If One Of Us Is Not Free, None Of Us Are

If One Of Us Is Not Free, None Of Us Are

Refuse Fascism Episode 127: September 18, 2022

Sunsara Taylor, Dr. Heather Costello, Sam Goldman

Dr. Heather Costello 00:00

The far right lawmakers are not going to stop at Roe. They will go federal and they will go bigger and we are all at risk. Fascists have been emboldened by the Supreme Court. Women will die and abortion providers will die. We move the needle by making a show, by being in the street, by making our voices heard. And if we don’t get our fundamental rights to our own bodies back, we need to shut it down. If one of us has no freedom, none of us have freedom.

Sam Goldman 00:44

Welcome to Episode 127 of the Refuse Fascism podcast, a podcast brought to you by volunteers with Refuse Fascism. I’m Sam Goldman, one of those volunteers and host of the show. Refuse Fascism exposes, analyzes and stands against the very real danger and threat of fascism coming to power in the United States. Thanks to everyone who goes the extra step and reads and reviews on Apple podcasts, shares and comments on social media or YouTube. It helps us reach more listeners. And of course, we read every one.

Here’s one from this past week on Apple podcasts from MTR fruit: “A wake up call. I’ll be honest, it’s not always easy to listen to this podcast. But I am so thankful to Sam Goldman, and the many amazing guests she has interviewed on this podcast. It’s really terrifying to watch what’s going on in our country. I think I’m like many people who are waking up to the reality that this fascist movement is not going to ebb on its own like a tide going out. Listening to this podcast every Sunday helps me stay awake, pay attention, and try to think about what I, a 66 year-old white woman and educator, a mom and a grandmother can do and should be doing. Thank you, Sam Goldman, for inspiring me and informing me and for making me feel like I’m not alone.”

Thank you to MTR fruit for that review, and for listening and being part of this community. So after listening to today’s episode, go help us find more people who want to refuse fascism by rating and reviewing on Apple podcasts and encouraging your friends and family who listen to do the same. Subscribe, follow so you never miss an episode. And of course, continue all that sharing and commenting on social media. In today’s episode, we’re sharing commentary from Sunsara Taylor on the national abortion ban introduced by Lindsey Graham this past week, and a conversation I had earlier this week with Dr. Heather Costello, an experienced hospice and emergency room doctor who is active in the struggle for abortion rights.

Sunsara Taylor and Dr. Heather Costello have different views on the role of the elections, and yet both are committed to acting now for abortion rights. Refuse Fascism, which unites people from diverse perspectives to sound the alarm and prevent the consolidation of this American fascism, emphasizes that what is most decisive is what we do in the streets together to stop this fascist assault on abortion rights.

Okay, to be blunt, y’all this week has been fucked with so much that we don’t have time to get into on this episode. In short, a Trump-appointed judge granted Trump’s motion to stall out the only investigation of him which is really in motion, which has been appealed to the 11th circuit, where a majority of those judges were appointed by Trump.

Meanwhile, DeSantis and Abbott have upped the ante on dehumanizing people at the border while once more showing Homeland Security, the federal government and the law itself to be endlessly amenable to fascist violence. And I’ve got to mention as well the full embrace from Trump in new levels of the Q-Anon movement where his Youngstown Ohio rally last night to Q-Anon-inspired if not straight up Q-Anon music played while he gave his fascist speech. And the crowd did a version of seig heil, Q-Anon style, with a one finger to their leader Trump.

This is especially ominous as this week we saw violence directly a product of Q-Anon-fueled conspiracy theories in at least two locations in this country. For more on the metastasizing fascist movement, I encourage people to go back and listen to last week’s episode where I interviewed Teddy Wilson. A movement sounding the alarm and refusing fascism right now, as this week made clear, is needed more than ever.

Now, here’s Sunsara Taylor, co host of the RNL show, and Co-initiator of Rise Up 4 Abortion Rights, speaking on the national abortion ban introduced this week by Lindsey Graham.

Sunsara Taylor 05:26

I want to take just a few minutes to speak frankly, about Lindsey Graham, that fascist Trump-supporting Senator who this past week introduced a federal 15 week ban on abortion. This ban on abortion would trump state abortion laws. So it would mean that even in places where people overwhelmingly support abortion rights, places like California, New York, and other states that support abortion rights deeply, would have to ban, comply with the federal law and ban abortion at 15 weeks. Women would be forced to have children against their will after that point. Women who develop complications — many fetal anomalies can’t be detected until after 15 weeks — will be forced to carry dangerous and fatally-flawed pregnancies. Already, we see this happening across this country. This is a horrifying prospect.

And yet, the big thing that we’re hearing about this –and this is what I want to call out — the big thing that we’re hearing about this in the media, from Democratic Party leaders and strategists, from the so-called leaders of the so-called pro-choice movement, the mainstream movements of the various kinds, who claim to champion the rights of women, the main thing that we are hearing is that this will be really good for the Democrats in the midterms.

You see, they look at this, and they look at the fact that banning abortion and forcing women to have children against their will is deeply unpopular. And they say okay, well, we can ride this outrage, to try to win the midterm elections, which everybody thought was going to be a whipping for the Democrats. But now they might have a foothold, because women are furious at their rights and their lives being endangered in this way. Now, I want to say, and you need to hear this, this is wrong. This is wrong. Not just because it is unlikely that this will be enough to enable the Democrats to come from behind and, hold on to and win a bigger majority in the Congress and win a majority in the Senate and come back and codify abortion rights nationwide. It’s wrong, not only because that is really an unlikely scenario.

It is even more profoundly wrong, because it’s the wrong question. It is part of the bourgeois electoral brainwash that trains you to think of everything that happens in this country and process it through the lens of whether it will help the Democrats or the Republicans, how it can be used, and what is possible within the confines of and on the terms of this systems’ elections. And what that erases is the actual reality of what this means.

Before June 24, it would have been impossible to introduce federal legislation to ban abortion, it would have been impossible, it would have been unthinkable. And now, this is the new normal. And this has been the dynamic that has been facilitated through that bourgeois electoral brainwash, through the notion that everything should be processed by. And your outrage and your fury at the crimes being committed against women and others should be channeled into supporting the Democrats in the elections. This is what gets normalized. This is the dynamic that has facilitated over decades. The dynamic where yesterday’s outrage becomes today’s compromise position and tomorrow’s limit of what can be imagined.

The real question is not will it help the Democrats or the Republicans. The real question is what does this mean for women’s lives and the future and the prospects and the rights of girls across this country? I want you to remember how you felt on June 24 2022, the day that the US Supreme Court, eviscerated, the Constitutional protection for women’s right to abortion.

I want you to remember that. Remember how you felt the outrage, the shock, the terror, the fury. Women across this country were sobbing. People pouring into the streets, people were curled up in fetal positions in their couches, listening to the news on the TV. People were remembering in horror the grandmothers and other dear friends whose lives were lost to botched illegal abortions more than 50 years ago, their deaths shrouded in shame and silence. People were remembering this and people were thinking with horror and dread about the threat that is now looming over every single girl child born in this country, that she may not have the right to her own body and her own reproductive decisions.

That is what was codified. That is what was made possible by that ruling and people were right to be outraged. This past week what happened was not a misstep by the Republicans that will help the Democrats that we should get excited about. What happened this last week was an unprecedented leap in this assault on the rights and lives of women.

Today we are contemplating a federal ban on abortion and saying, “Oh, well, maybe this can work for the for the Democrats.” No, this is normalizing atrocity. This is moving the goalposts and continuing to funnel your outrage into supporting these Democrats. And working in these elections will only further this horror. The only way this can be stopped is by people stepping outside that dynamic and rising up in furious, mass, unrelenting struggle to say “no, women are not incubators. Fetuses are not babies and abortion is not murder!”

These Christian fascists need to get their hands off the bodies and the lives of women and their futures. And that’s going to take struggle. That’s going to take stepping into the streets. That’s going to take putting it on the line. That’s going to take rising up. That’s how the right to abortion was won. That’s how every right for the oppressed has been won. And that’s the only way this right will be defended and won back. Ultimately, let’s be real sisters and brothers and beautiful people.

Let’s be real — defeating these Christian fascist theocrats, who have now captured the Supreme Court, who have captured the Republican Party who are dominating state court state houses across this country who have fully banned abortion in 13 states, who right now are shattering the lives of women and girls through forced motherhood, who right now are endangering women’s lives by compelling hospitals to deny necessary medical treatment to women if they happen to be pregnant, cancer treatment denied if it might endanger a fetal life, miscarriage management denied women sent home to bleed out and risk infection and even death because hospitals refuse to provide the abortions they need to safely finish their miscarriages. All of this is already going on.

Defeating all of this and preventing this from becoming a future for all women, everywhere with reverberations across the world, this is going to take ultimately making a revolution, getting rid of the system that has allowed these fascists to claw their way into power. Getting rid of this system that has the patriarchal domination of women by men woven into its foundation and its fabric, it is going to take breaking the chains and unleashing the fury of women as a mighty force, a driving force in making this revolution.

And we are living in a rare time sisters and brothers when a revolution is actually possible. Because of the very nature, the very momentum, the very level of crisis this system is in that has driven these fascists, that has given rise to these fascist clawing their way into power, threatening women’s lives in this way, and so much more. The coup attempt, last January 6, the rigging of elections, the building up of a violent social base ready to steal the election if they lose — all of this and more. The MAGA white supremacy, all of this ripping apart the norms that have held this country together for so long is part of what makes revolution possible in this time.

But we’ve got to get organized, we’ve got to get serious about it, we’ve got to break out of the bourgeois electoral brainwash, we’ve got to break out of the terms of this system and stop being played. We have to get serious about what it will really take to bring this system down and bring a better future, a better society into being where women and girls and differently-gendered people are treated as full human beings in law, and indeed in the culture and in the relations among people. And that is possible.

So I want to point you to a very important work that I promoted before I know Michael has promoted it. It’s called Something Terrible or Something Truly Emancipating: Profound Crisis, Deepening Divisions, the Looming Possibility of Civil War and Revolution that is Urgently Needed: a Necessary Foundation and a Basic Roadmap by Bob Avakian, revolutionary leader and architect of the New Communism. It is available at Revcom.us.

Part of fighting this for real for those who see the need for revolution and are getting organized for that, as well as for others who are not yet convinced of that but do not want to see women enslaved by forced motherhood, there is a need for mass struggle and protests. So I want to let you know about the movement and organization Rise Up 4 Abortion Rights at RiseUp4AbortionRights.org which we’ll be announcing very soon. Plans for days of action and other struggle to take this on, uniting people from many different diverse perspectives.

Sam Goldman 15:44

This segment you just heard originally aired on the Michael Slate Show guest-hosted Sunsara this past Friday on KPFK. You can find more from Sunsara by following her on Twitter @SunsaraTaylor.

Sam Goldman 16:00

(Women yelling “Our Lives Matter!”)

Sam Goldman 16:18

That was West Virginia this past week, when the state legislature voted for a near-total abortion ban. We salute all those who fought against this outrage including putting their bodies on the line when the vote went down. It is clear a blue wave in November is not enough. We need a green wave for legal abortion nationwide. Now.

Here is my conversation with Dr. Heather Costello. Today, I am glad to be introducing a woman that I feel like we really need to hear her perspective. Today we’re talking to Dr. Heather Costello. She is an experienced emergency room doctor. She’s someone who not only provides health care, but she lent her voice and her experience to rally people to take action to rise up for abortion rights. We’re speaking right now September 15 at a moment where the elimination of abortion rights and access is happening at an indescribable pace.

Here we are three months after the fall of Roe and there is an extremely reputable source that we need to hear more from. And that’s people that provide care for those seeking services, including general health care services that are affected when abortion is banned. Dr. Costello, who you’re going to hear from, gave a powerful speech at a rally in Chicago over the summer that is informative and full of the facts that people need to understand the scope of the crisis we’re facing. And so it’s my pleasure to introduce to you Dr. Costello, and have her share her powerful words.

Dr. Heather Costello 18:10

My name is Dr. Heather Costello, and I’m an emergency medicine and hospice physician and I’m here today to share some medical perspective about what will and is already happening to women because of this outrageous violation of our right to control our own bodies. The very short and honest version is that women and girls will die. And with the new laws and current fascist ideology growing, physicians will be very limited in how they can help. Many physicians will be too scared to help.

In Illinois, we supposedly have our blue bubble that protects us from what is happening in reproductive health care elsewhere. But as we know from the racism here in our state that Black and brown people continue to experience and die from, the fact that you can get shot by an assault weapon while attending a 4th of July parade, our bubble is fragile. In fact, our bubble is a selfish and privileged myth. The far-right lawmakers are not going to stop at Roe. They will go federal and they will go bigger and we are all at risk. And if one of us has no freedom, none of us have freedom. Our mothers and sisters and daughters all around us do not. Wisconsin, Ohio, Missouri, Kentucky and now Indiana. It’s right now very real for them and this cannot wait until November.

Suicides is a topic we need to talk about and unwanted pregnancy is a common trigger for suicide. In fact, suicide deaths are one of the leading causes of maternal mortality in the United States. And before the overturning of Roe it was already increasing, especially among women of color, women and girls with untreated mental illness and low income women. Suicide is the second leading cause of death among women aged 25 to 34. A gross underestimation is that thousands of women each year die by suicide because their pregnancy is catastrophic to them,when women will take their own lives rather than carry to term a catastrophic, unplanned pregnancy.

Domestic violence: pregnant women in the United States die by homicide more often than they die from pregnancy related complications. Murder committed by a partner is a leading cause of death for pregnant and postpartum women. Over 75% are murdered during the first trimester. So being pregnant is already a medical condition that can kill you and now being pregnant significantly increases the odds of a woman being murdered by her partner. The idea that pregnancy is a happy time for women is a true privilege and also often a myth. And of course, lower income, under-resourced, and people of color suffer these atrocities much more often. It was not until 2018 that all 50 states were required to even track on death certificates that a woman died while pregnant. So for a long time, nobody truly knew the real numbers. But now we know and they still don’t seem to care. The numbers we have about pregnant women being murdered or dying by suicide are already outrageously underestimated, and they are about to go up.

Ectopic pregnancies: a true medical emergency is a ruptured ectopic pregnancy when an early pregnancy is not in the uterus. This is a condition in the ER where all hands are on deck and things move very fast to save the life of the pregnant woman. The pregnancy ruptures the tube and ruptures a uterine artery and the woman rapidly hemorrhages blood into her pelvis, a truly life-threatening condition. An ectopic pregnancy, however, is never viable to the fetus. A fetus can’t grow and become a baby in a fallopian tube or elsewhere, other than the uterus. But now because the fetus has a heartbeat, its value is somehow more important than that of the pregnant woman. The pregnant woman’s own heartbeat literally does not count now in almost half of America. We are already seeing hospitals and clinics refuse to treat ectopic pregnancies because in the eyes of the new law, they are being told they would be aiding and abetting a murder. Some hospitals are insisting that doctors wait until the woman is literally actively hemorrhaging and on the verge of death before taking her to life-saving surgery. Because of this, more women will die.

Miscarriage: Often when a pregnancy miscarries the life-saving treatment to stop a hemorrhage or sepsis is a D and C (dilation & curettage – ed), but now physicians and nurses are being told this procedure is the same as performing an abortion in the eyes of the law. So when a woman is hemorrhaging or septic from a miscarriage, they’re being blocked or delayed from performing this simple procedure. And let’s be clear a fetus that is miscarrying is not viable. So a dying fetus that could never be saved is more valuable than a woman who has a chance to live. Doctors are being told to wait until it is crystal clear that the woman’s life is in grave danger. Hospitals are now afraid to allow these procedures. Many Catholic hospitals have not been permitting these for years. But when a woman is having a miscarriage or an ectopic pregnancy, she should not have to stop and research whether or not her nearest hospital is being run by pseudo-Christian fascist; she should not have to wonder whether or not the hospital will irrationally prioritize a dying fetus over her life.

Cancer treatment in early pregnancy: One in 1000 women every year will be diagnosed with cancer during her pregnancy. When I sat down to do some of this research to speak to you today, the lead sentence of a research article said “a rare one in 1000 pregnant women per year will be diagnosed with cancer.” One out of 1000 is not rare in the world of medicine, nor in epidemiology, nor in reality. One in 1000 pregnant women each year will be diagnosed with likely breast cancer, cervical cancer, lymphomas or leukemias. And when treated early these cancers have potential treatments. Women with desired pregnancies were already having to make heartbreaking decisions to terminate a pregnancy in order to seek treatment or risk giving birth and delaying their treatment by many months. Women will now be forced to carry a pregnancy to term while their own body is actively dying. They will not have a choice to even try to save themselves and more women will die.

Septic abortions: When faced with no choice and no local resources, we already know that women will take matters into their own hands. They will attempt or seek out so-called back alley abortions which come in many forms and many of those women will hemorrhage and die or become septic and die or become toxic and die. This was commonplace before 1973 and is still common where there is no safe and legal abortion now. The doctors who witnessed and tried to help these women pre-Roe v Wade are mostly retired or dead. And there is no more institutional or cultural memory of what happened back then. Women who survive a botched unsafe abortion will be charged with murder. Physicians who participate will be charged with murder and history is about to repeat itself and more women will die.

So here’s an additional problem. Let’s look at the horrific situation in Ohio with a child rape victim just a few months ago. Now, even when doctors are fully legally allowed to do their jobs, it is at the risk of their careers or their safety or that of their families. When a 10 year-old pregnant rape victim in Ohio was brought by her parents to Indiana where a safe abortion was a legal option, the OB GYN provided legal safe and compassionate abortion care to this child victim. The Attorney General came after that doctor and the rabid right- wing anti-choice fascists attacked her reputation, spread lies and threatened her and her family.

We know that abortion providers have been murdered in the past. We will now expect that to become more common because the fascists have been emboldened by the Supreme Court. Women will die and abortion providers will die. Even though most physicians surveyed support having safe and legal abortions available, only 56% of them consider themselves pro-choice. But even when the doctors are pro-choice, the legal machines that run the hospitals and the pharmacies are not. The hospital administrators will often not let them do the right thing.

We are already seeing pharmacists refuse to fill prescriptions for medicines like methotrexate because it could potentially terminate an early pregnancy. But these aren’t pregnant women even seeking this medicine. These are patients diagnosed with autoimmune diseases and cancers. Methotrexate can save a woman’s life if she has an ectopic pregnancy, but it can also save the life of a woman with lupus or certain cancers. Women are being denied a known treatment for medical conditions that threaten their lives even if they are not currently pregnant. Such overreach and interference with our ability to make our own medical decisions about our own bodies is simply outrageous. Women are no longer able to even follow medical standards of care as prescribed by their medical doctor, and the result will be more women will die.

So what do we do now? Women were already dying because of unwanted or high-risk pregnancies. And now even more will die. And the message we are hearing loud and clear from the Supreme Court and right-wing politicians and fake Christian fascists is that they do not care. This is not about saving babies. This is about controlling women and keeping their boots on our necks. For weeks, I have been rallying in online groups for friends, colleagues, physicians to come out and protest and it has been disheartening to see the complacency and the fear. Midterm elections are coming and the left is notoriously weak at turnout.

If we lose our majority in November, we will see more rights in this country stripped from women, from gays, from trans people, from the poor, from immigrants, from people of color, and history will and should judge us for this complacency. While it is all unraveling, we will lose mothers and sisters and daughters all around us. Women are dying. And it should not matter where. Unwanted pregnancies kill in many ways, whether your state is blue or red, and it is about to get much worse. I’m here literally to beg people to get out of their bubble and get into the streets and speak up for those with no voice.

We need to continue to raise awareness, we need to sound the alarm, we need to get our friends, families and colleagues out here with us. We need to show the politicians that we are not only watching but that we are out here now in the streets fighting for our rights. We need to show them that we will be voting and that we are not going to give up. We need to help out our mothers, sisters and daughters in red states. We need to stand up and fight back. We need to vote out politicians, local and federal, that are not fully on board with restoring our rights. And if we don’t get our fundamental rights to our own bodies back, we need to shut it down. And we need to keep it shut down with a women’s strike with a general strike. Simply said we need to rise up now for abortion rights. Thank you.

Sam Goldman 29:01

Thank you, Dr. Costello, for those powerful words. Again, for those listening, this was given at a rally in Chicago over the summer. And I really just feel that it was extremely informative, even months after you gave it the first time. It was full of very essential facts that people need to understand in terms of fully grasping the scope of the crisis we’re facing. And so I just want to thank you, Dr. Costello, for sharing your expertise on this critical topic. As has been said before, and I’ll say it again, abortion providers are heroes and as we know we should have known before but if you didn’t know before, after years of COVID, hopefully you got it now. Healthcare workers are heroes. So thank you for all your dedicated care for people who need it.

Dr. Heather Costello 30:00

I appreciate that. I mean, I wish I could say I was more on the frontline for the fight for women’s reproductive rights. I feel so strongly for my colleagues in obstetrics and gynecology and what they must be going through. It must be terrifying to them to watch what’s happening and what’s about to happen.

Sam Goldman 30:19

And as you got into in your remarks, the reality is that this crisis is not limited to the scope of an OBGYN anymore. Doctors’ diverse spheres, from mental health to psychiatric emergency rooms to standard emergency rooms, you know, in the case of attempted suicide and hemorrhaging.

Dr. Heather Costello 30:43

Absolutely. Psychiatric care is going to see a surge. Family practice physicians in rural and underserved areas where they do OB GYN care and psych are going to see one. Emergency rooms are going to see problems. Even in hospice, where I also work, we’re going to see it because of delayed diagnosis and delayed treatment and cancers for pregnant women. So yeah, it will affect everyone everywhere.

Sam Goldman 31:08

That’s the horrific reality. I was wondering if you could tell us a little bit about what personally motivated you to go into medicine and what motivated you to be out now, at this juncture. As you said before we started recording, we were talking about how so many people that are in this field you wish would speak out and marshal others, and they won’t. So it might be helpful to think about what motivated you.

Dr. Heather Costello 31:38

I was working on my master’s degree in critical cultural anthropology, and was learning about a fantastic physician Paul Farmer who was doing international humanitarian work. I was very inspired to go to medical school after reading his work and meeting him. So I kind of did a interesting pivot and had to start over from like the 101’s in the courses because I think the hardest science class I had taken at that point was literally geology. So I started over and decided to go to med school because I wanted another tool bag to help people. As cliche as that sounds, that is truly the most common answer you will get. If you ask a doctor or a med student or a resident, why they’re doing it, they genuinely want to help in a way that’s tangible and important.

While I was doing my pre med coursework, I thought, well, I should go get a job in the medical field. So I started to work at a local Planned Parenthood. I was kind of a medical assistant, jack of all trades. I would check women in, get them kind of oriented, started to draw blood ,kind of hold their hand through the whole process, including literally during an abortion procedure, I would be handing sterile instruments with this hand while holding the patient’s hand and then getting them through recovery. So I was kind of in it right from the beginning. I was drawn to Planned Parenthood because as a college student at the time, I knew what they provided that women couldn’t get elsewhere. I knew it was a safe haven with a sliding scale, with affordable birth control and STD treatment and cancer screening. So I wanted to be a part of it.

While I was working there, I was exposed to kind of my first reality of the terrors of our adversaries. I would pull into the parking lot, and there would be protesters and they would take pictures of our cars, they would take pictures of the license plates. They would go to the Secretary of State or DMV and be allowed to get our names and addresses which then they would post on their website literally as targets for their rabid people. Kind of right from the beginning, I was exposed to the antagonism and the terror and the threats from the other side.

I almost went into OB GYN. Honestly, I considered myself a chicken at the time because that was probably the reason I didn’t because I knew at some point our rights would be challenged and I’d have to be in that fight. I just didn’t know if I could put myself on that line. So ultimately, I went into emergency medicine where I could help women with different presentations. But we see reproductive health care emergencies in the ER all the time, whether it’s a rape or an ectopic pregnancy or a miscarriage. We deal with that. So we’re tight with the OB gyns and I respect them tremendously because they’ve got it rough right now. I don’t know if that answered your question. Why did I go in?

Sam Goldman 34:55

You put a lot out there and it was It was meaningful. I feel so deeply for everyone who is on the frontlines trying to make sure that women and girls have the ability to remain in control of their bodies, their lives and their destinies. The terror that for decades has been inflicted on those who are doing this heroic work is shameful, it’s horrific, it is unspeakable. It shows anyone who has any doubt that any illusion that this is about babies, just to look at the way that women and doctors are treated by the anti-abortion movement. This is a movement that is centered on violence that is centered on cruelty, and that is centered on a hatred of women.

Dr. Heather Costello 35:55

And centered on lies. Yeah. To top it all off, yeah.

Sam Goldman 36:00

To go back to your speech. Too few voices have been out there sounding the alarm on what was either about to happen, or what has transpired. You look at the reality that the whole medical field is being impacted about this — 12 states have basically complete and total abortion bans now in effect — and you would think that you would be hearing more from the medical field, and you were brave enough to do so. I’m wondering, it wasn’t just bravery reflecting back to this summer, what made you step out there? Because you’re right, it is scary. There is a danger of doing so.

Dr. Heather Costello 36:50

I think one of the reasons that I felt compelled to start talking about it more more vocally and more publicly was I’m really worried that the full effect of what’s happening is going to trickle in. It won’t make as big of a wave as it needs to because it’s going to be spotty and patchy at first. I think physicians and people supporting reproductive rights, because we’re in a different day and age now, people are assuming that they’re going to have a work-around. Women with privilege and resources are going to be able to travel, take off work, travel to another state to get an abortion should they need one. Meanwhile, their sisters who don’t have those same resources are not going to have that.

So the effect is going to be felt in weird ways that are gonna be tremendously tragic on an individual level. But we won’t see it at the population level for a long time. It will take a long time for those numbers to be collected and analyzed to show the public what’s happening. Research doesn’t happen fast, especially morbidity and mortality that happens after the deaths have occurred. There’s going to be stories in the news. But if it’s not a big giant wave of stories, I worry that a lot of people will think it’s not as big a deal as we thought it would be, because they’re insulated. Because in this day and age, we can pick and choose our news, we don’t necessarily all get the same info at the same time, like we did in the 60s and the 70s, when everybody got a newspaper, and everybody watched the six o’clock news. So it’s different now. So I was worried that complacency would translate into worse outcomes. So I figured I would sound the rally cry and see what I could do.

Dr. Heather Costello 38:53

But I feel like it’s not been enough. It was big for the first days and weeks and like the social media groups with other physicians that I’m in, like everybody was freaking out about it. But then when it came time to, hey, let’s get out in the streets and show that we need to be advocates, it wasn’t happening. Now, you know, the the protests are slowing down, the marches are slowing down. I hope it will pick back up as we move closer to the election. But for those 12 states, it’s already happening. So we shouldn’t be waiting until November. The deaths and the tragedies are already happening. But the media isn’t on top of it the way they should be. So that’s why I kind of got active again.

Sam Goldman 39:42

I really appreciate you laying that out. A lot of what you were saying in terms of why we’re not seeing what we’re seeing or when we might I think resonated a lot with me. The grappling with millions, millions having lost this right across the country, and how quickly I feel as a people, whether we like it or not, which we don’t, the majority in this country is pro-choice, but have accepted this as a new normal. I do think there is a connection between the illusions that many people hold in that there’s going to be some kind of magical savior from on high, a magical wand, this disbelief that such a horror could happen in this country.

Whatever mythology they have about this country, then guards them from really confronting what is happening right before their eyes to millions and millions of people right now. But I also think that it’s a refusal to look at what this battle is really about, that it’s not health care in the abstract or bodily autonomy in the abstract, but it really is about the status of women in the society. I feel like there’s a lot of resistance to talk about what forced motherhood is, what that means. The way that we talk about it impacts the way that we fight for it. That’s just something I’ve been thinking about.

Dr. Heather Costello 41:17

Yeah, I completely agree. We are so far removed from what it looked like 40-50 years ago, that we’ve forgotten. We don’t have a cultural memory of what not having those rights looked like and felt like, the lived experience of it. So we’ve got generations now who didn’t have to deal with it. It’s just heart-wrenching at these protests to see the majority of the people out there are these fantastic women in their 60s and 70s, who shouldn’t have to be doing this. Again, they already did it once–they already fought for us. It’s just the younger folks who need to get motivated and get out there and help because it’s going to affect them more directly than anybody else.

Dr. Heather Costello 42:01

But this is a little bit of a tangent. COVID was a very terrifying kind of wake-up call for the lack of community that we’re experiencing. We’ve got this kind of faux community from social media. But a pandemic that was killing thousands of people every week, and is still killing hundreds of people every week, and killed millions of people across the globe, didn’t pull us together to do some very easy basic things. That doesn’t give me a lot of hope that we’re gonna get it together to fight this fight. So that probably was also a big motivator for getting outraged and getting out there and trying to draw attention to it because it was pretty mortifying in the ER to watch COVID happen and watch people not care about each other unless it was directly happening to them. I worry that culturally that’s a bit where we’re at, that if I’m not threatened right now, then it’s okay. Even though it shouldn’t matter. Because in this world, we have to look out for each other. Those with the voice and the ability to stand up and fight need to get out there and do it.

Sam Goldman 43:12

I fully fully agree. That last part is so true about how people in these coastal cities for the most part think, “I’ll always have the right or something like that.” As I said before, on the show, totally fucking morally bankrupt, how dare you? But also, it’s delusional to think that these Christian fascists are going to accept a patchwork at this point. They’re telling you their plans, they’ve already announced that they’re going for a national abortion ban, they’re going for contraception. No one is immune to this. Even if you could, can you really as as a human being live with that? You’ll also not be able to. Even though Illinois isn’t a coastal city, it is considered safe and has in many ways tried to to strengthen or further safeguard protection for abortion access. But Indiana has literally banned all abortions with some narrow exceptions. That went into effect literally today, Thursday, September 15. And I was wondering, you know, has Illinois already seen an influx of abortion seekers?

Dr. Heather Costello 44:35

Illinois has declared itself a safe haven, which is great. That’s a good thing. I am glad that our governor and our politicians who support women’s rights and reproductive rights have come out in force to convey that, but it’s not enough. I am sure we are seeing an influx of patients from all of our surrounding states coming in for reproductive health care. But again that all only applies to a certain privileged few. That’s a small percentage. If you’re in southeastern Indiana and you’re poor, you’re not going to be able to make it to Chicago to get your health care. The impossibilities of what that would take — the money, the time, the resources, child care — I don’t care, it’s too much to ask of them. They should not have to fight that hard for a basic bodily right that we should have, that shouldn’t have been taken away.

The fascist right, their long game is strong, they have been at this for a long time, they’re patient, they’re plotting, they are more organized than we are, they’re succeeding at something that we kind of thought we were going to be immune to. You’re right, it’s gonna keep going, it’s gonna get bigger, this is not sufficient for them. So yeah, Illinois trying to do the right thing. But it’s not enough. We shouldn’t have to be doing that.

Sam Goldman 46:04

Are there any particular impacts that the medical community in Illinois has been talking about in terms of this devastating, blow for abortion rights in your region?

Dr. Heather Costello 46:20

In the groups I’m in. the talk is that the volumes are up, that women are having to travel to seek health care from elsewhere, and that those physicians are overextended and overwhelmed and having to do more with less, which is always a problem in medicine. But the alarm is still not sounded and it hasn’t translated into the bigger picture of, we should be working to make it so that they don’t have to do that, the patients don’t have to travel and come from another state to get their care. We should be advocating for the country, not just increasing funding.

It’s a great thing to donate and contribute to the organizations that provide the abortion care and get these women when they’re able to come to a state that can provide that, but it’s not enough. It doesn’t cover everyone. I don’t see how letting the poorest of the poor and the people who have the most at stake and will have the hardest time and have the highest risk suffer the burden. It’s not been enough. Yeah, there’s talk and there’s problems, but what’s happening here is nothing compared to what must be happening in those states themselves, in those OB gyns offices and in those ERs and in those morgues, because we’re gonna see it. That’s where the numbers are gonna go up.

Sam Goldman 47:43

You had mentioned in your talking about the students you had talked with about medication abortion. I did want to ask you a question on that, as many listeners who have been involved have heard, I believe it’s over 50% now of all abortions are done using medication these days, which can be prescribed via telemedicine, and may allow an avenue to access abortions for people who are able to circumvent surveillance and obtain abortions, even from states with draconian laws. I was wondering if you could talk about why you’ve made such an eloquent case for fighting to restore and expand this legal right nationwide, rather than perhaps simply spreading awareness of the means or methods that people can still try to get abortions from fascist controlled territory.

Dr. Heather Costello 48:34

I was seeing that in the social media groups I’m in with other female physicians in particular, that there was an interesting surge of non-OB GYN doctors saying, “I will do that. I will do telemedicine from where I’m at, and I will provide this service. I need the training. We need the OB-gyns to teach us what we need to know so that we can help with the inevitable waves that are coming of these people seeking the medicine.” So that’s an issue. Usually this is the purview of OB-gyns. I’m sure family practice as well; I’m sure some internists. It’s not something we generally do in the emergency department, but I’m sure it has been done.

Now, ob-gyns are already going to be overextended, overburdened, overwhelmed, and they don’t have time to train the masses of the other doctors to help. Some of them are and that’s great and they will, but they shouldn’t have to. Statistically the amount of doctors willing to sign up and get trained and do telemedicine and the risk that goes with that– because you could be in a state and provide telemedicine or be in one state and provide it to another and get in big trouble. If that state wants to try to get you they very well could try and they will succeed in some cases. So there’s there’s a risk there. It’s not going to be just “Oh, I can go on the internet and find a doc.” Even though I live in Indiana and find a doc in Illinois who will telehealth me a medical abortion, it’s going to get trickier than that. Because all it takes is one very motivated attorney general.

Somebody’s going to come after those physicians, because it already isn’t that you can just practice medicine across state lines. You can now currently because of COVID, but that’s complicated. And that might not be as widespread and as comprehensive as we need it to be to serve all the people who might need the medicine. So it’s complicated. And that’s another thing. I think the myth, the perception is that, “oh, don’t worry, I’ll be able to get what I need.” That may not be true. And we won’t see that unraveling until the numbers grow big enough to sound the alarm again. It’d be great if that was the easy solution for that medical need. But it’s so much more complicated than that, between the training, the state laws, finding physicians willing to do that, finding OB-gyns willing to help get those docs up and running and do the right thing. It’s not like there isn’t risk with that as well. You are providing a medical service that has risk and God forbid anything goes wrong. So it’s not just a simple thing for a doctor to decide to pick up that ball and run with it. I wish it were but it’s it’s not.

Sam Goldman 51:30

What you said was very helpful. I would add that for those listening who may not be aware, I’ve said it on the show before but if you’re new, the abortion pill is overwhelmingly safe, even when self-administered. The abortion pill has only been approved by the FDA up until 10 weeks of pregnancy. Many may not know that they’re pregnant or be in a position to know that that’s the decision that they want to make at that point, or need to make. But regardless of when in the pregnancy, this option can continue to be out of reach to huge numbers of folks, including folks who are young or living with abusers or are without homes or in prison or detention.

We need to talk about the fact that there is still for many, the risk of arrest, to public humiliation and imprisonment even where abortion is still legal. Some clinics have stopped providing the abortion pill to women from out of state for fear of legal prosecution. Some abortion funds have stopped their services out of the same fear. Honestly, it is harmful to think that even the most heroic efforts to spread the abortion pill or help women in travel could possibly keep pace with the power of the state, especially as it is increasingly captured by these Christian fascist theocrats hell bent on criminalizing all abortions. And to me, this underscores the need to wage a massive society-wide fight for legal abortion on demand nationwide. And that does not discount the work of people who are spreading the pill and making sure people have access and raising those funds. It is a beautiful thing that people are doing to care for one another. And at the same time, it is not sufficient to meet the need.

Dr. Heather Costello 53:26

I feel like I should add that I, by no means, do I know all the doctors everywhere. I know that there are advocate doctors on the front line in all the fields of medicine, especially OB -GYNs who are putting it all out there on the line every day and fighting this fight and raising the alarm. I know that I wanted to just have a caveat that I wish I were seeing more of it in our blue state. I don’t want anybody to be listening to think oh my god, the OB-GYNS aren’t doing enough. They are doing as much as they possibly can. and then some, but they shouldn’t have to be and we need to help them. So I just wanted to be crystal clear that I know that everybody’s trying to do the best that they can in that moment. But we need to collaborate and we need to coordinate and we need to make it a much bigger deal and draw much more attention to it than we’re getting.

Sam Goldman 54:22

Those of us who are not providing the heroic care need to get loud for those who need the care and for those who are providing it. Because we all have a role to play. What you were talking about earlier in our conversation about suicide, the shame, the stigma, it is a conversation that needs to be had much more. I want to express my appreciation to you for going there, for having that be part of the conversation. We’re talking about a situation of blame that is heaped on women, on survivors, on people who made mistakes; a culture where pregnancy is viewed as punishment for the act of having sex, and it is biblical level stigma. It has been heaped on women for centuries. It’s been backed up by violence for centuries, and it is becoming so much worse for those who live in states where women have just been reduced to officially less than human.

What we do or don’t do in this moment matters incredibly white you were saying about from now to November, what we do now is what matters is what is most decisive, not just only in my opinion for the individual lives that are on the line that are counting on us right now. But also because we’ve never won anything without our actions. Even the right for women to vote wasn’t won in the voting booth. That was won in the streets. So I really appreciate your remarks on that. I wanted to thank you so much, Dr. Costello, for sharing your expertise, your perspective, your time.

If there is anything else that you want to say, or resources that you think are important to get a shout out, I want to give you the opportunity to say so.

Dr. Heather Costello

You’ve been so kind and complimentary to the plight of physicians, and we appreciate that. We do not consider ourselves heroic. It truly is supposed to be part of the job to advocate for your patients and women are our patients and husbands and spouses and children and grandparents are our patients. So it should be expected that we are doing what we can do. Being a female in the United States right now shouldn’t be the heroic thing to acknowledge. Because Holy cow, it’s bad out there for women, and it’s gonna get worse. When the decision first came down, and I knew it was happening, and I knew it was coming, and it was being talked about, and on the day that it happened, I had multiple conversations with women my age. I’m 52 I’m not gonna have any more children. I’m not using my reproductive organs. A couple of women I’m friends with said, “it doesn’t really apply to me. So I’m okay.”

You know, we’re having this conversation. And I’m like, okay, doesn’t apply to me, we’re okay. And I’m kind of like initially saying that in my head. And I left the conversation and I was like, it absolutely applies to every woman, it applies to every person like we have been reduced to second class we are less than, and it applies to any female, any male who has a female in their life, it applies to every single person when the rights of a group are infringed upon, and especially to this degree.

So we need to look past ourselves and our personal situation and and reclaim our community and support each other and help where we can. So I am appreciative that people like you who can reach way more people than I could ever hope to are out there fighting this fight. We need that. We need attention, we need information, we need dissemination of the information. So I very much appreciate the opportunity to talk with you because I think what you are doing is critical in this fight.

As far as organizations, you know, there’s so many to choose from. And I’ve always been a fan for the on the ground work. the day to day health care of Planned Parenthood, so they have a big spot in my heart. I’ve been working with Rise Up 4 Abortion Rights. They have been fantastic with getting people out in the streets and keeping you know, the attention on the issue. So you know, shout out to them for all that they do. Because I do think we move the needle by making a show, by being in the street, by making our voices heard, by shutting down traffic. Civil disobedience needs to happen to get the attention this issue deserves. But I don’t have more groups off the top of my head to plug but there are so many and thank God for them because they’re picking up the slack for what the fascists are currently inflicting on women. It’s been such a delight to talk with you.

Sam Goldman
Thank you, Dr. Costello. With that I want to encourage everyone listening to take action Wednesday, September 28, in solidarity with people all around the world to protest and publicly manifest with green for abortion to demand, legal abortion on demand and without apology everywhere. September 28 is the International Safe Abortion Day which was first established by women in Latin America in 1990. And other Refuse Fascism podcasts are joining with Rise Up 4 Abortion Rights, empowering people to make a leap in gathering this wave of struggle here by raising the green bandanas in public acts of protests big and small. Learn more, find organizing tools, and register your actions for that day at RiseUp4AbortionRights.org.

We want to hear from you. Share your thoughts, questions, ideas, or topics or guests or lend a skill. Tweet me @SamBGoldman, or you can drop me a line at SamanthaGoldman@Refuse fascism.org or leave a voicemail by visiting Anchor.com/Refuse-Fascism and hit the message button. Want to support the show? It’s simple. Show us some love by rating and reviewing on Apple podcasts or your listening platform of choice. And of course, follow or subscribe on YouTube so you never miss an episode

Chip in to support our pod and content creation to help people understand and act to stop the fascist threat. We have no sponsors — we count on you. Head on over to RefuseFascism.org and hit that donate button. Thanks to Richie Marini, Lina Thorne and Mark TInkleman for helping produce this episode. Thanks to incredible volunteers, we have transcripts available for each episode, so be sure to visit RefuseFascism.org and sign up to get in your inbox each week. We’ll be back next Sunday.  In the name of humanity we refuse to accept a fascist America.