The New Pro-Choice Battle Of 2016

Unfortunately, 2015 was a terrible year for reproductive rights legislatively — and socially, with the Center for Medical Progress (CMP) releasing a series of highly manipulative videos targeting Planned Parenthood, which just sued the CMP for fraud and invasion of privacy. As we celebrate the 43rd anniversary of Roe v. Wade, a landmark moment in American reproductive rights, the forecast for patients in 2016 is grim, according to Jessica Mason Pieklo, a Senior Legislative Analyst for RH Reality Check. Already, Congress voted to defund Planned Parenthood and threatened to overturn a presidential veto, while anti-choice groups are gearing up for another banner year. "I think we're going to see a lot of action on abortion-related restrictions," Pieklo tells Bustle, adding that Republicans are spoiling with a fight to appeal to their base in an election year.

In 2015, states considered hundreds of abortion-related bills, with nearly 400 specifically targeting reproductive freedoms — and enacted 57 of them — reflecting a steadily climbing trend to suppress patient rights. Some of these were drawn directly from language drafted by groups like Americans United for Life (AUL), an anti-choice advocacy group that's highly active in the courts in addition to writing cut and paste legislation for anti-choice lawmakers. The group's annual "Defending Life" publication includes a detailed blueprint for incremental laws that slowly but steadily choke out abortion providers as well as patient options, and it has been the architect behind dozens of bills.

Targeted regulation of abortion providers (TRAP) laws are an ancient anti-choice tradition, and every year, activists look for new things to exploit, with Pieklo noting that the conservative movement has perfected an incremental approach to suppressing abortion rights. Thanks to the Center for Medical Progress, the anti-choice movement has another manufactured issue to seize upon: The disposition of fetal remains.

The videos claimed to show Planned Parenthood executives negotiating with medical companies that specialize in buying and selling tissue for research, with detailed discussions of the kinds of materials available, preying on what Pieklo calls the "ick factor." Such sales are illegal — but talking about what a clinic can make available and requesting small recovery and storage fees isn't. The videos, however, catapulted Planned Parenthood into the public eye again, demonizing it for the right and rallying the left, with videos like the one below from Americans United for Life stoking fear of reproductive health care.

The AUL already included the "Dignified Final Disposition Act" in the 2015 legislative package, and it will most certainly appear in 2016's "Defending Life" as well, and while no state used it as model legislation last year, CMP has found fuel for the fire, and it may debut in a legislature near you in the coming months.

The misleading, highly edited, possibly illegal, and definitely manipulative videos released by the Center for Medical Progress entrapped Planned Parenthood representatives, making it seem as though they were involved in a bloody trade involving donated fetal tissue. In fact, such donation is entirely legal, as is the collection of recovery and storage costs, and it can provide tremendous public health benefits and scientific advances. Anti-choicers want to change this, limiting the very research that can, among other things, actually help protect pregnant patients by making it easier to study fetal development. Surprisingly, many of the Republicans leading the charge on the issue were actually for fetal tissue research before they were against it.

One way to eradicate fetal tissue research is to simply ban it, which some states are already doing. But another tactic involves mandating "humane" disposal of fetal remains. By law in most states, they have to be treated like hazardous medical waste, just like other human tissue. Abortion providers need to dispose of it in a manner that protects public health, such as cremation or incineration to destroy potentially infectious material, or burial in a secured environment. Some state codes leave guidance on disposition up to public health agencies, while others prescribe it specifically under laws surrounding abortion.

Mandating that fetal remains be treated like deceased people reinforces the notion that they're actual babies.

That could be about to change, and in fact, in some states, warnings are already on the wall. Legislators in Ohio, which has borrowed heavily from the AUL already, just introduced a bill which would require pregnant patients to indicate whether they want fetal remains to be buried or cremated — and because abortion clinics would have to pay for it, they'd likely be forced to pass the cost on to patients, making the procedure even more costly, a common tactic used by the anti-choice movement, Pieklo says. The law was likely the direct consequence of an investigation that revealed a medical waste contractor was burying processed fetal tissue in landfills. Planned Parenthood representatives noted that sterilizing fetal remains and disposing of them via burial was in fact entirely legal — and, incidentally, Ohio already bans the use of fetal tissue in research.

Indiana just joined Ohio in cracking down on how fetal remains are handled, and like Ohio, it proposes further shaming patients by forcing them to endure counseling prior to abortion so they can elect to have the product of an abortion buried or cremated. Pieklo tells Bustle that this encroaches upon patient autonomy "in terms of how patients identify with their pregnancy." Mandating that fetal remains be treated like deceased people reinforces the notion that they're actual babies. "Pregnancy is both a medical and a personal event," she says, explaining that even before the CMP videos, states were already proposing birth certificates for abortions, a move that infringes on the doctor patient relationship — and creates the terrifying specter of an abortion database.

Making it impossible to use fetal remains in medical research would also be a tremendous blow. Such tissue is truly unique, and contributes to studies on Alzheimer's, Parkinson's, vaccines, and spinal cord injuries. Perhaps ironically, it also allows medical researchers to study what happens when pregnancies go wrong, so they can develop tools to help patients with high-risk pregnancies. In other words, bans on fetal tissue research from miscarriages, failed pregnancies, and unwanted pregnancies will directly contribute to poor outcomes for pregnant patients in the future.

We know 2016 will be a tough year for the pro-choice movement, with more legislation likely hitting the books, a critical Supreme Court decision surrounding Texas' HB2, court battles like the looming use of fights over embryos as a political weapon, and other tactics to cut off freedom of choice. One, Pieklo says, should be of special concern — the anti-choice pincer tactic that's trapping patients between the rock of legislation and the hard place of a Catholic-dominated health care system. As laws chip away at the operation of standalone clinics, patients have nowhere to go when they need abortion services, even during medical emergencies, with Catholic hospitals turning them away on the grounds that they have the obligation to follow doctrine — not, apparently, medical ethics.

Every little piece of the puzzle makes it harder for patients to get the care they need, and this is a particularly sinister one, as it simultaneously shames patients, makes it harder to get abortions, and elevates the status of the fetus in the public imagination by transforming it from medical waste to something that should be treated as equivalent to a human being — something states have already accomplished or pushed for with fetal personhood laws.

Clamping down on the disposition of fetal tissue deprives researchers of a valuable scientific tool, and it will make abortion more expensive and harder to access by adding a stumbling block for medical practices. As Pieklo says, "we are already living in the pre-Roe days," pointing out that for many patients across the United States, abortion is functionally inaccessible, driving them to attempt to self-induce. The coat hanger is back.

Watch out for cookie cutter legislation coming to a state house near you — and, oh, donate your fetal tissue while ye may, friends. While you're at it, make sure to campaign for pro-choice candidates, show up the polls, and keep your legislators on speed dial so you can oppose legislation like fetal disposition laws, because the decision on how to handle fetal remains should remain one between patient and physician.