Repro Health Hub

On June 30th, 1980, the US Supreme Court decided in Harris v. McRae that even though women have the legal right to an abortion, the government has no obligation to provide funds for medically necessary abortions. The Supreme Court’s 5-4 decision upheld the Hyde Amendment and allowed both federal and state governments to continue to prohibit the use of Medicaid funds for medically necessary abortions. The Court found that a woman’s freedom of choice did not carry with it “a constitutional entitlement to the financial resources to avail herself of the full range of protected choices.” In other words, even though the Court believed women should have a right to abortion, they did’t necessarily believe all women should be able to actually obtain one!

The four dissenting judges filed separate opinions expressing their disagreement with the decision. Justice Marshall explained that for low-income woman the “denial of Medicaid-funded abortion is equivalent to denial of legal abortion altogether.”

Appallingly, the Hyde Amendment continues to bar thousands of women from receiving abortions through their Medicaid health coverage every year. Advocates across the country are continuing to fight this dangerous policy, and the Hyde—30 Years is Enough Coalition is spearheading a national campaign to repeal the Hyde Amendment, complete with a petition and tips for getting involved.

By Myra Batchelder

The 8th Circuit Court of Appeals ruled today that South Dakota can begin enforcing a law compelling doctors to tell their patients seeking aboritons that an “abortion will terminate the life of a whole, separate, unique, living human being.” Doctors also must tell women they have the right to abortion, but that it could cause psychological harm, even suicide.

The court ruled that Planned Parenthood, which challenged the law, failed to show that the sentiment doctors will be forced to express is ideological.

Not ideological?! This law practically demands that doctors recite the anti-choice pledge of allegiance to women seeking abortions. Anti-choice pharmacists get away with not providing birth control because they say doing so would violate their freedom of conscience, but now doctors in South Dakota will be compelled to give patients information that is not only subjective, but medically inaccurate.

And if the court was really concerned with placing biological accuracy above ideological bias, you’d think it would allow doctors to determine what information patients needed to know. Instead, the court prefers government intrusion into the doctor-patient relationship. 

South Dakota is in a perilous position. In 2006 voters defeated an outright ban on abortion. A similar ban will appear on the ballot this coming November. Hopefully, today’s decision will trigger pro-choice activism in the state.

By Tara Sweeney

A study published this month found that very few doctors in the United States are telling their patients about the existence of emergency contraception. Based on surveys conducted in 2002, the researchers found that only 3% of those surveyed had ever had a doctor discuss EC with them, and of those who had seen their gynecologist in the previous year, only 4% had been informed about EC (Read the abstract for the full study.)

Since this data came from before EC was approved for over-the-counter use by women over 18, it is possible that the debates about that approval raised EC’s profile enough that more doctors are now talking about it. I’d be surprised if that was really the case though—doctors generally feel more need to discuss prescription products with their patients than over-the-counter ones, so a survey conducted this year could even find lower rates of physician counseling.

No one has more responsibility to provide women with information on EC (although reproductive justice organizations have definitely picked up some of the slack!) than doctors, so their silence is dangerous. This is the case particularly for women under 18, who still need a prescription for EC. One doctor interviewed for the article said he discusses EC with his patients regularly and prescribes it for his sexually active teenage patients to have on hand, just in case. “Emergency contraception is like a fire extinguisher. If your house catches fire, this is not the time to go out and buy one,” he said. “And if you have a contraceptive failure or, God forbid, you are involved in a nonconsensual sexual act, there is Plan B.”

Women of color were more likely (although still not very likely) to hear about EC from their OB/GYNs. Future studies should examine the correlations between EC counseling and urban locations.

I hope that this study generates some discussion within the gynecological community. The American College of Obstetricians and Gynecologists was active in helping EC be approved for over-the-counter sale, so perhaps it will start doing more to encourage its members to discuss EC with their patients. In the meantime, the next time you go to your OB/GYN, ask her or him about EC and about whether she or he talks to other patients about it. Maybe gynecologists just need a little encouragement.

By Nora Niedzielski-Eichner 

Wednesday night, NBC will premiere “The Baby Borrowers,” a reality show aimed at preventing teenage pregnancy—“It’s not TV, it’s birth control,” reads the Web site. The series, which NBC is marketing as an “intriguing new social experiment,” follows five 18-to-20-year-old couples as they spend 18 days tackling the “adult responsibilities” of raising children, managing homes, and holding jobs.

Each couple is given its own home outside of Boise, Idaho. One partner from each couple works while the other plays homemaker. The women wear fake pregnancy bellies and attend pre-natal classes. As the series progresses, the couples—whom NBC describes as “nervous” and “fumbling”—are entrusted with the lives of individuals from every stage of life. For three days at a time, the teens care for babies between the ages of six- and 11-months-old, toddlers, “sassy” pre-teens and their pets, teenagers, and finally (oddly?) senior citizens. Meanwhile, nannies and the children’s real parents watch the drama unfold from monitors in neighboring houses. NBC assures audiences that these adults can step in at any time.

The National Campaign to Prevent Teen and Unplanned Pregnancy worked with NBC to develop the series and says the show will advance its mission of “improv[ing] the lives and future prospects of children and families” and “ensur[ing] that children are born into stable, two-parent families who are committed to and ready for the demanding task of raising the next generation.” Critics of the show call its extreme approach harmful to the health and wellbeing of the poor children forced to live with these teenaged couples.

Also troubling is the idea of TV as birth control. I like to think that actual birth control—you know, contraceptives?—is the best way to reduce unplanned pregnancy. Is reality tv really the next frontier for birth control?

Will you tune in tomorrow night? I think I might have to.

By Allison Farer

People around the globe, as it turns out, believe that the decision to have an abortion should be left to the individual.

The collaborative research group WorldPublicOpinion.org published a poll last week showing that of 18 countries polled around the world — from the U.S. to China to Mexico and Turkey — the majority of people believe that the government should not “be involved in trying to discourage abortions.” In 17 out of 18 of those countries, majorities overwhelmingly reject using criminal penalties to prevent abortions.

In seven of the countries surveyed, the law of the land is out of sync with public sentiment. “Clearly many governments around the world using criminal penalties to try to prevent abortions are out of step with their publics,” WorldPublicOpinion.org Director Steven Kull said in the press release.

Here in the United States, 69% of respondents believe the government should not try to discourage abortions, while 27% think it is okay for the government to “use such methods as education, counseling, and adoption services” to discourage abortions, and only 8% believe that the government should use criminal penalties, like fines and imprisonment. 8%. That’s a rather piddling minority. Does anyone else want to e-mail copies of this report to lawmakers in Louisiana, Mississippi, and North Dakota, all of which have passed abortion bans, or to any others who support bans that would lead to the criminalization of abortion here in the states?

The citizens of the world realize that abortion is a decision made of necessity, often the result of complex medical or other personal considerations. And it should remain an individual choice.

Now if only the governments or the world would listen.

By Tara Sweeney

In an article on AlterNet today, writer Vanessa Valenti asks a central question in the movement to improve access to contraceptives: “Why is it that in a country where 98 percent of sexually active women have used a form of contraception, nearly half will have an unintended pregnancy?”

Valenti points to several factors inhibiting women’s ability to prevent unwanted pregnancy. First, there is simply a lack of access to contraception—“economic gaps, racial disparities and insurance status all play a role in determining women’s access to birth control.” Although 7 million women rely on Medicaid for birth control, Myra Batchelder, Director of the Low-Income Access Program (LIAP) of the National Institute for Reproductive Health, says that each state throws up barriers that can slow down the availability of birth control through Medicaid. For instance, even though emergency contraception is available over the counter, women on Medicaid in most states are still required to obtain a prescription. “This can cause a large burden for women that depend on Medicaid. In order to obtain a prescription from their doctor, women may need to wait additional hours or even days, which can cause a major delay in accessing a drug that is most effective the sooner it is taken,” Batchelder said.

Anti-contraception activists and federal opposition to the availability of birth control also block access where it is needed most. From President Bush’s Deficit Reduction Act to the United States Conference of Catholic Bishops’ opposition to the Equity in Prescription Insurance and Contraceptive Coverage Act to the American Life League’s “The Pill Kills!” campaign, various forces are united against women’s access to birth control. Valenti concludes,

So while organizations like [the Pro-Choice Education Project] and the National Institute for Reproductive Health are working hard to help women on the ground, it’s going to be a long road before contraception is available to everyone. [The Guttmacher Institute’s Kathleen] O’Connell said the internet allows women to inform themselves and become their own heath advocates, but a change in the presidential administration in November could play a significant role in improving women’s access to contraception.

And perhaps one day, birth control actually will be only a pharmacy away. “Before I retire, one of the goals that I hope for is that we’re going to see birth control over the counter,” O’Connell said. “I think that’s a step in the right direction.”

By Tara Sweeney

You’re probably familiar with the anecdotal evidence of select pharmacists across the country refusing to fill prescriptions for birth control. But an article in today’s issue of The Washington Post discusses how some pharmacies are taking this troubling trend one step further by refusing to carry contraceptives at all.

One strand of the argument in support of pharmacies’ “right” to refuse certain medications is that stores should be able to exclude any products they choose, and pharmacists should not have to do anything that violates their personal points of view.

But we have come to expect that pharmacists, as health care professionals, place the health and well-being of their clients above their own political ideology. And what about women’s right to receive adequate, and equal care? As Marcia Greenberg from the National Women’s Law Center told the Post, “Contraception is essential for women’s health. A pharmacy like this is walling off an essential part of health care. That could endanger women’s health.”

Another strand of the argument against the widespread availability of contraception says that consumers can simply go elsewhere to have their birth control prescriptions filled. That may well be the case in cities and large towns with a plethora of pharmacies. But what about women who live in areas with fewer pharmacies from which to choose? The Post quotes R. Alta Charo, a University of Wisconsin bioethicist who says,

We may find ourselves with whole regions of the country where virtually every pharmacy follows these limiting, discriminatory policies and women are unable to access legal, physician-prescribed medications. …We’re talking about creating a separate universe of pharmacies that puts women at a disadvantage.

And even if women are able to fill their prescriptions at another local pharmacy, what about the women who are so humiliated at being turned away from a pharmacy that they are afraid to even try their luck at other pharmacies? And what about women seeking the morning-after pill, who could lose vital hours in searching for a drugstore that provides this most basic service of filling a prescription?

While some states have laws that allow pharmacists to refuse to fill certain prescriptions (one wonders whether other medications, like Viagra, ever meet pharmacists’ refusal), California, New Jersey, Illinois, and Washington have passed legislation requiring pharmacists to either fill prescriptions or help women fill them elsewhere.

I doubt these anti-choice pharmacies would provide any such service. Even so, it could be too little, too late.

By Tara Sweeney

A poll of 1,200 women in March showed that about half of those who back Senator John McCain said they didn’t know enough about where he stands on abortion to determine whether he agrees with their own opinions on choice. That means they might not know that he wants to overturn Roe, that he opposes birth control, or that he has voted against women’s choice 123 out of 128 times in the Senate. If McCain is able to smuggle these anti-choice policies into the White House, consequences for women could include less control over their reproductive health, fewer choices in handling an unintended pregnancy, and even the criminalization of abortion.

A new video released by Brave New Films, in coordination with Planned Parenthood Federation of America, depicts a dystopian vision where clinics deny women the full range of services and even information about unintended pregnancies. In this video, a woman goes into a clinic asking for information about her options in dealing with an unwanted pregnancy, and is handed a blank sheet of paper, since under a McCain presidency, women would have no options. Videos like this may just be satire, good for mocking McCain and his anti-choice policies, but they eerily reflect the actual decisions that he and other pro-life policymakers have made about the fate of reproductive rights in America.

As NIRHealth has been stressing through the How Much Time campaign, one of the scariest possible consequences of electing a anti-choice candidate is that overturning Roe would lead to the criminalization of abortion. That means that women would be forced to choose between seeking an illegal, dangerous abortion and carrying an unwanted pregnancy to term. Doctors would have to choose between providing safe, quality abortion care and risking criminal prosecution, or turning women away when they need their doctors most. We know the results of such policies all too well—we’ve been down that road before, and we can’t go back.

And it’s not just John McCain that we have to fear. Many state legislatures are considering—or have already passed—laws that make abortion a crime. In 2007 alone, 14 states considered legislation that would make all abortions illegal, except in cases of rape, incest or where the mother’s life is at risk. For example, a key committee in the Colorado legislature came within one vote of passing legislation to make all abortions illegal. Three states—Louisiana, Mississippi, and North Dakota—have actually enacted complete bans on abortion that will likely take effect the day Roe is overturned by a conservative Supreme Court.

These nightmare scenarios are enough to urge anyone who cares about the fate of choice in America to do whatever possible to prevent the ascendancy of ill-advised and inhumane crusades against to the right to choose.

By Tara Sweeney

This Saturday, June 7th, marks the 43rd anniversary of the Griswold v. Connecticut decision in the Supreme Court, which established constitutional privacy protection for married couples’ use of contraception in 1965. Unmarried women obtained the right to use birth control a little later in 1972.

Sadly, despite the Supreme Court’s decisions, women across America are still fighting for their right to contraceptive access. From the financial barriers millions of women face in accessing contraception to pharmacists’ refusals to fill birth control prescriptions, women are left to defend their right to contraception. However, those aren’t the only barriers. Many in the anti-choice community are working not only to abolish the legal right to abortion but also to end women’s right to access birth control!

This Saturday, the American Life League is staging “Protest the Pill Day: The Pill Kills Babies” demonstrations across the country to protest the anniversary and women’s access to contraception. Their accusations about the dangers of the birth control pill are medically inaccurate and show the dangerous extent to which our opponents will go to control women’s bodies and their reproductive health. Show your support for women’s access to birth control by counter-demonstrating this Saturday!

The protest is only the beginning. Even more terrifying is the current campaign by anti-choice and conservative organizations to reinstate the “Domestic Gag Rule.” In May, over eighty conservative organizations, led by the Family Research Council, sent a letter to President Bush asking him to reinstate the “Domestic Gag Rule,” which would effectively strip family planning clinics’ eligibility for Title X funds if they refer patients for abortions or share facilities with abortion providers.

Title X is an essential source of funding for family planning clinics and, in fact, is the only federal program dedicated solely to funding family planning and related reproductive health care services. This restriction could severely harm the health of millions of women across the country and prevent them from obtaining needed contraception! Please take a moment to send an email to Michael O. Leavitt, Secretary of Health and Human Services, showing your support for Title X!

By Myra Batchelder