Sex (and Common Ground) in the City

Amy Boldosser

Cities can be, as the President said, incubators or “laboratories” for change. And, also, for common ground.

President Obama spoke this month to the Urban and Metropolitan Policy Roundtable. His remarks focused on economic revitalization of metropolitan areas, but also touched on health in these communities. With many reproductive health indicators, residents in urban areas experience worse reproductive health outcomes compared to the national average. AIDS incidence rates in cities are twice that of the national average. Rates of infant mortality, babies born of low-birth weight, unintended pregnancy, and the percentage of teenage mothers are also higher in large cities, especially among low-income women. The President noted in his remarks that, “Instead of waiting for Washington, a lot of cities have already gone ahead and become their own laboratories for change and innovation, some leading the world in coming up with new ways to solve the problems of our time.”  I agree with the President and think he might be onto some rich common ground here.

During the George W. Bush administration, for reproductive rights advocates, the fight was not about common ground, but losing ground. Many state legislatures, emboldened with resources and priorities set by the federal government, blocked pro-choice legislation and pursued a legislative agenda that included “fetal personhood” initiatives, abstinence-only education policies, and mandatory delay and biased counseling requirements for abortion procedures. Meanwhile, against this state and national backdrop, in cities and counties across the country, local advocates and elected officials were (and still are) working together to improve reproductive health programs and policies on a new common ground: their own backyards.

Rather than focusing on the broad ideological debates, local officials on both sides of the abortion issue have found common ground by responding to the needs they see every day in their communities. Along the way, they have improved not only the reproductive health but the overall health and potentially the economic outlook for the people they represent. The Urban Initiative for Reproductive Health, a project of the National Institute for Reproductive Health, is a multi-year initiative to create and promote real policy solutions to address the reproductive health challenges facing cities today. Some examples include:

•    Cuyahoga County leaders provided support for the Cleveland Metropolitan School District to institute a comprehensive sex education program which provides information about abstinence and safe sex andis showing results;

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•    New York City provides free emergency contraception and NYC branded condoms and has modernized care for women facing miscarriage as well as the training physicians receive in miscarriage management;

•    Based on the recommendations of the Mayor’s Task Force, the Boston Public Health Commission, through its Center for Health Equity and Social Justice, has invested in over 50 community and health institutions addressing reproductive health;

•    Pittsburgh passed strong local buffer zone legislation to protect clinic staff and patients from aggressive protesting;

•    Denver created a public-private partnership to offer a pregnancy prevention program targeting youth and their families;

•    Los Angeles County has launched an innovative home based STI testing program to address rising rates of Chlamydia and gonorrhea among young women.

How have these localities been successful in creating reproductive health policies around common goals? In our Urban Initiative work, we have found that there are many committed, progressive, pro-family planning elected and public health officials who have the political will and influence to improve the health of families living in their municipalities. Local officials are often more accessible and more accountable to the communities they represent than state or federal officials. Constituents are more likely to have access to their City Council member, and be heard (as we have done) than their State rep. In addition, because the reproductive health challenges facing individuals in urban settings are so inextricably linked to other social inequities, there is a great opportunity to work across different movements and issue areas to find common ground solutions and to create a stronger, more diverse coalition dedicated to improving the reproductive health of urban communities.  Working locally also allows for targeted interventions at the community level to provide tailored resources and support where they are needed most.

The quickest route to common ground is where the interest isn’t to debate whether abortion is right or wrong but to take action on issues that affect us most. The most effective common ground is when communities come together to prevent teen pregnancy, stop the spread of HIV and STIs, provide pre-natal care and reduce infant and maternal mortality, eliminate environmental toxins, address racial and ethnic health disparities, and improve care for low-income families who are disproportionately lacking healthcare access. This common ground starts where we all live, where the grassroots work takes place, where all politics is local. These innovative efforts are continuing, even in the midst of the current economic crisis, and I encourage the Obama Administration to consider the role cities and counties can play in doing the real common ground work on reproductive health. The President’s recently created Office of Urban Affairs has the potential to spearhead these efforts to improve the health of our cities.  

In addition to investment through the stimulus, other forms of investment in local areas could have an enormous impact on reducing reproductive health disparities and ensuring access. A share of the Federal money being allocated for comprehensive sexuality education could be given to urban cities and counties, instead of just to states. In this way, cities and counties can create local models that can be tested and evaluated, and those most effective can be replicated nationally. Cities can be, as the President said, incubators or “laboratories” for change. And, also, for common ground.

For more information on the Urban Initiative for Reproductive Health, please visit www.urbaninitiative.org

Thanks to Emily Alexander and Angela Hooton who contributed to this article.

News Law and Policy

Three Crisis Pregnancy Centers Served for Breaking California Law

Nicole Knight Shine

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

News Politics

NARAL President Tells Her Abortion Story at the Democratic National Convention

Ally Boguhn

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates.

Read more of our coverage of the Democratic National Convention here.

Ilyse Hogue, president of NARAL Pro-Choice America, told the story of her abortion on the stage of the Democratic National Convention (DNC) Wednesday evening in Philadelphia.

“Texas women are tough. We approach challenges with clear eyes and full hearts. To succeed in life, all we need are the tools, the trust, and the chance to chart our own path,” Hogue told the crowd on the third night of the party’s convention. “I was fortunate enough to have these things when I found out I was pregnant years ago. I wanted a family, but it was the wrong time.”

“I made the decision that was best for me — to have an abortion — and to get compassionate care at a clinic in my own community,” she continued. “Now, years later, my husband and I are parents to two incredible children.”

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Hogue noted that her experience is similar to those of women nationwide.

“About one in three American women have abortions by the age of 45, and the majority are mothers just trying to take care of the families they already have,” she said. “You see, it’s not as simple as bad girls get abortions and good girls have families. We are the same women at different times in our lives — each making decisions that are the best for us.”

As reported by Yahoo News, “Asked if she was the first to have spoken at a Democratic National Convention about having had an abortion for reasons other than a medical crisis, Hogue replied, ‘As far as I know.'”

Planned Parenthood Federation of America President Cecile Richards on Tuesday night was the first speaker at the DNC in Philadelphia to say the word “abortion” on stage, according to Vox’s Emily Crockett. 

Richards’ use of the word abortion was deliberate, and saying the word helps address the stigma that surrounds it, Planned Parenthood Action Fund’s Vice President of Communication Mary Alice Carter said in an interview with ThinkProgress. 

“When we talk about reproductive health, we talk about the full range of reproductive health, and that includes access to abortion. So we’re very deliberate in saying we stand up for a woman’s right to access an abortion,” Carter said.

“There is so much stigma around abortion and so many people that sit in shame and don’t talk about their abortion, and so it’s very important to have the head of Planned Parenthood say ‘abortion,’ it’s very important for any woman who’s had an abortion to say ‘abortion,’ and it’s important for us to start sharing those stories and start bringing it out of the shadows and recognizing that it’s a normal experience,” she added.

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates. In April, Clinton called out moderators for failing to ask “about a woman’s right to make her own decisions about reproductive health care” over the course of eight debates—though she did not use the term abortion in her condemnation.