News Contraception

Birth Control Blasphemy: Contraceptive Hysteria Grips Congress and the Religio-Patriarchy

Jodi Jacobson

The United States Congress is in the grip of contraceptive hysteria, and there are no signs of early recovery. Far right members of the House and Senate have decided that there is Nothing. More. Important. than making sure women in this country can not get access to birth control.

See all our coverage of the 2012 Contraceptive Mandate here.

The United States Congress is in the grip of contraceptive hysteria, and there are no signs of early recovery.

Far right members of the House and Senate have decided that there is Nothing. More. Important. than making sure women in this country can not get access to birth control. Given that contraceptive use is effectively universal and that most employer-purchased group health plans already cover contraception, it is a pretty far stretch to assume any support for this outside the Rayburn Building, but that never stops a fanatic.

Let’s recap some basics here. Ninety-eight percent of sexually-active women in the United States use contraception at some point in their lives (including, yes, 98 percent of Catholic women), and most do so for the majority of their reproductive years. This is so we gals can do such radical things as plan whether, when, and with whom to have a child; how many children to have; decide what educational, social and economic goals we want to attain for ourselves and maximize those opportunities we can give our children; and, just basically decide how to live our lives. You know… that whole freedom thing.

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To have a total family size of two or three children, the average woman will spend five years pregnant or trying to get pregnant, and nearly three decades trying to avoid pregnancy. (Yes, Cardinal Dolan, we know about abstinence, but thirty years is a long dry spell and we like sex.) Many women also require contraception as a medical intervention to treat problems like poly-cystic fibrosis and dysmenorrhea, among other conditions. Some need to avoid risky pregnancies. And… the vast majority of women using contraception are protecting themselves and their partners from unintended pregnancy. In other words, folks, the gals are using the contraception, but the guys are involved here, too. The whole it takes two to tango thing, you know. I am not getting into the whys and wherefores of women shouldering most of the responsibility for preventing unwanted pregnancies here. But the fact is women are not just protecting themselves, but their partners and frequently their families writ large from the burdens of unintended pregnancy. This is also part of the equation that kinda, you know, gets left out. Including for those Congressmen whose wives and partners clearly have been using some on the side.

Most insurance plans already cover contraception because it makes economic sense. Roughly 86 percent of all group health insurance plans purchased by employers for their employees–or almost nine in ten plans–now cover a full range of prescription contraceptives. In states with contraceptive-equity laws, contraceptive coverage has expanded dramatically and insurance plans in these states are more likely to provide a full range of contraceptive methods. According to NARAL Pro-Choice America, state contraceptive-equity laws have a positive influence everywhere because nationally-determined insurance plans, in use both in states with and without contraceptive-equity laws, typically provide contraceptive coverage in all states in accordance with the mandates.

Still, in 2006, according to NARAL, 36 million U.S. women were without insurance coverage for contraception. Of that number, approximately 23 million were non-Hispanic white, five million were non-Hispanic black and six million were Hispanic. Inadequate access to contraception carries substantial health risks for all these women. The recurrent cost of contraception is the single most important barrier to access cited by women at risk of unintended and unwanted pregnancy.

But anti-choicers in Congress and among the religious right have repeatedly shown three things:

  • One, they could not care less about women’s health and rights.
  • Two, they have absolutely no idea how women struggle with the costs, risks, and responsibilities of reproduction nor what it means to do so.
  • Three, they don’t like to let reality or facts get in the way of ideology.

The real issue is that, as with the created controversy over health reform and abortion, the birth control mandate has provided all of these actors with an opening to do something they have been itching to do since the sixties: Limit women’s access to birth control. And they see this whole hoopla as the single most effective way to dramatically curtail the share of women who now have insurance coverage for contraception. In other words, as with insurance coverage of abortion care, they want to take away coverage women now have.

It’s not about religious freedom. That is a red herring if ever there was one, as this piece by a former Quiverfull member so elegantly states. In fact, the hypocrisy of all of this is underscored by the fact that even Catholic institutions have been providing coverage of birth control in many states for years, and 28 states have contraceptive equity laws that require coverage either by everyone or under scenarios on which the Obama Administration based last week’s “accommodation” to the bishops.

No… it’s about putting women back in their place. Its about a deep-seated anger among male patriarchal figures that women have moved out into the world, can control their ferility and make their own decisions. It is about “biblical” beliefs that men should have dominion over women and children and that women should “sacrifice” themselves at all costs. It is also about unspoken but deeply-rooted racial and ethnic prejudices that rest on fears that on one hand, one or another religious or racial group will outpace another in population size, and on the other hand, that there aren’t enough babies being produced to keep wages down in the long run.

And as with the abortion debate in health care reform, the arguments being made about the birth control mandate bear no resemblance to reality. To shore up its arguments, for example, the United States Conference of Catholic Bishops (USCCB) has taken it upon itself to redefine as abortifacients virtually every form of medically-accepted modern contraception on the market. (It’s the Eleventh Commandment: Thou Shalt Make Up Your Own Facts When Necessary to Preserve the Patriarchy.) The USCCB has also moved from its previous and highly transparent “religious freedom” tantrum, during which it claimed it wanted to exempt from the birth control mandate any religiously-affiliated institutions that ostensibly provide medical care, education, and social services, to its current demand that any employer, anywhere, be able to deny women contraceptive coverage, for basically any reason.

And so we have the latest attacks on contraception in the House and Senate.

First, there is the Blunt Amendment.

Senator Roy Blunt (R-MO), has proposed an amendment to the Senate Surface Transportation bill and given it a name which would make George Orwell proud, The Respect the Rights of Conscience Act of 2011. This amendment, which may be voted on as early as Wednesday, February 15th (today, perhaps, as you read this), would, according to experts, give employers and health insurance companies carte blanche over peoples’ access to basic health care. If passed, the Blunt amendment would represent the single most expansive refusal provision in federal law, and it would dismantle hard-won protections in the Affordable Care Act.  It would allow any employer or insurance plan, with or without religious affiliation, to refuse to cover any essential health service required under the new health care law based on undefined religious or moral objections. Supporters of the amendment have made clear the intent of the amendment is to ensure that any employer or corporation is able to deny its employees birth control coverage.

This means, according to Planned Parenthood Federation of America (PPFA), that “employers and insurance companies can not only deny access to birth control, they can deny access to any health care service, including HIV/AIDS treatment, mammograms, cancer screenings, or maternity care.”

The Blunt proposal is not limited to religiously-affiliated entities. Any employer or health plan issuer can claim an exemption based on this vague and harmful standard. For instance, an owner of a business franchise could refuse to provide coverage for birth control or any other essential or preventive health care service to which they claim an objection.

If passed, it would create a giant loophole undermining the whole notion of health insurance. “Health insurance coverage is rooted in the principle of shared risk and shared protection,” says PPFA. “The Blunt proposal dismantles the very concept of health insurance by allowing health insurance companies and employers to take coverage away from people, even for the most basic health care.”

“The purpose of the Affordable Care Act is to give women and families, not insurance companies, more control over their own health care decisions while ensuring that all health plans are playing by the same rules and providing a baseline of coverage for the American people.”

But “the Blunt proposal is designed to undermine this core principle and would represent an enormous step backwards for millions of American families.” The Coalition to Protect Women’s Health is collecting signatures from women and men throughout the country in opposition to this amendment, and is working with more than 80 groups, ranging from reproductive health and justice organizations to HIV prevention and treatment to labor organizations and medical academies such as the American Public Health Association and the American College of Obstetricians and Gynecologists, to defeat it.

Guess who is in favor of this proposal? The USCCB, Focus on the Family, the Family Research Council, the National Right to Life Committee and the entire “Who’s Who” of religious right and fundamentalist notables. Never mind all those other Catholic teachings, birth control is the end of the world as we know it.

Or… the end of the world as they want it.

On top of the Blunt Amendment come hearings in the House of Representatives set for this Thursday, February 16th. Chairman Darrell Issa (R-CA) has announced that the House Committee on Oversight and Government Reform will hold a hearing entitled “Lines Crossed: Separation of Church and State. Has the Obama Administration Trampled on Freedom of Religion and Freedom of Conscience?” In keeping with the barely veiled male-dominated discussion of male control over women’s lives, the witness list includes eight men and only one woman. And none of the witnesses has expertise on public health, medicine, or reproductive health.  Because like I said, why let things like medical conditions, public health, or the lives of women get in the way of a good election-year ideological battle?

Add to this the fact that Speaker John Boehner (R-OH) took to the floor of the House of Representatives last week to announce that he would do everything in his power to overturn the contraceptive mandate–not to offer job creation strategies, not to deal with poverty, hunger, access to education, not to address climate change or the housing mortgage crisis but to deny women access to birth control; that Rick Santorum, Mitt Romney, Newt Gingrich and Ron Paul all are in a contest to become the “most misogynistic presidential candidate ever;” and that every male media anchor on cable and regular television news channels is in a frenzy about the birth control mandate but doesn’t stop to consider they know nothing about contraception (that’s your department, dear) or public health and not one of them seems to care, and you have what is clearly a frenzy of the fearful patriarchy.

And they call women hysterical?

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Visit the Coalition to Protect Women’s Health to take action.

Commentary Contraception

Hillary Clinton Played a Critical Role in Making Emergency Contraception More Accessible

Susan Wood

Today, women are able to access emergency contraception, a safe, second-chance option for preventing unintended pregnancy in a timely manner without a prescription. Clinton helped make this happen, and I can tell the story from having watched it unfold.

In the midst of election-year talk and debates about political controversies, we often forget examples of candidates’ past leadership. But we must not overlook the ways in which Hillary Clinton demonstrated her commitment to women’s health before she became the Democratic presidential nominee. In early 2008, I wrote the following article for Rewirewhich has been lightly edited—from my perspective as a former official at the U.S. Food and Drug Administration (FDA) about the critical role that Clinton, then a senator, had played in making the emergency contraception method Plan B available over the counter. She demanded that reproductive health benefits and the best available science drive decisions at the FDA, not politics. She challenged the Bush administration and pushed the Democratic-controlled Senate to protect the FDA’s decision making from political interference in order to help women get access to EC.

Since that time, Plan B and other emergency contraception pills have become fully over the counter with no age or ID requirements. Despite all the controversy, women at risk of unintended pregnancy finally can get timely access to another method of contraception if they need it—such as in cases of condom failure or sexual assault. By 2010, according to National Center for Health Statistics data, 11 percent of all sexually experienced women ages 15 to 44 had ever used EC, compared with only 4 percent in 2002. Indeed, nearly one-quarter of all women ages 20 to 24 had used emergency contraception by 2010.

As I stated in 2008, “All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.”

Now, there are new emergency contraceptive pills (Ella) available by prescription, women have access to insurance coverage of contraception without cost-sharing, and there is progress in making some regular contraceptive pills available over the counter, without prescription. Yet extreme calls for defunding Planned Parenthood, the costs and lack of coverage of over-the-counter EC, and refusals by some pharmacies to stock emergency contraception clearly demonstrate that politicization of science and limits to our access to contraception remain a serious problem.

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Today, women are able to access emergency contraception, a safe, second chance option for preventing unintended pregnancy in a timely manner without a prescription. Sen. Hillary Clinton (D-NY) helped make this happen, and I can tell the story from having watched it unfold.

Although stories about reproductive health and politicization of science have made headlines recently, stories of how these problems are solved are less often told. On August 31, 2005 I resigned my position as assistant commissioner for women’s health at the Food and Drug Administration (FDA) because the agency was not allowed to make its decisions based on the science or in the best interests of the public’s health. While my resignation was widely covered by the media, it would have been a hollow gesture were there not leaders in Congress who stepped in and demanded more accountability from the FDA.

I have been working to improve health care for women and families in the United States for nearly 20 years. In 2000, I became the director of women’s health for the FDA. I was rather quietly doing my job when the debate began in 2003 over whether or not emergency contraception should be provided over the counter (OTC). As a scientist, I knew the facts showed that this medication, which can be used after a rape or other emergency situations, prevents an unwanted pregnancy. It does not cause an abortion, but can help prevent the need for one. But it only works if used within 72 hours, and sooner is even better. Since it is completely safe, and many women find it impossible to get a doctor’s appointment within two to three days, making emergency contraception available to women without a prescription was simply the right thing to do. As an FDA employee, I knew it should have been a routine approval within the agency.

Plan B emergency contraception is just like birth control pills—it is not the “abortion pill,” RU-486, and most people in the United States don’t think access to safe and effective contraception is controversial. Sadly, in Congress and in the White House, there are many people who do oppose birth control. And although this may surprise you, this false “controversy” not only has affected emergency contraception, but also caused the recent dramatic increase in the cost of birth control pills on college campuses, and limited family planning services across the country.  The reality is that having more options for contraception helps each of us make our own decisions in planning our families and preventing unwanted pregnancies. This is something we can all agree on.

Meanwhile, inside the walls of the FDA in 2003 and 2004, the Bush administration continued to throw roadblocks at efforts to approve emergency contraception over the counter. When this struggle became public, I was struck by the leadership that Hillary Clinton displayed. She used the tools of a U.S. senator and fought ardently to preserve the FDA’s independent scientific decision-making authority. Many other senators and congressmen agreed, but she was the one who took the lead, saying she simply wanted the FDA to be able to make decisions based on its public health mission and on the medical evidence.

When it became clear that FDA scientists would continue to be overruled for non-scientific reasons, I resigned in protest in late 2005. I was interviewed by news media for months and traveled around the country hoping that many would stand up and demand that FDA do its job properly. But, although it can help, all the media in the world can’t make Congress or a president do the right thing.

Sen. Clinton made the difference. The FDA suddenly announced it would approve emergency contraception for use without a prescription for women ages 18 and older—one day before FDA officials were to face a determined Sen. Clinton and her colleague Sen. Murray (D-WA) at a Senate hearing in 2006. No one was more surprised than I was. All those who benefited from this decision should know it may not have happened were it not for Hillary Clinton.

Sometimes these success stories get lost in the “horse-race stories” about political campaigns and the exposes of taxpayer-funded bridges to nowhere, and who said what to whom. This story of emergency contraception at the FDA is just one story of many. Sen. Clinton saw a problem that affected people’s lives. She then stood up to the challenge and worked to solve it.

The challenges we face in health care, our economy, global climate change, and issues of war and peace, need to be tackled with experience, skills and the commitment to using the best available science and evidence to make the best possible policy.  This will benefit us all.

News Health Systems

Complaint: Citing Catholic Rules, Doctor Turns Away Bleeding Woman With Dislodged IUD

Amy Littlefield

“It felt heartbreaking,” said Melanie Jones. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

Melanie Jones arrived for her doctor’s appointment bleeding and in pain. Jones, 28, who lives in the Chicago area, had slipped in her bathroom, and suspected the fall had dislodged her copper intrauterine device (IUD).

Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“I think my first feeling was shock,” Jones told Rewire in an interview. “I thought that eventually they were going to recognize that my health was the top priority.”

The doctor left Jones to confer with colleagues, before returning to confirm that her “hands [were] tied,” according to two complaints filed by the ACLU of Illinois. Not only could she not help her, the doctor said, but no one in Jones’ health insurance network could remove the IUD, because all of them followed similar restrictions. Mercy, like many Catholic providers, follows directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, tubal ligations, and contraception.

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Some Catholic providers may get around the rules by purporting to prescribe hormonal contraception for acne or heavy periods, rather than for birth control, but in the case of copper IUDs, there is no such pretext available.

“She told Ms. Jones that that process [of switching networks] would take her a month, and that she should feel fortunate because sometimes switching networks takes up to six months or even a year,” the ACLU of Illinois wrote in a pair of complaints filed in late June.

Jones hadn’t even realized her health-care network was Catholic.

Mercy has about nine off-site locations in the Chicago area, including the Dearborn Station office Jones visited, said Eric Rhodes, senior vice president of administrative and professional services. It is part of Trinity Health, one of the largest Catholic health systems in the country.

The ACLU and ACLU of Michigan sued Trinity last year for its “repeated and systematic failure to provide women suffering pregnancy complications with appropriate emergency abortions as required by federal law.” The lawsuit was dismissed but the ACLU has asked for reconsideration.

In a written statement to Rewire, Mercy said, “Generally, our protocol in caring for a woman with a dislodged or troublesome IUD is to offer to remove it.”

Rhodes said Mercy was reviewing its education process on Catholic directives for physicians and residents.

“That act [of removing an IUD] in itself does not violate the directives,” Marty Folan, Mercy’s director of mission integration, told Rewire.

The number of acute care hospitals that are Catholic owned or affiliated has grown by 22 percent over the past 15 years, according to MergerWatch, with one in every six acute care hospital beds now in a Catholic owned or affiliated facility. Women in such hospitals have been turned away while miscarrying and denied tubal ligations.

“We think that people should be aware that they may face limitations on the kind of care they can receive when they go to the doctor based on religious restrictions,” said Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, in a phone interview with Rewire. “It’s really important that the public understand that this is going on and it is going on in a widespread fashion so that people can take whatever steps they need to do to protect themselves.”

Jones left her doctor’s office, still in pain and bleeding. Her options were limited. She couldn’t afford a $1,000 trip to the emergency room, and an urgent care facility was out of the question since her Blue Cross Blue Shield of Illinois insurance policy would only cover treatment within her network—and she had just been told that her entire network followed Catholic restrictions.

Jones, on the advice of a friend, contacted the ACLU of Illinois. Attorneys there advised Jones to call her insurance company and demand they expedite her network change. After five hours of phone calls, Jones was able to see a doctor who removed her IUD, five days after her initial appointment and almost two weeks after she fell in the bathroom.

Before the IUD was removed, Jones suffered from cramps she compared to those she felt after the IUD was first placed, severe enough that she medicated herself to cope with the pain.

She experienced another feeling after being turned away: stigma.

“It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

The ACLU of Illinois has filed two complaints in Jones’ case: one before the Illinois Department of Human Rights and another with the U.S. Department of Health and Human Services Office for Civil Rights under the anti-discrimination provision of the Affordable Care Act. Chaiten said it’s clear Jones was discriminated against because of her gender.

“We don’t know what Mercy’s policies are, but I would find it hard to believe that if there were a man who was suffering complications from a vasectomy and came to the emergency room, that they would turn him away,” Chaiten said. “This the equivalent of that, right, this is a woman who had an IUD, and because they couldn’t pretend the purpose of the IUD was something other than pregnancy prevention, they told her, ‘We can’t help you.’”

 

Tell us your story. Have religious restrictions affected your ability to access health care? Email stories@rewire.news

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