Commentary Abortion

Your Right to Abortion Care Is in Danger—No Matter Where You Live

Katie Klabusich

Since the Supreme Court gave people in the United States the legal right to abortion care with Roe v. Wade 42 years ago, residents of historically “safe” states have too frequently taken our access to reproductive rights for granted.

Read more stories commemorating the 42nd anniversary of Roe v. Wade here.

Since the Supreme Court gave people in the United States the legal right to abortion care with Roe v. Wade 42 years ago, residents of historically “safe” states have too frequently taken our access to reproductive health care for granted. As someone who has lived in the blue states of Illinois, Maryland, New York, and now California, I’ve seen the pervasive assumption by those who identify as pro-choice that candidates on the left will prioritize access to abortion care—and that we need to do nothing more than dutifully pull the lever for them each November.

This is simply not the case. It’s time we in blue states engaged en masse to demand bold, proactively pro-choice talking points on the campaign trail and in platforms from our would-be legislators and direct action from current office-holders. We should be aggressive about storytelling to end stigma, changing culture by posting our lived experiences on our social media networks, and normalizing abortion care so others in our networks also expect and demand access. If we do not curb our complacency, we risk the complete curtailing of our rights.

Those of us born around or after 1973 often have little, if any, personal connection to the time of abortion prohibition. We assume that although individual legislatures might propose, and even pass, bills restricting our rights, they’ll never get away with it in the long term. After all, we think, that’s what the court system is for! To protect us from extremist legislators and their fits of fancy! We rely on the courts because the media typically refers to Roe as the presiding law without including the effects of Planned Parenthood v. Casey, Gonzales v. Carhart, or other successful measures that have chipped away at our ability to obtain abortion care over the past few decades.

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Week one of the 114th Congress should have gotten everyone’s attention. With the reintroduction of the “Pain Capable Unborn Child Protection Act,” which would ban abortion after 20 weeks in all states, the GOP-led House of Representatives declared its top priority for the session: the contents of Americans’ wombs. The following day, not to be outdone by his pseudoscience-obsessed colleagues Reps. Trent Franks (R-AZ) and Marsha Blackburn (R-TN), Sen. David Vitter (R-LA) picked up the anti-choice baton by proposing four abortion-restricting laws. Vitter’s bills would see Planned Parenthood completely stripped of federal funding (a fight that led to the last government shutdown), outlaw the non-problem of sex-selective abortion, require admitting privileges for all providers, and allow doctors and nurses to refuse abortion care even in life-threatening situations.

These restrictions would endanger abortion access in every state: red, purple, and blue.

Currently, we have a presidential veto to fall back on. With primaries less than a year away and a new administration around the corner, however, that safeguard is not ensured. We can’t wait for that uncertain outcome to urge our elected and would-be legislators to make reproductive health care a priority.

And for those of us in progressives areas, our rallying cry must not simply be, “Please don’t let those restrictions creep across our state’s border!” It’s not just unconscionable for us blue-staters to breathe sighs of relief, confident that our access to safe, legal abortion care will hold as we watch it crumble for our neighbors in red and purple states; blue state access has been slowly and quietly eroded as well. If you’ve been one of those people waiting for restrictions to affect you before engaging, consider this your call to enlist: Your state is not safe, and your rights are not guaranteed.

This year, the Guttmacher Institute deemed more than half the states in the nation to be “hostile” to abortion care. Twenty-four prohibit Affordable Care Act (ACA) health insurance plans from covering abortion, most with only extreme exceptions such as in cases of rape or incest. Eighty-seven percent of U.S. counties have no abortion provider. None of these anti-choice environments are limited to red states.

In fact, in a recently released report card on reproductive rights and health from the international nonprofit group the Population Institute, only 17 states managed a rating of B- or above, based on a combination of factors that include affordability, implementation of comprehensive sex education, and access to clinics and emergency contraception. We should not look at the report card itself as a comprehensive depiction of the health-care access situation in the United States; after all, those of us living in the four A-rated states—California, New Mexico, Oregon, and Washington—can and do face significant barriers to abortion care. My newly adopted home of California, with its vast social safety net and recently enacted abortion provider-expanding law, still only offers care in 55 percent of its counties. My ACA plan through Blue Shield of California may have recently updated its policy to remove the words “medically necessary” from the abortion provision, but I’m still going to fork over substantial travel costs in order to use the coverage I pay for if I move to a rural area. This means none of us can afford to thank our lucky stars and call it a day. People are already being left behind in the “A” states—with more in jeopardy if we don’t safeguard against restrictions enacted on a national level.

In fact, the only reason we aren’t worse off nationally is the implementation of the ACA’s contraception mandate, which greatly improved prevention across the country. When it comes to the Population Institute’s report card, the ACA should have led to drastically higher marks, but thanks to the 231 laws enacted at the state level over the past four years, we’re barely clinging to our C grade overall. And we’re in serious jeopardy of backsliding.

So those of us in blue states with friendly representatives and the rare, but not yet extinct, pro-choice champion must make a habit of letting our legislators know we oppose coverage bans like the Hyde Amendment. When Congress debates a federal budget, Hyde will be reintroduced—as it is every year—in order to prevent Medicaid funds from being used to provide low-income Americans with safe, necessary abortion care. Furthermore, we must also press them to stand against TRAP (targeted regulation of abortion provider) laws that would make it even more difficult for patients to realistically access care. Legislators from conservative districts will seek to continue the tradition of punishing the poor, so we need to embolden our blue state reps by writing, tweeting, and signing petitions asking them to speak for us as well as for those whose representatives work against their interests.

Roe should have been more than a court decision; it should have cemented the right to safe, legal abortion care for all. That is not the case. As of 2012, just 15 percent of Americans said they required a candidate to agree with them on choice—but far more than that will be directly affected by the decisions their candidates make on their behalf. The time to ramp up our stigma-fighting, legislator-lobbying, and capitol-protesting is right now. Legislators in the state houses and in Washington need to hear loud and clear that bodily autonomy isn’t something we take for granted and that we expect them, no matter the ZIP code of their constituency, to affirm our right to decide what happens in our doctors’ offices.

Become part of the storytelling movement—something anyone can do in any state. Speak out against red-state-shaming and lift up the activists fighting uphill battles in their extremist state legislatures. And find out the state of access in your ZIP codes: Are there clinics? If so, do they need support, volunteers, or advocates? What’s the policy on sex ed in your school district? The full slate of positive reproductive health-care policies gets a massive lift when complacently pro-choice blue state residents get off the sidelines.

Take this week’s recognition of Roe and run with it. Use the anniversary as an excuse not just to demand proactive policies from your legislators, but also to discuss abortion and the reality of access in your networks. Then keep at it as though your bodily autonomy depends on it. Because, no matter where you live, it does.

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 (R-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.”

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.