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11
Jan 2013

An interview with Mary Krane Derr

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At the conference held for the 25th anniversary of Consistent Life (of which All Our Lives is a member group), Mary spoke with Elizabeth Palmberg about her views on how abortion relates to issues of reproductive justice faced by women, as well as to other forms of lifetaking. This interview is reprinted, with permission, from the Fall 2012 newsletter of Consistent Life.

When I was small, I had a strong intuition that all lives are sacred. And I heard about women’s liberation; I heard the feminists burned bras, and this and that and the other thing, but there was something about it that, inside, made me cheer. I was always kind of a free spirit. What I learned in college, at Bryn Mawr, was that if you’re for women’s rights, you have to be pro-choice— something about that just didn’t sit right with me. I didn’t know many people who felt the same way who would talk about it. I came from a very conservative background, and I came out of college feeling that some of my earlier moral and political intuitions were validated by feminism and progressive politics. But this issue of abortion—I just could not get away from the feeling that this is violence and it arises from injustice against women.

I wanted to do something about violence, but I felt very discontent with the pro-life movement as such. I became a social worker and worked in pregnancy care services. When I became too disabled to work a “normal” job, I went to being a writer and editor; one of my specializations is recovering lost history.

I’ve written on black history, Polish-American history. And I’ve done work on early feminists—even though the situation is different today, obviously, they have a very keen analysis, that still holds, why women have unintended pregnancies and abortions.

Two years ago Jennifer Roth and I co-founded a group called All Our Lives; we very consciously take a reproductive justice approach. Reproductive justice is a movement that arose from women of color, people with disabilities, people with a working-class perspective. Reproductive justice involves having not only the right to have a child but the social power to exercise that right, to raise the children we have in safety, and it also includes the right not to have a child.

Many people who identify with reproductive justice take a pro-choice stand on abortion, but there are many of us who don’t. Loretta Ross, the head of SisterSong, a very influential reproductive justice organization, talks about “perfect choice.” If everyone had the means to do what they wanted to do reproductively and sexually, that would be the state of perfect choice. Some people believe that in that state there would still be abortions, and others of us think that it would be rare to nonexistent.

So that’s why we started All Our Lives, and we’ve had very interesting dialogues, mostly behind the scenes, with both pro-life and pro-choice people. One thing that we’re finding is a niche that nobody’s taken up is that a lot of scientific research now suggests that methods that were considered abortifacient really aren’t—there is so much resistance to hearing that perspective. We also have on our website a PowerPoint presentation called “Family Planning Freedom is Prolife.” It gives 10 reasons, many backed up with scientific studies. It addresses a lot of myths that both pro-life and pro-choice people have.

“As many as God sends us” is a family planning choice, and natural family planning is one, but the important thing is I don’t think “choice” is an empty word. Some people think it’s a cover for all abortion all the time, but I think it’s very real. You can’t just talk about choice in a vacuum; you have to talk about how it’s compromised by issues of race, gender, disability, class, sexual orientation. Environmental justice is one; a lot of women are losing their ability to conceive when they want to because of environmental toxins.

Believing that all life is sacred, that means women’s lives too, and that means we do have a right over our own bodies. Pro-lifers often interpret that as a selfish demand, but I [don’t.] I remember Muhammad Ali, when I was a little kid, boasting about how great he was; a lot of white people were saying, “God, this man has an ego!” But after living in a black community for a long time and having an interracial family, I realized that that’s not egotism—that’s saying, “I’m somebody, I have value.” That’s what women are saying when they say, “We have a right over our own bodies.”

Now with pregnancy, it’s a matter of two bodies, two lives. Our responsibility has two sides: one is responsibility for pregnant women and their children, and the other side is the responsibility to respect women’s right to prevent conception when they want to. That is a difficult thing to write in the pro-life movement. Some Catholics have objections; the other thing is the belief in something called the “contra- ceptive mentality,” that if your contraception fails, that you automatically have an abortion—that doesn’t explain millions of pregnancy outcomes. It certainly doesn’t explain why I had my daughter and why she had her son. I know lots of women who use contraception in the knowledge that it doesn’t always work as intended. But if it doesn’t work as intended, then you and your child have a right to everything that will help you both survive.

A lot of [the bridge-building we at All Our Lives have] done so far is behind the scenes. We find, in surprising places, opportunities to join with people who have a common concern. We have found pro-choice people who say, “I don’t agree with you on abortion, but I have respect for your perspective because it’s consistent, because you value women’s lives.” We found pro-lifers who say, “That’s exactly how I feel.” We share a lot of supporters with the Pro-Life Alliance of Gays and Lesbians. One very interesting thing is that women of color, even those who identify as pro-choice, really can relate to this perspective. There’s probably a lot of opportunity for common ground there.

We have a small board; most of us have disabilities. We’re all female; one of our board members is a woman and an independent ordained Catholic priest. We’re not anti-religious; we’re open to people of all faiths. I’m someone with Catholic and Protestant ancestry, and I also practice Buddhism, and Jen Roth is an atheist. We really try to bring in multiple perspectives, which can be difficult sometimes, but so far it’s worked out really well.

I was involved in Feminists for Life, I think, from 1986 until I resigned in 2007. I don’t quarrel with what they do—what they do is good—but I left specifically in protest of their in- action on pre-conception issues. [They] said [they] couldn’t come to a consensus because people disagree. I feel like we’ve worked out another approach. I kind of understand; Catholics in the United States, including my white ethnic ancestors, Polish and Irish, were targeted for eugenics, and that collective memory is still there. That legacy is one reason it’s hard to talk about birth control in the pro-life movement. But I think it needs to come more out in the open, it needs to heal.

As a multiply disabled person who depends on expensive medical care, I am really concerned about the threat euthanasia poses, especially to people on public assistance. I think disability rights folks—who are often not included in the debates, but we have had some impact—have gotten people to think about the fact [euthanasia often] isn’t a free choice; it can easily slide into coercion. As for the death penalty, I really think that’s tied into racism, it’s tied into poverty. I know a family with a member who was eventually exonerated, but he was on death row for something like 14 years. He was a young man, and he lost those years of his life. So that issue has a very human face to me. All these issues do.

War is very tied in. I know people who have gone into the military for very noble reasons: they want to serve their country, they know that some things are worth dying for. It’s unfortunate that they’re dying for such horrible reasons.

I see a parallel between that and a lot of women I know who’ve had abortions. They are not evil people; they are people trying, like all of us, to make the best of very bad situations. I know women who’ve had abortions who go to either the pro-life or the pro-choice movements, and I see good people in both groups. A lot of women feel they have to have an abortion because it preserves a relationship with a man, or with their parents. They are concerned about the situation they bring the child into. I just think it’s unfair that women are placed in that position to begin with, that the whole karmic burden is thrown on that woman and that child. We always talk about most of these issues in terms of individual rights, but what about collective responsibility? I think that’s where Americans really, really have gone wrong.

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18
Nov 2012

New Resource from All Our Lives: Help for Family Planning Advocates

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One of our board members just gave a talk on “Family Planning: Myth, Reality, and the Lifesaving Power of Choice” at the Call to Action Conference, a large gathering of progressive US Catholics. The detailed, amply referenced handout from the presentation is useful for family planning advocates of all faiths and none. Like the presentation itself, it covers the following points.

–Family Planning Freedom Is A Universal Human Right.
–Family Planning Freedom Saves Lives.
–Pregnancy Prevention Choice Is Not Violence Against the Already-Born.
–Pregnancy Prevention Choice Is Not Violence Against the Unborn.
–Natural Family Planning Is A Good Answer for Some, But Not All.
–What You Can Do to Advocate for Family Planning Freedom!

You can download it as a free .pdf here.

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01
Nov 2012

Drawing Connections: Intimate Partner Violence, Poverty, and Abortion

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[Author's note: this article was originally published in Life Matters Journal, Volume 2, Issue 1.]

The consistent life ethic is traditionally seen as a way to draw connections among issues that do not seem related at first glance, such as war, the death penalty, and abortion. However, the connections between forms of violence and injustice are sometimes more immediate. Recent research, including a study published in August 2012 by the Guttmacher Institute, has highlighted connections between intimate partner violence, poverty, and abortion.

Intimate partner violence and abortion

Multiple studies from countries around the world have established a link between intimate partner violence (sometimes also known as domestic violence) and unintended pregnancy and abortion.[i],[ii],[iii],[iv]

The increased abortion rate among women who have experienced intimate partner violence begins with an increased prevalence of unintended pregnancy. A health survey in Massachusetts found that 40% of women who reported being abused had experienced one or more unintended pregnancies in the past five years, compared to 8% of non-abused women.[v]

Women in abusive relationships who become pregnant face numerous pressures to abort. These include fear of being punished if their partner doesn’t welcome the pregnancy, fear that the child will be abused, and the belief that having a child will make it impossible to leave the abusive partner for good. Among women who had abortions in the United States in 2008, about 7% reported having been physically or sexually abused by their child’s father, compared with about 1% of women in the general population who report experiencing physical or sexual abuse in the previous 12 months.[vi]

Reproductive coercion

In 2010, University of California-Davis researcher Elizabeth Miller and colleagues conducted the largest study to date of a phenomenon Miller has termed reproductive coercion[vii]. Miller’s team surveyed women aged 16-29 seeking reproductive health services in five clinics in northern California. Of these women, 53% had ever been physically or sexually abused by a partner. Nineteen percent had experienced pregnancy coercion, defined as a male partner using emotional or physical pressure or threats to get a woman to agree to become pregnant. Fifteen percent had experienced birth control sabotage, in which their partner had deliberately interfered with their efforts to use birth control. Miller uses the umbrella term reproductive coercion to cover pregnancy coercion and birth control sabotage.

Reproductive coercion is often associated with intimate partner violence and may partly explain why intimate partner violence is associated with high rates of unintended pregnancy.

Guttmacher study of “disruptive life events” and abortion

In August 2012, the Guttmacher Institute published a study in the Journal of Family Planning and Reproductive Health Care about the circumstances under which women have abortions. The researchers surveyed 9493 women who had abortions, and found that most had experienced at least one “disruptive life event” in the last year, such as unemployment, divorce or separation from a partner, getting behind on the rent or mortgage, moving two or more times, or having a baby.[viii]

The women in the study who were living in poverty experienced more disruptive life events – and hence, more abortions – than the women who were making greater than poverty incomes. Women living in poverty were also more likely to report having been physically or sexually abused by their partners.

In addition to the quantitative survey, researchers conducted in-depth interviews with 49 women. Nearly half of these women said that disruptive events interfered with their ability to use contraception consistently. Women reported losing health insurance and having trouble affording prescription contraception and getting to doctor’s appointments. Consistent use, not simply any use of contraception, is key to preventing unintended pregnancy. Poverty and disruptive life events appeared to make consistent use more difficult.

There were no questions on the quantitative survey about reproductive coercion, but six of the 49 women interviewed in-depth reported experiencing it.

Conclusions

Intimate partner violence and poverty both make it more difficult for women to avoid unintended pregnancy and to carry to term if they become pregnant.

For pro-life advocates who are working to reduce the demand for abortion, these data suggest two courses of action. The first is working to end poverty and abuse themselves, and ensuring a strong social safety net to buffer against the effects of disruptive life events. Second, it is also important to ensure that women currently experiencing poverty and abuse have the information and health care access they need to prevent unintended pregnancy, as well as social and material support if they do conceive.

Mitigating the effects of injustice and working to end the injustice itself are not mutually exclusive approaches. As one example, Elizabeth Miller and colleagues reported in 2011 on a pilot program that tested a new harm reduction intervention for women experiencing abuse or reproductive coercion.[ix] Their intervention enhanced standard intimate partner violence counseling with information on reproductive coercion and strategies for minimizing the risk of unintended pregnancy by using birth control methods that were concealable or hard to tamper with. The enhanced intervention both reduced the incidence of reproductive coercion and increased the likelihood that women would leave abusive male partners.

Protecting lives that are threatened by poverty and intimate partner violence also turns out to be a way to protect lives that are threatened by abortion.

 

[i] Christina C. Pallitto, Claudia García-Moreno, Henrica A.F.M. Jansen, Lori Heise, Mary Ellsberg, Charlotte Watts, on behalf of the WHO Multi-Country Study on Women’s Health and Intimate partner Violence, Intimate partner violence, abortion, and unintended pregnancy: Results from the WHO Multi-country Study on Women’s Health and Intimate partner Violence, Int J Gynecol Obstet 2012. Published online in advance of print September 6, 2012. Available at: http://dx.doi.org/10.1016/j.ijgo.2012.07.003. Accessed September 17, 2012.

[ii] Lockart I, Ryder N, McNulty AM. Prevalence and associations of recent physical intimate partner violence among women attending an Australian sexual health clinic. Sex Transm Infect 2011; 87(2): 174-176.

[iii] Alio AP, Salihu HM, Nana PN, Clayton HB, Mbah AK, Marty PJ. Association between intimate partner violence and induced abortion in Cameroon. Int J Gynecol Obstet 2011; 112(2): 83–87.

[iv] Fanslow J, Silva M, Whitehead A, Robinson E. Pregnancy outcomes and intimate partner violence in New Zealand. Aust N Z J Obstet Gynaecol 2008; 48(4): 391–397.

[v] Futures Without Violence. The Facts on Reproductive Health and Partner Abuse. Available at: http://www.knowmoresaymore.org/wp-content/uploads/2008/07/The-Facts-on-Reproductive-Health-and-Partner-Abuse.pdf. Accessed September 17, 2012.

[vi] Jones RK, Moore AM, Frohwirth LF. Perceptions of male knowledge and support among U.S. women obtaining abortions. Women Health Iss 2011; 21(2):117-23.

[vii] Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, Schoenwald P, Silverman JG. Pregnancy coercion, intimate partner violence and unintended pregnancy. Contraception 2010; 81(4):316-22.

[viii] Jones RK, Frohwirth L, Moore AM. More than poverty: disruptive events among women having abortions in the USA. J Fam Plann Reprod Health Care 2012; published online in advance of print August 20, 2012. Available at: http://dx.doi.org/10.1136/jfprhc-2012-100311. Accessed September 17, 2012.

[ix] Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, Schoenwald P, Silverman JG. A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion. Contraception 2011; 83(3):274-80.

 

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16
Oct 2012

In the news: family planning

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Yesterday, the New Evangelical Partnership held an event at the National Press Club to unveil a statement called “A Call to Christian Common Ground on Family Planning, and Maternal, and Children’s Health.”

The statement makes three main points:

  1. Family planning strengthens families and creates more stable and healthy communities worldwide.
  2. Family planning protects the health of women and children.
  3. Family planning reduces abortion.

We agree wholeheartedly, of course, and are pleased to have the New Evangelical Partnership as part of the movement for family planning freedom.

You can watch the whole event on YouTube. I recommend at least watching Rev. Jennifer Crumpton’s presentation of the NEP statement, starting at about 8:15 in, Dr. Mark Hathaway’s talk at 19:00 about the medical benefits of family planning for women and children, and Katherine Marshall’s talk at 28:10 about the international context of family planning.

Speakers at the NEP event referred more than once to a study recently conducted by Washington University in St. Louis. The project provided women and teens at high risk of unintended pregnancy with the contraceptive method of their own choice at no cost. The results were dramatic. The abortion rate fell to 6 per 1,000 women, compared with a national average of 20 per 1,000 women. The teen birth rate from to 6.3 per 1,000, compared with 34.1 per 1,000 nationwide.

Imagine the impact of cutting the abortion rate in the U.S. by almost two thirds.

As the Agence France write-up of the study noted: “If the same results were replicated across the United States, free birth control could prevent 1,060,370 unplanned pregnancies and 873,250 abortions a year.”

Yes, that’s a big “if.” [Edited to add: as the researchers pointed out, the sample of women who participated in this study is not generalizable to the total population of women of reproductive age in the United States. That said, they likely bear a great deal of similarity to the population of women at the highest risk for unintended pregnancy and abortion.] And of course, there are important caveats. Women’s consent must be free and fully informed. Women must never be coerced into using long-acting contraception because other people think it would be better for them not to reproduce. It must always, always be the woman’s choice to use contraception. In addition, protection against HIV or other STDs is vital, and the forms of contraception chosen by most women in the study did not provide that protection.

But imagine it. Imagine 873,250 fewer unborn human beings destroyed every year. Imagine 873,250 fewer women going through abortions. Imagine 1,060,370 fewer women having to experience unplanned pregnancy, and instead being able to bear children at a time when their age, health, and life situation are better suited for motherhood — or being free to choose a different life path than motherhood.

Earlier this month, a Republican-appointed federal judge in the United States District Court for the Eastern District of Missouri rejected a lawsuit brought against the U.S. Department of Health and Human Services by an employer in a secular industry (mining, metals, & ceramics) who, due to his own religious beliefs, doesn’t want to provide his employees with insurance that covers contraception.

Judge Carol Jackson noted that employers already pay their employees a form of compensation that could be used to purchase contraception: their salaries. This is an argument I’ve made in the past. The full ruling is online here.

The burden of which plaintiffs complain is that funds, which plaintiffs will contribute to a group health plan, might, after a series of independent decisions by health care providers and patients covered by OIH’s plan, subsidize someone else’s participation in an activity that is condemned by plaintiffs’ religion. This Court rejects the proposition that requiring indirect financial support of a practice, from which plaintiff himself abstains according to his religious principles, constitutes a substantial burden on plaintiff’s religious exercise.

RFRA is a shield, not a sword. It protects individuals from substantial burdens on religious exercise that occur when the government coerces action one’s religion forbids, or forbids action one’s religion requires; it is not a means to force one’s religious practices upon others. RFRA does not protect against the slight burden on religious exercise that arises when one’s money circuitously flows to support the conduct of other free-exercise-wielding individuals who hold religious beliefs that differ from one’s own…

Just as in Mead, plaintiffs must contribute to a health care plan which does not align with their religious beliefs. In this case, however, the burden on plaintiffs is even more remote; the health care plan will offend plaintiffs’ religious beliefs only if an OIH employee (or covered family member) makes an independent decision to use the plan to cover counseling related to or the purchase of contraceptives. Already, OIH and Frank O’Brien pay salaries to their employees—money the employees may use to purchase contraceptives or to contribute to a religious organization. [emphasis added] By comparison,the contribution to a health care plan has no more than a de minimus impact on the plaintiff’s religious beliefs than paying salaries and other benefits to employees.

And once again, despite the claims in this and similar lawsuits that the HHS mandate forces them to cover abortifacients, the belief that emergency contraception is abortifacient has not been borne out by the evidence. I’m going to keep repeating that until new evidence comes to light or people stop making this claim, so get used to it.

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30
Sep 2012

Why Women *Really* Use Contraception

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In countries where there is a vocal, well-funded minority against contraception, stereotypes against women who use it abound.

In the United States, for example, women who use contraceptives–the overwhelming majority of women, by the way–have been derided as feckless, irresponsible, selfish, monstrously unnatural, man-hating, child-hating sluts who want to live parasitically off hard-working, moral-paragon taxpayers, and who automatically have abortions without a thought if they become unintentionally pregnant. Women who do not use contraceptives, on the other hand, are praised as spiritually superior, virtuous, man-loving, child-loving, fruitful Good Girls who know their ordained place in G*d’s Order of Things.

What a different, and much more flattering, much more accurate picture emerges from a new Guttmacher Institute study, Reasons for Contraception: Perspectives of US Women Seeking Care at Specialized Family Planning Clinics, which is forthcoming in the journal Contraception.

From a release about the study:

“Women value the ability to plan their childbearing, and view doing so as critical to being able to achieve their life goals,” says study author Laura Lindberg. “They need continued access to a wide range of contraceptives so they can plan their families and determine when they are ready to have children.”

Few studies in the United States have asked women directly why they use contraception and what benefits they expect or have achieved from its use. To fill this gap, the authors surveyed 2,094 women receiving services at 22 family planning clinics nationwide.

The majority of participants reported that contraception has had a significant impact on their lives, allowing them to take better care of themselves or their families (63%), support themselves financially (56%), complete their education (51%), or keep or get a job (50%).

When asked why they are seeking contraceptive services now, women expressed concerns about the consequences of an unintended pregnancy on their families’ and their own lives. The single most frequently cited reason for using contraception was that women could not afford to take care of a baby at that time (65%). Nearly one in four women reported that they or their partners were unemployed, which was a very important reason for their contraceptive use. Among women with children, nearly all reported that their desire to care for their current children was a reason for contraceptive use.

Many women reported interrelated reasons for using contraception, suggesting that the complexities of women’s lives influence their decision to use contraception and their choice of method. Other reasons for using contraception, reported by a majority of respondents, include not being ready to have children (63%), feeling that using birth control gives them better control over their lives (60%) and wanting to wait until their lives are more stable to have a baby (60%).

The release also includes this commentary.

“Notably, the reasons women give for using contraception are similar to the reasons they give for seeking an abortion,” according to Lawrence B. Finer, author of a previous Guttmacher study on that topic. “This means we should see access to abortion in the broader context of women’s lives and their efforts to avoid unplanned childbearing, in light of its potential consequences for them and their families.”

What does this study mean from an All Our Lives sort of perspective? For one, it fits well with what we already know experientially about the critical reasons why women need and want access to the full range of pregnancy prevention methods. Reasons that have nothing to do with the abovementioned belittling stereotypes.

For another, any serious effort to reduce unintended pregnancies and abortions must include expanded access to the full range of methods and understanding and alleviation of any problems that might hinder their effectiveness.

We do not advocate this course because we equate contraception with abortion, let alone believe the hype about some foreordained, inevitable “contraceptive mentality.” We advocate it because it works best in the real world, honors most women’s preferences to avert rather than interrupt unintended pregnancies, and does not involve the taking of prenatal lives. In other words, it evinces the most respect for human beings and universal human rights.

For yet another–the study findings call into question the sharp division between women who use contraception and those who do not. All Our Lives has long questioned this as just another brutal variant on the sundering of womankind into Madonnas and Whores. We assert the right of all women to use/not use any particular method of pregnancy prevention in accordance with their own preferences, values, and circumstances.

Thanks, Cristina Page, for bringing the Guttmacher study to our attention.

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26
Sep 2012

World Contraception Day 2012

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Today is World Contraception Day 2012. In recognition, I’d like to call your attention to a sample of our writings discussing the ways in which the freedom to choose whether and how to prevent conception can save and improve the lives of women and their children.

We are also participating in discussions on Twitter using the hashtags #sheparty and #WCD2012. Join us!

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09
Jul 2012

We’re in the Financial Times–With a Lot of Company

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Because of the London Family Planning Summit, the British newspaper Financial Times has just published a special report on sexual and reproductive health.

And we get a little mention in at least the print and .pdf versions–see page 6, under the “North America” heading (although we would have preferred “Global.”) We join nearly 1300 other civil society organizations, many from the Two Thirds World, who agree that “Family Planning Saves Lives.”

You can also see the full list of endorsers here.

We are not specifically mentioned, but we are also one of the 200-plus organizational members of the Reproductive Health Supplies Coalition, whose ad appears on page 1 of the Financial Times report.

The ad mentions “unsafe abortion” as one consequence of lacking contraceptive access. All abortions are unsafe for unborn children. Some are maternally unsafe as well.

Wonder if any other endorsers of the civil society declaration would agree with us.

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23
Jun 2012

All Our Lives Endorses Two Critical Global Declarations on Family Planning

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Next month in London, England, the British government and the Bill and Melinda Gates Foundation will convene a global summit on family planning. All Our Lives has endorsed two important human rights declarations created in anticipation of the summit.

“Women’s Human Rights Must be at the Center of the Family Planning Summit” warns:

Our experience, built over decades of work around the world, has taught us that the failure to take actions guided by women’s human rights – to health, to life, to live free from discrimination among others – can have devastating consequences. Policies that accept or tacitly condone forced sterilization, the coercive provision of contraceptives, and the denial of essential services to the young, poor and marginalized women that need them every day have violated, and continue to violate, women’s human rights.

Nearly twenty years ago, governments at the [1994 Cairo] International Conference on Population and Development agreed that respect for women’s reproductive autonomy is the cornerstone of population policy. Any return to coercive family planning programs where quality of care and informed consent are ignored would be both shocking and retrograde.

A global letter of support for the summit emphasizes a program of action to increase family planning access to the millions of human beings who currently lack it.

We applaud the London Summit on Family Planning for its commitment to work with poor and vulnerable populations to increase individual awareness, address socio-cultural barriers, and increase community acceptability of family planning, including comprehensive sexuality education. In particular, we applaud the initiative’s emphasis on empowering women and girls, and delivery through increased service provision. We encourage you to focus on providing information and services to those who have historically faced poor access to family planning, especially young people, poor women, people with disabilities; rural, indigenous, displaced and post crisis populations. Similarly, we encourage you to make linkages to other programmes including those for economic development, education (especially for girls), environmental protection, HIV/AIDS,maternal and child health, security and youth.

We commit to working with communities and reaching poor and vulnerable women and girls with evidence-based information so that they can make informed choices regarding their fertility and choice of contraceptive method.

Yes and yes. If we are the sole prolife group signing on to these statements, well, it’s got to start somewhere.

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22
May 2012

Notes on the Notre Dame lawsuit

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The University of Notre Dame has filed a lawsuit against the Departments of Health and Human Serivces, Labor, and the Treasury. They object to HHS’ inclusion of contraception as one of the core preventive services that must be provided in health insurance plans without cost sharing, on the grounds that covering contraception (and, they claim, abortifacients, but we’ll get to that later) is against their religious beliefs and the exemption for religious employers isn’t broad enough. I’m not a lawyer, so I’m not going to claim that Notre Dame has zero points in its favor in this lawsuit, but its arguments have some problems.

80. “Other commenters noted that ‘preventive care’ could not reasonably be interpreted to include such practices. These groups explained that pregnancy was not a disease that needed to be ‘prevented,’ and that a contrary view would intrude on the sincerely held beliefs of many religiously affiliated organizations by requiring them to pay for services that violate their religious beliefs.”

Whether or not evidence shows a practice to be ‘preventive care’ has nothing to do with anyone’s sincerely held religious beliefs about that practice’s morality. Pregnancy is not a disease, but it is a tremendous exertion, and the ability to plan it for those times when a woman is best prepared is beneficial to both the mother’s and the child’s health.

OK, you might say, we’ll grant for the sake of argument that contraception can be considered preventive care, but making Notre Dame include it in their employee health plans still violates their right to practice their religion. Just how far does Notre Dame want to extend this ability for employers to simply not offer coverage for medical treatments they disapprove of? They’re hoary old examples, but they keep getting trotted out because they are still relevant: Should employers who are Christian Scientists be able to refuse to provide any health insurance? Should employers who are Scientologists be able to refuse to provide insurance that covers mental health care? What about employers with a sincerely held belief that vaccines are dangerous and shouldn’t be considered “preventive care”? Do all of these employers get to offer nonstandard health benefits that conform to their religious beliefs, or just the more numerous and more politically powerful anti-contraception employers? And do the conscience rights of employees with regard to how they use their own health insurance have any weight at all?

I would also argue that in most cases, employers are not paying for contraception, or for any other particular procedure or service. They are taking part of their employees’ compensation and using it to pay premiums so that the employee will have affordable access to health care. Then the employee and her doctor decide on what health care the employee needs, and then the insurance company takes money from the pool of all of its clients’ premiums and pays the claim. The employer is no more directly involved in the supposed evil of contraception than if the employee went out and bought condoms with her paycheck — and no employer gets to stipulate that wages can’t be used to buy contraception. I’ll grant that Notre Dame’s situation is a little different, because it’s self-insured for its employees’ health plans. I think that if the Administration was going to have this compromise saying that religious employees could punt responsibility for contraception coverage to the health insurance companies, it probably should have thought a little harder about what self-employed companies would do. Of course, Notre Dame also wants to make sure that its students, who are insured through Aetna, can’t access contraception with that insurance either (despite Aetna having all the responsibility of informing students of the benefit and paying for it), so the suit doesn’t exactly hinge on that distinction.

87. FDA-approved contraceptives that qualify under these guidelines include drugs that induce abortions. For example, the FDA has approved “emergency contraceptives” such as the morning-after pill (otherwise known as Plan B), which operates by preventing a fertilized embryo from implanting in the womb, and Ulipristal (otherwise known as HRP 2000 or Ella [sic]), which likewise can induce abortions of living embryos.”

As we have pointed out many times, Plan B has been shown to have no mechanism of action besides the prevention of implantation [edit: I can't believe this was up so long before I noticed this mistake -- of course it should read "no mechanism of action besides the prevention of fertilization."]. The mechanism of action of ella has not been fully explicated, and a contragestive effect can’t be ruled out at this time, especially since large or repeated doses of ulipristal acetate can be abortifacient. However, I have been able to find no studies in which a single dose of 30mg, as used in ella, has been shown to prevent implantation or to harm embryos after implantation. This paragraph is factually incorrect with regard to Plan B and presents speculation as fact with regard to ella. Arguments relying on the information in this paragraph should be discounted accordingly.

157. Furthermore, the U.S. Government Mandate is not narrowly tailored to promoting a compelling governmental interest. Even assuming the interest was compelling, the Government has numerous alternatives to furthering that interest other than forcing Notre Dame to violate its religious beliefs.

158. For example, the Government could provide or pay for the objectionable services through expansion of its existing network of family planning clinics funded by HHS under Title X or through other programs established by a duly enacted law. Or, at a minimum, it could create a broader exemption for religious employers, such as those found in numerous state laws throughout the country and in other federal laws.

Except that creating broad exemptions undermines the government’s interest in setting a minimum standard that all insurance policies must meet. This isn’t a new concept; the government sets minimum standards for many products, to protect consumers. And not including family planning as preventive care when evidence points to its usefulness in improving women’s and children’s health undermines the government’s interest in being able to shape its health care policy according to what actually works.

184. The religious employer exemption is based on an improper Government determination that “inculcation” is the only legitimate religious purpose.

Actually, the regulation does not say that organizations with a “legitimate religious purpose” will receive an exemption and then set out to define legitimate religious purpose. The regulation, quite properly, does not have anything to say about legitimacy. The limitations on the exemption appear designed to grant exemptions in those cases where employees can reasonably be expected to share the religious views of their employers, and therefore are less likely to be deprived by the exemption of a benefit that they might otherwise take advantage of.

Notre Dame then attemps to show that the mandate is not a neutral law of general applicability:

198. The Government has also crafted a religious exemption to the U.S. Government Mandate that favors certain religions over others. As noted, it applies only to plans sponsored by religious organizations that have, as their “purpose,” the “inculcation of religious values”; that “primarily” serve individuals that share those religious tenets; and that “primarily” employ such individuals. 45 C.F.R. § 147.130(a)(iv)(B)(1).

That does not favor particular religions over others. Notre Dame and other religiously-affiliated organizations are not, themselves, religions. Frankly, if anything the exemption favors religion over non-religion, but it does not favor any one religion over another. It distinguishes between organizations in which there is likely to be a difference of belief between the employer and the employees, and organizations in which there is less likelihood.

199. The U.S. Government Mandate, moreover, was promulgated by Government officials, and supported by non-governmental organizations, who strongly oppose Catholic teachings and beliefs regarding marriage and family. For example, on October 5, 2011, after Defendants announced the interim final rule but before they announced the final rule, Defendant Sebelius spoke at a fundraiser for NARAL Pro-Choice America. Defendant Sebelius has long been a staunch supporter of abortion rights and a vocal critic of Catholic teachings and beliefs regarding abortifacients and contraception. NARAL Pro-Choice America is a pro-abortion organization that likewise opposes many Catholic teachings. At that fundraiser, Defendant Sebelius criticized individuals and entities whose beliefs differed from those held by her and the other attendees of the NARAL Pro-Choice America fundraiser, stating: “Wouldn’t you think that people who want to reduce the number of abortions would champion the cause of widely available, widely affordable contraceptive services? Not so much.”

We live in a country in which government officials have the right to criticize the policy positions of religious organizations, especially when those policy positions have negative implications for people who do not share the beliefs of said organizations. This is not evidence of discrimination.

200. Consequently, on information and belief, Notre Dame alleges that the purpose of the U.S. Government Mandate, including the narrow exemption, is to discriminate against religious institutions and organizations that oppose contraception and abortifacients.

Notre Dame can only make this allegation because it refuses to acknowledge the validity of the evidence in favor of the health benefits of family planning, or to consider those health benefits a sufficiently compelling reason for the government to include family planning as part of its standards for health insurance plans. Notre Dame can only make this all about them by denying that their employees have any valid interest in being able to use the health insurance they earn to access health care services according to their own beliefs.

Notre Dame, not everything is about you.

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16
Mar 2012

Honduran women could be jailed for using emergency contraception

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Following a Supreme Court decision in February which inaccurately declared that emergency contraception is abortifacient, the Honduran Congress is poised to make distribution or use of levonorgestrel emergency contraception (LNG EC) a crime punishable by jail time. Once again, we see that misinformation about EC has severe consequences. The best available research shows that LNG EC has no mechanism of action other than the prevention of fertilization. The blog Feministas en Resistencia Honduras has more information (English translation).

 

Please sign this petition to the President of the National Congress of Honduras urging him not to criminalize the use of emergency contraception. Please also continue to educate governments, media, and pro-life or pro-choice organizations wherever you live on the facts about emergency contraception.

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