What does health care reform mean to you?

What does health care reform mean to you?

Health Care Reform Sign The debate around health care reform can very easily devolve into chaotic, and over the past few months it’s gotten diffiuclt to follow just what’s on and off the table — let alone how it might negatively or positively affect our future.

 

One thing we can do is make sure our representatives know exactly what we want to see happen. I, for instance, would like to make sure that birth control is covered, as is maternity care, and that things like C-sections aren’t considered pre-existing conditions. 

 

October 20 is the National Health Care Day of Action, and I’m happy to spread the word that Planned Parenthood of New York City is joining other Planned Parenthood affiliates across the country in holding a photo petition for real health care reform. PPNYC is asking folks to photograph themselves holding up signs asking for what they want to see included in health care reform, and then send them in. The organization will then post those online and send them into our Congressional representatives.

Because what’s more powerful than a constituent staring you in the face, asking you to make sure health care reform doesn’t leave her worse off than she was before? 

All the Help I Can Get: Thoughts on Brain Development, Dinner, and Let’s Talk Month

by Education and Outreach Department Staff
Planned Parenthood Minnesota, North Dakota, South Dakota

“No you can’t wear sandals and that sundress today, honey. It’s not summer anymore. It’s fall now—October. It’s too cold,” I say. “But I like to be cold,” says my daughter during our daily negotiation about what a person can wear outside the house. I take her outside. She says she’s not cold. I see goosebumps on her sleeveless arms. I ask her if she can see our breath when we talk. She says yes. She seems amazed and delighted by this, even as she starts to shiver slightly. I ask her if she feels cold yet. She says yes. “Let’s go put on some warmer clothes,” I say. She’s agreeable, even though it means taking off her favorite dress and well worn sandals and finding something more appropriate but not as familiar to put on. Change is tough when you’re four-and-a-half. And, on some mornings, getting dressed takes a very long time. Let's Talk Logo

As the season turns from summer to fall here in Minneapolis, the rate of change inside my house continues to astonish me. My two young daughters have educated me on the subject of human development unlike any of the latest research I try to keep up with in my professional life in Planned Parenthood’s Education & Outreach Department. Take the human brain, for example. David Walsh, founder of the Minneapolis-based National Institute on Media and the Family, is an expert on adolescent brain development. He says that our brains don’t really become “adult” until the age of about 25. (25?!? Will my daughter finally be able to dress herself appropriately by then?!? Will I be in my early sixties before getting out the door every morning doesn’t feel like a small miracle?) Walsh has helped us understand that the way our brains grow and develop is truly elegant and amazing, and that it takes a long time. And the resulting behavior during childhood and adolescence? Sometimes not so elegant and amazing. (I’m gonna need all the help I can get.)

It really is a great time to be a parent right now. It’s also a great time to be a professional who serves youth and families. Researchers, scientists, physicians, and other impressive people are working hard on expanding our knowledge about what is good for kids and families. Over at the University of Minnesota they’re working on something called Project EAT (Eating Among Teens). Their studies, among others, show that the simple act of regularly sharing a family meal could be one of the most important things we can do to contribute to the health and well-being of children as they grow. Children in families who eat together generally enjoy healthier food, but they are healthier in other ways too. They tend to do better in school, are less likely to smoke, drink or use drugs, less likely to have eating disorders or be overweight, less likely to be depressed, more likely to wait longer to have sex, and more likely to have a positive view of the future. Such a simple thing to do: eat dinner as a family.

I’m constantly trying to get my intentions to match my behavior as a parent. For example, I intend to breeze home after a rewarding day at work and put an appealing and nutritious meal on the table over which my family can enjoy each other’s company and catch up on the happenings of the day. What actually happens is that I dash home later than I’d like at the end of a busy day, sling a store-bought meatloaf in the microwave while I take my coat off, take the crying baby from my husband, take a moment to explain not so calmly and for the one hundredth time the virtues of asking nicely for something to my 4-year-old (who whines about the meatloaf), feed myself while also feeding my 9-month-old who spreads her mooshy baby food all over her face, hands, hair and ears, and then herd the dishes to the sink. I almost always feel rushed and frazzled. But when we are sitting down together at dinner, things feel a bit more orderly and manageable. And we talk and connect with each other. And it feels good.

I’m fortunate to have a job that enriches my personal life as much as it does. This month, October, is Let’s Talk Month, during which we at Planned Parenthood focus on helping families to make stronger connections and to talk honestly and openly about sexual health and relationships. This year, we are encouraging families to talk more around the table by using the Let’s Talk Tablemat – a conversation-starter tool. Anything to help that family meal live on! I fully intend to take it home and put it on my table, along with the reheated leftover meatloaf.

Parenting is such a challenge. There is a daily-ness to it that doesn’t let up. My life is full. But I do, after all, like a challenge. Monday morning it was the sundress and sandals; this morning it was the snowpants and boots—my daughter’s choice for school, which takes place indoors. “We’ll wear those when we go sledding in the winter,” I say. My daughter starts whining. I keep it upbeat. “Let’s go find your jeans and sparkly shoes.”

We eventually make it out the door. Another small miracle. And tonight, I’m really looking forward to what we’ll talk about over that meatloaf.

Get more info on the Let’s Talk Tablemat on our website or use the buttons below to download the tablemat.

Download English Tablemat Download Spanish Tablemat

Michigan HIV Activists Angered by No-Consent Testing Legislation

Activists with the group Michigan POZ Action
are organizing a campaign to get state lawmakers to stop legislation
that will remove a law that requires persons being tested for HIV do so
with informed consent.

Under current law, anyone seeking an HIV antibody test must sign a
document acknowledging they have consented to the test. But under revisions proposed in the House and the Senate, any doctor would be able to order an HIV test for a patient without permission, consultation or counseling.

The legislation has sparked concerns about no-consent testing causing patients to lose their health insurance.

Kendra Kleber who previously practiced law focused on HIV and government benefits, told Michigan Messenger earlier this year:

The whole idea of anonymous testing is that you can
control when you are tested and what happens to your results.
Everything about this bill, except that little section [on anonymous
testing], says you have no control over when you are tested and what
happens to your results. You have no control. … But the fact of the
matter is that if you went to your normal doctor and had a physical
last week and even if you doctor didn’t say anything to you about HIV,
he could have tested you and so your results could already be in the
record. Which means they are already knowable to an insurance company.

Kleber, who has been appointed to an administrative law judge
position in Cleveland, said she found the legislation to be “very,
very, very problematic.”

Activists infected with HIV and their advocates are up in arms.

“Being tested doesn’t do anything to prevent anything,” said Mark
Peterson, an HIV activist based in Detroit. “This sort of puts a wedge
between doctor and patient when it comes to an important health
conversation.”

The legislation was proposed in March by State Rep. Roy Schmidt, a Grand Rapids Democrat. He told Michigan Messenger in April the bill was created at the request of Spectrum Health,
a large health care provider in West Michigan. The system’s spokesman
Bruce Rossman confirmed Spectrum had requested the law, noting that
Spectrum physicians had indicated the current law created a barrier.

He also noted that Spectrum had not implemented a policy mandating HIV testing for patients over 16, as the Centers for Disease Control and Prevention has recommended.

“We have not [implemented the CDC guidelines] under the current law
because, unfortunately, a lot of our current physicians feel that it
[informed consent] is a hurdle,” he said.

An official with the Michigan Department of Community Health told Michigan Messenger the agency was opposed to no-consent testing.

“We feel [the CDC recommendations] can be implemented successfully
in the state without changing the law,” said Debra Szwedja, acting
director of the MDCH’s Division of Health, Wellness and Disease Control.

The Senate Health Policy Committee will take up the legislation
Wednesday at a 2:30 p.m. hearing in Lansing, and Michigan POZ Action
members plan to organize a grassroots lobbying campaign to oppose the
legislation.

“This is about a convenience for doctors versus the ability of
patients to have an informed conversation,” said Peterson. “The
patient’s informed consent outweighs the convenience issue for
physicians.”

The Democrats’ Missing Message For Women and Health Reform

Health care reform measures currently making their way through Congress would radically alter health care coverage for women in this country, for the better – and American women don’t know. 

Why? 

Democrats and President Obama aren’t speaking to us. The message that health care reform would eradicate gender inequities currently at the core of our health insurance system isn’t trickling down to the average woman in the United States.
According to an article on Politico about this missing message yesterday,

“There has been a lot of attention this year on the need for health
reform,” Sen. Sherrod Brown (D-Ohio) said last week, “but there has
been too little focused on how health reform will work to improve the
health and well-being of more than half our nation’s population —
America’s women.”

There are dramatic changes underfoot – changes that address heinous discrimination about which commentators and advocates writing on Rewire have been discussing for weeks now. In the Democrats’ plan, Politico notes:

Maternity care would be guaranteed. Insurance companies could no longer charge higher premiums for women than men.

And insurers now allowed to label a Cesarean section or even domestic
violence a pre-existing condition to deny coverage would be barred from
the practice.

If Democrats need anyone to get on board with this plan, it’s women. Celinda Lake, one of the most respected Democratic pollsters in this country, says that women are conflicted about health care reform measures at the moment but they are precisely the ones making the majority of health care decisions. From Politico:

“Women are the ones who are going to pay attention to health care,
women are the swing vote on health care, women are the ‘influentials,’
meaning if women like the plan, then the men in their lives like the
plan,” Lake said. “So in that sense, it makes sense to target women.”

Advocacy organizations, individual activists, progressive media and others are working hard to ensure that Senators and others on the Hill get the message: women are not pre-existing conditions and "gender rating" is no longer an acceptable form of discrimination in this country. 

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At a Senate Committee hearing last week, chaired by Senator Mikulski, called "What Women Want: Equal Health Care for Equal Premiums", legislators heard eye-opening testimony from women on the inequality inherent in the system. One woman, after having had a c-section, was told by her insurance company to get sterilized or lose coverage.

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Another one testified that she had to drop her $5,000/month premiums for maternity care after she went into debt for her pregnancy and birth costs with said insurance company. Robin Marty, writing on this site, told readers of her exponential increase in premium payments while pregnant as her insurance company apparently saw her pregnancy as an "unhealthy lifestyle choice".

Jodi Jacobson, on Rewire, writes about the eight female Senators who stood up on the floor of the Senate last week to tell their colleagues in Congress: Enough is enough!:

Eight women senators spoke strongly and succinctly about the
disparities in access to affordable health care in the United States,
each one hitting on separate but related issues.  The Senators also
appeared the same evening in a brief segment of Larry King Live. 
Though King consigned them to a couple of minutes at the end of an
otherwise largely vacuous show, the Senators nonetheless made clear
that the practice of denying women coverage based on the "pre-existing
condition" of being a woman would no longer fly.

The word is spreading within the halls of Congress, then, that to oppose health care reform measures is to oppose the elimination of serious discrimination against women in insurance coverage. Sen. Sherrod Brown calls the health care reform effort to get rid of gender inequity "historic" and compares it to the successful legislation outlawing unfair and unequal treatment between men and women in the workplace, in sports, and in education. But, still, most regular women around the country haven’t heard the message that health care reform measures will benefit you. 

So, what’s next?

Well, Politico reports that Linda Douglass, head of the White House Office of Health Care Reform, says that more events targeting women are in the works as part of a vigorous outreach program. 

But what else can we do – as activists, advocates, writers, women? Tell our stories. Share our experiences. I didn’t know that some women, during a home birth, beg not to be transferred while in labor, to the hospital, because of the possibility of crushing medical costs. Does this sound like an experience you’ve had? Write us and let us know: editor@rhrealitycheck.org. Were you denied coverage of a VBAC (vaginal birth after ceserean)? Tell us your story or jot down a note and let us know it’s happened to you. Did your insurance company drop you when you became pregnant? Denied you coverage because you are the survivor of domestic violence? Has it been impossible for you to find coverage for maternity care services? Again, let us know at editor@rhrealitycheck.org.

If we share our stories and our experiences, we can all work together to inform and educate women across the board. Health care reform measures will help eliminate the gross gender inequity in our current system but will only happen if women know what’s at stake. 

Roundup: The Obama Administration: For the Public Option Before They Were Against It… Sort Of?

Who stole the Change-Agents?

Can someone on the Obama Administration please make a decision about whether they are for or against the public option?  While the public wants a public option, and while the President-as-candidate campaigned on the promise of at least something akin to a public option, the Administration has, from day one of the health care reform process, done just about everything it could to say they are "for" a public option "kinda sorta" but "it’s not the defining piece" of health reform (so….it’s not important???  To me this is like saying that water is not the defining factor in putting out a fire).  This weekend, David Axelrod, Rahm Emanuel (as reported by Alternet) as well as other notables took the weekend talk shows to say so. 

Is this leadership?  I thought smart negotiators kept their cards close, pushed as hard as they could for what they wanted and only made the deal after they got as far as they could.  Instead, the Administration keeps signaling to everyone and their great-grandmother that they won’t stand firm on a public option cause it really ain’t that important.  I want to play poker with these guys cause it appears it might be easy to clean up.

Lawmakers in Michigan Push for Sex Education in Schools

Some form of leadership is evident today in Michigan at least, where lawmakers are pushing to require sex education in schools.

MLive.com reports today that:

Proposed legislation from the state would require districts to set up a sex education advisory board and train employees.

Districts
would have to provide factual and medically accurate information that
is age-appropriate at all grade levels. Topics would include family
planning, human sexuality and the emotional, physical, psychological,
hygienic, economic and socials aspects of family life.

Currently, sex education is optional curriculum that any district can choose to offer.

The push for sex ed comes in response to high rates of unintended pregnancy among teens. Since 2006, Michigan has had four percent increase in births for 15 to 19 year olds, according to Michigan NOW.

Parents who advocate abstinence-only curriculum would be able to opt out of any sex education classes under the proposed law.

 

October 19th, 2009

Another view on Belmont Abbey Baltimore Sun

Unveiling the evils of contraception The Cincinnati Enquirer

NYT Environment Reporter Floats Idea: Give Carbon Credits to Couples

That Limit Themselves to One Child CNSNews

Abortion rates falling Jamaica Observer

The Nobel Prize for Good Intentions Catholic Exchange

Going Green Means Having Fewer Kids AlterNet

Speaker addresses population concerns St. Cloud Times 

Inmate-abortion fight continues Arizona Republic

Lawsuit challenges Illinois’ parental notification law for abortions Chicago Tribune

Abortion, Health Care, Biden, Stem Cell Research, 40 Days for Life, More Pro-Life News

Peruvians oppose abortion for rape, fetal deformity: poll Asia One

China calls for efforts to resolve reproductive health issues Daily Times

 


October 18th, 2009

Tablet off its trolley: now it attacks government support for marriage Telegraph Blogs

Marriage not just a private matter, bishops say in proposed pastoral The Catholic Review Online

Quiet protest: Pro-Life teens to participate in Day of Silent Solidarity The Hickory Daily Record

Oklahoma’s New Abortion Law Not OK, Say Critics
Truthdig

Spain protesters oppose relaxation of abortion law
Jurist

Will Catholic Bishops Try to Block Reform? Time

We are the real pro-Americans Telegraph Blogs

China calls for more efforts in reproductive health China Daily

Pro-life leader calls health care proposals a ‘radical departure’ from current abortion policy Catholic News Agency

Liberals frustrated with President Obama; angry their issues took back seat to health care reform
Daily News

Does taking control mean taking life? News Journal

Bill of health for the pill Sunday Times

Stepping Up the Pressure: The Archbishop Comes to the Abortion Clinic
HuffPo

Catholics and Muslims defend life against abortion law in Indonesia
Catholic News Agency

A teen perspective on abstinence-only education
Feminists for Choice

Confidentiality fear over late abortion data Guardian UK

October 17th, 2009

The Pill helps women Bakersfield Californian

Can you imagine a pro-life crowd like this in the U.S.? The Deacon’s Bench

Anti-abortion spokesman: Arrival of abortion pill should not be taken lightly The State Journal-Register

Abstinence-only still being taught despite high pregnancy rates The Monitor

Marchers in Spain Protest Effort to Ease Abortion Law New York Times

There must be a public debate on late abortions Telegraph UK

October 16th, 2009

Latest anti-choice ad: A talking fetus Sacramento News & Review

Hispanic Pro-lifer Assaulted in Fresno, California NewsBusters

Abortion and Health Care Reform Religion & Ethics NewsWeekly

Abortion Practitioner Writes of Doing Abortions While Pregnant With Unborn Baby Life News

Abortion groups fight Catholic hospital expansion Baltimoresun.com

UC Gets Grant To Improve Female Condom WLWT Cincinnati

Guttmacher Wrong: Legalizing Abortions Yields More, Doesn’t Make Them Safer Life News

October 15th, 2009

Calling The Pro-Lifers’ Bluff On Contraception The Atlantic

If you visit a “prolife” pregnancy center, BEWARE of your counselor sharing your personal information with outsiders

If you decide to go to a "prolife" pregnancy center for help, BEWARE of your counselor sharing your pregnancy history and other personal information with outsiders.  

 

Instead of keeping information between you and your counselor where it belongs, a large number of pregnancy centers associated with CareNet.org, HeartBeatInternational.org, and OptionLine.org allow the information you trust them with to leave the center and get into the hands of the employees of internet service providers and other people.

 

Yes, they enter your data on the internet exposing it to the prying eyes of hackers and giving the employees of their local internet company free access to it without your consent.

 

"What happens in Vegas doesn’t stay in Vegas" in the case of these "prolife" pregnancy centers.

 

If you’re not sure whether or not your local pregnancy center does this, ask them if they use ekyros.com or waycoolsw.com to enter your information into the computer. If they do, your counselor is sending the information you give them across the internet and giving the employees of ekyros.com and waycoolsw.com access to view it.  

 

Hundreds of OptionLine.org local pregnancy centers use internet based client intake software products from ekyros.com and waycoolsw.com for “convenience”.

 

But, that convenience comes with a heavy price tag for you, the client who visits one of these centers.

 

These centers make you think that your pregnancy history and other confidential information will never leave the counseling room, then turn around and enter it online and put it into the hands of people you don’t know, outside the center, without your permission.

Will these local centers do anything to help you after your child is born? These pro lifers seem to turn their backs on you when a child has to grow up in low income housing projects and do nothing to help keep a child from turning to crime to support the household. I would guess many voted for Bush who believes in tough prison sentences instead of providing educational and other programs to help ensure that these youth do not turn to crime in the first place.

 

How about Care Net’s (OptionLine sponsor) financials? They take in millions a year. Their president makes over 100,000 a year. The financials seem to show that they give 0$ back to their affiliates or to the girls they say they serve.

All this is just to say that when the pro choice people say the "pro life" centers are deceptive and don’t respect and look out for the welfare of the client in the long run, it is possible they have a point in the case of these centers.

 

Maybe the ACLU should file a class action lawsuit on behalf of clients (many of whom are underage) who were promised absolute confidentiality but whose private information was allowed to leave the center without their consent and was placed in the hands of companies outside the center?

At the very least, a law should be passed that would require “prolife” pregnancy centers and  other organizations to inform their clients where their personal information is going and ask the clients whether or not they are comfortable with their personal information  leaving the center.

  

These "prolife" centers are deceptive. They run ads, in the same section of the phone book, with text which is deceptively close to that of legitimate medical facilities, and locate near these facilities so that maybe you will go to the "prolife" center instead of the original facility you intended on going to; so, these "prolife" centers will have no problem breaking their vow of absolute confidentiality to you lying to your face while they do it.

 

If you are at one of these "prolife" centers and they delay giving you the results of your pregnancy test, (most pregnancy tests take only minutes to determine the results), chances are they are trying to stall you instead of allowing you to weigh your options.

The Advantage of Bringing A Bill With A Public Option to the Floor

Sen. Jay Rockefeller (D-W.Va.), interviewed this weekend
in The Washington Post, points to the central reason that a health
reform bill that hits the floor with a public option already included
stands a better chance of ultimately keeping that provision: Namely,
the burden of getting 60 votes would shift from supporters trying to
add it to opponents trying to carve it out. From the transcript:

Kind of fun, isn’t it? We’re the ones that have always been trying to get 60 votes, now they’ll have to get 60 votes to remove.

You know, Harry Reid will, you know, make the final decision on it.

But I know the president is for it. I know Chris Dodd
is for it. Max Baucus didn’t speak against it. He just talked about the
need to get 60 votes. ‘I can’t do it because I have to get 60 votes.’
Well, if they do it there, he doesn’t have to get 60 votes. So, we’ll
get it.

Last week, a group of 30 Democrats sent a letter
to Reid (D-Nev.) urging the Senate majority leader to include a public
option in the compromise package he’s currently weaving together from
elements of the Finance and HELP committee bills. Sen. Tom Harkin
(D-Iowa), chairman of the HELP panel, told reporters today that the actual number of Senate Democrats supporting a robust public plan tops 50.

Monday, October 17th, 2009

Chile: The Long Struggle for Access to Emergency Contraception

In Chile, women’s rights are
perhaps even more contested than in other countries in Latin America. It is the
only country in the region where the law grants men the right to “manage the
patrimony” of their marriage.  It
was the last country in the region to legalize divorce. And it is one of the
few countries in the world where therapeutic abortion is criminalized.

 

On April 4th 2008,
the Constitutional Court of Chile banned free distribution of the emergency
contraceptive (EC) pill in the public health system. The judicial ruling came
after a debate on the reform of the National Norms on Fertility Regulation
(2006), which had resulted in introduction and free distribution of EC by
public health care centers to all women from 14 years of age, without their
parents’ consent.  Opponents of
birth control objected to the reform, so Chilean President Michelle Bachelet
secured access to EC by virtue of an executive order.  However, the judicial ruling annulled the reform and the
Bachelet’s order, deciding that the distribution of EC was unconstitutional
because, according to the justices, the hormone l
evonorgestrel, contained in the EC pills, is “abortive”, and therefore against the right to
life.

 

As a result of the court decision,
EC was partially removed from pharmacies, whereas other pills containing l
evonorgestrel continued to
be sold, but for a price that not all women can afford.

 

In
Chile, a high number of illegal abortions and teen pregnancies present serious
challenges to a government which has made reducing both abortion and unintended
pregnancy a focal point of its
reproductive
health policy.  So even despite the
Court ruling on EC, Bachelet’s Administration continued to seek new legal
mechanisms to ensure access for all women–poor and rich alike—to emergency
contraception.

 

The government introduced a
bill to regulate information and distribution of contraception methods. Last
July the Lower House of the Parliament of Chile passed the bill, which allows
–among other measures–the free distribution of EC in the public health system.

 

The bill aimed to guarantee
“every person, regardless of their economic situation” free access to the pill.

 

"The state isn’t
imposing anything on anyone," Bachelet said. "Each person may decide
on her own, but the state must guarantee equal conditions of access to birth
control methods."

 

A vast majority of the
legislators voted in favor of the bill–73 votes for, 34 against, and 2
lawmakers abstained from voting. All the votes against the bill were from
members of the party Unión Demócrata Independiente, which has linkages with the
Opus Dei organization. The feminist organizations celebrated the results while
the Catholic Church denounced it.

 

Now the bill awaits Senate
approval. Meanwhile, Chile is in the midst of an electoral campaign, a
circumstance which certainly will have an influence in the votes at the Senate,
with presidential candidates on the left and right seeking to assure their
potential supporters of their own position on this and other issues. Candidates
include Christian Democrat Eduardo Frei, who just three years ago sided with “pro-life”
organizations and Catholics against the distribution of the pill. On the other
hand is the right-wing candidate Sebastian Piñera, whose coalition also firmly
backs the prohibition.

 

As if the debate was not
already hot enough, this October the Ministerio de Salud Pública (Ministry of
Health) of Chile authorized the sale of the EC pill “Escapel-1” in
pharmacies.  Conservative members
of Parliament reacted against the decision, insisting that Escapel-1 has l
evonorgestrel, the hormone they declare to be “abortive”. The conservative
movement “Red por la Vida y la Familia” (Network for Life and Family), through
its lawyer Jorge Reyes, stated that this announcement shows that the health
authorities of the government are acting in opposition to the current legal
situation, where the public distribution of EC pills is banned.

 

At the same time, scientists
and reproductive health advocates have expressed strong support for expanded
access to EC in Chile.  “Those
opposed to this emergency contraceptive are a group of people that call
themselves “pro-life,” who are well organized and have significant power and
influence," said Dr. Soledad Diaz, president of the Chilean Institute for
Reproductive Medicine (ICMER). "They have a very stubborn doctrinaire
position that doesn’t want to recognize the scientific evidence that says the
pill is not abortive. It’s an ideological position, there is no other
explanation.”

 

Research and medical opinion
back them up.  The World
Health Organization states,
for example that
levonorgestrel emergency
contraceptive pills (Epps) have been shown to prevent ovulation and [do not]
have any detectable effect on the endometrium (uterine lining) or progesterone
levels when given after ovulation. 
ECPs are not effective once the process of implantation has begun, and
will not cause abortion.”

Chile: The Long Struggle for Access to Emergency Contraception

In Chile, women’s rights are
perhaps even more contested than in other countries in Latin America. It is the
only country in the region where the law grants men the right to “manage the
patrimony” of their marriage.  It
was the last country in the region to legalize divorce. And it is one of the
few countries in the world where therapeutic abortion is criminalized.

 

On April 4th 2008,
the Constitutional Court of Chile banned free distribution of the emergency
contraceptive (EC) pill in the public health system. The judicial ruling came
after a debate on the reform of the National Norms on Fertility Regulation
(2006), which had resulted in introduction and free distribution of EC by
public health care centers to all women from 14 years of age, without their
parents’ consent.  Opponents of
birth control objected to the reform, so Chilean President Michelle Bachelet
secured access to EC by virtue of an executive order.  However, the judicial ruling annulled the reform and the
Bachelet’s order, deciding that the distribution of EC was unconstitutional
because, according to the justices, the hormone l
evonorgestrel, contained in the EC pills, is “abortive”, and therefore against the right to
life.

As a result of the court decision,
EC was partially removed from pharmacies, whereas other pills containing l
evonorgestrel continued to
be sold, but for a price that not all women can afford.

In
Chile, a high number of illegal abortions and teen pregnancies present serious
challenges to a government which has made reducing both abortion and unintended
pregnancy a focal point of its
reproductive
health policy.  So even despite the
Court ruling on EC, Bachelet’s Administration continued to seek new legal
mechanisms to ensure access for all women–poor and rich alike—to emergency
contraception.

The government introduced a
bill to regulate information and distribution of contraception methods. Last
July the Lower House of the Parliament of Chile passed the bill, which allows
–among other measures–the free distribution of EC in the public health system.

The bill aimed to guarantee
“every person, regardless of their economic situation” free access to the pill.

"The state isn’t
imposing anything on anyone," Bachelet said. "Each person may decide
on her own, but the state must guarantee equal conditions of access to birth
control methods."

A vast majority of the
legislators voted in favor of the bill–73 votes for, 34 against, and 2
lawmakers abstained from voting. All the votes against the bill were from
members of the party Unión Demócrata Independiente, which has linkages with the
Opus Dei organization. The feminist organizations celebrated the results while
the Catholic Church denounced it.

Now the bill awaits Senate
approval. Meanwhile, Chile is in the midst of an electoral campaign, a
circumstance which certainly will have an influence in the votes at the Senate,
with presidential candidates on the left and right seeking to assure their
potential supporters of their own position on this and other issues. Candidates
include Christian Democrat Eduardo Frei, who just three years ago sided with “pro-life”
organizations and Catholics against the distribution of the pill. On the other
hand is the right-wing candidate Sebastian Piñera, whose coalition also firmly
backs the prohibition.

As if the debate was not
already hot enough, this October the Ministerio de Salud Pública (Ministry of
Health) of Chile authorized the sale of the EC pill “Escapel-1” in
pharmacies.  Conservative members
of Parliament reacted against the decision, insisting that Escapel-1 has l
evonorgestrel, the hormone they declare to be “abortive”. The conservative
movement “Red por la Vida y la Familia” (Network for Life and Family), through
its lawyer Jorge Reyes, stated that this announcement shows that the health
authorities of the government are acting in opposition to the current legal
situation, where the public distribution of EC pills is banned.

At the same time, scientists
and reproductive health advocates have expressed strong support for expanded
access to EC in Chile.  “Those
opposed to this emergency contraceptive are a group of people that call
themselves “pro-life,” who are well organized and have significant power and
influence," said Dr. Soledad Diaz, president of the Chilean Institute for
Reproductive Medicine (ICMER). "They have a very stubborn doctrinaire
position that doesn’t want to recognize the scientific evidence that says the
pill is not abortive. It’s an ideological position, there is no other
explanation.”

Research and medical opinion
back them up.  The World
Health Organization states,
for example that
levonorgestrel emergency
contraceptive pills (Epps) have been shown to prevent ovulation and [do not]
have any detectable effect on the endometrium (uterine lining) or progesterone
levels when given after ovulation. 
ECPs are not effective once the process of implantation has begun, and
will not cause abortion.”