The CDC recently released a report on sexual experience and birth control use among female teenagers in the United States. The agency used data from the National Survey of Family Growth for 1995, 2002, and 2006-2010 to look at sexual activity and birth control use among girls ages 15-19.
The percentage of teen girls who reported that they had never had vaginal intercourse rose from 48.9% in 1995 to 56.7% in the 2006-2010 period.
Of the girls who had had sex in the month before the interview, 59.8% used a highly effective contraceptive method (IUD or hormonal contraception), 16.3% used a moderately effective method (i.e., condoms alone), 6.1% used a less effective method (withdrawal, rhythm method, cervical cap, diaphragm, etc.). 17.9% did not use any contraception.
There was a trend over time toward more use of the highly effective contraceptives, but racial disparities exist. White teens were more likely than Black or Hispanic teens to use a highly effective contraceptive, and to use a contraceptive at all.
The study is limited somewhat in that the teenagers reported on their own sexual activity and contraceptive use. And since the researchers defined “sexual activity” as only heterosexual vaginal intercourse, the study also doesn’t give us information about overall trends in teen sexual activity.
The editors of the report note that the teen birth rate has also fallen to its lowest rate in several decades, and provide several suggestions for further reducing teen pregnancy, including:
Providing evidence-based sexual and reproductive health education in schools
Connecting teens to reproductive health services
Having health care providers encourage use of highly effective contraceptives along with condoms
Also having health-care professionals provide culturally competent, evidence-based sexual and reproductive health counseling on the importance of correct and consistent use of contraception and a variety of contraceptive methods.
Random note: the Policy Report links to Healthy People 2020 goals for reducing teen pregnancy; I created the PubMed searches for those and other HP2020 family planning objectives. For any objective, click on “View Details” and then on the PubMed search link to find citations in the medical literature about the specific topic.
Native American women are subjected to much higher levels of sexual violence than other women in the United States; the Department of Justice estimates that more than 1 in 3 Native American women will be raped in their lifetime, and they are often denied access to justice.
According to a new report, Native American women are also denied access to emergency contraception through the Indian Health Service (IHS). The report, from the Native American Women’s Health Education Resource Center, includes the personal experiences with sexual assault and the perspectives of women of a diverse number of Tribes. It describes the barriers Native American women face when attempting to access emergency contraception and outlines steps that should be taken in order to provide them with on-demand access to emergency contraception.
According to the organization’s 2009 research:
1) Only 10% of IHS unit pharmacies surveyed have Plan B available over the counter (OTC); 2) 37.5% of pharmacies surveyed offer an alternative form of emergency contraception; and 3) The remaining have no form of EC available at all.
At Change.org, a petition has been created to ask IHS Director Dr. Yvette Roubideaux to issue a directive to all IHS service providers to make emergency contraception available on demand without a prescription or doctor visit to all women 17 or older.
In the report’s introduction, Charon Asetoyer the Center’s director writes:
As the country debates the access to Plan B as an OTC for women 16 years and younger, Native American women 17 years and older have yet to receive access to Plan B as an OTC by their primary health care provider, the Indian Health Service. No one but Native American women are concerned about this denial of service. As Native American women we are the only race of women that is denied this service based on race. To make an exception to a legal form of contraception based on race is not acceptable. To deny a Native American woman access to Plan B as an OTC when every other woman in this country can access it is a denial to a basic health care service, which violates her human rights. It is a direct violation to her sovereign right to make decisions for her own health care, it removes her from the decision making process concerning a potential pregnancy resulting from a rape and puts that responsibility of decision in the hands of a government agency.
Sign the petition to support Native American women’s right to access emergency contraception.
See also: Why Native American Women Are Battling for Plan B – at Colorlines, an interview with Charon Asetoyer. In it, Asetoyer notes that another possible solution is for the Department of Health and Human Services to mandate that all Indian Health Service providers to make Plan B or its generic form available OTC. Contacting HHS on this issue may be another avenue for action.
Our 2009 post on side effects of stopping the injectable birth control Depo-Provera (depot medroxyprogesterone acetate, or DMPA) continues to generate important discussion — more than 100 women have shared their stories of adverse effects after stopping the drug.
Although a quick internet search finds many women complaining of or asking about post-Depo symptoms, there isn’t much published scientific evidence on the topic. Frustratingly, there is really not much new on the topic in the 2 1/2 years since we first posted on this. There don’t appear to be ongoing or upcoming studies on the concerns we’ve heard, either. A few studies here and there report some effects, like how long it took for menstruation to return, how long periods lasted, and how long it took to become pregnant after stopping.
Most of the existing research on women who stop using Depo-Provera seems to focus on bone mineral density. The drug comes with a “black box” warning that it may cause significant bone density losses, although research suggests that it’s possible that these losses may be made up after women stop taking the drug. The Society for Adolescent Medicine has said that “The data from all of these studies [of bone density in adolescent users] are encouraging, although it is unknown whether girls ultimately achieved the same peak bone mass as they would have in the absence of DMPA.” They also suggest that the advantages of preventing pregnancy may outweigh the risk for bone loss, but that patients should be informed of the potential for bone loss. Because of this concern, though, research on what happens when women stop using this birth control method tends to focus on understanding changes in their bone density.
Studies of “discontinuation” of birth control methods also tend to focus on the side effects of taking a drug and the reasons women stop using them, rather than what happens – aside from pregnancies – after they make that decision. It is thought that about half of women who quit Depo in order to get pregnant are able to do so by 10 months later, but that some women have longer waits before they are fertile. According to the drug label, “it is expected that 68% of women who do become pregnant may conceive within 12 months, 83% may conceive within 15 months, and 93% may conceive within 18 months from the last injection.” It also notes, though, that almost 40% of who discontinued the drug to become pregnant could not be followed up on, so they are not represented in those percentages.
What would you like to know about stopping Depo-Provera? What should researchers be examining? If you would like to share your own story of stopping Depo, please add them to the previous post.
Last December, a joint meeting of the FDA’s Reproductive Health Drugs and Drug Safety and Risk Management advisory committees met to discuss the safety of birth control pills containing drospirenone, such as Yasmin and YAZ (both Bayer products). Concerns have been raised about the increased risk from the drugs of venous thromboembolism – blood clots in the legs or that travel to the lungs, which can be fatal.
The committees were asked to consider, among other things, the conflicting evidence on these risks in reported studies, whether the benefits of using drospirenone-containing drugs for pregnancy prevention outweigh the risks, and whether users of these drugs are at an increased risk of clots (VTE) compared to users of other oral contraceptives.
According to the background documents for the advisory committee meeting, the studies funded by the drug company did not find any difference in the risk of VTE between women taking dropsirenone-containing drugs (Yasmin) compared to women taking other combined oral contraceptives.
The FDA funded a separate study combaring Yasmin to other oral contraceptives, and this study did find an increased risk of VTE with Yasmin, especially in women younger than 35 years old. They explain that because of the different designs of the different studies, and because the different results can’t be reconciled just by looking at these different study designs, “none of the studies to date provides a definitive answer” about the safety of drugs like Yasmin in terms of VTE risks.
The FDA also noted that all of the studies examined focused on Yasmin or its equivalent (3 mg drospirenone and .03 mg estrogen), while none of the studies reviewed by the committees examined YAZ (3mg drospirenone and .02 mg estrogen).
Former OBOS board member Pamela Bridgewater testified at the meeting, urging the committee to consider why “the studies that had the closest ties to Bayer show no evidence of an increase in blood clots.” Cindy Pearson of the National Women’s Health Network also testified, asking the agency to “take these more dangerous and no-more-beneficial products off the market, and get back to the arc of history and progress that protects women while supporting their contraceptive choices.”
While the committee members voted 15 to 11 that the benefits of drugs like Yasmin outweigh their risks, the transcript of the meeting provides illuminating comments they made as they voted. Many of those who voted yes said they believed that the risks of unwanted pregnancy are greater, and that the absolute risk of VTE is small. Others, however, expressed concerns about the conflicting data, and suggested that they’d change their vote to no if the standard was how the drug compared to other types of oral contraceptives. Many of the members voting no also expressed concerns that these drugs may be no better and may be more harmful that other oral contraceptives on the market.
For example, Dr. Jacqueline Gardner explained:
I don’t usually vote against choices, but this time I did. And the reason is because on the benefit side, I didn’t see any improved benefit over the existing available choices; and there are so many of them, I believe that as far as oral contraceptives are concerned, women could find alternatives. I don’t see that the alternative to this product is necessarily unintended pregnancy. That’s not the balance, but rather, other safer alternatives. And I, too, believe that when all of the studies are analyzed adequately, that we may find that the risk is even higher, and that translates to a large number of women, in public health terms.
Our Bodies Ourselves has signed onto a letter to FDA Commissioner Margaret Hamburg expressing concerns about the composition of the panel and the focus on comparison of risks and benefits of these oral contraceptives compared to pregnancy, rather than on whether the risks and benefits of drugs like Yasmin outweigh the risks and benefits compared to other oral contraceptives.
Bayer was previously required by the FDA to run corrective ads because their television commercials for the drug were found by the agency to be “misleading because they broaden the drug’s indication, overstate the efficacy of YAZ, and minimize serious risks associated with the use of the drug.” There have also been reports that Bayer previously withheld harms information about Yasmin and blood clots from the FDA.
This week, Garry Trudeau’s Doonesbury strip is taking on abortion, Texas-style – the state’s forced ultrasound bill has taken effect, to much less national attention that that of the recent Virginia forced ultrasound bill.
Because the law requires providers to describe the fetus and play the heartbeat, physicians have indicated that “they almost always must use the transvaginal probe to pick up the heartbeat and describe the fetus in the early stages of pregnancy.”
Trudeau is expected to refer to these non-medical, forced vaginal probes as rape – a sentiment many women have expressed in regard to such bills – and stood up for this position in an interview with The Washington Post:
Texas’s HB-15 isn’t hard to explain: The bill says that in order for a woman to obtain a perfectly legal medical procedure, she is first compelled by law to endure a vaginal probe with a hard, plastic 10-inch wand. The World Health Organization defines rape as “physically forced or otherwise coerced penetration — even if slight — of the vulva or anus, using a penis, other body parts or an object.” You tell me the difference.
Although Doonesbury has a long history of tackling political issues, focusing on abortion was apparently “too much” for some newspapers – the LA Times is moving the strip to the op ed section, and The Oregonian is among the papers that have refused to run it.
The Center for Reproductive Rights is asking supporters to send a quick message of thanks to newspapers who are carrying the abortion-themed installments of the strip, which should run from today through Sunday. The Center has previously filed a lawsuit challenging the Texas requirement.
The strip can be viewed online; today’s installment greets a woman seeking abortion at a Texas clinic, and invites her to wait in the “shaming room,” where “a middle-aged, male state Legislator” will be with her in a moment.
Meanwhile, Texas is expected to lose federal funding to its Medicaid Women’s Health Program which provides family planning and health screening services, because the state has moved to exclude Planned Parenthood from receiving any funding to provide those services.
OBOS has received funding to make blog entries available in Spanish. We hope to expand outreach efforts in the coming year.
Con una votación muy cerrada, 51 a 48 votos, hoy el Senado frenó una medida que permite a los empleadores y compañías de seguro médico negar cobertura para anticonceptivos y otros servicios médicos por cualquier objeción religiosa o moral.
El voto fue una de las enmiendas propuestas por el senador Republicano Roy Blunt de Missouri, quien buscó agregar la cuña política más grande entre un individuo y su doctor. La enmienda hubiera permitido que los empleadores y compañías de seguro nieguen cobertura de “puntos o servicios específicos” si la cobertura fuera “contraria a ciertas creencias religiosas y convicciones morales del patrocinador, emisor, u otra entidad que ofrece el plan.” Así es como se pudo desarrollar la propuesta, y como ésta pudo haber afectado a la comunidad LGBT.
La enmienda se escribió en respuesta al debate sobre el plan del presidente de exigir cobertura, sin copago, por servicios médicos que el Instituto de Medicina categoriza como “preventivos”—incluyendo los anticonceptivos.
Los republicanos obstaculizaron el acuerdo que el Presidente Obama presentó el mes pasado en un esfuerzo por responder a las preocupaciones generadas por la Conferencia de Obispos Católicos de los Estados Unidos. Según ellos, las organizaciones sin fines de lucro afiliadas a la iglesia, como hospitales y universidades, no deberían ser obligadas a proveer cobertura de control de la natalidad a sus empleados—aunque esas organizaciones reciben fondos públicos y emplean personas de todas las religiones. (Iglesias y otras organizaciones explícitamente religiosas ya son eximidas). Al evadir el problema, las compañías de seguro proveerían directamente cobertura de anticonceptivos, lo cual por supuesto, no gustó a los críticos.
De acuerdo a la encuesta de seguimiento hecha pública hoy por la Fundación de la Familia Kaiser, 6 de 10 americanos, incluyendo católicos, apoyan el requisito de que los planes de seguro médico provean servicios anticonceptivos gratuitos como beneficios preventivos para las mujeres.
El debate de hoy fue acalorado; muchos demócratas mostraban frustración, porque a su parecer, el país parece estar atascado en un debate de ya medio siglo sobre el control de la natalidad. El Senador Bernie Sanders de Vermont resumió la cuestión muy bien:
“Este ataque es terriblemente injusto, y espero que los hombres se unan a las mujeres en la lucha para proteger este derecho básico. Déjenme añadir mi fuerte opinión que si el Senado de los Estados Unidos tuviera 83 mujeres y 17 hombres en vez de 83 hombres y 17 mujeres, una propuesta de ley como ésta nunca hubiera llegado al piso.”
Además, algunos Republicanos parecían sorprendidos (¡sorprendidos!) al percatarse que la anticoncepción es considerada parte de los servicios de salud preventiva. Para examinar en profundidad sobre este asunto, lea este artículo escrito por Adam Sonfield que fue publicado en la edición de primavera del 2010 en el Guttmacher Policy Review. Incluimos aquí una sección del mismo:
[...] Healthy People (Gente Saludable) 2010, explica la importancia de la planificación familiar, como servicio preventivo, para controlar los costos sociales, económicos y médicos de los embarazos no planificados. En este contexto, los costo médicos son más notables: “Medicamente, los embarazos no planeados son graves por cuanto se pierde la oportunidad de preparación para un embarazo óptimo; aumenta la posibilidad de enfermedades en el bebé y en la madre, y hay la posibilidad de aborto. Es menos probable que la madre busque cuidado prenatal en el primer trimestre y es más probable que no busque cuidado prenatal en absoluto. Es menos probable que ella amamante a su bebe y es más probable que ella exponga a su bebe a drogas peligrosas, como el tabaco o el alcohol. El niño de este embarazo tiene mayor riesgo de un bajo peso neonatal, de morir en el primer año, de sufrir de abuso, y de no recibir suficientes recursos para un desarrollo saludable.
Los Centros para el Control y la Prevención de Enfermedades mencionan razones parecidas en su trabajo para prevenir los embarazos no planeados y para designar a la planificación familiar como uno de los 10 mejores éxitos del siglo 20. Y por supuesto, hay clara evidencia de que la anticoncepción es un cuidado preventivo efectivo. Así por ejemplo, solo los servicios anticonceptivos y provisiones con fondos públicos ayudan a las mujeres de los Estados Unidos a evitar casi dos millones de embarazos no planeados por año. Sin estos servicios (que se pueden recibir en centros de planificación familiar o de doctores que trabajan con pacientes que reciben ayuda pública “Medicaid”), el nivel de embarazos no planeados, abortos y partos no planeados en los Estados Unidos sería aproximadamente dos-tercios más alto en las mujeres en general, y casi el doble en las mujeres pobres. La evidencia es igualmente clara a nivel internacional: en el 2008, el uso de anticonceptivos modernos ayudó a las mujeres a prevenir 188 millones de embarazos no planeados y, por eso, prevenir 1.2 millones de muertes de bebes recién nacidos, y salvó decenas de millones de años de vida productiva (artículo relacionado, página 12).
Por tanto, no es sorpresa que la panificación familiar es una de las cinco áreas de prioridad enumeradas bajo “servicios preventivos de salud” en el primer número de Healthy People (Gente Saludable) del 1979 y ha sido una de las áreas de enfoque en cada edición siguiente.
Este enlace dirige también a otro excelente artículo, “Planificación Familiar y Maternidad Segura: Dólares y Sentido,” que provee una visión general más global. Para un resumen breve de los importantes beneficios globales, vea el testimonio de la Secretaria del Estado Hillary Clinton de esta semana sobre fondos de los EEUU para la panificación familiar internacional.
Estos son los aspectos sobresalientes del articulo de Clinton: “Los cálculos globales indican que al ayudar a las mujeres a separar sus partos y evitar embarazos no planeados, la planificación familiar tiene el potencial de prevenir el 25% de muertes de madres y bebés en los países en vías de desarrollo. La planificación familiar es la mejor manera que tenemos para prevenir embarazos no planeados y abortos.”
Just when we think Rush Limbaugh couldn’t possibly sink lower, he takes on Georgetown University Law student Sandra Fluke for testifying about the importance of insurance coverage for contraceptives. During his radio show this week, Limbaugh used the most offensive language he can get away with on-air: He called Fluke a slut.
The good news is at least two advertisers so far (Sleep Train and Sleep Number) have pulled their commercials off Limbaugh’s show (a petition is underway to get ProFlowers to do the same). Faculty, administrators and students from Georgetown and other law schools released a statement applauding Fluke’s “strength and grace” in the face of the attacks (really: Fluke is unflappable in every TV appearance, consistently taking the high road). President Obama called Fluke to thank her for speaking out on behalf of women — adding that her parents should be proud.
If Rush Limbaugh slut-shames you, you’re doing something right, because he is pulling out what he imagines to be his most hurtful, vicious, full-barreled defense strategy against a woman. If you call a woman a “slut,” you see, she will cower in a corner and hide because that is akin to calling her ugly, or worthless. At least that’s what small-thinking men (and sometimes women) assume; women would rather die than be dubbed such a thing! Slut-shaming is a tool of cowards who want to make women feel bad because, truthfully, they’re afraid of what those women might do given a platform like, say, the floor of Congress. And this means Limbaugh is not just a bully, but also an über-troll, exploiting his own drummed-up outrage and the Internet’s eagerness to amplify it. Which only makes Sandra Fluke, and all of the thoughtful people out there fighting for women’s contraceptive rights — who, for the record, aren’t resorting to name-calling or troll tractics — look even better.
With the recentfuror over contraceptive coverage, many of us have heard some version of, “But isn’t birth control really cheap and easy to get anyway?”
The reality is much less straightforward. When the Institute of Medicine looked at this issue while deciding whether to recommend that birth control be included among preventive services to be provided at no cost, it noted that while contraceptive coverage has expanded for many with private or federal coverage, many women still do not have insurance coverage or, if they do, their copays for prescriptions may have increased in recent years.
The Institute also cited evidence that even small increases like cost-sharing (requiring patients to pay more) create a barrier to preventive services like birth control. When out-of-pocket costs are reduced or eliminated, however, women are more likely to choose more effective methods of contraception. Testimony from the Guttmacher Institute (pdf) supported the preventive benefits of contraception and described the financial barriers to use.
While women with insurance may have coverage for birth control on paper, the actual costs may still pose a barrier to actually getting it — and probably contributes to half of pregnancies in the United States being unintended.
Jessica Arons of the Center for American Progress has a great piece at RH Reality Check, “The High Costs of Birth Control: A Major Barrier to Access.” Arons presents a number of facts and resources on contraceptive costs and use, explaining that “High costs have forced many women to stop or delay using their preferred method, while others have chosen to depend on less effective methods that are the most affordable.”
And Michelle Andrews at Kaiser Health News writes: “With prices ranging from about $1 for a condom to more than $800 for an intrauterine device (IUD), some of these women, maybe a lot of them, might switch methods if they could afford to.” She continues:
That’s exactly what many women’s health advocates hope. Long-acting methods such as the IUD and the hormonal implant are nearly 100 percent effective, require no effort after insertion and protect against pregnancy for up to 10 years. (In contrast, birth control pills are about 92 percent effective, and many other common methods are even less reliable in everyday use.)
For an estimate of how much a woman could expect to spend on birth control depending on her age, method, and insurance coverage, check out this calculator at Mother Jones.
Plus: Sandra Fluke, the law student at Georgetown University who was blocked from testifying at last week’s hearing on insurance coverage for contraception while five clergymen weighed in, testified today at a hearing the Democrats put together on women’s health. Yet in another move to silence debate, Republicans prevented C-SPAN from televising the hearing.
You know when you’re feverish and you overhear bits and pieces from the news and it all swirls together in headache-fueled song? That’s how I spent a good part of February. I’m still coming to terms with the fact that covering prenatal testing has been called into question, or that Virginia legislators thought it would be cool to mandate transvaginal ultrasounds for women seeking abortions — at least until Gov. Robert McDonnell saw his VP hopes sink lower every time the word “transvaginal” was mentioned (the Virginia House passed an amended bill today requiring external ultrasounds instead).
At one point I assumed Komen must be behind all of this — a PR maneuver to distract from the Planned Parenthood blowback — but that, too, was the fever talking. Reality was far harsher: Republicans had set the cultural clocks back to 1950.
“We need to take sensationalism out of this topic so that it can no longer be used by militants who have no real knowledge of the voluntary nature of the program but, rather, are using it as a political stepping stone,” said George H.W. Bush. “If family planning is anything, it is a public health matter.”
Title X, the law he sponsored that still funds family planning for the poor, passed the House by a vote of 298 to 32. It passed the Senate unanimously. A Republican president, Richard Nixon, enthusiastically signed it.
That was 1970.
Cable news channels played into the time warp, inviting almost twice as many men as women onto news programs to discuss women’s access to contraception — a huge topic thanks to a very small group, the U.S. Conference of Bishops. Jennifer Pozner, executive director of Women in Media and News, gives those media figures some depressing context:
The twitterverse seemed shocked to learn that female experts were sought out as commentators only 38 percent of the time on a story about women’s health. As a media critic, I was surprised, too—because that’s actually a higher percentage of women’s voices than typically heard across all news categories, not just in stories involving women’s bodies.
To understand institutional sexism within the media, look no further than the systematic sidelining of women’s perspectives in corporate news and public affairs programming. Women are a paltry 14 percent of all guests on influential, agenda-setting Sunday morning news shows on ABC, NBC, CBS, FOX and CNN—more than half of whose episodes feature no female guests at all (White House Project). The disparity is just as stark in nightly news, where women are 19 and 27 percent of cable and network news sources, respectively (Pew Project for Excellence in Journalism).
A new report from the Women’s Media Center paints a similarly bleak picture.
I’ve been frustrated, too, by the lack of useful information. Often (mostly) male anchors and guests ruminate over the politics of women’s health without bothering to fact-check the pompous statements and accusations, letting misinformation sit uncontested.
But there are signs of relief. While print/online publications and public radio are doing a better job than television at presenting the facts (see Erika Christakis’s smart column in Time magazine on the birth control debate and the rise of unintended pregnancies, and Irin Carmon’s longer analysis in Salon), TV news has shown some improvement.
In the wake of GOP candidate Rick Santorum’s harmful claims, I was grateful to see Marjorie Greenfield, a professor of obstetrics and gynecology at University Hospitals Medical Group and a longtime contributor to “Our Bodies, Ourselves,” address the importance of insurance coverage for prenatal testing Tuesday on MSNBC. She explained the difference between routine screening tests, such as ultrasounds, and more specific diagnostic tests, such as amniocentesis, which can determine whether a fetus has certain genetic conditions. Most women who are offered amniocentesis are carrying healthy fetuses, she said, so in the vast majority of cases, testing provides reassurance.
Greenfield noted that when she discusses amniocentesis to her patients, some are certain they would terminate a pregnancy if the fetus has a genetic anomaly such as Down Syndrome; others are sure they would not. In the middle are women who don’t have a clear position but who want more information so they can decide, with their families and physicians, the best course of action. Families may turn to support groups or specialists to learn how to prepare for a child with particular health challenges, or, if the genetic anomaly is fatal, arrange for hospice care.
Amniocentesis is expensive, often costing several thousand dollars. If it were not covered by insurance, many women would be unable to obtain the facts they need to make informed decisions.
That brings us to class issues that are rarely discussed, even though the intersections of race, class and gender are unavoidable in most any discussion about women’s health. So let’s cheer for Melissa Harris-Perry, a gifted debater, who is now hosting her own two-hour news program Saturday and Sunday mornings on MSNBC. Harris-Perry made her public intellectual name as frequently the only pundit to complicate solely political horse-race debates by providing a broader social context.
Additionally, Pozner notes that Harris-Perry is “the first black progressive woman to ever solo-host her own news and politics show on a major corporate TV news outlet.” And she isn’t giving up her day job — the Tulane professor is also “the first scholar to teach a full course-load during the week, and grill politicians and pundits on live TV over the weekends.”
This past weekend featured a discussion of gender roles and positions of power in religion and in Congress. Harris-Perry started with a wonderfully nerdy look at how schema affects our attitudes and expectations of who gets to be a leader — and the importance of changing the picture. And it might be good to start with our House — and Senate. Consider: Women comprise only 17 percent of the U.S. Senate and 16.8 percent of the House membership.
Harris-Perry also took on Virginia’s anti-women push — three bills that deal women a losing hand, including the aforementioned transvaginal probes for women seeking to have an abortion; Medicaid restrictions that would force poor women to carry pregnancies to term when the fetus has an incapacitating deformity or mental deficiency; and personhood legislation that could criminalize contraception and outlaw abortion.
There is quite a good amount of organizing going on against these and other attacks on women’s rights and health — including a silent protest this week at the Virginia state capitol and this-just-in news about a march on Washington on April 28.
A number of women’s health groups have formed the Coalition to Protect Women’s Healthcare. It’s new, and it will be interesting to see where it goes. Member groups are organizing visibility events this week at the district offices of members of Congress — especially those who have been promoting religious employer exemptions. You can visit the site for facts about contraception and sign a pledge calling for insurance coverage of birth control, no matter where women work.
Visit Pinterest much? Check out The War on Women page, started by Hello Ladies, for a running catalog of stories and images (love the description: “Ladies, we are under attack. Stay informed. Stay vocal. Run for office.”).
And there’s much needed humor, and not just from the typically awesome Jon Stewart and Stephen Colbert. See The Second City’s Network take on contraception hearings below.
This past week has been an absolute whirlwind of “What the….?!?” with ongoing attempts by Republicans to push back against women’s access to contraception and choice. If you’re catching up now, here’s some good reading:
The Democrats wanted to have one woman testify about the effects on women of lacking access to contraceptive coverage, but Oversight Committee Chair Darrell Issa refused to let her. You can view the intended testimony online.
Pelosi got it right when she asked in frustration: “Five men are testifying on women’s health. Where are the women? Imagine having a panel on women’s health and they don’t have any women on the panel. Duh?”
Santorum supporter Foster Friess told Andrea Mitchell that “back in (his) day,” women put an aspirin between their knees and that worked pretty well for contraception — the implication being that women could just keep their legs together (or feign a headache?). He’s since tried to say it was just a bad joke, but I think we know where that sentiment comes from — the insistence that women should not have sex if they don’t want to get pregnant (which also completely ignores the non-contraceptive uses for hormonal birth control).
At Slate, Virginia’s Proposed Ultrasound Law Is an Abomination. That state’s legislature passed a law requiring that women seeking an abortion undergo ultrasound imaging showing the fetal heartbeat and gestational age prior to the abortion. There is no medical purpose — just a shaming one. And since most abortions are done within the first trimester, the information required would necessitate a transvaginal ultrasound in which a condom-covered probe is inserted in the vagina. Thus, Virginia has mandated that women seeking abortions must be forced to have an object inserted in their vaginas for no medical reason.
RH Reality Check also covered this Virginia law, in State-Sanctioned Rape: Trans-Vaginal Ultrasound Laws in Virginia, Texas, and Iowa. I would just change this to “State-Mandated,” because I think it lets the legislature off too easy with “sanctioned” — they are explicitly demanding it. The story has a useful illustration of what it really means to get a transvaginal ultrasound.
Have other links we should read? Leave ‘em in the comments.
Last night, Rachel Maddow took on Republican anti-birth control, anti-abortion efforts around the states, including really egregious legislation in Virginia that would force women to undergo transvaginal ultrasounds if they want an abortion. This would be the state mandating that women have an object placed in their vaginas, for no medical purpose, with no opportunity to refuse consent if they wanted an abortion, and no opportunity for their healthcare provider to decide if the imaging was necessary.
Today, the White House released a document addressing recent controversy over one preventive service covered under the Affordable Care Act – birth control. Under the Act, insurance plans are required to provide coverage for contraception without charging a co-pay, co-insurance or a deductible. U.S. Catholic bishops objected to the coverage, claiming it was a violation of their religious beliefs.
The statement indicates:
The policy also ensures that if a woman works for a religious employer with objections to providing contraceptive services as part of its health plan, the religious employer will not be required to provide, pay for or refer for contraception coverage, but her insurance company will be required to directly offer her contraceptive care free of charge.
In other words, Catholic or other religiously affiliated organizations get to say they selected health insurance plans for their employees that do not cover contraception, while those employees can still receive no-cost contraception directly via the insurance providers. Whether these costs will be covered by the insurance companies directly, or perhaps reimbursed to those companies via Medicaid, is not clear, and we’ll need to watch the implementation to make sure this ends up working for women.
The provision already had exemptions for religiously-focused organizations like churches. At issue were the religiously affiliated organizations such as Catholic hospitals and universities, which typically employee people from a variety of (or no) faith traditions. Many such organizations already offer contraception coverage to employees, and a number of states require employer-based plans to provide this coverage.
According to one recent survey, the majority of Catholic Americans (52%) say religiously affiliated colleges and hospitals should have to provide coverage that includes contraception. A 2011 Guttmacher report indicated that, “Among all women who have had sex, 99% have ever used a contraceptive method other than natural family planning. This figure is virtually the same, 98%, among sexually experienced Catholic women.”
Here’s Rachel Maddow talking about the issue on Wednesday, placing it in the context of the current elections:
On Monday night, OBOS Executive Director Judy Norsigian discussed the politicization of women’s health on Al Jazeera with Hadley Heath, a senior policy analyst with the Independent Women’s Forum, and Tara McGuinness, senior vice president for communications at the Center for American Progress.
“Inside Story” host Shihab Rattansi was well prepared for what turned into a very interesting discussion. The questions on the table included: Is women’s health being damaged by politics in the U.S.? Has the controversy over funding to Planned Parenthood for breast cancer screening underlined the extent to which conservative groups now influence women’s health access?
On the subject of Komen backpedaling on its controversial decision to stop making grants to Planned Parenthood, Nosigian said: “What we see here is a conservatizing trend in this country that I think has emboldened many … I saw the reversal of the decision simply as damage control. I do not think there has been a profound change in perspective at all.”
McGuinness made this valuable point: “This was an effort to politicize what is not a political thing … I think when it comes to women’s health, there aren’t two sides to this issue.”
Even though Komen executive Karen Handel, who drove the decision to cut off funding to Planned Parenthood, resigned this morning, the controversy is far from being closed.
This week, we all learned a lot about Susan G. Komen for the Cure, and Planned Parenthood, and breast cancer. Now that Komen has caved (sort of; Planned Parenthood’s response), we might start to learn what it will take to mobilize an outcry to really stop the attacks on women’s health.
As Komen was committing a huge PR failure, it became clear via Facebook, Twitter and a new Tumblr site, Planned Parenthood Saved Me, that many women value and rely on Planned Parenthood for breast cancer exams and other preventive health services. A slam-dunk week for Planned Parenthood.
Part of what they do is help people plan. Parenthood. You know. They support birth control. In some cases, they provide it. Like your corner drugstore, but better.
And this week, the bishops are howling about it because the Obama administration refused to grant a broad religious exemption to contraception coverage.
Never mind that virtually all Catholics use birth control, that the Church itself only began to oppose it in 1968, that the Pope recently conceded that condoms are useful, and approved condom use for stopping the transmission of AIDS.
Never mind that most Catholic-affiliated hospitals, schools and charities cover birth control in their health plans — health plans that come out of the wages employees earn themselves.
Close to every cent the Church has not spent settling lawsuits against priests who sexually molested children has gone into this week’s media campaign to rile up opposition to covering birth control.
So far they’re doing a pretty effective job of it. The Obama administration is standing firm, but Congress is still on the warpath.
OBOS has received funding to make blog entries available in Spanish. We hope to expand outreach efforts in the coming year.
La secretaria del Departamento de Salud y Servicios Humanos (HHS), Kathleen Sebelius, publicó la declaración que establece el reglamento que requiere que los planes de seguro cubran el uso de anticonceptivos, sin la necesidad de un copago, un coaseguro, o un deducible.
Este servicio no siempre estuvo garantizado. El pasado agosto, el HHS adoptó las recomendaciones del Instituto de Medicina para incluir los servicios de planificación familiar como uno de los aspectos del cuidado preventivo de la salud para las mujeres, a ser cubierto por los nuevos planes de salud, pero solo fue un reglamento provisional, sujeto a interpretaciones.
En noviembre hubo mucha preocupación sobre si la decisión de que los anticonceptivos sean cubiertos como servicio preventivo por la Ley del Cuidado de Salud a Bajo Precio iba a sobrevivir. El Presidente Obama se reunió con obispos Católico Romanos, y uno de ellos salió de la reunión diciendo, “Salí sintiéndome un poco más en paz sobre el tema que cuando entré.”
Como se puede entender, muchas personas expresaron la preocupación de que la administración iba a abandonar los requisitos de cobertura para el control de la natalidad y a su vez ampliar el reglamento que permita el rechazo, para permitir que hospitales y universidades católicas nieguen cobertura de servicios de planificación familiar. Pero la administración rechazó los pedidos que permitían a los empleadores optar por no cubrir anticonceptivos. La declaración de Sebelius dice en parte:
Después de evaluar los comentarios, hemos decido añadir un elemento más al reglamento final. Los empleadores sin fines de lucro que basados en creencias religiosas no proveen cobertura para anticonceptivos en sus planes de seguro tendrán un año adicional, hasta el 1ro de agosto del 2013, para cumplir con la nueva ley. Los empleadores que quieran aprovechar del año adicional necesitan probar que califican para la implementación retardada. Este año adicional permitirá que estas organizaciones tengan más tiempo y flexibilidad para adaptarse a este nuevo reglamento. Nosotros esperamos requerir que los empleadores que no ofrecen cobertura de servicio de anticonceptivos provean notificación a sus empleados, informándoles que los servicios de anticonceptivos están disponibles en lugares como centros comunitarios de salud, clínicas públicas y hospitales con ayuda basada en los ingresos. Vamos a seguir trabajando estrechamente con grupos religiosos durante este periodo de transición para discutir sus preocupaciones.
Los científicos tienen mucha evidencia sobre los beneficios del control de la natalidad para la salud de mujeres y de sus familias. Se ha documentado que reduce los costos de salud considerablemente, y es el medicamento tomado con más frecuencia en los Estados Unidos por jóvenes y mujeres de edad mediana. Este reglamento proveerá a las mujeres mayor acceso a los anticonceptivos por cuanto requiere la cobertura y prohíbe los costos compartidos.
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