Tag Archives: Misoprostol

Pro-Choice Activists Can’t Play Chess

When I was in grade school, my best friend’s grandfather was a former chess grandmaster. He attempted to teach me the game. And he failed.

Every time I would start to make a move, he would swat my hand, reset the piece, and tell me no. Never move just to move or merely to react. He would demand that I think farther ahead and come up with a better move.

Although I was hopeless at chess, that one lesson did sink in. Never make a move without first anticipating the subsequent moves that may follow. No move should ever be merely a reaction and none should ever be made in isolation. Rather, every move must coordinate with every other move to advance a larger strategy.

It’s that strategic ability to anticipate, to corral your opponent, to control the board, and ultimately to trap them that constitutes the difference between the grandmaster and the novice, the winner and the loser. It is true in chess and it is no less true in the legal and political battle for abortion rights, a game where refusal to play is not an option.

As energetic, creative, and diligent as pro-choice activists may be, we have been outmatched by opponents who think many more steps ahead. Not only do they have more skill at this game, they have a level of ruthlessness and focus that we struggle to overcome, regardless of how passionate we are about preserving a woman’s right to choose.

Abortion activists do work very hard to counter each of the moves that anti-choice grandmasters make toward ending abortion. But while the moves of our opponents are well-coordinated and planned, our moves are mostly reactive. The following list of examples is long, but its very length serves to underscore the magnitude of the problem.

  • When they prohibited Medicaid and/or insurance from covering abortion, we set up funds that provided financial assistance.
  • When they required that patients must be given inaccurate or biased counseling, we developed websites and other sources of accurate info that patients could access.
  • When they required that counseling be provided by a physician days before the actual service, we started using videoconferencing or phone to enable patients to avoid an extra trip.
  • When they required parental approval for minors to have abortion, we set up services that helped minors to seek approval from a judge.
  • When they established unnecessary but onerous requirements about abortion clinic structure or provider credentials that were impossible for many clinics to meet, some clinics closed down. We started mailing pills to patients who were left with no nearby access.
  • When they required patients to have tests before the abortion, we found ways for patients to get the tests in their communities, without having to travel to the clinic itself.
  • When they banned abortion in certain states, we set up clinics in adjacent states, right across the border.
  • When they protested outside clinics, we engaged escorts to help patients get through the picket lines.
  • When they started killing abortion providers, we installed bulletproof barriers and hired guards.
  • When they started to harass or threaten people who had had abortions, we advised patients to say that they were miscarrying.
  • When they required that the provider show the patient any ultrasound pictures, we stopped doing ultrasounds unless they were absolutely necessary.
  • When they required that providers describe the fetus in detail to the patient, we gave patients headphones that they could use to block out the sound.

Again, these are all necessary and hard-fought actions taken to mitigate the damage caused by the anti-abortion movement. But they are isolated and reactive or predictably proactive at best. They do not demonstrate coordinated progress in advancing a strategic plan to win the larger battle. As just one example to illustrate, one prong of a strategic plan might be a generational effort to erect a legal foundation to ultimately establish that a fetus is not a person. None of these reactive efforts contribute to any such wider and longer term effort.

Our activists often lament that we cannot take any initiative because we are continually put on the defensive. But isn’t that the whole point of chess? To advance a strategic plan even as you deploy and defend your pieces?

If my friend’s grandfather were observing the abortion rights game we are engaged in, he would swat the hands of our pro-choice activists and insist that we think strategically, that even as we respond to counter immediate threats we simultaneously maneuver to take ultimate control of the gameboard; hopefully in subtle ways that our opponents never see coming.

Here is what seems clear. If we keep on as we have, if we continue to simply react without advancing a larger strategy to win, abortion is headed to a checkmate. And that checkmate will mean personhood for fetuses and a total nationwide ban on abortion under penalty of murder.

Like any novice in chess, we may be far closer to a loss than we can appreciate. If our opponents succeed and achieve an all-too-sudden checkmate, what should we expect?

Together with my wife, who is a leading abortion researcher, we put together a short video to depict the future that anti-abortion zealots may very well force upon us. It adapts a scene from the popular television show The Wire to illustrate how abortion medications may be administered in the not-too-distant future.

It may be that our best hope for relatively safe and effective abortions will lie with street corner drug dealers who can outthink and outmaneuver the forces arrayed against them to offer abortion medications to people who desperately need that help.

Not to in any way minimize the urgency of avoiding that dystopian future, but streetcorner sales might actually not be as disastrous as many might imagine.

Mifepristone and misoprostol are highly safe and effective abortion medications. Patients can almost always determine on their own whether they are pregnant, whether they want an abortion, and whether they are eligible for the treatment. And, in the rare instances in which the patient misjudges eligibility, the risk of severe complications is minimal. There are very few medical contraindications, and the risk of severe issues is low in even those cases. Studies have shown that the quality of the medications, even when produced by questionable foreign sources is, so far at least, perfectly fine. Supervised follow-up, while desirable, is not essential.

Be that as it may, no one wants to end up relying upon illegal drug sales as the mechanism for health care delivery in America. But to avoid that, we need to stop reacting and start taking control of this deplorable game of abortion chess that anti-choice zealots are forcing us to play.