Can We Please Have A Pro-Choice Secretary of State?

Jane Hamsher

There are rumors that Richard Lugar and Chuck Hagel are seriously being considered for the Secretary of State gig. They are both rabidly anti-choice.

There are rumors that Richard Lugar and Chuck Hagel are seriously
being considered for the Secretary of State gig, and Sam Stein reports
that Lugar has the inside track (although Lugar has said he’s not interested).

One of the biggest challenges the new Secretary of State will face
is dealing with whatever replaces the Kyoto agreement.  Hagel has a 9%
2008 rating from the League of Conservation Voters.  Lugar scores 18%. 
(PDF) Are they really the best people for the job?

Further, the Bush Administration has been murderous in its policies
regarding women’s health, choice and reproductive rights around the
world.  Lugar and Hagel are both rabidly anti-choice.  

Women turned out big in this election — unmarried women in
particular voted 70-29 for Obama.  I don’t imagine Dick Lugar, Chuck
Hagel and Larry Summers were exactly what they had in mind when they turned up at the voting booth.

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Susan Rice and John Kerry are also in the mix, and the decision has
evidently not yet been made.  If we really are intent on cleaning up
our image around the world, please let’s send someone who represents
our best and brightest in such a critical post.  Let’s not have some
Republican relic who sends the wrong message about women’s rights.

This post first appeared on firedoglake.

Commentary Abortion

11 Pro-Choice Successes of 2013

Rewire Staff

Though 2013 might have brought an array of new abortion restrictions and other setbacks for reproductive rights, there were also a number of reasons for pro-choice allies around the country to be proud this year. The staff of Rewire notes some of the top pro-choice successes of 2013.

Though 2013 might have brought an array of new abortion restrictions and other setbacks for reproductive rights, there were also a number of reasons for pro-choice allies around the country to be proud this year. Below, the staff of Rewire notes some of the top pro-choice successes of 2013.

1. The “feminist army” rose up in Texas.

How could a steamy Texas summer that saw the passage of some of the harshest abortion restrictions in the country be considered a great moment in reproductive rights? Because of the thousands of Texans who descended upon the state capitol building, clad in orange, to speak out against a bill that, when fully implemented, is expected to close all but six abortion clinics in the state. Average Texans took time off work and made the sometimes hours-long trip to Austin, day after day. They organized a “people’s filibuster,” testifying through the night in front of occasionally hostile right-wing legislators, paving the way for state Sen. Wendy Davis (D-Fort Worth) to pull off her remarkable 13-hour filibuster. Davis forced Gov. Rick Perry to call a third special session to force the law’s passage, but even today, the “orange army” doesn’t let up: Nearly 20,000 Texans refused to back down in the face of callous conservative politics and asked state health officials to mitigate the impact of the laws, continuing the fight for reproductive autonomy in the Lone Star State. —Andrea Grimes

texas listicle

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2. North Carolina residents turned out in droves—and in costume—to fight anti-choice legislation.

This year, some plucky progressives in very-red North Carolina pushed back against the idea that there’s anything “moral” about denying women birth control or safe abortion care. Under the thunderously charismatic leadership of North Carolina NAACP President William Barber, “Moral Monday” protesters came every week to give legislators headaches over voter restrictions, their refusal to expand Medicaid, and attacks on workers and public schools. But rolling back women’s rights really took the cake, and a few dozen protesters soon swelled to over 2,000 when state legislators snuck onerous abortion restrictions into a motorcycle safety bill. To top that off, protesters dressed as Mad Men characters to remind legislators that it’s total turn-back-the-clock crazy-talk to argue over whether women should have full access to birth control in 2013. —Emily Crockett

Picture via Planned Parenthood of Central North Carolina.

Picture via Planned Parenthood of Central North Carolina.

3. The Obamacare birth control benefit allowed many U.S. women to access contraception without a co-pay.

A whole lot of people stopped paying “lady taxes” for birth control in 2013.

Because of the Affordable Care Act, the number of privately insured individuals who don’t have a co-pay for birth control pills went from 15 percent to 40 percent! (And the percent of those women who are sluts stayed at zero.)

Thanks, Obama! —Erin Matson

4. Judge Edward R. Korman issued a smackdown on emergency contraception.

Despite a mountain of evidence on the safety of emergency contraception and the public health benefits to making it widely available, for at least a decade the federal government caved to pressure from the religious right and refused to make emergency contraception available over-the-counter and without age restrictions. But the Obama administration took political posturing on emergency contraception (EC) to a new level when Secretary of Health and Human Services Katherine Sebelius overruled the Food and Drug Administration’s own recommendation under the Obama Administration to lift sales restrictions and blocked widespread EC access. In April, a federal district court judge called the administration out on it in one of the most searing legal opinions of the year. Comparing the administration’s efforts to restrict the sale of emergency contraception to voter identification efforts, and accusing them of basing political decisions on their discomfort with the idea of teenagers having sex, Judge Edward Korman’s decision not only held the administration accountable for playing politics with women’s health—it was the first step in ending the protracted legal and political battle with the government over EC access. —Jessica Mason Pieklo

5. California expanded abortion access with new legislation.

Amid a sea of legislation restricting access to safe, legal abortion around the country this year, there was one state that bucked the national trend: California. In October, Gov. Jerry Brown signed a law allowing nurse practitioners, certified nurse midwives, and physician assistants to perform first-trimester abortions in the state, greatly expanding access to abortion care for women. —Lauren Kelley

California grungy stamp shutterstock_151919099 [Converted]

6. Albuquerque residents and grassroots organizers defeated anti-choice ordinance.

Last month, Albuquerque residents voted down an ordinance that would have banned all abortions after 20 weeks’ gestation in the city. The real-world impact of the ordinance would have been much broader, however, as Albuquerque is home to one of only four clinics in the entire country that openly provides later abortions. Credited with defeating the ordinance is a broad coalition of grassroots organizers, who worked to inform and connect with voters, and get as many folks to the polls as possible. —Lauren Kelley

respect ABQ women

7. Reproductive rights supporter Nina Pillard was confirmed to the D.C. Circuit Court of Appeals.

It only took changing the way the Senate did business for over 100 years in response to obstruction efforts unheard of even by Republican standards, but pro-choice advocates finally have an answer to far-right Judge Janice Rogers Brown on the D.C. Circuit Court of Appeals. Georgetown Law professor Cornelia “Nina” Pillard, who has been called the next Ruth Bader Ginsburg, has a history of fighting for reproductive autonomy and gender equality. And considering the D.C. Circuit Court of Appeals is often a stepping-stone to a Supreme Court gig, the impact of Pillard’s confirmation could last for decades. —Jessica Mason Pieklo

Nina Pillard during Sen. Ted Cruz’s Q&A at her nomination hearing.

8. SCOTUS stays out of Oklahoma’s medication abortion and ultrasound laws.

The U.S. Supreme Court punted in Oklahoma this year by refusing to hear appeals of blocks to two high-profile laws that would have piled on abortion restrictions in the Sooner State. In early November, the Court dismissed the state’s appeal to reinstate a law the Oklahoma Supreme Court ruled unconstitutional because it would have effectively banned medication abortion. About a week later, it refused to hear a challenge to the Oklahoma Supreme Court’s decision blocking the state’s ultrasound law, which would have forced every Oklahoman seeking an abortion to undergo a narrated ultrasound exam and to have the ultrasound image placed in front of her. The decision to leave in place the Oklahoma Supreme Court decisions blocking those restrictions suggests the Roberts Court is inclined to stay out of many of the fights over incremental restrictions on abortion rights. That’s good news for Oklahoma, but may not be such good news for places like Texas. —Sofia Resnick

9. Several states saw at least temporary legal wins against anti-choice laws.

2012 and 2013 may have seen a flood of draconian anti-choice restrictions, but it also saw a flood of litigation in response. In states like Arkansas and North Dakota, lawmakers passed blatantly unconstitutional laws that would ban abortion in some cases as early as six weeks. In Mississippi and Wisconsin, lawmakers attacked abortion access in targeted regulation of abortion providers (TRAP) laws designed to close clinics and drive providers out of the state. So far, courts have blocked those laws from going into effect while a lawsuit over their constitutionality proceeds. So we’re filing this one away in the “it could have been worse” category and keeping our eyes on these cases for 2014. —Jessica Mason Pieklo

10. West Virginia pro-choice advocates came out strong going into what could be a brutal year for reproductive rights attacks.

Hundreds of West Virginians protested this summer against what they see as Attorney General Patrick Morrissey’s brewing assault on reproductive rights. Morrissey, who is openly anti-choice, appears to be gearing up for an assault on abortion clinics in 2014’s legislative session. But local pro-choice groups have mounted a strong fight, which has already led to some embarrassing setbacks, including prominent anti-choice activists losing lawsuits they’d brought against doctors. “We’ve seen what’s happened in Texas, North Carolina, and Ohio,” said Margaret Chapman Pomponio, executive director of WV Free, a nonprofit organization that promotes reproductive rights and justice. “We’re saying the buck stops here.” —Sharona Coutts

11. Arizona abortion ban was permanently blocked.

In May, the Ninth Circuit Court of Appeals permanently blocked an Arizona law that would have banned all abortions at 20 weeks, except in cases of life-threatening medical emergencies. Passed in 2012, the law was intended to test the strength of viability as the point at which a state can restrict or ban access to abortion under Roe v. Wade. Sharply criticizing the district court, which had found that the law does not prohibit all abortions after 20 weeks’ gestation, but merely regulates them, the Ninth Circuit called the law unconstitutional. The court further pointed out that any ability of fetuses to feel pain at 20 weeks’ gestation did not give Arizona an overriding interest to prohibit pre-viability abortions. —Imani Gandy

Analysis Contraception

Plan B Becomes Available to Women of All Ages, But Everyone Should Have a Plan A

Martha Kempner

New decisions mean emergency contraception will soon be available over-the-counter to women of all ages.  While we celebrate this victory, we should also be using it as an opportunity to remind young people that there are much better ways to prevent pregnancy.

In the last few weeks, emergency contraception (EC) has gotten a lot of attention as the courts, the Food and Drug Administration (FDA), and the Obama administration worked out their differences (or put them aside) and agreed that one version of EC, Plan B One-Step, would be made available over-the-counter to women of all ages. This is a big step forward in efforts to expand access to contraception and, in turn, to prevent unintended pregnancies. Still, we have to remember that emergency contraception is not meant to be anyone’s primary method of birth control—it is taken after an act of sexual intercourse in which the couple forgot to use another method or used a method incorrectly, or in which the method failed. Here’s a quick review of methods that can be used effectively to prevent pregnancy.

Hormonal Methods

The birth control pill revolutionized contraception (and perhaps sexual relations) when it was introduced in the 1960s. Birth control pills were the first kinds of hormonal contraception. They work primarily by preventing ovulation (if there is no egg, there can be no fertilization and no pregnancy). Birth control pills and subsequent hormonal methods also thicken cervical mucus in order to prevent sperm from getting into the uterus.

Today, young women have numerous hormonal methods to choose from. The pill remains hugely popular, and there are many different kinds available; some run on a 21/7 cycle (meaning women take hormones for 21 days and then break for seven, during which time they get their period), others 24/4, and still others limit menstruation to just four times a year.

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For women who don’t want to swallow a pill every day or think they’ll have trouble remembering to do it, there are other hormonal methods that do not require daily action. The contraceptive patch, for example, which is sold under the brand name Ortho-Evra, is a bandage-like sticker that a woman wears on her upper arm, buttocks, back, or abdomen. It releases hormones through the skin. Women using the patch change it every week for three weeks. During the fourth week, they wear no patch and then get their periods.

Women can also choose the contraceptive ring. Sold as NuvaRing, this is a flexible piece of plastic that looks a little like a bracelet and is inserted into the vagina (the exact position isn’t important). It is left in for three weeks while it releases hormones. The user can then remove it, get their period, and put in a new one a week later. If inserted properly to begin with, most users don’t even feel it.

One of the older and more well-known hormonal methods is Depro-Provera, sometimes called the contraceptive shot. Women get an injection from their health-care provider every three months and are protected from pregnancy during that time.

If used perfectly, hormonal methods are all over 99 percent effective. People do make mistakes, however: they may forget to take a pill, forget to pick up a prescription for the patch, or forget to make an appointment to get a shot in time. For these reasons, the typical use failure rates are a little higher—they are between 91 and 94 percent effective. This means that out of every 100 couples who use hormonal methods, six to nine will experience an unintended pregnancy during their first year of use. Continuing users have lower rates of contraceptive failure than first-year users, as they become more accustomed to use.

Long-Acting Reversible Contraception (LARC) Methods

Contraceptive implants, which are now sold under the brand names Implanon and Nexplanon, are also hormonal methods, but last much longer. A single rod—about the size of a matchstick—is implanted by a health-care professional under the skin on the inside of a woman’s upper arm. It steadily releases hormones into a woman’s body for three years. These long-acting reversible contraception (LARC) methods last a long time but can be removed at any time and fertility will return quickly.

Implants were developed in the early 1980s and first approved by the FDA in 1990 under the brand name Norplant, which worked well but was taken off the market in 2002. At the time, the manufacturer cited “limitations on component supplies,” but difficulties with the removal process and negative public opinion were also clearly a factor in the decision. 

The new generation of implants was approved by the FDA in 2006. These single-rod implants are much easier for health-care providers to insert and remove. 

Intrauterine devices (IUDs), which are also considered to be LARCs, are flexible plastic devices that are inserted into the uterus to prevent pregnancy. IUDs prevent pregnancy by interfering with the movement of sperm toward eggs, thereby inhibiting fertilization. They may also change the lining of the uterus, preventing implantation of a fertilized egg (though this theory has not been proven) and thicken cervical mucus.

There are currently three IUDs on the market in the United States. ParaGard (also known as the Copper-T) releases a small amount of copper into the uterus and lasts ten years. Mirena releases a hormone similar to that in some birth control pills, which means it may also prevent ovulation in some women; it lasts for five years. The newest introduction to the market is called Skyla. It is also a hormonal IUD; it has been designed to be smaller and is specifically meant for younger women. Skyla lasts for three years. 

IUDs have a bit of a sordid history in the United States. They were first introduced in the 1960s and became quite popular. In fact, by the next decade there were over 17 models in development by 15 different companies. One model, the Dalkon Shield, had serious design flaws which resulted in higher rates of pelvic inflammatory disease (PID) in users, causing scarring in the uterus and fallopian tubes and, for many of these women, increased infertility. The Dalkon Shield also had a higher failure rate than expected, and women who became pregnant while using it risked spontaneous septic abortions (miscarriages followed by infection). Eighteen deaths were attributed to the Dalkon Shield, and more than 400,000 lawsuits were brought against the manufacturer. Though the design flaws were unique to the Dalkon Shield, public opinion of all IUDs soured, and by 1986 there was only one model of IUD on the market in the United States, and few women were using it.

ParaGard and Mirena became available in the early 2000s, but the FDA initially only approved them for use in women who had already had children. Research has shown, however, that they are safe for women of all ages, regardless of whether they’ve had children. Last summer, the American College of Obstetrics and Gynecology recommended that IUDs be among the first line of contraceptives offered to adolescents.

LARC methods are highly effective in part because user error is essentially taken out of the equation. The “get it and forget it” aspect of these methods means that perfect use and typical use rates are the same—IUDs are more than 99 percent effective.

For this reason, some in the public health world have started to see LARCs as the magic bullet for teen pregnancy—put one in at 15 and without changing her behavior or managing any medicines a girl can make it out of her teen years pregnancy-free. Though there has been an increase in the number of teens using both IUDs and implants over the past few years, these methods are not yet extremely popular with teens. Between 2008 and 2010, for example, only 4.4 percent of teens who were using contraception were using an IUD.

Don’t Forget the Condom

Condoms may be the original “plan B” for many teenagers, because unlike all the other methods they require almost no forethought. For those teens who find themselves hot and heavy but are not on the pill and don’t have an IUD, there is always the condom. Even if she doesn’t already have one in her purse and he doesn’t have one in his wallet, a teen is never far from a condom because this inexpensive form of birth control, which works by going over the penis and preventing sperm from entering the vagina, can often be purchased at a drug store, convenience store, or even a gas station.

If used perfectly, condoms are 98 percent effective, which is similar to hormonal methods. Typical failure rates are higher than those of other methods (about 18 of 100 couples using condoms as their primary method will experience a pregnancy in the first year of use) because people make mistakes—like putting it on too late, taking it off too soon, or opening the package with something sharp. Typical use rates for condoms also include those couples who say condoms are their primary method of contraception but weren’t actually using a condom when they got pregnant.

Using a condom correctly is not difficult, so instead of waiting until the next day to go to the drug store for emergency contraception, couples can hit the RiteAid or CVS for condoms before sex (even if it means taking a quick break from all the kissing and groping).

In fact, even those people who are on other birth control methods should consider hitting the condom aisle before a big date because—other than not having sex—condoms are the only way to prevent sexually transmitted infections (STIs). None of the other methods we talked about here prevent STIs.    

The ideal situation, of course, is dual use, where couples who want to avoid pregnancy use LARC methods for birth control and continue to rely on condoms to prevent STIs, including HIV. The good news is that more young couples are doing so; according to a recent National Survey of Family Growth 23 percent of teens reported dual use between 2008 and 2010 (up from 16 percent between 2006 and 2008).

Expanded access to emergency contraception is critical and represents a huge step forward in preventing unintended pregnancies. Still, we have to remember that, in the ideal world, emergency contraception would hardly ever be needed, because everyone would have the information and access they needed to use other reliable methods correctly and would be able to protect themselves against pregnancy and STIs in the moment every time they had sex.