Will a Lame Duck Congress Pass the Paycheck Fairness Act?

Will a Lame Duck Congress Pass the Paycheck Fairness Act?

The Paycheck Fairness Act is slated to come up for a vote this Wednesday, November 17th. It’s a bill that addresses pay discrimination based on gender; discriminatory practices that have not thoroughly been addressed in other laws, as evidenced by stagnation in wage gap between women and men. Women still make 77 cents for every one dollar men make and for women of color that number goes down to almost 62 cents for every one dollar a white man makes.  Efforts to close the wage gap have slowed down considerably since the 1990s and women’s rights advocates are just not willing to wait another 50 years for pay equity. Working families should not be willing to wait either.

Despite claims by the business community that this type of discrimination has already been covered in other laws, or that it will increase the number of lawsuits or (my personal favorite) create a disincentive for employers to hire women (wow, you know you’re reaching when you reason that if society passes a bill to reduce discrimination in the workplace, you’ll react by discriminating further!), the bill has already passed the House and has the full support of President Obama.

At the risk of repeating an entire post I’ve written about this act, I’ll just say that the Paycheck Fairness Act addresses loopholes in both the Equal Pay Act and is connected to the Lilly Ledbetter Act only in so much as it is a necessary “next step” piece of legislation. Where the Equal Pay Act notes that an employer must ensure that they are not paying a male and a female different pay for the same work (controlling for other issues like years of experience, for example), their reasoning can be, well, flimsy. Employers can say, “Well, Jeff negotiated more forcefully for a raise. Lucy just didn’t have the negotiation skills.” That may be true but does it address the underlying gender discrimination? The Paycheck Fairness Act says an employer must have a business reason for paying male and female employees – who are doing the exact same job – different wages. The Lilly Ledbetter Act, on the other hand, is simply a law which extends the statute of limitations for an employee to bring a wage discrimination suit against an employer. It does not provide parameters for pay equity in the workplace.

The Paycheck Fairness Act does more, however. It establishes negotation skills training for girls and women. It establishes a way for the government to track fields in which wage discrimination happens more frequently. It creates incentives for employers to maintain fair and equitable workplace environments in regard to pay. It also ensures that employees may discuss wages with each other without fear of recrimination from employers – a critical allowance when you consider that the only way Lilly Ledbetter knew she was the victim of discrimination was when a fellow employee left an anonymous note in her mail box at work.

And as for the business community’s contention that this will somehow weaken the already fragile economy? I have two responses. First of all, two working parents or a working single parent lead 70 percent of families in the United States. Single female-headed households are on the rise – yet account for the poorest sectors of our society.

Women are not putting the icing on the paycheck cake for families – we’re not bringing in a “little bit extra” for that fancy new car or week-long vacation. Women’s wages are integral to the economic health of our families. If we pay women fairly, we’re also strengthening the economy. As the Center for American Progress reports, men have been more likely to lose their jobs during this economic recession, “The persistent gender pay gap is adding insult to injury for families already hit hard by unemployment.”

Under this lens, it makes even more sense that if women are increasingly becoming sole breadwinners for the family, they must be paid fairly for the work they are doing,

Lilly Ledbetter estimated that she lost upwards of $200,000 over her professional lifetime as a result of gender-based wage discrimination. That’s a lot of money she could have spent – not only on saving money for her children’s education or for health care but on so many other items that would have helped support small and larger businesses alike. The Center for American Progress notes that the typical woman will lose approximately $431,000 over a 40-year span of time.

The American Assocation of University Women notes that, “…just one year out of college, women working full time already earn less than their male colleagues, even when they work in the same field. Ten years after graduation, the pay gap widens.”

Attempting to make the argument that paying women fairly will somehow place businesses in jeopardy is not sound reasoning.

The only option that truly makes sense, advocates say, during a time of recession and after waiting almost fifty years for fair pay since the passage of the Equal Pay Act, is to pass the Paycheck Fairness Act.

Abortion in Emergency Situations: The Story of the Democratic Republic of Congo

This is the seventh in a series of articles from Keeping Our Promise: Addressing Unsafe Abortion in Africa this week. The conference has brought together more than 250 health providers, advocates, policy makers and youth participants for a discussion of how to reduce the impact of unsafe abortion in Africa.

One in 13 women in the Democratic Republic of Congo dies in pregnancy or childbirth—that’s one death every half hour of every day.

Health problems related to pregnancy and childbirth remain the leading cause of ill health and death for women of childbearing age worldwide. But the impact is even greater in countries in the throes of a humanitarian emergency or crisis.

Addressing unsafe abortion in emergency situations at the ‘Keeping Our Promise’ conference in Accra last week, Dr Wilma Doedens of the Humanitarian Response Branch in UNFPA (the United Nations Population Fund) noted that, in the unstable environment created by a humanitarian crisis, women are at risk for an unwanted pregnancies, whether as a result of a breakdown in the health system (making family planning services unavailable), or as a result of rape that has become a consistent weapon against communities in eastern Congo.

In this context, pregnancy is particularly dangerous.

“Malnutrition and epidemics increase risks of pregnancy complications and often the lack of access to emergency obstetric care increases risk of maternal death,”said Dr Doedens.

Testimonies of women survivors of war played at the conference starkly illustrated the impact of rape and a lack of reproductive health care in the Congo.

One woman simply called Cecily explained:

“We have had war for many years and nothing has changed. We have nothing now, I have six children. It is hard to feed everyone. We have one meal per day and only my sons go to school since I do not have enough money to take the girls as well. I have heard that women can stop getting pregnant but I don’t know how and no one has told me how. I wish I could stop. I don’t want to be pregnant anymore.”

In an interview, Dr Boubacar Toure, Reproductive Health Advisor to the International Rescue Committee in Congo, outlined challenges to quality reproductive and post-rape health care in Congo.

He said that in Congo, the average age of women at their first pregnancy was 15 years, the age at which many girls were married. In addition the risk posed by pregnancy at younger ages, many hospitals in unstable areas cannot provide the medication and supplies necessary to provide the very basic obstetric services, such as antibiotics, syringes and long gloves needed for certain procedures.

Similarly, the ability of the Congolese health system to offer family planning services and prevent infections is limited by the lack of essential supplies at health and hospitals. Contraceptives are for instance offered only in a limited number of hospitals.

Staffing is also a major concern. Due to the war, many of the health staff fled for their lives, leaving a lack of staff in the health centres and hospitals to perform emergency obstetric care—such as treatment for women with complications for unsafe abortion. Those who do stay are often not paid for months and many rural health workers migrate to cities or go to work for international agencies to seek employment with a regular salary.

Some hospitals are staffed with as little as one doctor and fewer than five nurses. It is estimated that Congo lacks approximately 42,000 health professionals needed to adequately staff their hospitals.

Another barrier to proper reproductive health care is lack of female health staff in rural areas. Traditionally, Congolese women do not discuss reproductive health issues with men, much less rape. But the physical injuries from violent sexual assault will drive survivors seek help. The scarcity of female medical staff providing post-rape treatment throughout Congo is therefore problematic.

Testimony from another assault survivor attested to this. In a recording played at Keeping Our Promise she said:

“One day, at the age of 19, I was in bed asleep when I heard guns. The rebels had entered the village. I was so afraid, and I run with no belongings only the clothes I was wearing. I had to sleep in the bush for three days and on the fourth day I was kidnapped by an armed soldier who threatened me with death. He took me far away to the bushes and he raped me. After some weeks I found I was pregnant. I felt so ashamed but I could not keep the baby. I went and had an abortion. It was so painful and I still think about it everyday.”

In addition to a lack of materials and staff, there is little in-service training available to health care staff in the public sector, unless specifically funded by an external donor. Lack of training on newer, safer procedures is also a major challenge.

Without systematic and consistent training in the clinical care of survivors of sexual assault, when survivors report to health centers they are often not offered appropriate and life-saving care (such as post-abortion care) because it is simply unavailable.

Finally, addressing unsafe abortion in emergency settings is blocked by silence—little air-time is spent on women who have survived sexual assault only to risk their lives with an unsafe abortion. However, programs like the RAISE Initiative and others are working to ensure that post-abortion care is included in health care programs in emergency settings.

Now is the Time to Save Women from Needless Death

This is the sixth in a series of articles from Keeping Our Promise: Addressing Unsafe Abortion in Africa this week. The conference has brought together more than 250 health providers, advocates, policy makers and youth participants for a discussion of how to reduce the impact of unsafe abortion in Africa.

Of the nearly 67,000 deaths each year from unsafe abortion in the world, more than half are in Africa, and millions of African women suffer serious injuries from complications from unsafe abortion. Young women in particular are disproportionately affected. Between 30 and 60 women under 25 die each day in Africa from unsafe abortion.

In addition to its devastating impact on the health of women, girls, families and communities, managing complications of unsafe abortion imposes enormous costs to African health systems, including health workers’ time, drugs, medical supplies, and hospital stays.

Restrictive abortion laws and limited access to safe abortion services are the major factors contributing to the high mortality of African women from unsafe abortion. Most African countries operate under archaic abortion laws and policies that in no way reflect the realities of African women and their families. As Sharon Camp of the Guttmacher Institute mentions in her post today, these laws and policies must be changed.  Most African women and health-care providers remain unaware of their legal rights and obligations related even to the limited circumstances — such as in cases of rape, incest or to save a woman’s life — for which most African countries permit abortion.

“Most of the African conventions would have solved these problems, but they have not been implemented. It’s time to lift the veil on this experience shared by so many African families,” said Maiga sina Damba, minister for women’s, children’s and family affairs, Mali.

The Keeping Our Promise conference last week in Accra reinforced the challenges African women face and brought them out for discussion. More than 200 committed providers, policymakers, advocates and NGO workers put abortion on the table, so to speak. In the final conference declaration — drafted by sponsoring organizations with youth input and read by Fannie Kachale, deputy director of the Reproductive Health Unit, Ministry of Health, Malawi — reaffirms the promises African leaders and governments have made to African women.

Specifically, conference attendees, representing roughly 20 African countries, call on African governments to:

  • Give priority to reproductive health, particularly unsafe abortion, to achieve Millennium Development Goal 5, to reduce maternal mortality;
  • Honor commitments stipulated by the Maputo Protocol and Plan of Action;
  • Review laws that criminalize abortion;
  • Increase funding and build a sustainable supply of technologies for contraception and safe abortion care, including medical abortion.

Attendees and speakers themselves committed to lead the charge to increase access to safe abortion care and end needless deaths and injuries from unsafe abortion.

“I wish to add my voice to the call to end unsafe abortion. This is a matter of human rights,” said Honorable Juliana Azumah-Mensah, minister for women and children’s affairs, Ghana.

In agreement, Litha Musyimi Ogana, director of women, gender and development for the Africa Union, said:

“The issue of unsafe abortion demands our attention. We have the words of commitment. What we need now is action.”

The rallying cry was summed up by Ipas Vice President for Africa, Dr. Eunice Brookman Amissah, and leaders from around the continent: “You’ve heard the declaration. Our job is cut out for us.”

The time to act is now. Women and girls — mothers and sisters, daughters and friends — are dying every day in Africa. We have the knowledge, the will and the technologies to prevent these senseless deaths.

Repro Rights Roundup: Afternoon-Style

Lame ducks, home birth, the connection between climate change and birth control…and more!

  • The Paycheck Fairness Act and the DREAM Act will both be addressed during the lame duck session. Igniting Change has more information for you (including exactly how to take action)!
  • Illinois legislators will vote on the Home Birth Safety Act (a bill which would license Certified Professional Midwives in the state) this week and midwifery advocates are asking folks to speak up on behalf of home birth access for women and families in the state. 
  • How many different ways can the Catholic bishops continue to spread false information on health care reform, federal funding and abortion care for women in an attempt to justify why they held up a bill that will allow millions of men, women and children to access health care? The group is continuing to mis-state that health care reform, in any way, allows for taxpayer funding of abortions. Except when the woman who is pregnant may die if she doesn’t receive an abortion or she’s been the victim of rape or incest, the law is no different than what it’s been for almost forty years.
  • First she did, then she didn’t. Does she? Cindy McCain speaks out (or tweets out) against “Don’t Ask, Don’t Tell” and then comes out publicly in support. Slate’s XX Factor has more
  • Ms. Magazine’s Feminist Wire Daily reports that a new CDC report has found that inconsistent use of birth control accounts for much of this country’s unintended pregnancy rate. 
  • Are women in the United States getting the message that they’re at risk for HIV? Are health providers who serve women when they go in for an annual exam or birth control doing enough to encourage an HIV test? Brooke at TheBody.com explores these questions in anticipation of World AIDS Day 2010.

Just Facts: Is It Harmful to Take Emergency Contraception Multiple Times?

This article is part of an ongoing series on facts about contraception and contraceptive use provided in partnership with Planned Parenthood of New York City.

It’s happened to a lot of women:  The condom breaks. Or you’re just not as careful as you should be. Or you realize you’ve forgotten to take your birth control pill for the second day in a row. Or, anything really, we’re all human and mistakes happen. Hopefully you get and take emergency contraception before panic sets in about whether or not you might be facing an unplanned pregnancy.

The first time this happens, you might feel relief. But if it happens again?  Or a third time? Or a fourth? You may start to wonder, as we often hear from our patients, is it really okay for me to take emergency contraception over and over again? The short answer is yes.  And no. But not for the reasons you might at first think. 

First, what is emergency contraception?

 In order to understand the effects of something on our body, we should first understand what it is. Emergency contraception is a pill made of one of the hormones found in birth control pills — progestin – that can be taken up to five days after having unprotected sex. It works by preventing ovulation; thickening your cervical mucus, which can block sperm from connecting with an egg; and by thinning the lining of the uterus, preventing a fertilized egg from attaching. Emergency contraception is not the same thing as RU-486, the pill that causes a medical abortion. If you are 17 or older, emergency contraception can be purchased over the counter at a pharmacy. If you are under 17, it can be obtained from the pharmacy with a prescription.

So, is it harmful to keep taking emergency contraception?

From a medical perspective, no. There are no medical consequences to taking emergency contraception more than once. The hormone contained in the pill is the same as ones found in the birth control pill – and that naturally occur in your body. It will not have a long-term effect on your reproductive health. You may notice irregular bleeding patterns and your period may be early or late, but emergency contraception will not affect your fertility, or become less effective over time. In fact it will not even harm a pregnancy if you’ve already become pregnant.

However, if you find yourself continuously having to take emergency contraception, it may be time to reexamine your method of birth control. Emergency contraception works well as a safety net, it’s true. But it’s still far less effective at preventing pregnancy than most other methods of birth control. That means that the more often you take it, the more likely you are statistically to hit upon that one time it doesn’t work. And that’s regardless of the fact that emergency contraception in no way prevents transmission of HIV or Sexually Transmitted Infections.

So, if you find yourself in a position where you’re wondering if you should take emergency contraception, by all means take it. The only consequence you’ll be facing afterwards is the increased likelihood that you won’t have an unplanned pregnancy. But if you find yourself in that position over and over again, then it might be time to come to terms with the fact that your method of birth control isn’t working for you. There’s nothing to be ashamed of – one of the great by-products of having so many options available is that we all can find the one that truly works best for us.

Keep in mind, this column is purely informative and should not stand in for medical advice. Making good decisions about sexual health and birth control is vastly different for each person. That means that no matter how much what we have to say rings true, you should always discuss these topics with your health care provider to figure out what works best for your health, body, and lifestyle.

Roundup: Media Says Every Woman Regrets Her Abortion — No Exceptions

It’s become a non-stop theme now that every woman regrets her abortion, regardless of if she says so or not.  And it’s a theme that the media seems intent on pushing.

Recently, Abby Wisse Schachter wrote in the New York Post that abortion should always carry a stigma.  Now, after getting response back from Planned Parenthood that a woman should not feel shame over something that is best for her and her family, Wisse Schachter counters by totally changing the subject:

If we agree that the goal is to reduce the need for abortion, and Planned Parenthood is interested in having women make the best decision available to them, why isn’t choosing not to abort one of the options listed here? It seems possible, and even likely, that for some woman, somewhere, some of the time, staying pregnant and, say, giving the child up for adoption might actually be a better choice than abortion. And yet, according to this organization, such a choice is never the best option.

The reason that it isn’t mentioned as an option, of course, is because Wisse Schachter was originally discussing why all women should feel ashamed of having an abortion, regardless of if it is in their best interest or not, not “all women should be stigmatized for having a pregnancy they don’t want, regardless of what they intend to do with it.”

But maybe that’s really whatWisse Schachter meant?  If so, perhaps she should just come out and say it, like Valerie Ulene does in the Los Angeles Times:

For women, the consequences of an unintended pregnancy are obvious. But there are consequences for the baby as well. Women who aren’t actively trying to conceive may not recognize that they’re pregnant immediately — and, as a result, would be more likely to engage in potentially risky behaviors like drinking and smoking during the first few weeks of fetal development. Prenatal care, meanwhile, is often delayed. “The risk for damage is significant,” Nettleman says. A 2009 study she authored found that women who were late in learning that they were pregnant were more likely to have babies who are born prematurely.

Unfortunately, there’s no quick fix. “Some unintended pregnancies will be with us always,” Nettleman says. “It’s a complex issue. Simply telling women to straighten up and fly right isn’t the answer.”

Undoubtedly, women need to be better educated about birth control and its proper use. And more acceptable methods of contraception — ones that have fewer side effects and are more convenient to use — must be developed. But straightening up and flying right is part of the solution too.

With few exceptions, unintended pregnancies are not “accidents.” They are predictable consequences of having sex without contraception.

But in case you haven’t caught on yet, every unintended pregnancy is the result of an irresponsible woman, and apparently if you look inside the head of every woman seeking an abortion, she secretly just wanted someone to tell her she had to keep the baby.  Or so says The Guardian. From the article titled “What I’m Really Thinking: The Abortion Patient”

There isn’t a choice: I am an unemployed recent graduate barely able to afford the pregnancy test, with a boyfriend on bar wages. But after the scan, I want the nurse to find some unfathomable medical reason why termination isn’t an option, so I’d be justified in keeping a child I don’t want to lose but can’t really provide for.

Got it?  No wonder everyone thinks every woman is ashamed.

Mini Roundup: Can someone please explain “temporary sterilization” to me?  And if it’s voluntary, isn’t that what we are asking for in adding free birth control to preventative care?

November 15, 2010

November 14, 2010

November 13, 2010

My Patients Deserve Complete Care: Why I Support New York City’s Crisis Pregnancy Center Bill

As a family physician, I provide comprehensive health care for all of my patients, including safe abortions for women who decide to end a pregnancy. I’ve cared for many women who came to me in crisis when they learned they were pregnant. The last thing my patients need is to be misled by anti-abortion organizations masquerading as health clinics. I’m strongly in favor of the New York City bill requiring crisis pregnancy centers to disclose that they do not provide abortions or contraception, or offer referrals for these services.

I recently treated Michelle, a 16-year-old who came to my clinic for an abortion. Michelle received counseling from our social worker, and she was quiet when she entered the exam room—not unusual for a woman going through a difficult time. However, as I began to counsel her about what to expect during the procedure, she started to sob.

“Are you sure this is the right decision for you?” I asked.

She exclaimed through her tears, “I can’t have a baby right now!”

We sat down together and discussed the pros and cons. She was not ready to be a mother, or to be pregnant. She wanted to go to college. Michelle felt suicidal at the thought of carrying out the pregnancy. Her mother was opposed to abortion, but Michelle still concluded that it was right for her.

On the way to the clinic, however, Michelle saw a nearby building with a large sign: “Unintended Pregnancy?” Thinking it was our clinic, she went in. She was surprised that instead of taking her medical history, the staff asked her about her relationship with God. They told her that ending a pregnancy is murder, and if she followed through with her abortion, the baby would feel pain during the procedure. They showed her pictures of fetuses from much later in pregnancy. “I can’t get them out of my head,” she said.

I expected Michelle to say that she had changed her mind and wanted to leave our clinic. Instead, she touched my arm, looked into my eyes, and thanked me for being there. “I’m ready now.”

This young woman had determined on her own that she did not want to be pregnant. She considered all of her options, and she chose abortion. She did not want to be a mother right then. She wanted to continue her education. Despite the propaganda that the crisis pregnancy center forced on Michelle, she chose to end her pregnancy.

New York City has just introduced a bill that could help prevent women from being misled by crisis pregnancy centers. It would require these centers to post signs clearly stating that they do not offer abortion or contraceptives, and will not help women find a provider who does. The bill would also make centers without a licensed medical professional on staff add this fact to their signs. Michelle might have been spared her traumatic experience had she seen a sign like this on the door of the crisis pregnancy center.

Beliefs about abortion and reproductive health are all over the map. Some women in Michelle’s situation will choose parenting or adoption. But traumatizing women with misinformation doesn’t help anyone. Pregnant women need care and counseling based on medical evidence and compassion, not lies. That’s why I support the effort to give women in New York City clear information about what happens inside crisis pregnancy centers.

To Save Women’s Lives in Africa, Bring Abortion Out of the Shadows

Last week, in collaboration with Ipas, we published several in a series of articles on unsafe abortion coming out of Keeping Our Promise: Addressing Unsafe Abortion in Africa, a conference held in Accra, Ghana.  The conference brought together more than 250 health providers, advocates, policy makers and youth participants for a discussion on how to reduce the impact of unsafe abortion in Africa. Dr. Camp’s article was published separately in the Guardian.uk, and we republish it here with permission from the Guttmacher Institute.

More than 250 health professionals, advocates and parliamentarians from countries throughout Africa and other regions gathered in Accra, Ghana, last week to address the issue of unsafe abortion, one of the continent’s biggest threats to women’s health.

While abortion is very safe in countries where it is legal and provided by trained medical professionals, clandestine abortion – the norm in most of Africa – can lead to death and serious injury. Approximately 26,000 African women die as a result of unsafe abortion every year. Another 1.7 million are hospitalised, and many others also suffer serious health complications, but never seek treatment.

Over 90 percent of African women of childbearing age live in countries with limited or no access to safe abortion procedures. According to the most recent data available, of the 5.6 million abortions carried out in the region every year, only 100,000 are performed under safe conditions.

Here’s another way to think about that statistic: every year, about 5.5 million women in Africa risk their lives when they decide to terminate a pregnancy. Drinking bleach or inserting sharp objects into their cervix are only two of the horrifying methods they use. These are not risks any woman should be forced to take.

The terrible toll of unsafe abortion goes well beyond the individual woman. Losing their mother and care-giver devastates the lives of children and families, and losing a healthy woman’s many contributions to society weakens her community. Unsafe abortion is also a serious drain on very limited public health resources. African governments spend, on average, $114 per case to provide care for illness and disability associated with unsafe abortion, yet per-capita spending on healthcare averages just $48.

While some African nations have loosened abortion restrictions, 14 countries still prohibit it under all circumstances – even to save the pregnant woman’s life. This flies in the face of considerable evidence that legalising abortion saves lives and reduces persistently high maternal mortality rates. One good example is South Africa, where – just six years after the country liberalized its abortion laws – the number of women dying from unsafe abortion dropped by 50 percent, and the number of women suffering serious complications fell dramatically as well.

Restrictive abortion laws are also not very effective at achieving their purported goal – stopping women from obtaining abortions. Evidence from around the world shows that abortion happens at about the same rate in regions where it is highly restricted and where it is broadly legal. The key difference is safety.

If a country’s leaders want to reduce abortion, punitive laws clearly are not the way to go. Rather, they should focus on reducing the number of unplanned pregnancies. The single biggest thing a country can do to reduce the number of abortions, both safe and unsafe, and to improve women’s overall health is to make sure all women have access to and information about effective contraceptive methods.

But in Sub-Saharan Africa today, about 60 percent of women who want to avoid a pregnancy are not using family planning or are relying on a less effective traditional method.

Research by the Guttmacher Institute shows that expanding the availability of family planning in Sub-Saharan Africa, so that all women who want to delay pregnancy have access to effective contraception, would reduce the number of unsafe abortions from 5.2 million to 1.2 million per year. The number of women needing care for complications of these unsafe procedures would fall from 2.2 million to 500,000. Achieving these reductions will require significant financial investment from African governments and donor countries alike, but one with far-reaching benefits: fewer unplanned pregnancies, fewer unsafe abortions and fewer maternal and newborn deaths.

The evidence is clear and compelling, but if it falls on deaf ears women will continue to die and suffer from unsafe abortions. But as last week’s conference in Accra shows us, people are listening. There are dedicated individuals from all over the continent working together to take the evidence and translate it into action that will save the lives of African women. Government leaders must also start paying attention to the evidence that will help guide them toward laws, policies and programmes that will better protect women and build stronger families, communities and, ultimately, nations.