 Good afternoon. Good afternoon. On behalf of the McLean Center, the Department of Obstetrics and Gynecology, and the Bucksbaum Institute, I'm delighted to welcome you to today's lecture. It's part of the series on reproductive ethics. It's my pleasure now to introduce our speaker today, Dr. Willie Parker. Dr. Parker is an advocate for reproductive justice. He's a graduate of Berea College in Kentucky and holds degrees from the University of Iowa College of Medicine, the Harvard School of Public Health, as well as from the University of Cincinnati, and the University of Michigan. Board certified in obstetrics and gynecology and trained in preventive medicine and epidemiology at the Center for Disease Control, Dr. Parker provides abortion care for women in Alabama, Mississippi, Pennsylvania, Georgia, and Illinois. He's the former medical director of Planned Parenthood of Metropolitan of Washington, D.C. Dr. Parker's work includes a focus on violence against women, sexual assault prevention, and reproductive health rights through advocacy and the provision of contraceptive and abortion services. Dr. Parker has recently published, by recently I mean in April of 2017, a book entitled, Life's Work, A Moral Argument for Choice. Dr. Parker is a board member of the Religious Coalition for Reproductive Choice of a group called URGE, Unite for Reproductive and Gender Equity, and he was recently elected as chair of Physicians for Reproductive Health. Today, Dr. Parker's talk is entitled, Conscientious Provision of Abortion Care, The Counterpunch to Anti-Choice. Please join me in giving a warm welcome to Dr. Willie Parker. I'm elated to be here. Thank you for that wonderful introduction. And I want to say thank you to Julie Korr for making this project was over a year in planning. And she said she's happy to finally be giving birth. And I said, not yet. We're crowning, but we haven't delivered yet. So maybe by one o'clock hopefully we will have given birth to a healthy project, which is the idea of having a meaningful conversation around what I call the Conscientious Provision of Abortion Care as the counter narrative to the increasing reality that people who oppose to abortion on ideologic grounds are feeling empowered to oppose or conscientiously refuse access to this very important care. So I have no disclaimers. And what I want to do is do two things. I'm going to share my prepared remarks, which are very brief. And then I'm going to read from my chapter called A Theology of Abortion, Sometimes That People Call Consider Mutually Exclusive. And then I'm going to open up for questions and dialogue. Because as I share with my audience earlier, I'm more enamored with questions than I am answers. I think you asked the right questions. You can get to the right answers. And most of the time the answer that's correct is the answer that's right for you. It may not necessarily work for anybody else. So sometimes I think we can talk about things in the abstract. But what I want to do is start with a clip to kind of show you what the reality is of what women face as they try to access abortion services in the South. Pulling into the parking lot now. Lose his own soul. Whatever you can possibly profit from killing these babies. This place will someday brick by brick fall apart. If you stand before Father God without a parachute, it's like jumping out of a plane without a parachute. And your God jumps out. And you don't, you know you're going to die. 100% certainty you're going to die. What sickens me is that you're a black man and that you're having black women go in there and destroying black lives. All black lives matter. All black lives matter. All lives matter. Every child is made in the image of God. Black, white, each one of them. Yellow, red, green, blue. Now we all know that babies don't come out green and blue. And I'm a big fan and proponent of black lives matter. And I just didn't think that the support would come from there. But I want to create the tone around the question of the opposition. That's at the lay level. But increasingly within our specialty as the demand for abortion services, the prevalence of which is one in three women in their reproductive lives by the time they each reach age 45 in this country, there's increasingly people who feel empowered to say no to women who need this care. And so for me, watching notions of conscience oversimplified to mean refusal of vital health services for women on religious grounds has not been easy. What is held forth as the sacred moral principle for the conscientious objection is often really just the observance of patriarchal custom which denies women the right to make decisions about their lives. And thus it reserves power and privilege for men and boys in an unquestioned manner. Now this is especially the case when the issue at hand involves preventing women from making reproductive decisions other than continuing a pregnancy, whether she wants to or is able to. And it's often justified by the citation of passages of sacred texts that are often lifted out of context. And for me, what is problematic about this is that this perspective on conscience leaves no room for other understandings that might prompt us to consider different expressions of moral decision making, for example, the notion of contraintious provision which I embrace as I provide abortion care for women. And that includes, as I said, abortion in my own case, and I'm sure that for many of my colleagues who provide this care, some of them whom are in the room today. Conscience dictates that providing this service from a place of compassion that most of us acquire from a religious understanding or that we acquire compassion from a non religious understanding is what allows us to do this work. And in my case, I provide abortion care because of my religious understanding and not in spite of it. Now, having had a personal religious experience growing up in the south in Birmingham, the belt buckle of the Bible belt in my opinion. My conversion experience as a teenager to Christianity and my subsequent theology and understanding. After that, but at the time when I was 15 years old in the deep south in the late 70s, when I became, when I had my religious conversion experience, I anchor it in that time period because what I want you to understand is that even though I was brought up in a situation where I, in the pursuit of my Christian understanding, was raised with biblical literalism and, you know, taking things quite literally, it predated the whole pro-life pro-choice narrative because the moral majority had not come into its full political power. And so I don't remember being brought up in a narrative of a pro-life pro-choice. And while I grew up seeing many single women who had, I'm playing unwanted pregnancies and single women and teens who became pregnant in my community, I never heard discussions about abortion. It was just sort of expected that the women in my community who became pregnant would continue those pregnancies. Now, I'm sure women had abortions is just that as being born as a male and not having impregnated and when I never had to engage in that conversation and it was not one that was explicit in my community. Now, what I did see though, is that when young women acknowledged pregnancy, especially if they were active in the church was that they were forced to cease their actions in the church as well as once they gave birth, they were required to make a public apology for having brought this shame on the church. And for what it really announced was at that point, illegitimate sexual activity, but the boys in church with whom they were active and maybe who they became pregnant by would never force to publicly acknowledge their sexual debut. And so for me, that disparate valuation placed on sexuality never set well with me and even though I didn't have the language to talk about it in a justice or a way with regard to feminist ideology, I think that right away I knew that there was something wrong about that system and that system and that I would say that that became what were my earliest inclinations towards feminist thinking. Now, somebody once said that when you wrestle with your conscience and you lose, you actually win. And I, that's how I described my beginning as an abortion provider and the decision for me to serve women as an abortion provider was the culmination of a 12 year struggle that had begun when I was in residency in medical school and during my gynecologic training. What happened for me was as I in my in the core of my discipline became had to see women on a daily basis with I'm playing unwanted practices or wanted belief in flower ones. It led me to question what was gonna be my role in making how how how would I self describe as a woman's health provider and be unable to provide that kind of care to women. And so what happened for me was that I began to feel like my failure to respond to women when they made this request of me with regard to their medical needs. It began to feel like cowardice to me. And for me, cowardice or living without meaning and purpose is one of my greatest fears for my life. And I attribute that although I didn't have any major traumatic experience, the thing that was closest to a conversion type experience for me as an abortion provider came when I listened to a sermon by Dr. Martin Luther King. And most of you would know that sermon as the I've been to the mountaintop sermon is the last sermon he preached on April 3rd 1968 before he was assassinated the following day. But during that sermon, Dr. King uses the story of the good Samaritan to illustrate the need for more shared human concern. He noted that what made the Samaritan good was his ability to reverse the question and concern. Whereas everyone else who passed by this fallen traveler asked what will happen to me if I stop to help the Samaritan reverse the question of concern and ask what happened to this person if I don't help him. And that question brought precision to my own thinking about my role as a women's health provider and how I should be responding to women when they presented to me with the request to end the pregnancy. And so ultimately, I grew uncomfortable not providing abortions for women when I knew what they faced when those that service wasn't available. And that along with my previously stated fear of a life of cowardice is why I now provide abortion care and I'm convinced that the majority of my peers that they don't have the same dramatic narrative they are similarly convicted. So abortion provision for me as an act of conscience is a notion that's foreign to most because often the framing of my ability to mix what they would perceive as mutually exclusive concepts like in their mind the light and morality of conscience with the dark sin of abortion just doesn't make sense to them. I just personally don't see it that way. For some, you know, I will never be able to reconcile the notion that I self-identify as a Christian and the compassion that I derive from that identity for women who need abortion services. That compassion allows me to provide this care and that it emanates for my religious understanding. I understand for them as they look at this issue in the context of patriarchal norms that are thoroughly throughout fundamentalist Christian orthodoxy. I understand why they can't reconcile them to the point of they can't understand why I refuse to deny women the opportunity to control their lives through abortion. I accept that I can't reconcile it for them, but increasingly there's a theology for people who have a faith identity and who provide reproductive health care. Increasingly there's a theology evolving and ascending in the religious communities across different faith narratives that embrace and reflect the sacred reality of women being able to make decisions about their reproduction. And in these faith identities that honoring of a woman's sacred reality of making decisions about her body it reflects within those traditions the principles of autonomy, conscience and agency for women that should be on par with what we take for granted to be in evidence for men. Ecumenical organizations like the Religious Coalition for Reproductive Choice on whose board I sit, which is comprised of multiple faith organizations who hold sacred the agency of women and their families. These organizations and this emerging voice represents a much needed counter narrative to the orthodox notion that abortion is not supportable as a moral choice. This faith voice represents a new wine, if you will, to represent a to use religious parlance that honors the particularities of female existence that is rooted in the human experience and one that is unique to and not subsumed by the experience of men. For example, the fact that reproduction occurs in the body of women, even though men are males, as such as men, male and female, are complementary in that process. But given that the fact that this process plays out in the bodies of women, if we embrace that women are entitled to autonomy and self-determination and bodily integrity, then the embrace of the notion that women are entitled to this lead me as a women's health provider to find conscientious abortion provision as well as empowering women to make that choice that it creates new possibilities for actions and thoughts that go beyond the boundaries of conscience that are dictated by patriarchal sensibilities. So theologies or religious understandings that do not address moral decisions unique to the female experience. When they do that, they infantilize women in their own lives and they, in a way, dethrone women as the decision makers in their own lives. And now, unfortunately, the dethroning or these decentralizing women as the decision makers in their lives are being driven largely by the religious, but more importantly, the political sensibilities of people who have found that moralizing issues of reproduction result in the ability to mobilize political constituencies in a way that result in political outcomes that really have nothing to do with the health and safety of women. So when we start to understand the sacredness of the feminine in the human experience and when we began to, in a religious sense, explore conceptualizations of God that embody the feminine experience in lived experience, it creates space for women to make decisions and to engage in actions that are about situations that are physically as personal as reproduction as we perceive religious identity or spirituality to be. So reproduction, because it occurs in women's bodies, is very personal. Religion and spirituality are very personal. That's why I was very uncomfortable talking about mine publicly, but became willing to do so when I understood that it was the encroachment on the autonomy of women via people being very explicit about their moral and faith understanding. And I understood that the only effective counternarrative is not one for nonbelievers to talk to believers about their moral encroachment on the reproductive liberty of women. But it became important for my, it became a important point of advocacy for me as a believer to push back on other believers in the same way when it comes to white privilege people of color can't fix white privilege, white people have to fix white privilege. When it comes to patriarchy, women can't fix patriarchy, men have to fix patriarchy. When it comes to homophobia, LGBTQ people can't fix homophobia, straight people have to fix it. And so to me the most effective counter argument towards people denying women their access, if that argument is religious, has to be a religious pushback. And so that is the thrust of where I bring the personal and the religious in my craft together to honor the fact that for women, the personal and their reproductive lives along with their spirituality and their sense of agency is where these things come together. And therefore, when women are making decisions in the context of their spiritual frame of reference and in the privacy that they should be entitled to with regard to their reproduction, it demands that we have respect for their autonomy. So given that I and my colleagues have decided to honor the agency of women, I think my colleagues would agree with me when I say that the thing that's most compelling for me has been when I'm counseling a woman about her reproductive options and she is there in the context of seeking an abortion from me and her eyes say to me, whatever you say to me, please don't say no. It helps me to understand how important and sacred that agency is. And first of all, I think there's too much power for one human being to have over another. And that's why I struggle deeply to and make sure that a woman has to never sit across the table from one and beg them for the right to be self-determined, but she merely has to inform them of what she's decided to do. And so my ability to respect women in this regard is that when women are making decisions in the complexity of their lives, it does not match the over-simplified narrative of folk who are opposed to abortion. This decision is not lightly or frivolous for women who are often living in poverty and making decisions about themselves and for people who are dependent upon them. So given that she has that responsibility for her life, it is at no point clearer to me than at that moment when a woman is making that decision that her ability to make that decision is sacred. So that's why it means for me when I've seen a 35-year-old mother of two, of five, whose two-year-old recently died from a childhood cancer and she found herself nine weeks pregnant. When she says to me, I don't have the economic or the emotional capacity to care for another child at this point, I think it is important for me to honor her agency. When I see a 12-year-old girl pregnant by her adoptive father who's brought in by her mother to conceal this situation, and when she naively says to me that her father's pledged not to do it again and that he will take her for ice cream after the procedure, I understand the necessity of the work that I do. When I see a 37-year-old mother of three who had undergone, who was diagnosed with breast cancer in her, and in her third pregnancy, only to give birth and then have a mastectomy when she came back for her evaluation for reconstructive surgery and found herself 10 weeks pregnant. When she says to me, I decided to end this pregnancy so that I could be around to raise the three children that I have, they chagrin for me of having counseled this patient in the state of Mississippi where they mandated that I still had to tell her that having an abortion can increase her risk for breast cancer is when I understand the sacredness of this decision for women and when I argue and fight for the conscientious right to provide services for women that they need. So as I close my Christian teaching, as I understand it, it gives me two tasks. One, to love God with my whole heart and to love my neighbor as myself. And while I'm still figuring out what it means to love God with my whole heart, the clarity I have about loving my neighbors myself is simply to be that I want for women what I want for myself. I want a life of dignity, self-determination, well-being, and the ability to participate in the Commonwealth. I want no less for women and so because of that providing abortion care for women when they request it is the primary way that I can preserve the possibilities for the fact that one in three women in this country who seek abortion need it and my conscience demands that I do that. So I'm going to stop right there with the prepare remarks but what I want to do was to take advantage my I'm in the mode now reading from my new book Life's Work and because I have a chapter does anyone have a sense of what my time is let me just pull out my clock it's from 12 30 so I'm in good shape I want to leave more time to ask questions than you know like I said I'm enamored with questions so I want to leave you time for that but what I wanted to do was I said that I wrote a chapter and part of how to think about being a women's health provider and being enabling myself to provide the care that I know women need. Many religious traditions because of the overbearing nature of people opposed to abortion they feel the space such that people who religiously or morally from their religious tradition who are not opposed to abortion have not had space to think about a way of how they can reconcile being a person of faith and of conscience and participating in abortion care. Many people do most of our patients do because we know from our data that most patients have a religious identity that they acknowledge when they come for abortion care they don't leave that outside the room. So when I thought about what empowered me I decided to at least articulate the thinking that the path that I pursued in my thinking about providing this care and how I kind of integrated my my religious understanding with my scientific understanding as a as a scientist and as a clinician. And so I wrote a chapter called a theology a new theology of abortion and I'm not going to read the whole chapter but I want to read just a couple of segments to give you a flavor of how my mind works and that might be something I don't want to do publicly but I'm going to do it anyway. So the Christianity I learned as a boy began to seem as I continued to devour other ideas shallow emotional and naive. I now I know that every serious faithful person goes through a dark period of questioning and mine and my 20s were that for me. How might I reconcile my ability to think critically which was becoming a requirement as I pursued my path through science toward becoming a medical doctor and at the same time continue to see myself as a person of faith. In my day-to-day college life I was still hanging out with friends from inner varsity. The Christian group on campus I was still maintaining a position of abstinence and I just figured out that that's not the piece I want to read. So forgive me I'm much more skilled in the operating room than I am from reading from my own book so just indulge me I don't want to use my time reading that part. Okay so here's what I want to read I'm sure this time. I had no way of knowing that this when I was young when when I was writing my paper on abortion for issues and values are querying the boundaries of my faith but Christians have a long tradition of supporting abortion rights in public and in the political sphere. Even before Roe v. Wade progressive Christians and Jews have been preaching from the pulpit with the Reverend Tom Davis a minister in the United Church of Christ calls a humane theology a belief that a woman contemplating abortion deserves to be treated with comp with compassion and that her own judgment and experience must be trusted. Humane theology was the foundation of Dr. George Tillers practice. It dictates that Dr. Tiller was the last doctor assassinated providing abortion care. It dictates that alleviating needless suffering is a Christian's sacred responsibility. If God is in everything and everyone then God is as much in the woman's making a decision to terminate a pregnancy as in her Bible. The sacred rights Davis in his book sacred work Planned Parenthood in its clergy alliances is more often revealed not in abstract pronouncements but in the experience of human beings trying to deal with the inequities and tragedies of human life. The other part that I want to read is to say that conception or birth or even death is a miraculous it is miraculous does an injustice to God. Only a person lacking a scientific understanding of reproduction would say that God gives life or that God takes life or you won't get pregnant unless God makes you pregnant. This idea of God as a meddler is what allows the anti is to turn faithful people against themselves because in their eyes all decisions all the meaningful parts of life are quote God's will or quote not God's will. Is God really that temperamental in petty. Does God really need all that adoration. I'm thinking of the baseball player who comes up to bat and does some comical praying kissing thing with his hands and on the vise of his cap before he either hits a home runner strikes out swinging at the air. Does does that have anything to do with God. Does God really care about the outcome of a baseball game. Is God really on one team side. In this narrow view of God there are good guys and bad guys and only God gets to decide. If God is holy other than the miracle of life is not some ordinary meeting of sperm and over and a morally neutral purely biological event but rather the agency and the responsibility that come with being able to participate with God in the creative process is what is important. God is not human. God is not on the planet. God does not have babies or make babies people do. As part of a greater intelligence as a lover of beauty and creativity God made the world and sexual reproduction is part of a collaborative process. Between a male and a female in between God and humans. In that process all distinctions disappear. God has no hands but your hands. God has no ability but your ability. That is what the Bible means when it says that you are God's child. And so if you look at it that way if you set aside the idea that God is like Siri telling you to go left or to go right. Then the whole business is sacred. All of it. A pregnancy that intimates a baby is not more sacred than an abortion. You don't become sacred like Mary just because you conceived or the termination of a pregnancy is not the resolution of an era. It's merely one of the reproductive outcomes. So is miscarriage. So now is surrogacy and in vitro fertilization. All these are on a continuum and they all hold moral weight. The God part of you is your agency. The trust the divine trust is that you have an opportunity to participate in the population of the planet. And you have the opportunity to not participate. Is God vested one way or the other and whether you as an individual become pregnant. No. Is a pregnancy sacred because there will be a baby ultimately in a bassinet. Beautiful maybe the next Obama. No. The process is bigger than you are. The part of you that's like God is the part that makes a choice. The part that says I choose to or choose not to. That's what's sacred. That's the part of you that's like God to me. The procedure room in an abortion clinic is as sacred as any other space to me because that's where I'm privileged to honor your choice. In this moment where you need something that I'm trained to give you. God is meeting both of us where we are. So. I'll say finally conscientious provision is the space that I found in the context of my. Religious and moral beliefs to feel empowered to honor the agency of women. And their sacred choices. And. I found my place. But we each have to find our place in a society in a society that has. Made. The. Important and common reproductive decision of ending a pregnancy. We've made it into a moral one. And we've tried to exclude it from being a health care decision. But it's not either and it's both so. My hope is that as we each gain. Clarity about what abortion and reproduction is and what it means to us. That if we end up on opposite sides of the significance of reproduction. That we can at least begin to have honest disagreement about that. So I'll stop there now. Thank you for your attention and answering the questions that you might have. I'm sure I can take from here. Someone has a mic and so they can offer. Thank you very much. I'm really moved by your presentation. I think it's it's important that that we get this chance to see the the humanity that compassion the empathy that's behind all the other academic stuff that that we've been hearing about. So I hate to bring it down to a practical level but I have kind of a political question for you and I'm sure you're aware of the most recent abomination appointments by the Trump administration. The two under secretaries in the Department of Health and Human Services or anti science as well as anti choice and anti contraception. I have a lot of people who kind of look to me. I have a mailing list and I send them action alerts to do things. I'm kind of at a loss as to what to tell people to do about this because these are not appointments that are confirmed by the Senate. One thing I was thinking of is telling people to to give money to the Center for reproductive rights because they are fighting on the legal front. A lot of those battles. And I wondered if you had any other ideas about that. Well I think to your point the king has is certainly vested in appointing people around him who are willing to tell who are not willing to tell him that he has no clothes. But I think so there are a couple of things I think what the solution. Albert Einstein says that you have to have more intelligence to get you out of the problem that it took to get you into it. Right. You got to have more intelligence to get out of the problem than the amount of intelligence that it took to get you into it. And what got us into this problem was it was political. Right. It was either at the or. Political idealism that was not pragmatic. And so we have someone who has been elected based on how our system is constructed constructed. Legally. And so the solution is a political one. So I think we are in a position of like an attendance match when you're behind you have to break serve and that means you have to hold serve. And so the only thing we can do at this point is to resist politically news all the mechanisms. So we have to energize the only party that. Represent most of our interest if we are progressive in our leanings. To do all that they can mechanistically to block. We have to empower people to battle legally which is to your point of funding organizations like the Center for Reproductive Rights and the ACLU because they will mount the challenges that will give us the only sense of. Recourse we have the legislative the elected body. Is in sync with the executive branch. And now even the judicial branch is being reconfigured so that there is now no system of checks and balances in this whole ideologic. Reality that we're in. But the only legitimate option to actively do something is to push back politically. And so that means one for the people who are fighting the legal battles that's the. That's the temporizing measure. But we have to shift. The makeup of we can't shift the makeup of this Supreme Court. Without getting the executive branch out that's a four year decision from now. Shove impeachment or resignation. But the most immediate process is to engage politically and to shift the Congress. Right. We can't we can ship we can flip the Congress. Then the president and the president and we can work towards having a veto proof majority. Then I think that's the only job anarchy in just tearing the country apart that's the only solution. Other you know other things may feel good but I think the solutions are political. Thank you very much I was put in a plug for flippable dot org. Sure. Flipable dot org. It'll tell you give you information about various races around the country where we can have a good chance of flipping seats from Republican to Democrat. Thanks. I really appreciate your perspective your religious perspective on the sacredness of abortion. Last week we had an alternate religious perspective on and and his absolute thing and what he didn't come from so much a patriarchal although he was definitely patriarchal but I don't think that was what informed his decision was his decision was religiously. He saw our abortion as killing. As as murder and therefore you know his religious belief was that the sacredness of life prohibited him from doing that or sanctioning anybody doing that from a religious perspective. And how do you deal with that which is also I mean the sacredness of life is a religious perspective as a person who I would call myself a different believer as opposed to nonbeliever. I differently believe and for me you know I think there is a calculus that you figure out you know you know the notion of the when does life begin I think is a fruitless question to delve into and that acknowledging that yes this is killing a fetus but then moving ahead and saying we have to figure out when this is you know when this has to be done seems to me to be the perspective. I appreciate your perspective and I think that that he and I and you I applaud your you have a different perspective I have a he and I have a maybe a shared religious heritage but a different perspective. It is that plurality in itself that says that something as complex and as nuanced as life can't be arbitrated on the basis of individual religious beliefs in the country is pluralistic in a world is pluralistic as ours. Religion is not objective enough for us to make decisions about how we are going to live in community. I think you are right about you can't get asking the wrong getting the right answer to the wrong questions don't don't constitute progress even if we conclude that life begins at conception or by extension when people say that what they are saying is a unique person. Personhood is conferred at conception the problem would be what it means to be personhood and have agency and rights. How do you give rights to a person that's in the body of another person without compromising the rights of the person that the person is in. Right. It sounds like I know that little Russian doll of you know the little thing in there. So how do you open that up. So I think with when I encounter one of the reasons I make the argument that the most effective counter narrative that is going to speak to people trying to legislate from their personal religious position is for people understand the for religious people understand the need to keep religious. Thinking out of public decision making somebody said that when you say that your religion presents you from doing something is a good thing when you say that your religion presents me from doing something it becomes problematic. Right. So it is in a pluralistic society with multiple religious traditions where we cannot allow to say that Mike makes right. If we had let's say if we had a Muslim president a Muslim legislature and they said that the official religion of the U.S. is not going to be Islam and we now are required to face Mecca and pray five times a day. People will feel encroached upon right. That's why we can't have a national religion as a Christian who is trained and believes in prayer and believes that I don't believe that we can have Christian or a religious rituals in public spaces to the exclusion of other traditions. So I think the right pushback is to say you know we're all entitled to our own opinions. We're all entitled to our own beliefs but we're not entitled to our own facts and the only basis where we all stand equal before the facts is in science. So I think. I would say. You know I understand how what what you believe and how you believe. The question is what does that look like in the pluralistic society and given that I don't share your beliefs. How are we going to navigate this public space. So this touches a little bit on the conversation that you had earlier with some of the ethics fellows and also the presentation you just gave. I am sort of struggling with on the one hand agreeing with you that centering women's autonomy is so central here and and that this is an issue that overwhelmingly affects women particularly women living in poverty women who are working class who are women of color. You know all of those things that that prevent access to. Abortion care. And so on the one hand I I am so heartened. How much you return to this line about you know trusting women and wanting to honor women's decisions and that does need to be so central. At the same time you mentioned earlier that reproductive rights is is really thought of as a women's issue because men don't necessarily conceive of themselves as having reproductive needs and reproductive rights and so I guess where I'm stuck is this is a patriarchal society and these decisions that mainly affect women's health care are being made overwhelmingly by men and often men who are very hostile toward women's rights. How do we both keep the focus on women and their autonomy while also saying this is not just a women's issue in the same way that you saw these young women in your church community being penalized whereas their partners were not. I guess I'm struggling as as a young woman who wants the focus to be on women and is really hesitant to say oh but what about the men. At the same time this is a patriarchal society and when men are invested in something that makes a big impact. So how do we make the conversation go both ways. The the the goal is not to dethrone men or to venerate women the goal is to neutralize life chances based on sexual on on gender or sex. And so if you frame it as a human rights issue that's what's at stake for men I think part of the issue is helping men to understand the harm that is done by accommodating patriarchy to them as human beings. The the role of men should not in a human rights context the role of men is not shivery. Right. We can get rid of shivery we can replace shivery with kindness kindness kindness is gender neutral. So that means I am I'm over the moon as much when a young woman opens the door for me as she might be I heard. And so that's more about it's not about being a good guy when I say that I am deeply vested in the autonomy and control bodily control for women of their their their futures. I also share your concern about as I raise consciousness and awareness that men have reproductive health needs that that is not in the context of you have as much right to determine what happens to the fetus that you help to conceive because the person should ultimately decide what's in their best interest is the person in whose body the process is playing out in. So I even tell my patients whether when whoever you're talking about don't tell people what you what that you're pregnant until you decide what you want to do about it. You don't solicit information. There are states like Oklahoma that are trying to say that women should need to have the permission of the man that she's pregnant by in order to have an abortion. And so I think I think we can create a responsibility in men from the standpoint of a human rights framework without undermining or withdrawing the amount of work that we need to do to further empower women. It's not a zero sum game. But it has to be that if we're going to do it has to be in the context of reproductive rights or human rights. And as human beings both men and women that means that there's no difference in the entitlement to those rights. Okay. And I just wanted to speak specifically to the siloing of abortion care and how it's often placed as separate from reproductive health care and separate from necessary reproductive health care. So I was wondering if you could speak to that and how feminism and the reproductive justice framework helped to kind of guide you. So thank you for that. The fact that we silo and we say there is there is abortion there's adoption there is childbirth and for those of us who have who are more vested in one of those are the other. It's often to the exclusion. But if we look at reproduction in a continuum. No matter what one's aspirations are you can end up in one of the other categories and that's only possible if you see the fluidity of moving around in a continuum. And so if you can end up in in one of those other categories even though you had other aspirations. Your agency shouldn't and your morality should not be modulated based on where you end up. And so for me I think a step forward would be to place a moral weight on reproduction and in the context of what it means to have control over your agency and all things that fall in that continuum are weighed equally morally. So I say we should be no less committed to making sure that women get good prenatal care that we are to make sure they have access to end in a pregnancy that they don't want. And reproductive justice informs me of that way because reproductive justice provides the framework for me to think intersectionally. And so whereas it's almost reproductive justice is almost the same as mathematical modeling in statistics. Right. You have multiple factors you want to put in and you don't know what each one weighs but you create a model so that they are appropriately interacting way so that they can give you legitimate information. Reproductive justice framework is looking at the multiple determinants of health and well-being. Whether it be housing, race, poverty, gender discrimination and that kind of thing that are the lived experiences of folk. And when they interact you understand that racism is no more important than sexism is no important than homophobia and you see how a person who has those multiple identities how those all interact. They then allow you to think about what solutions are that are going to be effective and sustainable. So the fact that I see abortion as no more or less important than childbirth is not an insensitivity to the heavy weight that I was trained as an OBGYN. My training was more weighted towards obstetrics and the veneration that I got for delivering babies was to the same degree now I'm excoriated for ending pregnancies that women don't want. But in our reproductive justice framework and we see the intersection if you look at my role as an obstetrician gynecologist as helping pregnant people to fulfill their reproductive life goals then for me to end a pregnancy that a woman wants to end safely is the same as me helping a woman to safely give birth. So in the RJ framework allows you to think about that in a more rigorous way. You know you got me thinking about how hard the patriarchy wants to kind of control this abortion who gets this abortion issue. And you know Freud talked about penis envy and I don't know that you can believe everything that Freud said necessarily. But this makes me wonder about woman being. I didn't plant that question. But you know there are some people who think about you know the life giving capacity that childbirth represents and the sense. So there's women but there's also I think not as I was saying in an earlier conversation. There's a non scientific understanding that we have about reproduction and that people are still rooted in understanding a reproduction that's pre-gimeto genesis. So pre-gimeto genesis you thought of you know when we talk about sperm as seed it was almost as if women contributed nothing to the genetic composition and so women were merely receptacles and so when you look at it that way to compromise a pregnancy if it is the property of a man's genetic heritage it becomes a tort in a property right. So a woman who ends a pregnancy is defrauding the man who impregnated her. And so it really becomes a tort issue and what it also then becomes in my opinion a question of ends and means. A woman who's relegated to mere status of supporting or developing pregnancy in her body becomes a means and not an end. And that was what Dr. King said was the problem with slavery was that it reduced people to the status of things. So women get reduced to the status of a thing an incubator when she loses control over her ability to procreate. And so I, you know, so there's womb in me or there's I own that womb. And patriarchy says that the wombs of women are owned by the man whether it be their daughters or the women that they contract with other men to take on as their property. Because many in many patriarchal societies women never live independently they go from their father's house to their husband's house. So envy would be admirable over, you know, objectification and ownership. Maybe you would try harder if you like, I really want to be like her, right? Are we running out of time? I could do this all day. OK, so OK. Any other questions? Yes, ma'am. Hi, thank you for your wisdom on some of these really heavy, hard to answer topics. I'm a fourth year medical student at Rush, aspiring abortion provider. And I'm wondering what you see as the greatest personal challenges in your work and how you cope. It's interesting. Yesterday, well, Monday I did a book event at Jimmy Carter Center in Atlanta. That was yesterday, I guess. And then I had a no, that was two days ago. And then I had an interview with CNN and they're going to publish an interview next week. And so I asked me, what is it like to be you? You know, and that for me feels like a weird question. But I think what they're asking is, what does it feel like when you step knowingly into hostility? And my greatest challenge has been probably knowing from my core that I'm motivated by the highest callings of our craft of medicine. And medicine for me is really a vehicle to practice the altruism and the kindness and the compassion that I feel for women when they're in their plight. And to have that spoken evil of and to have people to question my integrity about whether I'm motivated by money or whether or not I'm detached and have a cold level of humanity that I can, they get distracted about the mechanism of abortion and they don't understand what the motivation for abortion is. So it's kind of as somebody who's sensitive whose feelings can be hurt too that people think poorly of me, I had to make my peace with that. But in a risk-benefit thing, you know, I find myself so, when I do this work now, when I've been on the road for a while, when I go back to do abortions, it means even more to me because I get refreshed around what it means to be there for somebody that nobody else will help. So that people disparage me and that, you know, they question my integrity. That may be the hardest thing, but I don't, there really hasn't been much that's been hard about this for me. Increasingly because of the book now, it's very few places I can go where people don't think that I'm either TD Jakes or somebody like that. But it's, you know, there have been no real cost for me. I think I saw Haley. So in your book, you touch on this a lot, just the scientific debate versus the anti-choice philosophical debate. And the current administration, they're really trying to limit access up to 20 weeks of gestational age. So how do you, in the book you were talking about fetal pain? And I think the reason why Trump and administration wants to limit access is like this concept of fetal pain and this like philosophical debate of what a fetus can actually feel. Like, how do you counter that with actual scientific data supporting that fetuses don't feel pain at 20 weeks? Well, I think we just have to continue to behave as a fact that facts matter. You know, maybe our data, you know, the conclusive, we, you know, the scientific model and the processes and the agencies that we respect, you know, is unequivocal in the absence of any new information that the structures necessary to carry pain are present at the place where most abortions are done. And that's, you know, the facts are the facts. We have to continue to behave as a facts matter and not allow there to be a false equivocation. You know, now we have, we don't have lies anymore. We have facts and we have alternative facts. Right? And I think the best way to proceed is to continue to do good science and to act as a facts matter and to push back on the notion that the proof positive that facts matter to me is that there are alternative facts because people don't try and fake things that don't matter. Right? So the proof that the facts matter is that they can't rebut the facts so they have to create their own. And in a court, you know, you have rules of evidence in court, right? What are going to be the rules of evidence in the public discourse around science versus alternative science or alternative facts? And I think we have to continue to say the facts matter and I think a good start was that scientists finally found the notion that we don't lose our objectivity when we exercise our civic duty and that is to participate in the politics. So we had a march. We had a march for science, right? And so the thing is, particularly in the healthcare arena, we are the third most trusted individuals in public polling. Sorry, we got the bronze, right? But we're the third most but we are the least likely to participate. We have some of the highest non-voting rates as physicians. You know, and so if we believe that facts matter and we believe that participating in the political process, which as I said earlier, is the only way we're going to turn this ship around, we have to not be, we have to not react to notions of things like alternative facts. We have to respond with facts. And I think the truth matters and we have to act like it does. I assume you've made your piece also with the possibility that you could be the next abortion provider to be assassinated? I have. I made my, I've decided, I said, one of the things I had to conclude is that life is fatal. None of us are getting out alive, right? And so with that degree of levity is how I keep my sanity. My flight-of-flight system is intact. My parasympathetics and sympathetics are intact. When I feel threatened, I respond just like you do. But, you know, I'm not, I have an appropriate sense of fear, but I'm not easily spooked. And by that I mean, I've chosen the right size to risk. And so I've categorized risk as being hypothetical ones and actual ones. And what I've become clear about is the hypothetical risks are much larger than the actual ones. Because my imagination is so vivid, the hypothetical risks get to be really larger than the actual ones. So when I'm clear about what real risks are, like people following me, like my car was locked when I left, but it's not locked now, like somebody keeps showing up in my block that I've seen, I've seen you before. And now I'm seeing you again, so I recognize that I've seen you before. And there's no context that you should be around me. My sensibilities go off, and I just honor my instincts. Because I know that the wildebeest that loses its fear of the lion becomes lunch. So having a real life assessment and also entering into this work where three of the providers who had been assassinated had already been assassinated before I decided to do this work, I met Dr. Tillard, so I know somebody personally who's been assassinated. But I've chosen to focus on what I live for and not how I might die. And so I'm 54 years old, part of my thing is that Dr. King was only 39. So you all get what you get, but when death does find me, it will find me doing what I believe in. And I hope that I'm 89 when that happens. Did you have a question that you then? Okay, I'll read it. That was it, actually. I wanted to know how you responded to, you know, like these attacks and like the fear. Like how do you keep it in check? How do you stay brave? How do you, you know, it's a big fight. Well, somebody said that you can't be brave unless you're scared. So I guess that makes me very brave. But, you know, Mark Twain said fear is not the absence of courage, it's not the absence of fear, it's the ability to move forward despite fear. Fear is a homestatic response. You're, you know, the sense that you feel danger or, you know, if you didn't have that, you wouldn't be here. We've evolved into that. But the ability to contextualize the stimulus that you feel for me, I know that a very important part of denying women access is the psychoterrorism that people who are opposed engage in. And so I've just become clear about what that is and made my peace. And so I don't blunt my responses, but I'm just clear. I also have a commitment that I've made to myself and that is, and I've made it to my family. The day that I'm more concerned about what will happen to me for doing this than I am about the benefit of what I do, I quit. Cause I don't have anything to prove to anybody. And there are other things that I could do. And you can't do this work from a place of just based on the need. You have to do it from the call because the need is not the call. Cause we all see things that we think are wrong. But if you're not moved to act on it, you know, when it really gets tough about this issue that you're addressing, it's not sustainable to do it from an intellectual ascent. It has to be something that comes from your gut. And that's where I do this work from. And so, you know, I've got a safe word, you know, that I can get out when it starts to, when I'm looking around the corner and when I'm more paranoid about what's gonna happen to me, I'll quit. I just wanna thank you from the bottom of my heart. And I suspect I feel I'm speaking for many, many other people in this room. Thank you. Because what you've done is what you're doing, both doing this work and also talking about it in public places is so critically important. Thank you. And I hope you feel the appreciation and gratitude and care. And I hope you feel surrounded by it. Thank you. Thank you so much. Thank you. Thank you. There, one last question. One last question. Thank you, sir. One last question. I just thought I'd ask that you mentioned about the politics and about the need to organize. We also mentioned that one in three women before they age 45 would be expected to have statistically have an abortion. Yes. And so I'm wondering if you could reflect on that tension, the fact that politically, and this is out of my own bewilderment, that politically we have such an incredibly constricted dialogue about abortion. And yet statistically it would seem like, particularly among women, and if every woman has a partner involved, there's a lot of people accessing these resources. And is that an opportunity? Is there a dialogue to be had about this? And how is that to play out politically? I think there are multiple things that factor into why women don't feel, with the prevalence of abortion, why women don't feel more vulnerable to needing access and fear the loss of it is, I think there's the stigmatization of abortion that drives it underground so that women actually don't know how prevalent the need is. And also there's also what I call the magical thinking of many women who have abortions because it's often unplanned, they never anticipate that they will need one. And so it sort of catches them by surprise. And so most people in a society where we stigmatize this and driven it underground so that people don't imagine themselves needing it, they don't think deeply about it. And so then when they're in this situation where it becomes an issue in their lives, they're kind of at a loss about what to do. So they're in crisis mode. And all they wanna do is get out of the situation that they're in and they don't think more deeply. So I think part of engaging women what I try to do with women by making this, raising public awareness, but also helping women when they do find themselves needing an abortion to link their care seeking experience around how difficult it was to the fact that it's related to their political activity or inactivity. So that's the degree to which I do advocacy in the context of trying to help women to act, I advocate with women for themselves about how to change the context of their lives. Please, please join me in thanking them.