News Contraception

Anti-Choicers Gear Up To Fight Guidelines on Preventive Care for Women

Jodi Jacobson

The Institute of Medicine recommended that insurance plans cover contraceptive care with no co-pays and alarm bells start ringing in anti-choice offices across the land.  So get ready for the smear campaign to come.

All articles included in Rewire’s coverage of the IOM Report can be found here.  This article was edited at 7:11 am Thursday, July 21st to include a paragraph (under the heading Misleading Argument #3) that was in advertantly left out of the original published draft.

It’s a predictable routine. 

Medical experts review clinical and public health data and evidence on a set of issues.  They make recommendations on the best way to improve individual and public health, save lives, and lower health care costs for individuals, businesses and the nation writ- large.

If those recommendations include, anywhere, the words “Women,” “Reproductive,” “Health,” and “Care,” alarm bells go off in the hallways of anti-choice group offices everywhere. 

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And then the flood of lies begins.

So it was with the release of today’s Institute of Medicine Report on Preventive Health Care for Women.

The IOM report (the Executive Summary of which can be found here) recommends, among other things, that the Department of Health and Human Services (HHS) include in its final guidelines on women’s preventive health care that insurance companies cover the “full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.”

And, oh boy, did those alarm bells start ringing, from the United States Conference of Catholic Bishops to the Family Research Council to the Americans United for Life and all those other rejectors of research and common sense.

First let’s do the evidence thing.  The IOM recommendations make eminent sense, whether you are concerned about individual rights, public health, or financial responsibility.

Why?

As the IOM report points out, reducing unintended pregnancies improves women’s health and the outcomes of later wanted pregnancies, enables women to plan their families effectively, and reduces the need for abortion. The full IOM report goes into significant detail on the rationale for contraceptive coverage and is worth reading on its own.

Nearly half of all pregnancies in the United States are unintended.  While some women and couples can and do decide to carry an unintended pregnancy to term, other women facing such pregnancies find them untenable and so resort to abortion. Approximately seven in 10 women of reproductive age (43 million women) are sexually active and do not want to become pregnant, but could become pregnant if they and their partners fail to use a contraceptive method. The typical U.S. woman wants only two children. To achieve this goal, she must use contraceptives for roughly three decades.  So even if all you care about is reducing the number of abortions, then the first step is to reduce the number of unintended pregnancies.  Making contraception more affordable and accessible does that.

Unintended pregnancy costs U.S. taxpayers roughly $11 billion each year.  A study by Adam Sonfield and colleagues at the Guttmacher Institute found that two-thirds of births resulting from unintended pregnancies—more than one million births—are publicly funded, and the proportion tops 80 percent in a couple of states. The cost of those births, and the potential gross saving from helping women to avert them, is estimated at $11.1 billion. 

“Investing in publicly funded family planning to help women avoid unintended pregnancy has a proven track record, says Sonfield. “In the absence of the services provided at publicly funded family planning centers, the costs of unintended pregnancy would be 60 percent higher than they are today.”  In a similar study, Emily Monea and Adam Thomas of the Brookings Institution found that:

The estimates of the cost to taxpayers of providing medical services to women who experience unintended pregnancies and to the infants who are born as a result of such pregnancies range between $9.6 and $12.6 billion per year, and average $11.3 billion. The estimates of the public savings that would result if these unintended pregnancies were prevented range from $4.7 billion to $6.2 billion per year, and average $5.6 billion.

“Like Sonfield and colleagues,” stated Thomas and Monea, “we find that the potential public savings from preventing unintended pregnancy are enormous.”

“Our results suggest that if unintended pregnancies could be eliminated altogether, the resulting savings on taxpayer-financed medical care alone would approach the amount that the federal government spends on Head Start each year. Policymakers should protect and even increase investments in such proven cost-saving strategies as publicly subsidized family planning services and evidence-based teen pregnancy prevention programs.”

Remember: We are talking here about assisting women in avoiding pregnancies which they do not intend, do not want, and/or for which they are not prepared in the first place. 

In its findings, the IOM not only rigorously considers the evidence, it also cites numerous other reports recommending the same:

The IOM Committee on Women’s Health Research recently identified unintended pregnancy to be a health condition of women for which little progress in prevention has been made, despite the availability of safe and effective preventive methods (IOM, 2010b). This report also found that progress in reducing the rate of unintended pregnancy would be possible by “making contraceptives more available, accessible, and acceptable through improved services (IOM, 2010b). Another IOM report on unintended pregnancy recommended that “all pregnancies should be intended” at the time of conception and set a goal to increase access to contraception in the United States (IOM, 1995). Healthy People 2020 (HHS, 2011a), which sets health goals for the United States, includes a national objective of increasing the proportion of pregnancies that are intended from 51 to 56 percent. In addition, Healthy People 2020 Effective Interventions sets goals to increase the number of insurance plans that offer contraceptive supplies and services, to reduce the proportion of pregnancies conceived within 18 months of a previous birth, and to increase the proportion of females or their partners at risk of unintended pregnancy who used contraception during the most recent sexual intercourse (HHS, 2011a).

Medical and scientific evidence is, alas, not sufficient for the anti-choice community, which would clearly prefer women get pregnant intentionally or not–whether in consensual sexual relationships or through rape or incest, whether or not their own health and well-being will be put at stake–and then force them to carry said pregnancies to term.  And in keeping with that, they must reject all evidence that undermines their agenda.

So in response to the IOM evidence, they are deploying the three most-frequently repeated and misleading arguments to rally their troops.

Misleading Argument #1: Health-care Reform Will Fund Abortion.

A central strategy of the anti-choice movement is to constantly redefine and confuse issues. And one of the most prevalent tactics is to repeat, endlessly, the lie that contraceptives cause abortion.  Today, the Family Research Council did just that when it  bemoaned the possibility that contraceptives might be included with no co-pay.

An FRC release stated that health care reform “also requires that “preventive care services for women,” without any co-pay from patients, be covered by all insurance plans based on Department of Health and Human Services (HHS) recommendations.”  (This is actually not true, as HHS has as yet not adopted the IOM recommendations, but I suppose FRC figures that when if they are going to lie, they might as well go full bore.)

FRC then went on to state that: “health plans will be required to cover drugs that can prevent implantation, such as Plan B, and even the new drug, ella, that, chemically like RU-486, can destroy implanted embryos.”  As noted by medical experts on the IOM panel during a press call today, and as clear from abundant evidence from any number of actual medical organizations, there is simply no evidence that emergency contraceptive methods “destroy implanted embryos,” that is not their mode of action, and as per medical definitions, a fertilized egg that has not implanted does not constitute a pregnancy in any case. In fact, there are no tests to confirm “fertilization,” and roughly half of all fertilized eggs do not implant in the first place and are flushed out during menstruation.

Misleading Argument #2: It Violates My Conscience!

FRC’s Director of its Center for Human Dignity, Jeanne Monahan, stated today on National Public Radio and in other press outreach that inclusion of birth control will “undermine the conscience rights of many Americans.”

I’m at a loss as to what group the statement “many Americans” includes, since more than 99 percent of all women ages 15 to 44 who have ever had sexual intercourse have used at least one contraceptive method. Overall, 62 percent of the 62 million women ages 15 to 44 are currently using a method of contraception. So the vast majority of women in the United States, whether Catholic, Protestant, Evangelical, Jewish, Muslim, Atheist, Agnostic or of other faith traditions use contraception. I believe that FRC staff may be living in another country, or perhaps, as they say, on another planet.

What FRC doesn’t want you to know is that polling proves them wrong. A national poll conducted in May of this year, found that 88 percent of voters, including four in five Republicans, support women’s access to contraception. Most Americans–using common sense–agree that improving women’s access to contraception is a more effective way to reduce the number of abortions than enacting more restrictive abortion laws.

Moreover, we don’t need any more “conscience” clauses and I sincerely hope that advocacy groups and others will push hard on HHS against yet another gratuitous conscience provision.  We have more than enough provisions that now enable professionals who trained for and accepted the role of physician or pharmacist to beg off doing the job for which they signed up whenever it comes to providing reproductive health care to women. We don’t need any more.  Suffice it to say it not only violates medical ethics, but it also violates the consciences and rights of all women who depend on the medical system to… deliver medical care.

Misleading Argument #3: Inclusion of Contraception Requires “Others” to Foot the Bill.

Most insurance plans today already cover contraceptive supplies to some degree.  The change is not that coverage will be included for the first time ever. It is that contraceptive supplies will become more affordable and therefore both more accessible and more reliable because unaffordable co-pays will be eliminated. A 2010 Planned Parenthood survey found that one in three women voters have struggled to pay for prescription birth control at some point, and have used it inconsistently as a result.

In fact, as pointed out today in a New York Times op-ed authored by Vanessa Cullins, vice president of medical affairs at Planned Parenthood Federation of America, “When the federal government offered full coverage of birth control to all federal employees in 1998, it experienced no increase in costs. In fact, by some estimates it costs employers more not to provide contraceptive coverage in employee health plans.”

More to the point, we are talking about plans into which people are paying premiums with their own funds. I pay a premium each month for my health insurance policy.  I don’t remember FRC offering to pay it for me. What they want to do is lay the (untruthful) groundwork for the same misleading arguments they make regarding abortion care, i.e. that if there is any government money anywhere in the system subsidizing even one single person’s insurance coverage, it “taints” the entire insurance pool.  It’s a ridiculous argument for abortion care and a ridiculous argument for contraceptive care and deserves to be ignored as the baseless claim that it is.

What others do foot the bill for, as illustrated above, is the high cost of unintended pregnancies that result from current contraceptive costs that are too high especially for low-income women at risk of unintended pregnancy.  But since those costs are borne first and most dearly, in isolation, by women who are in effect forced to carry unintended and untenable pregnancies to term, and then by all of us across the population as “hidden” costs, it is easier to mislead by saying that suddenly a burden will be laid at the feet of the apparently less than one-half of one percent of the population FRC and others purport to represent.

Our country, our health, and our rights are best served when legitimate evidence is used as a basis for sane policy.  It’s time to end the ideological was on women’s health care, starting with ensuring HHS adopts the IOM recommendations.  In full.

Various organizations are circulating petitions to HHS in support of the IOM recommendations, including:

Planned Parenthood Federation of America: No co-pay birth control for millions of women in America is within reach. Right now, the Dept. of Health and Human Services is deciding whether or not to require new insurance plans to cover birth control with no co-pays. We’re almost there — add your name to Planned Parenthood’s petition: http://ppact.org/iomfb

The National Women’s Law Center

and

NARAL Pro-Choice America

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (D-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

CORRECTION: A previous version of this article included a typo that misidentified Sen. Tim Kaine as a Republican. We regret this error.

Analysis Politics

The 2016 Republican Platform Is Riddled With Conservative Abortion Myths

Ally Boguhn

Anti-choice activists and leaders have embraced the Republican platform, which relies on a series of falsehoods about reproductive health care.

Republicans voted to ratify their 2016 platform this week, codifying what many deem one of the most extreme platforms ever accepted by the party.

“Platforms are traditionally written by and for the party faithful and largely ignored by everyone else,” wrote the New York Times‘ editorial board Monday. “But this year, the Republicans are putting out an agenda that demands notice.”

“It is as though, rather than trying to reconcile Mr. Trump’s heretical views with conservative orthodoxy, the writers of the platform simply opted to go with the most extreme version of every position,” it continued. “Tailored to Mr. Trump’s impulsive bluster, this document lays bare just how much the G.O.P. is driven by a regressive, extremist inner core.”

Tucked away in the 66-page document accepted by Republicans as their official guide to “the Party’s principles and policies” are countless resolutions that seem to back up the Times‘ assertion that the platform is “the most extreme” ever put forth by the party, including: rolling back marriage equalitydeclaring pornography a “public health crisis”; and codifying the Hyde Amendment to permanently block federal funding for abortion.

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Anti-choice activists and leaders have embraced the platform, which the Susan B. Anthony List deemed the “Most Pro-life Platform Ever” in a press release upon the GOP’s Monday vote at the convention. “The Republican platform has always been strong when it comes to protecting unborn children, their mothers, and the conscience rights of pro-life Americans,” said the organization’s president, Marjorie Dannenfelser, in a statement. “The platform ratified today takes that stand from good to great.”  

Operation Rescue, an organization known for its radical tactics and links to violence, similarly declared the platform a “victory,” noting its inclusion of so-called personhood language, which could ban abortion and many forms of contraception. “We are celebrating today on the streets of Cleveland. We got everything we have asked for in the party platform,” said Troy Newman, president of Operation Rescue, in a statement posted to the group’s website.

But what stands out most in the Republicans’ document is the series of falsehoods and myths relied upon to push their conservative agenda. Here are just a few of the most egregious pieces of misinformation about abortion to be found within the pages of the 2016 platform:

Myth #1: Planned Parenthood Profits From Fetal Tissue Donations

Featured in multiple sections of the Republican platform is the tired and repeatedly debunked claim that Planned Parenthood profits from fetal tissue donations. In the subsection on “protecting human life,” the platform says:

We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare. We urge all states and Congress to make it a crime to acquire, transfer, or sell fetal tissues from elective abortions for research, and we call on Congress to enact a ban on any sale of fetal body parts. In the meantime, we call on Congress to ban the practice of misleading women on so-called fetal harvesting consent forms, a fact revealed by a 2015 investigation. We will not fund or subsidize healthcare that includes abortion coverage.

Later in the document, under a section titled “Preserving Medicare and Medicaid,” the platform again asserts that abortion providers are selling “the body parts of aborted children”—presumably again referring to the controversy surrounding Planned Parenthood:

We respect the states’ authority and flexibility to exclude abortion providers from federal programs such as Medicaid and other healthcare and family planning programs so long as they continue to perform or refer for elective abortions or sell the body parts of aborted children.

The platform appears to reference the widely discredited videos produced by anti-choice organization Center for Medical Progress (CMP) as part of its smear campaign against Planned Parenthood. The videos were deceptively edited, as Rewire has extensively reported. CMP’s leader David Daleiden is currently under federal indictment for tampering with government documents in connection with obtaining the footage. Republicans have nonetheless steadfastly clung to the group’s claims in an effort to block access to reproductive health care.

Since CMP began releasing its videos last year, 13 state and three congressional inquiries into allegations based on the videos have turned up no evidence of wrongdoing on behalf of Planned Parenthood.

Dawn Laguens, executive vice president of Planned Parenthood Action Fund—which has endorsed Hillary Clinton—called the Republicans’ inclusion of CMP’s allegation in their platform “despicable” in a statement to the Huffington Post. “This isn’t just an attack on Planned Parenthood health centers,” said Laguens. “It’s an attack on the millions of patients who rely on Planned Parenthood each year for basic health care. It’s an attack on the brave doctors and nurses who have been facing down violent rhetoric and threats just to provide people with cancer screenings, birth control, and well-woman exams.”

Myth #2: The Supreme Court Struck Down “Commonsense” Laws About “Basic Health and Safety” in Whole Woman’s Health v. Hellerstedt

In the section focusing on the party’s opposition to abortion, the GOP’s platform also reaffirms their commitment to targeted regulation of abortion providers (TRAP) laws. According to the platform:

We salute the many states that now protect women and girls through laws requiring informed consent, parental consent, waiting periods, and clinic regulation. We condemn the Supreme Court’s activist decision in Whole Woman’s Health v. Hellerstedt striking down commonsense Texas laws providing for basic health and safety standards in abortion clinics.

The idea that TRAP laws, such as those struck down by the recent Supreme Court decision in Whole Woman’s Health, are solely for protecting women and keeping them safe is just as common among conservatives as it is false. However, as Rewire explained when Paul Ryan agreed with a nearly identical claim last week about Texas’ clinic regulations, “the provisions of the law in question were not about keeping anybody safe”:

As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”

Myth #3: 20-Week Abortion Bans Are Justified By “Current Medical Research” Suggesting That Is When a Fetus Can Feel Pain

The platform went on to point to Republicans’ Pain-Capable Unborn Child Protection Act, a piece of anti-choice legislation already passed in several states that, if approved in Congress, would create a federal ban on abortion after 20 weeks based on junk science claiming fetuses can feel pain at that point in pregnancy:

Over a dozen states have passed Pain-Capable Unborn Child Protection Acts prohibiting abortion after twenty weeks, the point at which current medical research shows that unborn babies can feel excruciating pain during abortions, and we call on Congress to enact the federal version.

Major medical groups and experts, however, agree that a fetus has not developed to the point where it can feel pain until the third trimester. According to a 2013 letter from the American Congress of Obstetricians and Gynecologists, “A rigorous 2005 scientific review of evidence published in the Journal of the American Medical Association (JAMA) concluded that fetal perception of pain is unlikely before the third trimester,” which begins around the 28th week of pregnancy. A 2010 review of the scientific evidence on the issue conducted by the British Royal College of Obstetricians and Gynaecologists similarly found “that the fetus cannot experience pain in any sense prior” to 24 weeks’ gestation.

Doctors who testify otherwise often have a history of anti-choice activism. For example, a letter read aloud during a debate over West Virginia’s ultimately failed 20-week abortion ban was drafted by Dr. Byron Calhoun, who was caught lying about the number of abortion-related complications he saw in Charleston.

Myth #4: Abortion “Endangers the Health and Well-being of Women”

In an apparent effort to criticize the Affordable Care Act for promoting “the notion of abortion as healthcare,” the platform baselessly claimed that abortion “endangers the health and well-being” of those who receive care:

Through Obamacare, the current Administration has promoted the notion of abortion as healthcare. We, however, affirm the dignity of women by protecting the sanctity of human life. Numerous studies have shown that abortion endangers the health and well-being of women, and we stand firmly against it.

Scientific evidence overwhelmingly supports the conclusion that abortion is safe. Research shows that a first-trimester abortion carries less than 0.05 percent risk of major complications, according to the Guttmacher Institute, and “pose[s] virtually no long-term risk of problems such as infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and little or no risk of preterm or low-birth-weight deliveries.”

There is similarly no evidence to back up the GOP’s claim that abortion endangers the well-being of women. A 2008 study from the American Psychological Association’s Task Force on Mental Health and Abortion, an expansive analysis on current research regarding the issue, found that while those who have an abortion may experience a variety of feelings, “no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.”

As is the case for many of the anti-abortion myths perpetuated within the platform, many of the so-called experts who claim there is a link between abortion and mental illness are discredited anti-choice activists.

Myth #5: Mifepristone, a Drug Used for Medical Abortions, Is “Dangerous”

Both anti-choice activists and conservative Republicans have been vocal opponents of the Food and Drug Administration (FDA’s) March update to the regulations for mifepristone, a drug also known as Mifeprex and RU-486 that is used in medication abortions. However, in this year’s platform, the GOP goes a step further to claim that both the drug and its general approval by the FDA are “dangerous”:

We believe the FDA’s approval of Mifeprex, a dangerous abortifacient formerly known as RU-486, threatens women’s health, as does the agency’s endorsement of over-the-counter sales of powerful contraceptives without a physician’s recommendation. We support cutting federal and state funding for entities that endanger women’s health by performing abortions in a manner inconsistent with federal or state law.

Studies, however, have overwhelmingly found mifepristone to be safe. In fact, the Association of Reproductive Health Professionals says mifepristone “is safer than acetaminophen,” aspirin, and Viagra. When the FDA conducted a 2011 post-market study of those who have used the drug since it was approved by the agency, they found that more than 1.5 million women in the U.S. had used it to end a pregnancy, only 2,200 of whom had experienced an “adverse event” after.

The platform also appears to reference the FDA’s approval of making emergency contraception such as Plan B available over the counter, claiming that it too is a threat to women’s health. However, studies show that emergency contraception is safe and effective at preventing pregnancy. According to the World Health Organization, side effects are “uncommon and generally mild.”