Trump Guts Requirement That Employer Health Plans Pay For Birth Control

October 6, 2017
11:15 AM ET

NPR Alison Kodjak

The Trump administration is rolling back the Obama-era requirement that employer-provided health insurance policies cover birth control methods at no cost to women.

According to senior officials with the Department of Health and Human Services, the goal of the new rule is to allow any company or nonprofit group to exclude the coverage for contraception if it has a religious or moral objection.

"This provides an exemption, and it's a limited one," said Roger Severino, director of the HHS Office of Civil Rights. "We should have space for organizations to live out their religious identity and not face discrimination."

He said he expects that most companies will continue to provide coverage for birth control and that the changes will only affect a tiny percentage of U.S. women. The new rules are being published Friday in the Federal Register and go into effect immediately.

But some health policy analysts say the new rule creates a huge opening that lets any employer claim an exemption, leaving their female workers to pay the full cost of any birth control out of pocket.

"It is a huge loophole for any employer that does not want to provide birth control coverage to their employees," says Dania Palanker, a professor at Georgetown University's Center on Health Insurance Reform.

The change fulfills a promise President Trump made in May to the Catholic religious order The Little Sisters of the Poor in a ceremony in the White House Rose Garden. The nuns had sued the Obama administration over the birth control requirement.

It also sets up a fight between advocates of religious freedom and those of equal rights for women. The American Civil Liberties Union sued the Trump Administration within hours of the rule being published, claiming it violated the 14th Amendment's Equal Protection Clause, which ensures that all people receive equal protection under the law.

"The Trump Administration is forcing women to pay for their boss's religious beliefs," said ACLU senior staff attorney Brigitte Amiri, in a statement.

The Affordable Care Act, also known as Obamacare, requires employer-provided health insurance policies to include coverage for preventive health care. After the law passed, HHS used its regulatory authority to specify what has to be included in those preventive services and birth control, including "all Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity."

But the policy was controversial from the start.

Several companies and religious groups sued, saying the rule infringed on their religious freedom.

The Obama administration created an exemption for churches and allowed other "religious employers" to opt out by notifying the government. When they did so, the administration would arrange with their insurance companies to provide the coverage directly, without the employers' involvement.

But the Little Sisters of the Poor weren't happy with that workaround and sued.

The group's case, and a second one involving private businesses including the Hobby Lobby chain of craft stores, which has 32,000 employees, went to the Supreme Court.

The court ruled in favor of Hobby Lobby in 2014, saying privately held companies could object on religious grounds. And then, last year, the court issued a split ruling in the Little Sisters case, saying the government shouldn't fine the nuns but ordering the two sides to work out an arrangement that accommodates their religious beliefs.

Before a deal was reached, Trump became president.

At the Rose Garden ceremony in May, he told the Little Sisters of the Poor that he planned to change the rules. "Your long ordeal will soon be over," he promised.

Under the new rule, women who work for Hobby Lobby or the religious group may no longer have access to birth control coverage through the Obama-era workaround. A Hobby Lobby spokesman said the company would have no comment on Friday, and the Little Sisters of the Poor didn't respond to NPR's emails seeking comment.

Hobby Lobby's founder and CEO David Green told reporters in 2013, "Our family is now being forced to choose between following the laws of the land that we love or maintaining the religious beliefs that have made our business successful and have supported our family and thousands of our employees and their families."

HHS officials said they don't expect many companies to seek waivers. They said the group seeking waivers will likely be limited to those about 200 companies and nonprofits that have already sued.

But Palanker says the impact could be a lot bigger. There are a lot of large private companies, she says, whose owners may hold strong religious beliefs but did not want the publicity and expense of suing the federal government.

"A lot of women will retain birth control coverage," Palanker says, "but there will be a lot of women who will lose that coverage."

That means they'll find themselves paying out of pocket. A one-month supply of birth control pills can cost anywhere from $4 to $55 or more, according to

Longer-acting contraception, like an intrauterine device, can cost more than $1,000, says Sarah Lipton-Lubet, a vice president at the National Partnership for Women and Families. She says the new rule is a tool for discrimination against women.

"Women shouldn't be denied access to basic health care based on their employers' religious beliefs," she says. "We all have the right to our religious beliefs. But the way that this rule treats religion is really an excuse to discriminate."

HHS officials say they also plan more stringent enforcement of a provision in the Affordable Care Act that prohibits federal subsidies from being used for insurance policies that cover abortion. The agency will issue guidelines for insurers Friday on how they have to charge women who want abortion coverage at least $12 a year more for such a policy, and they have to keep that money in a separate fund to be used only to pay for abortions.

In addition to the ACLU, Massachusetts Attorney General Maura Healey, and California Attorney General Javier Becerra announced they too plan to file suit opposing the new rule.


UConn Prof: Republican Health Care Bill Could Lead To "Disaster" For Women

June 26, 2017

wnpr | Harriet Jones

Women’s health care is one of the areas most deeply affected by the changes contained in the Republicans' recently revealed reform bill. Some experts in the field have described it as damaging and dangerous.

Medicaid currently covers health care needs for 25 million low-income women in the U.S. For those of childbearing age, the Republican reforms would completely remove coverage for maternity and childbirth.

“My concern is we’re going to have more and more women who aren’t going to get prenatal care, and they’re going to show up at labor and delivery with a disaster,” said Dr. Molly Brewer, the chair of the Department of Obstetrics and Gynecology at UConn.

And she said that women covered by private insurance may not be any better off.

The bill gives states the right to allow insurers to opt out of covering maternity care and birth control, something that’s currently required under the Affordable Care Act.

“So if we’re not providing birth control, and we’re not providing maternity care - how are women going to take care of themselves?” Brewer asked.

In addition, the bill removes all federal funding for Planned Parenthood, which provides care for tens of thousands of low income women in Connecticut.

While the organization has become controversial for its provision of abortion, that’s just a tiny fraction of the services it offers.

“They do pap smears; they do breast screening; they do STD screening; they provide pregnancy counseling; they provide birth control,” said Brewer.

Abortion itself is further restricted by this bill. Any plan provided with tax credits on a state exchange would be prohibited from covering abortion.

Sarah Croucher is the state director of NARAL Pro Choice in Connecticut. She believes that’s not a decision about health care, but about politics.

"This is something we should be deeply worried about," she told WNPR. "This is a way for Repubican senators to roll out an anti-choice agenda across the country. And so this is a way in which federal policy is going to deeply impact the choices available to Connecticut women."

Croucher said the bill represents a misogynist agenda, crafted without the input of women.

"What this is is a tax cut for the very wealthy at the expense of the health of literally millions of women across the country. What that does is literally place women's lives in danger, and I think that's truly disgusting," she said.  

Both Croucher and Brewer stressed that the changes made by this legislation affect not just women, but the health of children.

“I think we’re going to be in a problem. I think it’s going to impact the health of our babies, and that’s going to be the next generation of people in this country,” Brewer said.

Republican supporters say the legislation moves the nation towards a more affordable health care system. Senate Majority Leader Mitch McConnell has said he wants to see a vote on the bill this week.

NARAL, Family Institute Endorse in Legislative Races

October 17, 2016

Hartford Courant | Daniela Altimari

The abortion rights group NARAL and the anti-abortion Family Institute of Connecticut have each announced their endorsements in this fall's legislative races.

Not surprisingly, there is no overlap between the two lists.

The Family Institute of Connecticut Action Committee is backing seven state senate candidates and 21 candidates for the House. All but one -- Democratic Rep. Minnie Gonzalez of Hartford -- are Republicans.

The endorsements were based on candidate questionnaires. The group may release additional endorsements because it has yet to receive responses from all of those running for the legislature. 

In an email to its supporters announcing its endorsements, the Family Institute's political arm said it was most concerned about the candidates "who expressly refused to return our questionnaire or indicated in some other way that they did not want our endorsement... In liberal districts it is understandable but in conservative or swing districts it is worrisome. FIC PAC endorsements can mean the difference between victory and defeat in a competitive race.''

Meanwhile, the NARAL Pro-Choice Connecticut PAC released a list of 57 candidates it is backing this election cycle. The list includes six Republicans running in the House.

"In national political campaigns, choice has been a debated topic, with the presidential ticket providing a clear division between pro-choice Democrats and anti-choice Republicans,'' the group said in a press release. "This division isn’t so clear when we look down ballot in Connecticut, where some Republicans hold similar pro-choice positions to their Democratic rivals."

The Republican House challengers receiving NARAL's endorsement are: Todd Brown of Rocky Hill, John Scott of Groton, Scott Storms of Windsor Locks and Douglas Losty of New Haven. Incumbent Republicans endorsed by NARAL are Aundre Bumgardner of Groton and Prasad Srinivasan of Glastonbury.

NARAL Pro-Choice-CT Chief To Speak On Latest Supreme Court Ruling

July 7, 2016

Nancy On Norwalk | Mark Chapman

NORWALK, Conn. — The Humanists and Freethinkers of Fairfield County (HFFC) has engaged Sarah Croucher, the executive director of NARAL Pro-Choice Connecticut, to discuss the recent U.S. Supreme Court ruling on state attempts to restrict access to abortion clinics.

The event will be held at 6:30 p.m. Monday, July 11, at the Silver Star Diner, 210 Connecticut Ave., Norwalk. The event is free and open to the public.  Food and beverages are available from the restaurant.

“Reproductive rights in the U.S. today seem to present a paradox,” HFFC wrote in announcing Croucher’s visit. “On one hand, attacks on abortion rights threaten to roll back the protection of Roe vs. Wade for many American women. But progressive states such as Maryland and Vermont are passing laws that expand birth control access, with other states such as New York pushing forward with paid family leave. Sarah will discuss the threats to reproductive rights, along with the victories. She will talk about what we can do here in Connecticut to ensure that we are at the forefront of progressive legislation, the new threats that are rising, and the need to stay active in state politics to ensure our freedoms.”

Croucher moved to Connecticut from the United Kingdom nine years ago. She recently made a move from academia (Wesleyan and Columbia Universities) to NARAL, and is looking forward to making sure that Connecticut is one of the strongest states in the nation for reproductive rights.

The Humanists and Freethinkers of Fairfield County “combine reason with compassion, integrating modern understanding of the world with an affirmative life view,” the release states.

For more information on HFFC, including talks, discussions, book group, movie events, and parties, visit

NARAL Honors Blumenthal

September 16, 2015

New Haven Independant | Staff

The following was provided by NARAL Pro-Choice Connecticut.
U.S. Sen. Richard Blumenthal received a special award from NARAL Pro-Choice America in appreciation of his support for women’s reproductive rights.

The award honored Blumenthal as a “champion of choice.”

“I am proud to stand with NARAL in fighting to protect a woman’s right to choose in the most personal of health care decisions. Politicians and partisan politics simply have no place in our clinics and doctors’ offices,” Blumenthal, who has championed women’s rights since his days as attorney general of Connecticut, said. “NARAL is a powerful, passionate voice for women, and I am deeply honored by this award.

“I promise to continue to fight alongside NARAL on behalf of women in Connecticut and across this nation to ensure every woman has access to the medical services they need and deserve—without disgraceful and dangerous partisan interference,” Blumenthal said.

“It is good to take a breath and remember those working for women’s rights in Washington, D.C., and to show appreciation for Senator Blumenthal’s diligence and support,” said Shannon Lane, Board Chair of NARAL Pro-Choice Connecticut.

Abortion Issue Runs Through Some Key Connecticut Campaigns

August 22, 2010

Hartford Courant | Daniela Altimari

Abortion is a surprising subtext in a number of key political campaigns in Connecticut this year.

No one expects the outcome of any race to turn solely on the issue, especially in an election cycle dominated by the economy. Yet the success of several candidates who oppose legalized abortion in this reliably blue state has galvanized activists on both sides of the divide.

The shift is most visible within the Republican Party, where traditional Yankee moderation on social issues has not held sway with a number of GOP candidates on the issue of abortion. Among those clear about their anti-abortion stance are Martha Dean, a candidate for attorney general, and Mark Boughton, the GOP nominee for lieutenant governor. Dean and Boughton both beat primary opponents who support abortion rights. (On the Democratic side, abortion foe Michael Jarjura lost his party's nomination for state comptroller to Kevin Lembo, who was endorsed by NARAL Pro-Choice Connecticut.)

"'In Connecticut, traditionally the Republican voter has been pro-choice,'' said Jillian Gilchrest, executive director of NARAL Pro-Choice Connecticut, "but this is a different kind of campaign and a different kind of election year.''

The success of Dean and Boughton prompted Peter Wolfgang, executive director of the Family Institute of Connecticut, to call 2010 "a breakthrough year for the pro-life movement'' in the state.

"Connecticut is not going to elect a Henry Hyde or a Rick Santorum in the next year or two,'' Wolfgang said, citing two widely known anti-abortion advocates on the national level. "But there is movement in our direction. … Below that veneer of New England Republican enlightenment, there is still a wellspring of pro-lifers to be found."

'Not A Side Issue'

Dean handily beat back a challenge from her fellow Republican, the NARAL-endorsed Ross Garber, to win the party primary earlier this month. She said she does not expect her anti-abortion stance to play a major role in her race against Democrat George Jepsen, who favors abortion rights.

"This is not an issue for the attorney general's office,'' Dean said. "Abortion policy is under the exclusive purview of the legislature.''

But, she added, it's not a side issue, either. "I would never characterize life as a side issue,'' Dean said. "I think voters want to know who candidates are as individuals. They want to know about their personal beliefs. I've been very open about who I am out of respect for the voters. I've been open about a variety of issues I have no impact over as attorney general. It gives voters an insight into your character, it gives them some insight as to the thinking process you go through."

Although Dean's stance is clear, others walk a more delicate line. Republican Linda McMahon, a political newcomer running for U.S. Senate, defines herself as "pro-choice, with a caveat." She supports requiring minors to obtain parental consent before undergoing an abortion and also favors a ban on a medical procedure known as "partial-birth abortion."

McMahon has been lobbied by both opponents and supporters of abortion rights. Woody Bliss, chairman of the Connecticut chapter of the Republican Majority for Choice, has spoken with her several times and plans to meet with her again soon. The group had donated to the campaign of her now-vanquished GOP opponent, Rob Simmons, a strong advocate of abortion rights.

Whenever Bliss meets with a candidate, he says, he tells that candidate that more than 70 percent of state residents define themselves as "pro-choice.''

"I counsel them: 'You may have religious convictions or [whatever] but that dog doesn't hunt in Connecticut,' '' Bliss said. "We try and sit down and talk to them, especially newly running candidates, and become a source of information to them [and] educate them.''

Wolfgang, too, has met with McMahon, former CEO of World Wrestling Entertainment. "She may be a harbinger of things to come in the abortion issue,'' Wolfgang said. "Simmons staked out a position so extreme on abortion that all Linda McMahon had to do was be a little to the right of him.''

Yet Wolfgang said he is in "watch and see mode" when it comes to McMahon's candidacy. "She reached out to me early and often and she's running one of the most professional campaigns I've seen,'' he said. "The questions that linger have to do with the WWE and its effect on the popular culture."

NARAL called McMahon "an untested wild card" and has embraced her Democratic opponent, Richard Blumenthal.

Himes-Debicella Race

The abortion debate is likely to resonate strongly in the state's 4th Congressional District, home to an affluent base of voters who tend to favor fiscally conservative, socially moderate candidates. Republican U.S. Rep. Chris Shays, who favored abortion rights but also opposed "partial-birth abortions," represented the district for more than two decades before losing to Jim Himes in 2008.

Both Himes and his current GOP opponent, Dan Debicella, identify themselves as "pro-choice." But the Himes campaign senses softness in Debicella's support for abortion rights. When he served in the state Senate, Debicella was one of three senators to vote against a bill requiring all hospitals, even those run by the Catholic church, to offer emergency contraception to rape victims.

"I think the Himes campaign will want to highlight that vote,'' said Gilchrest of NARAL Pro-Choice Connecticut.

Himes is doing just that.

"Dan Debicella's vote against making emergency contraception available to rape victims is radical and wrong,'' said Himes' campaign manager, Mark Henson. "The economy is our main focus, but that's not the only area where Debicella is wrong for southwest Connecticut: he votes against the environment, he votes against consumers, he's against Wall Street reform, and he votes against the interests of women and families."

Suburban women are a key voting bloc in Connecticut, and a new group affiliated with the Himes campaign aims to capture their support. Himes "is also a firm believer that women should have complete control over their reproductive rights, without interference from politicians or government,'' states a press release announcing the creation of the group, Women for Himes.

Debicella's campaign manager, Jason Perillo, accused the Himes camp of misrepresenting Debicella's views.

"Jim Himes is trying to draw a distinction between himself and Dan Debicella that doesn't exist in order to distract voters from his failures on the economy,'' Perillo said. "Dan Debicella has been a strong advocate for women. He co-sponsored laws that help police departments convict rapists and that double the minimum sentence for abusive spouses. He is pro-choice. He proposed legislation to increase funding for rape crisis centers and increase breast cancer care funding.''

Debicella won kind words, if not the endorsement, of the Family Institute's Wolfgang.

In Wolfgang's view, Debicella isn't the perfect candidate. But the Family Institute's goal is "to build a bench of serious candidates who are pro-life, or open to the pro-life message, who can eventually get to Congress,'' he said, citing as examples Debicella and Republican Sam Caligiuri, running for Congress from the 5th District.

Wolfgang said he is aware of the realities facing Connecticut candidates who run on a platform that opposes rights to an abortion.

"A sure-loser, pro-life candidate who says all the right things then goes down to noble defeat won't save a single unborn life,'' Wolfgang said. "But a Caligiuri victory, even a Debicella victory, can. That's why 2010 is such a breakthrough year for the pro-life movement in Connecticut.''

Should Church Control Access To Health Care?

June 21, 2010

The Washington Post | Nancy Northup, President of Center for Reproductive Rights

Opinion pages of U.S. newspapers lambasted a decision by St. Joseph’s Hospital, a Catholic institution in Phoenix, over the excommunication and demotion of a nun. Sister Margaret McBride was a head administrator at St. Joseph’s Hospital who compassionately granted a critically ill young woman permission to have an abortion because continuing the pregnancy posed an immediate and grave risk to her life.

While many focused on the Church’s “automatic excommunication” of McBride, an action squarely within the Church’s religious purview, only a few addressed the secular punishment – her demotion from head administrator. In that action, the St. Joseph’s Hospital was acting as a provider to the public of essential health care. As such, it should not be able to penalize an employee who acted within legal boundaries to deliver life-saving medical care, nor should it be permitted to withhold needed care for those who find themselves in its hospital wings. Indeed, a decision to let the young woman die instead would have been medical negligence as well as a grave violation of her legal and human rights.

The St. Joseph’s story is, sadly, unsurprising. As human rights lawyers who work around the globe, we repeatedly confront the tragic consequences of the Catholic Church’s sustained hostility to reproductive health services when it imposes its theology on public policy and the provision of health services to the public. In countries where the Church wields considerable power, the repercussions for women’s lives are palpable.

In Kenya, for example, Catholic leaders are currently threatening to scuttle the adoption of a new constitution-widely seen as critical to ending political bloodshed there-because it contains a clause on abortion. The provision in fact would forbid abortion except in emergencies or when a woman’s life or health is in danger. But the Church would prefer to preserve the narrower exceptions on the books today, which criminalize abortion except to save the woman’s life. Poverty, a dearth of sexuality education, and sexual violence all fuel an epidemic of unintended pregnancy. Ultimately, Kenyan women ingest bleach, detergent, or other dangerous liquids, insert sharp objects or resort to back-alley abortions . Every year, tens of thousands die or suffer debilitating damage to their health.

In Europe, the Catholic hierarchy has become especially effective in some former Eastern Bloc countries, resulting in backsliding on access to reproductive health services. In 2008, when a Catholic priest in a Polish town found out that a 14-year-old girl was seeking an abortion (for grounds legal under Polish law), he unleashed a campaign of harassment against her and her mother. They were besieged by protests, phone calls, and text messages. The priest cornered the girl alone in her hospital room in an attempt to convince her to continue her pregnancy. He then helped persuade authorities to take her away from her parents and place her in a state-run juvenile center. The girl and her mother are now suing Poland in the European Court of Human Rights. It’s the fourth abortion-related case against Poland in the court that we’ve been involved in over the last six years.

The Philippines, where the government is closely tied to the Catholic hierarchy, provides another example. Not only is abortion is criminalized with no clear exceptions, but due to the Church’s influence, the government strongly discourages contraception. In Manila, an order by the mayor pulled every birth control pill and condom off the shelves of public health facilities, and forbade even sterilization.

For the population in Manila, most who live below the poverty line, the policy banning modern methods of contraception causes irreparable damage. It’s not uncommon to see families with six or more severely malnourished children, living in one-room shacks surrounded by garbage and streams of sewage, and facing very few prospects for relief. Understandably, without access to affordable contraception, over half-a-million Filipino women in desperate circumstances turn to unsafe abortion each year. As in Kenya, the methods are crude and painful, and the subsequent deaths and complications suffered by women can only be described as a public health crisis.

This year at home, we saw the U.S. government give the Conference on Catholic Bishops veto power over the health-care reform bill, and in the end, millions of American women were left with a policy that restricts insurance coverage for abortion services even for those who pay for their insurance with their own hard-earned dollars.

The Catholic Church promises to serve the interests of the poor and marginalized, but its position on reproductive health is deeply at odds with those laudable goals. Societies thrive when women thrive – when they are able to finish their education, decide the number and spacing of their children, and live in dignity and equality. Depriving women of the ability to control their reproductive health and fertility does not create a moral and just world. It only further traps women, their families, and their communities in poverty and despair.

The Catholic Church, like any religion, is sovereign in the realm of its theology, liturgy, practice, and requirements of membership. But when it chooses to provide health services to the public as in the case of Saint Joseph’s Hospital, or enters the realm of public policy debates in Kenya, the Philippines, Poland or the U.S., the governing standard must be the basic human rights of women to control their health and lives.

Fireworks over New "Morning After Pill"?

June 17, 2010


A Food and Drug Administration advisory panel was slated to meet Thursday to discuss approval of an emergency contraceptive pill, dubbed "Ella," that's already sold in 22 European countries.

"Ella" is expected to prove highly controversial here.

It's designed to prevent pregnancy if taken up to five days after intercourse, two more than "Plan B."

On "The Early Show" Thursday, CBS News Medical Correspondent Dr. Jennifer Ashton observed that, "Obviously, there are heavy moral, ethical, social, even financial, political issues with this. We're going to stick to the medical ones, which really, for the most part -- most experts are saying the real big difference between Ella and Plan B is just the duration of time in which they can be used."

One thing raising eyebrows, co-anchor Harry Smith, is the chemical similarity between Ella and the so-called abortion pill, RU-486.

Plan B, Ashton explained, "is made of Levonorgestrel, which is a progesterone-like hormone compound. It can prevent pregnancy up to 72 hours after intercourse ... and it's about 85 percent effective. Ella, or the new one, works up to 120 hours, or five days. (It contains) Ulipristal Acetate, which works to moderate the progesterone effects on ovaries and possibly the uterus."

You don't need a prescription for Plan B in the U.S. If Ella is OK'd, it would only be available with a prescription.

As for Ella's side effects, Ashton says, the most common ones reported include nausea, headaches, abdominal or pelvic pain, menstrual-like pain, fatigue and dizziness -- you're always gonna see those things."

What will the panel and FDA be looking at in considering whether to approve Ella?

"Is it effective," Ashton responded, "does it work in the 120 hours, as it's said to? Is it safe? Obviously, always important. Do there need to be special recommendations for subpopulations, in terms of obese women, and will there be the potential for off-label use? They're going to have to address that."

FDA advisory committees don't have the final word on matters they take up. They're made up of outside experts who make recommendations to the agency, which makes the final decision -- though it usually heeds the advice of the panels.

FDA Panel To Decide On U.S. Distribution Of Controversial Contraceptive Pill, Ellaone

June 16, 2010

ABCNews | Courtney Hutchison and ABC News Medical Unit

A controversial, longer-lasting morning after pill has received the unanimous backing of a Food and Drug Administration panel of experts.

The panel today recommended that ellaOne, a one-pill treatment that has proved effective in preventing pregnancy up to five days after unprotected intercourse, be approved for use in the United States. Although the FDA is not required to follow the panel's recommendation, it usually does.

EllaOne, made by French drugmaker HRA Pharma, was approved for use in Europe last year, but discussion of selling it in the U.S. has spurred controversy as critics of the drug say that it is not so much emergency contraception as emergency abortion.

"This is a thinly veiled attempt to get an abortion drug over-the-counter," said Dr. Donna Harrison, president of the American Association of Pro-Life Obstetricians and Gynecologists.

Because fertilization of egg and sperm can only be prevented within 24 hours of intercourse if the woman has just ovulated, Harrison argues, any emergency contraceptive that is effective five days after sex most likely works by preventing the already-fertilized egg from implanting in the uterus. If one believes pregnancy begins with fertilization, that action would be considered abortion.

"To label this as emergency contraception when it's clearly an abortive action is dishonest," said Harrison.

But according to Dr. Lauren Streicher, clinical instructor in obstetrics and gynecology at Northwestern Medical School, believing that emergency contraception is equivalent to an abortion "is a big misconception."

It takes five to seven days for the fertilized egg to implant in the uterus and begin to grow, she says. She argues that if one interrupts the process before this implantation takes place, pregnancy never occurs.

"There are many people who are reluctant to take emergency contraception because they think it's abortive, but it's apples and oranges," she said. "With emergency contraception, it's really to stop a pregnancy from occurring."

Not surprisingly, these differing opinions hinge on the same definitional controversy that has plagued the abortion debates for decades: at what point does pregnancy begin -- when the egg is fertilized, or when it implants in the uterus?

Because these two events can occur up to a week apart, emergency contraceptives, especially ellaOne with its five-day window for use, walk the line in this controversy.

New Drug Revives Old Debates

Available by prescription in Europe since September, ellaOne is 50 percent more effective -- and effective for 48 hours longer -- than the "morning-after pill" or Plan B, according to new research recently in the Lancet.

In the study of nearly 1,700 women between the ages of 16 and 36 who sought emergency contraception, women who took a morning-after pill had a 2.6 percent chance of becoming pregnant, while women who took ellaOne had only a 1.8 percent chance, and a five-day window of opportunity to take the pill.

Researchers noted that all forms of emergency contraception are more effective the sooner after intercourse they are taken, but ellaOne was found to be even more effective -- two thirds more -- than Plan B when taken within 24 hours of intercourse.

For those who support the use of emergency contraceptives, ellaOne is considered an important and vital innovation that will provide more reliable pregnancy prevention.

"This is great news [because] the need for emergency contraception is so great," Streicher said, pointing out that 50 percent of pregnancies are unplanned. Among those, she said, half involve couples using contraceptives that either malfunctioned -- like a condom breaking -- or were insufficient, like a diaphragm used without spermicidal foam.

"People often think unplanned pregnancies are [the consequence of] people being irresponsible, but that's not [usually] the case. It's often from a failed attempt at contraception -- that's why it's so important that we have emergency contraception."

Streicher says the longer window for taking ellaOne fills a much-needed gap in reproductive health because those who most often have unwanted pregnancies -- teenagers and those without access to adequate gynelogical care -- cannot always get to a doctor for treatment within a day or two.

While teens 17 and older can get Plan B over-the-counter, those under 17 would need to see a doctor, and it is these girls that may be most affected by a three-day time limit on the existing emergency contraceptive pills, Streicher says.

"In a perfect world you want anyone to use emergency contraception within 24 hours, but the reality is that having this five-day option is going to decrease the number of undesired pregnancies," she said.

Emergency Contraception -- A False Sense of Reproductive Security?

But this more powerful form of emergency contraception raises several concerns for anti-abortion rights advocates.

Harrison said that unlike Plan B, ellaOne is chemically similar to the common abortion pill RU-486, which is taken to abort a fetus as late as two months into pregnancy.

She believes that ellaOne is likely to carry the same risks as RU-486, such as excessive bleeding and infection, and said her biggest concern is the often overlooked risks this new drug could pose to the women who take it.

Harrison cites one study of Plan B, currently available over-the-counter, in which more than half the women who participated didn't know how to use the pill correctly. Incorrect use can lead in a failure of the drug and/or adverse side effects.

Harrison fears that if ellaOne were to be brought to the states as another over-the-counter option, the chance for misuse and adverse side effects would be high.

If the FDA approves ellaOne for use in the states, however, it will be given only through a doctor, not over-the-counter.What's more, in a recent study on the drug, the only serious adverse event researchers found with ellaOne was dizziness, and this only occurred in one subject.

Another concern among pro-life critics of the drug is the fear that it will give women a sense of false security, leading them to be more lax about using contraception or practicing abstinence.

"Habits follow technology. Contraception was supposed to prevent an abortion, but it has led to an increase in abortion when people got used to it being around. The increased effectiveness of technology [like this] means people will relax that much more on their inhibitions," said Stephen Phelan, communications manager for Human Life International, an anti-abortion missionary organization.

But Streicher countered that in her twenty years of experience, and in the literature on the topic, this fear is unfounded.

"Emergency contraception does not increase the chance that someone is going to not use contraception or that someone is going to start sexual activity at an earlier age. On the contrary, it is necessary option for women who have that rare contraception failure or...even more importantly, for those who are raped."

Del. Marshall says abortion remark misconstrued, apologizes

February 23, 2010

The Washington Post | Fredrick Kunkle

Virginia Del. Robert G. Marshall apologized Monday to people with disabilities for remarks suggesting that women who have abortions risk having later children with birth defects as a punishment from God.

Marshall (R-Prince William) made the comment Thursday at a news conference calling for an end to state funding to Planned Parenthood. Calling the nonprofit group "Planned Barrenhood," Marshall joined the Virginia Christian Alliance, several African American ministers and others who blamed the abortion provider for a host of social ills.

"The number of children who are born subsequent to a first abortion who have handicaps has increased dramatically. Why? Because when you abort the firstborn of any, nature takes its vengeance on the subsequent children," Marshall said.

"In the Old Testament, the firstborn of every being, animal and man, was dedicated to the Lord," he added. "There's a special punishment Christians would suggest -- and with the knowledge that they have in faith, it's been verified by a study from Virginia Commonwealth University -- first abortions, of a first pregnancy, are much more damaging than later abortions."

The VCU study he referred to was published in 2008 in the Journal of Epidemiology & Community Health and suggested that there is a higher risk of premature birth and low birth weight in children born to women who have had an abortion.

Few seized on the remarks at the time Marshall made them. But outrage built on social networking sites and political blogs after some Virginia newspapers picked up the story from Capital News Service, a program at VCU's School of Mass Communications.

"I am amazed that someone has been able to slander my child, my wife and my God in one comment," said Brett Wills, 38, a Staunton paint salesman who is the father of an 8-year-old boy with autism. "To imply that someone's disabilities are an act of God to punish women in an immoral society is just the most outrageous thing I've ever heard."

An online petition called for Marshall's resignation.

Marshall, appearing shaken by criticism gone viral, said his remarks had been shortened in some news reports and twisted out of context.

Marshall said his broader point on Thursday was that he had collected a substantial amount of published medical research suggesting that abortions raise the risk of miscarriage and birth defects in subsequent pregnancies and that those findings echoed the Bible's teaching that abortion is wrong.

"The point is, there are profound consequences to the act of abortion," Marshall said.

Late Monday, his office released a formal apology. Addressing the story that his office said had "conveyed the impression that I believe disabled children are a punishment for prior abortions," Marshall explained:

"No one who knows me or my record would imagine that I believe or intended to communicate such an offensive notion. I have devoted a generation of work to defending disabled and unwanted children, and have always maintained that they are special blessings to their parents. Nevertheless, I regret any misimpression my poorly chosen words may have created as to my deep commitment to fighting for these vulnerable children and their families."

Marshall said in an interview that his belief in the sanctity of all life was demonstrated by his commitment to seeking state-mandated insurance coverage for specialized therapy needed by autistic children, a stance so at odds with his own party's that he said he was threatened with expulsion from the Republican caucus last year.

Nancy Mercer, executive director of ARC of Northern Virginia, an advocacy and assistance group for the disabled, said that Marshall has been supportive of the needs of people with disabilities but that his remarks on Thursday were insensitive, particularly when budget cuts threaten services for them.

"Families are reeling, and then to have this come on top of it added insult to injury," she said.

Even some allies in the cause distanced themselves from Marshall's remarks.

"I think there are studies medically demonstrating that there are future health risks to abortion," said Chris Freund, a spokesman for the conservative Family Foundation of Virginia. "To say that's evidence of God's judgment goes too far."

Jennifer McMillen, whose 8-year-old son has autism and cerebral palsy, said she was outraged.

"Quite honestly, I don't care what he intended to say," said McMillen, 37. "His comments were inappropriate and unacceptable, and something needs to be done."

Abortion Rights Supporters Squabble Over Bill

February 21, 2010

The New York Times - City Room | Nicholas Confessore

ALBANY — For years, lawmakers in New York have been trying to pass legislation that would protect existing abortion rights by codifying the Supreme Court’s 1973 Roe v. Wade decision, which guarantees rights broader than the laws still on New York’s books.

The legislation, never a winner when Republicans controlled the State Senate, has been the top priority of abortion rights groups since Democrats took control of the chamber last year.

But as Albany’s legislative session draws to a close, a split is emerging between the abortion-rights group Naral Pro-Choice New York and the Senate Democrats, who have not yet scheduled the bill for a vote on the floor.

Under current state law — overriden by the 1973 Supreme Court decision but still on the books — women in New York can have a late-term abortion only if their life is in immediate danger. The new bill would add to that an exception for a woman’s health, as currently permitted under Roe. 

Advocates say the legislation would clear up confusion that exists among some health care providers while guaranteeing abortion rights if the Supreme Court reverses its decision in the future.

After weeks of trying to whip up the 32 votes needed for passage, Naral has asked for an immediate up-or-down vote on the bill — and let the chips fall where they may. 

“Our feeling is that going into an election year, on an issue that is as fundamental as women’s reproductive rights, voters need to know where their legislator stands,” said Kelli M. Conlin, the group’s president. 

The advocates are motivated, in part, by the Senate Democrats’ willingness to bring to a vote other bills where the margin of support was uncertain, including a bill supported by gun control advocates that went to the floor last week, only to be pulled midvote when it seemed likely to fail.

“We think we have the votes,” Ms. Conlin said. “We feel good about getting some Republican votes. We’re just asking for the Democratic leadership to put it to a vote, as they have on other issues this year.”

But that stance is at odds with other reproductive rights advocates working on the issue, such as the Family Planning Advocates of New York State, which wants more time to lobby lawmakers, especially the Republicans needed to push the bill over the top. (At least two of the chamber’s 32 Democrats have said they will vote against it.) The bill’s Senate sponsor, Andrea Stewart-Cousins, a Westchester County Democrat, has the same view. 

“The bill hasn’t come on the floor because it doesn’t have the votes to pass,” Senator Stewart-Cousins said. “When the advocates came to me, they had about 20 Democrats. I spoke to my Democratic colleagues, and I got 26 sponsors on the bill. We just need the votes. I think it is really too important to put a bill out there, again, that for whatever the reason, fails.”

Tracey Brooks, the president of Family Planning Advocates of New York State, said she also wanted to see an up-or-down vote before the end of session. But Ms. Brooks said that her group, a coalition of dozens of health care providers and civic and religious groups, was waiting before asking for a floor vote.

“Family Planning Advocates is not asking for the bill to be moved because we’re not done with the work we need to do to get it to the floor,” Ms. Brooks said. “We are confident we will pass it this year.”

Ms. Brooks added: “There are other advocates who show up in town once in a while. We’re the ones who are there five days a week. When we walk into the leadership and ask for the bill to move, the bill will move. It’s just not there yet.” 

One reason for the difference? Naral is in some respects the most politically oriented of the state’s abortion-rights groups: The group and its affiliated political action committee spent roughly $800,000 during the last election cycle, while its endorsement of a candidate functions as seal of approval for an important bloc of wealthy female donors based in New York City. The group is thus eager to get lawmakers on the record, especially any Republicans who have privately pledged their support for the bill.

“I’d like to know where our Republicans stand,” Ms. Conlin said. “I don’t want to work against Republicans who are for this bill.”

But Senate Democrats have other concerns. Last year’s failure to pass a bill legalizing same-sex marriage — after votes promised by gay-marriage advocates failed to materialize — still sears them. 

This year, they say, Republicans have previously offered votes in private and then left Democrats hanging on the floor, embarrassing the party and its Senate leader, John L. Sampon, a Brooklyn Democrat. They also fear that a failure on the abortion bill, known as the Reproductive Health Act, could sap political momentum for abortion rights. (The matching Assembly bill is considered a much easier lift because Democrats hold a much wider majority there, but it has never passed that chamber before, either.)

“The advocates say, get people on the record,” Ms. Stewart-Cousins said. “And maybe that’s what advocates do. I’m a legislator. I’m trying to pass the bill.”

The President’s Budget: A Mixed Bag for Women’s Health

February 16, 2010

RH Reality Check | Susan A. Cohen, Guttmacher Institute

In his proposed Fiscal Year 2011 budget, President Obama increases funding for teen pregnancy prevention and international reproductive health, but neglects abortion rights.

On February 1, President Obama sent his proposed budget for the fiscal year starting October 1, 2010 to Congress. On the domestic front, the administration’s top priority for reproductive health and rights is teen pregnancy prevention, for which the administration is recommending a significant boost in funding. With the abstinence-only-until-marriage approach of the bygone era defeated, the new initiative will emphasize an evidence-based approach to reducing teenage pregnancy and the underlying factors that put teens at risk.

On the international front, the administration has unveiled the outlines of the Global Health Initiative that the president first announced last year. Family planning and reproductive health programs and maternal and child health programs figure prominently, and the administration is recommending significant increases in both areas.

On abortion rights, however, the president is taking a pass. There can be little doubt that the fact that health care reform legislation remains in limbo has something to do with that—with the options on an ultimate compromise on abortion coverage ranging from terrible to horrible.

Also tied up in health care reform is the fate of two other key provisions: one to make it easier for states to expand eligibility for family planning under Medicaid and a second to establish new funding for home visiting programs for low-income first-time mothers.

Domestic Family Planning: Modest Improvement
A year into the Obama administration, its much-hypedinitiative to reduce unintended pregnancy and thereby reduce the need for abortion has yet to emerge. In the meantime, funding for domestic family planning is nearly stagnant. As it did last year, the Title X family planning program would receive a 3 percent, or $10 million, increase, which would bring funding to $327.4 million. Many publicly funded family planning providers are struggling to meet a growing need for subsidized contraceptive care, which is driven by more women wanting to postpone childbearing during tough economic times.

Sex Education: Where the Action Will Be
Teen pregnancy prevention is likely to emerge as a key component of the president’s “common ground” strategy around reducing the need for abortion. The issue may be especially urgent after a recent Guttmacher study found that, for the first time in over a decade, teen pregnancy rates rose in 2006. The administration’s budget proposes to increase the teen pregnancy prevention program created last year by $19 million, bringing the total to $133.7 million. This new initiative is designed to fund proven, as well as promising, programs. It will be housed within the newly created Office of Adolescent Health, which will support and expand teen pregnancy prevention efforts while also addressing a broader range of adolescent health issues, such as those related to mental health, violence, substance use, nutrition and physical activity, and tobacco use. In addition, the administration is recommending that Congress create another program of grants to the states, funded at $50 million per year, to reduce teen pregnancy.

Fatherhood, Marriage and Families: A New Take on Old Themes
The budget proposes to redirect and expand existing funding to a new Fatherhood, Marriage and Families Innovation Fund. The proposed $500 million would support evaluation of comprehensive responsible fatherhood programs and efforts geared toward improving child outcomes by helping custodial parents with serious barriers to self-sufficiency. Funded activities would focus on barriers to employment and could include interventions like home visits, subsidized employment, transitional jobs, and mental health and substance abuse treatment.

Access to Abortion for Low-income Women: Not This Year
As last year, the administration has refrained from even asking Congress to consider repealing the Hyde Amendment banning federal abortion funding under Medicaid. Abortion funding restrictions riddle the federal budget and, technically speaking, come up for review annually on the various appropriations bills. Beyond Medicaid, these funding restrictions ban abortion coverage under the Federal Employees Health Benefits Program, for Native American women seeking care at Indian Health Service facilities, for Peace Corps volunteers and for women in federal prison. Last year, the president did at least ask Congress to repeal the ban on Washington, D.C.’s ability to pay for abortions with its own funds for its residents on Medicaid, the way states have the option to do. Congress agreed, so that new policy would go forward into FY 2011 under the president’s budget.

International Family Planning and Reproductive Health: Steady Progress
Preventing unintended pregnancy is a core goal of the administration’s Global Health Initiative. According to the president’s budget proposal, support for international family planning and reproductive health programs would increase by about 8% to approximately $700 million, $50 million of which would go to the United Nations Population Fund (UNFPA). The increase is in keeping with Secretary of State Hillary Clinton’s January speech, in which she declared the U.S. government’s renewed support for and dedication to international family planning and reproductive health programs.

Maternal and Child Health Globally: A Big Leap Forward
Efforts to reduce maternal mortality and improve maternal health would gain significantly under the president’s proposal, with its new focus on maternal and newborn health. By recommending a 28 percent increase in funding, administration officials say they want to make up for lost time in this neglected area, especially in light of the looming deadlines to meet Millennium Development Goal 5, which calls for measurable improvements in maternal health by 2015. The budget proposal notes that the maternal and child health program “will also actively invest in integrating across all health programs, particularly family planning, nutrition and infectious diseases.” A 2009 study by Guttmacher and UNFPA found that maternal deaths in developing countries could be slashed by 70 percent and newborn deaths cut nearly in half if the world doubled investment in family planning and pregnancy-related care.

Global Health Initiative: Up and Running
Along with the budget, the administration published an initial paper providing an overview of the Global Health Initiative. A stated goal of the initiative is to invest a total of $63 billion between FY 2009 and FY 2014 on key global health programs. However, for FY 2011 the administration is recommending $8.5 billion, raising doubts about the trajectory for achieving that funding goal. Among its targets, the initiative calls for preventing 54 million unintended pregnancies by increasing contraceptive prevalence to 35 percent across assisted countries, as well as decreasing maternal mortality by 30 percent by preventing 360,000 deaths across assisted countries.

A main focus of the initiative is to have the various global health programs (including those on HIV, family planning, pregnancy care and nutrition) work better together toward saving lives and improving health in developing countries. In addition, the Global Health Initiative seeks to increase the focus on information and services for adolescent girls, including providing support for “adolescent-friendly health services; behavior change messages promoting healthy reproductive behavior and delaying age of marriage; prevention of HIV and unintended pregnancy; and prevention and treatment of neglected tropical diseases.” The details are still evolving.

Rise In Teenage Pregnancy Rate Spurs New Debate On Arresting It

January 26, 2010

The Washington Post | Rob Stein

The pregnancy rate among teenage girls in the United States has jumped for the first time in more than a decade, raising alarm that the long campaign to reduce motherhood among adolescents is faltering, according to a report released Tuesday.

The pregnancy rate among 15-to-19-year-olds increased 3 percent between 2005 and 2006 -- the first jump since 1990, according to an analysis of the most recent data collected by the federal government and the nation's leading reproductive-health think tank.

Teen pregnancy has long been one of the most pressing social issues and has triggered intense political debate over sex education, particularly whether the federal government should fund programs that encourage abstinence until marriage or focus on birth control.

"The decline in teen pregnancy has stopped -- and in fact has turned around," said Lawrence Finer, director of domestic research for the Guttmacher Institute, the nonprofit, nonpartisan research group in New York that conducted the analysis. "These data are certainly cause for concern."

The abortion rate also inched up for the first time in more than a decade -- rising 1 percent -- intensifying concern across the ideological spectrum.

"One of the nation's shining success stories of the past two decades is in danger of unraveling," said Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy. "Clearly, the nation's collective efforts to convince teens to postpone childbearing must be more creative and more intense, and they must begin today."

The cause of the increase is the subject of debate. Several experts blamed the increase in teen pregnancies on sex-education programs that focus on encouraging abstinence. Others said the reversal could be due to a variety of factors, including an increase in poverty, an influx of Hispanics and complacency about AIDS, prompting lax use of birth control such as condoms.

"It could be a lot of things coming together," said Rebecca Maynard, a professor of economics and social policy at the University of Pennsylvania. "It could be we just bottomed out, and whenever you are at the bottom, it tends to wiggle around. This may or may not be a sustained rise."

The report comes as Congress might consider restoring federal funding to sex-education programs that focus on abstinence. The Obama administration eliminated more than $150 million in funds for such groups, but the Senate's health-care reform legislation would reinstate $50 million.

The new findings immediately set off a debate over funding. Critics argued that the disturbing new data were just the latest in a long series of indications that the focus on abstinence programs was a dismal failure.

"Now we know that after 10 years and over $1.5 billion in abstinence-only funding, the U.S. is lurching backwards on teen sexual health," said James Wagoner of Advocates for Youth, a Washington advocacy group.

Supporters of abstinence programs, however, said the findings provided powerful evidence of the need to continue to encourage delayed sexual activity, not only to avoid pregnancy but also to reduce the risk for AIDS and other sexually transmitted diseases.

"Research unmistakably indicates that delaying sexual initiation rates and reducing the total number of lifetime partners is more valuable in protecting the sexual health of young people than simply passing out condoms," said Valerie Huber of the National Abstinence Education Association, who blamed the increase on several factors.

"Contributors include an over-sexualized culture, lack of involved and positive role models, and the dominant message that teen sex is expected and without consequences," Huber said. The Obama administration is launching a $110 million pregnancy prevention initiative focused on programs with proven effectiveness but has left open the possibility of funding some innovative approaches that include encouraging abstinence.

The rate at which U.S. teenagers were having sex rose steadily through the 1970s and 1980s, fueling a sharp rise in teen pregnancies and births. That trend reversed around 1991 because of AIDS, changing social mores about sex and other factors, including greater use of contraceptives, which pushed the U.S. teen pregnancy rate to historic lows.

The U.S. rates still remained higher than those in other industrialized countries.

The decline in teen sexual activity had leveled off starting about nine years ago, and the teen birth rate began to increase in 2005. It wasn't known before if the increase was due to more pregnancies or fewer abortions and miscarriages. For the first time, the new analysis uses those factors in calculating the teen pregnancy rate.

The analysis examined data on teenage sex and births collected by the federal Centers for Disease Control and Prevention's National Center for Health Statistics and data on abortions collected by the CDC and Guttmacher -- the two best sources of such data.

The abortion rate among teenagers rose 1 percent in 2006 from the previous year -- to 19.3 abortions per 1,000 women in that age group, the analysis found. Taking that and miscarriages into account, the analysis showed that the pregnancy rate among U.S. women younger than 20 in 2006 was 71.5 per 1,000 women, a 3 percent increase from the rate of 69.5 in 2005. That translated into 743,000 pregnancies among teenagers, or about 7 percent of women in this age group.

"When birth rates go up and down, it could be the result of kids getting fewer abortions," said John Santelli, a professor of population and family health at Columbia University. "This shows that it's a true rise in pregnancies."

The rate increase was highest for blacks. Among blacks, the rate increased from 122.7 per 1,000 in 2005 to 126.3. For Hispanics the rate rose from 124.9 per 1,000 women to 126.6. Among whites, the rate increased from 43.3 per 1,000 women to 44.0.

Male Abusers Often Sabotage Birth Control With Partners

Study found physical violence often accompanied by attempts to get young women pregnant

January 25, 2010

BusinessWeek | Randy Dotinga

A new report says that male partners of teenage girls and young women who engage in physical and sexual violence also often try to sabotage the birth control the women are using.

The study, which appears online in the January issue of Contraception, also finds that women who experience both birth-control sabotage and violence from their partner are twice as likely to have an unintended pregnancy.

"This study highlights an under-recognized phenomenon where male partners actively attempt to promote pregnancy against the will of their female partners," study author Elizabeth Miller, an assistant professor of pediatrics in the University of California at Davis School of Medicine, said in a news release from the school. "Not only is reproductive coercion associated with violence from male partners, but when women report experiencing both reproductive coercion and partner violence, the risk for unintended pregnancy increases significantly."

The study was conducted from 2008-2009 at five health clinics that deal with reproductive issues in Northern California. About 1,300 women aged 16 to 29 took part by responding to a computerized survey.

About 15 percent said they'd experienced birth-control sabotage, and more than half reported physical or sexual violence from a partner. More than one-third of those who said they had been the victim of partner violence also acknowledged experiencing either pregnancy coercion or birth-control sabotage, the researchers found.

"We have known about the association between partner violence and unintended pregnancy for many years," study senior author Jay Silverman, an associate professor of society, human development and health in the Harvard School of Public Health, said in the news release. "What this study shows is that reproductive coercion likely explains why unintended pregnancies are far more common among abused women and teens."

Birth Weights Fell From 1990 to 2005

Researchers Can't Explain the Two-Ounce Decline in U.S., Worry the Trend Could Lead to Increase in Health Problems

January 22, 2010 | Shirley S. Wang

Mothers are giving birth to lighter babies in the U.S., and no one is quite sure why.

The finding, published Thursday in the Journal of Obstetrics and Gynecology, has potentially troubling public-health implications, if the trend continues. Low-birth-weight babies are at higher risk for a host of health problems.

Between 1990 and 2005, the birth weight of full-term babies in the U.S. declined nearly two ounces to an average of

Can You Hear Us Now?

Leadership Needed on the 37th Anniversary of Roe v. Wade

January 22, 2010

Center for American Progress | Jessica Arons and Shira Saperstein

On Roe v. Wade’s 32nd anniversary five years ago, we urged progressive leaders to articulate and defend a clear, comprehensive, and moral vision for reproductive rights, grounded in “a core set of principles that runs throughout the progressive agenda–principles that include equality for women, support for healthy families, and the right to make personal decisions free from governmental interference.” Unfortunately, little has changed since then, and we find it necessary to repeat ourselves today on the 37th anniversary of that seminal decision.

Most pro-choice politicians—with the exception of a few stalwarts—have continued to shy away from this set of issues. And President Barack Obama is exhibit number one. He ran as a progressive on reproductive rights, but since his election he has tried to downplay the issue of abortion and find “common ground.” He has made some improvements in the international arena—appointing Hillary Clinton, a strong advocate of women’s health and rights, as Secretary of State; reversing the global gag rule; and restoring funding to the United Nations Population Fund, for instance. But his domestic actions have been weak if not downright damaging.

President Obama originally included family planning funding in his 2009 stimulus package, but he quickly jettisoned it after the first hint of opposition, making no attempt to defend the need for those funds as a critical basis for women and families’ economic security. Since then, as unemployment has worsened, we have seen the demand for contraception—and abortion—skyrocket from couples seeking to curb their family size.

Obama did issue a rule in March to rescind the last-minute Bush regulation allowing health care providers to refuse to provide services to which they have an objection, regardless of the basis or of the patients’ needs. But the administration has taken no final action even though the notice and comment period expired last April.

And, most famously, President Obama conceded early in the health reform debate that a prohibition on federal funding for abortion was the “status quo” and would be maintained in a new health insurance system. He made no attempt to ensure that a legal and constitutionally protected health service, one used by one in three women, would be available, accessible, and affordable as part of basic health care. Nor did he try to educate his colleagues and the public about the terrible burden abortion funding bans place on poor women, Native American women, women in prison, and women in the military, the Peace Corps, and the federal workforce.

The result: abortion opponents were only emboldened by the president’s stance and used it to push for even harsher restrictions that prohibited “indirect” as well as direct government spending on abortion. Instead of putting the issue to bed and finishing health reform, abortion coverage became one of the largest sticking points.

When will progressive leaders learn? Politicians who favor reproductive rights will never beat their opponents with acquiescence or silence. The only way to build the political will necessary to achieve a progressive agenda—in this area or any other—is by clearly articulating their point of view and unabashedly defending their positions.

Pro-choice leaders, including President Obama, should have started the health care reform debate by defending the need for private and public abortion coverage. It’s not that hard to do. As the slain abortion provider, Dr. George Tiller, once said, “Abortion is about women’s hopes, dreams, potential, the rest of their lives. Abortion is a matter of survival for women.”

If the conversation had begun there, rather than with an offer to wall off government-paid premiums from abortion funding, people might have been able to recognize the proposed compromise as middle ground when it came. But by starting in the center, pro-choice politicians left themselves nowhere to go and may have gained nothing in the bargain.

The search for common ground can at times be a worthwhile and even noble effort, but it cannot come at the expense of core beliefs. It is great when people of different political persuasions can find ways to work together. But when deep disagreement exists, leadership requires a clear vision and the courage of one’s convictions.

There is no opportunity to educate people or change their hearts and minds when social progressives ignore or avoid the toughest issues. We also lose the chance to work on the many other important reproductive rights issues that need attention—contraception, medically accurate sex education, pre- and post-natal care, birthing options, child care, paid family leave, and so much more.

When social conservatives refuse to compromise on what they see as core, fundamental values, they must be met with equal intensity from the left—because core, fundamental values are at stake for us as well. Otherwise, the public hears only one side of the issue and does not have the information necessary to consider another viewpoint.

We’ve said it before and we’ll say it again: “if progressives lead on this issue, Americans will follow.” We hope this time our message will be heard.

Abortion Is Health Care

January 22, 2010

The Huffington Post | Joan Malin, President and CEO of Planned Parenthood of New York City (PPNYC)

In the thirty-seven years since Roe V. Wade was decided, we have seen women’s access to abortion slowly eroded. There have been legal restrictions, mandatory waiting periods, prohibitions on federal funding, clinic closings, murders of providers, bomb threats, campaigns to stigmatize the procedure, and attempts to ban the procedure completely. 

Yet, on this anniversary of Roe. V. Wade, Congress could pass one of the biggest restrictions to abortion access thus far. The health care reform bill, while currently in flux, contains language that would essentially eliminate insurance coverage for any and all abortions, leaving women much worse off than they were before. 

Which leaves me begging the question: when will this country realize that abortion care is health care? 

It was health care when, for example, a good friend of mine was diagnosed with breast cancer right in the middle of a very wanted pregnancy. She was put in a heartbreaking position: forgo her own lifesaving treatment and continue the pregnancy; or select to have an abortion and undergo chemotherapy, in the hopes that she could become pregnant again at a later time. 

Under the restrictive language currently being considered by Congress, her abortion would not have been covered by her insurance, leaving her to face not only the anxiety of a medical procedure but the added stress of how to pay for it. 

It’s also health care when you’re talking about some of the youngest patients we see. There are very real medical reasons why a young girl should not carry a pregnancy to term. While their situation may not be life-threatening, a pregnancy at that age can do severe, lasting damage to the girl’s physical health. 

Yet under the language being considered by Congress, these girls would not be able to have their abortions covered by medical insurance. 

Neither would insurance cover an abortion for a woman who found out her fetus would not live for longer than a few hours past birth. Nor would it cover an abortion for a woman who found out that carrying a pregnancy to term would severely damage her health and/or her ability to bear children in the future. The bill’s language only contains exceptions for life-threatening situations, not ones that just threaten a woman’s general health. 

Women will not stop getting abortions. The restrictive language in health care reform does nothing to change the reasons why women decide to get abortions; it only changes whether or not insurance policies will help pay for them. What this language will do, however, is make it more difficult to obtain a safe abortion. Women will delay care, or resort to increasingly more desperate means to raise money for the procedure, or find someone who will perform the procedure at a price they can afford. 

Abortion is a legal medical procedure, one so common that one in three women will have an abortion in her lifetime. Each woman faces her own unique situation when deciding whether or not to terminate a pregnancy. Ultimately though, that decision is about her health care.

Abortion is legal, but it’s certainly not right

January 19, 2010 | John Hembling

The annual March for Life takes place in Washington, D.C., on Friday, the same date as in 1973 when the Supreme Court made the decision to legalize abortion in all 50 states as a result of Roe vs. Wade.

The Doe vs. Bolton and Webster vs. Reproductive Health Services decisions made abortion legal until just about the moment of birth. They call it "partial birth abortion." Why is this not called murder? If a person is shot and killed while leaving a residence with one foot out the door, is it not considered murder even though most of his body had not passed through yet? We are talking a difference of only minutes in the birthing process.

Everyone should be made to see a filming of a full-term abortion and the grotesque procedure that takes place to end the life of an innocent being. Would anyone then be able to come to the defense of this barbaric practice? How some doctors, taking an oath to save lives, can participate in these "authorized crimes" is beyond me.

Just because something is "legal" doesn't make it morally right. I wonder how they sleep at night.

Foundation Presidents Commend Secretary Clinton on Speech Renewing U.S. Support for Reproductive Health Worldwide

Event marks the 15th anniversary of the International Conference on Population and Development

January 13, 2010

PRWeb | Yolanda Johnny Taylor, United Nations Foundation

The United Nations Foundation joined six of the country’s leading foundations in a joint statement applauding Friday’s announcement by Secretary of State Hillary Rodham Clinton that the United States is fully committed to ensuring that all women worldwide have access to safe and effective reproductive health care.

The declaration came as part of a major speech Secretary Clinton made Friday marking 15th anniversary of the International Conference on Population and Development (ICPD). At this historic meeting, 179 countries, including the United States, vowed to achieve universal access to reproductive health care by 2014. The Foundation presidents praised Secretary Clinton’s announcement and the United States’ renewed commitment as a step that “would save lives, improve global health outcomes, and spur progress toward the United Nation’s Millennium Development Goals.”

In a related joint column, UN Foundation President Timothy E. Wirth and Planned Parenthood Federation of America President Cecile Richards echoed this sentiment, agreeing that the status quo is unacceptable. They state that Secretary Clinton's "promise of support for women like this one would go a long way to making good on our commitment to promote the health of women and their families by ensuring that they have increased access to the family planning they need."

Millions of lives have been improved and saved through effective and affordable reproductive health programs, which have proven to prevent the deaths of women and children, reduce the spread of HIV/AIDS, grow economies, and preserve natural resources.

Though successful programs exist, far more progress needs to be made. To achieve the ICPD's goals in the next five years, a sustained, long-term commitment is needed by both the public and private sectors.

Visit to view the speech and for more information.

About the Joint Statement: 
The joint statement was signed by Paul Brest, President, The William and Flora Hewlett Foundation; Ellen Dorsey, Executive Director, Wallace Global Fund; Carol S. Larson, President, The David and Lucile Packard Foundation; Jeff Raikes, Chief Executive Officer, The Bill & Melinda Gates Foundation; Vicki Sant, President, The Summit Foundation; Luis A. Ubiñas, President, Ford Foundation; and Timothy E. Wirth, President, United Nations Foundation. The full body of the statement is attached.

About the United Nations Foundation
The United Nations Foundation, a public charity was created in 1998 with entrepreneur and philanthropist Ted Turner’s historic $1 billion gift to support UN causes and activities. We build and implement public/private partnerships to address the world’s most pressing problems, and work to broaden support for the UN through advocacy and public outreach. Through our campaigns and partnerships, we connect people, ideas, and resources to help the UN solve global problems. The campaigns we conduct reduce child mortality, empower women and girls, create a new energy future, secure peace and human rights, and promote technology innovation to improve health outcomes. For more information, visit

Press Contact: 
Yolanda Johnny Taylor, United Nations Foundation, (o) 202-778-9040, (e) ytaylor (at) unfoundation (dot) org


Stupak Abortion Curbs Fit District

Liberals Oppose Health Clause, but Michigan Democrat Cites Support at Home

January 12, 2010 | Douglas Belkin and Janet Adamy

IRONWOOD, Mich. -- Democratic Rep. Bart Stupak's push for restrictions on abortion funding in the health-care overhaul is anathema to many liberal supporters of the bill. But Mr. Stupak sees them as a natural mix of the economic liberalism and social conservatism that defines his home district, Michigan's economically depressed Upper Peninsula.

"You find it wherever you go," said Mr. Stupak, a 57-year-old former state...