This is not the advocate you’re looking for.

Ivanka Trump, daughter and adviser of U.S. President Donald Trump arrives for the W20 summit in Berlin, Tuesday, April 25, 2017. CREDIT: Michael Kappeler/dpa via AP

Ivanka Trump wants the world to know that she’s a feminist. Under the hashtag #womenwhowork (also the title of her new book on women in business, which was released on Tuesday), she’s spent the past few years building a brand based on how to be a woman who “has it all” — the adorable children, the high-powered job, and the tasteful Ivanka Trump™️ sheath dress, too, of course.

Now, as the first daughter and as an official White House aide, Ivanka has said she plans to be a “moderating” force on her brash father, and wants to turn her focus on women’s empowerment from selling pumps to crafting policy.

The problem? Ivanka’s advocacy is often all style and no substance, and she has repeatedly revealed fundamental misunderstandings about the actual barriers facing many women and gender non-conforming people who don’t benefit from the privileges afforded to men.

Last week, she championed economic empowerment for women around the globe in an op-ed, without mentioning that the Trump administration is actually gutting funding for aid programs focused on women, girls, and entrepreneurship. During the campaign, she offered a parental leave policythat would primarily benefit wealthy women like herself.

And on Tuesday, a line in a New York Times profile on Tuesday highlighted yet another area of ignorance: reproductive rights.

Here is the relevant section, from near the end of the article (emphasis mine).

“with congressional Republicans threatening to cut all funding to Planned Parenthood (even though the women’s health organization says it receives no federal funding for abortions), Ms. Trump approached its president, Cecile Richards, to start a broader dialogue. She also had a proposal: Planned Parenthood should split in two, Ms. Trump suggested, with a smaller arm to provide abortions and a larger one devoted to women’s health services.”

Firstly, Planned Parenthood doesn’t just say it doesn’t receive federal funding for abortions — it doesn’t, full stop. That’s because it’s currently illegal under the Hyde Amendment, which prohibits taxpayer funds from paying for abortion.

In reality, most of Planned Parenthood’s federal funding comes from Medicaid payments for basic health care services. That means that congressional Republicans’ current crusade to defund Planned Parenthood is actually a push to prevent low-income people on Medicaid from going to the organization’s clinics for care such as cancer screenings, birth control consultations, prenatal care, and STD tests. Stripping federal funding from the group will mean preventing many low-income people from being able to access this care at all.

But Ivanka’s solution — to segregate Planned Parenthood’s abortion care from its other health care services — also betrays a deep misunderstanding of the interconnected nature of reproductive health.

Abortion care is health care. It cannot be neatly separated from other medical decisions; for many people, having control over when and if to have a child is fundamental to their health and economic well being. And though abortion care may represent a small percentage of Planned Parenthood’s overall services, it is central to the group’s mission of providing reproductive care.

Source: Think Progress

https://thinkprogress.org/ivanka-trump-doesnt-understand-how-reproductive-health-care-works-cdab743f60fe

Congressional-sealCongress began the 2015 session proposing more anti-abortion legislation, keeping in step with legislators at the state level doing the same. Abortion rights have been chipped away so continuously, many of us have come to expect more, no matter how ludicrous.

The proposed laws calling for intrusive, expensive, and uncomfortable (even painful)  transvaginal ultrasounds and mandated scripted information containing unscientific , inaccurate or incorrect information to abortion patients serve no purpose but to promote anti-abortion propaganda and delay access to abortion services.  Some proposals are truly bizarre. An addendum to legislation in North Carolina that passed in 2013 is currently being pushed by some politicians to “…[establish] governing and quality assurance boards and [designate] a chief executive to handle day-to-day operations…”  Exactly what will an additional layer of bureaucracy in a medical practice accomplish for women’s health?

restrictions-2011-2013_smWhen asked to describe the benefits of these laws, the answers are generally the same and women generally have reactions of disbelief to their claims:

Women need to be “properly” informed. Once they are provided the right information, they will be less likely to have an abortion. Uh, yeah, even we women know that we really just do not know what we are doing when it comes to pregnancy, abortion, or other decisions involving our reproductive lives. Yep. We women need the wisdom and personal, often religious, convictions of politicians before we can feel confidence in our decision. We should not trust ourselves or our medical care providers.

It protects women’s health. Abortion is such a dangerous procedure with two victims – the pregnant mom is scarred for life and her child is killed. Can you please just give specifics about how it actually protects women? Are you saying that childbirth is safer or, really, be honest, are you just trying to put another barrier in place to stop women from choosing to have an abortion? Or, are you thinking illegal abortion would be better somehow?

We care about women and children. Oh, I know, I know…you will eventually convince me to give birth whether I am a healthy young woman, a 46-year-old woman with four children and no desire for more, a woman with chronic health conditions, a 13-year-old unprepared for pregnancy and parenting, an 11-year-old pregnant as a result of repeated sexual molestation from a male relative, or any other woman in any other circumstance. You care so much that you will promise to support me spiritually, emotionally, and financially until my offspring become adults. Oh, wait…I forgot, most of you actually stop supporting women once we give birth, once the fetus becomes a child.

preg patientsIf we assume for a moment that those who support abortion restrictions are sincere in their claims that they believe women should be properly informed, that the laws protect women’s health, and that they care about women and children, then they should also support other reproductive healthcare-related proposals that have the same goal in mind. If the premise of restrictive abortion laws is really about informing and protecting women, then laws must be developed to ensure that all women who get pregnant and plan to give birth are aware of the risks involved. All medical practices that have pregnant women as patients must arrange for structural modifications to their facilities to ensure women and the government that they can properly respond to medical emergencies that might arise. The medical providers of pregnant women must also be required to make specific, politically dictated statements about the range of risks involved in pregnancy and childbirth although, unlike the “abortion information,” statements can be based on empirical data and medical facts.

acogResearch by Elizabeth G. Raymond, MD, MPH and David A. Grimes, MD and published in the American College of Obstetrician and Gynecology’s Obstetrics & Gynecology (February 2012), concluded, “Legal induced abortion is markedly safer than childbirth. The risk of death associated with childbirth is approximately 14 times higher than that with abortion. Similarly, the overall morbidity associated with childbirth exceeds that with abortion.”  (Full PDF article available at no charge through embedded link.) While I am not interested in shattering the joy of women learning of a wanted positive pregnancy test, fair is fair. There are risks associated with pregnancy and childbearing for which women should receive appropriate medical information. Given the political and religious propaganda out there, the chances are that a lot of women think that pregnancy and childbirth are safe. If women cannot be respected as able to independently make decisions about abortion, how can we possibly believe them able to make decisions concerning pregnancy and childbirth?

In addition to pregnancy and childbearing putting women at a higher risk of death than abortion, there are numerous risk factors that require medical attention and monitoring, including prior to conception. Rh incompatibility, kidney disease, diabetes, polycystic ovary syndrome, and autoimmune diseases are among the many conditions that can dramatically complicate the health of pregnant women and their babies. Age and lifestyle are other factors that obstetricians must consider during preconception consultations and prenatal treatment practices. The latest blow to pregnant women and fetal wellbeing is research concerning the influence of the time interval between the delivery of the first baby and conception of the second.  “[A]n interval of less than 12 months causes an increased risk for severe preterm birth in women who already suffered preterm birth in their first pregnancy” was the primary finding of the research, which will be presented this week at the Society of Maternal-Fetal Medicine’s annual meeting.

Obesity is one of the most common risk factors for women in developed countries. According to research published in Science Daily (July 2010), “The heavier the woman, the higher the risk of induced preterm birth before 37 weeks, with very obese women at 70% greater risk than normal weight women.  Overweight or obese women also had a higher risk of early preterm birth (before 32 or 33 weeks). Again, the heavier the woman, the higher the risk of early preterm birth, with very obese women at 82% greater risk than normal weight women.”

CDC pregnancy-related-death-2010_600pxAll proposed Pregnancy and Childbearing Risk Awareness legislation should reach far to include all possible complications – just as restrictive abortion legislation underscores improbable complications such as a perforated uterus or death. For example, maternal mortality is on the rise in the United States, with roughly 18 out of 100,000 women dying from pregnancy-related complications in 2013; between 1998 and 2005, the figure was much lower, with roughly eight deaths per 100,000 pregnant women. In 2011, the Center for Disease Control reported 17.8 deaths per
100,000 pregnant women, noting also significant racial disparities with a rate of 12.5 per 100,000 white women and 42.8 per 100.000 black women. The death rate from abortion is one for every one million abortions performed at eight weeks or less, one for every 29,000 abortions performed at 16 to 20 weeks gestation, and one for every 11,000 abortions performed at 21 weeks or later. Obviously, far more women die due to pregnancy-related complications than abortion complications, even at the later stages of gestation. It is only appropriate to ensure that women have the correct information so that they can decide if they really want to be pregnant and if motherhood is actually worth such possible health concerns.

Those of us who believe that reproductive justice is critical to achieving social and economic equality for women know that women can and do think for themselves in every sphere of life and most especially their reproductive lives. We also make many household and relationship decisions, not to mention educational and career decisions. We do not need politicians, pastors, or “sidewalk counselors” to help us make informed, personal decisions nor do we need them to create laws to try to impose their views on us. If they feel they must be a part of our reproductive lives, they should go about it fairly and provide complete and accurate information on abortion and pregnancy.

The Hobby Lobby v Sebelius case is extremely important in its determination of whether business owners, acting as corporate agents, have a right to freely exercise religion through their companies. However, since its inception the case has been riddled with misconceptions about everything from precedents of corporations to exercise religion to whether Plan B is an abortifacient. The following is an attempt to clear up some of the more confusing and pervasive misperceptions surrounding the case.

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This case is about individual rights, not corporate rights.

Hobby Lobby’s challenge to the birth control mandate has often been portrayed as an unprecedented case of government encroachment on individual religious rights, with more conservative outlets going so far as to represent the case as a determination of whether “[business owners] have a right to run their business in a manner consistent with their moral beliefs,” but that is a mischaracterization of the case.

The case would determine whether a business itself is capable of exercising a religious right, and insofar as Hobby Lobby’s owners are individuals, FreedomOutpost.com may have a point. But it ignores the legal precedent that separates individuals from corporations, and accords individuals while acting as corporate agents the rights accorded only to the business, rather than those that would otherwise be accorded to the individuals personally (see below). Therefore, the question of whether a for-profit, secular business can exercise religion under the Free Exercise clause is actually completely germane, not a “smokescreen.” So what rights are purely personal, and what corporate?

It is inaccurate to say that secular, for-profit corporations hold no rights guaranteed under the First Amendment, but whether the application of the Free Speech clause to corporations as decided by the Citizens United ruling also necessitates an extension of the Free Exercise clause depends on whether the latter is considered a “purely personal” right. From the First National Bank of Boston v. Bellotti (1978) ruling, “Certain ‘purely personal’ guarantees, such as the privilege against compulsory self-incrimination, are unavailable to corporations and other organizations because the ‘historic function’ of the particular guarantee has been limited to the protection of individuals…Whether or not a particular guarantee is ‘purely personal’ or is unavailable to corporations for some other reason depends on the nature, history, and purpose of the constitutional provision.”

Whether the extension of the Free Exercise clause extends to corporations, then, depends on whether they are capable of exercising religion and the extent to which legal precedent upholds their right to do so. According to the Third Circuit opinion on the Conestoga Wood Specialties Corp. v. Sebelius case, there is a “total absence of caselaw … in which a for-profit, secular corporation was itself found to have free exercise rights.” It additionally notes that the Supreme Court has previously specified the Free Exercise Clause as an “individual” liberty. In a related case, the Sixth Circuit sided with the Third Circuit in Autocam Corp. v. Sebelius with a unanimous decision that Free Exercise does not extend to secular, for-profit corporations.

However, the water has been muddied by a Tenth Circuit opinion, in which a majority decided that Hobby Lobby has grounds to challenge the birth control mandate of the PPACA under the Religious Freedom Restoration Act for two reasons. First, in the RFRA, the term “person” was not explicitly defined to exclude corporations and so, by the Dictionary Act, could be assumed to include them, as the court did not interpret the context to indicate otherwise. Second, the RFRA did not explicitly exclude for-profit, secular businesses from consideration, and the court’s opinion indicated that Congress would have been capable of specifically excluding secular for-profits in the wording of the RFRA had it intended to do so.

Seemingly in response to this opinion, the Amicus Curiae brief filed close to 4 months later by the Constitutional Accountability Center addressed these arguments. It noted that the word “person” in the RFRA should necessarily have been taken to exclude for-profit businesses because of precedent set in the Braswell v. United States case, in which the 5th Amendment right to not be compelled to self-incriminate did not extend to a business owner’s refusal to produce (incidentally incriminating) corporate records. Importantly, the brief notes from the Braswell opinion that those acting in an official capacity as agents of a corporation “cannot be said to be exercising their personal rights and duties, nor to be entitled to their purely personal privileges, [but instead] assume the rights, duties, and privileges of the artificial entity.”

Like the Third Circuit court, the CAC’s Amicus brief noted the complete absence of precedent for treatment of secular, for-profit businesses as capable of exercising religion. Most importantly, in terms of the context of “person” in the RFRA, “constitutional text and history, as well as settled law, give a special status to churches and other religious institutions [such that …] religious institutions receive many types of legal protections for religious exercise rightly considered inapplicable to business corporations.” This long history is implied to be sufficient to provide the context to the word “person” that the Tenth Circuit opinion stated was lacking in the RFRA.

It’s important to note that where the “religious institution” line is drawn in the sand is also in heavy dispute. An Amicus brief filed by The Association of Gospel Rescue Missions (AGRM) contests that “the Mandate unilaterally re-defined most religious employers to be non-religious employers [such that…only] churches, their integrated auxiliaries, conventions or associations of churches, or religious orders’ exclusively religious activities fall within the Mandate’s exemption.”

The brief filed by the CAC, however, notes that the separation of corporations into “ecclesiastical and lay” has been distinct since the founding era, with the former defined as “’those of which not only the members are spiritual persons, but of which the object of the institution is also spiritual.’” (from Stewart Kyd’s A Treatise on the Law of Corporations, 1793). For instance, business corporations (even those with institutionalized actions accordant with Christian principles) are not exempt from federal anti-discrimination laws, unlike religious institutions. Between this and the complete lack of legal precedent for businesses to be granted rights under the Free Exercise clause of the First Amendment, it seems that the ACA mandate does not in fact “unilaterally re-define” what a religious employer is.

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Businesses should not be expected to have to cover abortifacients.

This is perhaps the biggest misperception in this entire case. Allow me to set the record straight. This lawsuit does not involve abortifacients. None of the contraceptives in dispute can end an existing pregnancy.

The main issue at stake here is where Hobby Lobby’s business owners’ beliefs clash with existing medical definitions. Medically, a pregnancy is taken to extend from implantation to birth. Although difficult to determine, estimates of the number of embryos lost pre-implantation without contraception range from half to between 60%-80%. Contraceptives that prevent a fertilized egg from implanting are not, therefore, abortifacients, a term defined by drugs that can disrupt the uterine lining already containing a fertilized embryo. None of the contraceptives at dispute in this lawsuit are capable of this.  A major problem in the depiction of this case in the media is the conflation of the Greens’ beliefs about when pregnancy begins with when pregnancy actually begins.

This is a problem that extends even to the case’s legal treatment. While the Brief for Respondents is sometimes careful to differentiate between abortion and “what [the Greens] believe to be an abortion,” both it and the brief filed by the AGRM inaccurately label the contraceptives as abortifacients multiple times. Unfortunately, whether something is an abortifacient or not is not an opinion, but a medical fact. Labeling contraceptives as abortifacients in court proceedings inappropriately extends a religious belief to a redefinition of a medical term, and in the process fuels politically and emotionally charged misconceptions surrounding this case.

However, even by the Greens’ incorrect definition of what they feel to be abortifacients, only one of the two forms of IUD they oppose covering can even prevent implantation. Emergency contraceptives (as well as the levonorgestrel-releasing IUD), which the company also opposes covering, cannot prevent implantation. The FDA’s product label for emergency contraception (used by Hobby Lobby’s defense to justify their opposition to covering it) was approved in—and has not been updated since—1999, and included a list of possible mechanisms by which the contraception was thought to work before it was fully investigated. Since then, however, strong and repeated evidence has shown that emergency contraception only works by preventing ovulation; for already-fertilized eggs, it has no effect whatsoever.

The evidence is so strong, in fact, that the International Federation of Gynecology and Obstetrics has issued the definitive statement that Plan B’s active ingredient (levonorgestrel, or LN)”do[es] not inhibit implantation.” The other form of emergency contraception (commonly known as Ella), which uses ulipristal acetate rather than LN as an active ingredient, also cannot prevent implantation.

Likewise, the hormonal LN-IUD cannot prevent or disrupt implantation, but rather prevents sperm from reaching eggs and may also inhibit ovulation.  Even the copper IUD does not work primarily by preventing implantation; its primary mechanism is spermicidal. However, some evidence does suggest it can prevent implantation when inserted as a form of emergency contraception.

While the argument over whether emergency contraception and IUDs are “abortifacients” is irrelevant to other challenges to the birth control mandate by businesses which oppose coverage of all forms of birth control, it’s important to note that Hobby Lobby’s arguments aren’t even factually based. They are so wrong, in fact, that three of the four types of contraceptives Hobby Lobby opposes covering don’t even work in a way that could even justify its objection! Essentially, Hobby Lobby’s opposition to covering emergency contraception relies on both the belief that pregnancy occurs prior to the medical definition of the beginning of pregnancy, and that emergency contraception and the LN-IUD work in a way they don’t actually work.

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Hobby Lobby’s owners would not be preventing employees from getting birth control. They merely wouldn’t cover them under the group plan.

Hobby Lobby supporters point out that employees can obtain birth control on their own, outside the company health plan. They argue that by not providing birth control, the Greens are remaining true to their religious precepts without actually invading their employees’ reproductive freedom. This argument is disingenuous because it incorrectly implies the Green family’s lack of involvement in their employees’ birth control decisions. Far from being the case, explicitly excluding a form of birth control from insurance coverage places the onus of affording it onto employees. Where such excluded birth control is prohibitively expensive for an employee, the company has effectively prohibited the employee from procuring the birth control, not the precise opposite. Lack of “cash on hand” combined with the urgency of procurement may easily limit employee access to OTC Plan B One-Step (average cost is close to $50); exorbitant upfront costs may do the same for IUDs (which cost from around $500 to over $1,000).

Which brings me to…

Hobby Lobby isn’t excluding all forms of birth control. Employees could get a different type of birth control under the group plan still.

This last argument ignores two very important points.

First, the forms of birth control Hobby Lobby would specifically exclude from coverage are two of the most crucial to prevent unwanted pregnancies (and therefore—ironically—abortions).

A 2012 study published in the New England Journal of Medicine, which followed 7,486 women over three years, found that the IUD (along with implants and hormone injections) is twenty times more effective than more popular short-term birth control methods such as the Pill, patch, and vaginal ring because it eliminates human error. Emergency contraception, on the other hand, prevents pregnancy after birth control failure or unprotected sex.

Removing a birth control method from coverage that is massively more effective than the most common method used is extremely counterproductive of the Greens if their stated intent is to reduce abortions. So is removing the only birth control method that may be used after unprotected sex or birth control failure.

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Secondly, and more importantly, as the Amicus brief by the AJC notes, if the courts rule with finality that a corporation has rights under the Free Exercise clause, it would either create a precedent that would allow religious objections by corporations to any extent under the mandate (even beyond these two forms of birth control, or, indeed, beyond birth control whatsoever), or put the justice system in the awkward position of appearing to favor one religion over another (e.g. Protestantism, which opposes emergency contraception as the Greens do, over Catholicism, which opposes all contraceptives and sterilization procedures).

In the former case, a decision that corporations can exercise religion would create precedent for Jehovah’s Witness business owners to refuse to cover blood transfusions or hematopoietic stem cell transplants, for Christian Scientist business owners to refuse to cover any healthcare, for Scientologist business owners to refuse to cover medication or therapy used to treat psychological illnesses, etc.

When I have brought up this point before, the most common argument I have encountered can be paraphrased by: “It’s different. Medicine that has to do with the beginning of life, especially that terminating life, is very different from life-saving medical treatments.” Again, this argument inaccurately conflates beliefs about how these forms of contraception work with how they actually work, as they are not abortifacients.

But far more importantly, it loses sight of the fact that it is only the purview of the justice system to determine whether a corporation has religious rights under the Free Exercise clause, not to make ethical judgments about the relative morality of the decisions it would make if it did. In fact, if businesses have a right to freely exercise religion, then preventing business owners of other faiths than the Greens from refusing to cover other forms of medical treatment they disapprove of for religious reasons (including any treatments that have nothing to do with birth control), would actually directly infringe on their rights.

It seems that the support of people who think the Greens should be able to refuse birth control coverage for religious reasons only extends to coverage exemptions their views just happen to agree with. But extend the religious right of businesses to refuse coverage for treatments most people don’t oppose (like, say, blood transfusions) and suddenly many Hobby Lobby supporters are going to be much less enthusiastic about the consequences of this case, if Hobby Lobby wins it.

 

Misunderstanding abounds in the discussion of the Hobby Lobby v Sebelius case. While Hobby Lobby supporters have portrayed the challenge to the birth control mandate as a crusade for individual religious rights, they ignore the complete lack of precedent for granting secular businesses religious rights as well as the precedent treating people acting as corporate agents differently than as individuals.  When they appeal to the emotions of people who oppose abortion by re-defining Plan B and IUDs as “abortifacients,” they demonstrate that they feel their beliefs trump facts. And when they claim that refusing to cover birth control is somehow “different” than refusing to cover any other medical treatment for religious reasons, they appear unaware of the actual implications of this case. A judgment in favor of Hobby Lobby would set a very dangerous precedent: it would empower corporations to mandate their beliefs, while simultaneously ruling that those beliefs trump medical facts, even when used to make decisions about medical coverage.

 

Sources:

1) The FreedomOutpost article “Hobby Lobby Case against Obamacare is About Rights, not Contraceptives.” http://freedomoutpost.com/2013/12/hobby-lobby-case-obamacare-rights-contraceptives/

2) SCOTUSblog, Sebelius v. Hobby Lobby Stores, Inc. http://www.scotusblog.com/case-files/cases/sebelius-v-hobby-lobby-stores-inc/

3) Amicus Curiae brief on behalf of the Constitutional Accountability Center: http://sblog.s3.amazonaws.com/wp-content/uploads/2013/10/13-354-Amicus-OK-TO-PRINT.pdf

4) Amicus Curiae brief on behalf of 11 professional medical organizations including ACOG, Physicians for Reproductive Health, and the American Medical Women’s Association: http://sblog.s3.amazonaws.com/wp-content/uploads/2013/10/13-354-BRIEF-OF-AMICI-CURIAE-PHYSICIANS-FOR-REPRODUCTIVE-HEALTH-et-al….pdf

5) Amicus Curiae brief of the American Jewish Committee: http://sblog.s3.amazonaws.com/wp-content/uploads/2013/11/13-354-13-356-Brief-of-Amicus-Curiae-American-Jewish-Committee.pdf

6) Third Circuit opinion on the Conestoga v Sebelius case: http://www2.ca3.uscourts.gov/opinarch/131144p.pdf 

7) Sixth Circuit opinion on the Autocam Corp. v Sebelius case: http://www.ca6.uscourts.gov/opinions.pdf/13a0278p-06.pdf

8) Tenth Circuit opinion on Hobby Lobby v. Sebelius:  http://www.ca10.uscourts.gov/opinions/12/12-6294.pdf 

9) “The Good Egg,” a 2004 Discover article on the beginning of pregnancy: http://discovermagazine.com/2004/may/cover#.UrSsaGiARUQ

10) Durand, et al. “On the mechnaisms of action of short-term levonorgestrel administration in emergency contraception.” http://www.ncbi.nlm.nih.gov/pubmed/11747872

11) International Federation of Gynecology and Obstetrics Statement on Mechanism of Action of LN-EC: http://www.cngof.asso.fr/D_TELE/081022FIGO.pdf

12) “What Birth Control Works Best? (Hint: It’s Not The Pill)” http://healthland.time.com/2012/05/24/iuds-and-implants-beat-the-pill-in-preventing-pregnancy/

13) Winner, et al. “Effectiveness of Long-Acting Reversible Contraception,” New England Journal of Medicine. http://www.nejm.org/doi/full/10.1056/NEJMoa1110855

14) On the Religious Freedom Restoration Act of 1993: http://www.justice.gov/jmd/ls/legislative_histories/pl103-141/pl103-141.html

15) Human Reproduction Update, “Intrauterine devices and intrauterine systems” http://humupd.oxfordjournals.org/content/14/3/197.abstract 

16) First National Bank of Boston v. Bellotti: http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=US&vol=435&invol=765

Abortion Rights Sebelius

Abortion Rights Sebelius

The pro-choice groups are understandably up in arms over HHS Secretary Kathleen Sebelius’ decision to overrule the FDA and prohibit the “morning after pill” from being available over the counter to minors.  By now, they have issued their press releases condemning the action and personally castigating President Obama.   Some groups, like Physicians for Reproductive Choice and Health have been particularly aggressive, which is part of their relatively new effort to convince others that they are now a leading advocacy organization (i.e., “please send us money because we’re really fighting for you”).  But I digress.

The day after the decision the President – the pro-choice president – said that he agreed with Sebelius, expressing concern that a young girl might not use the medication properly.  Suddenly, he was the Father in Chief, clearly thinking about thirteen year old daughter, Malia.

Morning After Pill?

Morning After Pill?

I am going to assume that Obama knew what Sibelius wanted to do.  I mean, c’mon folks, do you really think that she would make that kind of decision without discussing it with the President?  So, if you accept the assumption that they discussed it before hand, the question then becomes was Obama’s decision to support Sibelius based on science or politics?

Actually, that question is too simple.  It suggests that the President or any other politician only examines an issue from one perspective.  But the President (and some of those other politicians) is actually a smart guy and he can analyze an issue from several perspectives.  Heck, he does it all the time.

Abortion Rights

Abortion Rights

From the substantive point of view, he is a father first.  He’s got two young daughters who may soon be having sexual thoughts.  And Obama clearly had to be thinking about the possibility (although highly unlikely) of his daughters going down the drugstore one day to get a box of these pills.  Then, he must have envisioned them in a state of panic taking the wrong dosage or not being physically capable of taking the drug.  He must have projected his fatherly perspective to the thousands and thousands of other fathers (and mothers) who might ultimately be in the same situation.

Then there was the political side of the issue.  It’s no secret that it will be a tough re-election and he has to woo a number of interest groups, including the Catholics and independents.  The problem is that many, if not most, Catholics believe these pills cause an abortion.  Now, if they really thought it through, versus simply taking marching orders from a virgin Pope, they would realize that the pills actually prevent an abortion on a developing fetus.  But that’s another story.  Meanwhile, Obama must have dreamt about the commercials from Newt or Mitt painting him as promoting promiscuity among little teenage girls (cue the dark foreboding music).

Continuing his political analysis, there is his relationship with the pro-choice groups, which has been somewhat strained because of the health care “surrender” and a few other issues.  He certainly knew that he would piss them off if he supported the Secretary’s decision, but he is also smart enough to know that the pro-choice groups have no place to go.  Let’s face it, they cannot support someone who wants to reverse Roe v. Wade, so pro-choicers would have to at least vote for him.  The calculated risk he took was whether or not he would make them less enthusiastic about his campaign?  Would they withhold money from him, not work on the campaign, not run independent commercials like they did in 2008?  He probably concluded what I would have concluded:  that when they hear the Republican nominee talking about banning abortion and the polls are a dead heat, they’ll forget this little tussle and will jump on the bandwagon.

His position on this controversial issue is risky and it’s hard to say whether substance or politics ruled the day.  But we need Obama to be re-elected so, as much as I hate to say it, I think he made the right decision.

Ugh.

Empty Press Conference Room

About a year after we formed the National Coalition of Abortion Providers, its members decided it was time to hold their first conference.  For years, many of them had been attending regular conferences hosted by the National Abortion Federation but some of the NCAP members were not members of NAF and the NAF meetings tended to focus on the medical side of the abortion issue.   The folks who belonged to NCAP believed strongly in having a political voice on Capitol Hill.  They argued that while NARAL was focusing on the general right to abortion, they needed someone to educate the Congress on the issues of direct importance to abortion doctors and clinics.

So, we booked the new Hilton Hotel in Alexandria, Virginia, put out the suggested agenda and kept our fingers crossed.  Like anyone

who is putting on a party, we were very nervous that no one would show up.  But, much to our surprise, about 70 clinic staff, owners and doctors came to Alexandria for the two day affair.  Two of the attendees were Doctors George Tiller and Bart Slepian, who both would ultimately be murdered by pro-life activists.

To highlight how NCAP was already establishing a presence on Capitol Hill, we persuaded Virginia Congressman Jim Moran, a leader of the pro-choice movement, to kick off the event.  Jim gave a rousing speech to a crowd of people, many of whom had never even met a real live Congressman.  The next few hours were devoted to public relations and business issues.  For example, we discussed how to conduct an “open house” for abortion clinics and where to get the best malpractice insurance.

The highlight of the meeting, however, was the adoption of NCAP’s first resolution.  At that time, the clinics were under siege legislatively on both the national and state levels.  It seemed that every day a bill was introduced requiring parental consent for minors, a 24 hour waiting period, the distribution of fetal development brochures, etc.  At one point, however, an NCAP member suggested that those who were introducing these bills really had no idea how clinics opera

Proud Providers

ted to begin with and how women approached the decision.  So, the members decided to adopt a statement which made it very clear how clinics operated and how patients were treated.  So, for example, they noted that 95% of minors already talked to their parent or parents, that women DID wait at least 24 hours from the time they decided to have an abortion and that the clinics were already subject to many federal and state regulations.

The resolution was adopted unanimously and we decided to have a press conference on Capitol Hill the next day.  We quickly hired a public relations firm to get the word out.  Besides the resolution, their pitch was that this would be a

chance for the press to see in person the owners, doctors and staff who actually worked in abortion clinics.  This was a “coming out party” of sorts for our folks.

The next day, about 30 members of NCAP, all dressed up in their best Capitol Hill attire, took taxis to the House Cannon Office Building and walked into the ornate Post Office and Civil Service Committee Room, ready to conduct their press conference.  But as we walked through the large mahogany doors, we entered an empty room.  Not one member of the press showed up.  We had given a press conference and no one came.  I was totally ticked off but the NCAP members were just thrilled to be in the room and when a young media student from Georgetown University came walking in with his little camera, they agreed to stand behind the podium and make their statements.

To this day, I’ll never forget them standing there, facing that one camera, looking very proud that they had adopted this resolution and were finally showing their faces to the public.  It was just one camera but for all they knew, they could have been talking to CNN.

Yellow Pages Search "The Old Days"

Once a woman decides to have an abortion, the next step is to find a facility in her area that actually can perform the abortion.  In years past, most women would go to their closet, get out the Yellow Pages and let their fingers do the walking to the “Abortion” category.  Once there, she would see a number of ads placed by the clinics.

What a lot of women didn’t realize, however, was that a number of the ads were actually placed by anti-abortion facilities or “crisis pregnancy centers.”  The ads were slick, never really saying whether or not they performed abortions.  The goal was to try to get unsuspecting women to come to their facility where they would then try to dissuade them, often using hard-handed and questionable “information” to do so.  The abuses are pretty well documented.  Indeed, once these “phony abortion clinics” were exposed, the Yellow Page Association was forced to create a new separate category entitled “Abortion Alternatives” for anti-abortion facilities.  I am intimately aware of the course of these events because I was on the staff of the National Coalition of Abortion Providers at the time – the organization that spearheaded the effort to make sure women knew exactly who they were calling.

Today, most patients do not go to the Yellow Pages for abortion services.  Heck, they don’t go to the Yellow Pages for anything anymore.  Instead, they go to Al Gore’s Internet.  And now, the problem of sketchy advertising is rearing its ugly head again.

A woman who has decided to have an abortion will probably do a Google Search for “abortion” or “abortion services” or “abortion clinics.”  If she were interested in getting the pro-life perspective, she might search for “pro-life” or “anti-abortion information” or words to that effect.  But if she wants the abortion, she will do her search, get to that page and immediately sees a number of ads listed in the “sponsored links” section.  That means those facilities are actually paying Google to be advertised in those prominent positions.  And, lo and behold, included in some of the sponsored links are some anti-abortion crisis pregnancy centers!  Then, when you click into their ad and get to their website, it’s the same old story.  They use phrases like “abortion counseling,” “abortion stories,” and “abortion information.”  I searched and searched and found nothing that says “we are anti-abortion.”

Now, I get that the cpcs could argue that they are in fact providing “abortion information” or “counseling.”  But I think the more honest approach would be to say you are providing “anti-abortion counseling.”   Also, I’m sure the pro-lifers who read my world famous blog will come up with examples of how the advertising for the clinics can be “deceptive.”  Indeed, if you DO have examples let us know and we’d be happy to respond.

The point is why do folks play such games with women who are in very emotionally sensitive situations?  Why not be totally up front about what you want to offer?  Then let the women make up their minds if they want to utilize your services.   Meanwhile, I think it would very interesting if someone (perhaps those that manage www.abortion.com) sent an inquiry to the folks at Google and the other search engines asking them to devise something like the Yellow Page folks did years ago so the Internet advertising was just a little more “honest.”

Don’t the women deserve that much?

Abortion Clinic Bombed

I was talking to an old friend of mine yesterday, a doctor who used to perform abortions in the Midwest years ago.  He retired in 2004 and in the course of the conversation we started talking about, as he put it, the “wild west days” when the bullets were flying and the bombs exploding at abortion clinics all across the country.  He then expressed his concern that the younger activists do not remember or just simply did not know what was going on in this country at that time.

As a staff person for the National Coalition of Abortion Providers, I was in the middle of it all.  Our office served as one of the “command posts” that sprung into action when the crap hit the fan.  The minute we got the news about a shooting or any other kind of violent act, we would send out an “Emergency Fax” to all of our clinics alerting them about the incident.  The main reason why we did this was to simply let them know that one of their colleagues had been involved in some heinous act and more often than not the other clinics would communicate their concerns and well wishes to their friends who had just joined the growing number of victims of anti-abortion violence.  In essence, we generated a nationwide group hug.

After talking to this doctor, I started to think about the particularly “bad” years and 1997-1998 was a period that really stuck out in my mind.  Yes, by that time several doctors had been murdered and other acts of violence had been committed, but this time period was a particularly bad one:

In January, 1997, a bomb exploded outside an office building in Atlanta that housed an abortion clinic.  Then, an hour later, while the police and rescue workers were still on the scene, another bomb exploded near a trash can. Seven people were injured;

In March, a Molotov cocktail was thrown into the window of Family Planning Associates and an anti-abortion advocate drove his truck through the doors of another clinic in the area.  Two weeks later, four fires were set on the roof of the Mountain Country Women’s Clinic in Montana;

In May, an arsonist drove up to the Lovejoy Surgi-Center, ran a hose from a metal drum containing an unidentified flammable liquid into the clinic and ignited it.  A month later, an incendiary device was thrown through a hole cut into the air conditioning duct on the roof of the West Alabama Women’s Center;

A few months later, a bomb exploded at the New Woman All Women Health Care in Alabama killing an off duty policeman and critically injuring a nurse.  Five months later, in the space of one week there were eight butyric acid attacks on clinics in Florida.  In these cases, the assailant injected the acid into the clinic using a syringe and because of the horrific and noxious smell, the clinics had to be evacuated, washed down and closed for several days.  This incident started a spate of similar attacks over the next few months;

Towards the end of 1998, my good friend, Doctor Barnett Slepian, was murdered in upstate New York when anti-abortion activist James Kopp fired a shot through a window in his house.

This list is, of course, a small sampling of what was going on in those days.  And, as I read this list and recall the people involved, I honestly do get chills.  I can remember the fear, the loss, the insanity and the sense of helplessness that overwhelmed all of us.

Today, there is less violence when compared to those days but that is no consolation.  History can repeat itself and so every so often I intend to write about an incident or two in more detail in the hopes of reminding those coming up behind us of the sacrifices made by the doctors, the staff and others in defending the right to choose abortion.  I also look forward to seeing our friends in the pro-life movement condemning the violence.