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the Body Politic
Vol. 6, No. 4 - April 1996, Page 17
Copyright © 1996, 1997 by the Body Politic Inc.

National Abortion Federation:

20 Years of Courage

Interview by Anne Bower

As time draws near for the annual NAF convention, members are looking forward to celebrating their 20th anniversary, while Vickie Saporta, new Executive Director, is anticipating presiding over her first conference.

D&X is a life-saving procedure. It's not unsafe and there's no reason for it to be banned. If they can ban D&X this year, next year it'll be D&E.
As executive officers of a reproductive rights and health care agency go, Ms. Saporta has an unusual background – the Teamsters Union. During her interview, Ms. Saporta revealed she had been with the Teamsters 20 years; first, as a field grassroots organizer, then 10 years as director of organizing for the international union. When asked how that prepared her to head NAF Ms. Saporta said, "There are a lot of similarities in the two movements, although they're not instantly clear to everyone. You're basically fighting the same enemy. Those who support the Right to Work movement support the Right to Life movement – you're fighting the Right."

According to Ms. Saporta, NAF and the Teamsters are both membership organizations and she is used to representing health care professionals. Unions and union organizers have been engaged in dangerous, sometimes bloody battles, but seldom have the imprecations of heaven been called down on union leaders or members as they have on doctors who provide abortion services. There are no organizations circulating petitions saying it is "Justifiable" to kill Teamsters. No banquets celebrating those who have murdered union members.

When asked why she wanted to take a job representing people who had been maligned, vilified, and even murdered, Ms. Saporta responded with a rueful laugh. Then said, "I'm delighted and proud to represent providers. They're the people who make choice a reality for millions of women and they do put their lives on the line every day. I have tremendous respect for them and what they do."

As her interview reveals, Ms. Saporta had little time to ease into her job. The debate over the D&X abortion procedure, misleading ads about breast cancer and abortion, and a federal grand jury investigation are just a few of the challenges she has faced in her 10 month tenure.

NAF Logo However, Ms. Saporta is undaunted in her commitment and knows just what needs to be done. She said the union and pro-choice movements are very similar. You do the same things like public information, education, and training, lobbying and government relations. To Ms. Saporta, a long-time pro-choice supporter with a desire to enter the fray, it was the perfect match.

Ms. Saporta's courage, toughness, and determination does seem a good match for the members of NAF. If the next 20 years are anything like the last, they will need all the courage they can get.

Q: NAF is celebrating its 20th anniversary this year and I want to step back a little and ask how it got started?

A: In 1977 it became apparent that after Roe, providers needed an organization that represented their interests. I believe there were two separate groups that came together and formed NAF. It started as an organization for doctors, administrators, staff, and activists.

Q: How long after NAF began did the violence start?

A: That's a good question. We have 19 years of statistics, so violence has always been a problem, but it accelerated during the late 70s. Then began the blockades of the 80s and now it progressed to murder in the 90s.

Q: Has NAF changed over the years?

A: NAF is a unique organization in the pro-choice community in that we're the organization that represents providers so we bring that perspective into the debate whether it's on a piece of legislation or public relations issues. We've always had a focus – training and education being primary. NAF is the only pro-choice organization that provides continuing medical educations credits for physicians, nurse practitioners and nurses. This year we began a training curriculum for residency practice which we sold to schools, hospitals, and libraries.

Q: What does NAF do now?

A: Several years ago we started an Access Project where we asked the question, who will provide abortions in the future. In 84% of the nation's counties there are no providers. Our message was we need additional training requirements. It was primarily our efforts that caused the ACGME to pass new requirements that abortion needs to be taught in OB/GYN residency programs. We also launched Medical Students for Choice to inspire new doctors. There seems to be a generation that was missed. Doctors from the 50s and 60s saw women dying in hospitals from illegal abortion. Then a generation was skipped, so we formed MSC. This year MSC is a separate organization.

We also have a Hotline which answers women's questions about abortion. A woman calling can get a referral to a physician who meets our standards. NAF can also give referrals to organizations that will help women pay for abortions. Of course, we have fact sheets available. NAF is the organization that sets standards for quality care. This month we sent out clinical policy guidelines to our members, a document which has been in formation for three years. We will also have a Web Site up and running by the end of March.

For those who are trying to regulate providers we offer that information including model regulations. NAF also works to see that providers are not singled out for special regulations that other health care providers aren't subject to.

Q: But you've always had to deal with violence?

A: Violence and disruption has been part of our history from the beginning. Our statistics go back 19 years. When the federal marshals were looking at compiling statistics to put together a data base allowing them to respond to requests for assistance they relied on our statistics. Of course, we work in coalition with other pro- choice groups. Last month we met with the Justice Department over our concern of the disbanding of the Federal Grand Jury.

Q: Could you address where that investigation stands?

A: The DOJ won't comment about an on-going investigations but they seemed to feel they would come out with something that would make us happy. I know that Norfolk has convened a Grand Jury investigation to take a look at violence there. Other people tell me the DoJ thinks they have solved 7 arsons.

But it's amazing to me that a week before the federal Grand Jury disbands, you have the White Rose Banquet, featuring the who's who of the anti-choice community, taking place in Washington, DC. Letters from Paul Hill and Shelley Shannon were read congratulating each other on the violence. People were urged to leave there and go throughout the country and perpetrate more violence on abortion providers. When we met with the FBI, they weren't aware the banquet had taken place.

That was distressing to us. Here are people meeting, sharing information, encouraging each other to go out and commit acts of violence, but the government doesn't believe there's a conspiracy. We do have assurances that the Attorney General is committed to continuing the investigation and keeping the task force together because the AG believes, as a result of their activities, violence has decreased. NAF is putting together tools to help our members assess who is the potential biggest threats to their safety.

Q: There are other threats to abortion access – legislation. Let's start with the so-called Partial Birth Abortion ban.

A: This bill has passed both houses and the Senate amended it to include a narrow "life" exception that doesn't provide for a real "life" exception. The House needs to vote on that current version of the bill. Instead of bringing it to the floor, we understand the House will hold hearings next week. Again, we have a commitment from the President to veto the bill because it doesn't have a "life and health of the mother" clause and doesn't track Roe, therefore, is unconstitutional.

This bill arrived the second week I was here. I asked someone to explain the D&X procedure to me and it was clear this attempted ban is part of a much broader agenda. Later it came out that our opponents can't ban abortion because the bill would never pass. So they intend to ban it procedure by procedure. When they can make people uncomfortable with the medicine, then they think they have a better chance to, eventually, ban abortion.

With D&X, they chose a procedure primarily used in late term abortions which gets less public support. This procedure is most often used when women find out late in a very wanted pregnancy they are carrying fetuses that have anomalies not compatible with life. It is a matter of a woman's health. Initially, we got three women to testify about their D&X abortions. After this received press, more women came forward. NAF has basically lead this campaign. The patients' own stories is what has helped us gain a lot of support against this ban.

Q: This has been a very difficult discussion – even in the pro- choice community. Particularly since some people claim this is just done as elective surgery.

A: When you talk about elective abortions you're talking about two different things.

In the second trimester, abortions can be done for any reason. D&X is sometimes used in the second trimester. It's most often used in the third trimester when physicians will only perform an abortion by any method to save the life and health of the mother.

If you want to ban a medical procedure, that is the responsibility of the medical profession – not Congress. You ban a procedure by showing it's mortality and morbidity rates were very high and it's, therefore, unsafe. D&X is one of the safest procedures that can be used under certain circumstances. There has been no deaths as a result of D&X and the morbidity rate is extremely low in terms of complications, making this the safest procedure under certain circumstances. Congress shouldn't be intruding into the practice of medicine and looking over the shoulders of doctors in the operating room.

When a woman goes to her doctor, she wants him to make a decision based on his training, knowledge, and experience. Sometimes it happens a doctor starts to use another procedure, but needs to use D&X. Perhaps there is a hydrocephaly that wasn't diagnosed. It's simply not up to Congress to intrude into medical practice. They wouldn't be doing this if it were heart surgery.

If you describe any surgery to the average person they're uncomfortable. We're not trained to do that. D&X is a life-saving procedure. It's not unsafe and there's no reason for it to be banned. If they can ban D&X this year, next year it'll be D&E. I'm not sure you can describe any medical procedure that doesn't make people feel uncomfortable.

Q: Besides D&X, Congress is also debating the Medical Training Non- Discrimination Act. What is this?

A: Right now, Congress is trying to add the Coates Amendment to the continuing resolution which would nullify the American Council on Graduate Medical Education's requirements for residency. Congress is saying the regulation the ACGME passed making institutions responsible for teaching abortion in their residency programs should not become law. The ACGME just spent two years deciding residents should have this training because abortion is the most common OB/GYN surgery. Congress wants to say the regulation can't be enforced and institutions that don't teach this could not be penalized by losing funding or accreditation.

Q: So, once again, Congress is interfering in medical practice.

A: Interfering with an accreditation body which has concluded this is appropriate! Congress is trying to second guess the ACGME, even after they put in a "conscience clause." Any institution, such as Catholic, which didn't want to participate, could make training available off- site.

This is the "book burning" of the 90s. No one is saying you have to go out and perform abortions, just that, as an OB/GYN you need to know how an abortion is performed and have to have some experience with it. This is another attempt to marginalize abortion providers and make sure training is not available. It's so often aimed at the doctors. Training is hard to get and once you perform abortions, then they want to restrict who can have them with waiting periods, and parental consent. Couple this with criminalizing doctors for using a certain late-term procedure that saves women's lives,

Q: Well, besides dealing with legislation, you've recently had an opportunity to dip you toes in the "ad biz." Christ's Bride Ministries has put up posters saying that having an abortion causes more dangerous breast cancer. Want to tell us about this breast cancer scare?

A: The ads appeared in DC after the first of the year. They were run by the Washington metro as "public service" for a month. When we discovered they were up, we talked to the medical community and the cancer organizations. They all agreed the ads were false, misleading and not supported by scientific evidence which is inconclusive at this time. (Two studies said abortion decreased the chance of breast cancer.) Certainly, there was no evidence women would suffer from any deadlier breast cancer.

NAF mobilized the medical com-munity, including HHS and influential local politicians to write letters to the Metro to remove the ads. In the meantime, the ads appeared in Phila-delphia, Delaware and were supposed to go up in Baltimore. The pro-choice community contacted Baltimore and got them to run counter ads that said, "Abortion does not cause breast cancer. Get the facts." The ad included a number to call. The Baltimore metro system paid to produce and put up the ads. Concerns about First Amendment rights prevented Baltimore from refusing to run the anti-ads, but, in the interest of giving women balanced information, they felt it would be irresponsible to just run the other ads.

In Philadelphia, there was a regulation that prevented posting ads for alcohol and tobacco based on health reasons. This gave Philadelphia a legislative basis to refuse false information not supported by scientific studies. The HHS letter was very helpful. Our victory in Philadelphia was especially good, because those ads were scheduled to run for a year. Now we understand they have surfaced in Hartford and Stamford and may appear in Boston. We are mobilizing our members up there to use one of our remedies.

Q: What is Christ's Bride Ministries?

A: When you call the number listed on the ad you find out Christ's Bride is really the American Rights Coalition, based in Tennessee. They solicit women to file malpractice suits against doctors. They say that one out of every two women who have an abortion get breast cancer. This is a ludicrous statistic.

If that wasn't enough, then they begin to quiz women about where they had their abortion and who performed it and offer information about how to file a malpractice suit because you weren't told about the cancer risk. We tried to get the Washington Metro to understand that the First Amendment doesn't give people a right to free advertising – just free speech. In essence you are using public sector money to solicit business for private sector enterprise, in this case, malpractice attorneys. As a result of this, the DC Metro is considering never running public service ads again. Of course, this is a disservice to the public.

Mr. Crutcher attempts to equate every abortion complication with malpractice, saying that abortion is unsafe. He goes as far as to say the Center for Disease Control is complicit in a coverup of abortion statistics.
Then there is Lime 5.

Q: How did you guess that was my next question? How is NAF handling this?

A: Lime 5 is a self-published book written by Mark Crutcher of Life Dynamics, a group dedicated to putting abortion providers out of business. Mr. Crutcher claims Lime 5 is an expose of the abortion industry. Right now, NAF is putting together a packet for our members to deal with this.

To our amazement, Congressman Henry Hyde sent this book to every state legislator in the country. In Oklahoma, they have already tried to institute some legislation based on this book.

In the book, Mr. Crutcher attempts to equate every abortion complication with malpractice, saying that abortion is unsafe. He goes as far as to say the Center for Disease Control is complicit in a coverup of abortion statistics. This is absolutely absurd. The CDC is a respected agency. When Surgeon General Koop was given the task of proving abortion unsafe, he did all kinds of studies and couldn't find any evidence it was. The safety record of abortion is well-documented. It is one of the safest surgeries in the country and safer than carrying a child to term.

Q: Part of Mark Crutcher's agenda is to institute harassment malpractice suits against doctors. What does NAF do about that?

A: We begin with information about LDI and what they do. Our annual meeting will have a session about how to protect yourself from this tactic. NAF has doctors who review charts and can assist in making referral when there is a bogus suit.

Q: Does NAF have any mechanism to discipline providers should it be proved they were offering sub-standard care?

A: We would revoke their membership. There are complication statistics that members fill out quarterly and there is a quality assurance committee that reviews any complaints. Because there is a complication doesn't mean there is malpractice. If you wrote a book on any other type of surgery like heart, I'm sure you could fill a book with complications. This doesn't make it unsafe or mean malpractice has occurred.

Q: Vickie, do you have your crystal ball today or would you just like to make an informed guess about the state of abortion services in the next ten years? What's the biggest threat?

A: Public opinion has been consistent for the last 20 years. They support a woman's right to choose and want abortion to be safe, legal, and accessible. I think the anti-choice movement will never give up. They'll continue to try and pass restrictions on the methods and trimesters and basically continue the legislative assault.

However, in ten years Roe will be the law of the land. Changes in the health care system, like managed care, will have an impact, but our clinics will adapt. Women will continue to want to have abortions and the service will be available.

Q: Do you see any end to the violence?

A: Americans abhor violence but they see so much of it, they get numb. Part of our responsibility over the next 10 years is to make sure that nobody thinks that violence is OK – that it's OK to injure or murder providers. We must keep up pressure on the federal government to prosecute and get these people behind bars. We have to hold the government's feet to the fire.

I would like to see our movement play offense, instead of defense. In the labor movement, I learned how to analyze an opponent and figure out vulnerabilities. Our opponents have a program. I would like us to get more aggressive with them. There's a number of tools at our disposal: legal, political, legislative, and organizing. We need to make sure these people are not on the streets.

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