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"No one expects to need an abortion ..." A Q&A with Dr. Chastine

Dr. Chastine answered mnsbc community questions regarding her work as an abortion provider in Wichita.

It has been five years since Kansas abortion provider, Dr. Tiller was murdered. Last week, msnbc's Irin Carmon reported on the heroic leaders who've continued to run his Wichita clinic. Among them is Dr. Cheryl Chastine, a 32-year old Chicago-based practitioner who travels to the clinic once a month to provide Kansas women and families with the medical services and support they need. Despite the danger Dr. Chastine faces daily from anti-choice extremists, she took msnbc reader questions. Here are the highlights from the Q&A. 

@FredOrth: I understand and deeply appreciate the courage required to help women in need, but I wonder if the level of security ever feels like it is getting to a reasonable level? Are the legal forces in Wichita becoming more proactive in providing security? Is the community waking up to their own shame, in creating an environment that actually encouraged horrible crimes, against health care givers? Is there an increasing sense of safety?

"No one expects to need an abortion until they need an abortion. I can’t count the number of tearful patients who’ve said to me, 'I never thought that I would do this.'"'

Dr. Chastine: I definitely feel the legal system has taken all available actions to protect my safety. The FBI has been quite proactive about monitoring anti-choice extremists, who are rightly classed as domestic terrorists. The Wichita police department has been appropriately concerned and responsive in regard to the presence of protesters at our clinic -- they have to balance protecting our safety against the protesters' rights within the law, but it's clear they don't want another incident of violence.

Wichita has been Ground Zero for the abortion wars for decades, and so the community is traumatized around the subject. For that reason, support for us is often expressed sotto voce, as though people are afraid to stir up the old conflict. That said, we've been heartened by the support from much of the community. Many people have gone out of their way to tell us they support what we do and they were appalled by Dr. Tiller's murder. A number of the patients who see us had also seen Dr. Tiller, and have told us how thankful they are to have us there and how impressed they are with the quality of our care.

It's important to remember, though, that the campaign of harassment and violence against abortion providers is not restricted to Wichita. Dr. Tiller was the subject of national attention for years before his murder, including Bill O'Reilly ,referring to him repeatedly as "Tiller the baby killer." According to the Guttmacher Institute, nearly nine in 10 abortion clinics reported some form of harassment in 2008. As long as we continue to tolerate anti-choice picketers loudly comparing abortion to the Holocaust, we foster an environment that encourages extremists to commit acts of violence.

Jennifer Fessler: What are your thoughts on women's health needs being less and less available to women in 'red' states and how can the tide be turned?

Dr. Chastine: I'm glad you asked about this. There's been a barrage of devastating state-level anti-choice laws, many of which have been pushed through in ways that circumvent the normal democratic process - special sessions, midnight votes, last-minute hearings, truncated comment periods. That these are happening simultaneously in so many states is no coincidence.

Virtually all of these laws are based on "model legislation" from the Washington, D.C.-based anti-abortion advocacy group Americans United for Life. States are pushing through different versions of these bills in a coordinated attempt to see what restrictions can survive a constitutional challenge. The anti-choice movement has been quite clear that their goal is to force a reconsideration of Roe v. Wade.

"Wichita has been Ground Zero for the abortion wars for decades, and so the community is traumatized around the subject."'

I would like to see a Supreme Court decision that upholds a person's right to abortion as constitutionally protected - and recognizes these tactics for what they are: backdoor strategies to prevent abortions by shuttering the clinics that provide access. If these laws are upheld, I think you'll see a return to the pre-Roe state of affairs, in which a pregnant person's access to safe abortion services was dictated by geography and personal wealth. The powerless will give birth to unwanted children - or resort to illegal, possibly unsafe methods.

I think that Americans need to be asking some very hard questions of their elected officials about how beholden they are to this Washington special interest lobby. We'll need our citizens to send a message to their legislators: that we did not elect you so that you could dictate a person's private medical decisionmaking, nor to use gerrymandering and rule changes to protect your political party.

Gillian Brent: Dear Dr. Chastine, I've been lucky enough to live in a country with choice. Thank you for continuing to give women a choice there. We know the "antis" picket and harass and threaten doctors and clinics - what can people both on the ground and supporting from afar do to help maintain a woman's choice?

Jennifer Turner: I just wanted to thank you for your brave work to help the women who need it the most. How can people help? As Canadians, how can we help? (We are lucky in that there is no more real debate about access here. Our government officially recognizes access as a human right). 

Dr. Chastine: The anti-abortion movement wins its victories largely by isolating providers and clinics from the community. Anything you can do to counter that is crucial. If you have a business -- a restaurant, a hotel, a bookstore, a construction company -- be steadfast in being willing to do business with clinics. Letters to newspapers and politicians help foster a supportive environment. Talk with your health care providers and let them know that you're pro-choice and it's important that your family's care providers be too.

A great way to support both patients and clinics is to donate to abortion funds, which provide low-income people with funding that helps bridge the gap between abortion's legal status and its financial inaccessibility. Abortion funds in low-access states like Texas are particularly essential. You can find a listing of funds through the National Network of Abortion Funds at Fund Abortion Now

Antis also isolate people who've had the experience of abortion. The narrative surrounding abortion in the U.S. is dominated by blaming, finger-pointing and pontificating. If you or a loved one have had an abortion and are in a position to speak about it, your words are some of the most powerful defenders of the necessity of legal, safe abortion care. Claims that the choice of abortion is rare, frivolous or selfish are untenable in the face of actual people's stories.

silverwolf104: While abortion would not have been the right choice for me, it is for others. I have no question for Dr. Chastine except to say to her that she's to be congratulated for following not just her heart, but her medical ethics in choosing to continue Dr. Tiller's legacy. Our society cannot afford to go back to the back alley butchers that were so prevalent years ago and which cost many young women their lives.

Dr. Chastine: Thank you. No one expects to need an abortion until they need an abortion. I can't count the number of tearful patients who've said to me, "I never thought that I would do this." One of the lasting truths of the human mind is that we simply aren't able to anticipate how we'll feel in certain circumstances until we're in them. That's why it's so critical to protect abortion as a right, and why I feel called to provide. The decision to continue a pregnancy must be chosen freely, not compelled. Without clinics and providers, there is no choice -- a fact that the anti-choice movement knows all too well.

"The anti-abortion movement wins its victories largely by isolating providers and clinics from the community. Anything you can do to counter that is crucial."'