accurate information. Telemedicine has revolutionized abortion care for the aforementioned groups. In 2006, Planned Parenthood of the Heartland in Iowa launched a telemedicine service that provided medical abortion care at rural clinics. The initiative was wildly successful: Research showed that telemedicine availability increased access to abortion care for people living in remote parts of the state. Moreover, the study showed that telemedicine availability increased access for women seeking abortion services at earlier gestational stages, for which medical abortion could be a silver bullet against the cost, distance, and stigma of an in-clinic abortion. In short, Google results for “self-induced abortion” may have ticked up because more women are simply aware that it exists.

While it seems intuitive that restrictive abortion laws would increase the incidence of illegal abortions, the inference that Stephens-Davidowitz draws about self-induced abortions is not necessarily backed up by the Google search data. Clear, detailed terminology is critical in discussing abortion, especially when the consequences can result in devastating outcomes for people seeking health care. Mistaken inferences, even when they have good intentions, have harmful consequences when placed in the nefarious hands of anti-choice activists—and can result in even more limitations on women’s health care.

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Justice

Let Me Remind You Who Jeff Sessions Is

For the past several weeks, media coverage of Attorney General Jeff Sessions has taken a sympathetic turn. In article after article, the “beleaguered” Sessions is described as a victim of bullying, under Twitter assault by the president who appointed him. Meanwhile, Trump—angry that the law-and-order man he chose did not live up to his idea of loyalty—seems to be taking some joy in Sessions’s discomfort.

I have been reading about Sessions with a kind of perverse fascination—but I have not read anything that makes me feel sorry for him. The things he stands for—the things he has stood for over the course of his decades-long career—are abhorrent. The President’s mean tweets haven’t made Sessions’s brand of law enforcement any kinder to poor and black and brown people.

Sessions has bought into Trump’s false narrative about rising crime rates (which are actually near historic lows), and has proposed solutions founded on harsh punishment that’s meted out with impunity. He wants to reinstate lengthy, mandatory sentences for nonviolent offenses, and plans to undermine Department of Justice mandates designed to reign in abusive arrest patterns in communities of color. He believes racism in policing is a fact of life, but believes that being called a racist is the worst thing that can ever happen to a person.

His policy goals reflect a characteristically Southern paternalism towards black people, imbuing him with the air of a Great White Disciplinarian. He maintains an impersonal distance from the concerns of underserved black communities, such as Charleston’s Eastside, where I lived long enough to know that Sessions’s stances reflect the attitudes of many white Southerners.

The impoverished Eastside community was judged harshly. Passersby pointed at the trash on the street and the homes in disrepair as they drove through town, and shook their heads at the teenage drug dealers who idled on street corners looking bored or depressed.

I remember one young dealer—tall and lanky, without a wrinkle on his face—that I used to pass by almost every day. I assumed he was new to the trade when he appeared on my street in between my apartment and the local corner grocery, and I had no intention of speaking to him. Nope. I wasn’t giving encouragement.

Eventually, I noticed that he tended to frown and mutter at me when I passed by. I ignored him at first, but eventually his persistence made me curious. One day I stopped and listened. His hurried, garbled words astonished me.

“Teach me something,” he said.

If Jeff Sessions’ got his way, that young man would have been promptly arrested.

I didn’t know what to say. So, we talked. He did not need me to lecture him or tell him he was wasting his life. He knew that he was on a dead-end track, and that he was barely literate. He told me he had dropped out of high school. He had applied for jobs as a dishwasher, but never got called back. So he did the one thing he could do to make money.

At the end of our first conversation, I promised that I would “educate him” by telling him a new fact every day when I saw him on the corner.

This isn’t a cheesy Hollywood movie, so I’m not going to tell you that I changed his life by teaching him when the Constitution was ratified. No matter how many facts I shared, I could not give this young man what he really needed. I could not counteract the notoriously unequal South Carolina school system. I could not provide a decent summer job, a community energized by economic development, or a society committed to easing the plight of the people in poverty.

I knew I couldn’t do that when I started. And by the time he disappeared from the street corner a few months later, I was sure I hadn’t. He needed too much. The Eastside needed too much.

If Jeff Sessions’ got his way, that young man would have been promptly arrested and given the harshest possible sentence. For him, that’s the end of the problem. Put the criminal behind bars, and move on.

I would love to see that teenager teach Jeff Sessions a few facts. I would love to see him tell the Attorney General what it’s like to be young, black, and full of hope for a better life and opportunities, but facing bleak options.

Maybe Sessions would learn that the law enforcement policies he favors will only perpetuate a vicious cycle of wasted lives. Maybe Sessions would learn that educational programs, substance abuse counseling, and economic opportunity accomplish more than harsh sentences.

Maybe.

Or maybe Sessions will at least soon learn what it’s like to be unemployed—after the Donald fires Sessions during one of his tweetstorms.

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Media and Politics

Don’t Let the White House’s Dysfunction Distract You From the Things Trump Is Getting Done

While the media and much of the public have been consumed with the spectacle of dysfunction and failure in the Trump White House—The Mooch, the Russia investigation, and the demise of the Republican Party’s plans to repeal the Affordable Care Act—the administration has quietly succeeded in doing some real damage that has received little attention. In normal times, these actions likely would get more coverage, and that points to a problem of access to vital information as citizens and activists try to adjust to the daily tectonic shifts of Trump.

Here are a few big deal political maneuvers that haven’t received the reporting—or an outcry from a distracted public—that they need and deserve.

Reversing the Ban on Neurotoxic Pesticide

In March, the Trump administration’s Office of Pesticide Programs—which last year received 30 percent of its operating budget from the pesticide-manufacturing industry—canceled the Environmental Protection Agency’s proposed ban of chlorpyrifos, a common pesticide used on crops that was derived from nerve gas developed by the Nazis.

The Obama administration had called for the ban after “three long-term, independently funded studies showed the substance was toxic,” according to Reuters. Particularly vulnerable are farmworkers, and the brain development of children, infants, and fetuses.

“Chlorpyrifos has been shown beyond any shadow of a doubt to damage the brains of children, especially those of fetuses in the womb,” said Philip Landrigan, a pediatrician and dean for global health at the Icahn School of Medicine at Mount Sinai in New York. The American Academy of Pediatrics also urged EPA Administrator Scott Pruitt to reconsider his decision.

Yet Pruitt saw fit to hail the ban reversal as “returning to using sound science in decision-making.”

Dow Chemical—whose CEO leads a White House manufacturers working group—sells the chemical. More than 6 million pounds of it are used annually in the United States on crops like apples, oranges, broccoli, berries, and tree nuts. Two months after Pruitt’s decision, more than 50 farmworkers in cabbage fields were sickened when winds blew the chemical from nearby mandarin orchards.

You can get informed and fight for a chlorpyrifos ban here and here. You can tell grocers to stop buying foods that might have residue from the chemical here. Senator Tom Udall (D-NM) has introduced a bill to ban the pesticide.

Nixing Science-Based Teen Pregnancy Prevention Programs

Last month, the administration cut more than $213 million from teen pregnancy prevention programs and research, eliminating the final two years of funding for 5-year projects. More than 80 institutions across the country lost their funding, and none of the programs provided abortion counseling.

Health officials told the Center for Investigative Reporting (CIR) that denying funding midway through a grant is “highly unusual and wasteful because it means there can be no scientifically valid finding.”

Some of the programs cut include: work Johns Hopkins University has been doing with American Indian teens to reduce sexually transmitted infections and pregnancy; University of Southern California’s workshops for parents on “how to talk to middle school kids about delaying sexual activity”; the University of New Mexico Health Sciences Center program that helps “doctors talk to Native American and Latino teens about avoiding pregnancy”; and Planned Parenthood’s work in five states to bring “rural youths and parents together to share family values, strengthen family bonds, and talk about healthy relationships and sexual health.”

“We’re not out there doing what feels good,” Luanne Rohrbach, associate professor of preventive medicine at USC, told CIR. “We’re doing what we know is effective.”

Despite the fact that the teen birth rate has declined steadily over the past 20 years, the ongoing need for science-based approaches to pregnancy prevention is clear. CIR notes that the rate is still high compared to other industrialized nations, and the decline isn’t as steep in low-income communities. Perhaps that’s why the cuts were made outside the normal appropriations process as the administration pursues an ideologically-driven agenda that is out of step with real public health and education needs.

You can let your elected representatives know how you feel about this decision here.

DACA at Risk

In June, 10 states, led by Texas Attorney General Ken Paxton, informed the Trump administration that it must end the Deferred Action for Childhood Arrivals (DACA) program by September 5 or face a lawsuit that would be heard by an anti-immigrant judge who has halted similar initiatives in the past.

Past assurances by a notoriously fickle president to keep DACA intact are hardly sufficient. Even if the administration ignores the deadline, there is little reason to believe Attorney General Jeff Sessions would defend DACA in court. As Representative Luis Gutiérrez (D-IL) told The Washington Post, “Jeff Sessions is going to say, ‘Deport them.’ If you’re going to count on Jeff Sessions to save DACA, then DACA is ended.”

More than 780,000 young people, known as “Dreamers,” have been protected from deportation and made eligible to work since DACA’s inception in 2012. Seventy-eight percent of voters believe Dreamers should be allowed to remain in the United States permanently, including 73 percent of Trump voters.

Aside from the moral argument that people who grew up as Americans should be allowed to remain in the country, the Center for American Progress notes the economic case as well. Ending DACA would drain more than $460 billion from the national GDP over the next decade, and remove about 685,000 workers from the economy. Combined, the 10 states that are suing would lose $8 billion annually.

There is an opportunity take this issue out of the hands of extremists like the Texas attorney general and an unpredictable Trump administration. In July, the DREAM Act of 2017 was introduced with bipartisan support from Senators Dick Durbin (D-IL), Jeff Flake (R-AZ), Lindsey Graham (R-SC), and Chuck Schumer (D-NY).

You can let your elected representatives know you want them to support DACA here.

Chemical Accident Prevention and Protection Delayed

After a 2013 explosion at a fertilizer storage facility in West, Texas, killed 15 people, including 12 firefighters, and injured 260—the Obama administration directed the Environmental Protection Agency to strengthen the safety requirements for facilities using and storing potentially toxic or dangerous chemicals.

In January 2017, after four years of deliberations, the EPA finalized its Chemical Accident Safety Rule, which would apply to more than 12,000 chemical facilities across the nation. It included commonsense measures like making information more available to communities to support emergency preparedness, and safety audits.

However, in June, after complaints from the chemical industry that the new rule “may actually compromise the security of our facilities, emergency responders, and our communities,” the Trump administration delayed implementation until February 2019. Even as it did so, it released a fact sheet noting 58 deaths and $2 billion worth of property damage caused by 1,517 facility accidents over the past 10 years.

A coalition of 11 states led by New York Attorney General Eric Schneiderman has sued the EPA over the delay. You can tell EPA Administrator Pruitt to implement the new rule here.

Trump is losing many of his high-profile fights. But in dozens of less-noticed ways, his administration is advancing its extreme agenda that exacerbates political and economic inequality. As much of the media remains fixated on the Russia story and the Great Trump Dysfunction, journalists and advocates will need to work harder than ever to make sure the damaging daily actions of this administration aren’t ignored.

This article is a collaboration between TalkPoverty and The Nation.

Alison Cassady, Director of Domestic Energy and Environment Policy at the Center for American Progress, contributed research for this article.

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Labor

Texas Just Passed a Law About College Work Study. Here’s Why It Matters.

For a full-time, in-state student at The University of Texas at Austin to pay their tuition by working a minimum wage job, they would need to work more than 17 hours per day, 7 days per week. If students cast off all other trappings of modern life, they would divide their remaining hours between going to class (assuming a standard course load, that’s at least three hours per day), completing assignments (three more hours), sleeping (eight hours, or your risk of stroke increases), and commuting (that’s another hour, if you’re lucky).

That bare-bones schedule adds up to a 32-hour day. And that’s without eating, showering, or any of the extracurriculars—like internships—that get students hired.

For students who work to pay their way through school, an unpaid internship isn’t an option. In Texas, as in other states, these students take work in the retail or food industries to pay their bills. They graduate with a degree, but without the work experience that helps them to compete against their more-affluent peers.

That’s why Texas’s new, deeply-wonky law requiring the state to start collecting more data on state work-study participants is actually a big deal. Simply collecting data won’t amount to much for Texas students—but it’s a first step toward addressing gaps that plague the state’s higher education system.

Low Higher Educational Attainment, Low Financial Aid Investment

Between 1990 and 2010, costs at public four-year institutions in Texas increased by 286 percent—more than double the national rate. Meanwhile, Texas’s higher education attainment rate is below the national average. Less than 1 in 5 Texas eighth graders will eventually complete a higher education degree or certificate in 11 years, with that number plummeting to 1 in 10 for those from low-income families.

That’s at least in part because the state has also failed to invest in student aid at adequate levels, ranking second to last among the most-populous states. Students in Texas are much more likely to have to rely on loans, as opposed to grants, to pay for school than their peers in other states.

The Need for a Degree and a Resume

As college becomes more inaccessible to low-income students, it’s also becoming more important. In less than five years, more than half of jobs in all states will require some type of higher education—including 62 percent of jobs in Texas. At the same time, employers have reduced the number of entry-level positions and the amount of training time they offer. An administrator at Baylor University explained that young workers who previously expected two years of training time when entering a company would “be lucky” to get six months of training. And while previous generations could have expected positions similar to what we now call internships to pay, the use of unpaid internships to fill entry-level work has rapidly risen.

That leaves students who need to earn their way through school in a tight spot, since paid, career-related work is hard to come by. “I’ve never had a problem getting a job,” one University of Texas student explained, “[but] the only jobs that are available to get is like waitressing or … retail.” Similarly, a senior at UT from Dallas had worked all four years of school, and with the additional help of grants, had only accumulated $5,000 in student debt. But because she relied on her own earnings, she had to turn down multiple internships that would have given her experience in her intended field—and potential employers noted problems with a lack of experience on her resume as she launched her post-graduation job hunt.

Given these facts, it is understandable—though perhaps slightly tone-deaf—that Texas employers recently reported not being able to find qualified applicants as a top work-related concern.

Work-Study Could Be a Way Forward

Texas is one of fourteen states with its own work-study program Work study is a form of financial aid that places students in paid work to help manage tuition bills. —the Texas College Work-Study Program (TCWSP)—in addition to the federal program. Traditionally, work-study positions have been limited to on-campus placements like monitoring computer labs, reshelving library books, and running the mailroom. But two years ago, the Texas legislature began requiring that a significant percentage of placements be off-campus, which makes career-oriented work at outside companies a possibility.

The state already collects some data on participating employers, but under the new bill the state will report on participating students, too. That will allow administrators and advocates to track whether employers in the TWSP are mismatched with students’ career paths, and identify where the program is failing to foster career-growth opportunities. That will help students build out their resumes, and it will help administrators recruit companies from industries that are underrepresented in the program.

And, as the program becomes more effective, the popularity of expanding it—both among families and employers—will likely grow.

That’s essential, because work study is one of the few forms of state financial aid in Texas that remains a consistently bipartisan topic. Before Texas’s past legislative session, state leaders directed a 4 percent budget reduction among agencies across the board. In such a political climate, a significant investment in state grant programs was essentially off the table.

Work-study cannot be the only vehicle to increase opportunity for low-income students. But for the many other states facing budget reductions or led by lawmakers disinclined to invest in higher education, the progress in Texas could serve as an example as one important way to do so.

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Media and Politics

I Grew Up in Tom Price’s District. The Sex Ed He Promotes Is Dangerous.

Last month, the Trump administration silently slashed $213.6 million from at least 81 institutions working on teen pregnancy prevention. The cuts hit a wide variety of programs: the Choctaw Nation’s initiatives to reduce teen pregnancy in Oklahoma, the University of Texas’ guidance for youth in foster care, and Baltimore’s Healthy Teen Network’s work on an app that could answer health questions from teen girls.

This move came at the recommendation of the Department of Health and Human Services (HHS), headed by Tom Price. In many ways, it’s on brand with Price’s career as an enthusiastic advocate for restricting women’s choices: He has signed personhood acts that ban emergency contraception and abortion, opposed the Obamacare birth control mandate, tried to defund Planned Parenthood, and defended cuts to Medicaid that would deny millions of low-income women health care.

On an intellectual level, Price’s cuts are frustrating because they represent another piece of a regressive puzzle the Trump administration is assembling in order to control women’s choices. And personally, I’m devastated because I know what these cuts mean to the communities that they will affect.

I attended public school for my entire K-12 education in Tom Price’s former district, where abstinence-only education is the norm. The single day of sex education I received promoted the idea that all sexual acts outside of a heterosexual marriage are dangerous and shameful, and did not make any distinction about whether these acts were consensual or not. It espoused gendered roles that posited women as defenders of their precious virginity, and put the responsibility on women to prevent sex from happening to them. That’s perfectly in line with the content requirements for sex education in Georgia: They consciously exclude information about contraception, coercion, orientation, and HIV/AIDS, and they stress abstinence and marriage.

Because I was lucky, and because I am privileged, I was able to go to a college with real resources—extracurricular trainings, a health clinic, and actual academic courses—that helped me unlearn the detrimental sexual education I received in high school. I got the practical information that I needed, and I started unraveling my skewed concept of consent.

I attended public school in Tom Price’s former district, where abstinence-only education is the norm.

When I attended a “Take Back the Night” rally my freshman year of college, I realized that my abstinence-only education had led me to view myself as responsible for sexual acts committed without my consent. Consequently, I felt shame instead of empowerment to take the steps I needed to recover. This is a common phenomenon for young people that experience abstinence-only education; when all expressions of sexuality are described as negative and shameful, the lines between consensual and nonconsensual acts become blurred.

College gave me a second chance at sex ed, but a lot of people don’t have that opportunity. For rural communities, low-income communities, and communities of color, high school sex education and community-based programs are often the only options available to acquire stigma-free, accurate education about consent, contraception, and sexual health. These populations already face myriad barriers to sex education, including culture, finances, and distance. In my home state of Georgia, there are only four Planned Parenthood clinics—one of the only affordable health centers with enough name recognition that people know to seek it out when they need help—and three of the four are located in the Atlanta metro area in the northwest corner of the state.

Still, teen pregnancy and birth rates are at an all-time low across the country. Georgia has experienced one of the most drastic declines in these rates, from the highest teen birth rate in the United States in 1995 to the 17th in 2015. The grants that Price slashed last week were a part of that story. The target audience of all of these programs are marginalized youth who have a demonstrated need for increased education. And these are the groups that are at the greatest risk for high teen birth rates: Rural counties reported an average birth rate of 30.9 (30.9 teens per 1,000 females aged 15–19), compared with the much lower rate of 18.9 for urban counties. Similarly, black and Latino teenagers experience teen pregnancy at rates twice as high as white teenagers. For these communities, removing teen pregnancy prevention programs that these grants funded will restore the negative effects of abstinence-only education that the grants were originally provided to combat. For example, one of the programs cut was run by the Augusta Partnership for Children Inc., which focuses on reducing teen pregnancy and STI rates in four rural East Georgia counties. In one of these counties, Augusta-Richmond county, the teen birthrate is 22.9 percent higher than the state average.

These cuts can’t be written off as a difference in ideology.
It almost goes without saying that cuts to teen pregnancy prevention programs could reverse the downward trends in teen pregnancy and birth rates. And the Trump administration is attacking other lifelines marginalized groups depend on, too. Funding decreases imposed on safety net programs and Medicaid, both threatened under the Trump and congressional budgets, will significantly impact teen parents who often rely on public assistance for food, housing, and healthcare. Similarly, without sex education and community-based programs funded by HHS, teen parents and youth in general will likely need to turn to Title X providers Title X family planning clinics provide reproductive health care and preventive health services for low-income and uninsured individuals. for contraception, abortion services, and sex education. But President Trump and congressional Republicans have been chipping away at Title X providers too, by rolling back an Obama-era regulation that prevents state and local governments from denying funding to health care providers for “political” reasons—namely, the provision of abortion services.

These cuts can’t be written off as a difference in ideology. I experienced firsthand the powerlessness that results from a shaming, abstinence-focused education, and it can be a matter of life and death for communities already on the margins. I had a second chance at a more holistic education, but it was due to luck and privilege that most folks in Georgia do not have access to. And when we’re talking about pregnancy, HIV/AIDS infection rates, and domestic and sexual violence, luck and privilege shouldn’t be the factors we have to rely on.

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