The Family Research Council (FRC) is a savvy bunch.
The FRC, as a reminder, has apparently decided to act on their contention that federal contraception funding (Title X program) is too connected to centers that also provide abortion (because we all know how silly it is for a woman who has received an abortion to be given access to birth control afterwards or for women to be able to receive all or most of their reproductive health care in one place).
But here’s the interesting part:
Who oversees the above mentioned Title X program? Why, it’s Susan Orr. And who is Susan Orr? Dr. Orr is a former top official with the Family Research Council, the very same organization that is now petitioning to severely impair family planning access for low-income women and men in this country.
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If you remember, Susan Orr was the focus of a media frenzy back when she was appointed to her current position as head of our country’s contraception program last year. As a vocal opponent of contraception, it was (and still is) a slap in the face to, well, all Americans who use and access contraception – including the 98% of women who will use birth control at some point in their lives.
The questions to explore are: was this all a part of a larger strategy conceived of by the FRC once Susan Orr was appointed as head of the Title X program? How could they not have thought, at that time, they would have a real opportunity to inflict severe damage on this public health program with their former colleague and leader at the helm?
And, finally, was this aforementioned strategy discussed with Susan Orr prior to the letter they recently sent? Isn’t this a bit like the oil companies setting energy policy with Dick Cheney?
Planned Parenthood relies on Title X funding to provide family planning and contraceptive services to milions of low-income women and men around the country. Which organizations would pick up that slack should the funding be cut off?
More to come as it develops but if you haven’t yet please take a moment to send a letter to Department of Health and Human Services Secretary Mike Leavitt (and mention Susan Orr’s curious ties to the FRC in your letter as well).
It's time for a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities.
As a chronically ill, chronically poor person, I have feelings about when, why, and how the phrase “self-care” is invoked. When International Self-Care Day came to my attention, I realized that while I laud the effort to prevent some of the 16 million people the World Health Organization reports die prematurely every year from noncommunicable diseases, the American notion of self-care—ironically—needs some work.
I propose a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities. How we think about what constitutes vital versus optional care affects whether/when we do those things we should for our health and well-being. Some of what we have come to designate as self-care—getting sufficient sleep, treating chronic illness, allowing ourselves needed sick days—shouldn’t be seen as optional; our culture should prioritize these things rather than praising us when we scrape by without them.
International Self-Care Day began in China, and it has spread over the past few years to include other countries and an effort seeking official recognition at the United Nations of July 24 (get it? 7/24: 24 hours a day, 7 days a week) as an important advocacy day. The online academic journal SelfCare calls its namesake “a very broad concept” that by definition varies from person to person.
“Self-care means different things to different people: to the person with a headache it might mean a buying a tablet, but to the person with a chronic illness it can mean every element of self-management that takes place outside the doctor’s office,” according to SelfCare. “[I]n the broadest sense of the term, self-care is a philosophy that transcends national boundaries and the healthcare systems which they contain.”
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In short, self-care was never intended to be the health version of duct tape—a way to patch ourselves up when we’re in pieces from the outrageous demands of our work-centric society. It’s supposed to be part of our preventive care plan alongside working out, eating right, getting enough sleep, and/or other activities that are important for our personalized needs.
The notion of self-care has gotten a recent visibility boost as those of us who work in human rights and/or are activists encourage each other publicly to recharge. Most of the people I know who remind themselves and those in our movements to take time off do so to combat the productivity anxiety embedded in our work. We’re underpaid and overworked, but still feel guilty taking a break or, worse, spending money on ourselves when it could go to something movement- or bill-related.
The guilt is intensified by our capitalist system having infected the self-care philosophy, much as it seems to have infected everything else. Our bootstrap, do-it-yourself culture demands we work to the point of exhaustion—some of us because it’s the only way to almost make ends meet and others because putting work/career first is expected and applauded. Our previous president called it “uniquely American” that someone at his Omaha, Nebraska, event promoting “reform” of (aka cuts to) Social Security worked three jobs.
“Uniquely American, isn’t it?” he said. “I mean, that is fantastic that you’re doing that. (Applause.) Get any sleep? (Laughter.)”
The audience was applauding working hours that are disastrous for health and well-being, laughing at sleep as though our bodies don’t require it to function properly. Bush actually nailed it: Throughout our country, we hold Who Worked the Most Hours This Week competitions and attempt to one-up the people at the coffee shop, bar, gym, or book club with what we accomplished. We have reached a point where we consider getting more than five or six hours of sleep a night to be “self-care” even though it should simply be part of regular care.
Most of us know intuitively that, in general, we don’t take good enough care of ourselves on a day-to-day basis. This isn’t something that just happened; it’s a function of our work culture. Don’t let the statistic that we work on average 34.4 hours per week fool you—that includes people working part time by choice or necessity, which distorts the reality for those of us who work full time. (Full time is defined by the Internal Revenue Service as 30 or more hours per week.) Gallup’s annual Work and Education Survey conducted in 2014 found that 39 percent of us work 50 or more hours per week. Only 8 percent of us on average work less than 40 hours per week. Millennials are projected to enjoy a lifetime of multiple jobs or a full-time job with one or more side hustles via the “gig economy.”
Despite worker productivity skyrocketing during the past 40 years, we don’t work fewer hours or make more money once cost of living is factored in. As Gillian White outlined at the Atlantic last year, despite politicians and “job creators” blaming financial crises for wage stagnation, it’s more about priorities:
Though productivity (defined as the output of goods and services per hours worked) grew by about 74 percent between 1973 and 2013, compensation for workers grew at a much slower rate of only 9 percent during the same time period, according to data from the Economic Policy Institute.
It’s no wonder we don’t sleep. The Centers for Disease Control and Prevention (CDC) has been sounding the alarm for some time. The American Academy of Sleep Medicine and the Sleep Research Society recommend people between 18 and 60 years old get seven or more hours sleep each night “to promote optimal health and well-being.” The CDC website has an entire section under the heading “Insufficient Sleep Is a Public Health Problem,” outlining statistics and negative outcomes from our inability to find time to tend to this most basic need.
We also don’t get to the doctor when we should for preventive care. Roughly half of us, according to the CDC, never visit a primary care or family physician for an annual check-up. We go in when we are sick, but not to have screenings and discuss a basic wellness plan. And rarely do those of us who do go tell our doctors about all of our symptoms.
I recently had my first really wonderful check-up with a new primary care physician who made a point of asking about all the “little things” leading her to encourage me to consider further diagnosis for fibromyalgia. I started crying in her office, relieved that someone had finally listened and at the idea that my headaches, difficulty sleeping, recovering from illness, exhaustion, and pain might have an actual source.
Considering our deeply-ingrained priority problems, it’s no wonder that when I post on social media that I’ve taken a sick day—a concept I’ve struggled with after 20 years of working multiple jobs, often more than 80 hours a week trying to make ends meet—people applaud me for “doing self-care.” Calling my sick day “self-care” tells me that the commenter sees my post-traumatic stress disorder or depression as something I could work through if I so chose, amplifying the stigma I’m pushing back on by owning that a mental illness is an appropriate reason to take off work. And it’s not the commenter’s fault; the notion that working constantly is a virtue is so pervasive, it affects all of us.
Things in addition to sick days and sleep that I’ve had to learn are not engaging in self-care: going to the doctor, eating, taking my meds, going to therapy, turning off my computer after a 12-hour day, drinking enough water, writing, and traveling for work. Because it’s so important, I’m going to say it separately: Preventive health care—Pap smears, check-ups, cancer screenings, follow-ups—is not self-care. We do extras and nice things for ourselves to prevent burnout, not as bandaids to put ourselves back together when we break down. You can’t bandaid over skipping doctors appointments, not sleeping, and working your body until it’s a breath away from collapsing. If you’re already at that point, you need straight-up care.
Plenty of activities are self-care! My absolutely not comprehensive personal list includes: brunch with friends, adult coloring (especially the swear word books and glitter pens), soy wax with essential oils, painting my toenails, reading a book that’s not for review, a glass of wine with dinner, ice cream, spending time outside, last-minute dinner with my boyfriend, the puzzle app on my iPad, Netflix, participating in Caturday, and alone time.
My someday self-care wish list includes things like vacation, concerts, the theater, regular massages, visiting my nieces, decent wine, the occasional dinner out, and so very, very many books. A lot of what constitutes self-care is rather expensive (think weekly pedicures, spa days, and hobbies with gear and/or outfit requirements)—which leads to the privilege of getting to call any part of one’s routine self-care in the first place.
It would serve us well to consciously add an intersectional view to our enthusiasm for self-care when encouraging others to engage in activities that may be out of reach financially, may disregard disability, or may not be right for them for a variety of other reasons, including compounded oppression and violence, which affects women of color differently.
I hear the term self-care a lot and often it is defined as practicing yoga, journaling, speaking positive affirmations and meditation. I agree that those are successful and inspiring forms of self-care, but what we often don’t hear people talking about is self-care at the intersection of race and trauma, social justice and most importantly, the unawareness of repressed emotional issues that make us victims of our past.
The often-quoted Audre Lorde wrote in A Burst of Light: “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
But as we continue to talk about self-care, we need to be clear about the difference between self-care and actual care and work to bring the necessities of life within reach for everyone. Actual care should not have to be optional. It should be a priority in our culture so that it can be a priority in all our lives.
The Conscience Protection Act would give health-care providers a private right of action to seek civil damages in court, should they face supposed coercion to provide abortion care or discrimination stemming from their refusal to assist in abortion care. The Act allows providers to sue not only for threats, but also for perceived threats.
UPDATE: July 14, 10 a.m.: The House passed the Conscience Protection Act Wednesday night in a largely party line 245-182 vote. Prior to floor consideration, House Republicans stripped the text of an unrelated Senate-passed bill (S. 304) and replaced it with the Conscience Protection Act. They likely did so to skip the Senate committee referral process, House Democratic aides told Rewire, expediting consideration across the capitol and, in theory, ushering a final bill to the president’s desk. President Barack Obama, however, would veto the Conscience Protection Act, according to a statement of administration policy.
The U.S. House of Representatives will vote next Wednesday on legislation that would allow a broadened swath of health-care providers to sue if they’re supposedly coerced into providing abortion care, or if they face discrimination for refusing to provide such care, according to a prominent anti-choice lawmaker.
Rep. Joe Pitts (R-PA) told Rewire in a Friday morning interview that House leadership confirmed a vote on the Conscience Protection Act (H.R. 4828) for July 13, days before the chamber adjourns for the presidential nominating conventions and the August recess. Pitts said he expects the bill to be brought up as a standalone measure, rather than as an amendment to any of the spending bills that have seen Republican amendments attacking a range of reproductive health care and LGBTQ protections.
The office of U.S. House Speaker Paul Ryan (R-WI) had no immediate comment.
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Pitts’ remarks came during and after he hosted a “Forum on Conscience Protections” in the House Energy and Commerce Committee room to garner support for the bill.
Energy and Commerce Democrats boycotted the forum, a House Democratic aide told Rewire in a subsequent interview.
Legislation Builds on Precedent
Conscience protections are nothing new, the aide said. The latest iteration is a successor to the Health Care Conscience Rights Act (S. 1919/H.R. 940), which remains pending in the House and U.S. Senate. There’s also the Abortion Non-Discrimination Act (S. 50) and similarly named bills in both chambers. The fiscal year 2017 Labor, Health, and Human Services funding bill, which guts Title X and Teen Pregnancy Prevention grants, includes the Health Care Conscience Rights Act.
At the leadership level, Ryan’s recently released health-care plan mimics key provisions in the Conscience Protection Act. Both would give health-care providers a private right of action to seek civil damages in court, should they face alleged coercion or discrimination stemming from their refusal to assist in abortion care. The Conscience Protection Act goes a step further, allowing providers to sue not only for threats, but also for perceived threats.
The proposals would also codify and expand the Weldon Amendment, named for former Rep. Dave Weldon (R-FL), who participated in Pitts’ conscience forum. The Weldon Amendment prohibits states that receive federal family planning funding from discriminating against health-care plans based on whether they cover abortion care. Currently, Congress must pass Weldon every year as an amendment to annual appropriations bills.
Administration Action Provides Impetus
There hadn’t been much public dialogue around conscience protections with the exception of some anti-choice groups that “have really been all over it,” the aide said. The National Right to Life issued an action alert, as did the Susan B. Anthony List, to galvanize support for the Conscience Protection Act.
The relative silence on the issue began to break after the Obama administration took a stand on abortion care in June.
The California decision reinvigorated support for the Conscience Protection Act, the aide said. Ryan’s earlier health-care plan also specifically references the decision.
“We think this is going to be a big issue for us throughout the rest of this Congress,” the aide said.
Aide Outlines Additional Consequences
Beyond creating a private right of action and codifying Weldon, the Conscience Protection Act contains additional consequences for abortion care, the aide said.
The legislation would expand the definition of health-care providers to employers, social service organizations, and any other entity that offers insurance coverage, allowing them to raise objections under Weldon, the aide said. The aide characterized the change as a direct response to the California decision.
The legislation also broadens the list of objectionable services to include facilitating or making arrangements for abortion care, according to the aide.
The Republican-dominated House is likely to pass the Conscience Protection Act. But the aide did not expect it to advance in the Senate, which would all but certainly require a 60-vote threshold for such a controversial measure. More than anything, the aide said, the bill seems to be catering to anti-choice groups and long-time proponents of conscience clauses.
“The House oftentimes will pass these kinds of anti-choice proposals, and then they just go nowhere in the Senate,” the aide said.