Roundup: Mental Health and the Abortion Debate, South Dakota’s Attempt to Ban Abortion

"Protecting" the mental health of women is the latest front in the abortion debate; The state of South Dakota's second abortion ban attempt; The Oregonian responds to Secretary Leavitt; New England Journal of Medicine reviews PEPFAR five years after inception.

New Front in Abortion Debate … The Wall Street Journal today takes a look at the new tack being taken by the right arguing that abortion should be limited to protect the mental health of the woman involved.  The assertion is that "a woman may think she wants to end a pregnancy, may even feel relief
when she does, but she will suffer for it later. So the state has a
duty to stop her."  The U.S. Supreme Court cited this reasoning, that the government needs to protect women from themselves, last year in upholding a
ban on a late-term abortions.  And later this week both sides will be working to spin a new "comprehensive report reviewing two decades of published research on mental health and abortion" from the American Psychological Association:

Both sides agree the mental-health issue has powerful
potential to shape public policy for years to come. And both hope to
use the American Psychological Association’s report to their advantage.

The organization has long held that abortion has no
negative mental-health consequences for most women. Indeed, the
psychologists’ group and the separate American Psychiatric Association
say it is crucial for women’s mental health that they have access to
safe, legal abortions.

About two years ago, the psychological association
pulled its fact sheet on mental health and abortion from its Web site
for updating. The result is exhaustive but ambiguous, according to
reviewers who have seen drafts.

These reviewers cautioned that they haven’t seen the
final report. But they said the drafts state that some women may
experience higher rates of emotional distress after abortions. Most
vulnerable: teens and young women who feel pressured into or ambivalent
about their abortions and who lack solid support networks.

The brisk conclusion paragraph on a recent draft,
however, focuses on adult women seeking elective abortions in the first
trimester of an unwanted pregnancy — which covers the majority of
abortions. The takeaway message: They have no greater risk of
mental-health problems.

South Dakota’s Abortion Ban Vote Draws Attention … The Wall Street Journal is running a related story today on the state of South Dakota’s second attempt to pass an abortion ban that could lead to a Supreme Court challenge to Roe v. Wade.  Two years ago, South Dakota voters rejected an abortion ban in a
referendum, 56% to 44%. But polls then showed that many who voted
against the ban would have switched sides if the proposal had made
exceptions for women impregnated through rape or incest:

Those exceptions — as well as one for women in poor health — are
included in the new measure. But they are far from simple; the full
text of the proposed law is more than 2,400 words. In the voting booth
this November, citizens will be presented only a 249-word summary.
Abortion-rights advocates say the exceptions are so narrowly drawn as
to be meaningless.

The changes in the wording of the ballot initiative will make the vote much closer this time around and may result in a victory for anti-choicers.

Oregonian Responds to HHS Director’s Comments on Anti-contraception Proposal … We’re nearing a month since a draft HHS proposal that would effectively limit women’s access to birth control, including the pill, was leaked.  The leaked proposal (PDF) has generated an emotional debate on the right to accessible, affordable birth control.   Last week the Secretary of the Department of Health and Human Services, Michael Leavitt, responded to Scott Swenson’s questions on the proposed regs. Today the Oregonian has written a worthy response to Secretary Leavit.  Leavitt is focusing on the reason for the regualtions, to protect the "conscience clause" for doctors who personally disagree with the use of birth control for non-scientific reasons while refusing to discuss the cost of rigorously enforcing the "conscience clause," which in this case is a great loss of access to birth control for many women:

In the most simple terms, Leavitt is right. The regulations
would indeed protect medical workers who morally object to
abortion or contraceptives. But in the real world of
politics and health care, the changes would also create a
mess.

They would undermine efforts in Oregon and other states to
improve access to birth control, including emergency
contraception for rape victims. More insidiously, they would
assist the anti-abortion campaign to criminalize all
abortions by defining legal personhood as the moment the
sperm fertilizes the egg, rather than at birth.

New England Journal of Medicine Reviews PEPFAR … The most recent edition of the New England Journal of Medicine has a review of the President’s Emergency Plan for AIDS Relief, which recently won reauthorization by the US Congress.  The short review discusses the arguments from both supporters and detractors of the plan and measures the successes and failures of PEPFAR’s approach.  The article’s title asks if the emergency is over and it concludes:

The key challenge for PEPFAR will be to maintain its sense of urgency and its razor-sharp focus on results — factors that have resulted in remarkable achievements in the face of enormous challenges. The advances have been dramatic, but much remains to be done.