{"id":10376,"date":"2011-08-04T16:52:04","date_gmt":"2011-08-04T15:52:04","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=10376"},"modified":"2011-08-05T08:18:04","modified_gmt":"2011-08-05T07:18:04","slug":"bob-roehr-on-mila-means-a-physician-at-the-centre-of-the-us-abortion-wars","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2011\/08\/04\/bob-roehr-on-mila-means-a-physician-at-the-centre-of-the-us-abortion-wars\/","title":{"rendered":"Bob Roehr on Mila Means &#8211; a physician at the centre of the US abortion wars"},"content":{"rendered":"<p>Demonstrations\u00a0for and\u00a0against the question of abortion are going on all this week outside a clinic in Germantown, Maryland, in the suburbs of Washington, DC. Opponents of abortion have also broadened their attack to seek greater restrictions on sex education and reproductive health. They have particularly targeted government funding and services contracts for the medical charity Planned Parenthood. As that plays out, the <em>BMJ<\/em> spoke with a physician at the traditional epicentre of the US abortion wars.<!--more--><\/p>\n<p>Shouts of \u201cMila, Mila, don\u2019t kill any babies!\u201d greeted Dr Mila Lee Means as she stepped from the front door of her home towards the car. The 54 year old physician was on her way to the office in Wichita, Kansas where she practises medicine and one day hopes to add abortion services as part of her solo practice.<\/p>\n<p>Pro-life organisers are using harassment and changes in the law to prevent that day from ever arriving.<\/p>\n<p>Put your finger on the centre of a map of the United States and it is likely to hit Wichita. The metropolitan region of 630,000 lies in the wheat belt and is a centre for small aircraft manufacturing as the home of Cessna, Beechcraft, and Learjet.<\/p>\n<p>It also is the epicentre of the struggle for abortion rights in the US. Dr George Tiller ran one of only three clinics in the entire country that performed \u201clate-term\u201d (post 21 weeks) abortions. The pro-life group Operation Rescue staged daily protests outside the clinic for years on end.<\/p>\n<p>Tiller\u2019s clinic was firebombed in 1986. An anti-abortion fanatic shot him in both arms in an assassination attempt in 1996. Another shot Tiller through the head while he was attending church, and he died instantly on 31\u00a0May 2009.<\/p>\n<p>Mila Means trained with Tiller in the 1980s. \u201cA year after he was murdered, nobody had stepped up to the plate to offer services in Wichita, and that is when I started looking into maybe becoming a provider,\u201d she told the <em>BMJ<\/em> during a recent phone conversation.<\/p>\n<p>Some of her patients had asked where they might go for an abortion. \u201cThey didn\u2019t want their partner to know they were pregnant and simply couldn\u2019t travel the three hours [to the nearest available provider] I was seeing that the services were not available, and that was changing women\u2019s lives here in Wichita. I decided to go ahead and get involved.\u201d<\/p>\n<p>A year ago she purchased Tiller\u2019s equipment used for early but not late-term abortions.<\/p>\n<p>Opposition arose almost immediately. The landlord sued to prevent her from providing abortion services at the office, and she agreed to seek another location. But Operation Rescue learned of each potential site and harassed the owners who might rent to her.<\/p>\n<p>\u201cThey would visit the people\u2019s [owner\u2019s] home at night. They even vandalised one of the buildings; they painted in red letters &#8216;wake&#8217; across the front of the white building. Those people really did want to lease to us, but they got too scared to,\u201d Means said.<\/p>\n<p>She now sees that delay as a blessing because abortion opponents pushed a law through the Kansas state legislature that imposes onerous restrictions on providing those services.<\/p>\n<p>\u201cThe regulations say it has to be a minor surgical centre with all of the regulations for that. They regulate the size of the janitor closet; it has to be 8 foot by 8 foot. You have to have all of the resuscitative equipment necessary for infants and children even though they would never be using the facility. I think that we would even have to have a blood bank.\u201d\u00a0<\/p>\n<p>She began training on procedures to deliver early term abortions at another regional clinic. By the second day protesters had traced her license plate number and greeted her with, \u201cMila, why did you travel 300 miles to kill babies?\u201d<\/p>\n<p>The ongoing harassment has made her \u201cdefinitely more aware of security issues.\u201d Organisers who included her on a church panel discussion of abortion spent $700 on security because of it, while others have simply dropped discussion of the topic because they cannot afford to provide adequate security.<\/p>\n<p>Means praises the local police, the FBI, and other law enforcement agencies for their diligence. They provided training to her office staff \u201con how to protect themselves\u201d soon after the initial protests erupted. And they have been responsive whenever other demonstrations arose.<\/p>\n<p>\u201cThere is a real awareness in the police community that maybe they dropped the ball when\u00a0Tiller was murdered and so they really want to avoid that situation again.\u201d Means says, \u201cThey are being really responsive.\u201d<\/p>\n<p>The court system gets a lower grade. \u201cI was involved with trying to get an injunction against one woman who sent threatening letters stating that everyone would know where I was, what vehicle I drove, and some day there would be explosives under the car; very specific threatening things that our justices decided did not constitute threat but were just a form of free speech.\u201d\u00a0<\/p>\n<p>Local and state judges are elected in Kansas. Means notes that all of the local judges \u201cmake donations to the organisation Kansas for Life, which is another one of the anti-abortion protest organisations here.\u201d She believes that ideological commitment by the judges compromises her ability to get a fair hearing.<\/p>\n<p>A few of her fellow physicians in the local community have been quietly supportive, but they do not want to be publicly identified with Means.<\/p>\n<p>A handful of patients with pro-life views have left her practice over the last year, while others with those views have chosen to stay because of the quality of care. And the visibility has attracted new patients who appreciate her stand. Means adds, \u201cI had a patient yesterday who said that since I was pro-choice I wouldn\u2019t be judgmental about other areas of her life.&#8221;<\/p>\n<p>The protests and harassment still unnerve Mila Means a year after they began, but they have not deterred her. They have served only\u00a0to strengthen her resolve.<\/p>\n<p>\u201cI have financially and personally sacrificed to continue to be in this position, and I am pursuing the ability to provide abortions because I really believe that this is a right for women and that, regardless of the costs, we need to work toward reinstating women\u2019s rights in our area of Kansas,\u201d she says.<\/p>\n<p><em><strong>Bob Roehr<\/strong> is a biomedical journalist based in Washington, DC, and a regular contributor to the BMJ.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Demonstrations\u00a0for and\u00a0against the question of abortion are going on all this week outside a clinic in Germantown, Maryland, in the suburbs of Washington, DC. Opponents of abortion have also broadened [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2011\/08\/04\/bob-roehr-on-mila-means-a-physician-at-the-centre-of-the-us-abortion-wars\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223,1357],"tags":[367],"class_list":["post-10376","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers","category-us-health-care","tag-abortion"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Bob Roehr on Mila Means - a physician at the centre of the US abortion wars - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2011\/08\/04\/bob-roehr-on-mila-means-a-physician-at-the-centre-of-the-us-abortion-wars\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Bob Roehr on Mila Means - a physician at the centre of the US abortion wars - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Demonstrations\u00a0for and\u00a0against the question of abortion are going on all this week outside a clinic in Germantown, Maryland, in the suburbs of Washington, DC. 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