A public awareness campaign with banners about ‘Vasectomy week'. (Special Arrangement )
A fortnight after the national ‘Vasectomy Fortnight', the Telangana experience reveals the gap in India's family planning programme
Sterilisation is simpler in men than women recovery time and surgical risk are smaller, complications are rare and deaths rarer. Yet, as the national ‘Vasectomy Fortnight' came to end earlier this month, the writing on the wall is clear: men are unwilling to share the burden of birth control.
The government observed ‘Vasectomy Fortnight' between November 21 and December 4 with the hope to create awareness about male sterilisation and, more importantly, to facilitate district administrations reach sterilisation targets through campaigns. Of the 40 lakh sterilisation procedures done in 2014-15, vasectomies accounted for minuscule 1.9 per cent.
Experiments in the country's youngest State, Telangana, reveal the sterilisation gap in India's family planning programme. This fortnight, five men walked into the vasectomy camp in Ranga Reddy, a district adjoining Telangana's capital Hyderabad with a 25 lakh population. The district administration managed to convince them to opt for the procedure. A second camp on December 8 found no takers and officials have renewed efforts to draw more men before the end of the financial year. With an annual target of 2,500 vasectomies this year the district's count stands at 5. Last year's numbers only seem marginally better with 37 men undergoing the procedure. The State paid them Rs.1,100 each for undergoing sterilisation while the 24,000 women who underwent sterilisation were paid Rs.880 per person.
Counselling the key "Vigorous campaigning, efficient counselling and post-operative services as well as education are real differentiators," says Renu Kapoor of the Family Planning Association of India. She pegs the lack of willingness to share the burden of contraception on a misplaced sense of masculinity.
"Men who avail vasectomies at our centres are educated and from organised work sectors. They do not require much counselling but have queries. They have heard of it from other men," Dr. Kapoor says. She stressed the importance of counselling in understanding the strong likelihood of pregnancy for three months after the procedure. Her observations suggest most men from middle- and higher-income groups who decide to undergo vasectomy arrive with their partners for counselling and the procedure; most women who opt for sterilisation, mainly from low-income groups, seek counsel of other women.
India's total fertility rate of 2.3 is expected to sink below 2 within the next decade. Telangana's fertility rate reached replacement levels before the State came into being in 2014 "replacement level fertility" is when the total fertility rate, i.e. the average number of children born per woman is the same as the dying population, implying that the population exactly replaces itself from one generation to the next. The third round of National Family Health Survey (NFHS) done a decade ago established that undivided Andhra Pradesh had recorded fertility rate of 1.8.
The latest survey in 2015 affirmed Telangana's fertility rate stood at 1.8 births per woman. "For men, concerns of losing sexual potency and physical vigour make them unwilling to discuss vasectomy," says Harish Chandra Reddy, health official in Ranga Reddy district. "A small number of unintended pregnancies and a few unfavourable post-vasectomy fallouts seem to have thrown it out of the reckoning."
Experts maintain that the gap between vasectomy targets and achievements remain unchanged over the years even as country's fertility and birth rates continue to fall, driven mainly by female sterilisation.
Tubectomies still the norm Despite aggressive promotional campaigns over the last decade, only a small proportion of couples use State-distributed condoms (0.5 per cent in 7,786 Telangana households surveyed in 2015), oral contraceptives (0.3 per cent), intra-uterine devices (0.3 per cent) and male sterilisation to prevent birth. Of the 77,000 sterilisation procedures performed in the State' s public health sector till October 2016, only 1,287 or 1.6 per cent were vasectomies. In the two years since Telangana's creation, vasectomies as a percentage of total sterilisations stood at 3 per cent, unchanged over the last decade. The State's health administration, under no pressure to reach targets given that Telangana has achieved replacement level fertility, aims to perform around two lakh sterilisations this year. If last year's numbers are any indication, one lakh more Telangana women will undergo sterilisation in the next three months.
An analysis of family health data published in 2012 reveals that up to 5 per cent women who underwent sterilisation before 2006 regret doing so, either because they feel they were too young at the time or because they opted for it without having any sons. The study noted that in States with lowest fertility rates, including undivided Andhra Pradesh, the median age of women being sterilised was around 23.
"Lack of gender equality, vulnerability of women and early marriages makes them agreeable to mass sterilisation programmes," says women's rights activist Rukmini Rao. "In rural India, women are against their husbands undergoing vasectomies fearing it may rob the family of its means of earnings and cast aspersions on them should pregnancy ensue after vasectomy."
Women's rights activists across the country had discussed and commented on the National Policy for Women when the government introduced the draft in May. Among other things, the policy envisages shifting focus of the country's family planning programme to male sterilisations but those like Dr. Rao who participated in the discussions remain highly sceptical. She believes sterilisation should be the last option of birth control.
Two years after 18 women died at tubectomy camp, little has changed at India's sterilisation drives
Scenes from an event in Chhindwara, Madhya Pradesh.
In the second week of November 2014 ,18 women died in government sterilisation camps in Bilaspur district of Chhattisgarh. Two years later and 430 kilometres away, a camp was held in Parasia block of Chhindwara district in Madhya Pradesh that was similar in many ways to the one in Bilaspur.
It was November 9, a Wednesday, the day of the week when sterilisation camps are held at community health centres in the district. This camp, therefore, was a routine exercise and well-entrenched in the government health services system. On Wednesdays in Chhindwara, regular hospital check-ups and consultations are closed in order to conduct these camps.
Notice on the door about closure of out-patient services on the day of the sterlisation camp at the community health centre in Harrai, Chhindwara. (Nikhil Srivastav)
Despite being organised in an accredited health centre, unlike the camps held in an abandoned building in Bilaspur or at a school in Bihar, this camp was chaotic. Twenty eight women, none of whom looked older than 30, were lying sedated on the floor of a hall. A few auxillary nurse midwives and a female doctor were standing by to assist them.
Each woman was accompanied by an accredited social health activist or ASHA to an adjacent room where she was made to sit on the steps of one of the two inclined operating tables, ready to go as soon as woman before her was finished. Women who had been sterilised were carried back to the hall by one of the male assistants. No stretchers were available.
A team comprising of a male surgeon, two nurses and two male assistants worked with utmost speed. A sterilisation, timed from the moment a woman was made to lie on the operating table to being carried out, took an astounding four and a half minutes. The team moved swiftly between the two operating tables, doing two operations simultaneously. As soon as the surgeon finished the crucial cuts and moved to the next table, the nurses completed the procedure on the previous one.
Inclined operating tables used for tubectomies. (Nikhil Srivastav)
It is clear that given the time frame, it would be difficult, if not impossible, to maintain the medical as well as safety and hygiene protocols laid down in the Standards and Quality Assurance in Sterilisation Services of 2014 or those in the Reference Manual for Female Sterilisation, 2014.
The medical team also allowd little time between giving a patient local anaesthesia and making the incision. According to the Reference Manual for Female Sterilisation, 2014, which provides uniform standards for surgical technique, the onset of action of the usual dose of local anathesia is typically within three to five minutes. The effect of anathesia is to be confirmed before making the incision or surgery through continuous oral communication. None of this was done. It could very well be the case that to maintain the time, incision was made even before anathesia could have its effect, defeating the very purpose of pain management.
One of the guidelines from the Standards and Quality Assurance in Sterilisation Services of 2014 is that the camp timing should be between 9 am to 5 pm. This is particularly important in areas such as this where lack of public transport, early sunsets in winter, and remote locations of the villages around forests make it particularly hard for women and their families to reach home in the evening. At 7 pm not even half of the women had been operated upon. There was no arrangement for them to stay the night, either. The recently operated women, mostly in pain and still sedated, and their families were likely left to fend for themselves. So much for the government’s concept of “family welfare”.
The state’s claims of a target-free approach to family planning rings hollow when one speaks to ASHAs, who are often called the backbone of government’s rural health schemes. The ASHAs confirmed that they were expected to get at least two to three women from her village each month to one of these Wednesday camps. Many were worried about not having reached their target for this month due to festivals, and said that they would have to make up for it in the coming months.
Writing on the wall that says, "Chase away poverty and disease, get sterilised after having one or two children." (Nikhil Srivastav)
Female sterilisation continues to be the main method of family planning in India. The annual health survey of 2012-2013 reports that 59.4% women used any modern method of contraception in Madhya Pradesh. Out of that, 48.7% were sterilised, which is to say that out of total number of women using modern methods, almost 82% have been sterilised. For Chhindwara, it is 82.7 %.
Female sterilisation has been one of the most discussed topics and an area of substantial activism for decades in an otherwise neglected field of women’s health in India. Yet, things have not improved, indicating just how poorly India values the wellbeing of its women. The rhetoric of empowerment, choice and autonomy does not stand true when women, mostly from low-income, adivasi and dalit families, are herded into camps to be cut open and sewed back in less than five minutes. Some are lucky to survive. Others like those in Bihar, Bilaspur and Balaghat, die or suffer gravely to satisfy the state’s never-ending obsession with population control.
Kanika Sharma is an M.Phil scholar at the Centre for Social Medicine and Community Health, Jawaharlal Nehru University.
Abortion remains legal in the United States but anti-abortion efforts have succeeded in making it virtually inaccessible in some places and in the Deep South, often unthinkable. At one time Mississippi had fourteen abortion clinics. Now only one remains.
Since the passage of Roe v. Wade more than four decades ago, the self-labeled “pro-life” movement has won significant cultural, political and legal battles. Now, the stigma of abortion is prolific in Mississippi and women in poverty and women of color are particularly vulnerable. Jackson is wrought with the racial and religious undertones of the Deep South and explores the nuanced nature of abortion in America’s Bible Belt.
Shannon Brewer is the director ofJackson Women’s Health Organization, the only remaining abortion clinic in the state. Barbara Beaver runs the Center for Pregnancy Choices and is a leader of the anti-abortion movement in Mississippi. April Jackson is a young mother of four children faced with another unplanned pregnancy.
Jackson is an intimate, unprecedented look at the lives of three women caught up in the complex issues surrounding abortion access. Set against the backdrop of the fight to close the last abortion clinic in Mississippi, Jackson captures the essential and hard truth of the lives at the center of the debate over reproductive healthcare in America.
MAISIE CROW Director / Producer / Director of Photography After an award-winning career as a photojournalist, Maisie turned her attention to filmmaking. In 2014 her short film, The Last Clinic was nominated for a News and Documentary Emmy, and she was listed as one of PDN InMotion’s 20 Emerging Artists to Watch in Film and Video. In 2012, her multimedia project, Half Lives: Chernobyl Workers Now won an Overseas Press Club award. In 2010, her short film A Life Alone was nominated for a News and Documentary Emmy. She has taught as an adjunct professor at Columbia University’s Graduate School of Journalism and CUNY Graduate School of Journalism. She recently worked as a director of photography on MTV's documentary series, True Life.
JAMIE BOYLE Editor / Producer / Cinematographer Jamie Boyle is a film editor working in New York. She was the Associate Editor and Production Manager on ETEAM, which won the Cinematography Award at the 2014 Sundance Film Festival and was nominated for two News and Documentary Emmys. She was the lead video editor for Human Rights Watch. Her work for them premiered at the 2014 Human Rights Watch Film Festival and won an Overseas Press Club Award in 2015. In 2014, she worked as an assistant editor on the short film, The House at the Edge of the Galaxy, which premiered at the Cannes International Film Festival in 2013. She has edited for numerous leading digital media companies, working on videos for top fashion and lifestyle brands. She has worked as an assistant editor on short films and commercials, including Ross Kauffman's spot for GE and Fire with Fire, part of a series of films in the GE-commissioned Focus Forward initiative.
JOHANNA HAMILTON Executive Producer Johanna Hamilton directed and produced 1971, about the break-in of a small FBI office in Media, PA by a group of activists. The burglary exposed COINTELPRO, a illegal domestic surveillance program. 1971 premiered at the Tribeca Film Festival in 2014 and was broadcast on PBS’s Independent Lens in May 2015. Previously she co-produced Pray the Devil Back to Hell the gripping account of a group of brave and visionary women who demanded peace for Liberia, a nation torn to shreds by a decades old civil war. It premiered at the 2008 Tribeca Film Festival and was short-listed for an Academy Award.
ALISSA QUART Executive Producer Alissa Quart is Executive Editor of the journalism non-profit Economic Hardship Reporting Project. She is the author of three non-fiction books including Branded and Republic of Outsiders and has had numerous features and opinion pieces in The New York Times, The Atlantic, Elle, Vogue and many other publications. She wrote the accompanying story and produced the Emmy- and ASME-nominated multimedia project “The Last Clinic” among other multimedia projects.Her poetry book Monetized was published in 2015: her poems have appeared in the London Review of Books, The Awl et al. She was a 2010 Nieman Fellow at Harvard and has taught non-fiction at Columbia University's Journalism School, SUNY New Paltz and elsewhere. She is currently working on a non-fiction book for HarperCollins on social class and the family.
BARBARA EHRENREICH Executive Producer Barbara Ehrenreich is the Founder of EHRP. An acclaimed journalist, author and Fellow at the Institute for Policy Studies, Barbara has worked with her IPS colleagues to synthesize and catalyze a broad consensus among working journalists, community organizers, service providers and policy analysts: the U.S. public and its policymakers need help confronting and addressing the scope and depth of economic hardship in the wake of the economic collapse of 2008 and its continuing reverberations. Her leadership role in EHRP is twofold. She is writing big picture analytic pieces that remind us of the basics that the national conversation often ignores.
TYLER STRICKLAND Composer Tyler Strickland is a film composer based in Los Angeles. His scores have accompanied recent award-winning documentary films such as; Audrie & Daisy (Sundance/Netflix 2016), Best and Most Beautiful Things (SXSW 2016), The Return (Tribeca 2016), Fresh Dressed (Sundance/CNN Films 2015), Emmy-Nominated hit, Hot Girls Wanted (Sundance/Netflix 2015), The Many Sad Fates of Mr. Toledano (Tribeca 2015), The Genius of Marian (Tribeca/POV), and many others. Tyler has also scored several TV specials for National Geographic Explorer, a handful of New York Times' OpDocs, and Field of Vision short documentaries.
“Easily one of the year's strongest documentaries...” -Criterion Cast
“...Elegant, unsettling...” - Village Voice
“This well-crafted film adds to our understanding by humanizing some of the opponents.” -The Hollywood Reporter
“A devastating account of a broken commons, the movie reveals just how much the road to hell is paved with the best of intentions…” -Filmmaker Magazine
“Maisie Crow’s Jackson, about the last-remaining abortion clinic in the state of Mississippi, where the Dixie flag still flies over the capital, brings to mind Nina Simone’s song “Mississippi Goddam.” She wrote it after Medgar Evers’ 1963 assassination in Jackson. Watching this documentary about the embattled clinic, audiences will wonder if anything has changed since then.” -Film Journal International
“...A grim warning of what restrictive abortion legislation across the U.S. actually looks like...” -The Huffington Post
“Long after watching, the lingering effects are harrowing and haunting.” -Words of Choice
“...Sharply attuned to the racial and class issues that underpin the religious tensions.” -Films for Two
“In her new film Jackson, director Maisie Crow shows what happens when women can't get the information and support they need.” -Cosmopolitan
“...Moving, staggering and painful to watch...” -The Reveler: A Review of Religion and Media
“Because Crow was given incredible access and spent so much time with the women, she captures every crucial moment: She is with Brewer right after the clinic is vandalized, during her call with the FBI, and when she unexpectedly meets the wife of her son’s baseball coach, who works at the pro-life pregnancy center with Beavers. She is in April's bedroom when she goes into labor at 4 a.m., her mother refuses to drive her to the hospital, and she's forced to call an ambulance. Crow also pushes her characters in complicated ways, like when she asks Beavers, the pregnancy center director, if April should go on birth control after having her fifth child.” -New York Magazine
"From first-time writer/director Maisie Crow, it’s an assured film that is simultaneously fierce and kind in its depiction of two sides of a desperate crisis and in the questions that it asks and (implicitly) answers. " -Patheos
“...an empathetic portrait of a seemingly unending debate and the lives it affects.” -What [Not] to Doc
“...Jackson allows all sides in the abortion issue to have their say to illuminate the issue’s truths and lies. The results are sometimes engrossing, sometimes anger-inducing.” -BeyondChron
“Maisie Crow’s film represents a strong and scrupulously even-handed addition to the annals of documentaries on this most divisive of subjects, including ’12th & Delaware,’ ’After Tiller’ and the recent ’Trapped.’” -Los Angeles Times
“Outbursts from a captivated audience echoed through The Bronx Documentary Center during a film screening at the opening night Women’s Film Series in the Melrose neighborhood of the Bronx. The movie was Jackson, a documentary about the only abortion clinic in the state of Mississippi and the pro-life opposition attempts to shut it down.” -The Bronx Ink
“It seems every festival year we get an "important" work of art, something that cuts through the rhetoric, and Jackson shows all signs of being very important.” -LA WEEKLY
“A single mother, an abortion clinic director, and a fervent pro-lifer lay bare their stakes in the fight of one of the last remaining abortion clinics to stay open against the pro-life movement's efforts to make abortions illegal in the Deep South.” - Shadow and Act ~~~~~~~~~~~ Volume 388, No. 10058, p 2343–2344, 12 November 2016
A victory in the fight for sexual and reproductive justice
By George L Askew
When my children were younger, I loved taking one-on-one trips with each of them. It was always particularly special when exploring places new to us or that generated conversations about the world we live in. I had such a trip in 2010 with my son, then a 13-year-old budding drummer and social activist, when we visited Jackson, Mississippi, as part of what we called our Civil Rights and Blues/Jazz Tour. Jackson, Maisie Crow's provocative film about the battle to close the last abortion clinic in Mississippi, Jackson Women's Health Organization, brought back memories of that trip which reflect the core issues of the film. It also resonated with work I am doing with my colleagues in New York City (NYC) to address sexual and reproductive justice. In Crow's film voices on all sides of the abortion debate are heard. She talks with the clinic director Shannon Brewer, April Jackson a pregnant woman and mother of four children, and anti-abortionist Barbara Beavers who runs the Center for Pregnancy Choices. Jackson is a powerful reflection on reproductive health and justice in the USA.
That family trip took us through Selma, Montgomery, and Birmingham, Alabama, over to the Mississippi Delta, travelling to Jackson, via Clarksburg, Cleveland, and Vicksburg. We learned a lot about blues and jazz music, as well as the history of the civil rights struggle, including the parts of that history that exist today in continued social injustice and structural racism. Many of the places we went, particularly in Mississippi, revealed stark health, economic, and social challenges that still plague so many citizens in the USA, most often people of colour, who live amid inequity and injustice.
As I watched Jackson, I remembered what I saw and felt then with my son and I was reminded of the words of Martin Luther King, when he said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane”. So, when Mississippi's 64th Governor, Governor Bryant, says in Jackson that “we want Mississippi to be abortion free”, it seems to me that he is saying we want Mississippi one step closer to being completely void of equity and justice in sexual and reproductive health. As is often the case, the particular assault on reproductive health that Jackson highlights would disproportionately affect poor women and women of colour, not only in terms of access to abortion but access to a wide range of reproductive health services.
All these issues play out in Jackson, as Crow deftly allows the story to unfold in the words, deeds, and realities of those involved without pushing too hard in one direction. In the end, the viewer is left to draw their own conclusions and work out their own feelings about whether the film chronicles the tale of a victory or a defeat. For me, a staunch supporter of a woman's right and access to all forms of reproductive health services and choice, it was gratifying as the end result represented a small victory for sexual and reproductive justice. This battle ended in the courtroom where, at least for the moment, the Mississippi law that could lead to the closure of its lone remaining abortion clinic was blocked.
Sexual and reproductive justice exists when all people have the power and resources to make decisions about their bodies, sexuality, and reproduction. It means that every person has the human right to choose to have or not to have children, care for their children in a safe and healthy environment, and control their own body and self-expression, free from any form of sexual or reproductive oppression. The term reproductive justice came to prominence at the 1994 International Conference on Population and Development in Cairo, Egypt. It was used in the USA, and emerged as a framework, in November, 2003, by Sister Song Women of Color Reproductive Justice Collective, led by and for Indigenous women and women of colour. The modified term sexual and reproductive justice is now used to reflect the importance of bodily autonomy and justice across the spectrum of human sexuality. In my work in NYC, our goal is to increase awareness and access to a full continuum of sexual and reproductive health and related services and contraceptive methods, so that all people can make informed decisions about their sexual and reproductive health, and act on those decisions. The sexual and reproductive justice framework facilitates this by providing a theory and strategy developed by women of colour to address sexual and reproductive oppression.
As part of that work, it was about this time last year that I met obstetrician and gynaecologist Willie Parker, who I consider to be one of the heroes in this film and certainly a hero for sexual and reproductive justice. I was moved by his compassion, passion, and dedication. In Jackson when he says, “We're here to make sure that you can have safe, legal access to abortion. And that's your choice and that's your right to do that”, you know he will do all he can to make it so, even risking his life. Tragically, the USA has a history of deadly attacks on abortion clinics and providers. Crow highlights Parker's unflinching commitment to providing reproductive health in the face of such hostility. He unapologetically pursues his work as a health-care provider who provides abortion services, in a caring and comforting way, and through his words and actions affirms for his patients that the choice to abort or not is theirs and theirs alone to make.
A woman's choice to have an abortion is nuanced, complicated, and deeply personal. Jackson captures this complexity. I found the events documented in the film tragic, heart-breaking, and maddening. Although some continue to vehemently challenge abortion, politically push for leverage to repeal it, and in states across the country enact “restrictive” laws to diminish access to it, the reality is that the legal right to choose exists in the USA and has existed since the historic 1973 Roe versus Wade Supreme Court Decision. Mississippi's attempts to limit or eliminate this right and personal choice in the face of the ruling by the Supreme Court shows that, sadly, in the case of sexual and reproductive justice, the USA has quite a way to go.
Jackson Women's Health Organization, as shown in the powerful new documentary Jackson. (Maisie Crow ) While the Supreme Court is expected this month to rule on its most significant abortion rights case in over 20 years, one documentary premiering on Monday at the Los Angeles Film Festival shows exactly what’s at stake. The film Jackson tells the story of Mississippi’s last remaining abortion clinic, tracing the lives of three women on all sides of the issue: the abortion clinic’s director, a pro-life pregnancy-center director, and a poor, black single mother who is pregnant with her fifth child.
Directed by Maisie Crow with co-producer and editor Jamie Boyle and executive producers Barbara Ehrenreich, Johanna Hamilton, and Alissa Quart, the vérité-style documentary is an expansion of the Emmy-nominated short The Last Clinic, published by the Atavist magazine in 2013, and a National Magazine Award finalist. As Crow’s debut feature film, Jackson comes at a pivotal moment for reproductive rights: This month the Supreme Court is expected to rule in Whole Woman’s Health v. Hellerstedt; the 2013 Texas TRAP law shuttered half of the state’s abortion clinics. Since 2010, 288 TRAP laws restricting abortion access have been passed throughout the U.S., meaning that the country is still moving toward becoming like Mississippi, one of five states with only one remaining abortion clinic (the others: Missouri, North Dakota, South Dakota, and Wyoming).
Mississippi has one abortion clinic and, according to Jackson, 38 known crisis pregnancy centers, which are often funded by pro-life groups. It is the poorest U.S. state, with abstinence-based sex education in public schools and one of the country’s highest teen pregnancy rates (a trend that predominantly affects women of color).
The documentary follows three Mississippi women. There is Shannon Brewer, director of , a divorced black woman who grew up poor outside Jackson, has six children, and started working at the abortion clinic 15 years ago as a scrub technician. April, a 24-year-old single black mother to four children aged 1, 2, 3, and 4 is pregnant with her fifth child; she drank Clorox to self-abort her first pregnancy at age 16. “I’ve got so much I want to be,” she says early in the film. But she was taught that abortion is wrong. She seeks help from the film’s third character, Barbara Beavers, the pro-life executive director of the Center for Pregnancy Choices.
Crow decided to make the film after reading a 2012 Jezebel article about a Mississippi TRAP law very similar to the Texas law now before the Supreme Court; it required abortion-care providers (read: at the state’s only abortion clinic) to have admitting privileges at a local hospital. Crow flew to Jackson the next day, found the clinic, and asked to film a documentary, to which the clinic’s director, Brewer, said no, as she almost always does.
“I normally cannot deal with cameras and the people and all of this stuff when I’m trying to handle this,” Brewer said in an interview ahead of Jackson’s premiere. But Crow was persistent, hanging around the clinic for months with a still camera before Brewer agreed to wear a microphone. “There’s something different about her,” Brewer continued. “She took the time, whereas a lot of people come here and they’re in a rush to just get a story. She kept her word, she earned my trust.”
Crow and her team shot 700 hours of footage over three years for the 90-minute film, which captures the important day-to-day routine anti-abortion protesters’ verbal abuse outside the clinic, abortion procedures in clinic rooms, and the pregnancy center’s religious-based counseling sessions against the backdrop of national news stories and speeches by lawmakers like Mississippi Governor Phil Bryant, who riles up a crowd that is overjoyed at the possibility of making Mississippi the nation’s first abortion-free state.
Because Crow was given incredible access and spent so much time with the women, she captures every crucial moment: She is with Brewer right after the clinic is vandalized, during her call with the FBI, and when she unexpectedly meets the wife of her son’s baseball coach, who works at the pro-life pregnancy center with Beavers. She is in April’s bedroom when she goes into labor at 4 a.m., her mother refuses to drive her to the hospital, and she’s forced to call an ambulance. Crow also pushes her characters in complicated ways, like when she asks Beavers, the pregnancy center director, if April should go on birth control after having her fifth child. Beavers cannot answer the question, even later when April brings up the idea herself. “We need someone to father all these babies,” Beavers says, rejecting the possibility while discouraging April from having sex, to which April replies, “We don’t need no father to all them babies, I am.” The film ends with a final note: April is currently pregnant with twins, who are due in September.
It is fitting that Crow, a South Texas native, made this film. She vividly recalls the shame she felt in a Planned Parenthood one day as a teenager, when her cheer-leading coach walked in while she waited to get birth control. She remembers a high-school teacher slapping Velcro gloves together during a sex-ed class, explaining each ripping apart is what happens to your heart after having sex again and again. The most challenging aspect of making the film was fundraising, she said. With grants from Ehrenreich’s Economic Hardship Reporting Project and the NYSCA, she funded the project with most of her own money and slept on a clinic nurse’s couch for months before opting for motel rooms. An anonymous donor arrived weeks before Monday’s premiere to fund their finishing costs.
“For me it’s really important that people start to understand the disparities in access; the intersections of reproductive, economic, and racial justice; and what’s really happening down in Mississippi, what it feels like to be someone who is caught in that [abortion care] stigma,” Crow said in an interview. “If these pro-life-funded crisis pregnancy centers are now drastically outnumbering abortion clinics we need to know what they’re doing, how they’re operating, and why are there so many more of those than there are abortion clinics? … At the end of the day helping to limit unplanned, unwanted pregnancy is something that I think both sides can agree on.”
Brewer, who spoke with the Cut before flying out for the L.A. premiere, said she felt positive about the pending Supreme Court decision. “No matter what they’ve tried to do, every day I get to come in here, unlock these doors, and these women still get to come here,” she said. “Every day that you open the doors it’s like, Y’all didn’t win today y’all did not win today.” ~~~~~~~~~~~
I am woman, hear me sob. For today's US election has broken my heart.
Surely, I believed we had made some progress. I knew feminism has a way to go but the world was ready for a female President. Especially one with such experience, such conviction and such a sexist, narcissist, megalomaniac oaf as an alternative.
Democrat voters react while watching the election results. (Darrian Traynor)
I believed, or make that hoped at least, that Donald Trump was an aberration, a distraction that we would look back in horror on. He was the close call we all would be relieved to see put back in his penthouse box, his ego broken, his scary bluster a hot wind that was extinguished by good sense.
But no. I have watched today as I did 9/11, with my hands over my eyes in shock, disgust and horror and cries of "this can't be happening!" on constant rotation.
But it has.
As I sit here, I'm aware Trump will soon accept his victory. It is something I don't think I can watch. Because I know there will be cheering for a man who I believe is mentally unstable. A man who is dangerous. And a man who will divide this world at a time when unity is needed more than ever.
What's more, I know I will see women applauding his victory, women who should know better.
Women who voted for a man who is intent on not just taking back our right to choose, but advocating punishment for having control over our own bodies. A man who ridiculed women for their looks, who boasted he can grope at will and it will be enjoyed. A man with no respect.
I have already witnessed Sarah Palin gloating, Pauline Hanson sending her regards, Julie Bishop attempting to hose down the catastrophe. I don't think there is much more I can take.
There are events in history that deserve a black line put through them and I believe this is one of them.
America should be ashamed. For ignorance has triumphed over reason.
To every woman who voted for Trump, I say good luck. Because you have voted against equality. And you will now have to pay for your folly.
What today has proven is that hate sells. And America has bought it. And the rest of the world will pay the price.
Doubts About the Promised Bounty of Genetically Modified Crops
By DANNY HAKIM
Arnaud Rousseau, a sixth-generation farmer in France, in a field of rapeseed. Twenty years ago, Europe largely rejected genetic modification at the same time the United States and Canada were embracing it. (Ed Alcock for The New York Times)
LONDON The controversy over genetically modified crops has long focused on largely unsubstantiated fears that they are unsafe to eat.
But an extensive examination by The New York Times indicates that the debate has missed a more basic problem genetic modification in the United States and Canada has not accelerated increases in crop yields or led to an overall reduction in the use of chemical pesticides.
The promise of genetic modification was twofold: By making crops immune to the effects of weedkillers and inherently resistant to many pests, they would grow so robustly that they would become indispensable to feeding the world’s growing population, while also requiring fewer applications of sprayed pesticides.
Twenty years ago, Europe largely rejected genetic modification at the same time the United States and Canada were embracing it. Comparing results on the two continents, using independent data as well as academic and industry research, shows how the technology has fallen short of the promise.
Broken Promises of Genetically Modified Crops About 20 years ago, the United States and Canada began introducing genetic modifications in agriculture. Europe did not embrace the technology. This is how it has played out.
An analysis by The Times using United Nations data showed that the United States and Canada have gained no discernible advantage in yields food per acre when measured against Western Europe, a region with comparably modernized agricultural producers like France and Germany. Also, a recent National Academy of Sciences report found that “there was little evidence” that the introduction of genetically modified crops in the United States had led to yield gains beyond those seen in conventional crops.
At the same time, herbicide use has increased in the United States, even as major crops like corn, soybeans and cotton have been converted to modified varieties. And the United States has fallen behind Europe’s biggest producer, France, in reducing the overall use of pesticides, which includes both herbicides and insecticides.
One measure, contained in data from the United States Geological Survey, shows the stark difference in the use of pesticides. Since genetically modified crops were introduced in the United States two decades ago for crops like corn, cotton and soybeans, the use of toxins that kill insects and fungi has fallen by a third, but the spraying of herbicides, which are used in much higher volumes, has risen by 21 percent.
By contrast, in France, use of insecticides and fungicides has fallen by a far greater percentage 65 percent and herbicide use has decreased as well, by 36 percent.
Profound differences over genetic engineering have split Americans and Europeans for decades. Although American protesters as far back as 1987 pulled up prototype potato plants, European anger at the idea of fooling with nature has been far more sustained. In the last few years, the March Against Monsanto has drawn thousands of protesters in cities like Paris and Basel, Switzerland, and opposition to G.M. foods is a foundation of the Green political movement. Still, Europeans eat those foods when they buy imports from the United States and elsewhere.
In Rowland, N.C., a worker loads G.M. corn seed into a planting machine on Bo Stone’s farm. Mr. Stone values genetic modifications to reduce his insecticide use. (Jeremy M. Lange for The New York Times)
Fears about the harmful effects of eating G.M. foods have proved to be largely without scientific basis. The potential harm from pesticides, however, has drawn researchers’ attention. Pesticides are toxic by design weaponized versions, like sarin, were developed in Nazi Germany and have been linked to developmental delays and cancer.
“These chemicals are largely unknown,” said David Bellinger, a professor at the Harvard University School of Public Health, whose research has attributed the loss of nearly 17 million I.Q. points among American children 5 years old and under to one class of insecticides. “We do natural experiments on a population,” he said, referring to exposure to chemicals in agriculture, “and wait until it shows up as bad.”
The industry is winning on both ends because the same companies make and sell both the genetically modified plants and the poisons. Driven by these sales, the combined market capitalizations of Monsanto, the largest seed company, and Syngenta, the Swiss pesticide giant, have grown more than sixfold in the last decade and a half. The two companies are separately involved in merger agreements that would lift their new combined values to more than $100 billion each.
When presented with the findings, Robert T. Fraley, the chief technology officer at Monsanto, said The Times had cherry-picked its data to reflect poorly on the industry. “Every farmer is a smart businessperson, and a farmer is not going to pay for a technology if they don’t think it provides a major benefit,” he said. “Biotech tools have clearly driven yield increases enormously.”
Uncertain Harvest Articles in this series examine the globe-spanning relationship of chemical companies, academics and regulators, and the powerful toxins and genetically modified seeds used to grow food in many parts of the world.
Regarding the use of herbicides, in a statement, Monsanto said, “While overall herbicide use may be increasing in some areas where farmers are following best practices to manage emerging weed issues, farmers in other areas with different circumstances may have decreased or maintained their herbicide usage.”
Genetically modified crops can sometimes be effective. Monsanto and others often cite the work of Matin Qaim, a researcher at Georg-August-University of Göttingen, Germany, including a meta-analysis of studies that he helped write finding significant yield gains from genetically modified crops. But in an interview and emails, Dr. Qaim said he saw significant effects mostly from insect-resistant varieties in the developing world, particularly in India.
“Currently available G.M. crops would not lead to major yield gains in Europe,” he said. And regarding herbicide-resistant crops in general: “I don’t consider this to be the miracle type of technology that we couldn’t live without.” A Vow to Curb Chemicals First came the Flavr Savr tomato in 1994, which was supposed to stay fresh longer. The next year it was a small number of bug-resistant russet potatoes. And by 1996, major genetically modified crops were being planted in the United States.
Monsanto, the most prominent champion of these new genetic traits, pitched them as a way to curb the use of its pesticides. “We’re certainly not encouraging farmers to use more chemicals,” a company executive told The Los Angeles Times in 1994. The next year, in a news release, the company said that its new gene for seeds, named Roundup Ready, “can reduce overall herbicide use.”
Originally, the two main types of genetically modified crops were either resistant to herbicides, allowing crops to be sprayed with weedkillers, or resistant to some insects.
Arnaud Rousseau holds non-G.M. corn seed, produced by Pioneer, a unit of DuPont. (Ed Alcock for The New York Times)
Figures from the United States Department of Agriculture show herbicide use skyrocketing in soybeans, a leading G.M. crop, growing by two and a half times in the last two decades, at a time when planted acreage of the crop grew by less than a third. Use in corn was trending downward even before the introduction of G.M. crops, but then nearly doubled from 2002 to 2010, before leveling off. Weed resistance problems in such crops have pushed overall usage up.
To some, this outcome was predictable. The whole point of engineering bug-resistant plants “was to reduce insecticide use, and it did,” said Joseph Kovach, a retired Ohio State University researcher who studied the environmental risks of pesticides. But the goal of herbicide-resistant seeds was to “sell more product,” he said more herbicide.
Farmers with crops overcome by weeds, or a particular pest or disease, can understandably be G.M. evangelists. “It’s silly bordering on ridiculous to turn our backs on a technology that has so much to offer,” said Duane Grant, the chairman of the Amalgamated Sugar Company, a cooperative of more than 750 sugar beet farmers in the Northwest.
He says crops resistant to Roundup, Monsanto’s most popular weedkiller, saved his cooperative.
But weeds are becoming resistant to Roundup around the world creating an opening for the industry to sell more seeds and more pesticides. The latest seeds have been engineered for resistance to two weedkillers, with resistance to as many as five planned. That will also make it easier for farmers battling resistant weeds to spray a widening array of poisons sold by the same companies.
Growing resistance to Roundup is also reviving old, and contentious, chemicals. One is 2,4-D, an ingredient in Agent Orange, the infamous Vietnam War defoliant. Its potential risks have long divided scientists and have alarmed advocacy groups.
Another is dicamba. In Louisiana, Monsanto is spending nearly $1 billion to begin production of the chemical there. And even though Monsanto’s version is not yet approved for use, the company is already selling seeds that are resistant to it leading to reports that some farmers are damaging neighbors’ crops by illegally spraying older versions of the toxin.
High-Tech Kernels Bo Stone, a sixth-generation farmer, in Rowland, N.C. The seeds on Mr. Stone’s farm brim with genetically modified traits. (Jeremy M. Lange for The New York Times)
Two farmers, 4,000 miles apart, recently showed a visitor their corn seeds. The farmers, Bo Stone and Arnaud Rousseau, are sixth-generation tillers of the land. Both use seeds made by DuPont, the giant chemical company that is merging with Dow Chemical.
To the naked eye, the seeds looked identical. Inside, the differences are profound.
In Rowland, N.C., near the South Carolina border, Mr. Stone’s seeds brim with genetically modified traits. They contain Roundup Ready, a Monsanto-made trait resistant to Roundup, as well as a gene made by Bayer that makes crops impervious to a second herbicide. A trait called Herculex I was developed by Dow and Pioneer, now part of DuPont, and attacks the guts of insect larvae. So does YieldGard, made by Monsanto.
Another big difference: the price tag. Mr. Rousseau’s seeds cost about $85 for a 50,000-seed bag. Mr. Stone spends roughly $153 for the same amount of biotech seeds.
For farmers, doing without genetically modified crops is not a simple choice. Genetic traits are not sold à la carte.
Two Corn Seeds, but Very Different Manufacturing the corn seed on the left involves gene modifications by three additional companies. The seed on the right is created using only conventional breeding methods.
A genetic trait developed by Dow AgroSciences and Pioneer that creates a bacterium that breaks down the gut wall of insect larvae. (The New York Times)
Mr. Stone, 45, has a master’s degree in agriculture and listens to Prime Country radio in his Ford pickup. He has a test field where he tries out new seeds, looking for characteristics that he particularly values like plants that stand well, without support.
“I’m choosing on yield capabilities and plant characteristics more than I am on G.M.O. traits” like bug and poison resistance, he said, underscoring a crucial point: Yield is still driven by breeding plants to bring out desirable traits, as it has been for thousands of years.
That said, Mr. Stone values genetic modifications to reduce his insecticide use (though he would welcome help with stink bugs, a troublesome pest for many farmers). And Roundup resistance in pigweed has emerged as a problem.
“No G.M. trait for us is a silver bullet,” he said.
By contrast, at Mr. Rousseau’s farm in Trocy-en-Multien, a village outside Paris, his corn has none of this engineering because the European Union bans most crops like these.
“The door is closed,” says Mr. Rousseau, 42, who is vice president of one of France’s many agricultural unions. His 840-acre farm was a site of World War I carnage in the Battle of the Marne.
As with Mr. Stone, Mr. Rousseau’s yields have been increasing, though they go up and down depending on the year. Farm technology has also been transformative. “My grandfather had horses and cattle for cropping,” Mr. Rousseau said. “I’ve got tractors with motors.”
He wants access to the same technologies as his competitors across the Atlantic, and thinks G.M. crops could save time and money.
“Seen from Europe, when you speak with American farmers or Canadian farmers, we’ve got the feeling that it’s easier,” Mr. Rousseau said. “Maybe it’s not right. I don’t know, but it’s our feeling.”
Feeding the World Brazilian soybean plants at the end of their life cycle at Bayer’s research center in Durham, N.C. The plants have “stacked” traits, meaning they have been genetically modified for more than one specific trait, like bug resistance. (Jeremy M. Lange for The New York Times)
With the world’s population expected to reach nearly 10 billion by 2050, Monsanto has long held out its products as a way “to help meet the food demands of these added billions,” as it said in a 1995 statement. That remains an industry mantra.
“It’s absolutely key that we keep innovating,” said Kurt Boudonck, who manages Bayer’s sprawling North Carolina greenhouses. “With the current production practices, we are not going to be able to feed that amount of people.”
But a broad yield advantage has not emerged. The Times looked at regional data from the United Nations Food and Agriculture Organization, comparing main genetically modified crops in the United States and Canada with varieties grown in Western Europe, a grouping used by the agency that comprises seven nations, including the two largest agricultural producers, France and Germany.
For rapeseed, a variant of which is used to produce canola oil, The Times compared Western Europe with Canada, the largest producer, over three decades, including a period well before the introduction of genetically modified crops.
Despite rejecting genetically modified crops, Western Europe maintained a lead over Canada in yields. While that is partly because different varieties are grown in the two regions, the trend lines in the relative yields have not shifted in Canada’s favor since the introduction of G.M. crops, the data shows.
Stink bugs raised by Bayer for experimental purposes at its research center in Morrisville, N.C. (Jeremy M. Lange for The New York Times)
For corn, The Times compared the United States with Western Europe. Over three decades, the trend lines between the two barely deviate. And sugar beets, a major source of sugar, have shown stronger yield growth recently in Western Europe than the United States, despite the dominance of genetically modified varieties over the last decade.
Jack Heinemann, a professor at the University of Canterbury in New Zealand, did a pioneering 2013 study comparing trans-Atlantic yield trends, using United Nations data. Western Europe, he said, “hasn’t been penalized in any way for not making genetic engineering one of its biotechnology choices.”
Biotech executives suggested making narrower comparisons. Dr. Fraley of Monsanto highlighted data comparing yield growth in Nebraska and France, while an official at Bayer suggested Ohio and France. These comparisons can be favorable to the industry, while comparing other individual American states can be unfavorable.
Michael Owen, a weed scientist at Iowa State University, said that while the industry had long said G.M.O.s would “save the world,” they still “haven’t found the mythical yield gene.”
Few New Markets Battered by falling crop prices and consumer resistance that has made it hard to win over new markets, the agrochemical industry has been swept by buyouts. Bayer recently announced a deal to acquire Monsanto. And the state-owned China National Chemical Corporation has received American regulatory approval to acquire Syngenta, though Syngenta later warned the takeover could be delayed by scrutiny from European authorities.
A research assistant at a Bayer center in North Carolina, where experiments are carried out to find new toxins to eradicate pests like stinkbugs, a problem at farms like Mr. Stone’s in Rowland. (Jeremy M. Lange for The New York Times)
The deals are aimed at creating giants even more adept at selling both seeds and chemicals. Already, a new generation of seeds is coming to market or in development. And they have grand titles. There is the Bayer Balance GT Soybean Performance System. Monsanto’s Genuity SmartStax RIB Complete corn. Dow’s PhytoGen with Enlist and WideStrike 3 Insect Protection.
In industry jargon, they are “stacked” with many different genetically modified traits. And there are more to come. Monsanto has said that the corn seed of 2025 will have 14 traits and allow farmers to spray five different kinds of herbicide.
Newer genetically modified crops claim to do many things, such as protecting against crop diseases and making food more nutritious. Some may be effective, some not. To the industry, shifting crucial crops like corn, soybeans, cotton and rapeseed almost entirely to genetically modified varieties in many parts of the world fulfills a genuine need. To critics, it is a marketing opportunity.
“G.M.O. acceptance is exceptionally low in Europe,” said Liam Condon, the head of Bayer’s crop science division, in an interview the day the Monsanto deal was announced. He added: “But there are many geographies around the world where the need is much higher and where G.M.O. is accepted. We will go where the market and the customers demand our technology.”