Men Can Help Prevent Unintended Pregnancy, Too

Brian Nguyen

If ever there was a perfect time for men to band together against a loss of fatherhood, that time is now -- with their demand for access to emergency contraception. Those who feel that they have been hurt by abortion have more reason than anyone else to spread knowledge of Plan B and support its widespread provision to men.

Finding himself faced with his partner's unplanned pregnancy, today's man may well be confronted for the first time with a situation in which his opinions and beliefs carry less weight than those of his female partner. In absence of a critical day-to-day assessment of their gender-based privilege and power, privileged men rarely find themselves pushed to recognize the negative effects of their power on the lives of others. So when men create an anti-abortion movement that turns a woman's decision to have an abortion into a story of male victimization and loss of fatherhood, their reaction is understandable — and even predictable.

But the men who claim that they have been victimized by abortion were not powerless to prevent their circumstances. When a couple uses contraception, they make an implicit agreement that they are not ready to be pregnant. For a man to not be ready to face these decisions, have unprotected sex, and then be upset with his partner for having obtained an abortion and deprived him of his reproductive rights is totally contradictory.

These arguments should in no way delegitimize the suffering that men may feel. Abortion can be a difficult experience, but it is one that women should always have the choice to make. No, men cannot have the final say on their partners' decisions. But they can assert their ability to be knowledgeable and supportive both before and after an abortion. Men can spread a positive message of partnership in decision-making. Masculinity does not have to entail a man making the final decisions in a relationship and giving up his personal aspirations to care for his child. Instead, being strong can mean that a man is willing to discuss family planning with his partner so that when pregnancy occurs, it will be intended, and he will be ready to support the family that he helped to create.

Reproductive responsibility has long been considered to be a woman's task — but men are deeply affected by the pregnancy-related decisions women make. Abortion decisions have been considered anecdotally to affect the social, emotional, and physical health of men, especially when men are not considered valuable enough to even hear about the decision making process. As seen from November's "Reclaiming Fatherhood" conference in San Francisco, California, which gathered more than a hundred grief-stricken men who had been directly or indirectly involved in abortions, men do want to play a larger part in reproductive decision making — even if they intend to allow only one option to women and therefore no decision at all. We can sympathize for men who have not had the opportunity to show a more compassionate and supportive side such that their partners would have more likely noticed their potential to both be helpful husbands and unfailing fathers, but we cannot overlook the fact that these sensitivities among men are late in coming. The majority of men seem to want to become part of pregnancy decisions only after having had unprotected sex, and without ever having previously considered their partners' desires to be pregnant with their genetic offspring — or to be pregnant at all.

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Male Involvement in Birth Control and Family Planning

Can men be blamed for sitting back and letting women take the lead in handling birth control? Biology has never forced men to bear the consequences of pregnancy. Nor has our society also asked men to shoulder this burden. The 2005 Debt Reductions Act reduced federal funding for state-run child support enforcement agencies – so men have been with even fewer reasons to be sexually and socially responsible. Meanwhile, the Child Support Protection Act of 2007 has stalled. But even the paternalistic US government is not solely to blame for men playing too small a part in the prevention of unplanned pregnancy. Medical research has been slow to provide contraceptive options for men and because many men assume that women have already secured a birth control method of their own, they have not demanded them for themselves. Current options that men have to prevent pregnancy are limited to condoms, periodic abstinence, withdrawal, and vasectomy — and these options are woefully inadequate, when compared to options available to women. Yet even if there existed a better birth control option for men, the difficulties public health organizations have had convincing men to use condoms belie a more desperate situation, in which, for many men, possible consequences of sexual activity are considered only after sex takes place.

But men can do better and women should expect this of them. One simple and very concrete way men can take more responsibility for reproductive health and family planning has been made possible by the FDA approval of over-the-counter provision of emergency contraception.

Male Access to Emergency Contraception

If ever there was a perfect time for men to band together against a loss of fatherhood, that time is now — with their demand for access to emergency contraception. Those who feel that they have been hurt by abortion have more reason than anyone else to spread knowledge of Plan B and support its widespread provision to men.

Men who have not been responsible enough to find out if their partners want to create an environment fit for raising a child may not be ready to be fathers. If men want to reclaim fatherhood, they need reclaim partnership first. To reclaim partnership, they need to take reproductive responsibility into their own hands, before becoming sexually active.

In August 2006, the FDA approved of Plan B as an over-the-counter emergency contraceptive option for women age 18 and up. But not until December of the same year did the FDA clarify that Plan B could be sold to men aged 18 and over for personal provision to women. While a publicity buzz accompanied the monumental status change of August of 2006, the access for men that came five months later has been inadequately emphasized, both to the demanding public and dispensing pharmacists. Neglecting male involvement as an asset for family planning can only worsen problematic behaviors that studies have already identified: that men tend not to concern themselves with pregnancy until after being involved in unprotected sexual encounters. If men can be made aware of this post-coital method, they may have an opportunity to become partners for the prevention of unplanned pregnancy.

Men can share the financial burden of Plan B, be advocates of Plan B usage, become knowledgeable resources on where to obtain Plan B, and defend women against any social stigma entailed in pursuit of emergency contraception. The added male resources and support of women are especially important considering that a 2005 survey of university students showed that almost half of students believed that Plan B was the same as RU-486 (the "abortion pill") and 100% of students felt that they would feel embarrassed or judged when asking for it. For some men, being acknowledged during his partner's concern over a possible unplanned pregnancy can also prevent a feeling of alienation from what has been socially considered a woman's responsibility.

As Plan B is most effective (89%) within 72 hours of unprotected sexual intercourse, with effectiveness decreasing with each moment after initiation of unprotected intercourse, a male ally can access Plan B when his partner is unaware of its existence, is at work, incapacitated, financially unable, or underage, and this could be significant for the prevention of unplanned pregnancy. Doubling the population of knowledgeable buyers of emergency contraception through the recruitment of men could go a long way in preventing unplanned pregnancies – in addition to the negative feelings entailed by abortion decisions.

In spite of the substantial promise of this role for men, cases have been reported of men being turned away from their purchase attempts at pharmacies. Along with pharmacists who have opted not to sell Plan B in general, there are pharmacists who, either as a result of a lack of education or an unfounded bias against male intentions, continue to limit the sale of Plan B. Men trying to buy for their partners or buy before having sex for "just in case" moments where condoms break have been turned away when unable to prove the age of their partners. Although the prevalence of denial to men has never been surveyed, its existence is alarming enough. For each man who is denied a chance to participate in family planning interventions, society loses its chance at creating a population of enlightened men, cognizant of their capability and responsibility to women and their future or present families.

A Role for Men That Supports Women

The plea for the assessment of male feelings of sadness and regret after his partner's abortion is not unwarranted. But men cannot appeal for this assessment without understanding the negative effects that male-directed decisions can have upon women. To equate the consequences of an unplanned pregnancy on men with the consequences for their female partners is untenable. Rather than taking away from women for their own gain, men should try to think of a role for themselves that supports both parties. Sex and the creation of a family should be based on love. Men may say that they love their partners, but when they become part of a movement that aims to deprive their partners of a freedom to pursue life as they themselves do, that is not love. Though men may find it difficult to accept a woman's ownership of her own body without having prior been aware of any other form of gender discrimination, men need come to understand a new role for themselves in today's society. As advocates for Plan B, male contraception, the inclusion of male perspectives in family planning, and better sexual health education, men today can ensure a more productive and loving relationship with women in the future.

Photo By: Steve Todey

To start reclaiming fatherhood, contact your local pharmacy to find out if they will provide Plan B to men. Researchers at Brown Medical School in Rhode Island have already begun a survey of male access to Plan B and would be interested to hear more about your experiences with access and thoughts about how men can be supportively involved in reproductive decisions. Send an email to provoicepartners@gmail.com.

News Politics

Missouri ‘Witch Hunt Hearings’ Modeled on Anti-Choice Congressional Crusade

Christine Grimaldi

Missouri state Rep. Stacey Newman (D) said the Missouri General Assembly's "witch hunt hearings" were "closely modeled" on those in the U.S. Congress. Specifically, she drew parallels between Republicans' special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life.

Congressional Republicans are responsible for perpetuating widely discredited and often inflammatory allegations about fetal tissue and abortion care practices for a year and counting. Their actions may have charted the course for at least one Republican-controlled state legislature to advance an anti-choice agenda based on a fabricated market in aborted “baby body parts.”

“They say that a lot in Missouri,” state Rep. Stacey Newman (D) told Rewire in an interview at the Democratic National Convention last month.

Newman is a longtime abortion rights advocate who proposed legislation that would subject firearms purchases to the same types of restrictions, including mandatory waiting periods, as abortion care.

Newman said the Missouri General Assembly’s “witch hunt hearings” were “closely modeled” on those in the U.S. Congress. Specifically, she drew parallels between Republicans’ special investigative bodies—the U.S. House of Representatives’ Select Investigative Panel on Infant Lives and the Missouri Senate’s Committee on the Sanctity of Life. Both formed last year in response to videos from the anti-choice front group the Center for Medical Progress (CMP) accusing Planned Parenthood of profiting from fetal tissue donations. Both released reports last month condemning the reproductive health-care provider even though Missouri’s attorney general, among officials in 13 states to date, and three congressional investigations all previously found no evidence of wrongdoing.

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Missouri state Sen. Kurt Schaefer (R), the chair of the committee, and his colleagues alleged that the report potentially contradicted the attorney general’s findings. Schaefer’s district includes the University of Missouri, which ended a 26-year relationship with Planned Parenthood as anti-choice state lawmakers ramped up their inquiries in the legislature. Schaefer’s refusal to confront evidence to the contrary aligned with how Newman described his leadership of the committee.

“It was based on what was going on in Congress, but then Kurt Schaefer took it a step further,” Newman said.

As Schaefer waged an ultimately unsuccessful campaign in the Missouri Republican attorney general primary, the once moderate Republican “felt he needed to jump on the extreme [anti-choice] bandwagon,” she said.

Schaefer in April sought to punish the head of Planned Parenthood’s St. Louis affiliate with fines and jail time for protecting patient documents he had subpoenaed. The state senate suspended contempt proceedings against Mary Kogut, the CEO of Planned Parenthood of St. Louis Region and Southwest Missouri, reaching an agreement before the end of the month, according to news reports.

Newman speculated that Schaefer’s threats thwarted an omnibus abortion bill (HB 1953, SB 644) from proceeding before the end of the 2016 legislative session in May, despite Republican majorities in the Missouri house and senate.

“I think it was part of the compromise that they came up with Planned Parenthood, when they realized their backs [were] against the wall, because she was not, obviously, going to illegally turn over medical records.” Newman said of her Republican colleagues.

Republicans on the select panel in Washington have frequently made similar complaints, and threats, in their pursuit of subpoenas.

Rep. Marsha Blackburn (R-TN), the chair of the select panel, in May pledged “to pursue all means necessary” to obtain documents from the tissue procurement company targeted in the CMP videos. In June, she told a conservative crowd at the faith-based Road to Majority conference that she planned to start contempt of Congress proceedings after little cooperation from “middle men” and their suppliers—“big abortion.” By July, Blackburn seemingly walked back that pledge in front of reporters at a press conference where she unveiled the select panel’s interim report.

The investigations share another common denominator: a lack of transparency about how much money they have cost taxpayers.

“The excuse that’s come back from leadership, both [in the] House and the Senate, is that not everybody has turned in their expense reports,” Newman said. Republicans have used “every stalling tactic” to rebuff inquiries from her and reporters in the state, she said.

Congressional Republicans with varying degrees of oversight over the select panel—Blackburn, House Speaker Paul Ryan (WI), and House Energy and Commerce Committee Chair Fred Upton (MI)—all declined to answer Rewire’s funding questions. Rewire confirmed with a high-ranking GOP aide that Republicans budgeted $1.2 million for the investigation through the end of the year.

Blackburn is expected to resume the panel’s activities after Congress returns from recess in early September. Schaeffer and his fellow Republicans on the committee indicated in their report that an investigation could continue in the 2017 legislative session, which begins in January.

Commentary Contraception

Hillary Clinton Played a Critical Role in Making Emergency Contraception More Accessible

Susan Wood

Today, women are able to access emergency contraception, a safe, second-chance option for preventing unintended pregnancy in a timely manner without a prescription. Clinton helped make this happen, and I can tell the story from having watched it unfold.

In the midst of election-year talk and debates about political controversies, we often forget examples of candidates’ past leadership. But we must not overlook the ways in which Hillary Clinton demonstrated her commitment to women’s health before she became the Democratic presidential nominee. In early 2008, I wrote the following article for Rewirewhich has been lightly edited—from my perspective as a former official at the U.S. Food and Drug Administration (FDA) about the critical role that Clinton, then a senator, had played in making the emergency contraception method Plan B available over the counter. She demanded that reproductive health benefits and the best available science drive decisions at the FDA, not politics. She challenged the Bush administration and pushed the Democratic-controlled Senate to protect the FDA’s decision making from political interference in order to help women get access to EC.

Since that time, Plan B and other emergency contraception pills have become fully over the counter with no age or ID requirements. Despite all the controversy, women at risk of unintended pregnancy finally can get timely access to another method of contraception if they need it—such as in cases of condom failure or sexual assault. By 2010, according to National Center for Health Statistics data, 11 percent of all sexually experienced women ages 15 to 44 had ever used EC, compared with only 4 percent in 2002. Indeed, nearly one-quarter of all women ages 20 to 24 had used emergency contraception by 2010.

As I stated in 2008, “All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.”

Now, there are new emergency contraceptive pills (Ella) available by prescription, women have access to insurance coverage of contraception without cost-sharing, and there is progress in making some regular contraceptive pills available over the counter, without prescription. Yet extreme calls for defunding Planned Parenthood, the costs and lack of coverage of over-the-counter EC, and refusals by some pharmacies to stock emergency contraception clearly demonstrate that politicization of science and limits to our access to contraception remain a serious problem.

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Today, women are able to access emergency contraception, a safe, second chance option for preventing unintended pregnancy in a timely manner without a prescription. Sen. Hillary Clinton (D-NY) helped make this happen, and I can tell the story from having watched it unfold.

Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told. On August 31, 2005 I resigned my position as assistant commissioner for women’s health at the Food and Drug Administration (FDA) because the agency was not allowed to make its decisions based on the science or in the best interests of the public’s health. While my resignation was widely covered by the media, it would have been a hollow gesture were there not leaders in Congress who stepped in and demanded more accountability from the FDA.

I have been working to improve health care for women and families in the United States for nearly 20 years. In 2000, I became the director of women’s health for the FDA. I was rather quietly doing my job when the debate began in 2003 over whether or not emergency contraception should be provided over the counter (OTC). As a scientist, I knew the facts showed that this medication, which can be used after a rape or other emergency situations, prevents an unwanted pregnancy. It does not cause an abortion, but can help prevent the need for one. But it only works if used within 72 hours, and sooner is even better. Since it is completely safe, and many women find it impossible to get a doctor’s appointment within two to three days, making emergency contraception available to women without a prescription was simply the right thing to do. As an FDA employee, I knew it should have been a routine approval within the agency.

Plan B emergency contraception is just like birth control pills—it is not the “abortion pill,” RU-486, and most people in the United States don’t think access to safe and effective contraception is controversial. Sadly, in Congress and in the White House, there are many people who do oppose birth control. And although this may surprise you, this false “controversy” not only has affected emergency contraception, but also caused the recent dramatic increase in the cost of birth control pills on college campuses, and limited family planning services across the country.  The reality is that having more options for contraception helps each of us make our own decisions in planning our families and preventing unwanted pregnancies. This is something we can all agree on.

Meanwhile, inside the walls of the FDA in 2003 and 2004, the Bush administration continued to throw roadblocks at efforts to approve emergency contraception over the counter. When this struggle became public, I was struck by the leadership that Hillary Clinton displayed. She used the tools of a U.S. senator and fought ardently to preserve the FDA’s independent scientific decision-making authority. Many other senators and congressmen agreed, but she was the one who took the lead, saying she simply wanted the FDA to be able to make decisions based on its public health mission and on the medical evidence.

When it became clear that FDA scientists would continue to be overruled for non-scientific reasons, I resigned in protest in late 2005. I was interviewed by news media for months and traveled around the country hoping that many would stand up and demand that FDA do its job properly. But, although it can help, all the media in the world can’t make Congress or a president do the right thing.

Sen. Clinton made the difference. The FDA suddenly announced it would approve emergency contraception for use without a prescription for women ages 18 and older—one day before FDA officials were to face a determined Sen. Clinton and her colleague Sen. Murray (D-WA) at a Senate hearing in 2006. No one was more surprised than I was. All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.

Sometimes these success stories get lost in the “horse-race stories” about political campaigns and the exposes of taxpayer-funded bridges to nowhere, and who said what to whom. This story of emergency contraception at the FDA is just one story of many. Sen. Clinton saw a problem that affected people’s lives. She then stood up to the challenge and worked to solve it.

The challenges we face in health care, our economy, global climate change, and issues of war and peace, need to be tackled with experience, skills and the commitment to using the best available science and evidence to make the best possible policy.  This will benefit us all.

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