Support For Abortion (And Contraception) Remains Strong Among Voters

 

The charts above are from the Navigator Poll -- done between June 4th and 8th of a nationwide sample of 1,000 registered voters, with a 3.1 point margin of error.

Supreme Court Rules Abortion Pill Is Still Legal In All States

In a unanimous ruling, the U.S. Supreme Court overturned lower court rulings that would have banned or restricted the sale of mifepristone (the abortion pill). That means the pill is still legal in all 50 states.

This is a good thing, but it's not time to celebrate yet. The court did NOT rule that women have a right to the pill. They simply ruled that those who filed the case (a group of anti-abortion doctors) did not have standing to bring the case. That means the decision might be different if the case is filed again by someone the court believes does have standing.

The six right-wing justices just avoided the question in this ruling. If actually forced to rule on the legality of the abortion pill, they might vote very differently. And you can be sure the anti-abortion crowd will try again (as many times as they can). It took them 50 years to get Roe vs. Wade overturned, and they will not soon give up on trying to ban the pill. 

And banning mifepristone is just the first step. Many on the right, both in Congress and the Supreme Court, have made it clear they would like to also ban contraception. And IVF (in-vitro fertilization) is also on the chopping block. The Alabama Supreme Court has already made a ruling that stopped IVF in that state. They are not alone. The largest evangelical church has just voted to make opposition to IVF a tenet of their religious organization.

Both the political right and the religious right seem determined to restrict women's rights in this country. The overturning of Roe vs. Wade was just the beginning.  We must be prepared for a long fight on these issues as long as the Republicans have the power to block efforts to make sure women have equal rights.

Fortunately, President Biden understands this. Here is part of the statement he released about this latest decision of the court:

It does mean that mifepristone, or medication abortion, remains available and approved. Women can continue to access this medication – approved by the FDA as safe and effective more than 20 years ago. 

But let’s be clear: attacks on medication abortion are part of Republican elected officials’ extreme and dangerous agenda to ban abortion nationwide. Since the overturning of Roe v. Wade, Republican elected officials have imposed extreme abortion bans in 21 states, some of which include zero exceptions for rape or incest. Women are being turned away from emergency rooms, or forced to go to court to plead for care that their doctor recommended or to travel hundreds of miles for care. Doctors and nurses are being threatened with jail time, including life in prison, for providing the health care they have been trained to provide. And contraception and IVF are under attack.

The stakes could not be higher for women across America. Vice President Harris and I stand with the vast majority of Americans who support a woman’s right to make deeply personal health care decisions. We will continue to fight to ensure that women in every state get the health care they need and we will continue to call on Congress to restore the protections of Roe v. Wade in federal law — that is our commitment.

Will GOP Go After Contraceptives After Killing Roe?

The following thought-provoking op-ed is by Steve Benen at MSNBC.com:

It was around this time 10 years ago when Republicans targeted the Affordable Care Act in an unexpected way. The Democrats’ landmark health care reform package expanded access to contraception, and as regular readers may recall, a surprising number of GOP lawmakers on Capitol Hill had a problem with that.

In fact, in March 2012, the Senate narrowly defeated a proposal, known as the Blunt Amendment, intended to allow all U.S. employers to deny contraception coverage to employees as part of the businesses’ health plans.

A decade later, the issue is back with a vengeance.

After Justice Samuel Alito’s draft ruling leaked last week, it quickly became clear that Republican-appointed justices on the Supreme Court were likely to overturn Roe v. Wade. The initial focus, naturally, focused on the expected demise of American women’s constitutional right to terminate unwanted pregnancies.

But it wasn’t long before many, including President Joe Biden, started wondering aloud about related effects. If, for example, the right to privacy upon which much of Roe was based no longer exists, what’s to come of marriage equality? And court rulings protecting interracial marriages? And access to birth control?

It was against this backdrop that Mississippi Gov. Tate Reeves faced some good questions yesterday. The Washington Post reported:

Mississippi Gov. Tate Reeves (R) on Sunday refused to rule out the possibility that his state would ban certain forms of contraception, sidestepping questions about what would happen next if Roe v. Wade is overturned.

The Republican governor specifically told CNN’s Jake Tapper that limiting access to contraceptives isn’t what Mississippi policymakers are focused on “at this time.”

Also yesterday, the Mississippi governor talked to NBC News’ Chuck Todd, and the “Meet the Press” host further pressed Reeves on the issue. Todd asked, “You’ve just said that you believe life begins at conception. If there is legislation brought to you to ban contraception, would you sign it?” The governor replied, “Well, I don’t think that’s going to happen in Mississippi.”

The problem for proponents of reproductive health, of course, is that these evasive answers left open the possibility that GOP officials in Mississippi might very well focus on contraception access in the not-too-distant future. The governor could’ve taken the issue off the table, but Reeves didn’t — and by all appearances, he didn’t want to.

The Magnolia State is hardly the only state where this is an issue:

• Republican legislators in Louisiana are working on an abortion ban that would “arguably criminalize in vitro fertilization and forms of birth control.”
• Republican legislators in Idaho are currently weighing new restrictions on some forms of contraception.
• Republican Sen. Marsha Blackburn of Tennessee recently denounced Griswold v. Connecticut, a 1965 case that struck down a state law that restricted married couples’ access to birth control.
• Each of the Republican candidates running for state attorney general in Michigan also denounced the Griswold precedent.
• Blake Masters, a Republican U.S. Senate candidate in Arizona, not only denounced the Griswold precedent, he’s told voters that he’ll only vote to confirm judges who agree with him.

For many years, contraception simply wasn’t a major political issue in the United States. There are plenty of reasons to believe that may soon change.

Trump Is Still Acting Against What The Public Wants

Trump recently overruled Obama's directive that employer-based health plans must contain a provision for free contraceptions. As with most of his actions since being sworn in, that goes against the wishes of a majority of Americans. Americans, by a 19 point margin, think those plans should provide women coverage for contraception.

The chart represents the results of a new Rasmussen Poll -- done between October 12th and 15th of a random national sample of 1,000 likely voters, with a 3 point margin of error.

Teen Pregnancy Rate Drops (But Not Due To Abstinence)

The chart above is from a report in The Journal of Adolescent Health. It shows that since 2007 the rate of both teen pregnancies and teen births have been dropping. That's a good thing, but what's is causing the drop?

Were the "abstinence only" folks right? Is their message finally starting to sink in with teens? NO. The study also found that the percentage of teens having sex has remained constant. The percentage of teens having sex is the same as it was in 2007.

Is the drop in teen births due to more use of abortion? Again NO. It seems that the abortion rate has also been falling.

So, what is causing the drop in teen pregnancies and births? It's exactly what public health officials have been saying for years. It's a wider availability of effective contraceptive methods. If you provide effective contraceptive and teach teens how to use them, the rate of teen pregnancies and teen births will go down.

We shouldn't have needed a study to show us that, since common sense will say the same thing. But for those hard-headed people among us, we now have a scientific study to prove it.

NOTE -- And in a back-handed way the study also shoots down the notion that the wider availability of contraceptive methods will cause more teens to have sex. As reported above, the percentage of teens having sex has remained constant.

The Public Is Split On The "Hobby Lobby" Decision, But Most Think It Will Be Abused By Employers In The Future

Frankly, I am a bit disappointed with the results of this survey by the Kaiser Family Foundation (who usually does among the best polls on health care issues). It seems that Americans are split over whether the recent Supreme Court decision saying Hobby Lobby doesn't have to include the providing of contraception in its employee insurance policies.

The costs for these contraceptives for female employees was not paid for by the company, but by the insurance company (who saves money by including free contraceptives). That means the company is allowed to deny this to their female employees simply because of the religious views of the company owners. I would have hoped that the American people wouldn't want religious views of a company owner to trump the health care of the company's employers -- but sadly, it seems nearly half of the public has been convinced that this is a religious issue.

Making these results even more strange is that while the public is split on whether the "Hobby Lobby" decision was a good one or not, a significant percentage of the public (58%) believes that other employers will seize on this decision and use it to deny other coverages to their employers. How can anyone think this is a good decision, when they are convinced that it will be used to abuse workers in the future?

The Kaiser Health Tracking Poll was taken between July 15th and 21st of a random national sample of 1,507 adults, and has a 3 point margin of error.

Supremes Say Corporate Rights Trumps Women's Rights

In a 5 to 4 vote, the conservatives on the Supreme Court have made a decision that should shame all Americans. They have decided that the religious rights of a corporation are more important than the rights of women who work for that corporation. They ruled that corporations like Hobby Lobby have the right to make sure the insurance they provide for employees doesn't contain anything that would offend the religious beliefs of the corporation's owners -- in this case many kinds of contraception, such as IUD's, the morning after pill, and some types of birth control pills.

The crazy part of this is that the corporation did not have to pay even a penny for that coverage of contraceptives. The insurance companies had taken that expense on themselves (since contraceptive coverage saved them money). But even though they didn't have to pay for that coverage (since their insurance would cost the same with or without contraceptive coverage), the company decided their religious views were offended and demanded that the insurance they provided for employees should not cover contraceptives for women.

I was not really surprised by this decision by the court's right-wingers. The right-wing in America seems determined to keep women as second-class citizens. They deny women the right to control their own bodies, to be paid equally for equal work, and now the right to have contraception covered by their employer-provided health insurance policy. The sad fact is that these same companies who deny contraception coverage are also the companies that pay poverty wages -- so that at least some women will be unable to pay for their own contraception.

The only good thing about this decision is that it doesn't seem to apply to publicly-owned corporations (but only to companies owned by an individual, a family, or a small group). And Hobby Lobby does say there are some forms of contraception they approve of (sponges, some types of pills, etc.) -- but there is nothing in this ruling that would keep them from deciding in the future that no form of contraception meets with their religious approval (or that could be decided by some other company).

This decision also puts health care rights on a slippery slope. If these companies can deny contraception in their policies, can other companies deny other health benefits based on religious beliefs -- like blood transfusions (or in the case of a company owned by a Christian Scientist, any kind of medical care other than prayer)?

This was a very bad court decision, and like the Citizens United decision, needs to be overturned. Courts have made bad decisions in the past (like the infamous Dred Scott decision) that was overturned by a better court. Hopefully this will happen.

Ruth Bader Ginsburg wrote the minority opinion. Here are some excerpts from her opinion:

"The exemption sought by Hobby Lobby and Conestoga would...deny legions of women who do not hold their employers’ beliefs access to contraceptive coverage."

"Religious organizations exist to foster the interests of persons subscribing to the same religious faith. Not so of for-profit corporations. Workers who sustain the operations of those corporations commonly are not drawn from one religious community."

"Any decision to use contraceptives made by a woman covered under Hobby Lobby’s or Conestoga’s plan will not be propelled by the Government, it will be the woman’s autonomous choice, informed by the physician she consults."

"It bears note in this regard that the cost of an IUD is nearly equivalent to a month’s full-time pay for workers earning the minimum wage."

"Would the exemption...extend to employers with religiously grounded objections to blood transfusions (Jehovah’s Witnesses); antidepressants (Scientologists); medications derived from pigs, including anesthesia, intravenous fluids, and pills coated with gelatin (certain Muslims, Jews, and Hindus); and vaccinations[?]...Not much help there for the lower courts bound by today’s decision."

"Approving some religious claims while deeming others unworthy of accommodation could be 'perceived as favoring one religion over another,' the very 'risk the [Constitution's] Establishment Clause was designed to preclude."

"The court, I fear, has ventured into a minefield."

FDA Makes "Plan B" Contraception Cheaper To Buy

The United States is slowly but surely beginning to adopt a more reasonable position on making contraception available to all women in this country. The Affordable Care Act mandates that all insurance policies provide contraception to women free of charge.

That was a good first step, but it did not help women without insurance, or teenagers who need some kind of contraception (but have parents who refuse to provide it). Last April, a federal judge helped to remedy this by ordering that Plan B (commonly called the "morning after" pill) contraceptives be made available over-the-counter at pharmacies -- with no prescription from a doctor needed and no age restrictions on who could buy it.

The Obama administration initially appealed the decision, wanting to restrict those who could buy the contraceptive to those at least 16 years old. But seeing this was a battle he would probably lose in court (and that the position had angered those on both sides of the contraception issue), President Obama changed his position in June of 2013 and agreed to the judge's order.

That was a big step in making contraception easy and accessible for all women. And now the FDA has taken another step -- this time making the easily accessible Plan B contraceptive less expensive to buy. They did this by approving the sale of generic alternatives to the brand name drug. While the brand name Plan B drug costs around $50, the generics will cost between $20 and $35. That may not sound like a big difference to those with plenty of money, but to a poor person or a teenager it is a significant difference.

Now the FDA needs to take the next logical step in making contraceptives easily accessible to all women. They need to make all contraceptives (even oral contraceptives) available over-the-counter (without the need for a doctor's prescription). That is the position of the American College of Obstetricians and Gynecologists, who say these drugs are very safe. There is simply no need to have to pay for an expensive doctor's visit to get contraceptives.

Most Americans, regardless of their position on a woman's right to choose what happens to her own body, would like to see the number of abortions reduced significantly in the United States. That won't be done by trying to ban abortions -- since that will just drive the procedure underground and put women's lives in danger. The only way to do it is to prevent unwanted pregnancies -- and the best way to do that is to make all contraceptives free (or very cheap) and easily & widely accessible to all women who want them. That's not only reasonable, but it's the way a free society should operate.

Abortion Has Decreased Significantly In Last Two Decades

The prestigious Guttmacher Institute has released a new report on abortion in the United States. The report focuses on the years between 1991 and 2011 (the last year for which complete statistics are available). And that report has good news, regardless of which side of the abortion debate one happens to be on.

It seems that since 1991 the number of reported abortions in the United States has decreased -- and not by just a tiny amount. It has decreased significantly -- from about 1.56 million in 1991 to about 1.06 million in 2011. That's a decrease of about 500,000 per year (or about 1/3). And it's not just the number of abortions that has dropped significantly. The rate of abortion has also dropped (from 27.4 per 1,000 women to about 21.2). The report then goes on to examine why this decrease has happened.

I'm sure fundamentalist anti-choice people would like to think the decrease has been to all the new laws that make it more difficult to get an abortion, but that's not what the Guttmacher Institute found. These new laws have done little, since a person needing an abortion will find a way to get one. The new laws have just made it more difficult, more expensive, and more dangerous -- but they are not causing the decrease.

The decrease is mainly due to the wider availability of cheap and effective contraceptives. This makes a lot of sense. Preventing a pregnancy has always been the best way to prevent an abortion. And now that Obamacare has kicked in, requiring insurance companies to provide free contraceptives to those on their rolls, we can expect the abortion numbers to fall even further.

The makes it clear why the national organization representing obstetricians and gynecologists has recommended that contraceptives be sold over the counter to women without any age restrictions. They know these drugs and methods of preventing pregnancies are both safe and the best way to prevent abortions.

And it also makes the stance taken by many fundamentalists to make no sense at all. They oppose both abortion and contraception (the best way to prevent abortions). One would think if they truly opposed abortions, they would happily support making contraceptives widely available and affordable for all women. The fact they they oppose both means they are just promoting their own religious views, and consider those religious views more important than preventing abortions. Instead they just want to make abortions illegal -- a religious stance that has been shown throughout history to be ineffective in preventing abortions, and only makes the procedure much more dangerous for women.

13 States Get An "F" In Reproductive Health And Rights

The map above is by the Population Institute in Washington, D.C.

For the second year, the Population Institute has issued a report that grades the country and the individual states on reproductive health and rights (using research information gathered by the Guttmacher Institute, the Kaiser Family Foundation, Planned Parenthood Federation of America, and others).

The United States as a whole received a grade of C-, mainly because of the large number of unplanned pregnancies (about half of all pregnancies in U.S.), the possibility that reproductive health gains could be reversed as social conservatives gain power, and the threat of funding cuts & burdensome regulations to family planning clinics. That's not a grade to be real proud of, but at least it's not a failing grade.

But the same cannot be said of the individual states. While some have respectable scores (those above in blue and green), others get poor to mediocre scores (those in yellow and orange), and too many get a failing grade (those in red on the map).

How were these grades arrived at? The Population used research to grade the states on nine different criteria. These criteria (and the maximum points that can be earned in each) are:

1. A low rate of teenage pregnancy (15 points maximum)
   
2. A low rate of unintended pregnancy (15 points maximum)
   
3. Comprehensive sex education in the schools (15 points maximum)
   
4. Access to emergency contraception in the emergency room (5 points maximum)
   
5. Medicaid expansion under the Affordable Care Act (10 points maximum)
   
6. A Medicaid “waiver” expanding eligibility for family planning services (10 points maximum)
   
7. Adequate state funding for family planning clinics serving low-income households, measured by dollars of assistance per woman in need (10 points maximum)
   
8. An absence of burdensome abortion restrictions (10 points maximum)
   
9. County-level access to family planning and abortion services (10 points maximum) 
   

There were 13 states that received a failing grade (an F). These are the states where fundamentalists and other social conservatives have a lot of power -- those who think women should be happy with a second-class citizenship status. Here are those states (and their grades, out of a possible 100 points):

Georgia..........43.8
Idaho..........43.0
Indiana..........38.6
Kansas..........37.0
Louisiana..........37.6
Mississippi..........34.8
Missouri..........43.8
Nebraska..........41.3
South Dakota..........37.0
Tennessee..........41.7
Texas..........41.3
Utah..........44.0
Wyoming..........40.1

On the other end of the spectrum, several states are doing pretty well. The following states have received either an A (80 to 100) or a B (65 to 79):

California..........87.2 (A)
Maryland..........80.9 (A)
Oregon..........90.0 (A)
Washington..........84.1 (A)

Connecticut..........75.2 (B)
Delaware..........74.7 (B)
Illinois..........69.7 (B)
Iowa..........65.0 (B)
New Jersey..........79.6 (B)
New Mexico..........78.1 (B)
New York..........77.1 (B)
North Carolina..........65.0 (B)
Ohio..........66.3 (B)
Rhode Island..........68.3 (B)
South Carolina..........65.2 (B)
Vermont..........78.0 (B)
West Virginia..........66.1 (B)

And then there are those states in the middle. Their scores are certainly nothing to brag about, but they aren't as bad as the 13 failing states either. The states scoring a C (55 to 64) or a D (46 to 54) are :

Arizona..........55.9 (C)
Colorado..........61.1 (C)
District of Columbia..........63.9 (C)
Hawaii..........62.3 (C)
Maine..........62.3 (C)
Massachusetts..........64.6 (C)
Michigan..........58.6 (C)
Minnesota..........63.7 (C)
Wisconsin..........61.0 (C)

Alabama..........46.3 (D)
Alaska..........47.5 (D)
Arkansas..........54.3 (D)
Florida..........46.4 (D)
Kentucky..........54.3 (D)
Montana..........51.0 (D)
Nevada..........51.7 (D)
New Hampshire..........51.0 (D)
North Dakota..........46.6 (D)
Oklahoma..........54.5 (D)
Pennsylvania..........48.3 (D)
Virginia..........51.9 (D)

Maybe I have too high a standard, but I don't find any of these 51 scores to be acceptable (but I do give the states with an A credit for trying hard). They should all be 100. Anything less than that shows at least some lack of respect for reproductive health and rights -- and therefore for women's rights (since reproductive health rights, along with voting and property rights, have been the biggest boon for women's rights in our country's history). We must do better.

An Oklahoma Republican Speaks The Truth

As regular readers of this blog will know, I seldom have anything good to say about today's Republican Party. That's because they seem to have abandoned their conservative principles in favor of a mean-spirited ideology -- an ideology that puts right-wing religious fundamentalism above common sense solutions to this country's problems.

But every now and then, a Republican will surprise me by actually seeing and speaking the truth -- and when they do, I feel an obligation to point it out. One of those Republicans is Oklahoma State Rep. Doug Cox. I probably will disagree with Rep. Cox on many issues, but on the issue of contraceptives we are in agreement (an issue he should be familiar with since he is a practicing physician).

Rep. Cox wrote the following in The Oklahoman on May 29th of this year:

All of the new Oklahoma laws aimed at limiting abortion and contraception are great for the Republican family that lives in a gingerbread house with a two-car garage, two planned kids and a dog. In the real world, they are less than perfect.

As a practicing physician (who never has or will perform an abortion), I deal with the real world. In the real world, 15- and 16-year-olds get pregnant (sadly, 12-, 13- and 14-year-olds do also). In the real world, 62 percent of women ages 20 to 24 who give birth are unmarried. And in the world I work and live in, an unplanned pregnancy can throw up a real roadblock on a woman's path to escaping the shackles of poverty.

Yet I cannot convince my Republican colleagues that one of the best ways to eliminate abortions is to ensure access to contraception. A recent attempt by my fellow lawmakers to prevent Medicaid dollars from covering the “morning after” pill is a case in point. Denying access to this important contraceptive is a sure way to increase legal and back-alley abortions. Moreover, such a law would discriminate against low-income women who depend on Medicaid for their health care.

But wait, some lawmakers want to go even further and limit everyone's access to birth control by allowing pharmacists to refuse to fill prescriptions for contraception.

What happened to the Republican Party that I joined? The party where conservative presidential candidate Barry Goldwater felt women should have the right to control their own destiny? The party where President Ronald Reagan said a poor person showing up in the emergency room deserved needed treatment regardless of ability to pay? What happened to the Republican Party that felt government should not overregulate people until (as we say in Oklahoma) “you have walked a mile in their moccasins”?

Dr. Cox is right. The best (and probably the only) way to reduce or eliminate the number of abortions is to make contraceptives easily available to all women. And I believe this should be done at no cost and without any age restrictions (as recommended by the American College of Obstetricians and Gynecologists).

It simply makes no sense to be against both contraceptives and abortion -- since the one is the solution for the other. Those who are against both don't really have the health and well-being of women in mind. They are just trying to shove their own religious view on their fellow Americans -- a view that women should be kept in a second-class status in this country.

I can understand the desire of many to reduce or eliminate abortions -- but the way to do that is not to criminalize abortions. It is to make contraceptives free and easy for all women to access -- and to educate Americans on their proper use, starting in our schools.

I applaud State Rep. Doug Cox for speaking the truth on this issue.

Obama Offers Final "Compromise" On Free Birth Control For Women

A few months ago, the Obama administration issued a ruling that said insurance companies must offer and pay for all of the cost of contraceptives for women covered by their policies. The insurance companies didn't object to this rule, because that was cheaper for them to do than pay for a bunch of unwanted pregnancies. But some faith-based groups did object -- seeing an opportunity to try and embarrass the president (while denying free and easy access to contraceptives to their employees). They quickly claimed that the new rule violated their religious rights, since they opposed the use of birth control.

It was always a silly argument. None of these groups was going to have to pay a penny for the free contraceptives for their employees (since all of the cost was to be absorbed by the insurance companies). And none of these groups has the right to make health care choices for their employees, regardless of any religious views. Fortunately, the Obama administration has refused to back down.

But they have made some paperwork changes on the requirement in a final "compromise" offer. This final offer says if a group notifies its insurance carrier that they oppose birth control being included in their policies, then the insurance companies will provide those employees with a free additional policy that will pay for the birth control. Kathleen Sebelius, Secretary of Health and Human Services, said:

“Today’s announcement reinforces our commitment to respect the concerns of houses of worship and other non-profit religious organizations that object to contraceptive coverage, while helping to ensure that women get the care they need, regardless of where they work." 

This is an extremely reasonable effort by the Obama administration. It lets the ridiculous religious nuts save face, while still providing free and easy access to birth control for any of their employees who want it. But I'm sure some of those groups will still oppose it, since I think their opposition was more political (and misogynistic) than religious anyway.

I commend the Obama administration for this "compromise". It was the right thing to do (to not back down on this important issue). Misogynistic religious views should never be allowed to trump women's health. This was always a health issue -- not a religious issue.

Birth Control Benefits Everyone

This is very true. Birth control has allowed women to take control of their own lives -- and Obamacare has made it cheaper and easier for women to access birth control. Now we need to take the next step, and make oral contraceptives available to all women over-the-counter (without a prescription) like the College of Obstetricians and Gynecologists has recommended. These drugs are not dangerous, and making them available over-the-counter would make it even easier for all women to have access to them.

And there is another benefit not mentioned in the graphic above. Birth control (and medically-accurate education for everyone) eliminates the need for abortions. I have never understood why the anti-choice crowd also oppose birth control. It makes me think they are really anti-woman -- not anti-choice.

Obama Comes To His Senses On Plan B

A couple of months ago, U.S. District Judge Edward R. Korman ordered the government to approve the over-the-counter sale of the Plan B contraceptive (commonly called the "morning after pill") for all women, regardless of age, with no prescription requirement. The judge said that not doing this deprived "the overwhelming majority of women of their right to obtain contraceptives without unjustified and burdensome restrictions".

This was not an unreasonable decision. The American College of Obstetricians and Gynecologists (ACOG) had already declared their support for this view, saying the drug was safe for women of all ages -- and that the threat of an unwanted pregnancy posed a far greater threat to a woman's health than the contraceptive did. In fact, ACOG recommended that all oral contraceptives be made available for over-the-counter sale, without prescription. But the Obama administration didn't have the common sense of ACOG or the political courage displayed by Judge Korman.

The Obama administration instituted a halfway measure (approving over-the-counter sales for women age 16 or older), and appealed the judge's order. Obama said the idea that his daughters could buy the drug made him "uncomfortable". Of course, this middle road made no one happy (except maybe a few die-hard Democrats who support the president no matter what he does). Liberals didn't think the Obama administration had gone far enough, and conservatives thought he had gone too far. It left the president with few friends on either side of the political spectrum on this issue.

And recently, the Obama administration got some more bad news. They learned that the appeals court had refused to stay the judge's order pending the outcome of the appeal -- which meant the appeals court was not likely to rule in favor of the president's position.

So, last Monday the Obama administration reversed its position -- withdrawing the appeal, and sending Judge Korman a letter saying the government would abide by his ruling. Administration spokesmen said the company that makes the Plan B contraceptive had been asked to file an application requesting no age or sales restrictions to the FDA, and said the FDA "will approve it without delay".

This was the right move. Now they need to go further, and approve the over-the-counter sale of all oral contraceptives without age restrictions. I'm sure that would anger most right-wingers, but women's health and rights are more important than keeping the right-wingers happy.

It Doesn't Make Sense

I have never understood why the right-wing could be opposed to all of the four things listed above. It just doesn't make sense. After all, the first three (sex education, Plan B, contraceptives) are the best way to prevent the fourth (abortion).

Plan B Should Be Available For Any Age

A couple of weeks ago, a federal judge in New York ordered that the Plan B contraceptive (commonly called the "morning-after pill") should be available over-the-counter (without any prescription) to all women -- regardless of age. It was no surprise that the GOP howled loudly at the idea, since many of them are opposed to any kind of contraceptive. But the most disappointing thing was the reaction of the Obama administration.

The White House has refused to completely follow the judge's order -- going only halfway. They decreed that Plan B would be available over-the-counter, but only to those 15 years-old or older. Those under 15 will still need their parents permission to buy the drug. This is nothing more than a lack of political courage, since the Plan B drug is very safe.

The judge's decision was not something out of left field -- not was it unreasonable. He simply did what most obstetricians and gynecologists have been recommending for quite a while now. And at the recent convention of the American Congress of Obstetricians & Gynecologists, the doctors once again called for the drug to be made available to everyone over-the-counter. Here are some of their comments:

– Owen Montgomery, MD: “I would much rather have a 13- to 14-year-old girl who needs emergency contraception have access to it than come to my office with an unwanted pregnancy… In our clinics in the university, we see lots and lots of teenagers. And many of these young ladies have no access to good parental role models, and they need access to emergency contraception when they need access. And they can’t wait for permission from a judge, or someone else of authority.”

– Alison Edelman, MD, MPH, of Oregon Health & Science University: “Emergency contraception is a really, really important part of our toolkit for contraception. It helps women who have emergencies, i.e., they aren’t using contraception at the time of sexual activity or they had a misstep with their contraception, like a condom break or slip.”

– Barbara S. Levy, MD, ACOG’s vice president for health policy: “There’s failure of other methods. There are rapes. There are other things that occur. Women need to be able to access emergency contraception and have the knowledge and understanding of how to use it, so we can prevent unwanted pregnancies and unintended pregnancies that happen, because life happens.”

– Laurie J. McKenzie, MD, of both the University of Texas and Baylor College of Medicine: “I find it very interesting that there are these concessions that are being made in terms of age limitation … There are more deaths associated with Tylenol overdose than there are with oral contraceptive overdoses or potential overdose with Plan B. There have never, to my knowledge, been any overdoses with hormonal contraception.”

– Eve Espey, MD, MPH, of the University of New Mexico in Albuquerque: “Plan B should be over the counter… All emergency contraceptives should be over the counter with no age restrictions.”

Judge Removes Restrictions On Plan B

Last year, the American College of Obstetricians and Gynecologists (ACOG) issued a report recommending that oral contraceptives be made available to women over-the-counter (without a prescription). They declared the drug was safe enough, and making it available over-the-counter would make it available to more women. Now it looks like the first step toward  achieving that has finally been taken, at least for one type of contraceptive -- the Plan B contraceptive (more commonly called the "morning-after pill").

A federal judge in New York has ordered Plan B to be sold over-the-counter (beginning in 30 days), and has removed any age restrictions on the drug. In other words, he has ordered the drug to be available without prescription for any female old enough to be able to get pregnant. Here is how this landmark decision is described in an e-mail I got yesterday from WORD (Women Organized to Resist and Defend):

Today, a U.S. federal judge ordered that the Morning-After Pill be made available "without a prescription and without point-of-sale or age restrictions within thirty days."

Judge Edward R. Korman of the U.S. District Court for the Eastern District of New York issued his Memorandum Opinion and Order in Tummino v. Hamburg which reversed a prior decision by the Food and Drug Administration (FDA) and Health and Human Services (HHS).

Judge Korman found that "[t]hese emergency contraceptives would be among the safest drugs sold over-the-counter." 

Citing the Obama administration's "unjustified departures" from established policy to make safe medications available to the public, the court found that the administration invoked arguments that were an "excuse to deprive the overwhelming majority of women of their right to obtain contraceptives without unjustified and burdensome restrictions."

Referring to "political interference" from the White House, the judge stated "the motivation for [Secretary Sebelius'] action was obviously political. ... [I]t was an election year decision that 'many public health experts saw as a politically motivated effort to avoid riling religious groups and others opposed to making birth control available to girls.'" 

And here is a little background on the court fight:

The Partnership for Civil Justice Fund (PCJF) represents grassroots feminists activists with National Women’s Liberation (NWL) and 15 year-old Anaya Kelly in Tummino v. Hamburg, the lawsuit against the Food and Drug Administration and Health and Human Services to remove all restrictions on over-the-counter access to the Morning-After Pill (also known as Plan B One-Step or “emergency contraception”) for all women and girls in the United States. As of the court’s ruling today, emergency contraception was kept behind a counter, only available without a prescription for women age 17 and older, and government issued identification had to be shown to buy it.

The lawsuit, originally filed on January 21, 2005, uncovered evidence that the Bush Administration pressured FDA review staff to enact an age limit on the pill for political reasons. On March 23, 2009, the Court ruled that the FDA “acted in bad faith and in response to political pressure,” “departed in significant ways from the agency’s normal procedures,” and engaged in “repeated and unreasonable delays.” The Court ordered the FDA to make Plan B available over-the-counter without a prescription to 17 year olds (the drug was previously limited to women ages 18 and up). The Court also ruled that the FDA had to reconsider whether to approve a Citizen Petition, filed by women’s health and reproductive rights organizations in 2001, asking for unrestricted over-the-counter status for women and girls of all ages.

In December 2011, the FDA finally decided to eliminate the unnecessary age restriction, but in an unprecedented move, HHS blocked the change with President Obama’s support. The FDA then denied the Citizen Petition. On February 8, 2012, Plaintiffs moved to re-open the case, added HHS Secretary Kathleen Sebelius as a Defendant and filed a motion for preliminary injunction and for summary judgment. 

Unfortunately, this may not be the end of this fight. The Justice Department is considering an appeal, and that will probably happened since this administration is not known for its political courage (just look at how long they drug their feet on same-sex marriage, waiting until numerous polls showed it to be popular with a majority). They should not fight it any further though, and in fact, should follow the recommendation of the ACOG (the real experts on contraceptives) and make all oral contraceptives available over-the-counter, and without age restrictions. The drugs are safe, and doing so would prevent many unwanted pregnancies (and abortions).

Birth Control

There are a lot of misconceptions about the new directive from President Obama that gives women with health insurance free birth control. Two of the biggest misconceptions are that somehow taxpayers are paying for this, or that employers (especially religious employers) are paying for it. Neither is true. Taxpayers pay nothing, and the employers pay the same as they did before the benefit was specified. The new benefit is paid for by the insurance companies -- and they are happy to do it, because it's a lot cheaper for them than having to pay for a lot of pregnancies (some of them very expensive premature births).

All the president did was talk the insurance companies into doing something for their own benefit. It is not a burden on taxpayers, and it is not a violation of anyone's religious freedom (because no employer is paying any more for their insurance than if the benefit did not exist). And if anyone tells you different, they are either misinformed or they are lying.

Texans Support Obama On Contraception

As I have said before, Texas is a very red state. No Democrat has held an elective statewide office in more than twenty years. And not only are all statewide elected officials right-wing Republicans, both the Senate and the House in the state legislature have large majorities of right-wing Republicans. And while President Obama easily won re-election nationwide, he lost in Texas by 16 points.

All of that might make a person think that Texans would also back the right-wing positions on contraception (that it should be restricted) and oppose President Obama's position (that all women should have easy access to contraception). But a new poll shows that is not true. While Texans seem to love Republican politicians, they don't care much for the positions those politicians have taken on contraception availability. As the chart above shows, Texans generally support President Obama regarding the easy availability of contraceptives.

The chart was made from results of a poll of 604 Texans by Greenberg Quinlan Rosner between February 6th and 11th (with a 3.99 point margin of error). As it shows, nearly 7 out of every 10 Texans believes it is important for all women, even poor women, to have contraceptives easily available to them. And that support cuts across party lines, with even 50% of the state's Republican supporting that (and the figure rises to 56% among Republican women).

That support also cuts across the predominant religious groups in Texas (with all of the majority percentages being well above the margin of error). Here are those numbers:
Catholic...............68%
Protestant...............65%
Evangelical...............60%
Here are some other interesting results from the survey:

PERCENTAGE BELIEVING THERE SHOULD BE STATE-FUNDED FAMILY PLANNING, INCLUDING BIRTH CONTROL, FOR LOW-INCOME WOMEN.
General public...............73%
Catholic...............70%
Protestant...............73%
Evangelical...............66%

PERCENTAGE WHO OPPOSE THE CUTS MADE TO FAMILY PLANNING AND BIRTH CONTROL PROGRAMS BY THE GOP IN THE LAST LEGISLATIVE SESSION.
General public...............57%
Independents...............53%
Democrats..............74%
Democratic women...............84%
Republicans...............49%
Republican women...............59%

DO YOU SUPPORT OR OPPOSE ALLOWING AN EMPLOYER TO DENY COVERAGE FOR CONTRACEPTIVES IN THEIR EMPLOYEE HEALTH CARE PLAN DUE TO THEIR RELIGIOUS BELIEFS?
Support...............40%
Oppose...............56%

DO YOU SUPPORT OR OPPOSE ALLOWING EMPLOYERS TO DENY COVERAGE IN HEALTH PLANS FOR EMERGENCY CONTRACEPTIVES (LIKE PLAN B) ON RELIGIOUS GROUNDS?
Support...............43%
Oppose...............53%

While they might not put it this way, Texans support the president's actions in making contraceptives easily accessible to all women. And they support it even if it takes state funds to provide poor women that benefit. The state GOP is simply out of step with the majority of Texans on this issue.

Over-The-Counter Contraceptives ?

The right-wing fundamentalists in the United States have taken the ridiculous position of opposing the free and easy access to contraceptives for all American women. They claim they are doing this because their religion forbids it, but frankly, it looks more like a move to defend the patriarchy (men's dominance over women) that these people are used to and don't want to give up. They know that effective and available contraception has freed women to an extent never before seen, and has allowed women to pursue the equality they have always deserved.

President Obama has struck a blow for women by requiring insurance companies to provide for free contraception for the women they cover. Now a physicians group that knows more about the medical needs of women than anyone else -- the American College of Obstetricians and Gynecologists (ACOG) -- wants to go even further. They have come out in favor of making oral contraceptives an over-the-counter drug, available without a prescription at any pharmacy.

They say the oral contraceptives are safe enough to be sold over-the-counter, and doing so would help to make them even more available to all women. Currently, they are available only with a check-up and a prescription by a doctor. The only real concern they have is that insurance might stop paying for it, since insurance companies rarely cover over-the-counter medications. That could easily be fixed by the government requiring them to continue paying for it though.

If you would like to read the whole opinion written by ACOG you can go here, but I post a part of that opinion for you to read:

ABSTRACT: Unintended pregnancy remains a major public health problem in the United States. Access and cost issues are common reasons why women either do not use contraception or have gaps in use. A potential way to improve contraceptive access and use, and possibly decrease unintended pregnancy rates, is to allow over-the-counter access to oral contraceptives (OCs). Screening for cervical cancer or sexually transmitted infections is not medically required to provide hormonal contraception. Concerns include payment for pharmacist services, payment for over-the-counter OCs by insurers, and the possibility of pharmacists inappropriately refusing to provide OCs. Weighing the risks versus the benefits based on currently available data, OCs should be available over-the-counter. Women should self-screen for most contraindications to OCs using checklists.

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Unintended pregnancy remains a major public health problem in the United States. Over the past 20 years, the overall rate of unintended pregnancy has not changed and remains unacceptably high, accounting for approximately 50% of all pregnancies (1). The economic burden of unintended pregnancy has been recently estimated to cost taxpayers $11.1 billion dollars each year (2). According to the Institute of Medicine, women with unintended pregnancy are more likely to smoke or drink alcohol during pregnancy, have depression, experience domestic violence, and are less likely to obtain prenatal care or breastfeed. Short interpregnancy intervals have been associated with adverse neonatal outcomes, including low birth weight and prematurity, which increase the chances of children’s health and developmental problems (3).

Many factors contribute to the high rate of unintended pregnancy. Access and cost issues are common reasons why women either do not use contraception or have gaps in use (4). Although oral contraceptives (OCs) are the most widely used reversible method of family planning in the United States (5), OC use is subject to problems with adherence and continuation, often due to logistics or practical issues (6, 7). A potential way to improve contraceptive access and use, and possibly decrease the unintended pregnancy rate, is to allow over-the-counter access to OCs.

Interest in Over-the-Counter Access

A 2004 national telephone survey of 811 women aged 18–44 years found that 68% of women at risk of unintended pregnancy would utilize pharmacy access for OCs, the contraceptive patch, the contraceptive vaginal ring, and emergency contraception. Also, 47% of uninsured women and 40% of low-income women who were not using OCs, the contraceptive patch, or the contraceptive vaginal ring said they would start using those methods if they were available from pharmacies without a prescription (8). In another survey of 1,271 women aged 18–49 years, 60% of women not currently using a highly effective contraceptive method said they would be more likely to use OCs if they were available over-the-counter (9). A national survey of 2,725 pharmacists found that 85% were interested in providing hormonal contraception, with 66% expressing concerns about reimbursement (10).

Safety of Over-the-Counter Medications

No drug or intervention is completely without risk of harm. For example, common nonsteroidal antiinflammatory drugs, such as aspirin, have documented adverse effects, including gastrointestinal bleeding. These effects may occur even at doses used for prophylaxis of cardiovascular disease (11). Additionally, over-the-counter use of acetaminophen is linked to serious liver damage (12). Safety concerns about OCs frequently focus on the increased risk of venous thromboembolism. However, it is important to understand that the rate of venous thromboembolism for OC users is extremely low (3–10.22/10,000 women-years) (13, 14) and to put this risk in context by recognizing the much greater risk of venous thromboembolism during pregnancy (5–20/10,000 women-years) or in the postpartum period (40–65/10,000 women-years) (14). Overall, the consensus is that OC use is safe (15–17).