Commentary Contraception

Vulnerable Women and Contraception: Obama Turns Clock Back Nearly 100 Years

Carole Joffe

A critique of reproductive politics written in the 1970s about events in the ‘20s and ‘30s is remarkably relevant to today’s leading reproductive controversy: the Obama Administration’s overruling of the FDA decision to allow over-the-counter status of Plan B emergency contraception for young women under the age of seventeen.

See all our coverage of the Administration’s 2011 Emergency Contraception Reversal here.

“For a woman to ‘ask her physician’ for a safe and effective contraceptive  presupposed that she had a physician, that she could afford a contraceptive, and that the physician would be willing to give it to her, regardless of her marital status.”

These are the words of the historian Sheila Rothman, writing about the setbacks Margaret Sanger faced in the 1920s and 1930s in trying to realize her vision of making birth control widely available to all women, including the poorest—and about the ultimate “ownership” of contraceptive services during that era by physicians. Sanger’s original vision was a fleet of clinics, to be run by public health nurses. But as Rothman and others have documented, when she attempted to open such clinics, she experienced repeated arrests and the closures of her facilities, as contraception was then illegal. In the years leading up to the 1965 Supreme Court Griswold decision, which legalized birth control for married persons, only physicians were legally permitted to provide such services, and as the quote from Rothman implies, this situation put poor women at a tremendous disadvantage.

Rothman’s critique, written in the 1970s about events in the ‘20s and ‘30s,  is remarkably relevant to today’s leading reproductive controversy: the Obama administration’s overruling of the FDA decision to allow over-the-counter status of Plan B, an Emergency Contraceptive product, for young women under the age of seventeen. If one substitutes “teenager” for “woman” and “Plan B” for “a safe and effective contraceptive” in Rothman’s quote, one can readily appreciate how, once again in America’s longstanding reproductive wars, the needs of the most vulnerable are willfully neglected.

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Secretary of Health and Human Services Kathleen Sebelius and President Obama justified the Administration’s action because of concerns about pre-teens’ ability to use EC correctly. But as been repeatedly observed, only a tiny portion of this age group is sexually active.  It is 15- and 16-year-olds who are sexually active in far greater numbers, and therefore, far likelier to have need of EC (and to be able to use it correctly). But many in this group do not have a primary health care provider to whom they can go for a prescription.  Some of those who do have a relationship with a provider may be too embarrassed, or afraid of a breach of confidentiality, to ask for such a prescription.

To be sure, some things have improved in the contraceptive world since the dominance of private practice physicians in Margaret Sanger’s time. In 1970, Congress authorized the Title X program, which made federal funds available for family planning services for poor women including, notably, teenagers. (As a sign of how much the reproductive battle lines have hardened in the last 30 years, Title X was signed by a Republican president, Richard Nixon, and one of its most enthusiastic sponsors in Congress was a future Republican president, George H.W. Bush). A number of contraceptive products are available on the shelves of drugstores.

And it is no longer just physicians who can advise and dispense contraception. In public health clinics and Planned Parenthood facilities, nurses are in fact the main providers of contraception. We can hope that some portion of those teenagers who need EC can find their way to a Planned Parenthood or other Title X site in the three day window in which the drug is most effective.

But this recent decision of the Obama administration on EC occurs, of course, in an atmosphere in which Republicans in Congress are attempting to abolish Title X, and various states have defunded Planned Parenthood, leading to a closing of numerous clinics. The reproductive wars drag drearily on—and in our times, as in Sanger’s, the most vulnerable of women pay the greatest price.

“For a woman to ‘ask her physician’ for a safe and effective contraceptive  presupposed that she had a physician, that she could afford a contraceptive, and that the physician would be willing to give it to her, regardless of her marital status.” “For a woman to ‘ask her physician’ for a safe and effective contraceptive  presupposed that she had a physician, that she could afford a contraceptive, and that the physician would be willing to give it to her, regardless of her marital status.”

Analysis Human Rights

El Salvador Bill Would Put Those Found Guilty of Abortion Behind Bars for 30 to 50 Years

Kathy Bougher

Under El Salvador’s current law, when women are accused of abortion, prosecutors can—but do not always—increase the charges to aggravated homicide, thereby increasing their prison sentence. This new bill, advocates say, would heighten the likelihood that those charged with abortion will spend decades behind bars.

Abortion has been illegal under all circumstances in El Salvador since 1997, with a penalty of two to eight years in prison. Now, the right-wing ARENA Party has introduced a bill that would increase that penalty to a prison sentence of 30 to 50 years—the same as aggravated homicide.

The bill also lengthens the prison time for physicians who perform abortions to 30 to 50 years and establishes jail terms—of one to three years and six months to two years, respectively—for persons who sell or publicize abortion-causing substances.

The bill’s major sponsor, Rep. Ricardo Andrés Velásquez Parker, explained in a television interview on July 11 that this was simply an administrative matter and “shouldn’t need any further discussion.”

Since the Salvadoran Constitution recognizes “the human being from the moment of conception,” he said, it “is necessary to align the Criminal Code with this principle, and substitute the current penalty for abortion, which is two to eight years in prison, with that of aggravated homicide.”

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The bill has yet to be discussed in the Salvadoran legislature; if it were to pass, it would still have to go to the president for his signature. It could also be referred to committee, and potentially left to die.

Under El Salvador’s current law, when women are accused of abortion, prosecutors can—but do not always—increase the charges to aggravated homicide, thereby increasing their prison sentence. This new bill, advocates say, would worsen the criminalization of women, continue to take away options, and heighten the likelihood that those charged with abortion will spend decades behind bars.

In recent years, local feminist groups have drawn attention to “Las 17 and More,” a group of Salvadoran women who have been incarcerated with prison terms of up to 40 years after obstetrical emergencies. In 2014, the Agrupación Ciudadana por la Despenalización del Aborto (Citizen Group for the Decriminalization of Abortion) submitted requests for pardons for 17 of the women. Each case wound its way through the legislature and other branches of government; in the end, only one woman received a pardon. Earlier this year, however, a May 2016 court decision overturned the conviction of another one of the women, Maria Teresa Rivera, vacating her 40-year sentence.

Velásquez Parker noted in his July 11 interview that he had not reviewed any of those cases. To do so was not “within his purview” and those cases have been “subjective and philosophical,” he claimed. “I am dealing with Salvadoran constitutional law.”

During a protest outside of the legislature last Thursday, Morena Herrera, president of the Agrupación, addressed Velásquez Parker directly, saying that his bill demonstrated an ignorance of the realities faced by women and girls in El Salvador and demanding its revocation.

“How is it possible that you do not know that last week the United Nations presented a report that shows that in our country a girl or an adolescent gives birth every 20 minutes? You should be obligated to know this. You get paid to know about this,” Herrera told him. Herrera was referring to the United Nations Population Fund and the Salvadoran Ministry of Health’s report, “Map of Pregnancies Among Girls and Adolescents in El Salvador 2015,” which also revealed that 30 percent of all births in the country were by girls ages 10 to 19.

“You say that you know nothing about women unjustly incarcerated, yet we presented to this legislature a group of requests for pardons. With what you earn, you as legislators were obligated to read and know about those,” Herrera continued, speaking about Las 17. “We are not going to discuss this proposal that you have. It is undiscussable. We demand that the ARENA party withdraw this proposed legislation.”

As part of its campaign of resistance to the proposed law, the Agrupación produced and distributed numerous videos with messages such as “They Don’t Represent Me,” which shows the names and faces of the 21 legislators who signed on to the ARENA proposal. Another video, subtitled in English, asks, “30 to 50 Years in Prison?

International groups have also joined in resisting the bill. In a pronouncement shared with legislators, the Agrupación, and the public, the Latin American and Caribbean Committee for the Defense of the Rights of Women (CLADEM) reminded the Salvadoran government of it international commitments and obligations:

[The] United Nations has recognized on repeated occasions that the total criminalization of abortion is a form of torture, that abortion is a human right when carried out with certain assumptions, and it also recommends completely decriminalizing abortion in our region.

The United Nations Committee on Economic, Social, and Cultural Rights reiterated to the Salvadoran government its concern about the persistence of the total prohibition on abortion … [and] expressly requested that it revise its legislation.

The Committee established in March 2016 that the criminalization of abortion and any obstacles to access to abortion are discriminatory and constitute violations of women’s right to health. Given that El Salvador has ratified [the International Covenant on Economic, Social and Cultural Rights], the country has an obligation to comply with its provisions.

Amnesty International, meanwhile, described the proposal as “scandalous.” Erika Guevara-Rosas, Amnesty International’s Americas director, emphasized in a statement on the organization’s website, “Parliamentarians in El Salvador are playing a very dangerous game with the lives of millions of women. Banning life-saving abortions in all circumstances is atrocious but seeking to raise jail terms for women who seek an abortion or those who provide support is simply despicable.”

“Instead of continuing to criminalize women, authorities in El Salvador must repeal the outdated anti-abortion law once and for all,” Guevara-Rosas continued.

In the United States, Rep. Norma J. Torres (D-CA) and Rep. Debbie Wasserman Schultz (D-FL) issued a press release on July 19 condemning the proposal in El Salvador. Rep. Torres wrote, “It is terrifying to consider that, if this law passed, a Salvadoran woman who has a miscarriage could go to prison for decades or a woman who is raped and decides to undergo an abortion could be jailed for longer than the man who raped her.”

ARENA’s bill follows a campaign from May orchestrated by the right-wing Fundación Sí a la Vida (Right to Life Foundation) of El Salvador, “El Derecho a la Vida No Se Debate,” or “The Right to Life Is Not Up for Debate,” featuring misleading photos of fetuses and promoting adoption as an alternative to abortion.

The Agrupacion countered with a series of ads and vignettes that have also been applied to the fight against the bill, “The Health and Life of Women Are Well Worth a Debate.”

bien vale un debate-la salud de las mujeres

Mariana Moisa, media coordinator for the Agrupación, told Rewire that the widespread reaction to Velásquez Parker’s proposal indicates some shift in public perception around reproductive rights in the country.

“The public image around abortion is changing. These kinds of ideas and proposals don’t go through the system as easily as they once did. It used to be that a person in power made a couple of phone calls and poof—it was taken care of. Now, people see that Velásquez Parker’s insistence that his proposal doesn’t need any debate is undemocratic. People know that women are in prison because of these laws, and the public is asking more questions,” Moisa said.

At this point, it’s not certain whether ARENA, in coalition with other parties, has the votes to pass the bill, but it is clearly within the realm of possibility. As Sara Garcia, coordinator of the Agrupación, told Rewire, “We know this misogynist proposal has generated serious anger and indignation, and we are working with other groups to pressure the legislature. More and more groups are participating with declarations, images, and videos and a clear call to withdraw the proposal. Stopping this proposed law is what is most important at this point. Then we also have to expose what happens in El Salvador with the criminalization of women.”

Even though there has been extensive exposure of what activists see as the grave problems with such a law, Garcia said, “The risk is still very real that it could pass.”

Culture & Conversation Abortion

The Burden Is Undue: What I Have Learned and Unlearned About Abortion

Madeline Gomez

For all 29 years of my life, the right to abortion has been under attack. In early March, I slept at the Supreme Court overnight, waiting for oral arguments, and had time to reflect on the experiences that have made me an advocate.

Thirteen years before I was born, the Supreme Court declared abortion a fundamental right in Roe v. Wade. Despite this, for all 29 years of my life, the right to abortion has been under attack.

In the past six years alone, states have enacted 288 provisions restricting access to abortion care. Three years ago, the Texas state legislature enacted HB 2, an omnibus anti-abortion bill. And on Monday, the Supreme Court ruled two provisions of that law are unconstitutional.

I am a Texas native, a Latina, a lawyer, and a reproductive justice advocate, so this case, Whole Woman’s Health v. Hellerstedt, naturally hits close to home.

In the years since HB 2 has passed, I have heard from friends who have waited weeks and been forced to drive hours just to get an appointment at a clinic. And, as my colleagues and I wrote in an amicus brief the National Latina Institute for Reproductive Health filed with the Supreme Court, women of color in Texas, particularly the 2.5 million Latinas of reproductive age, have been disproportionately affected by the clinic closings resulting from the expensive, onerous, and medically unnecessary standards HB 2 imposed. For example, if the law had been allowed to go into full effect, residents of my birthplace, El Paso, Texas, where 81 percent of the population is Latinx, would have to drive over 500 miles to San Antonio in order to get an abortion in the state.

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In early March, I slept at the Court overnight, waiting for oral arguments. In the 24 hours I spent outside the Court, I had time to reflect on the experiences that have made me an advocate.

***

I am 12, with my mother and her dear friend at the dinner table. As the three of us sit together, I regale them with stories of a teacher I deeply admire. She’s been telling us about how she prays the rosary and speaks to women entering abortion clinics, urging them to “choose life.” I believe this is a good act, something I want to be part of, and I’m proud of my righteousness. My mother’s friend says to me simply, “There are a lot of reasons women have abortions.” Almost 20 years later I will learn that this friend had an abortion, which makes sense statistically speaking, since one in three women do.

I am 14 and sitting in high school religion class. The male instructor tells us that pre-marital sex and contraception are forbidden by our Catholic faith. He says the risk especially isn’t worth it for women: It is, according to him, physically impossible for women to orgasm. At the time, and still, I despair for this man’s wife, and for him. Shortly after this lesson the class watches a 45-minute “documentary” about “partial-birth abortion.” This concludes my sexual health education.

I am 18 and counting 180 seconds, waiting to see whether one or two lines appear on a white stick. In a few weeks I am moving to New York to begin college. In those 180 seconds I decide with little fanfare that, regardless of the number of lines, I will not be pregnant when I go. One line appears and I move, able to begin the education I’ve dreamed of and worked for.

I am 19 and talking with a friend. We get to a question that often comes up among women: What would you do if you got pregnant? She tells me calmly and candidly that she would have an abortion. She is the first person I’ve heard say this aloud. Her certitude resonates with me. I know that I would too, and that though I always felt I should be sorry, I would not be. I feel the weight of the shame I’ve been carrying and I stop apologizing for what I know.

I am 20 and teaching sexual education classes to high school students. More than one young woman tells me that she believes she can prevent pregnancy by spraying Coca-Cola into her vagina after intercourse. We talk about safe and effective methods of contraception. Years later, I still think about the damage and danger inflicted upon young women out of fear of our sexuality and power.

I am 21 and lying naked in bed next to a man I’ve been seeing. We’re discussing monogamy. I’m on the pill and he’d like to stop using condoms. He wants me to know, though, that if I become pregnant he won’t let me have an abortion. Because I am desperate to be loved and because I don’t yet understand that love doesn’t mean conceding your autonomy, it will take another year before I leave him.

I am 22 and my friend—the first I know oftells me she is having an abortion. After the procedure I do not know the right thing to do or say or how to comfort and support her. We will lose touch. Like 95 percent of women who have abortionsshe will not regret her choice. When we reconnect years later, we will talk about her happiness and success and about how far we’ve both come.

I am 24 and reading about Congress making a budget deal contingent on “defunding” Planned Parenthood. I understand that though I now refuse to date men who believe they have a say in my reproductive choices, I’m stuck with hundreds of representatives and senators who think they do and who will use my body and health as a bargaining chip.

I am 26 and in my home state of Texas, Wendy Davis is filibustering an anti-abortion bill with two pink tennis shoes on her feet. I watch her all night, my heart swollen with pride at hundreds of women screaming in the rotunda, refusing to be ignored. Despite their efforts, Texas HB 2 will pass. Within three years, over half the abortion clinics in Texas will close.

Today I am 29 and five justices of the Supreme Court have declared the burden imposed by two provisions of HB 2 undue. Limiting abortion and lying about the effects of these laws hurts women’s health, and now the highest court in this nation has declared these actions and these laws unacceptable and unconstitutional. I am in Washington, D.C., 1,362 miles from the home where I grew up, the day the decision is announcedbut it is not just about me and it’s not just about Texas. It is about the recognition and vindication of our worth and rights as human beings. All 162 million of us.

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