For a Women’s Health Center
To the editor:
The Independent’s excellent coverage of the availability of abortion and other pregnancy-related health care on the Cape has been revelatory, upending reasonable assumptions about women’s health care here.
Your reporting reveals the uncertain availability of abortion services at the hospitals and medical practices of Cape Cod Healthcare (CCHC), which is unwilling to state which patients may receive an abortion and under what conditions. This turns a routine medical procedure into an experience akin to the uncertainty of illegal pre-Roe back-alley terminations. For what other health needs are the availability of CCHC’s services so opaque?
Because of CCHC’s monopoly, women in Barnstable County who need abortion services have nowhere else to turn. As a nonprofit, CCHC has a legal obligation to serve its community’s health needs. It would be interesting to see how its annually updated I.R.S. Community Health Needs Assessment claims to meet the routine range of pregnancy-related health needs of women on the Cape.
Cape women might as well be living in Texas a hundred miles south of the Oklahoma border when it comes to terminating a pregnancy or receiving treatment during or after a miscarriage. To be clear, we are talking about routine health care, not brain surgery requiring a highly specialized medical team and technologically sophisticated facilities.
I have a modest proposal for CCHC and its new Orleans Medical Center. Why not turn the facility into a women’s health center reliably offering abortions and other women’s health related services?
Better yet, since CCHC’s commitment to women’s health is ambiguous, I suggest it open this new facility in partnership with Planned Parenthood, the one organization women know they can trust to get their health needs met without having to satisfy CCHC’s unstated list of conditions for receiving this common and still (theoretically) legal medical procedure on Cape Cod.
Wellfleet and Newton
The writer, a licensed independent clinical social worker, is a retired Mass General Brigham reproductive health social worker who served in the abortion and infertility clinics at its Longwood Medical Area campus in Boston.
Hiding Behind Hyde
To the editor:
“Abortion Access Is Unclear on Cape Cod” (July 14, front page) reports that Outer Cape Health Services’ physicians “do not prescribe abortion pills because OCHS is a federally qualified health center and therefore is prohibited from providing abortion services by the Hyde Amendment.”
Every year since 1977, Congress has attached the Hyde Amendment to the annual Health and Human Services appropriations bill, prohibiting the use of Medicaid funds to pay for abortions (except to save the life of the mother or when the pregnancy is the result of rape or incest). Nothing in the Hyde Amendment prohibits the provision of abortion services. It deals only with who pays for them.
The Hyde Amendment is silent on counseling and referral. Title X, the federal program that provides family planning services for low-income patients, requires clinics to provide “neutral, factual information and nondirective counseling on each of the options, and referral upon request….” To comply with Title X, OCHS would have to counsel and refer patients who request abortion services.
Outer Cape Health Services could, in fact, provide medically induced abortions without jeopardizing its federal funding by excluding federal funds from a fiscally isolated segment of its operation and prescribing abortion pills from that division. Payment for the medication and the clinic visit would come from MassHealth or private health insurance, similar to the coverage available for surgical abortions.
Planned Parenthood uses a comparable fiscal arrangement to receive Title X family planning funds and federal Medicaid reimbursements while performing surgical and medical abortions.
Ronald A. Gabel, M.D.
The writer, a retired anesthesiologist, was the medical director of an ambulatory surgery center that provided abortion services in Rochester, N.Y.
Medication Abortion Is Available
To the editor:
I commend your ongoing coverage of the issue of abortion accessibility in the U.S. and, in particular, on Cape Cod in the July 14 issue of the Independent.
Two additional useful pieces of information: medication abortions are in fact widely available on Cape Cod, as they are throughout Massachusetts, via telemedicine. Verified providers of all types of abortion services can be found at abortionfinder.org.
Anyone who wants to do something that will have an immediate effect on the miserable state of abortion access in the U.S. should make a donation to the National Network of Abortion Funds (abortionfunds.org). Its website includes links to organizations in every state that directly help people to access abortions, including the Eastern Massachusetts Abortion Fund (emafund.org).
Nicola Moore, M.D.
The writer has provided women’s reproductive health services at the Planned Parenthood clinic in Waco, Texas for the past five years.
The Justices’ Motives
To the editor:
In response to John Cumbler’s query as to the mindset of the six justices who control the U.S. Supreme Court [“The Supreme Court’s Flawed Reasoning on Guns,” July 14, page A3], I would answer that they are political operatives. The notion of original intent gleaned from the actual text of the Constitution is but a pretense to find a justification to reach a desired result.
The word “corporation” does not appear in the Constitution. Yet the Court in Citizens United v. Federal Election Commission gave corporations the right to free speech. The recent decisions in the all-important matters of abortion, the power of the E.P.A. to deal with pollution, and the rights of cities and states to deal with gun violence are right out of the G.O.P. handbook.
Perhaps funding for the Court for the next several decades should come from the Republican National Committee. That might address to some minor degree the hypocrisy issue raised by Mr. Cumbler.
When Chickens Laugh
To the editor:
Sadie Hutchings’s writing is deliciously funny and usually right on point, but I wish to point out one little thing about “A Needle Poke Gone Wrong” [June 30, page B9] that should be obvious: chickens will find anything hilarious.
So, it was unnecessary to mention that her chickens were amused when the animal control officer’s notebook was shredded by her goats and strewn about the yard. They will laugh at anything! Anyone who has spent any time with our chicken friends would know that.
Please keep Dr. Sadie writing as she is always a good laugh, and not just for chickens. Haha!