Obama at Notre Dame: A Perfect Choice to Promote the Culture of Life

Lynn Paltrow

Notre Dame should be praised for inviting a speaker, President Obama, who is committed to promoting a true culture of life--one that includes and values the women who give that life.

More than 55 leading Catholic Bishops, all members of the United
States Catholic Conference of Bishops, are speaking out against the
University of Notre Dame’s decision to host and honor President Barak
Obama at their commencement ceremony on the 17th. Much of their ire is
due to President Obama’s support of the right to choose abortion. And,
indeed coverage of the Bishops’ opposition has largely, and
unfortunately, centered on the issue of abortion, rather than on the
pregnant women who have them. Sixty one percent of women who have
abortions are already mothers and 84 percent of all women become
pregnant and give birth over the course of their lifetimes. While
Bishops criticize the president for being unwilling "to hold human life
as sacred," an examination of the United States Catholic Conference of
Bishop’s (USCCB) public positions in two historic legal cases makes
clear that that the USCCB itself is unwilling to "hold human life as
sacred" when the life belongs to a pregnant woman.

Twenty-two years ago this June, when a District of Columbia court
ordered 27 year-old Angela Carder to undergo cesarean surgery against
her wishes, she said: "I don’t want it done. I don’t want it done." The
unborn child who the surgery was intended to save survived for just two
hours. Carder died two days later with the cesarean listed as a
contributing factor.
In the highly publicized appeal that followed, and that reversed the
order, only two groups defended the forced surgery: one was the United
Catholic Conference — now known as the USCCB.

While the USCCB defended the forced surgery that contributed to a
pregnant woman’s death as "the correct choice," it vigorously opposed
removing Terri Schiavo’s feeding tube because it would lead to her
death. Terri Schiavo who was not pregnant had suffered irreversible
brain damage and had been in a persistent vegetative state for 15
years. Experts who examined her concluded that she had no consciousness
whatsoever, and that there were no treatments that could possibly
improve or reverse her condition. Nevertheless, according to the USCCB,
Schiavo’s condition was anything but futile, describing her as someone
with "cognitive disabilities." The USCCB rejected the notion "that
there are some lives that aren’t worth living."

In contrast, the USCCB explicitly viewed efforts to preserve
Carder’s life as futile and her life as not worth living. According to
the USCCB the forced cesarean surgery was justified because Carder "was
lying very near death" and "had at most one, possibly two days, to
live." At best, "A.C. might have lived 24-48 hours without surgery"
arguing that, "with or without the cesarean operation, A.C. would most
probably die within 24-48 hours of the court hearing." Although Carder
had specifically agreed to treatments that might prolong her life, the
USCCB defended the surgery because the "attempt to save A.C.’s unborn
child properly recognized . . . the futility of improving A.C.’s
situation."

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Not only did the USCCB discount the value of Carder’s life, it urged
the court to ignore her pain and the fact that subjecting her to a
c-section — major abdominal surgery — could only make that pain
worse. The USCCB argued that refusing a c-section "could not save her
life or even make it more bearable."

The USCCB did not even object to the fact that Carder was stripped
of due process –the opportunity to have her rights fully reviewed. Her
rights were decided at an emergency hearing, leaving her no opportunity
to select a lawyer, obtain medical records, or find experts. Still, the
USCCB hoped a precedent would be set for the "next case" so that future
courts could similarly force surgery on pregnant women whose rights
would be "decided in the same emergency setting." In contrast, the
USCCB supported legislation to guarantee that Schiavo, who had eight
years of judicial review, would have additional access to the court
system.

In other words, according to the USCCB, eight years of due process
is not enough for someone in a persistent vegetative state, but less
than a day of due process is plenty for a pregnant woman.

In Terri Schiavo’s case, the USCCB argued "every human life has
incalculable worth and meaning, no matter its age or condition." Their
position in the Angela Carder case, one that they have never recanted
and that is embodied in the Religious Directives in force in Catholic
Hospitals across the country, suggests that the one form of life that
does not have incalculable worth or meaning is that of pregnant women.

If it is true that the USCCB in fact prioritizes some lives over
others, and excludes pregnant women from the right to life it claims to
so vehemently defend, Notre Dame should be praised for inviting a
speaker, President Obama, who is committed to promoting a true culture
of life–one that includes and values the women who give that life.

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.

Analysis Politics

New Hampshire Sen. Kelly Ayotte’s Record on Women’s Health at Center of Heated Race

Ally Boguhn

Sen. Kelly Ayotte's defenders have made claims about her commitment to "strengthening women's health" through action on various measures; reproductive rights advocates point out, however, that most of these measures would have done more harm than good.

The tight race between incumbent Sen. Kelly Ayotte (R-NH) and challenger Gov. Maggie Hassan (D) could help determine which party takes control of the U.S. Senate after the November elections. In recent months, a key point of contention has emerged among Ayotte’s supporters and critics: the senator’s record on reproductive rights and women’s health.

Planned Parenthood Votes released an ad in April claiming Ayotte is “bad for New Hampshire women,” signaling the continuation of the heated narrative in the lead-up to the election. Ayotte’s defenders have responded to the accusations with claims of her commitment to “strengthening women’s health” through action on various measures; reproductive rights advocates point out, however, that most of these measures would have done more harm than good.

“For months, Senator Kelly Ayotte has followed party bosses, refusing to fill the Supreme Court vacancy. And for years, Ayotte has waited for an opportunity to push for someone to end access to safe, legal abortion and overturn Roe v. Wade,” claims the Planned Parenthood Votes ad, before playing an August 2010 clip of Ayotte advocating for the Supreme Court to overturn Roe. “For New Hampshire women, the consequences of letting Kelly Ayotte play politics with the Constitution could last a lifetime.”

The $400,000 ad buy, slated to run on broadcast and cable in New Hampshire, has been Planned Parenthood Votes’ first on-air ad targeting a Senate race in the 2016 election cycle. The organization, a national independent expenditure political committee, is criticizing Ayotte for claiming to protect women but failing to protect reproductive rights, also drawing on her pledge to obstruct filling the vacant Supreme Court seat in the aftermath of Justice Antonin Scalia’s death.

“Kelly Ayotte may try to paint herself as pro-woman, but her record tells a very different story. Every chance she’s gotten she’s voted to ‘defund’ Planned Parenthood and cut women off from essential health care like birth control and breast and cervical cancer screenings,” said Deirdre Schifeling, executive director of Planned Parenthood Votes, in a statement on the organization’s new ad. “She has been advocating for years to ban women’s access to safe, legal abortion, and it’s clear she now sees her chance in the Supreme Court process. Kelly Ayotte is refusing to do her job, and abdicating her constitutional duty, in order to push an extreme agenda that no one in New Hampshire wants.”

Ayotte’s campaign manager, Jon Kohan, meanwhile, defended the senator’s record on women’s health and rights in a press release. He wrote, “Kelly’s long record of standing up for New Hampshire women and families is clear, and she cares deeply about ensuring all women have access to health services.” The release included a bulleted list providing examples of Ayotte’s work “strengthening women’s health care,” “supporting working women,” and “protecting domestic or sexual assault victims.”

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The claims may be familiar to those following the New Hampshire race. After Hassan announced her candidacy in October, for example, One Nation, an issue-advocacy organization that does not need to disclose where their funding comes from and is affiliated with Karl Rove’s American Crossroads super PAC, pushed a 17-day, $1.4 million ad campaign touting Ayotte’s record on women’s health.

Hassan, on the other hand, has the support of organizations such as EMILY’s List, whose stated mission is to help elect pro-choice women into office. After endorsing the governor in the Senate race, the group added Ayotte to its “On Notice” list for “voting for anti-woman legislation and standing in the way of policies that give working families a fair shot.”

But with both sides of the race simultaneously claiming opposing positions on whether Ayotte has been good for women and reproductive rights, what is the truth?

Ayotte has made no secret of her desire to defund Planned Parenthood, and she “has shown support for defunding the organization or opposition to continued funding in at least six votes,” according to PolitiFact, though some of those votes were procedural. Though she famously chided Sen. Ted Cruz (R-TX) for attempting to shut down the government over his crusade to strip the reproductive health provider of money in the wake of anti-choice front group Center for Medical Progress’ deceptively edited videos, it was because she didn’t view his methods as a winning strategy for accomplishing that goal—not because she didn’t believe in the cause.

In a letter to Cruz, Ayotte told the Republican presidential candidate that she too is “deeply disturbed by” CMP’s videos and doesn’t believe Planned Parenthood should have federal funding.”This callous disregard for the dignity of human life is heinous, and I do not believe taxpayer dollars should be used to fund a private organization that performs hundreds of thousands of abortions each year and harvests the body parts of unborn children,” wrote Ayotte. She went on to ask what Cruz’s “strategy to succeed in actually defunding Planned Parenthood” really was, given that their mutual efforts to redirect the organization’s funding to other clinics had failed.

Planned Parenthood does not use its federal funding to provide abortions; its fetal tissue donation program has been cleared of wrongdoing in multiple state and federal investigations. And despite claims from conservatives, including Ayotte, that other facilities could provide Planned Parenthood’s patients with health care should the organization lose funding, the Guttmacher Institute found that “credible evidence suggests this is unlikely. In some areas, Planned Parenthood is the sole safety-net provider of contraceptive care.”

“Our analysis shows unequivocally that Planned Parenthood plays a major role in delivering publicly supported contraceptive services and supplies to women who are in need of such care nationwide,” the Guttmacher Institute concluded.

Ayotte has also supported numerous other anti-choice restrictions and legislation, including a 2015 20-week abortion ban based on the medically unfounded claim that fetuses feel pain at this point in pregnancy.

According to NPR, Ayotte has “been a hero to anti-abortion activists since 2005, when as New Hampshire attorney general she defended a parental notification law all the way to the U.S. Supreme Court.” The law required doctors to notify parents of minors seeking an abortion at least 48 hours prior to the procedure, and contained no exceptions for the health of the patient. The Court ultimately ruled against Ayotte, affirming that states may not enact abortion laws that don’t protect women’s health and safety.

National Right to Life found that the New Hampshire senator voted “with” the anti-choice organization in all 14 of the scored votes from 2012 to 2015 it examined.

In 2012, Ayotte co-sponsored the failed “Blunt Amendment,” which would have allowed exemptions from the Affordable Care Act’s birth control benefit for any employers or insurers that had moral objections to providing contraceptive coverage to their employees. And in a 2014 commentary for the Wall Street Journal, Ayotte and Sen. Deb Fischer (R-NE) defended the Supreme Court’s ruling in Burwell v. Hobby Lobby, which grants some employers the right to deny contraceptive coverage to their staff based on the owner’s religious beliefs, falsely claiming that the ruling did “not take away women’s access to birth control.”

Ayotte’s campaign is quick to point to legislation sponsored by the senator that would have allowed over-the-counter contraception as proof that she cares about women’s health. Reproductive health advocates, however, called Ayotte’s Allowing Greater Access to Safe and Effective Contraception Act a “sham” when it was introduced in 2015. Though the American Congress of Obstetricians and Gynecologists (ACOG) generally supports over-the-counter birth control, the organization’s president Dr. Mark S. DeFrancesco, said in a statement that Ayotte’s measure “would actually make more women have to pay for their birth control, and for some women, the cost would be prohibitive.”

Paid leave is yet another issue in which Ayotte has put forth legislation in the name of helping women. Ayotte introduced the Family Friendly and Workplace Flexibility Act of 2015 in March of that year, claiming it would “allow greater flexibility for workers who are looking to better balance their work-life demands.” Analysis by ThinkProgress, however, found that the measure “could weaken already weak rules that require workers to be paid extra for working extra hours, thus ensuring that workweeks don’t grow out of control and employees are compensated fairly.”

Earlier in 2015, Ayotte signed on as a co-sponsor of the Working Families Flexibility Act. According to a statement from the National Partnership for Women and Families (NPWF) condemning the legislation, the act claimed to “give hourly workers more flexibility and time with their loved ones by allowing them to choose paid time off, rather than time-and-a-half wages, as compensation for working more than 40 hours in one week.” However, the bill did “not promote family friendly or flexible workplaces,” explained the nonprofit organization in a fact sheet. “Instead, it would erode hourly workers’ ability to make ends meet, plan for family time, and have predictability, stability, and true flexibility at work.”

Ayotte’s record on equal pay has been similarly debunked by advocates. One of the policies highlighted by Ayotte’s campaign in the wake of Planned Parenthood Votes’ ad was the senator’s introduction of the Gender Advancement In Pay (GAP) Act in September 2015, which she reintroduced ahead of Equal Pay Day this April. The measure was meant to make clear that “employers must pay men and women equal wages for equal work, without reducing the opportunity for employers to reward merit,” according to a press release from Ayotte’s office upon the initial release of the bill.

Critics argued that Ayotte’s bill was nothing other than an election-year stunt. New Hampshire state Sen. Donna Soucy (D-Manchester) told NH1 News that Ayotte’s move was an attempt to look “for some cover … in an effort to be more in line with” New Hampshire voters, after Ayotte voted against other fair pay measures. However, Soucy said, the legislation didn’t really address the issue of pay equity. “Sen. Ayotte’s bill attempts to create paycheck fairness but doesn’t in fact do so because employers could preclude their employees from discussing what they make with their fellow employees,” claimed Soucy.

Similar arguments were made when Ayotte co-sponsored another equal pay measure, the Workplace Advancement Act, with Sens. Deb Fischer (R-NE), Susan Collins (R-ME), Joni Ernst (R-IA), Thad Cochran (R-MS), and Shelley Moore Capito (R-WV) in April 2015. Though the legislation would ban employers from retaliating against their staff, it failed to garner support from Democrats. According to the National Women’s Law Center, the bill would have done “more harm than good” as it “entirely [ignored] the many loopholes and inadequacies in current equal pay laws and simply [stated] that pay discrimination ‘violates existing law.'”

Their arguments are bolstered by Ayotte’s repeated votes against the federal Paycheck Fairness Act, though as Politifact again pointed out, some of these votes were procedural and not against the bill itself. Ayotte did cast one vote in favor of ending debate on the measure and advancing it; the fact-checking site noted, though, that Ayotte’s office reportedly did so in the ultimately denied hopes of changing the bill.

Had it passed, the legislation would have updated the Equal Pay Act of 1963 to include protections such as prohibiting retaliation against employees who share their salary and strengthening penalties for those who violate the law. Ayotte claims she voted against the measure because it “could reduce the ability of employers to award merit pay for good performance and limit the opportunity for women to have flexible work schedules,” according to a press release on the matter.

Speaking at a town hall event in 2013, Ayotte had previously justified her vote against equal pay legislation by asserting that it “created a lot of additional burdens that would … make it more difficult for job creators to create jobs.” The New Hampshire senator went on to add that there were already laws in place that could help address the issue.

There are, however, some examples of Ayotte supporting and introducing legislation that would help women. In June 2015, Ayotte co-sponsored the Pregnant Workers Fairness Act to protect pregnant people from workplace discrimination. Though the legislation never came to a vote, it would have helped “end … discrimination and promote healthy pregnancies and the economic security of pregnant women and their families,” according to the NPWF. That same year, the New Hampshire senator co-sponsored the Protect Access to Lifesaving Screenings (PALS) Act, bipartisan legislation that would have safeguarded access to free annual mammograms for women ages 40 to 74. Ayotte co-sponsored the bipartisan Campus Accountability and Safety Act in 2014 and 2015, which, according to Democratic New York Sen. Kirsten Gillibrand’s website, would “protect students and boost accountability and transparency at colleges and universities” when it comes to sexual assault. Ayotte also co-sponsored the Combating Military Sexual Assault Act of 2013 to address the issue in the military.

Overall, Ayotte has signed onto or supported numerous pieces of legislation that at face value seem to promote reproductive health and women’s rights. Further examination shows, however, that—with a few exceptions—they largely failed to hold up to scrutiny. While Ayotte’s campaign alleges that many of her measures would have helped women and families, analysis suggests that her conservative solutions to addressing these issues often would have made the problems worse. This, coupled with the senator’s fierce anti-choice advocacy, will no doubt keep this portion of Ayotte’s record under tight observation as November’s election approaches.