Commentary Contraception

Five Reasons Contraceptive Coverage Is Essential

Dr. Tania Basu

As an OB-GYN and a patient advocate, I want to move the discussion about the Hobby Lobby case out of the courts for a moment and into my clinic, to focus on the lives of women and their families.

Read more of our coverage on the Hobby Lobby and Conestoga Wood cases here.

On Tuesday, the Supreme Court hears Sebelius v. Hobby Lobby Stores, which argues that the birth control benefit in the Affordable Care Act (ACA) is a direct attack on religious freedom of for-profit companies.

As an OB-GYN and a patient advocate, I want to move the discussion out of the courts for a moment and into my clinic, to focus on the lives of women and their families. I feel an immense sense of responsibility to the women I care for, and part of that responsibility includes advocating for insurance coverage of birth control.

Here are my top five reasons for why contraceptive coverage is essential and needs to be protected.

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1. Contraception saves lives. I realized this the moment I placed my patient Rosa’s intrauterine device (IUD) while she was in the ICU for a condition called peripartum cardiomyopathy, a cause of heart failure during pregnancy. Rosa (not her real name) was transferred to our hospital in florid heart failure and suffered a stillbirth at eight months of pregnancy. While I was counseling Rosa on her contraceptive options, she told me that she had wanted an IUD after her first pregnancy, when she faced similar complications. However, she was unable to get an IUD then because of restrictions on contraception at the religiously affiliated institution where she received medical care at the time. Fortunately, I saw her at a facility where she could utilize her insurance and get the care she needed. Rosa’s story is similar to that of many women for whom pregnancy can be life-threatening. Ensuring access to the full spectrum of contraception is a vital part of comprehensive women’s health care.

2. Contraception helps build healthy families and healthy communities. Half of all pregnancies in the United States are unintended. Women with unplanned pregnancies are at greater risk for preterm birth, low birth weight, and delayed prenatal care, whereas planned pregnancies have better birth outcomes. Numerous studies have shown that increased access to contraception leads to a reduction in unintended pregnancy and birth rates, leading to healthier outcomes for mothers, babies, and families.

3. Contraception is one of public health’s top ten greatest achievements. It’s right up there with vaccines and water sanitation. According to the Centers for Disease Control and Prevention, access to contraception has improved birth spacing and has led to smaller families, which in turn “have contributed to the better health of infants, children, and women, and have improved the social and economic role of women.” The young women I see in my clinic are from all walks of life but many will be the first in their families to graduate high school and attend college without having their dreams interrupted by an unintended pregnancy. Contraception is as valuable as any other preventive public health measure that has made a positive impact on our society and thus, like clean water, should be accessible to all.

4. Contraceptive coverage would allow a woman to choose the method that is right for her, not just the one that fits her budget. From 2007 to 2011, the Contraceptive CHOICE Project conducted a large prospective cohort study of almost 10,000 women in the St. Louis area to determine what would happen if cost was not a factor for women seeking birth control. The study found that when financial barriers were removed, 75 percent of the study’s participants chose a long-acting, highly effective method (an IUD or contraceptive implant), which typically has a high up-front cost of hundreds of dollars. In today’s economy, when families are struggling to pay for basic needs, the cost of contraception can be overwhelming. Cost should not be a limiting factor to the provision of quality preventive care. Not every woman can use a generic pill or other lower cost birth control methods. It is critical that women have coverage for the full range of Food and Drug Administration-approved contraceptive methods so health-care providers can work with each patient to determine what works best for them.

5. Contraception has many health benefits. In addition to preventing pregnancy, some contraceptive methods can also decrease the risk of pelvic inflammatory disease and ovarian and uterine cancers, and treat other gynecologic conditions such as endometriosis and heavy bleeding. As a resident, I cared for Patty (not her real name), who was diabetic, struggling with infertility, and who also had irregular bleeding because of a condition called endometrial hyperplasia, which carries a risk of uterine cancer. After she and I came to the decision of optimizing her overall health and treating her condition before she would resume trying to become pregnant, I was able to place her hormonal IUD, which resolved her hyperplasia as her overall health improved. She and her husband now have a beautiful daughter, and Patty continues to use an IUD.

Affordable family planning services are essential to building healthy families and communities. I hope that when the Supreme Court justices consider the Sebelius v. Hobby Lobby Stores case, they recognize the value of contraceptive coverage to all Americans.

News Politics

Anti-Choice Democrats: ‘Open The Big Tent’ for Us

Christine Grimaldi & Ally Boguhn

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America gathered Wednesday in Philadelphia during the party’s convention to honor Louisiana Gov. John Bel Edwards (D) for his anti-choice viewpoints, and to strategize ways to incorporate their policies into the party.

The group attributed Democratic losses at the state and federal level to the party’s increasing embrace of pro-choice politics. The best way for Democrats to reclaim seats in state houses, governors’ offices, and the U.S. Congress, they charged, is to “open the big tent” to candidates who oppose legal abortion care.

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Democrats for Life of America members repeatedly attempted to distance themselves from Republicans, reiterating their support for policies such as Medicaid expansion and paid maternity leave, which they believe could convince people to carry their pregnancies to term.

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Their strategy, however, could have been lifted directly from conservatives’ anti-choice playbook.

The group relies, in part, on data from Marist, a group associated with anti-choice polling, to suggest that many in the party side with them on abortion rights. Executive Director Kristen Day could not explain to Rewire why the group supports a 20-week abortion ban, while Janet Robert, president of the group’s board of directors, trotted out scientifically false claims about fetal pain

Day told Rewire that she is working with pro-choice Democrats, including Sen. Kirsten Gillibrand and Rep. Rosa DeLauro, both from New York, on paid maternity leave. Day said she met with DeLauro the day before the group’s event.

Day identifies with Democrats despite a platform that for the first time embraces the repeal of restrictions for federal funding of abortion care. 

“Those are my people,” she said.

Day claimed to have been “kicked out of the pro-life movement” for supporting the Affordable Care Act. She said Democrats for Life of America is “not opposed to contraception,” though the group filed an amicus brief in U.S. Supreme Court cases on contraception. 

Democrats for Life of America says it has important allies in the U.S. House of Representatives and the U.S. Senate. Sens. Joe Donnelly (IN), Joe Manchin (WV), and Rep. Dan Lipinski (IL), along with former Rep. Bart Stupak (MI), serve on the group’s board of advisors, according to literature distributed at the convention.

Another alleged ally, Sen. Bob Casey (D-PA), came up during Edwards’ speech. Edwards said he had discussed the award, named for Casey’s father, former Pennsylvania Gov. Robert P. Casey, the defendant in the landmark Supreme Court decision, Planned Parenthood v. Casey, which opened up a flood of state-level abortions restrictions as long as those anti-choice policies did not represent an “undue burden.”

“Last night I happened to have the opportunity to speak to Sen. Bob Casey, and I told him … I was in Philadelphia, receiving this award today named after his father,” Edwards said.

The Louisiana governor added that though it may not seem it, there are many more anti-choice Democrats like the two of them who aren’t comfortable coming forward about their views.

“I’m telling you there are many more people out there like us than you might imagine,” Edwards said. “But sometimes it’s easier for those folks who feel like we do on these issues to remain silent because they’re not going to  be questioned, and they’re not going to be receiving any criticism.”

During his speech, Edwards touted the way he has put his views as an anti-choice Democrat into practice in his home state. “I am a proud Democrat, and I am also very proudly pro-life,” Edwards told the small gathering.

Citing his support for Medicaid expansion in Louisiana—which went into effect July 1—Edwards claimed he had run on an otherwise “progressive” platform except for when it came to abortion rights, adding that his policies demonstrate that “there is a difference between being anti-abortion and being pro-life.”

Edwards later made clear that he was disappointed with news that Emily’s List President Stephanie Schriock, whose organization works to elect pro-choice women to office, was being considered to fill the position of party chair in light of Rep. Debbie Wasserman Schultz’s resignation.

“It wouldn’t” help elect anti-choice politicians to office, said Edwards when asked about it by a reporter. “I don’t want to be overly critical, I don’t know the person, I just know that the signal that would send to the country—and to Democrats such as myself—would just be another step in the opposite direction of being a big tent party [on abortion].” 

Edwards made no secret of his anti-choice viewpoints during his run for governor in 2015. While on the campaign trail, he released a 30-second ad highlighting his wife’s decision not to terminate her pregnancy after a doctor told the couple their daughter would have spina bifida.

He received a 100 percent rating from anti-choice organization Louisiana Right to Life while running for governor, based off a scorecard asking him questions such as, “Do you support the reversal of Roe v. Wade?”

Though the Democratic Party platform and nominee have voiced the party’s support for abortion rights, Edwards has forged ahead with signing numerous pieces of anti-choice legislation into law, including a ban on the commonly used dilation and evacuation (D and E) procedure, and an extension of the state’s abortion care waiting period from 24 hours to 72 hours.

News Politics

NARAL President Tells Her Abortion Story at the Democratic National Convention

Ally Boguhn

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates.

Read more of our coverage of the Democratic National Convention here.

Ilyse Hogue, president of NARAL Pro-Choice America, told the story of her abortion on the stage of the Democratic National Convention (DNC) Wednesday evening in Philadelphia.

“Texas women are tough. We approach challenges with clear eyes and full hearts. To succeed in life, all we need are the tools, the trust, and the chance to chart our own path,” Hogue told the crowd on the third night of the party’s convention. “I was fortunate enough to have these things when I found out I was pregnant years ago. I wanted a family, but it was the wrong time.”

“I made the decision that was best for me — to have an abortion — and to get compassionate care at a clinic in my own community,” she continued. “Now, years later, my husband and I are parents to two incredible children.”

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Hogue noted that her experience is similar to those of women nationwide.

“About one in three American women have abortions by the age of 45, and the majority are mothers just trying to take care of the families they already have,” she said. “You see, it’s not as simple as bad girls get abortions and good girls have families. We are the same women at different times in our lives — each making decisions that are the best for us.”

As reported by Yahoo News, “Asked if she was the first to have spoken at a Democratic National Convention about having had an abortion for reasons other than a medical crisis, Hogue replied, ‘As far as I know.'”

Planned Parenthood Federation of America President Cecile Richards on Tuesday night was the first speaker at the DNC in Philadelphia to say the word “abortion” on stage, according to Vox’s Emily Crockett. 

Richards’ use of the word abortion was deliberate, and saying the word helps address the stigma that surrounds it, Planned Parenthood Action Fund’s Vice President of Communication Mary Alice Carter said in an interview with ThinkProgress. 

“When we talk about reproductive health, we talk about the full range of reproductive health, and that includes access to abortion. So we’re very deliberate in saying we stand up for a woman’s right to access an abortion,” Carter said.

“There is so much stigma around abortion and so many people that sit in shame and don’t talk about their abortion, and so it’s very important to have the head of Planned Parenthood say ‘abortion,’ it’s very important for any woman who’s had an abortion to say ‘abortion,’ and it’s important for us to start sharing those stories and start bringing it out of the shadows and recognizing that it’s a normal experience,” she added.

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates. In April, Clinton called out moderators for failing to ask “about a woman’s right to make her own decisions about reproductive health care” over the course of eight debates—though she did not use the term abortion in her condemnation.