The Prevention President: A Report Card

Cristina Page

It'd be wrong to say only pro-choice people have reason to rejoice from President Obama's stellar first hundred days.

For those in favor of women’s rights, the first 100 days of the
Obama administration has been like a honeymoon. We’ve continually been
reminded why we fell in love in the first place. Coming off an
eight-year abusive relationship (to put it mildly), none of Obama’s
kindnesses are lost on us. He seems to be the kind of guy who does what
he says he’s going to do, another relief. And his gifts have not just
been for the pro-choice movement either. Nearly all of Obama’s actions
on reproductive rights to date have focused on preventing the need for
abortion, one of his "common ground" issues. And while he’s won no fans
in traditional pro-life groups, it’s an approach the majority of
pro-life Americans want.

Here’s a report card of the Obama administration’s work on reproductive rights in the first hundred days.


Obama’s first gift was global. In his first month in office, with a
stroke of his pen, Obama lifted the Global Gag Rule, a Reagan-era
policy that withheld funding from any group that referred a woman for
an abortion, most of which were family planning providers.

Lifting the funding ban will restore these NGO’s access to
USAID-supplied condoms and other forms of contraception and result in
dramatic improvements in women’s health for those living in the most
desperate regions on earth. Despite anti-abortion operatives’ claims,
the policy change will not increase abortion rates since the funding
was never used to provide abortion services in the first place. In
fact, we expect just the opposite. Johns Hopkins researchers estimate
that every million dollars spent on contraceptive care prevents 150,000
abortions, 360,000 unintended pregnancies, 11,000 infant deaths and 800
maternal deaths .

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The Stimulus Package:

There was, to continue the honeymoon metaphor, our first lover’s
quarrel too. Obama quickly folded once the Republicans picked a fight
over inclusion of a family planning provision in the stimulus package.
In Obama’s defense, passage of the package was too critical to hold up
for a minor provision that could be included elsewhere. But the
concession came easily, a little too easily. Why not stand up to the
bullies who happened also to be lying to the American public about what
the contraception provision was? Obama could have pointed out that,
despite claims to the contrary, there was no $200 million budget line
for contraception in the stimulus package. That figure represented the
projected cost savings to the states if a simple administrative,
non-budgetary proposal were adopted. It gets complicated, but sadly the
unchallenged final message was "contraception has nothing to do with
economic recovery." The last few months have certainly proven
otherwise. There’s been a surge of American’s getting contraception,
and long-acting methods at that. Clearly, pregnancy prevention has a
lot to do with individual economic stability. It’s also proven that
Republicans are deeply out of touch with what struggling Americans need
to protect themselves during tough times, as if we needed more evidence.


With the key positions that impact women’s health and rights most,
Obama has appointed wisely. Hillary Clinton overseeing foreign policy
will impact women’s health worldwide. She is the possibly the strongest
pro-choice advocate we’ve ever had in government and there was no
better display of her pro-choice backbone than an exchange she and
anti-abortion/anti-contraception Rep. Chris Smith from NJ had last week.

Without question, the Department of Health and Human Services (HHS)
is the most important federal agency for American women’s health
issues. That’s one reason why the chief of staff to one of Bush’s heads
of HHS, Tommy Thompson, described it as "ground zero for the
ideological wars in this country." HHS includes the FDA (approves new
reproductive health drugs), the Title X program (nation’s contraception
program for the poor), the Office of Medicaid (pays for 1/3 of all US
births and the largest health payer of contraception services for the
low-income;) and the Centers for Disease Control and Prevention,
(oversees STD prevention programs.) For this post Obama chose Governor
Kathleen Sebelius who was confirmed yesterday. During her confirmation
hearings, the anti-abortion movement, in true Rove form, attempted to
portray the exceedingly moderate Sebelius as an extremist on abortion.
Very little of what HHS does has to do with abortion rights, though, so
the charge was not only false but irrelevant. Sebelius, through her
role, is likely to make contraception more available, implement the
most effective sex education programs, and focus on preventing the
spread of STDs: all strategies the traditional anti-abortion
establishment has historically opposed. Of course, it was better for
them to say she’s an abortion nut than a prevention nut.

Common Ground:

But not all pro-lifers were opposed to Sebelius’ nominaton. One of
the most revolutionary and inspiring events to emerge from the election
of Obama’s has been real common ground partners in a growing segment of
the pro-life movement. These are people who while disagreeing on some
fundamental issues have pledged to seek points of agreement with
pro-choice activists. Catholics United is one such pro-life common ground group. Among many of their cutting edge campaigns was Catholics for Sebelius,
which defended her nomination by arguing that her policies have led to
dramatic declines in the unintended pregnancy and abortion in Kansas.
Several other pro-life groups, like Pro-Life Pro-Obama and,
as well as a handful of pro-life leaders, have risen to answer Obama’s
common ground call. These groups and leaders believe that rather than
focusing on banning abortion, which has never had a significant impact
on abortion rates, Obama’s prevention policies hold the greatest
promise for those seeking tangible pro-life results.

Obama has committed his administration to finding common ground in the abortion conflict. He’s assigned his Office of Faith Based and Neighborhood Partnerships to work with his Council on Women and Girls on the task. Last month, the White House hosted its first conference call
of leaders on each side and presented a broad strokes common ground
agenda. It’s decidedly straightforward and hard to argue with from both
pro-choice and pro-life perspectives. The focus will "look at how we
support women and children, address teenage pregnancy, and reduce the
need for abortion." Both sides of the abortion debate have much to gain
from this common ground effort. If it results in any success, which is
still no certainty, the American public, particularly women, and our
political discourse will be the greatest beneficiaries.

Plan B:

One of the greatest examples of the abuses of the Bush
administration was the very transparent derailing of the Plan B,
emergency contraception (EC), over the counter application at the FDA.
Bush appointed anti-contraception ideologues to the panel reviewing the
application. The majority of the panel wound up recommending over-the
counter access to EC for all women and the application had support from
all women’s and adolescent medical groups. Still the Bush FDA denied
minors over the counter access to emergency contraception. This
decision is held up as a one of the greatest examples of Bush’s attacks
on science and the administration’s misuse of agencies for purely
ideological aims. Obama has set about restoring confidence
in our scientific agencies. One step in that direction was sending the
Plan B decision back for review and demanding the agency base it’s
decision on over-the-counter access solely on scientific evidence. In
the meantime, Obama directed the agency to establish immediate
over-the-counter access for 17 year-old women to the highly effective
contraceptive method.

Obama also restored affordable birth control for college-aged women.
After Bush removed college health centers from discounted drug
programs, contraceptive costs increased
as much as 900% for college women. Obama signed legislation to restore
access to affordable birth control for college-age women who,
statistics show, are most in need of it: they’re the demographic with
the highest rate of unintended pregnancy, the highest rate of abortion,
and little disposable income.

HHS Regulations

In the final days of the Bush administration, the Christian Right just about went looting. They tried to walk away with a regulation allowing
healthcare workers’ religious beliefs to override patient’s medical
decisions. One HHS regulation, which went into effect literally moments
before Obama took office, was so broad and would cause such chaos in
the medical establishment that even Bush’s own EEOC came out against
it. It would have allowed any healthcare worker for practically any
"conscience-related" reason to deny a patient any type of medical care.
The healthcare worker wouldn’t have had to inform the employer
beforehand of the care he or she objected to and couldn’t be fired for
refusing to provide the service. Patients did not have to be informed
of the healthcare worker’s objection or that they were being denied
information about their medical options. In the service of protecting
"conscience objectors," the regulation threw patient rights out a
window. Since ample protection already exists in law for those who
don’t want to take part in abortion services, it was widely understood
that the goal of the HHS regulations was to give cover to those who
wish to obstruct women’s access to contraception. Obama rescinded the
HHS regulations.

At the end of the Bush administration and ever since, as a result of
its mismanagement and commitment to proven-to-fail approaches, abortion
and teen pregnancy rates have been spiking. Obama has, in the first 100
days, reversed course in favor of the policies that have proven,
wherever tried, to result in dramatic declines in unintended pregnancy
and abortion rates. It’d be wrong to say only pro-choice people have
reason to rejoice from this stellar first hundred days.

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