An Urgent Sexual and Reproductive Health Agenda for a Pro-Choice President and Congress

Marilyn Keefe

A supporter of reproductive health and rights will occupy the White House come January. The ranks of pro-choice legislators in the House and Senate will grow significantly. There is a lot for a new administration to do and undo on reproductive health, but it's what we voted for.

They said this would never
happen again.  They said choice was a losing issue.  They
said pro-choice Democrats should avoid the issue, and pro-choice Republicans
should hide their views.  They said this day would never again

Here it is.  One day after
an historic election and we can say, conclusively:  The naysayers
were wrong.  A supporter of reproductive health
and rights will occupy the White House come January. The ranks of pro-family,
pro-choice legislators in both the House and Senate
are slated to grow significantly. On January 20, at least five new
pro-choice/pro-family planning senators will take office along with
15 or so new choice/pro-family planning members of the House.  

Make no mistake.  The
pro-choice gains were not incidental; nobody won in spite of
being pro-choice.  The overwhelming defeat of four anti-choice
ballot measures across the country, including the key swing state of
Colorado, tells us that.  So does the fact that "right to life"
groups were as active as ever this year, and that the issue was discussed
in the last presidential debate. 

America doesn’t want to go
where President Bush wanted to take us – to a Supreme Court that overturns
Roe v. Wade
, to new and impenetrable obstacles that prevent low-income
women from getting the contraceptives they need, to tax dollars supporting
abstinence-only programs that don’t work, to the world Governor Palin
inhabits which has no grey areas, no middle ground, no room for good
people to disagree. 

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The increased support in Congress
will be critical as supporters of choice begin working to reverse the
legacy of the past eight years and press for an agenda more reflective
of the needs of women and families. President Bush did a lot to erode
the rights of women, both in this country and abroad.  He opposed
access to emergency contraception, gave lifetime appointments to two
stridently anti-choice Supreme Court justices, promoted abstinence-only
sex education programs, under-funded cost-effective family planning
services though Title X and Medicaid, and used U.S. dollars internationally
to deny women the reproductive health care they need.

But can we reasonably
ask – and realistically expect – action on sexual and reproductive health in the coming months, especially
given the record federal deficits and an economy in deep trouble?

There are reasons to be optimistic. Here’s why.

1. President-Elect Obama’s
record of support for reproductive rights

His record of support is consistent
and clear, both in the Illinois legislature and the U.S. Senate. He
has been a strong proponent of sex education, sponsoring legislation
to replace failed abstinence-only programs with comprehensive, medically
accurate curricula. He cosponsored legislation to restore birth control
discounts for low-income and college women. He cosponsored the Freedom
of Choice Act, to codify Roe v. Wade. Obama is an original co-sponsor
of Prevention First, which would expand access to contraception for
low-income women, require health insurance companies to cover contraception,
and provide a dedicated funding stream for age-appropriate, medically
accurate and honest sex education programs. He also co-sponsored legislation
to expand coverage of family planning services so that it matches Medicaid
coverage for pregnancy-related care – a bill that would help low-income
women prevent some 500,000 unintended pregnancies each year, 200,000
of which result in abortion. 

2. There’s safety in numbers:
We have more pro-choice members in Congress and some of the most vocal
opponents are gone.  Gone is ultra-conservative Colorado Republican
Marilyn Musgrave, who in 2006 called the fight against gay marriage
"the most important issue that we face today." Musgrave will be
replaced by Betsy Markey (D-CO), who is pro-choice. Gone is Rep. Tom
Feeney (FL), a "passionate pro-life" member who staunchly opposed
the Title X family planning program. In the Senate, newly elected Jeanne
Shaheen (D-NH), Mark Udall (D-CO), Tom Udall (D-NM), Mark Warner (D-VA)
and Kay Hagan (D-NC) will be replacing five senators whose records on
reproductive choice were unequivocally hostile.   

3. Inaction is
not an option.
  The unmet public health needs and the inattention
to the public health infrastructure for the last eight years make inaction
impossible.  The litany of problems facing women seeking reproductive
health care is long, and the coming action on health care reform will
bring this issue to the fore. Whether trying to avoid pregnancy or
to plan a family, access to birth control and reproductive health services
is a necessary component of basic health care. Today, nearly one-half
of pregnancies in this country are unintended at the time of conception.
By age 45, nearly half of all women will have experienced an unintended
pregnancy. Nearly half of Americans contract a sexually transmitted
infection (STI) in their lives. Our nation’s real and compelling need
to improve access to comprehensive reproductive health care services
has not been well-served by the demonization of these issues over the
last eight years.

So what’s a president to
do? Here are a few suggestions for an incoming administration. 

1.  Reverse the HHS
Refusal Rule
, which will likely be published in final form
any day now.  This ill-conceived and unnecessary rule will obstruct
access to reproductive and other health services, counseling and referrals. 
It could open the door for more widespread health service refusals. 
This rule not only ignores patients’ health care needs, it also conflicts
with accepted medical standards of health care and treatment and may
create conflicts with state laws designed to enhance access to reproductive
health services.   

2. Ensure Health
Care Reform Efforts Advance Access to Reproductive Health Care:
First and foremost, reproductive health – including coverage of abortion
and contraception – must be recognized as a
critical component of care, not an afterthought or the "third rail"
of the discussion. The public health infrastructure needs to be preserved
and expanded.  

3. Prioritize
and normalize prevention: Widespread use of birth control improves
maternal and child health and has been the driving force in reducing
unintended pregnancy and preventing STIs. Yet the cost of contraception
can be a significant barrier to accessing services, especially for low-income
and adolescent women. Investing in programs to expand access to subsidized
family planning services is a cost-effective and proven way to improve
public health.  Priority should be given to increasing funding
for the Title X family planning program and for the CDC’s program
to screen and treat sexually transmitted infections. Eligibility for
cost-effective Medicaid-funded family planning services should be expanded
so more women can access services. And instead of funding ineffective
abstinence-only education programs, we should support comprehensive
sex education that give young people the information and skills they
need to make responsible and safe choices about their reproductive health.

4. Renew U.S. support for
international family planning programs:
  U.S. investments in
reproductive health yield an array of benefits in developing countries,
including improved maternal and child health, fewer unintended pregnancies
and abortions, lower HIV rates, and higher standards of living.  Funding
should be increased for USAID’s overseas family planning and for the
United Nations Population Fund (UNFPA).
We should reverse harmful policies, including the global gag rule and
this administration’s interpretation of the Kemp-Kasten law, which
have reduced the ability of international non-governmental organizations
to provide vital preventive and life-saving health services in some
of the world’s poorest nations.  

5. End the current restrictions
on embryonic stem cell research
and supplement growing studies of
reprogrammed stem cells with renewed funding for embryonic lines, accompanied
by rigorous scientific and ethical oversight. 

Remove Barriers to Abortion Care: 

In addition to the recently proposed rule that undermines access to
reproductive health care services, long-standing bans on public funding
for abortion services have severely restricted access to safe abortion
care for women who depend on the government for their health care. These
policies disproportionately harm low income women, women in the military,
women of color, and certain immigrant women – all of whom already
face significant barriers to receiving timely, high quality health care.   

That’s a lot to do – and
undo, but it’s what the nation wants and needs.  It’s also
what we voted for.   

There’s an urgent agenda
for advocates, too, and it starts with staying active and engaged, and
continuing to fight every day to improve reproductive health care. 
Opponents will surely call our agenda radical, but we simply cannot
let them dominate the debate.  There’s nothing radical about
putting in place the programs, policies and priorities that give all
women access to the education and reproductive health care services
that can reduce teen and unintended pregnancy, stop the epidemic of
sexually transmitted infection, and help women have healthier babies. 

News Politics

Anti-Choice Democrats: ‘Open The Big Tent’ for Us

Christine Grimaldi & Ally Boguhn

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America gathered Wednesday in Philadelphia during the party’s convention to honor Louisiana Gov. John Bel Edwards (D) for his anti-choice viewpoints, and to strategize ways to incorporate their policies into the party.

The group attributed Democratic losses at the state and federal level to the party’s increasing embrace of pro-choice politics. The best way for Democrats to reclaim seats in state houses, governors’ offices, and the U.S. Congress, they charged, is to “open the big tent” to candidates who oppose legal abortion care.

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America members repeatedly attempted to distance themselves from Republicans, reiterating their support for policies such as Medicaid expansion and paid maternity leave, which they believe could convince people to carry their pregnancies to term.

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Their strategy, however, could have been lifted directly from conservatives’ anti-choice playbook.

The group relies, in part, on data from Marist, a group associated with anti-choice polling, to suggest that many in the party side with them on abortion rights. Executive Director Kristen Day could not explain to Rewire why the group supports a 20-week abortion ban, while Janet Robert, president of the group’s board of directors, trotted out scientifically false claims about fetal pain

Day told Rewire that she is working with pro-choice Democrats, including Sen. Kirsten Gillibrand and Rep. Rosa DeLauro, both from New York, on paid maternity leave. Day said she met with DeLauro the day before the group’s event.

Day identifies with Democrats despite a platform that for the first time embraces the repeal of restrictions for federal funding of abortion care. 

“Those are my people,” she said.

Day claimed to have been “kicked out of the pro-life movement” for supporting the Affordable Care Act. She said Democrats for Life of America is “not opposed to contraception,” though the group filed an amicus brief in U.S. Supreme Court cases on contraception. 

Democrats for Life of America says it has important allies in the U.S. House of Representatives and the U.S. Senate. Sens. Joe Donnelly (IN), Joe Manchin (WV), and Rep. Dan Lipinski (IL), along with former Rep. Bart Stupak (MI), serve on the group’s board of advisors, according to literature distributed at the convention.

Another alleged ally, Sen. Bob Casey (D-PA), came up during Edwards’ speech. Edwards said he had discussed the award, named for Casey’s father, former Pennsylvania Gov. Robert P. Casey, the defendant in the landmark Supreme Court decision, Planned Parenthood v. Casey, which opened up a flood of state-level abortions restrictions as long as those anti-choice policies did not represent an “undue burden.”

“Last night I happened to have the opportunity to speak to Sen. Bob Casey, and I told him … I was in Philadelphia, receiving this award today named after his father,” Edwards said.

The Louisiana governor added that though it may not seem it, there are many more anti-choice Democrats like the two of them who aren’t comfortable coming forward about their views.

“I’m telling you there are many more people out there like us than you might imagine,” Edwards said. “But sometimes it’s easier for those folks who feel like we do on these issues to remain silent because they’re not going to  be questioned, and they’re not going to be receiving any criticism.”

During his speech, Edwards touted the way he has put his views as an anti-choice Democrat into practice in his home state. “I am a proud Democrat, and I am also very proudly pro-life,” Edwards told the small gathering.

Citing his support for Medicaid expansion in Louisiana—which went into effect July 1—Edwards claimed he had run on an otherwise “progressive” platform except for when it came to abortion rights, adding that his policies demonstrate that “there is a difference between being anti-abortion and being pro-life.”

Edwards later made clear that he was disappointed with news that Emily’s List President Stephanie Schriock, whose organization works to elect pro-choice women to office, was being considered to fill the position of party chair in light of Rep. Debbie Wasserman Schultz’s resignation.

“It wouldn’t” help elect anti-choice politicians to office, said Edwards when asked about it by a reporter. “I don’t want to be overly critical, I don’t know the person, I just know that the signal that would send to the country—and to Democrats such as myself—would just be another step in the opposite direction of being a big tent party [on abortion].” 

Edwards made no secret of his anti-choice viewpoints during his run for governor in 2015. While on the campaign trail, he released a 30-second ad highlighting his wife’s decision not to terminate her pregnancy after a doctor told the couple their daughter would have spina bifida.

He received a 100 percent rating from anti-choice organization Louisiana Right to Life while running for governor, based off a scorecard asking him questions such as, “Do you support the reversal of Roe v. Wade?”

Though the Democratic Party platform and nominee have voiced the party’s support for abortion rights, Edwards has forged ahead with signing numerous pieces of anti-choice legislation into law, including a ban on the commonly used dilation and evacuation (D and E) procedure, and an extension of the state’s abortion care waiting period from 24 hours to 72 hours.

News Law and Policy

Three Crisis Pregnancy Centers Served for Breaking California Law

Nicole Knight Shine

The notices of violation issued this month mark the first time authorities anywhere in the state are enforcing the seven-month-old Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act.

The Los Angeles City Attorney is warning three area fake clinics, commonly known as crisis pregnancy centers (CPCs), that they’re breaking a new state reproductive disclosure law and could face fines of $500 if they don’t comply.

The notices of violation issued this month mark the first time authorities anywhere in the state are enforcing the seven-month-old Reproductive Freedom, Accountability, Comprehensive Care, and Transparency (FACT) Act, advocates and the state Attorney General’s office indicate.

The office of City Attorney Mike Feuer served the notices on July 15 and July 18 to two unlicensed and one licensed clinic, a representative from the office told Rewire. The Los Angeles area facilities are Harbor Pregnancy Help Center, Los Angeles Pregnancy Services, and Pregnancy Counseling Center.

The law requires the state’s licensed pregnancy-related centers to display a brief statement with a number to call for access to free and low-cost birth control and abortion care, and for unlicensed centers to disclose that they are not medical facilities.

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“Our investigation revealed,” one of the letters from the city attorney warns, “that your facility failed to post the required onsite notice anywhere at your facility and that your facility failed to distribute the required notice either through a printed document or digitally.”

The centers have 30 days from the date of the letter to comply or face a $500 fine for an initial offense and $1,000 for subsequent violations.

“I think this is the first instance of a city attorney or any other authority enforcing the FACT Act, and we really admire City Attorney Mike Feuer for taking the lead,” Amy Everitt, state director of NARAL Pro-Choice California, told Rewire on Wednesday.

Feuer in May unveiled a campaign to crack down on violators, announcing that his office was “not going to wait” amid reports that some jurisdictions had chosen not to enforce the law while five separate court challenges brought by multiple fake clinics are pending.

Federal and state courts have denied requests to temporarily block the law, although appeals are pending before U.S. Court of Appeals for the Ninth Circuit.

In April, Rebecca Plevin of the local NPR affiliate KPCC found that six of eight area fake clinics were defying the FACT Act.

Although firm numbers are hard to come by, around 25 fake clinics, or CPCs, operate in Los Angeles County, according to estimates from a representative of NARAL Pro-Choice California. There are upwards of 1,200 CPCs across the country, according to their own accounting.

Last week, Rewire paid visits to the three violators: Harbor Pregnancy Help Center, Los Angeles Pregnancy Services, and Pregnancy Counseling Center.

Christie Kwan, a nurse manager at Pregnancy Counseling Center, declined to discuss the clinic’s noncompliance, but described their opposition to the state law as a “First Amendment concern.”

All three centers referred questions to their legal counsel, Alliance Defending Freedom (ADF), an Arizona-based nonprofit and frequent defender of discriminatory “religious liberty” laws.

Matt Bowman, senior counsel with ADF, said in an email to Rewire that forcing faith-based clinics to “communicate messages or promote ideas they disagree with, especially on life-and-death issues like abortion,” violates their “core beliefs” and threatens their free speech rights.

“The First Amendment protects all Americans, including pro-life people, from being targeted by a government conspiring with pro-abortion activists,” Bowman said.

Rewire found that some clinics are following the law. Claris Health, which was contacted as part of Feuer’s enforcement campaign in May, includes the public notice with patient intake forms, where it’s translated into more than a dozen languages, CEO Talitha Phillips said in an email to Rewire.

Open Arms Pregnancy Center in the San Fernando Valley has posted the public notice in the waiting room.

“To us, it’s a non-issue,” Debi Harvey, the center’s executive director, told Rewire. “We don’t provide abortion, we’re an abortion-alternative organization, we’re very clear on that. But we educate on all options.”

Even so, reports of deceit by 91 percent of fake clinics surveyed by NARAL Pro-Choice California helped spur the passage of the FACT Act last October. Until recently, a person who Googled “abortion clinic” might be directed to a fake clinic, or CPC.

Oakland last week became the second U.S. city to ban false advertising by facilities that city leaders described as “fronts for anti-abortion activists.” San Francisco passed a similar ordinance in 2011.