Monthly Archives: June 2022

By Akilah JohnsonThe Washington Post

MONTGOMERY, Ala.Nailah Nicolas stood in the late-afternoon Southern sun at a park dedicated to three enslaved Black women who suffered torturous experiments to advance the field of gynecology.

That day, hanging heavy in the air surrounding the soaring steel monuments to Anarcha, Lucy and Betsey was the Supreme Courts decision in an abortion case that could overturn Roe v. Wade, which at that point had not yet arrived.

Because of mistreatment and neglect of Black women by the medical profession, and society more broadly, the courts decision adds a layer of complexity to the continued struggle for equity in gynecologic and obstetric services and to the divergent views on abortion.

Abortion care is opposed by some for religious reasons or regarded as a form of genocide, while others say overturning Roe would mark the latest effort to take away what generations of Black women have seldom had: control of their own bodies.

Nicolas fought for Black liberation as a college student in the late 1960s. As the years progressed, she recognized how the malignant forces of racism, sexism and classism intertwine in Black womens battle for agency over their bodies.

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She shudders to think of reverting to the secretive, shame-filled world she lived in before birth control pills were available to unmarried women and abortion was legalized nationwide in 1973, the year after she graduated from the University of California at Los Angeles. It was a time when sex, pregnancy, abortion reproductive health in general were in the shadows, even as hospitals dedicated entire wards to women suffering from complications of abortion because they did not have access to safe procedures.

They never talked to us younger folks about it, Nicolas, 71, said. You almost had to be sneaky and listen to grown folk talk to grown folks.

Nicolas became an activist, and alongside others, fought for more than the right to choose; they fought for the right to control what happens to their bodies, including having children on their terms and raising them in a safe and secure world that provides for the basic needs of parent and child.

She became a public school teacher as part of her mission and began to feel a broader cultural shift in the late 1970s when the curriculum expanded to fact-based lessons on reproduction, shifting away from moral deliberations.

No storks. Medical books, Nicolas said.

That Sunday at the Mothers of Gynecology Monument Park was a day of reflection on the progress achieved in overcoming the burdens and barriers Black women face in accessing not just abortions but also prenatal care and safe births and the work still to be done.

The United States faces an ever-growing maternal health crisis that is especially deadly for Black women, who, along with Native American women, live shorter lives than many other Americans. Pregnancy and childbirth are among the leading causes of death of all teenage girls and women 15 to 44 years old, and Black women are three times as likely to die as a result of pregnancy as white women.

Nearly 2 out of 3 maternal deaths are preventable, research shows.

For the women such as Alexis King who gathered at the park, medical racism and the disparities in gynecological care remain all too present. King struggled for eight years to find the cause of excruciating pelvic pain, mood swings, irregular menstrual cycle and excessive facial hair.

Her symptoms started immediately after giving birth to her second daughter in 2008. The 39-year-old had a tubal ligation and wondered if she was experiencing complications. One day, she doubled over with what felt like labor pains and was rushed to the emergency room, where she learned there was blood in her pelvic floor from a ruptured ovarian cyst.

Her doctor was blas about the whole situation, she said, prescribing birth control pills to regulate her period.

She never took what I was saying serious, said King, a medical billing specialist from Birmingham. It was traumatic.

It wasnt until she switched doctors that King was diagnosed with polycystic ovary syndrome, a hormonal disorder that causes the ovaries to develop fluid-filled sacs.

The new doctor performed two procedures that remove tissue from the uterus to help alleviate heavy bleeding, including a dilation and curettage the same procedure used during surgical abortions and endometrial ablation.

The specter of the courts decision worries me for my girls, King said. Them being limited in what they can do and what resources they might need is worrisome. We never know what life will bring.

The Mothers of Gynecology Monument Park, a place of proud defiance and serene restoration, sits on the More Up campus, the future site of a conference center and resource museum.

We overcome by the words of our what? Testimony, Michelle Browder, the artist and creator of the park, told the crowd gathered at the monument.

Betsey stands 12 feet tall and wears speculums in her crown. Her pregnant form is made of discarded metal objects, much like Lucy (9 feet) and Anarcha, who has a gaping hole through the midsection of her 15-foot metal figure.

Less than a mile away, J. Marion Sims, the physician known as the father of modern gynecology, conducted surgeries without anesthesia on the three women and about seven other enslaved Black women in the 1840s. He was credited with curing whats known as a vesicovaginal fistula a hole that forms between the bladder and vagina after childbirth, cancer or surgery, causing incontinence though his legacy in recent years has been scrutinized by scholars and debunked.

Browder urged the crowd to step into a small guard shack, a cathartic space decorated to rival the relaxation room at any spa, and record stories of the care received from the medical system.

This is not just a piece of art, she said. Its a healing. Its history.

Maternal health is informed by an accumulation of life events that start long before pregnancy begins, said Kanika Harris, director of maternal and child health at the Black Womens Health Imperative, which works to improve the health and wellness of Black women and girls.

This is about how you show up to pregnancy, she said.

The shorter life spans of Black women years taken by higher rates of maternal mortality reflect hurdles piled one on top of another in a society where poverty and pollution often are concentrated in redlined neighborhoods but not affordable housing, grocery stores or reliable internet.

Black women confront racist stereotypes lascivious, aggressive, welfare queen that reduce them to caricatures, which affects their physical well-being and the medical care they receive. Health-care providers are more likely to dismiss Black pain and to negatively describe Black patients in electronic health records, studies have reported. And researchers have found that the unrelenting stress caused by racism wears the body down, aging it prematurely.

The end of legal access to abortion nationwide will absolutely exacerbate this crisis, said Rachel Villanueva, an obstetrician-gynecologist in New York and president of the National Medical Association, the nations largest and oldest national organization representing African American physicians.

We already have a situation where women lack access, Villanueva said. States that did not have Medicaid expansion have some of the worst maternal outcomes.

But there also can be financial barriers in states where Medicaid covers abortions. Thats especially true if a woman earns too much to qualify for the public health insurance program but not enough to afford the cost of an abortion, as one woman explained to University of California at San Francisco researchers who published a study last month examining how the enduring legacy of racism affects Black womens access to and experiences with abortion care.

Researchers interviewed 23 Black women between the ages of 21 and 46 who had abortions. Most were parents living in the Bay Area. The report described a complex web of painful injustices that affected the womens experiences with pregnancy, abortion and parenting.

About 18% of U.S. pregnancies end with an induced abortion, the Centers for Disease Control and Prevention reports. In 2019, more than one-third of abortion patients were Black women, whose rate of abortions was more than three times that of white women, according to federal figures, which did not include California, Maryland and New Hampshire.

Asking patients if theyve ever been pregnant and the outcome of that pregnancy is part of understanding someones medical history, Villanueva said.

Its the same as asking when your last Pap smear was . . . not a matter of judgment, said Villanueva, who like other reproductive health experts, worries that what they regard as a routine part of the doctor-patient conversation abortion could become increasingly fraught, deepening mistrust of the medical system amid the churning landscape of state reproductive politics, which, in some cases, would lead to punishing providers and delaying care.

The narrative that a lot of groups like to dictate is: People are careless. Theyre just having sex. They have an abortion because theyre indiscriminate in what they do, she said. We know thats not the case.

Thats the same argument Kings 16-year-old daughter, Amarie King, introduced in history class recently when the conversation turned to the imminent ruling on abortion rights.

Like I was telling them: You dont know why she ended up pregnant and why she doesnt want to keep the baby. People get raped all the time. Incest. It could be financial reasons, she said. Its not always what you think it is.

Just like the reason she started taking birth control: to help mitigate severe cramps and heavy bleeding that accompanied her menses.

Polls show relatively few people have absolutist views on abortion rights, believing abortion should be completely illegal or legal no exceptions. There are, however, certain situations in which the consensus is clear, according to a recent poll by the Pew Research Center: when a pregnancy threatens someones life or health.

Star Parker, founder and president of the Center for Urban Renewal and Education, a Black conservative think tank known by the acronym CURE, is among the 8% identified by Pew for whom there is no middle ground.

We as a society need to explore much deeper how killing your offspring became health care, said Parker, who sees the abortion debate as a distraction from the economic and social barriers that disproportionately keep Black people from getting medical care.

Parker said she believes there should be a total ban on abortions regardless of the circumstances.

Situational ethics should not drive national policy, she said.

A recent CURE report said the higher rate of abortion among Black women stems from predatory practices of an abortion industry that devalues Black lives. If our goal is to improve access to beneficial healthcare for Black communities, abortion is not the way, the think tanks report says.

Like Parker, Louisiana state Sen. Katrina R. Jackson, a Democrat who is a member of the legislatures womens and Black caucuses, said she doesnt believe outlawing abortion threatens the medical care Black women receive, including the ability to have candid conversations about previous abortions.

I cant subscribe to abortion being health care, said Jackson, who recently sponsored legislation to increase penalties for providers of abortion under the states trigger laws. Im not willing to state that abortion is some sort of remedy. That would be putting Band-Aids where we need to be putting stitches.

To truly improve health care for African American women and girls, research dollars should be spent determining why there are higher rates of diabetes, preeclampsia and fibroids in the Black community, Jackson said. And more should be invested in removing barriers to health care such as improving transit systems and expanding access to contraceptives and sex education, and ensuring Black women receive respectful care, Jackson added.

Instead of focusing on providing funding and researching and addressing the issue of Black maternal health, people want to tell Black women abortion is whats going to keep you healthy, said Jackson, who told NBC News that abortion was modern-day genocide in 2019.

That year, Justice Clarence Thomas argued in an opinion that the eugenics movement opened the door for abortion rights. Social scientists have discredited eugenics, which was popular in the early 20th century, as a pseudoscience obsessed with the genetic fitness of white Americans.

It was an argument also found in the footnotes of the leaked draft decision overturning Roe in which Justice Samuel Alito wrote, Some such supporters have been motivated by a desire to suppress the size of the African American population.

Historians of the eugenics and abortion movements have called this argument a deeply flawed, willful distortion of history. Rana A. Hogarth, an associate professor at the University of Illinois at Urbana-Champaign who studies the medical and scientific constructions of race during slavery and beyond, said it was extreme cherry-picking.

Abortion is a personal choice, not the state intervening and being like, Were going to forcibly sterilize you, which was a basic concept of eugenicists, Hogarth said.

It is a history with deep roots in Montgomery.

It was here in the 1970s that two young girls Minnie and Mary Alice Relf, who were 12 and 14 sued the federal government, exposing the widespread practice of the involuntary and coerced sterilization of thousands of Black, Native American, Puerto Rican and poor white women. Their mother was illiterate and signed with an X on a piece of paper she thought was authorizing her daughters to get birth control. They were surgically sterilized instead.

Standing before The Mothers of Gynecology and a panel that honors the Relf sisters, Joia Crear-Perry, an obstetrician-gynecologist and founder of the National Birth Equity Collaborative, a nonprofit group dedicated to eliminating racial inequities in birth outcomes, told the crowd: People who are the descendants of the enslaved should never want anyone controlling our bodies. No matter your gender. No matter your race.

As a medical student at Louisiana State University in the mid-1990s, she was taught race-based medicine. One embryology professor told students there were three races Mongoloid, Caucasoid and Negroid as he taught about skin types. She was tested on the different pelvic shapes of Black, white and Asian women. And during training, Crear-Perry was taught that Black people had a different pain tolerance, a myth Sims propagated with his surgeries.

So the physicians that you know that went to school in Mississippi, Alabama, Louisiana, where Im from. . . . We were taught that by professors, she said. I had to unlearn that for myself.

Crear-Perrys story was top of mind as Nicolas and her daughter drove home that night. Her daughter brought up how Nicolas received neither anesthesia nor pain medication in 1991 when a doctor performed a biopsy of a uterine fibroid. Maybe, she wondered, he believed the myth about Black peoples pain. And now, Nicolas wondered about that, too.

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In abortion debate, echoes of another battle: Reproductive rights for Black women - Richmond Times-Dispatch

As with so many aspects of the culture wars, the American debate over abortion seems to spend little time considering what policies will actually do to the people at whom theyre aimed.

Proponents of restrictions or outright bans believe theyre fighting to save unborn lives. But while the question of when an unborn fetus becomes a person is more a question of faith than science, those restrictions can have profound impacts on many who are undeniably people.

Of course, the people who will be most profoundly affected will be women and families who dont or barely have the money to leave the state for an abortion in the likely event that Ohio severely restricts or bans the procedure after Roe v Wade is overturned.

So it seems important to see what data can say about who these women are and what restricting their ability to end unwanted pregnancies means for Ohio and the rest of the country.

Each year, the Ohio Department of health compiles abortion statistics in the state, giving a partial picture of who is getting them.

One striking fact is how many fewer women from all backgrounds are terminating their pregnancies. The number has plummeted from just under 45,000 in 1977, the first year for which the state published the statistics, to around 20,000 in 2020, the most recent year for which numbers are available.

Perhaps not surprisingly, the largest group of women who got Ohio abortions in 2020 were in their 20s 59% followed by women in their 30s, 29%. Also unsurprising is that 62% of women got abortions before they were nine weeks pregnant, while less than 2% got them after 19 weeks of pregnancy.

And, while its not surprising that unmarried women are more likely to get abortions, in 2020 they were much more so. The Ohio health stats indicated that 82% of the 20,605 women who received abortions in the state were never married, separated, divorced, or widowed.

But what is perhaps most striking among the Ohio statistics is how overrepresented Black women were.

Ohio is only 13% Black, but Black women received 48% of all abortions in in 2020, the largest single group. Whites, by contrast, make up 82% of the states population, but white women made up only 44% of the group receiving abortions.

The fact that so many unmarried and Black women were having abortions might suggest they didnt believe they have the emotional and financial support they needed to raise a child often in addition to children they already have. Also, more than 27% of Ohios Black people were living in poverty in 2020, compared to just 10% of white people.

However, there is evidence that at least nationally, the poorest women are less likely to seek abortions than their more affluent peers.

A 2015 study by the Brookings Institution found that while women living below the poverty line were much less likely to use contraception and more likely to become unintentionally pregnant, those who did were less likely to get abortions.

Between 2011 and 2013, 32% of women making four times the federal poverty level who had become unintentionally pregnant got abortions, the study said. That compares to less than 9% of women living below the poverty line during the same period.

Cost might be something keeping the poorest women away from the abortion clinic.

Planned Parenthood reports that its lowest-cost, early-pregnancy procedure in Ohio costs $650. If so, further restrictions seem likely to force up the cost particularly if they force women to travel out of state for the procedure.

It seems important with the U.S. Supreme Court apparently poised to overturn the 1973 decision to look at the consequences it might have for women who wont be able to get abortions and for society generally.

One paper published in 2020 by the National Bureau of Economic Research attempted to do that.

In it, two economists and a demographer used credit data to build on the 2016 Turnaway Study, which followed 1,000 women who had sought abortions at 30 clinics across the country. Through follow-up interviews, that study sought to compare women who were turned away from abortions to those who received them.

In the follow-up analysis, The Economic Consequences of Being Denied an Abortion, the research team compared credit information between women who were denied abortions due to gestational limits in states to those of women who received abortions, but were within two weeks of those limits. It sought to look at financial stress caused not only not only from the costs of having and raising a child, but also from a well-documented large and persistent decline in earnings (i.e. child penalty) that women experience on average following the birth of a child.

The three researchers detected a lot of financial stress.

We find that abortion denial resulted in increases in the amount of debt 30 days or more past due of $1,750, an increase of 78% relative to their pre-birth mean, and in negative public records on the credit report such as bankruptcy, evictions, and tax liens, of about 0.07 additional records, or an increase of 81%, the paper said.

It added, These effects are persistent over time, with elevated rates of financial distress observed the year of the birth and for the entire 5 subsequent years for which we observe the women. Our point estimates also suggest that being denied an abortion may reduce credit access and self-sufficiency, particularly in the years immediately following the birth, although these estimates are not always statistically significant.

Of course, worse economic outcomes for those mothers and their babies dont just affect them. They also affect any other children and family members the woman is caring for.

Being forced to carry a child to term might also increase the chances that a child is unwanted and that can cause bad societal outcomes, such as an increase in crime.

In 2001, economists John J. Donohue III and Steven Levitt published The Impact of Legalized Abortion on Crime in the Quarterly Journal of Economics. It tried to explain the precipitous drop in crime through the 1990s from all-time highs in the 1960s, 1970s and 1980s.

After ruling out other theories for the drop, it concluded that the 1973 legalization of abortion resulted in many fewer unwanted children and, as that cohort came of age, a lot less crime.

Legalized abortion appears to account for as much as 50% of the recent drop in crime, it said.

The paper stirred a ferocious response across the political spectrum. Some, including Supreme Court Justice Clarence Thomas, compared it to the pseudo-science of eugenics, which advocated sterilization of people with traits deemed undesirable.

In a 2019 podcast, Levitt said subsequent research reinforced their earlier work. He also denied that his and Donohues research advocated forcing anybody to do anything.

I actually think that our paper makes really clear why this has nothing to do with eugenics, Levitt said. In our hypothesis what happens is abortion becomes legal, women are given the right to choose and what our data suggest is that women are pretty good at choosing when they can bring kids into the world; when they can provide good environments for them.

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Beyond the rhetoric: Abortion restrictions will affect poor & minorities unequally - Ohio Capital Journal

The only corrective is the high court itself, as future generations reconsider once-settled doctrines. But problems often get worse before they get better, because Supreme Court errors are rarely one-offs. When a cabal of justices goes astray, they tend to keep on going. Mistake follows mistake, and the boundaries of American freedom get squeezed.

Mistakes are, of course, in the eyes of the beholder. The current courts decision to overrule Roe v. Wade wasnt unwelcome to the sizable minority who oppose abortion rights. In their eyes, the Roe precedent was the mistake. But a more rigorous assessment awaits. There have been many high-court rulings that, while comforting to supporters, look abominable, even unconscionable in the fullness of time cases that few rational jurists, left or right, would ever try to defend.

Taken together, the judicial errors of the past paint a tragic, almost mournful, picture of the courts role in American history. Eugenics. Forced sterilization. Racial segregation. Internment for citizens based on ancestry.

Demonstrators protest outside of the U.S. Supreme Court on June 28, 2022, in Washington, D.C.|Mariam Zuhaib/AP Photo

In our governmental system, the Supreme Court, on constitutional questions, is infallible, though, as everyone knows, no one of its members comes within sight or sound of infallibility, averred Justice David Brewer, who served from 1889 to 1910.

Brewer knew what he was talking about, because he sat with a group of justices who were far more conservative than the nation they served. Their decisions damaged American life for generations, denying the government the power to combat the economic excesses of the Gilded Age while giving the imprimatur of the highest law in the land to discrimination and segregation.

The occasion for Brewers remark was a dinner feting the 25th anniversary of the investiture of that courts great dissenter, John Marshall Harlan. By todays standards, its hard to classify Harlan as a liberal or conservative he is, in fact, claimed by both sides but he shared with todays liberals a sense of foreboding about the courts impact on the country. His refuge was his faith in the power of dissent. And dissent he did with a roar that continues to be heard through the centuries.

But an examination of Harlans most significant cases provides almost a civics-class primer on the ways that judicial mistakes can linger and do great harm before finally being overcome. And it reveals that there is no single route to reconsideration.

The easiest path but one less likely to provide optimism for abortion rights supporters is simple persuasion. In 1895, the nations economy was being strangled by monopolistic trusts. Conservative justices were alarmed by the prospect of antitrust prosecutions under the newly approved Sherman Antitrust Act. When the Cleveland administration tried to break up the sugar trust the lowest-hanging fruit in the orchard of trusts, controlling 98 percent of sugar manufacturing the justices balked. A convoluted majority led by Chief Justice Melville Fuller insisted that control of manufacturing did not, in itself, indicate an intent to control prices.

Shockingly, Harlan was the only justice who saw the fallacy in this, rebutting, Was it necessary that formal proof be made that the persons engaged in this combination admitted in words that they intended to restrain trade or commerce? Did anyone expect to find in the written agreements which resulted in the formation of this combination a distinct expression of purpose to restrain trade or commerce?

This was no small matter: In industry after industry, manufacturers were banding together and cutting exclusive deals with railroad operators to drive out competitors and set wages and prices. The vast extent of the problem seemed to force some of the same justices to alter their thinking. Shifting political winds and relentless criticism of the courts logic changed the tide. By 1905 only 10 years later the court had reopened the door to government actions to break up monopolies.

For supporters of Roe, however, a change of heart by existing justices seems patently unlikely. The close margin on abortion rights 5-4, as opposed to the courts 8-1 ruling in the sugar-trust case may give the impression that the court doesnt have so far to go to reach a different result. But unlike the nascent world of antitrust in the 1890s, the dug-in nature of the moral, political and legal issues surrounding abortion rights suggests no reconsideration is in the offing, barring a change in the courts lineup.

Shielding trusts from legal action wasnt the only way the Supreme Court extended the Gilded Age: It also blocked efforts to impose an income tax on the wealthy, leaving the government to fund itself through tariffs on basic goods. Once again, a group of judicial conservatives decided that the Rockefellers, Vanderbilts and others who held great fortunes were the victims of government overreach.

But unlike the Sherman Antitrust Act, the income tax was hardly a new idea. It had been utilized to fund the Civil War, so the court couldnt escape the impression that it was making up new rules to protect the wealthy. After the justices split 4-4, the chief justice coaxed an ailing colleague back to Washington to cast the deciding vote. Except he didnt: While the ill jurist supported the income tax, another justice shifted his position against it. The air of behind-the-scenes skullduggery was furthered when Chief Justice Fuller ordered an abrupt announcement of the decision before the opinions were written.

Harlan railed against this, scorching the majority for cravenly upending a long-settled precedent; he also argued that forcing the government to rely on tariffs would be disastrous in a global war, when trade would evaporate.

His warnings resonated with the public. But opponents of the income tax seized on the ruling to block any progressive taxation for nearly two decades. Finally, seeking to quiet demands for a new tax to test the courts mettle, Senate leaders instead agreed to begin the arduous process of amending the Constitution. They doubted the requisite three-quarters of states would ratify an income-tax amendment. They were wrong. Three and a half years later, after Wyoming, Delaware and New Mexico approved the Sixteenth Amendment on the same day, the tax was back to stay.

It was, however, the last time that a deeply contentious political issue was resolved through the amendment process. Changing the Constitution remains a long, hard road, as those seeking direct election of the president can attest.

The greatest tragedy of the court during Harlans years was its fast retreat on the rights of African Americans, an injustice not only to millions of people but to the spirit and plain wording of the Constitution. The court struck down federal civil rights protections, refused to enforce voting rights and allowed states to ban interracial education. It also endorsed the idea that separating Blacks and whites was wholly consistent with the Constitutions equal-protection clause, as long as the accommodations were roughly equal.

That case, the infamous Plessy v. Ferguson, occasioned Harlans famous declarations that the Constitution is color-blind and neither knows nor tolerates classes among its citizens, and that under the law, the humblest is the peer of the powerful.

Thurgood Marshall stands outside the Supreme Court in Washington, D.C., on Aug. 22, 1958.|AP Photo

Harlans dissent was immediately recognized by African Americans as a defining statement of purpose under the law, but drew little attention in the white world. A half-century later, though, it was adopted by Thurgood Marshall and other civil rights lawyers as a component of their legal case to overturn Plessy.

A new generation of justices recognized the tragic cost to Black people of racial separation. They also anticipated an inevitable backlash among white racists that would occur if the court were to demand desegregation. So they worked hard, over months and years, to project a unified front. When the court overruled Plessy in the 1954 case of Brown v. Board of Education, the vote was 9-0. It was an unambiguous message, a definitive statement.

Todays supporters of the courts decision to overrule Roe v. Wade invite comparisons with the saga of Plessy and Brown, as a way of showing that justices must follow their consciences over legal precedent. But the comparisons also reveal the vast distance in spirit between the Brown decision and that in Dobbs v. Jackson Womens Health. While the Brown court recognized the potential disturbance to the county and spoke with one voice, the Dobbs majority couldnt resist overturning abortion rights by a one-vote margin, all but challenging future justices to undo their work.

Flipping back and forth on a constitutional right based on a single change in court membership cant help but undermine the force of the law and the courts mystique. Thus, it might be predicted that Chief Justice John Roberts whose concern for the courts credibility led him to refrain from voting to overturn Roe might now be reluctant to overturn Dobbs for the same reason. To prevail, abortion rights supporters would then need at least two changes in court membership plus the willingness of new justices to abandon any semblance of respect for precedent.

Its a tall order, but one that may, in fact, represent the likeliest source of repeal. In Harlans era, the appeal to future generations was a cry for greater wisdom. Today, such appeals are more direct to justices appointed with a different agenda.

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When the Supreme Court Makes a Mistake - POLITICO

On Wednesday, the feast of Sts. Peter and Paul, House Speaker Nancy Pelosi attended Mass in St. Peters Basilica in the Vatican. She greeted Pope Francis before the Mass and later received Holy Communion, despite being prohibited from doing so over her pro-abortion beliefs by her home archbishop.

The event generated an understandable flurry of Catholic media attention. Her decision to receive Communion (not distributed by the pope) has been held up in some corners as an act of defiance by the Speaker against her bishop, Archbishop Salvatore Cordileone of San Francisco, and the fact that she wasn't denied at the Communion plate as tacit Vatican, even papal, support for her.

But how should Catholics interpret Pelosis Roman holiday?

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Last month, Archbishop Cordileone announced that Pelosi would not be admitted to Holy Communion in her home archdiocese, invoking canon 915 of the Code of Canon Law, which says that Catholics obstinately persevering in manifest grave sin are not to be admitted to Holy Communion.

Citing the Speakers decades of support for legal abortion, in May, Cordileone wrote that a Catholic legislator who supports procured abortion, after knowing the teaching of the Church, commits a manifestly grave sin which is a cause of most serious scandal to others, and outlined his own years of pastoral attempts to dialogue with her on the subject.

After the Supreme Courts decision overturning Roe v. Wade last week, Pelosi has been, if anything, even more strident in her support for legal abortion, and continued to attend Mass at her usual parish in Georgetown, D.C.

With regards to Pelosis attendance at St. Peters on Wednesday, its clear she wasnt there as an anonymous member of the assembly she met briefly with the pope before Mass began, and she was seated in the VIP diplomatic section.

While it's unclear if the individual priest who distributed Communion to her knew who she was, in a sense its irrelevant the Vatican is certainly aware of her situation and could have taken steps accordingly, if it wanted to.

But jumping to the conclusion that by allowing Pelosi to present herself for Communion is some kind of pointed rebuke to Cordileone doesnt necessarily follow.

Its not unreasonable to observe that denying Pelosi Communion on Wednesday would hardly be a neutral act while many of Cordileones brother bishops lined up to support the archbishops action, and promised to honor his decision, as Pelosis proper pastor in their own dioceses, others disagreed, including Cardinal Wilton Gregory of Washington, echoing a debate among the bishops last year about who, if anyone ever, should be denied Communion.

Its also worth noting that, while he did so invoking and applying canon law, Cordileone didnt impose a canonical punishment on Pelosi, or declare her to be excommunicated; he issued a public account of a pastoral judgment he had made.

While other bishops would be bound by law to honor a formal canonical penalty imposed on Pelosi, choosing to honor Cordileones pastoral judgment is, essentially, a matter of episcopal collegiality.

Ordering St. Peters Eucharistic ministers to recognize and deny Pelosi Communion would have been as pointed an intervention in a live debate among the U.S. bishops as on the Speakers individual circumstances. And this is to say nothing of the diplomatic ramifications.

Many Catholic state figures have presented themselves for Communion at the Vatican over the years, despite being generally known to be at odds with the Churchs moral teachings, and the default position has been not to deny them, even when it creates controversy: In 2011, former Zimbabwean dictator Robert Mugabe famously received Communion at St. Peters during the Mass of beatification for St. John Paul II, and few took this to be an implied endorsement of his actions in government by the pope.

Indeed, on abortion the pope has been every bit as outspoken as Cordileone, calling it daily homicide and comparing the practice to Nazi eugenics while repeatedly likening abortion doctors to hitmen.

Even on the subject of Communion and pro-abortion politicians, it was Francis who said last year that those who are not in the community, cannot receive Communion, while stressing his desire to see bishops demonstrate the kind of committed pastoral concern for them which Cordileone outlined in his announcement regarding Pelosi.

Even if he was speaking in the abstract and not of particular cases, Francis actually went further than Cordileone, describing pro-abortion politicians as excommunicated: Out of the community: excommunicated. Its a harsh word, but they dont belong in the community, because they were not baptized, or because they are estranged from it.

While Francis noted that hed never himself been confronted with a pro-abortion politician in the Communion line, he also stopped distributing Communion himself as Archbishop of Buenos Aires, avoiding just such potential encounters.

It is, perhaps, fair to ask if the pope should be more publicly encouraging of bishops like Cordileone who take him at his word, but declining to make the second most visible American politicians relationship with the Church a Vatican problem isnt the same thing as lining up against the archbishop.

Its also worth noting that, among much discussion about abortion, the pope, the U.S. bishops, and the politicization of Communion, the person most directly affected by the situation is Pelosi herself.

Leaving aside the public scandal her political support for abortion occasions, both for Catholics and non-Catholics, both Francis and Cordileone would seem to agree that her political actions carry heavy consequences for her soul.

Her spiritual welfare is probably a far more pressing concern for both Francis and her local archbishop than sending coded messages through the Communion line.

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What to make of Pelosi's Roman holiday - by Ed. Condon - The Pillar