Preserving choice

Despite the intensity of the abortion debate, Planned Parenthood's Kathy Kushnir is sanguine about the outlook for reproductive rights

by Kathleen Hughes

Kathy Kushnir

Although abortion rights have been constitutionally ensured for nearly 30 years, they've been eroding for the last 20, as attacks on clinics and anti-choice legislation has reduced the number of providers by 30 percent since 1982, according to the New York Times. Now, with an aging Supreme Court, an anti-choice presidential candidate in a close race, and the still-raging debate on partial-birth abortion, reproductive rights remain under siege.

But Kathy Kushnir, executive director of the Rhode Island chapter of Planned Parenthood Votes!, the lobbying arm of the health clinic, sees the positive side of the conflict. Kushnir, a native of Avon, Connecticut, who was a public defender in Chicago for 20 years before coming to Providence to practice healthcare law, joined Planned Parenthood in June. She cites the US Food and Drug Administration's approval of RU-486, and a recent Supreme Court that overturned a partial-birth abortion ban in many states, including Rhode Island, as evidence of support for abortion rights.

RU-486, Kushnir hopes, will privatize reproductive choices, and make abortion available in suburban and rural America -- parts of the country where surgically-equipped clinics are few and far between. Mifepristone, the clinical name for RU-486, works by blocking progesterone, a hormone necessary for pregnancy. The drug is taken at a doctor's office in two doses, two days apart, followed by a third visit to make sure the abortion was successful -- a procedure that's neither as easy nor as private as some might think. Misconceptions about RU-486 will certainly abound, as they have with the misleadingly dubbed "partial-birth abortion" procedure. Kushnir hopes RU-486 will become available in Rhode Island early in 2001.

For state elections, Planned Parenthood Votes! compiled a voters' guide that indicates the stances of candidates on 12 issues, ranging from support for Roe v. Wade to whether they back state funding of abortions for low-income women. The guide, which is sent to contributors, is also available at Planned Parenthood (111 Point Street, Providence).

Kushnir, whose affiliation with a state Planned Parenthood chapter prohibits her from discussing federal elections, spoke with the Phoenix in her office recently.

Q: Most women take for granted the ability to get a safe abortion. Is this an accurate assumption, and how does the situation in Providence compare to other parts of the country?
A: Women have access to safe, legal abortions in Rhode Island and all over the United States. But I read recently that . . . only 14 percent of the counties in the US have abortion services that women can access -- services they're entitled to by law. Just doing the math tells you that some women have to travel, maybe even out of state . . . If you look at Rhode Island, in the Providence area you have access with three providers, and another in North Attleboro. If you are in Newport or South County, you have to come to Providence . . . So, if you're by a major metropolitan area, access is reasonable. If you're in an outlying area, even in our state, access becomes a burden.

Q: Do you expect that RU-486 will reach those outlying areas?
A: That's absolutely our hope . . . because RU-486 will be able to be offered by gynecologists and family practitioners, so there won't be that necessity to go to a clinic that provides surgical services.

Q: The popular image of RU-486 is that it provides an abortion as easily as taking an aspirin cures a headache. What does someone considering the use of RU-486 need to know?
A: She needs to know that she has to discuss the entire procedure with a counselor and a trained clinician who knows how to administer RU-486. The question of whether to do a medical abortion [RU-486], as opposed to a surgical abortion, is a private choice. It's always really important to get the facts. That's how the best decisions are made.

Q: What are the facts of RU-486?
A: That it requires more than one visit to a doctor; that it is a procedure that continues for seven to 14 days; that one can make the choice not to go through the RU-486 procedure by choosing a surgical abortion, which takes about a half-day.

Q: How do you think RU-486 will change the image of abortion?
A: It's our hope is that it will give women an early, safe, private option in the way that surgical abortions are not offered in this country. The hope is that RU-486 will help privatize a woman's health decisions and medical choices.

Q: How does the use of the term "partial-birth abortion" -- an inaccurate description of a third-trimester procedure that is performed very, very rarely in most states, usually because of the mother's endangered health -- reflect the current atmosphere on reproductive rights?
A: The use of the term "partial birth," which is not a medical term or a legal term of any factual basis . . . speaks to the total politics surrounding abortion. When facts aren't used, it could lead somebody to believe that there's a deliberate effort to misinform . . . Using the term "partial-birth abortion" doesn't give the public anything they can use to make an informed decision, and that seems political.

Q: Isn't the use of the term a failure of choice supporters to more effectively articulate their viewpoint?
A: What's really hard is working against total fabrication . . . I think we have to be careful about the anti-choice lobby misinforming around the issue of RU-486. Hopefully, that won't happen, but look what's been done with the partial-birth abortion campaign of the anti-choice lobby . . . It will be our responsibility, as Planned Parenthood of Rhode Island, and as part of the pro-choice community, to be sure correct information gets out regarding RU-486.

Q: But aren't there already some misconceptions about RU-486?
A: Yes, and with it being so new, I think that perhaps any misconceptions that are forming now will be taken care of as we have the time and ability to properly educate the public. That's our responsibility.

Q: Is RU-486 an election issue? How is choice prominent in this year's state and local elections, and is it more so than in the past?
A: It seems that choice really is out there during this election cycle, maybe for several reasons. Number one, the Supreme Court decision in Stenburg v. Carhart at the end of June, in which the Supreme Court found Nebraska's so-called partial-birth abortion ban to be unconstitutional. That was big news. The FDA approval of RU-486, not even two months later. That was big news that we were waiting for in this country for a dozen years. The fact that we have major women's health care issues being decided by the Supreme Court of the United States and the FDA -- it's big news. It gets people talking . . . All of the indications from the decision-makers have been very positive for women's health.

Q: Rhode Island is dominated by Democrats and Catholics -- two groups that are often at odds when it comes to abortion. How does this play out?
A: People always talk about Rhode Island being a dominantly Catholic state. Over and over again, I read information that identifies Rhode Island also as a predominantly pro-choice state. So, how people reconcile their religious beliefs with their decision to be pro-choice is personal, but apparently people are doing it . . . Very often, people prefer to remain private in how they make those decisions, and we respect that.

Q: What are signs of the state of choice in Rhode Island?
A: The fact that the contraceptive access bill got passed last session, by an overwhelming majority in both the House and the Senate, uniting both pro-choice and anti-choice legislators, is tremendous. The bill mandates that insurers who cover prescription drugs also cover FDA approved-prescription contraception-- the pill, IUD -- effective January 1, 2001. We are one of 13 states who have passed a contraceptive access bill . . . It wasn't a partisan issue. It wasn't even a choice/anti-choice issue. Providing contraception is good health care, and the legislators united to provide that to the women of Rhode Island.

Also, Rhode Island's so-called partial-birth abortion ban was declared unconstitutional by the federal judge, [Ronald] Lagueux, in August of 1999. It was taken up on appeal by the attorney general's office and the governor's office. After the Stenburg decision came down in June, the attorney general's office withdrew their notice of appeal, which makes great sense. The governor's office believes that they can distinguish Rhode Island's law from the Nebraska law.

Q: Doesn't that suggest an anti-choice atmosphere in Rhode Island -- if the governor's office is still going after it?
A: It may indicate an anti-choice agenda on the part of the governor's office, but we don't know what the basis of their appeal is yet . . . They think that they can distinguish [the Rhode Island partial birth abortion law] from the Nebraska law in some way. We don't know how that can happen, because they're virtually identical laws. But then Governor Almond also signed the contraceptive access bill, and he indicates himself to be a pro-choice governor.

Q: What will the change in leadership in the state Senate mean for reproductive rights?
A: Senator [William] Irons was instrumental in moving forward the contraceptive access bill. I do believe it came out of his committee. So, we look forward to working with the leadership on all the issues important to women's health.

Q: Every Thursday, when I drive to work, I see protesters outside your clinic. Given the violence at clinics in the last 10 years, what kind of security precautions are taken at Planned Parenthood of Rhode Island?
A: On Thursdays, we have private security in addition to our regular security system. And we have our escorts, who are excellent . . . We are constantly assessing our level of threat. If there is any viable threat, we make adjustments accordingly. We've operated at the same level [of security] for the last five or six years. We haven't had any problems here. The murders [by gunman John Salvi] at Brookline [Massachusetts] are the closest to our facility, and events like that are always too close for comfort. Something like that immediately puts people on alert.

Q: Is the glass half-full or half-empty regarding reproductive rights?
A: Definitely half-full. We'll be celebrating 30 years of Roe v. Wade, and the developments just this past year have been tremendous for women. It's absolutely half-full. Preserving reproductive rights for women is a priority for a majority of Rhode Islanders and a majority of Americans.

Kathleen Hughes can be reached at khughes[a]phx.com.