The Rhythm Method Makes a Comeback

Elisabeth Garber-Paul

Don't like condoms? Cringe at the thought of exposing your body to a daily hormonal treatment? According to recent tests, there may be a safe, all-natural method to avoid conception with your partner.

Don’t like condoms? Cringe at the thought of exposing your body to a daily hormonal treatment? According to recent tests, there may be a safe, all-natural method to avoid conception with your partner.

According to the Dawn Stacey M.Ed, LMHC Contraception blog on About.com, "14 pilot studies around the world, family planning associations, ministries of health, and community development organizations studied the Standard Days Method (SDM), a fertility awareness method of birth control." Surprisingly, the study of 1,646 women showed that SDM is effective in preventing pregnancy more than 85 percent of the time, which is consistent with the generally accepted 88 percent that was previously established.

Essentially, the program calls for couples to abstain from unprotected sex from day 9 to 18 of the cycle—apparently disproving my ninth grade sex ed teacher’s theory that the rhythm method is about as reliable as pulling out. But while I’m certainly intrigued by this method of safe sex, I can hardly keep track of my deadlines—much less my ovulation cycle.

Of course, Georgetown University has already thought of that. For less than $15, a product called Cycle Beads offers a simple, cheap and effective way to keep track of your cycle and prevent unwanted pregnancy.

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"They are a string of 32 color-coded beads, with each bead representing a day of a woman’s menstrual cycle. They have a black rubber ring that the woman moves one bead each day in the direction of the arrow. When the woman starts her period, she puts the ring on the first bead, which is red. She continues moving the ring one bead each day of her cycle. When the ring is on a dark bead, she is on a day in her cycle when she can have intercourse without getting pregnant. But when she in on a day represented by the white beads, she may be fertile and could get pregnant if she has unprotected intercourse."


So what to do about those pesky white-bead days when you feel the urge? Dr. Stacey says that using SDM actually helped increase the probability of sex being safe during the time when the woman is fertile because it "allows for increased male involvement as it encourages men to abstain or use condoms during fertile days, obtaining condoms and helping their wives keep track of her fertile days."

I don’t know if I’m brave enough to leave my risk of pregnancy up to a colorful string of beads, but it certainly represents a viable alternative for married women across the world—especially those who can’t afford disposable options.

Analysis Abortion

‘Pro-Life’ Pence Transfers Money Intended for Vulnerable Households to Anti-Choice Crisis Pregnancy Centers

Jenn Stanley

Donald Trump's running mate has said that "life is winning in Indiana"—and the biggest winner is probably a chain of crisis pregnancy centers that landed a $3.5 million contract in funds originally intended for poor Hoosiers.

Much has been made of Republican Gov. Mike Pence’s record on LGBTQ issues. In 2000, when he was running for U.S. representative, Pence wrote that “Congress should oppose any effort to recognize homosexual’s [sic] as a ‘discreet and insular minority’ [sic] entitled to the protection of anti-discrimination laws similar to those extended to women and ethnic minorities.” He also said that funds meant to help people living with HIV or AIDS should no longer be given to organizations that provide HIV prevention services because they “celebrate and encourage” homosexual activity. Instead, he proposed redirecting those funds to anti-LGBTQ “conversion therapy” programs, which have been widely discredited by the medical community as being ineffective and dangerous.

Under Pence, ideology has replaced evidence in many areas of public life. In fact, Republican presidential nominee Donald Trump has just hired a running mate who, in the past year, has reallocated millions of dollars in public funds intended to provide food and health care for needy families to anti-choice crisis pregnancy centers.

Gov. Pence, who declined multiple requests for an interview with Rewire, has been outspoken about his anti-choice agenda. Currently, Indiana law requires people seeking abortions to receive in-person “counseling” and written information from a physician or other health-care provider 18 hours before the abortion begins. And thanks, in part, to other restrictive laws making it more difficult for clinics to operate, there are currently six abortion providers in Indiana, and none in the northern part of the state. Only four of Indiana’s 92 counties have an abortion provider. All this means that many people in need of abortion care are forced to take significant time off work, arrange child care, and possibly pay for a place to stay overnight in order to obtain it.

This environment is why a contract quietly signed by Pence last fall with the crisis pregnancy center umbrella organization Real Alternatives is so potentially dangerous for Indiana residents seeking abortion: State-subsidized crisis pregnancy centers not only don’t provide abortion but seek to persuade people out of seeking abortion, thus limiting their options.

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“Indiana is committed to the health, safety, and wellbeing [sic] of Hoosier families, women, and children,” reads the first line of the contract between the Indiana State Department of Health and Real Alternatives. The contract, which began on October 1, 2015, allocates $3.5 million over the course of a year for Real Alternatives to use to fund crisis pregnancy centers throughout the state.

Where Funding Comes From

The money for the Real Alternatives contract comes from Indiana’s Temporary Assistance for Needy Families (TANF) block grant, a federally funded, state-run program meant to support the most vulnerable households with children. The program was created by the 1996 Personal Responsibility and Work Opportunity Reconciliation Act signed by former President Bill Clinton. It changed welfare from a federal program that gave money directly to needy families to one that gave money, and a lot of flexibility with how to use it, to the states.

This TANF block grant is supposed to provide low-income families a monthly cash stipend that can be used for rent, child care, and food. But states have wide discretion over these funds: In general, they must use the money to serve families with children, but they can also fund programs meant, for example, to promote marriage. They can also make changes to the requirements for fund eligibility.

As of 2012, to be eligible for cash assistance in Indiana, a household’s maximum monthly earnings could not exceed $377, the fourth-lowest level of qualification of all 50 states, according to a report by the Congressional Research Service. Indiana’s program also has some of the lowest maximum payouts to recipients in the country.

Part of this is due to a 2011 work requirement that stripped eligibility from many families. Under the new work requirement, a parent or caretaker receiving assistance needs to be “engaged in work once the State determines the parent or caretaker is ready to engage in work,” or after 24 months of receiving benefits. The maximum time allowed federally for a family to receive assistance is 60 months.

“There was a TANF policy change effective November 2011 that required an up-front job search to be completed at the point of application before we would proceed in authorizing TANF benefits,” Jim Gavin, a spokesman for the state’s Family and Social Services Administration (FSSA), told Rewire. “Most [applicants] did not complete the required job search and thus applications were denied.”

Unspent money from the block grant can be carried over to following years. Indiana receives an annual block grant of $206,799,109, but the state hasn’t been using all of it thanks to those low payouts and strict eligibility requirements. The budget for the Real Alternatives contract comes from these carry-over funds.

According to the U.S. Department of Health and Human Services, TANF is explicitly meant to clothe and feed children, or to create programs that help prevent “non-marital childbearing,” and Indiana’s contract with Real Alternatives does neither. The contract stipulates that Real Alternatives and its subcontractors must “actively promote childbirth instead of abortion.” The funds, the contract says, cannot be used for organizations that will refer clients to abortion providers or promote contraceptives as a way to avoid unplanned pregnancies and sexually transmitted infections.

Parties involved in the contract defended it to Rewire by saying they provide material goods to expecting and new parents, but Rewire obtained documents that showed a much different reality.

Real Alternatives is an anti-choice organization run by Kevin Bagatta, a Pennsylvania lawyer who has no known professional experience with medical or mental health services. It helps open, finance, and refer clients to crisis pregnancy centers. The program started in Pennsylvania, where it received a $30 million, five-year grant to support a network of 40 subcontracting crisis pregnancy centers. Auditor General Eugene DePasquale called for an audit of the organization between June 2012 and June 2015 after hearing reports of mismanaged funds, and found $485,000 in inappropriate billing. According to the audit, Real Alternatives would not permit DHS to review how the organization used those funds. However, the Pittsburgh Post-Gazette reported in April that at least some of the money appears to have been designated for programs outside the state.

Real Alternatives also received an $800,000 contract in Michigan, which inspired Gov. Pence to fund a $1 million yearlong pilot program in northern Indiana in the fall of 2014.

“The widespread success [of the pilot program] and large demand for these services led to the statewide expansion of the program,” reads the current $3.5 million contract. It is unclear what measures the state used to define “success.”

 

“Every Other Baby … Starts With Women’s Care Center”

Real Alternatives has 18 subcontracting centers in Indiana; 15 of them are owned by Women’s Care Center, a chain of crisis pregnancy centers. According to its website, Women’s Care Center serves 25,000 women annually in 23 centers throughout Florida, Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin.

Women’s Care Centers in Indiana received 18 percent of their operating budget from state’s Real Alternatives program during the pilot year, October 1, 2014 through September 30, 2015, which were mostly reimbursements for counseling and classes throughout pregnancy, rather than goods and services for new parents.

In fact, instead of the dispensation of diapers and food, “the primary purpose of the [Real Alternatives] program is to provide core services consisting of information, sharing education, and counseling that promotes childbirth and assists pregnant women in their decision regarding adoption or parenting,” the most recent contract reads.

The program’s reimbursement system prioritizes these anti-choice classes and counseling sessions: The more they bill for, the more likely they are to get more funding and thus open more clinics.

“This performance driven [sic] reimbursement system rewards vendor service providers who take their program reimbursement and reinvest in their services by opening more centers and hiring more counselors to serve more women in need,” reads the contract.

Classes, which are billed as chastity classes, parenting classes, pregnancy classes, and childbirth classes, are reimbursed at $21.80 per client. Meanwhile, as per the most recent contract, counseling sessions, which are separate from the classes, are reimbursed by the state at minimum rates of $1.09 per minute.

Jenny Hunsberger, vice president of Women’s Care Center, told Rewire that half of all pregnant women in Elkhart, LaPorte, Marshall, and St. Joseph Counties, and one in four pregnant women in Allen County, are clients of their centers. To receive any material goods, such as diapers, food, and clothing, she said, all clients must receive this counseling, at no cost to them. Such counseling is billed by the minute for reimbursement.

“When every other baby born [in those counties] starts with Women’s Care Center, that’s a lot of minutes,” Hunsberger told Rewire.

Rewire was unable to verify exactly what is said in those counseling sessions, except that they are meant to encourage clients to carry their pregnancies to term and to help them decide between adoption or child rearing, according to Hunsberger. As mandated by the contract, both counseling and classes must “provide abstinence education as the best and only method of avoiding unplanned pregnancies and sexually transmitted infections.”

In the first quarter of the new contract alone, Women’s Care Center billed Real Alternatives and, in turn, the state, $239,290.97; about $150,000 of that was for counseling, according to documents obtained by Rewire. In contrast, goods like food, diapers, and other essentials for new parents made up only about 18.5 percent of Women’s Care Center’s first-quarter reimbursements.

Despite the fact that the state is paying for counseling at Women’s Care Center, Rewire was unable to find any licensing for counselors affiliated with the centers. Hunsberger told Rewire that counseling assistants and counselors complete a minimum training of 200 hours overseen by a master’s level counselor, but the counselors and assistants do not all have social work or psychology degrees. Hunsberger wrote in an email to Rewire that “a typical Women’s Care Center is staffed with one or more highly skilled counselors, MSW or equivalent.”

Rewire followed up for more information regarding what “typical” or “equivalent” meant, but Hunsberger declined to answer. A search for licenses for the known counselors at Women’s Care Center’s Indiana locations turned up nothing. The Indiana State Department of Health told Rewire that it does not monitor or regulate the staff at Real Alternatives’ subcontractors, and both Women’s Care Center and Real Alternatives were uncooperative when asked for more information regarding their counseling staff and training.

Bethany Christian Services and Heartline Pregnancy Center, Real Alternatives’ other Indiana subcontractors, billed the program $380.41 and $404.39 respectively in the first quarter. They billed only for counseling sessions, and not goods or classes.

In a 2011 interview with Philadelphia City Paper, Kevin Bagatta said that Real Alternatives counselors were not required to have a degree.

“We don’t provide medical services. We provide human services,” Bagatta told the City Paper.

There are pregnancy centers in Indiana that provide a full range of referrals for reproductive health care, including for STI testing and abortion. However, they are not eligible for reimbursement under the Real Alternatives contract because they do not maintain an anti-choice mission.

Parker Dockray is the executive director of Backline, an all-options pregnancy resource center. She told Rewire that Backline serves hundreds of Indiana residents each month, and is overwhelmed by demand for diapers and other goods, but it is ineligible for the funding because it will refer women to abortion providers if they choose not to carry a pregnancy to term.

“At a time when so many Hoosier families are struggling to make ends meet, it is irresponsible for the state to divert funds intended to support low-income women and children and give it to organizations that provide biased pregnancy counseling,” Dockray told Rewire. “We wish that Indiana would use this funding to truly support families by providing job training, child care, and other safety net services, rather than using it to promote an anti-abortion agenda.”

“Life Is Winning in Indiana”

Time and again, Bagatta and Hunsberger stressed to Rewire that their organizations do not employ deceitful tactics to get women in the door and to convince them not to have abortions. However, multiple studies have proven that crisis pregnancy centers often lie to women from the moment they search online for an abortion provider through the end of their appointments inside the center.

These studies have also shown that publicly funded crisis pregnancy centers dispense medically inaccurate information to clients. In addition to spreading lies like abortion causing infertility or breast cancer, they are known to give false hopes of miscarriages to people who are pregnant and don’t want to be. A 2015 report by NARAL Pro-Choice America found this practice to be ubiquitous in centers throughout the United States, and Rewire found that Women’s Care Center is no exception. The organization’s website says that as many as 40 percent of pregnancies end in natural miscarriage. While early pregnancy loss is common, it occurs in about 10 percent of known pregnancies, according to the American Congress of Obstetricians and Gynecologists.

Crisis pregnancy centers also tend to crop up next to abortion clinics with flashy, deceitful signs that lead many to mistakenly walk into the wrong building. Once inside, clients are encouraged not to have an abortion.

A Google search for “abortion” and “Indianapolis” turns up an ad for the Women’s Care Center as the first result. It reads: “Abortion – Indianapolis – Free Ultrasound before Abortion. Located on 86th and Georgetown. We’re Here to Help – Call Us Today: Abortion, Ultrasound, Locations, Pregnancy.”

Hunsberger denies any deceit on the part of Women’s Care Center.

“Clients who walk in the wrong door are informed that we are not the abortion clinic and that we do not provide abortions,” Hunsberger told Rewire. “Often a woman will choose to stay or return because we provide services that she feels will help her make the best decision for her, including free medical-grade pregnancy tests and ultrasounds which help determine viability and gestational age.”

Planned Parenthood of Indiana and Kentucky told Rewire that since Women’s Care Center opened on 86th and Georgetown in Indianapolis, many patients looking for its Georgetown Health Center have walked through the “wrong door.”

“We have had patients miss appointments because they went into their building and were kept there so long they missed their scheduled time,” Judi Morrison, vice president of marketing and education, told Rewire.

Sarah Bardol, director of Women’s Care Center’s Indianapolis clinic, told the Criterion Online Edition, a publication of the Archdiocese of Indianapolis, that the first day the center was open, a woman and her boyfriend did walk into the “wrong door” hoping to have an abortion.

“The staff of the new Women’s Care Center in Indianapolis, located just yards from the largest abortion provider in the state, hopes for many such ‘wrong-door’ incidents as they seek to help women choose life for their unborn babies,” reported the Criterion Online Edition.

If they submit to counseling, Hoosiers who walk into the “wrong door” and “choose life” can receive up to about $40 in goods over the course their pregnancy and the first year of that child’s life. Perhaps several years ago they may have been eligible for Temporary Assistance for Needy Families, but now with the work requirement, they may not qualify.

In a February 2016 interview with National Right to Life, one of the nation’s most prominent anti-choice groups, Gov. Pence said, “Life is winning in Indiana.” Though Pence was referring to the Real Alternatives contract, and the wave of anti-choice legislation sweeping through the state, it’s not clear what “life is winning” actually means. The state’s opioid epidemic claimed 1,172 lives in 2014, a statistically significant increase from the previous year, according to the Centers for Disease Control and Prevention. HIV infections have spread dramatically throughout the state, in part because of Pence’s unwillingness to support medically sound prevention practices. Indiana’s infant mortality rate is above the national average, and infant mortality among Black babies is even higher. And Pence has reduced access to prevention services such as those offered by Planned Parenthood through budget cuts and unnecessary regulations—while increasing spending on anti-choice crisis pregnancy centers.

Gov. Pence’s track record shows that these policies are no mistake. The medical and financial needs of his most vulnerable constituents have taken a backseat to religious ideology throughout his time in office. He has literally reallocated money for poor Hoosiers to fund anti-choice organizations. In his tenure as both a congressman and a governor, he’s proven that whether on a national or state level, he’s willing to put “pro-life” over quality-of-life for his constituents.

Culture & Conversation Media

A Q&A With ‘Never Too Real’ Author Carmen Rita Wong on Why #WeNeedDiverseBooks

Ilana Masad

Rewire had a chance to chat with Wong about her experience finding a place for the work she wanted to create, and what the media often gets wrong when portraying Latina women and other women of color.

Carmen Rita Wong says the characters in her new novel, Never Too Real, are largely invisible in media, which is why she chose to tell their stories. The fictional work is about Latina women who are both struggling and successful in their various fields. Wong says she’s treating this writing project as a mission, a way to tell the story of women like her: Latina women and other women of color who exist in ways other than the stereotypes so often portrayed on television and in films.

Wong herself is a master of media: She’s written for countless outlets, been the host of her own TV show, written books on finance, and now, she’s turned to fiction.

Rewire had a chance to chat with Wong about her experience finding a place for the work she wanted to create, and what the media often gets wrong when portraying Latina women and other women of color.

Rewire: How did this novel come about?

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Carmen Rita Wong: My a-ha! moment came with my daughter; we were walking together and passed a bus stop with [a poster for] a show and she said, “Mom, that poster, all those women look like you. But why are they maids?”

My daughter’s frame of reference is very different from mine: She’s growing up more privileged and with a Black president, surrounded by family where she happens to be a blonde Latina while her cousins are Black Latinas. I waited tables alongside my mom to put myself through college, so I have a deep respect for every form of work. But it was definitely one of those things where you only see yourself reflected in one way—and that’s how I grew up, seeing Latinas being shown in one way; but this is not how I live, and not how my daughter lives, now.

That same month I was having a party, celebrating my wonderful, successful girlfriends. We all came up together, we’ve all supported each other, and we’re all women of color, mostly Latina. I looked around and wondered, how come nobody knows we exist?

So I thought, all right, you know what? Now’s the time. This has just got to get done. I’m in a position to do this, I need to do it. It was very much a mission; I didn’t approach it as a side project.

Rewire: Kirkus Reviews, a book review site, called Never Too Real a “multicultural edition of Sex and the City.” How would you characterize the book? Would you call it that?

CRW: I think that superficially that’s a nice, easy elevator pitch because there are four of these women, they’re glamorous, and they’re in New York City. I think that’s where the similarities pretty much end. The book goes a lot deeper than that. If you had to categorize it TV-wise, it’s a “dramedy”: There’s some lightheartedness, there’s some playfulness, some glamor, but it is really about real issues in your life as you try to do well, if you try to be the first generation to do better than the previous. I think that’s one of the uniting factors of these four women—they’re all … first [in their families] to be born in the United States, and grow up and finish college. And that’s an important bonding issue that makes it very different [from] Sex in the City.

Rewire: Diversity in literature is a widely-discussed issue in the literary community these days, with hashtags like #WeNeedDiverseBooks. Was it hard for you to find a place for your book, to publish it?

CRW: I don’t know—hard for some people is not hard for others. Let’s just say—my agent’s probably going to kill me—but my favorite rejection from a major publisher, which actually confirmed to me that I was on the right track, was (and I have it memorized): “We are not looking for aspirational in this market at this time.”

Rewire: They called it aspirational?

CRW: Exactly. So it was mildly crushing, and then I realized—I’m on it, I am so on it. Because these publishers, who are they, and what have they published? Books by white men. Yes, those publishers are powerful, and yes, they’re rich, but they don’t get it. They don’t see it. They don’t know we exist. What is “this market,” and what is “aspirational?”

When I was coming up in media, in publishing and magazines, I would hear from people, “Carmen, we know you want to get ahead, but we just don’t know what to do with you.” And that’s code. What it really means is, “Carmen, you’re a brown girl, and we can promote this white guy or girl, but we can’t promote you. We just don’t know what to do with you.” But they would never say that to a white male. They would never say, “You know what, Bob? We just don’t know what to do with you.” So to me that rejection letter was just like that.

I remember back in the ’90s, there was a really great push of [books] like Waiting to Exhale or Joy Luck Club. There was just a lot more in fiction about successful, multigenerational, multicultural families. It just was normal and it was not considered crazy. I think there was a trend, and it just became a different trend. And then there was a push for powerful stories, but stories of only one note, for a long time in Latino fiction. I can’t read that stuff, because I lived it already. I want to read stories that make me escape or make me inspired or make me feel heard.

Rewire: In the book, you introduce women who come from all walks of life and economic backgrounds, but they’re all upper-middle-class at the time of the narrative. Going back to your daughter seeing the poster of Latina women portrayed as maids, do you find that economic diversity is what’s often missing in popular and literary culture?

CRW: My book wasn’t as calculated as that, because this is my life, and these are my friends and the people I surround myself with. I think what I saw missing in these cultures was that niche [of successful Latina women].

Latinos in popular culture … I’ve watched it be a very hard process. For example, when I was in magazines, they tried to push me to the Spanish-language property, and I’d say that I don’t primarily speak in Spanish. Why can’t I be used in the English-dominant space? Why? Give me a reason why! And they’d have to say, “Well, because you’re Latina.” So? Latinos speak English! We’re Americans! If you were Black or Latina you’d have to be in that particular space and you weren’t allowed to exist in the general market. And as we’ve seen, and as we see now, that has changed a lot.

Rewire: How so?

CRW: We have huge growth in numbers, but also too, if you look at, for example, ShondaLand, [the production company] on ABC—it’s an example of an openness to seeing and consuming media from all cultures, whether it’s music or TV. I definitely feel that things have changed, there’s a big shift and a huge push now toward inclusion.

I think with social media too, you see the pressure of people saying, for example, #OscarsSoWhite. I grew up in a time when media was controlled by a small group of people and I’ve watched it change, morph, and transform. Fifteen years ago, when I was co-chair of the Hispanic Affinity Group at Time Inc., I was saying we’re here, we consume stuff in English, and you need to pay attention to us. When the census came out [proving what I had been saying], I said, the census, look at the census!

And still the dollars didn’t come in; but when social media happened, that’s when the money started coming in. And finally people started saying, “Oh, they’re, they’re quite vocal, they exist.” [Laughs.] But our ethnicity or color shouldn’t be our only draw. We’re here and have been here. What they’re seeing shouldn’t come as such a shock.

This interview has been edited for length and clarity.