The Bush Administration’s Tortured Logic

Carole Joffe

An administration that has done everything in its power to oppose abortion is now going after the very thing that can best prevent unintended pregnancies.

Fans of Jewish folklore are familiar with tales from the town of Chelm, the legendary center of foolishness.
Chelm’s citizens unfailingly choose actions guaranteed to achieve the
opposite of what was desired. The children need more milk? Buy a billy
goat! The synagogue needs a new roof? Build a new floor! There has been
much about the eight long years of the George W. Bush presidency that
has made one think s/he was living in Chelm (remember how we were told
the U.S. invasion of Iraq would be greeted by Iraqis bearing flowers
and sweets?). Now, in the waning days of this presidency comes a move
that would no doubt earn special respect from the people of Chelm
because of its tortured logic. Draft regulations now circulating in the
Department of Health and Human Services would redefine many forms of contraception (including most birth control pills) as "abortions."

So an administration that has done everything in its power to oppose
abortion-making sure its appointments to the Supreme Court and other
key positions are reliably anti-abortion, signing a bill banning a
rarely used but sometimes medically necessary abortion procedure and so
on — now goes after the main thing that can prevent unwanted pregnancies?
In true Chelm-like fashion, this Administration is proposing a policy
that virtually assures there will be more abortions.

Specifically, the proposed rule advocates a dramatically broadened interpretation of the Weldon Amendment,
a 2004 measure which prohibits recipients of federal funds from
"discriminating" against individuals or institutions who refuse to
provide abortion services or be otherwise involved in abortion care,
including referrals. Here is the wording from HHS
[pdf]: "the Department proposes to define abortion as any of the
various procedures- including the prescription and administration of
any drug or the performance of any procedure or any other action-that
results in the termination of the life of a human being in utero
between conception and natural birth, whether before or after

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This definition of when pregnancy begins — and therefore what
constitutes an "abortion" — is at odds with a longstanding consensus
within the medical community which defines pregnancy as beginning with
implantation into the uterine wall, and not fertilization. Jessica
Arons, in an excellent posting on Science Progress,
points out a number of compelling scientific reasons why implantation
is the medical marker for pregnancy: there is actually no way to know
if a woman is pregnant prior to implantation; fertilization itself is a
process that can take up to 24 hours, and anywhere from one third to
one half of all fertilized eggs never begin or complete implantation.

But this HHS proposal of course is not about science, but about
politics. This proposal, if implemented, could potentially wreak havoc
with the country’s family planning programs for low income women and
teens, dissemination of Emergency Contraception in hospital ERs, and
the ability of women in various places to pick up their monthly packet
of birth control pills at their local pharmacy, to name just a few. The
proposal very cleverly speaks to two main policy objectives of the
Religious Right: to change the cultural — as well as bureaucratic —
understanding of contraception, and to further the cause of "health worker refusals" —
the growing movement of individuals who withhold access to various
medications and procedures with which they have political disagreement.

How did we arrive at such a surreal and backward turning moment in
public policy, nearly 50 years after the discovery of oral
contraception- an invention, in the words of Economist magazine, that "defined a century" — and more than 40 years after the Supreme Court, in the Griswold decision,
legalized birth control? Not so long ago, contraception was seen by
many politicians as "common ground" between the supporters and
opponents of abortion. One of the most enthusiastic supporters of Title X (the
leading government program that funds family planning services for low
income women and teens) when the program was established in 1970, was
George H.W. Bush. Then a Congressman from Texas, he was nicknamed
"rubbers" because of his promotion of contraception.

But this common ground approach did not last long after the election
of Ronald Reagan in 1980, and the rise of the Religious Right as a
powerful force in the Republican Party. Rightwing extremists began to
reframe contraception as "supportive of the abortion mentality," and
not as something that actually might reduce the need for abortions.
Opposition to publically funded family planning, as well as abstinence-only sex education
(programs that are forbidden to even mention birth control methods,
except to give misinformation about their effectiveness) joined
abortion as key domestic targets of these religious conservatives. The
elevation of contraception to actual abortion status was a logical next
step in a presidential administration that has often shown contempt for scientific findings when they are inconvenient. (Think of the Bush administration’s record on climate change).

Meanwhile, just in the last few days, the highly respected Guttmacher Institute,
which specializes in reproductive health issues, issued a report
stating that without the publically funded contraceptive services
currently provided to seven million women each year, the number of
unintended pregnancies and abortions in the U.S. would be 50% higher.
In other words, 1.4 million pregnancies and 600,000 abortions are averted each year because of these programs.

The Religious Right for years has tried to get rid of Title X
altogether, and has managed to keep the program greatly underfunded.
The HHS proposal, if it went into effect, offers a new line of attack:
Title X sites would quite likely be faced with an orchestrated campaign
of applications by religious conservatives who would invoke their
newfound right to refuse to dispense contraception.

It is not clear, as of this writing, what will be become of the HHS
draft proposal. Predictably, the reproductive health community is appalled
and the Religious Right is thrilled with the prospect of it becoming
policy. The Bush administration could order this regulation to be
implemented- which would not require Congressional approval. The next
president, if he is so inclined, could overturn it. Barack Obama has
joined with lawmakers from both parties in a letter of outrage to HHS.
John McCain, on the other hand, has "declined to comment" on the matter. One hopes that the 98% of heterosexually active women who have used at least one contraceptive method will note these differing positions. Chelm is charming as folklore, not as reality.

This article first appeared on the Beacon Broadside.

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