ACLU weighs in...
Obama Administration Initiates Review Of Bush Health Care Denial Rule Bush Rule Hampers Access To Reproductive Health Services And Should Be Rescinded, Says ACLU FOR IMMEDIATE RELEASE February 27, 2009 WASHINGTON – The Obama administration is initiating a review of an ill-advised Bush administration rule that allows health care workers and facilities to refuse to provide reproductive health care services, even at the expense of patient safety. The rule, pushed through in the waning hours of the Bush administration despite public objection,threatens access to basic reproductive health services, including contraception and counseling for abortion care. “We are pleased that the Obama administration recognizes that this rule was essentially the Bush administration’s parting shot against women’s health and warrants careful review,” said Caroline Fredrickson, Director of the ACLU Washington Legislative Office. “The rule jeopardizes patients’ access to important reproductive health services, especially for low-income and uninsured women who rely on federally funded health centers for care.” Before issuing the rule in December 2008, the Bush administration received more than 200,000 comments, the overwhelming majority of which opposed the rule. Comments were submitted from major medical associations such as the American Medical Association and the American College of Obstetricians and Gynecologists, women's health organizations, members of Congress, state governors and attorneys general, the Equal Employment Opportunity Commission, religious advocates, and the general public. “The Obama administration has taken the first step toward rescinding this rule that fails to properly balance protections for individual religious liberty and patients’ access to health care,” said Jennifer Dalven, Deputy Director of the ACLU Reproductive Freedom Project. “At a time when more and more Americans are either uninsured or struggling with the soaring costs of health care, our federal government should be expanding, not hampering access to important health services. We are confident this ill-advised rule will ultimately be completely rescinded.” On January 15, 2009, the ACLU, on behalf of the National Family Planning & Reproductive Health Association, filed a lawsuit in federal court challenging the Bush rule. The case was filed along with two other legal challenges: one brought by the state of Connecticut, joined by California, Illinois, Massachusetts, New Jersey, New York, Oregon, and Rhode Island; and the other, by Planned Parenthood Federation of America and Planned Parenthood of Connecticut. For ACLU’s legal claim, go here. # # #
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BREAKING NEWS: Obama administration may rescind 'conscience rule' Officials say the move seeks to clarify rules for health care workers
The Chicago Tribune is reporting this morning that Obama administration will rescind Bush's midnight regulations that would allow any health care worker to obstruct a woman's access to contraception. In its place they will make another rule that clarifies "what health-care workers can reasonably refuse for patients." In an effort to strike "common ground," the Tribune reports that the administration is seeking perspective from "across the ideological spectrum before it finalizes the rollback." An unnamed official to the paper, ""We believe that this is a complex issue that requires a thoughtful process where all voices can be heard." It would appear the regulation was already beginning to wreak havoc in the mere two months it's been in effect. The Tribune reports, Seven states, including California, Illinois and Connecticut, as well as two family planning groups, have filed suits challenging the Bush rule, arguing it sacrifices the health of patients to religious beliefs of medical providers.
The American College of Obstetrics and Gynecology has reported cases such as that of a Virginia mother of two who became pregnant because she was denied emergency contraception. In Texas, the group said, a rape victim had her prescription for emergency contraception rejected by a pharmacist. We can expect the pro-lie movement to be at it's finest making its case to the public to retain the refusal regulation. I predict we'll hear a lot about healthcare providers to be forced to take part in abortion services and that they'll fail to mention that by "abortion" they mean "contraception." What often gets reported as a footnote in news stories is that three separate laws dating back 30 years already protect health care workers who refuse to take part in the delivery of abortions services. The refusal regulation Obama is beginning to rescind today is very different. The following is an excerpt from my piece, " Bush, Our Ex-Boyfriend," published on the day the regs took effect, inauguration days, literally in the last minutes of the Bush administration: The HHS regulations were a last minute, hastily executed, unconstitutionally vague, attempt by Bush to repay his only loyal constituency left, the religious right wing. The regulations attempt to expand health care workers right to "consciously object" to the broadest array of health care services imaginable, basically anything, even in medical emergencies. They can, in other words, refuse to provide you medical care, because it offends them! It opens the door to many patient abuses, shreds state laws and contradicts federal discrimination statutes. Healthcare workers would be able to withhold information from a patient about healthcare options without the patient even knowing that any information is being withheld. Patients can be refused referrals if the healthcare worker objects to the care they're seeking somewhere else.
And here is one particularly bizarre twist. The regulations specify that workers don't have to inform their employers of the service or services they object to before hand. It's also unclear the extent to which employers have the right to ask job applicants about their willingness to take part in the services they provide. Thus, imagine the situation in which an anti-choice person applies for a position at Planned Parenthood. The employer couldn't ascertain that she's against abortion, nor could it fire her when she refused to have anything to do with it.
But the regulations real intent (revealed in a draft version of the proposal leaked this summer) is perhaps worse: to allow those who want to obstruct a woman's access to birth control full license. Keep in mind, there is already ample protection for those who do not wish to take part in abortion services, three laws in fact. The right to refuse to take part in abortion services has existed for over 30 years. Here's the thrust of the new regulations (in my own words), "If you'd like to consider contraception an abortion method and refuse to take part, please do, but also feel free to object to contraception, or any other health care service, for any reason you can dream up. The only thing limiting your right to refuse is your own imagination." Your conscience is yours. Use it how you want. Even if it infringes on the conscience of others. There will be a 30-day comment period about the rescinding of the regulation. I will post information here about how to comment so please check back soon. The Obama Administration promises to listen to all perspectives--one of the clearest hallmarks of how different an administration this is from the last. But as a result, we can't assume administration officials understand all the problems with the original regulations. That's why we must speak up as clearly now as we did before. We know for sure opponents of birth control will be.
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BREAKING NEWS: OBAMA PUTS FAMILY PLANNING PROVISION REMOVED FROM STIMULUS IN THE FY 2010 BUDGET
Here's the Press Statement Released by National Family Planning and Reproductive Health Association moments ago: MEDIA ALERT Providers Applaud the President’s Commitment to Family Planning Statement of Mary Jane Gallagher President & CEO, National Family Planning & Reproductive Health Association “Family Planning providers are ecstatic about the bold step towards universal health care that President Obama has laid out in the Fiscal Year 2010 budget outline he will submit to Congress this morning. We are thrilled that the President articulated a commitment to fix our broken health care system while ensuring access to family planning services in his Budget outline. Quality, affordable health care is essential for every single person in this country. The inclusion of a provision to expand eligibility for Medicaid funded family planning services and a substantial increase in funding for Title X will go a long way to reduce unintended pregnancies and the need for abortion in this country. With more than 17.5 Million women of child bearing age with inadequate access to quality reproductive health care –the numbers of pregnancies and abortions will continue to climb, if there is not a substantial investment in both of these programs. It will not be easy to achieve, but if elected officials are willing to set politics aside for our nation’s well being then we can get it done. The President’s Budget works towards these goals in part by making common-sense improvements to existing health care programs, including giving states the option to expand eligibility for Medicaid-funded family planning services. Giving states the option to expand eligibility for family planning services under Medicaid will better the quality of life for millions of low-income and uninsured women and families, while saving hundreds of millions of tax payer dollars. Our nation’s family planning providers look forward to a significant investment in reproductive health care to assist the millions of women and families who are currently in need. Now, Members of Congress must step forward and do their part to support this budget, its provision for a new reserve fund for health care reform and a significant investment in family planning services.” -###- The National Family Planning & Reproductive Health Association (NFPRHA) is a vital membership organization of dedicated family planning providers – public health departments, hospitals, general health providers and stand-alone reproductive health caregivers.
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Is the Fix In?
Let’s synchronize our watches. Then we can together count the mili-seconds between the announcement of the birth control pricing fix for college women and the moment the religious right and its Congressional enablers begin misleading the public about it. The birth control pricing fix, which was included in the appropriations bill released today, neutralizes a Bush era anti-contraception maneuver that caused the price of birth control to skyrocket for college women, in some cases by 900%. Bush removed college health centers from group discount drug programs. The fix would simply put college health centers back into the program. The almost immediate result will be a reduction in the cost of contraception for college women: the demographic most at risk of unintended pregnancy. It bears repeating: this fix will cost the taxpayers nothing. The studies, in fact, show that such a program which does little more than give people the opportunity to make their own important life decisions, will save taxpayers money. In these economic times, you’d hope any and every cost-neutral/cost-savings proposal would be given serious attention by lawmakers. But that’s not how the anti-contraception movement rolls. And that’s sad. Because one of the few areas of common ground in this divisive debate is contraception. The truth is the American public supports contraception. And 72 percent of voting Americans even believe that taxpayers should pay for birth control for low-income women. An even greater percentage, 80 percent of voters, believes that women won’t achieve full equality without access to family planning. The dramatic results of family planning are hard to argue with. Honest fiscal conservatives and even so called “pro-lifers” cannot ignore the facts. According to the newest information from the Guttmacher Institute, the leading non-partisan research organization on reproductive health, for every public dollar spent on family planning we save $4 in averted costs. Guttmacher studies show that each year public funding for contraception prevents 1.94 million unintended pregnancies, including almost 400,000 teen pregnancies. And that’s at the starvation budget-levels for programs enforced by the Bush administration for programs like Title X. In upcoming months, along with the birth control pricing fix, we will need to increase public funding for contraception to the same level (when adjusted for inflation) that we invested in it in the 1970’s, when the nation’s contraceptive program began. Unfortunately, the debate on this and other contraceptive issues is often hijacked by ideological zealots. In fact, just two weeks ago we witnessed a rightwing take-down of a contraception-related proposal. That takedown required a misleading sleight of hand by Representative John Boehner, who recently pledged his support to the Pope’s anti-contraception agenda. Boehner blithely led the public to believe that Obama’s economic stimulus package included $200 million for contraception. And like the search for WMDs, it took investigators some time to find it wasn’t there. Turns out the $200 million figure in the stimulus package actually referred to the cost-savings that would have resulted by giving more women access to birth control. Unfortunately, the media coverage of the Boehner-led fiasco had that fraternity-style, fact-light coverage that serves right wing issues. On MSNC Chris Matthews, seemingly fresh off a bong hit, compared government funding contraception to China’s coercive one child policy. We should expect the same demeaning media horseplay with any future proposals on birth control. This conversation needs some designated drivers. Especially since one of the outcomes of Bush era policies is that the number of women in need of publicly funded services increased by more than a million (7%) between 2000 and 2006. And that was before our economy disappeared. Americans’ most important life decisions, like when to start or expand a family, now take place against the backdrop of a society in economic free fall. Even though the media treats contraception as a springboard for irrational right wing fulminating, for the millions who have lost their jobs and their health insurance, access to contraception is essential. There are no doubt plenty of wisecracks to be made about stimulus and contraception—but unless a factual national conversation about family planning starts real soon, the joke will be on us.
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Bristol Palin: Media Maven with a Message
In a stroke of media mastery, Bristol Palin harnessed the Palin family-doting Fox News last night to announce a powerful (and decidedly non-Fox News) message for policy makers: abstinence only is "not realistic." The new teen mom also told Great Van Susteren that she would "love to be an advocate to prevent teen pregnancy." Making this announcement on one of the most watched, and most conservative, news stations in the nation is already a pretty good display of her ability to reach a large swath of Americans (particularly the most difficult to reach on this issue.) As we all remember, Bristol and her unplanned pregnancy dominated the national news for a month during the Presidential campaign. Yet this is really the first time we've heard from Bristol herself. It appears she is striking out on her own. In fact, she told her mother about the interview, and her plans to discuss teen pregnancy prevention during it, just the day before. Some have spun this story as Bristol attacking her mother's abstinence-only policies. She clearly is not, but she is finding her own voice. (Anyway, it appears Governor Palin is reconsidering her position. She makes an appearance during the interview and admits that the abstinence-only approach is, as she puts it, "naive" which, in itself, is big news the main stream media has yet to pick up on.) What the interview reveals is that Bristol is lovely, humble, honest, no doubt still a teenager and refreshingly free of any political agenda--except to use her experience to steer teens away from the same fate. In startling candidness, Bristol expresses the conflicting emotions that come packaged with teen parenthood; her love for her child and of motherhood and her belief that waiting ten years before becoming a parent would have been a better path. She explained, "I like being a mom, I love it. Just seeing him smile and stuff, it's awesome...It is very challenging but it's so rewarding...Of course, I wish it would happen in ten years so I could have a job and an education and be, like, prepared and have my own house and stuff... I just hope that people learn from my story and, I don't know, prevent teen pregnancy I guess... It's not just the baby part of it that's hard, it's that I'm not living for myself anymore I'm living for another human being...I'd like to be an advocate to prevent teen pregnancy because its not a situation you strive for I guess...Kids should just wait--it's not glamorous at all." In many ways, Bristol appears on the national stage just in the nick of time. Teen birth rates are suddenly spiking nationally after fifteen years of steady decline and Congress is about to consider re-funding the failed abstinence-only policies that likely led to this trend. An organization like The National Campaign for the Prevention of Teen and Unplanned Pregnancy could use a spokesperson like Palin right about now. Together, armed with real data, they can educate teens about the real life consequences of sex and lobby for the policies that help delay teen sexual activity and prevent unintended pregnancy. Palin has already won fans in the organization. One is Bill Albert, Chief Program Officer. He described Palin as 'brave.' "There has to be some real passion, great inner fortitude to come forward to talk about these issues," Albert explained, "she said something very powerful--'I wish I had waited, I wish this beautiful event could have happened in ten years.' She said it in her own words and it was not an anti-child message, not an anti-family message--it was about timing and what order you want to take life's most important events. If she could turn back the big hands on the clock of time she would have waited. That is a message on target with all the teen parents we talk to. Teen mothers and fathers are the most powerful messengers of all. She already is an advocate."
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Anti-contraception crew still at work at HHS
A perplexing story popped up in my Google alerts the other day. It was from The Hoya, Georgetown University's college newspaper, and the headline read: " Med Center Receives Research Grant for Natural Family Planning." Georgetown is a Catholic university which aroused my suspicions; after all, in the 21st century, the Catholic Church still bans contraception for its adherents. The research grant was from HHS, for $600,000. Not much as research grants go, but in this economy spending money to research a quote-unquote contraceptive method with a failure rate of 25% seems pretty lavish. I poked around the website of the grant recipients, The Institute for Reproductive Health (not to be confused with the National Institute for Reproductive Health to which I am a consultant) and, unlike most natural family planning endeavors, there were actual MDs at work on the project--in particular those with real field experience in family planning. Several were former USAID and UNFPA employees. I also happened to have a chat with a colleague with impressive pro-choice credentials who mentioned the lead researcher, Dr. Victoria Jennings, in glowing terms. Typically, this would be enough to put my mind at ease and dim the flashing warning sign. That's if it weren't for the following passage in the article, "The $600,000 award will enable researchers not only to make natural family planning methods accessible for Title X clients, but also "to test strategies to overcome barriers that limit the availability and use of natural family planning methods by individuals who get their health care through this government-funded program," according to a medical center press release." Wha?! The goal is to integrate "natural family planning" into the array of contraceptive services offered to Title X recipients. First of all, it's worth repeating that the typical failure rate is 25%. (Withdrawal is 27%.) And that's of those dedicated 2% of Americans who even try it, a slim percentage who are most likely very religious and fervent in their belief that natural family planning works. Now, a few Title X facts could come in handy. 70% of Title X clients are unmarried. 28% of Title X clients are teens. If natural family planning which requires a couple to have sex only at prescribed times of the month, doesn't work within stable relationships, imagine how impressive the failure rate will be among the actively dating. Here's my real suspicion. The Bush appointees are still running the shop over at the unmanned HHS - recall that the Daschle debacle left the agency without a head - of which the Title X program is a subset. It seems this grant is like the baubles Madoff sent to family members in the weeks after his scam was exposed. The anti-contraception crew is still at work at Title X off loading the family's jewels to friends. These are the officials, remember, who defended the abstinence-only approach in the face of conclusive evidence it fails and who think contraceptives are "demeaning to women." Getting a prestigious university like Georgetown, with its Vatican-mandated anti-contraception agenda, to endorse natural family planning for the poor appears to be a slick way to make crisis pregnancy centers eligible for Title X funding. What witting or unwitting role the esteemed MDs are playing in this is not yet clear. But don't forget that crisis pregnancy centers refuse to tell women grappling with unwanted pregnancy the most effective way to prevent another. A long-term goal of the anti-contraception movement is to validate, in a scientific-seeming way, the anti-contraception "contraceptive." This is the Bush administration still at work, the very people who lead the campaigns against contraception still at the wheel and driving funds to those who support their ideology. We should get loud about this. If only as a way to vent about the anti-contraception stunt staged during the stimulus debate. They moaned about spending money on contraception, which by the way, turned out not to be in the bill, but never mind. Meanwhile the Bush team is cutting checks and mailing them to friends.
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Sexonomics
Over the past two weeks there has been lots of public huffing and puffing over the inclusion (and then exclusion) in the stimulus package of a provision for contraception. Much of the discussion was little more than media hot air, unanchored by anything as weighty as facts. The media discussion was notable for among other things: the absence of experts. To cite one blunder: the shock media gleefully tore into the supposed controversy of a $200 million allocation of taxpayer money for pregnancy prevention, despite the fact that there was no $200 million allocation of taxpayer money for pregnancy prevention. That fable sadly got passed off as fact. In reality, the bill proposed an administrative change that would have saved the states 200 million dollars in five years. (This “mistake” was courtesy of Rep. John Boehner, a friend of the anti-contraception movement.) In all this, a more important point has been mangled. And that is that family planning has profound economic benefits. As someone who often writes about the benefits of family planning, I’ve long been struck by the dearth of information on the impact of family planning on economics. I’d once spent some time looking through fifteen years of back issues of the journal Feminist Economics while researching my book on sex and family planning, How the Pro-Choice Movement Saved America. Even there I found hardly any articles on the relationship of family planning and the economy. Recently though, several economists have stepped forward. Writing for the New York Times blog, Economix, Nancy Folbre, an economics professor at the University of Massachusetts, Amherst, writes about family planning and the economy. Those reflexively attacking the inclusion of contraception in a stimulus bill argued that it doesn’t stimulate the economy. Folbre pushes back, arguing in part for the stimulative effects of public support for family planning. She writes, “Increased spending on family planning (including contraceptives) would generate about as many direct and indirect jobs as any other health expenditures, and probably more than an equivalent tax cut." But for Folbre the short-term effects are less important than benefits down the road which is where the real savings (and consequently the real economic stimulus) will come. She explains, “The long-term benefits include significant reductions in unplanned births and abortions. Teenagers, in particular, would benefit. A research paper by Melissa Kearney and Phillip Levine finds that recent state-level Medicaid policy changes reduced births among teenagers by more than 4 percent. The authors offer estimates of the cost per averted birth, which could be compared with the social costs — to children, parents, and society — of unwanted pregnancies.” The brainy people over at the Brookings Institute, economist Isabel Sawhill and researcher Adam Thomas, recently echoed this point. On Feb 5th, in a piece entitled, Keep Politics Away from the Promise of Family Planning, the Brookings researchers concluded that when poor women were given access to contraception it “led to a significant reduction in the number of sexually-active women who have unprotected sex.” They used that premise to look at the policy’s economic projections, writing, “We have incorporated this finding into a cutting-edge simulation model of family formation. Our results suggest that a similar expansion in contraceptive services in the remaining states would reduce the annual number of children born out of wedlock by more than 25,000, would reduce the number of pregnancies to unmarried teenagers each year by 19,000, and would reduce the annual number of abortions to unmarried women by nearly 12,000.
Children in single-parent families are more than four times as likely to be poor as children in two-parent families. Moreover, children who were born as the result of an unplanned pregnancy are less likely to have received adequate prenatal care, are more likely to have a low birthweight, and are more likely to perform poorly in school. Unintended pregnancies are also expensive. A recent study by Princeton University's James Trussell found that unplanned pregnancies generate $5 billion annually in direct medical costs. Many of these expenses are borne by society in the form of subsidized medical care. Indeed, the Congressional Budget Office has estimated that the Medicaid family planning provision, if enacted, would result in a net government savings of $700 million over ten years." These effects are substantial, and while lost on the media, they do have important economic implications. Folbre also refers to a study conducted by Harvard researchers worth highlighting. Entitled “ The Power of the Pill,” it argues that the economic benefits of contraception are particularly important for women’s economic futures. The study points out that the surge of women entering college and the professions seemed to happen almost immediately after the legalization of contraception. Goldin and Katz (authors of the Power of the Pill), found that the percentage of all lawyers and judges who are women more than doubled in the 1970s (from 5.1 percent in 1970 to 13.6 percent in 1980) and was 29.7 percent in 2000. The share of female physicians increased from 9.1 percent in 1970 to 14.1 in 1980 and was 27.9 percent in 2000. Similar patterns hold for occupations such as dentists, architects, veterinarians, economists, and most the engineering fields. (It's worth pointing out that the legalization of family planning appears to have had an impact on the number of female economists we have today.) Before we enter into the next debate about the virtues of public funding for family planning, a discussion Obama indicates we will have again soon, we need to hear from more economists like Folbre and Sawhill. They should educate the public and media about the stabilizing force family planning plays in our lives and how that impacts society. Without them, it'll just be Neil Cavuto on FOX News telling us unwanted pregnancy should be encouraged so we'll have eventually have more people paying into social security. It's time for the experts to take the wheel.
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Can Pro-Choice People Support the Pregnant Women Support Act?
A few weeks ago, Senator Bob Casey, who opposes legal abortion, introduced what he described as a common ground bill: The Pregnant Women Support Act. He explained, "I believe there is more common ground in America than we might realize. If only we focus on how we can truly help and support women who wish to carry their pregnancies to term and how we can give them and their babies what they really need to begin healthy and productive lives together." Pro-choice people, like myself, get a little defensive over proposals such as this, and the righteous rhetoric that accompanies them. This legislation proposes to provide support to low-income women who want to bring a pregnancy to term. Pro-choice elected officials have proposed providing more support to low-income women and families for years. But let's put aside pride of authorship for the time being. In the new age of conciliation we might file away such grievances in the hopes that having the anti-choice side think it was their idea might help get it done. That's not to say that the Pregnant Woman Support Act is perfect -- it's not. (It fails to mention family planning. Planning a pregnancy is step one to having a healthy one. And how can any proposal aimed at reducing abortion be taken seriously without including contraception?) But it does do a lot of great things and there are solutions for the areas that are problematic. First let's review its attributes: The Pregnant Women Support Act is inspired by the belief that if women facing unintended pregnancy are provided substantive help they might continue, rather than terminate, a pregnancy. Two-thirds of all women seeking abortion care report it's because they cannot afford to have a child. Perhaps choosing abortion because one can't afford to have a child is not the best choice for her. In a perfect pro-choice world, parenting, abortion and adoption would be equally available options, and, importantly, none would be stigmatized. Neutralizing income as a determining factor for what a woman does in her reproductive life is reproductive justice. Much of the Pregnant Women Support Act is a means to that end. For example it would provide financial, medical, educational assistance, insurance coverage for those in need who ordinarily would not qualify for it. A woman can get nurse home visits, counseling, shelter, help with child care, assistance to help her stay in school, and a lot of other services that may broaden her choices. That's all good. Here's where the problem starts for pro-choice people. The bill would: "Create a new pilot program for "Life Support Centers" to offer comprehensive and supportive services for pregnant women, mothers, and children." Life Support Centers appears to be a way, among other things, to funnel money into crisis pregnancy centers. These have been a ruse of pro-life activists. They are billed as places a pregnant woman can visit to consider all her options. But they mislead women about the options available to them, offering up inaccurate information intended to scare women about abortion. Misleading women is not something pro-choice organizations or elected officials will be able to support (nor should any self-respecting pro-lifer). Removal of the section should be fought for vigorously. Or alternatively, find a way to legislate out its heavy-handed agenda. If the ideological, coercive and misleading tactics that are the signature of crisis pregnancy centers were prohibited, there could be a limited but legitimate role for these centers to play in the delivery of support services. But an affirmative and explicit disclaimer should be issued right up front. The Pregnant Women Support Act would be a good place to begin to insist that crisis pregnancy centers act in a responsible way. Make "Life Support Centers" stick to medical facts rather than ideology. There ought to be a "no propaganda" agreement right up front in every common ground campaign. Anti-abortion activists have, in several states, succeeded in passing legislation mandating that ideological, medically inaccurate scripts be read to patients who seek abortions services. Mandating that ideology and inaccuracy be inserted into a medical environment, as the anti-abortion movement has done, is ethically troublesome. But what if, instead, the law mandated that medical and scientific accuracy be required of ideological organizations masquerading as health centers? An amendment to the Pregnant Women Support Act could propose that every "Life Support Center" receiving federal funds be required to provide medically accurate information to all it counsels and also disclose that its mission is to convince women not to have an abortion. Providing accurate information should be a common ground goal and anti-abortion organizations should have no problem admitting that convincing women not to choose abortion is their intent. Each center would be required to read a script that include information like this: "This is not a medical facility. There are no medical personnel on staff. The staff of this facility is unable to diagnose complications of pregnancy or fetal anomalies (birth defects). This facility is staffed by people who are opposed to abortion and contraception. Medical research shows that women who have an abortion are at no greater risk of breast cancer, miscarriage in future pregnancies, mental distress or any other mental or physical disorder than women who have never had an abortion. Ultrasound images may exaggerate the size of the embryo/fetus." Etc. Sprinkled throughout the Pregnant Women Support Act is the term "counseling." The "no propaganda" rule should apply in every instance a woman receives counseling. (To pre-emptively address a point that will be made by opponents of abortion: no, medically, scientifically accepted, peer-reviewed evidence does not fall under the category of propaganda.) Another area of concern is that the bill proposes to promote adoption as an alternative to abortion. There is no doubt that the adoption industry has changed dramatically in the last forty years, in great part because of legal abortion. Many Americans, including women confronting unwanted pregnancy, are not aware that the adoption choice now offers many avenues, including open adoption. There is a real need to update Americans' understanding of adoption as an option for unwanted pregnancy. But, it should not be in the context of disparaging other choices. As the book, The Girls Who Went Away, and even recent discussions on RH Reality Check reveal, adoption is typically a difficult choice and many women suffer immensely by being pressured into that option. For some women abortion is the wrong choice and for some women adoption is the wrong choice. There is great need for education about adoption, there's no need to present it as an alternative to abortion or parenting. A woman, if given comprehensive and accurate information about all of her choices, is her own best moral agent. The last sticking point for pro-choice people with the bill is that it seeks to codify the regulation that extends coverage under the State Children's Health Insurance Program (SCHIP) to both low-income pregnant women and unborn children. As long as pregnant women are extended prenatal care coverage through Medicaid, this is a superfluous section and a back-door attempt to create independent rights in law for a fetus. This section would not prevent one abortion or make it any easier for women to bring a pregnancy to term. It defies the "common-ground" spirit the bill was intended to cultivate. Keeping it in the bill could only be interpreted as a cynical attempt to co-opt "common ground" for anti-choice purposes. With these important changes, none of which jeopardize the true intent of the bill, we should be prepared, for the moment, to take Senator Casey at his word when he says he wants a common ground approach. Senator Casey stated, "I introduce this bill with the deepest conviction that we can find common ground. I believe that we can transform this debate by focusing upon the issues that unite us, not the issues that divide us." If that is true, and these slight changes are made to the bill, pro-choice people are a more likely constituency of support. But if these proposals remain, common ground will not be achieved and pregnant women won't get the support they deserve.
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