The Problem Over forty years after the Supreme Court's Roe v. Wade decision established abortion to be a constitutional right, the state of Ohio has begun to deny women their ability to exercise it. Three abortion clinics were shuttered in 2013, with more facing closure soon. Within the span of a few years, access may be virtually nonexistent. Toledo is likely to be the first major metropolitan area in the state without an abortion provider. One clinic, Capital Care Network, has received orders to shut down and remains open pending a hearing with the Ohio Department of Health. Their chances of remaining open after the hearing are slim to none, although the move has bought some time. The other clinic, the Center For Choice, closed in June after operating for thirty years. It had survived constant harassment, anthrax scares and even being firebombed. It could not, however, survive the smothering bureaucracy thrust onto it by a state government determined to scale back women's rights by half a century. The Process The systematic dismantling of abortion access in Ohio has been an ongoing project of the Republican-led state legislature for some time. However, the most effective weapon in their arsenal has been a law which requires each clinic to possess a transfer agreement. These agreements bind a clinic to a specific hospital in the event that a patient suffers unexpected injuries. Originally passed to curtail the practice of patient dumping (knowingly moving low-income patients to another hospital in order to avoid the cost of treating them), this law has found double use as a way of quietly blackballing abortion clinics. The method works in concert with another major trend in the healthcare industry: the elimination of independent hospitals and the rise of sprawling, corporatized healthcare provider networks. With fewer institutions to negotiate a transfer agreement with, it has become easier than ever for anti-choice advocates to court, control or intimidate a handful of controversy-avoidant policy makers in order to advance their agenda. Many cities have only a few such networks to work with. The Toledo area has three - all of which have rejected pleas by both abortion clinics for an agreement. Mercy Health Partners, a Catholic network, refuses on religious grounds. The University of Toledo Medical Center, which is part of a public university, is legally prohibited from holding a transfer agreement with abortion clinics as part of a provision that was slipped into the 2014 state budget (a provision which the ACLU filed suit to block in October). This leaves ProMedica, a private non-profit and the largest of the three, which stated through a spokesman that it doesn't "want to be put into a position of choosing a political position that is only divisive and polarizing"- apparently ignorant of Howard Zinn's famous maxim that "you can't be neutral on a moving train" and ultimately siding with anti-choice sentiment through deliberate inaction. But Toledo is not alone. Cleveland's Center for Women's Health and Capital Care Network of Cuyahoga Falls have both been forced to shut down for lacking a transfer agreement, while the Cincinnati-area Lebanon Road Surgery Center has been ordered to close and is awaiting a hearing with the Ohio Department of Health. This leaves just nine clinics remaining across the state, all of which are vulnerable to being shuttered on the same basis over the coming years. The Perpetrators Exit polls conducted by CNN in the last Presidential election revealed that 56 percent of Ohio voters believe abortion should be legal all or most of the time, while only 39 percent believed it should be illegal. In a state where pro-choice sentiment leads anti-choice sentiment by 17 points, how is it that the state legislature has been able to persist in promoting an agenda contrary to the public it serves? The answer lies in gerrymandering, or the deliberate reconstruction of legislative district boundaries in order to better serve partisan interests. While not a new problem, advances in technology have given unprecedented advantage to the ruling Republican Party, who are able to determine what configuration will extract the maximum political advantage while still remaining in compliance of the anemic laws that govern the process. The result is a partisan skew unlike any seen before in history. A 2012 ballot initiative to reform the broken process, Issue 2, was conspicuously ignored by the Democratic Party and failed spectacularly. Anti-choice legislators have flourished in the new, heavily redistricted state legislature. Among them is District 81 Representative and former ALEC state chair Lynn Wachtmann, who has gained national attention as the primary sponsor of one of the most restrictive pieces of abortion legislation in the country - the "Heartbeat Bill." If passed, the bill would prohibit abortions after a fetal heartbeat can be detected, which can be as early as six weeks into pregnancy - a direct violation of the 22-24 weeks guaranteed and protected by the Supreme Court's Roe v. Wade decision. The bill has been deemed too extreme even for anti-choice vanguard Ohio Right To Life, which has refused to support it on the grounds that it is likely to be declared unconstitutional by the courts. When first introduced in 2011, the bill was able to clear the House only to die in the Senate; it has since been reintroduced and enjoys the sponsorship of 40 other Representatives. "One of my goals as a legislator is to push the pro-life agenda as far as we can," said Wachtmann. Another strong voice against women's rights has been District 84 Representative Jim Buchy, the sponsor of numerous anti-choice bills. The moral depth of his ideology was best exemplified when he was asked by an Al-Jazeera reporter, "What do you think makes a woman want to have an abortion?" He had this to say: "Well, there’s probably a lot of — I’m not a woman so I’m thinking, if I’m a woman, why would I want to get one — some of it has to do with economics. A lot has to do with economics. I don’t know, I have never —It’s a question I have never thought about." But perhaps the strongest ally of anti-woman extremism has been Governor John Kasich. While tactfully avoiding statements that publicly declare his intentions, Kasich has consistently signed into law every bill restricting access to abortion and birth control that has come before him. His authority in the statehouse has emboldened state legislators to pursue anti-woman legislation with fervor, knowing that the Governor approves of their mission and disabling the checks and balances that would normally prevent such extreme agendas from getting as far as they have. The People Consider the story of Laurie, an unmarried mother of a special needs child. Nine years ago, she became pregnant with a child she could not afford to take care of, and found the Center For Choice in Toledo after scanning the local yellow pages. While struggling to make the decision, she ultimately decided to seek an abortion out of concern for how the child would affect her family's fragile economic state. When she discovered a few months ago that she was pregnant again, her thoughts turned toward the ongoing cuts to assistance programs that she relies on, as well as her still-fragile economic state - only marginally enhanced by the acquisition of a graduate degree. Deciding once again to have an abortion, she attempted to locate the same clinic she had been to before - only to find that it had closed. "I'm sad, because Toledo’s clinic was full of wonderful doctors and nurses who understood this situation and were kind, compassionate and empathetic,” she said. “I'll always remember fondly the nurse who held my hand and told me she understood. The clinic was full of love, hope, and understanding." Laurie found it difficult to get information about other clinics. Searching online led her to a number of Crisis Pregnancy Centers, which use deceptive language to appear as though they provided abortion access. After determining that a woman is pregnant, these centers devote their efforts into talking women out of an abortion by attempting to guilt or shame them while they are at their most vulnerable. John Kasich's 2014 budget funds these centers with tax dollars by cutting funding to the Temporary Assistance for Needy Families program. Having been aware of these fraudulent practices, Laurie was eventually able to locate an abortion provider in another city and arrange travel over the holidays - one of the few times in the year that she was able to get time off from work. Ariel had a similar experience with Crisis Pregnancy Centers. As an impoverished mother of two, she settled on having an abortion after a long personal struggle with the issue. Like Laurie, she felt that she simply could not ensure a decent quality of life for her and her two children if she took on the burden of caring for another child. Initially tricked into talking to a CPC, she spent 45 minutes on the phone with a woman who attempted to shame her out of seeking the procedure. Eventually, seeing that Ariel had made up her mind, the woman hung up. After talking to a friend who turned out to be a former employee, Ariel was among one of the last women able to receive an abortion at the Center For Choice. Identifying as apolitical, she said she had always felt that abortion was something she felt comfortable with other people choosing, but did not think she could do it herself. That changed with her third pregnancy, when economic reality forced her to rethink her position. No longer attaching a stigma to the act, she remarked that it was "one of the best decisions (she) ever made." On hearing that the Center For Choice had since closed, Ariel said, "I know when I was there, it was fairly busy. You know, there are a lot of people out there who need that choice because they aren't ready to have a baby. There are going to be a lot of people just left in the cold."

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