On Ramen Noodles and Birth Control

Dawna Cornelissen

College students all over the country are rallying, protesting, chanting and writing petitions to get Congress to reinstate affordable birth control at university health centers.

Last week, students at the University of Houston displayed a stack of Ramen Noodles at a visibility event demanding cheaper birth control. The connection: $35 worth of Ramen Noodles could feed someone for a month — or it could purchase one month's supply of birth control. Birth control that had been only $10 a few months ago at the University of Houston health center has now more than tripled in price. And this isn't happening in just Houston. Students all over the country are demanding that Congress fix the birth control pricing problem caused by the Deficit Reduction Act before the legislative session ends in December.

At some schools, students are protesting the increase with petitions and rallies. In Iowa, where at the University of Iowa Ortho Tri-Cyclen Lo jumped from $15 to $53 per month, more than 400 college students signed a petition protesting the increase in the cost of birth control. The petition will be delivered to the state's Senators next month. Students from New York University rallied in Washington Square Park while chanting, "Birth control shouldn't break the bank, who in congress do we thank?" and "What do we want? Birth control! How do we want it? Cheap!"

Another way students are making their voices heard is by writing letters to the editors and news stories for their school papers. At Washington University in St. Louis, MO, students wrote, "Birth control is a facet of basic health care and all women should have easy and affordable access to it. If Congress is truly serious about reducing the rate of unintended pregnancies, then fixing this law should be a top priority."

Lastly, and most impressively, students are reaching out to university spokespeople and officials in order to demand Congress' attention and action. A few weeks ago, the University of Montana at Missoula's student government association (ASUM) passed a resolution expressing the association's support for discounted birth control for students and pledged to contact Montana's congressional delegation about the issue. Legislators may be able to ignore students, but I believe university presidents and regents will make elected officials think twice about ignoring this issue.

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The issue, after all, is an easy, no-cost fix. In fact, legislation has already been introduced by the Congress that would restore access to affordable birth control for college and not-for-profit health clinics. The bill is called the Prevention Through Affordable Access Act and already has more than 100 sponsors in the House. To help ensure the passage of the Prevention through Affordable Access Act, check out Lon Newman's action suggestions!

News Law and Policy

Wisconsin GOP’s Voter Restriction Law Suffers Another Legal Blow

Imani Gandy

In blocking many of Wisconsin's elections restrictions, the lower court ruled that the state must reform how it deals with voters who have difficulty obtaining the required photo ID to vote.

A federal appeals court yesterday refused to stay a lower court order blocking several Wisconsin voting restrictions, allowing election officials to move forward with early voting in the state next month.

Attorneys on behalf of the state of Wisconsin filed the request for a stay with the Seventh Circuit Court of Appeals after a lower court judge last month issued an injunction that blocked parts of Wisconsin’s sweepings elections laws.

The lower court ruled that the justification for the laws did not justify the burden on voting rights that they impose. And this week a three-judge panel of the Seventh Circuit declined to stay that ruling, without explaining.

The ruling comes days after elections officials in Madison and Milwaukee announced their intention to kick off early voting in late September, a month earlier than would have been allowed had the lower court not struck down the restrictions on early voting, according to the Milwaukee-Wisconsin Journal Sentinel.

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The Republican-backed elections law created state-imposed limitations on the time and location for in-person absentee voting, a provision requiring absentee ballots be sent by mail instead of fax or email, the requirement that dorm lists—a certified list provided by the university of the students living in college housing, which student voters may use as proof of residence—must include citizenship information, a ban on using expired but otherwise qualifying student IDs to establish proof of residency, and a 28-day durational residency requirement.

In blocking many of Wisconsin’s elections restrictions, the lower court ruled that the state must reform how it deals with voters who have difficulty obtaining the required photo ID to vote. Gov. Scott Walker (R) and the GOP-controlled Wisconsin legislature had implemented a system under which people who don’t have birth certificates or who have problems with gathering documentation needed to obtain the proper identification would still be able to vote.

The lower court noted that the Walker administration’s system did not provide a viable long-term solution for those voters who could not obtain their birth certificates because they were destroyed in fires or misplaced by bureaucrats.

The court later stayed that portion of the ruling, stating that the system created by Walker’s administration—which provides people with temporary voting credentials while they await a decision about whether they qualify for an ID—was sufficient to allow people to vote during the upcoming November election and therefore does not need to be immediately reformed.

The ruling comes on the heels of a ruling in another voting rights case in Wisconsin, Frank v. Walker, about the state’s voter ID law. In that case, a three-judge panel of the Seventh Circuit stayed a ruling that would have permitted anyone eligible to vote in Wisconsin to an accommodation that would permit that voter to cast a ballot after signing an affidavit stating that they could not easily obtain an ID.

Commentary Contraception

The Double Standard of Military Pregnancy: What Contraceptive Access Won’t Fix

Stephanie Russell-Kraft

Unique military gender politics that make it hard for some servicewomen to ask for birth control also stigmatize them if they get pregnant—especially when that happens at an overseas post or on a deployment. Any effort to increase birth control availability can only be understood against that particular cultural backdrop.

At the beginning of May, pharmaceutical giant Allergan announced that, in partnership with nonprofit Medicines360, it would begin offering its new intrauterine device (IUD) Liletta at a reduced price to military treatment facilities and veterans hospitals across the United States. The company would also support “an educational effort to raise contraception awareness among healthcare providers treating U.S. military service women,” according to its press release.

Military personnel and medical professionals agree Allergan’s initiative represents an important step toward expanding access to the IUD, which along with other long-acting reversible contraceptives (like injections) are particularly well suited to the demands of military training and deployment schedules. But this push to increase IUD use can’t be fully understood outside the context of the unique challenges and stigmas facing women of reproductive age in the U.S. military (who numbered just under 200,000 as of 2011, the latest available data obtained via FOIA by Ibis Reproductive Health).

Despite theoretically having access to a wide variety of contraceptive options, women in the military still report higher rates of unplanned pregnancy than their civilian peers, and it remains somewhat of a mystery exactly why. What is clear is that the unique military gender politics that make it hard for some women to ask for birth control also stigmatize them if they get pregnant—especially when that happens at an overseas post or on a deployment. Any effort to increase birth control availability, including Allergan’s, can only be understood against that particular cultural backdrop.

Nearly every time a U.S. military branch changes policies to include more women, critics raise the old argument that allowing women into the service, particularly in combat roles, will lead to sex between soldiers and thereby distract from the mission. Because of that, the military generally prohibits sex during deployments between service members not married to each other (exact policies vary across the branches and across units, and some are less strict). Taken as a whole, the U.S. military’s policy basically amounts to an abstinence-only approach, with women shouldering nearly all of the risk and blame when soldiers do decide to have sex on deployment.

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Bethany Saros, who enlisted in the Army as an 18-year-old in 2002, faced this blame head-on when she became pregnant by a fellow soldier during a 2007 tour in Iraq.

Although condoms were available to soldiers at her deployment site, Saros did not use birth control. Her decision not to end the pregnancy meant her deployment was over, and Saros recalls meeting several other pregnant women in Kuwait while they all waited to get shipped back. “I felt like a pariah, and I think the other girls did too,” she said.

“It’s not like anyone does this on purpose,” Saros explained. “The fathers of these babies, they don’t get any problems, and they were screwing around just as we were.”

Across all branches of service, pregnant women are typically not allowed to serve on deployments, and, though the length of time varies by branch, women are not allowed to deploy in the six to 12 months after they give birth. According to spokespeople from each of the branches, the reasoning behind the policies is to protect servicewomen and give them the time they need to recover from birth. All of the women I spoke with for this piece told me that soldiers—both male and female—often believe a woman who gets pregnant right before or during a deployment is simply trying to avoid her work.

“The first thing someone talked about when a woman got pregnant was that she was trying to get out of a deployment,” said Lauren Zapf, a former Naval officer, mental health clinician, and fellow with the Service Women’s Action Network. “Whereas if men announce that they’re going to have a baby, there’s a lot of backslapping and congratulations.”

According to Ibis Reproductive Health’s analysis of Department of Defense data, about 11 percent of active-duty military women reported an unintended pregnancy in 2008 and 7 percent reported an unintended pregnancy in 2011—in both years, this was far more than the general population. Younger, less educated, nonwhite women were much more likely to become pregnant unintentionally, as were those who were married or living with a partner, according to Ibis. Contrary to military lore, the pregnancy rates did not differ between those women who had deployed and those who didn’t during that time, the study found.

It remains unclear why exactly military women have higher reported rates of unplanned pregnancy than their civilian counterparts, but one reason has likely been their inconsistent access to birth control and limited access to abortion services. As with most institutions, there’s a difference between official policy and what happens on a day-to-day basis on military bases and in medical exam rooms. Just because most military branches officially require routine birth control consultations doesn’t mean women will always get them, according to Ibis researcher Kate Grindlay, who is one of very few independent researchers looking into this issue.

“One of the challenges that we found [in our research] was that these things were not being done in a consistent way,” Grindlay said. “Some providers having these conversations in a routine way, some weren’t.”

Access to birth control—and the conversations that lead up to it—has improved greatly for military women in the past 20 years. Elizabeth McCormick, a former Black Hawk pilot who served in the Army from 1994 to 2001, recalled that “no one talked about birth control” in any of her pre-deployment medical events in the 1990s. By contrast, some of the women I spoke with who served more recently said they didn’t have issues getting the care they needed.

However, in a 2010 Ibis survey of deployed women, 59 percent of respondents said they hadn’t discussed contraception with a military health-care provider before deployment and 41 percent said they had difficulty obtaining the birth control refills they needed while away from home. Servicewomen also reported being denied an IUD because they had not yet had children, even though nulliparous women can use the devices.

These inconsistencies are part of the problem Allergan says it hopes to address with its education efforts for military health-care providers. The company hasn’t explicitly said what those efforts will look like.

Another part of the problem, according to former Marine Corps officer and Cobra helicopter pilot Kyleanne Hunter, might be cultural. Conversations with military medical providers likely present another major barrier to proper contraceptive care because most military doctors are not only men, but also officers, who, outside the context of a hospital exam room, can give orders that must be respected.

Young female enlisted service members who have internalized the military’s rigid power structures might be reluctant to speak honestly and openly about reproductive care, posited Hunter, who’s currently a University of Denver PhD candidate studying the national security impact of integrating women into western militaries. She said the same dynamic often prevents women from coming forward after they have been sexually assaulted by a fellow service member.

“It adds one more layer to what’s already an uncomfortable conversation,” Hunter said.

When Bethany Saros returned to Fort Lewis, Washington, after leaving Iraq for her pregnancy, a conversation with a male doctor solidified her decision to quit the Army altogether.

“I had to go through a physical, and there was a Marine doctor, and he said, ‘Was there enough room on the plane for all the pregnant ladies that came back?’” she told me, still taken aback by the incident.

Grindlay said efforts like Allergan’s to increase the use of IUDs in the military are “very beneficial” to servicewomen. She also applauded a provision in the 2016 National Defense Authorization Act to require standardized clinical guidelines for contraceptive care across the armed forces. Under the new provisions, women in the armed forces must receive counseling on the “full range of methods of contraception provided by health care providers” during pre-deployment health care visits, visits during deployment, and annual physical exams.

But there’s still work to be done in order for the military to provide full access to reproductive health care, particularly when it comes to abortion. Tricare, the military’s health and insurance provider, only covers abortions “if pregnancy is the result of rape or incest or the mother’s life is at risk,” and certain countries in which the military operates ban the procedure altogether.

In a sampling of 130 online responses for a medication abortion consultation service reviewed by Ibis in 2011, several military women reported considered using “unsafe methods” to try to terminate a pregnancy themselves, according to Grindlay. One of the women, a 23-year-old stationed in Bahrain, said she had been turned away by five clinics and had contemplated taking “drastic measures.”

According to the 2011 Ibis report, many women sought abortions so that they could continue their military tour. Others feared a pregnancy would otherwise ruin their careers.

Virginia Koday, a former Marine Corps electronics technician who left the service in 2013, said in a phone interview that women can face losing their rank or getting charged for violating military policy if they become pregnant overseas. “Getting pregnant in Afghanistan is good cause to terminate your own pregnancy without anyone finding out,” she said.

“The unspoken code is that a good soldier will have an abortion, continue the mission, and get some sympathy because she chose duty over motherhood,” wrote Bethany Saros in a 2011 Salon piece about her unplanned pregnancy.

For these women, one act of unprotected sex had the potential to derail their career. For the men, it was just a night of fun.

Kyleanne Hunter said that while she doesn’t have a “whole lot of sympathy” for women who become pregnant on deployments (they’re not supposed to be having sex in the first place, she argues), she disagrees with the double standard that allows the men involved to escape punishment.

“Both parties need to be held exactly to the same accountability standards,” said Hunter. “If the woman is punished, then whoever she is involved with should be punished a well, because it takes two. She’s not alone in it. There’s no immaculate conception going on there.”

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