Two recent news items highlight the need for better education about pregnancy and birth control. The first is a survey by the American College of Nurse-Midwives:

Despite the broad range of options available to women for birth control and family planning, a survey of more than 1200 US women between 18 and 45 released today by the American College of Nurse-Midwives (ACNM) shows that women do not feel knowledgeable about many of these options and have harmful misperceptions about their effectiveness. The survey also found that many women don’t feel they are able to have in-depth conversations with their health care providers to make well-informed decisions on birth control and family planning.

And what are the consequences of lack of knowledge and misperceptions?

We interviewed a sample of women obtaining abortions in the U.S. in 2008 (n=49) and explored their attitudes towards and beliefs about their risk of pregnancy. We found that most respondents perceived themselves to have a low likelihood of becoming pregnant at the time that the index pregnancy occurred. Respondents’ reasons for this perceived low likelihood fell into four categories: perceived invulnerability to pregnancy without contraceptive use, perceptions of subfecundity, self-described inattention to the possibility of conception and perceived protection from their current use of contraception (although the majority in this subgroup were using contraception inconsistently or incorrectly).

Far too many people don’t get factual education from their schools or adequate information from their doctors about how their own bodies work. The result is unintended pregnancy and, often, abortion.

Senators Bob Casey (D-PA) and Jeanne Shaheen (D-NH) in the Senate, and Representatives Jerrold Nadler (D-NY), Carolyn Maloney (D-NY), Jackie Speier (D-CA), Susan Davis (D-CA), and Marcia Fudge (D-OH) in the House, have re-introduced the Pregnant Workers Fairness Act in the new Congress. PWFA would require companies to provide pregnant employees with the same types of accommodations that are required for disabled workers under the Americans with Disabilities Act. According to Casey’s office:

Currently, pregnant working women around the country are being denied simple adjustments – permission to use a stool while working a cash register, or to carry a bottle of water to stay hydrated, or temporary reassignment to lighter duty tasks – that would keep them working and supporting their families while maintaining healthy pregnancies. The legislation will close legal loopholes and ensure that pregnant women are treated fairly on the job.

The Pregnant Workers Fairness Act will accomplish this by requiring employers to make reasonable accommodations for pregnant workers and preventing employers from forcing women out on leave when another reasonable accommodation would allow them to continue working. The bill also bars employers from denying employment opportunities to women based on their need for reasonable accommodations related to pregnancy, childbirth, or related medical conditions.

In recent and startling examples, Amy Crosby, a hospital cleaner in Tallahassee, Florida, was forced into unpaid leave from her job when the hospital refused to accommodate her doctor’s request that she not lift more than 20 pounds because of her pregnancy; Heather Wiseman, a retail worker in Salina, Kansas, was fired because she needed to carry a water bottle to stay hydrated and prevent bladder infections; and Victoria Serednyj, an activity director at a nursing home in Valparaiso, Indiana, was terminated because she required help with some physically strenuous aspects of her job to prevent having another miscarriage. For the well-being of pregnant workers, and for the sake of the economic stability of American families, our laws must be updated and clarified.

The National Women’s Law Center has more information in their PWFA factsheet.

Preventing pregnant mothers from having to choose between the jobs they need to provide for their families on one hand, and their own health and the health of their unborn children on the other, is pro-life. If you agree and you are in the U.S., please contact your Senators and Representatives to ask them to cosponsor the Pregnant Workers Fairness Act (H.R. 1975 in the House and S. 942 in the Senate).

Here are some talking points you can use in your email and phone call:

  • Women make up about half of the U.S. workforce. Two-thirds of women who had their first child between 2006 and 2008 worked during their pregnancies. Workers are not machines to be shaped to suit jobs — we are people who deserve to have our needs accommodated.
  • The PWFA relies on a reasonable accommodation framework already familiar to employers accustomed to the requirements of the Americans with Disabilities Act.
  • Most of the required accomodations are small and inexpensive for the employer — such as allowing employees to use a stool instead of standing or to have a water bottle with them as they work — but they can make a huge difference for the employee and her child.
  • If your Representative or Senator identifies as pro-life, remind them that they would be helping to protect the lives and health of unborn children as well as their mothers.

Please let us know how your call goes, or if you get a response to your email!

Starting today, people in the U.S. who need health insurance can go to healthcare.gov to enroll in a plan through their states’ new exchanges.

There’s a lot for pro-lifers to love about health insurance reform. All plans offered on the exchanges must cover prenatal care, delivery, and care for mother and baby after birth. Prior to the Affordable Care Act, most individual insurance plans didn’t cover maternity care, and women who were already pregnant often couldn’t get insurance at all.

In addition to the reform of maternity care coverage, the ACA requires insurance plans to cover a number of preventive services with no cost-sharing. These include, but are definitely not limited to:

Having these vital preventive services available without a co-payment will help more women and children live healthy lives as well as making it easier for women to avoid unintended pregnancy and abortion.

* These are currently required to be covered for women but should be available without cost-sharing to everyone, in my opinion.

Beatriz, the woman in El Salvador whose doctors petitioned to allow her to have an abortion because of her severe health problems, had a C-section yesterday after starting to have contractions Sunday night.

Beatriz is in stable condition in intensive care. Her daughter died five hours after birth. We extend our condolences and best wishes to Beatriz and her family.

Doctors in El Salvador have petitioned the Supreme Court to allow them to perform an abortion that they argue is necessary to save their patient’s life. The penal code of El Salvador bans abortion under all circumstances, with no exception to save the life of the mother. (Such an exception was previously part of the code, but was removed in 1998.)

The patient in question, a 22-year-old woman named Beatriz, has lupus and kidney disease. Her doctors argue that these conditions are worsened by her pregnancy and that her life is in danger. Recent reports say that Beatriz has now entered early stage renal failure.

Obviously, if care is available that will preserve both her life and her child’s, it should be pursued. But that isn’t always possible. All Our Lives has always held that a woman has a right to the medical care she needs to preserve her life, even if that care will result in the death of the child she carries. Neither she nor her doctors should have to worry about facing jail as a result.

I do want to say that I’m troubled by the way the case has been framed in many media outlets. They’ve emphasized that Beatriz’s baby is anencephalic and has a low chance of survival outside the womb. The implication is that the child’s severe disability makes this a more clear-cut case. That the child is anencephalic makes it far less likely that both could be saved, so it’s relevant in that sense. But Beatriz is entitled to life-saving care regardless of the health status of her child. And while the child’s death may be unavoidable, it’s still a death, and no less so for having been likely to happen soon anyway.

If you want to send a message to the El Salvador Supreme Court, they have a website, Facebook page, and Twitter account. Ask them to remember Beatriz’s constitutional right to life, and to allow her to receive whatever care she might need to preserve it. Letting her die would not be pro-life.

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.

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.

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!

I've been reluctant to post on the whole Susan G. Komen/Planned Parenthood debacle because I kept feeling like there was information I didn't have. Some of my questions have been answered in the past few days. We now know that:

What's still not clear to me is how much PP's ability to provide breast exams and referrals would have been affected by the loss of this money. If someone is seeing a provider anyway, it doesn't seem to add any cost to also have them do an exam, but I may well be missing something there.

To the extent that women are relying on Planned Parenthood for essential breast health care, pro-lifers who want to promote breast health have three options:

  1. Support those women getting breast health care at PP.
  2. Provide a viable alternative: a clinic where women can get affordable comprehensive reproductive and sexual health care, but that doesn't do abortions.
  3. Leave those particular women to rely solely on donations and services from pro-choicers – which has the side effect of teaching them that abortion proponents are the only people who care about their health.


I'd rather women didn't get their health care from a provider that also performs and lobbies for abortion. I'd rather they didn't have to. But many women do, and pro-lifers needs to ask themselves why. To me, the real outrage in this whole episode is this:

"The grants in question supplied breast health counseling, screening, and treatment to rural women, poor women, Native American women, many women of color who were underserved–if served at all–in areas where Planned Parenthood facilities were often the only infrastructure available. Though it meant losing corporate money from Curves, we were not about to turn our backs on these women."

That was Susan G. Komen founder Nancy Brinker in 2010, explaining why Komen funded Planned Parenthood. Areas where Planned Parenthood facilities were often the only infrastructure available. If you don't want money to go to Planned Parenthood – fix that.

The U.S. Department of Health and Human Services has accepted the Institute of Medicine’s recommendations about women’s health care services that should be provided by all insurers without co-payment under the Affordable Care Act. Among these services are HIV screening and counseling, domestic violence screening and counseling, support for breastfeeding, and contraception. These recommendations will be in effect for insurance policies with plan years beginning on or after August 1, 2012. Religious organizations which are opposed to contraception may opt out of having that coverage provided by their insurance.

All Our Lives applauds HHS’s acceptance of the recommendations. Having these vital services available without a co-payment will help more women and children live healthy lives as well as making it easier for women to avoid unintended pregnancy and abortion.