Repro Health Hub

The National Institute for Reproductive Health advocates for women to have access to all reproductive health choices when faced with an unplanned pregnancy. While access to abortion is often the spotlighted issue concerning reproductive justice, there is a whole spectrum of choices to which women must have access. Adoption is one of those choices.

Each year in the US, 1 percent of unplanned pregnancies results in adoption, meaning approximately 13,000 infants are placed for adoption domestically. When international and foster care adoptions are included, the total number of adopted children in the US is about 1.5 million—just over two percent. And 25 percent of the women choosing an adoption are teens.

For these children, birthmothers, and adoptive parents, the issues surrounding adoption are vast. From inequities regarding race and ethnicity, to class and sexual orientation, there is much work to be done to ensure that the system is just and respects the dignity of all parties involved.

Gay and lesbian couples who want to adopt, for example, have been singled out in several states in recent years. Reported The New York Times in July, “Last year, Arkansas passed a ballot initiative prohibiting adoption by unmarried couples, which effectively makes it impossible for gay parents to adopt jointly. Utah and Michigan have similar laws; Mississippi and Florida ban adoption by same-sex couples outright.”

Race is another complicated factor with regard to adoption. Black and white families looking to adopt often face discrimination, the latter in their desire for transracial abortion and the former in screening processes. The New York Times reports that in 2004 “more than 45,000 black children were waiting to be adopted from foster care.” Historically, there has been resistance to transracial adoptions, but with the passage of the Multiethnic Placement Act of 1994—which prohibits discrimination in making placements of children to parents based on race, color or national origin of either party for federally financed agencies—more and more transracial adoptions are occurring domestically and abroad.

Cost of adoption is another hurdle that excludes certain people from the adoption process; there still isn’t justice when only middle- and upper-class families can afford to adopt. The Evan B. Donaldson Adoption Institute reports that domestic adoptions from private agencies can cost as much as $30,000. While foster care adoptions are more affordable, efforts must be made to ensure that all potential adoptive parents have equal opportunity and access to the system as a whole.

Some questions we might ask as we look at adoption as a reproductive justice issue include the following: What populations are placing their children and who is adopting? How can we make sure that all women who want to choose adoption have support through this process and aren’t facing coercion or pressure? What steps can be taken to ensure that people from all races and ethnicities are being recruited as adoptive parents, especially given that children placed for adoption are disproportionately children of color?

For the past several months, the National Institute for Reproductive Health and NARAL Pro-Choice New York have hosted the ongoing speaker series “Choices,” which closely examines the full spectrum of reproductive health choices. Emergency contraception, parenting, abortion, and LGBTQ reproductive rights have all been topics of discussion.  In tonight’s installment, “Choices: Adoption,” advocates from pro-choice adoption agency Spence-Chapin will be speaking, along with a birthmother and an expert on transracial adoption. Tonight’s event will address the complex issues surrounding adoption in an attempt to arrive at an understanding of what would constitute justice, equality, and true choice in the adoption process.

Stay tuned for video and a summary of the event in the coming days!

By Anna Bean

The Urban Initiative for Reproductive Health has begun! The Rocky Mountain West Regional Summit, the first of four regional summits that will take place in the next month, was held last week in Denver. Wendy Norris covered the summit on RH Reality Check:

After weathering eight years of conservative attacks, the pro-choice community held high hopes that the Obama Administration, bolstered by democratic majorities in Congress, would signal an end to partisan bickering over federal funding for comprehensive care and the tedious national obsession with abortion.

With that optimism scattering to the four winds of manufactured political controversy, the National Institute for Reproductive Health is organizing the Urban Initiative for Reproductive Heath, four regional urban summits to bring providers, policymakers, activists, funders and legislators together to share effective program strategies and localized incidence data.

“There is a limitless potential to create change for women’s health at a local level,” said NIRH president Kelli Conlin at a Sept. 23 kick-off event in Denver. “What people here realize, much more clearly than people out East or in Washington, is that not everything has to be a knock-down, drag-out fight. You can get things done without burning down the house.”

Seeking common ground was a frequent theme throughout the discussions on sexuality education, underserved populations, and the intersection of reproductive freedom and economic self-sufficiency. Check out the whole piece to read about the lessons learned by our partners from Missoula, MT to Portland, OR.

Next, we’re headed to Atlanta for the Southeastern Regional Summit on Sept. 30-Oct. 2, followed by Chicago, Ill., (Oct. 21-23) and Los Angeles, Calif., (Oct. 29-30). Visit the Urban Initiative for Reproductive Health website to stay up-to-date!

On Thursday, March 5^th, President Obama held the White House Summit on Health Care Reform, which brought together members of Congress, health care experts and advocates in the field of health to discuss how our current health care system need to be revamped. The Summit follows the recent news that health care will be a major aspect of the budget plan, with a first ever down payment made towards ensuring health care access for all.  President Obama asked Congress to set aside $634 billion over the course of ten years, much of the money coming from savings made from restructuring government spending on current public health programs.

Thankfully, some women’s health advocates attended the Summit, including Cecile Richards, President of Planned Parenthood Federation of America, and Marcia Greenberger, President of the National Women’s Law Center. Although it will be weeks before President Obama outlines specific plans to reform health care, it is reassuring to know that health care is a top priority for this administration. Tell Congress that health care means a lot to you too.

Watch Cecile Richards speak at the Summit about how reproductive health care is an essential part of overall health care:

(Thanks to RH Reality Check for posting video.)

By Pooja Awatramani

A new report released by the Guttmacher Institute today provides ample evidence that publicly funded family planning services are much-needed and extremely cost-effective.

According to the report, publicly funded family planning services prevent 1.94 million unintended pregnancies each year. Not only are these services improving quality of life, they are also saving taxpayer dollars. For every dollar put into family planning programs, $4.02 is saved in Medicaid funds that would otherwise be spent on pregnancy-related care. Even with these great strides, many women still do not have access to services due to lack of resources. Unintended pregnancies among low-income women have started to rise at the same time that they are decreasing in other groups.

The majority of family planning programs are publicly funded, with over 9 million clients receiving publicly funded contraceptive services in 2006. Increasing Medicaid family planning coverage and updating Title X policies is a necessary step for more women to have access to these services.

The report calls for a national floor of family planning coverage to fill in the gaps in state programs. The effect would be an additional 800,000 prevented unintended pregnancies, overall saving $2.6 billion in Medicaid costs.

Recognizing the savings associated with the program, 21 states have chosen to expand eligibility for family planning for low-income women who otherwise would not qualify for Medicaid. However, in order to do so, states must first go through a time-consuming process to get a federal waiver, and a proposal to eliminate this cumbersome red tape was unfortunately dropped from the economic stimulus package last month after adamant Republican opposition.

While highlighting the effectiveness of the program, the authors point to a number of policy changes that could help further increase its value. In addition to eliminating the waiver requirement, they recommend lifting a ban on family planning coverage for legal immigrants in their first five years in the United States and increasing funding for the Title X program, the main federal family planning program.

A proposal to increase—perhaps even double—Title X funding is already pending in Congress. Hopefully, armed with this evidence from Guttmacher, advocates for women’s health will have no trouble pushing through such a cost-effective proposal. As one of the report’s authors notes, “Family planning should be noncontroversial.”

Download the full report here.

By Monika Grzeniewski and Maya Dusenbery

Today, after weeks of often tense negotiations, President Obama signs the economic stimulus package into law. The final version of the stimulus package will contain many stipulations for basic health care, but will notably not contain a provision that would have allowed states to more easily extend Medicaid coverage for family planning services.

House Republicans demanded that the provision be dropped amid a mainstream media debate marked by its misinformation and dismissive innuendo.

Early in the process, Rep. John Boehner claimed the stimulus package included a $200 million budget request for contraception. But the proposal simply eliminated a long application process before states can expand Medicaid family planning services and over 5 years would have helped an estimated 2.3 million low-income women prevent unintended pregnancies.

The $200 million figure Rep. Boehner mistakenly referenced was the estimated amount the provision would have saved the government within 5 years, according to the Congressional Budget Office (CBO). After 10 years, projected savings would reach $700 million.

From the tone and quality of the media debate that ensued, however, you’d never have guessed the provision was so benign.

Representatives tittered through a House Caucus meeting on the subject. Chris Matthews, in all apparent seriousness, compared expanding access to contraception to China’s one-child policy. Fox New’s Neal Cavuto, asked with a wink, “How is this, no pun intended, ’stimulative’ of the economy?”

Had he really wanted to know, plenty of people could have answered that question. Many, including House Majority Leader Nancy Pelosi, tried without much success to explain how making it easier to provide basic reproductive health care to low-income women would provide much-needed relief to women affected by the economic crisis and save the government money by reducing unintended pregnancies.

On The Huffington Post, Julie Menin of the DNC’s Women’s Leadership Forum explained that in a stimulus bill designed to offer relief, reform, and reconstruction, the contraception provision would fall into the “relief” category:

The family planning aid fails under the rubric of “relief” for those who are struggling in this dire economy. Close to 50 million Americans lack health care coverage and 40 percent of all Americans have medical debts. Just as the New Deal created jobs and built new infrastructure and provided relief in the form of aid to those who needed it most, our economic stimulus bill must provide relief on the vital issue of basic health care.

On the New York Times Economix Blog, Nancy Folbre, an economics professor at the University of Massachusetts, Amherst, discussed the often over-looked effects of family planning spending on the economy, writing, “Increased spending on family planning (including contraceptives) would generate about as many direct and indirect jobs as any other health expenditures, and probably more than an equivalent tax cut.” The Brookings Institution also offered an analysis of the beneficial impact of the policy.

President of the National Family Planning & Reproductive Health Association, Mary Jane Gallagher, perhaps summarized the benefits of the contraception provision best on RH Reality Check:

The vehement opposition to a provision that would enable states to provide quality, essential health care to millions of women, all the while creating jobs AND saving the government precious tax dollars is beyond the limits of reason…until you realize that reason has nothing to do with it.

The American public similarly understands the benefits of expanding access to affordable contraception. A new survey by the YWCA and National Women’s Law Center found that nearly three-quarters of 1,000 self-identified Republicans and Independents favor legislation that would make it easier for people at all income levels to obtain contraception.

President Obama has assured women’s health advocates that the proposal, or a similar one, though stripped from the stimulus package, will be reintroduced on its own or added onto another piece of legislation in the near future. Hopefully, the next time around, the discussion—in both Congress and the media—will focus more on the merits of the provision and less on how many times one can make a pun with the word “stimulate.”

By Maya Dusenbery

The Director of the National Institute’s Low Income Access Program, Myra Batchelder has an article on RH Reality Check about the possible cost barriers to over-the-counter contraception.

A number of pilot projects in England have begun offering hormonal birth control pills over-the-counter at pharmacies. Although the benefits of being able to obtain birth control pills without having to see a doctor or get a prescription are clear, Batchelder warns that before we move to an over-the-counter model, we must ensure that costs remain affordable for all women:

We must ensure that public and private health insurance programs will provide coverage for over-the-counter oral contraceptives so that all women will be able to obtain the product - not just those who can afford to pay a high price.

Batchelder points to the lessons learned when emergency contraception (EC) became available over-the-counter. Most state Medicaid programs still require women to obtain a prescription in order for EC to be covered. As a result, the cost of over-the-counter EC remains prohibitively high for many low income women.

In the end, we must be aware of the cost and insurance barriers across the entire spectrum of reproductive health care, Batchelder says:

Ensuring access to reproductive health care, including contraception and abortion, is about more than just the legal ability to obtain these services. As advocates we need to work to ensure that all women have access to needed contraception and abortion services, regardless of their socioeconomic status or the health care program in which they participate. We will not have true reproductive rights until all women have the ability to access quality reproductive health care.

The long-term goal is to establish a universal health care system that will provide everyone with access to all needed medical services, including abortion and over-the-counter contraception. The important steps along the way include providing Medicaid and other public and private insurance coverage for over-the-counter EC and other forms of birth control without a prescription, as well as for abortion.

Together, we can work to achieve this. As advocates we must always recognize the cost and insurance pieces of any reproductive health care service and work to ensure that all women have access; cost must never be a barrier to accessing these services.

By Maya Dusenbery

While 3.5 million pregnancies are among women ages 19–29 and one-third of all HIV diagnoses are made among young adults, many people in this age group are uninsured and lack regular health care.

According to a new report from the Commonwealth Fund, 13.7 million young adults, ages 19–29 were uninsured in 2006, an increase from 13.3 million in 2005. What’s even worse is that low-income young adults, especially young adults of color, are disproportionately uninsured. 53 percent of Hispanics and 36 of African Americans in this age group lack insurance, compared to 23 percent of whites.

Many young adults go without coverage because they lose it as soon as they graduate from college. In the year following their undergraduate graduation, 34 percent are uninsured at least part of the time. Those who do not wish to further their education after high school are also cut from their health care policies. 60 percent of young adults who do not enroll in college full-time lose coverage under a parent’s policy around the age of 18. To avoid becoming uninsured, some graduates resort to creative methods. According to a Wall Street Journal article, one college grad enrolled in an online university simply so he could stay on his parent’s insurance plan as a student.

What’s most upsetting about this data is that young adults, and particularly young women, are left without coverage to receive regular preventative and reproductive health care. Having no insurance, young adults are either burdened with the costs of health care or forced to go without. More than 60 percent of uninsured young adults opted out of getting health care they needed in the past year due to high costs. This includes failing to fill prescriptions, skipping treatments, and avoiding the doctor all together. Presumed to be a strong, vital source of life, young adults are becoming a larger demographic within the uninsured, overlooked as a group of people that both need and deserve good health care.

By Samantha Hurley

Since the spring of 2007, women of New Orleans have had a new place to access much- needed, affordable women’s health services. The New Orleans Women’s Health Clinic (NOWHC), a project of INCITE! Women of Color Against Violence New Orleans, opened its doors in May of 2007 with the mission:

“To equip marginalized and underserved women with the means to control and care for their own bodies, sexuality and reproduction through a holistic, community-centered well women approach to healthcare which integrates sexual health and reproductive justice.”

Their opening came in the wake of Hurricane Katrina, which left many previously marginalized and underserved women with even less access to basic women’s health services. Not surprisingly, recovery efforts have been slow (one year after the storm, all the public family planning and STD clinics remained closed leaving 15,000 without care). However, the New Orleans Women’s Health Clinic has been proactive—not waiting for a previously lacking healthcare infrastructure to be rebuilt. 

Instead, they are challenging the accepted norms of sub-par care and offering an alternative comprehensive model of care to the women of New Orleans, regardless of their ability to pay. Since opening less than two years ago, NOWHC has served over 350 clients, offering a sliding scale for services through their Women’s Health Fund. The sliding scale at NOWHC puts health services within the reach of many women who otherwise could not afford them. Currently NOWHC offers a range of women’s health services including pap smears, pelvic exams, testing and treatment of sexually transmitted diseases, pregnancy testing, preliminary obstetric visits, and contraceptive services. Recent partnerships with the Latino Health Outreach Project and CAMP ACE have also allowed for Spanish language services as well as free HIV testing at the clinic on a weekly basis.  

In addition to the health services offered, NOWHC is more than a place to access affordable care. As Shana Griffin, organizer with INCITE! New Orleans explained in an August 2006 interview:

“It’s more than providing healthcare services it’s also about challenging the conditions that limit our access and our opportunities, such as poverty, racism, gender-based violence, imperialism, and war. We see it as more than just a clinic, we want it to also be an organizing center that can meet immediate needs while also working for racial, gender, economic, and environmental justice.”

If you’re interested in advancing the goals and efforts of NOWHC, send an email to nowhc_info@yahoo.com for more information on ways you can help. 

Don’t have plans the first weekend of April? Craving some inspiring talk about reproductive and social justice? Then you should take a trip to Amherst, Massachusetts! Hampshire College (haven for the free spirited, pro-active and socially conscious) is hosting a free weekend conference called From Abortion Rights to Social Justice: Building the Movement for Reproductive Freedom.  

The event is part of a project by the Civil Liberties and Public Policy Program, “a reproductive rights organization that trains, educates, and inspires new leaders, organizers, and supporters nationwide.” The action-packed weekend will be full of great opportunities to participate in workshops, hear some great musical performances, and listen to some awesome discussions about reproductive freedom in the context of other social issues such as racial equality, health care reform, economic justice, and LGBTQ rights (to name a few!).  

From Abortion Rights to Social Justice:
Building the Movement for Reproductive Freedom
April 4-6, 2008
Hampshire College, Amherst, MA 

 It’s free, so register now!

 With so much positive and progressive work going on around the country, those of us at the Repro Health Hub would like to take a moment out of each week to give the spotlight to some of the awesome organizations that are working hard to promote equality and reproductive health, rights and justice by initiating our Hero of the Week!   Without further ado, our first Hero of the Week is (drumroll please!)… 

The Pro-Choice Public Education Project!   Based out of  New York City, the project is an empowering resource for young women looking to develop their leadership skills and become more active in the promotion of reproductive justice. Just check out their mission statement: 

To educate young women and the organizations that serve them about reproductive health, rights, and justice in order to develop a new generation of leaders. 

Aside from leadership development and effective pro-choice campaigning, the Public Education Project (PEP) also conducts research initiatives in reproductive health. Their latest undertaking (which comes out this spring! We can’t wait!) will focus on African-American,  Latina, and Asian Pacific Islander women and provide a quantitative study on these populations’ perspectives regarding reproductive health, rights, and activism.  Be sure to check out their website for volunteer opportunities near you or to download some of their great campaign material! 

A big cheers and thanks from your friends here at the Repro Health Hub!