Wednesday, June 22, 2016
The Atlantic, June 14, 2016 Can the U.S. End Teen Pregnancy?, by Caitlin Cadieux, Olga Khazan, Nicolas Pollock:
An animated video by the Atlantic discusses teen pregnancy in the U.S.:
Teen birth rates in the U.S. are down 9 percent from 2013, and they are the lowest they’ve been since 1940. However, America still has the highest teen pregnancy rate among 21 similar countries. Why is this? In this video, staff writer Olga Khazan explores how poverty, culture, and religion can all play a role.
Tuesday, June 21, 2016
Refinery 29 (June 16, 2016): Denied Birth Control, Teens Still Have Sex — Unsafe Sex, by Hayley MacMillen:
From the 2016 International Conference on Family Planning in Indonesia, Refinery 29 provides first hand accounts of young people denied safe sex options and education. A recent Lancet study has identified unsafe sex as the fastest growing risk factor for ill health for young people around the world. At the conference, attendees stressed the importance of accurate, as well as widespread, sex ed to all adolescents. Haley MacMillen writes:
Birth control fallacies are, of course, not limited to East Africa but crop up wherever medically accurate, comprehensive sex ed is withheld. When I ask Philippines-based journalist and sex columnist Ana Santos, another attendee of the International Conference on Family Planning, about contraception myths in her country, she’s armed with some horrifying ones. People believe that "jumping after sex will prevent pregnancy" — although she notes, drily, that "a jump from what height is never mentioned" — and that "drinking coconut juice laced with bleach or Tide detergent will wash away the spermies." And since condoms can be hard to come by, people, especially young people, wrap Calypso plastic, a brand used to package iced candy, around their penises instead. "Totally ouchy, right?" Santos asks. Yes. And ineffective.
The article emphasizes the need for comprehensive sex ed - both internationally and locally - in order to help young people around the world and around the corner.
Saturday, June 18, 2016
Rewire, June 9, 2016, Here’s What You Need to Know About Your Birth Control Access Post-Supreme Court Ruling, by Bridgette Dunlap
In a well-thought-out and organized article, Bridgette Dunlap looks at the impact the Supreme Court’s “non-decision” in Zubik v. Burwell will actually have on women’s access to contraceptives. Quelling what she assumes to be a reader's ever present worry, Dunlap discusses the current legal mandates in place for employers of all kinds and emphasizes that “the vast majority of people with insurance are currently entitled to contraption without a co-payment – that includes people for the most part, who work for religiously affiliated organizations.” Dunlap emphasizes the importance that coverage of the Supreme Court's ruling in Zubik not not overstate the impact of the non-decision:
The fact that equitable coverage of women’s health care is the new status quo is a very big deal that can be lost in the news about the unprecedented litigation campaign to block access to birth control and attacks on Obamacare more generally. Seriously, tell your friends.
Friday, June 17, 2016
Refinery 29 (May 28, 2016): Unsafe Sex Is Now The Biggest Health Risk Among Women Worldwide, by Sara Coughlin
Researchers tracked health trends of participants for over 23 years in order to determine the causes of death among them. While the prevalence of STI's weren't even ranking as a major risk factor at the time the study commenced, they shot up the scale to the number one cause of death by the end, strikingly. This pattern seems to be a worldwide trend, bolstering the importance of getting tested, as well as communicating frankly and effectively to young people about the risks associated with unprotected sex, and how to stay safe when sexually active.
The report, which was published in theLancet and is the result of a commission to look at health challenges facing young people worldwide, found that today's teens are growing up in a world where preventable and treatable health issues, such as HIV/AIDS and unplanned pregnancy, abound. Among the most shocking findings of the report: For women between the ages of 10 and 24, unsafe sex is the fastest-growing risk factor for illness and death worldwide.
Thursday, May 26, 2016
Local health care providers and wider contraceptive options increase contraceptive use in many countries
Vox (May 20,2016): What the US can learn from Ethiopia about birth control, by Sarah Frostenson:
The use of modern contraceptives has tripled in Ethiopia since 2005, following a government program to train women health workers to go door to door to deliver birth control.
What's more, women in Ethiopia are having fewer children (the fertility rate fell from an average of 6.5 children per woman in 2000 to 4.6 currently), maternal deaths are in decline, and more women are staying in school longer. Plus, more women are opting for long-acting reversible contraceptives (LARCs) instead of more traditional short-term methods like birth control pills or condoms.
Local health care providers can make a big difference in women's access to contraceptives as can providing a range of contraceptive options. Long acting reversible contraceptives (LARCs) play a big part in increasing effective use of contraceptives in many countries. LARC implants last for 3 years and do not require going to a clinic to take medication or remembering to take a pill. They also allow women to keep their contraceptive use secret. However, LARC use can be prohibitively expensive for low-income women who would otherwise choose them. Some poorer countries are able to provide contraceptives that are donated by NGOs and the international community, removing the cost-barrier for many women.
Use of LARCs is increasing at a faster rate in some poorer countries than in the U.S. About 12% of women in the U.S. use LARC methods. Recent cuts to family planning in the U.S. resulting in closure of local family planning clinics decrease women's options of contraceptive methods and make it more difficult and expensive for them to access birth control. For instance in Texas, 82 of family planning clinics closed following a recent drastic cut in family planning funding. A study found the cuts lead to an increased birth rate for low income women and a "sharp decrease " in use of LARCs.
Tuesday, April 19, 2016
Inquisitor (April 10, 2106): California Birth Control Law Allows Pharmacists to Dispense Contraception Practically Over-the-Counter, by John Houck:
Earlier this month a California law went into effect that allows pharmacists to distribute self-administered hormonal contraceptives. The law was passed in 2013, but did not go into effect until April 8, 2016 because of regulatory hurdles.
Although women are not required to get a doctor's prescription, access isn't quite "over-the-counter."
To get birth control, a woman will need to answer some questions about her health as well as consult with a pharmacist to determine the most appropriate contraceptive method. A woman’s blood pressure will have to be measured if the particular method poses a high blood pressure risk.
After the consultation, a woman can request a specific type or ask the pharmacist for a recommendation. Once the method is chosen, instructions for use and information regarding side effects will be explained. Some methods, like implants or intrauterine devices, are only available from a doctor.
Birth control administered in this manner will be covered by insurance plans that include birth control. Oregon and Washington already have similar legislation in place, and Hawaii, New Mexico and Alaska are considering similar measures.
Tuesday, March 29, 2016
Think Progress (March 29, 2016): How to Make Sense of the Baffling Order the Supreme Court Just Handed Down on Birth Control, by Ian Millhiser:
On Tuesday, the Supreme Court handed down an unusual order seeking more briefing in Zubik v. Burwell, a challenge to Obama administration regulations intended to expand access to birth control. Under the regulations at issue in Zubik, most employees must include contraceptive coverage in their employer-provided health plan. Employers who object to birth control as religious groups, however, may either fill out a form or write a brief letter seeking an exemption from this requirement. Once they do so, they are permitted to offer insurance that does not cover birth control, and, in most cases, their insurance provider will offer a separate, contraception-only plan to the employer’s workers.
The Supreme Court's order instructs the parties to “file supplemental briefs that address whether and how contraceptive coverage may be obtained by petitioners’ employees through petitioners’ insurance companies, but in a way that does not require any involvement of petitioners beyond their own decision to provide health insurance without contraceptive coverage to their employees.” The Court appears interested in whether the employer could notify the insurance company that it does not wish to provide birth control when they contract for insurance and the insurance company could then notify employees that it will separately provide contraceptive coverage cost-free separate from the employers' plan. This solution would allow employees to receive coverage from the employer's insurer and avoid the need to purchase a separate policy.
The catch, however, is that it may not be possible for the federal government to put such a solution in place, at least without a change to federal law. Employer benefits are governed by complex federal statutes such as the Employee Retirement Income Security Act (ERISA). The Obama administration found authorization for its current rules in the existing ERISA statute, but it is not entirely clear that current law will enable them to move forward with the idiosyncratic solution described in the Supreme Court’s Tuesday order. Indeed, it is likely that one reason that the Court asked for additional briefing in this case was to determine whether the government has the authority to implement the justices’ preferred solution under ERISA.
Thursday, March 17, 2016
Professor Caroline Mala Corbin has posted to SSRN (here) the issue brief she wrote for the American Constitution Society on why the Religious Freedom Restoration Act does not provide a defense to the contraception mandate under the Affordable Care Act. The issue is presented in the case of Zubik v. Burwell.
Here is the abstract:
The Affordable Care Act requires that health care plans include all FDA-approved contraception without any cost sharing. In Hobby Lobby v. Burwell, for-profit businesses with religious objections successfully challenged this “contraception mandate.” In this term’s Zubik v. Burwell, it is religiously affiliated nonprofits like Baptist universities and Catholic Charities challenging the contraception benefit. But there is a major difference: these religiously affiliated nonprofits are exempt from the contraception mandate. Once they certify that they are religiously opposed to contraception and notify either their insurance carriers or the Department of Health and Human Services, the responsibility for contraception coverage shifts to private insurance companies. The nonprofits do not have to provide, pay for, or even inform their employees or students of the separate coverage.
Despite the ability to opt out of contraception coverage, many nonprofits complain that the religious accommodation itself imposes a substantial religious burden in violation of the Religious Freedom Restoration Act (RFRA). According to these nonprofits, providing notice of their objections triggers the provision of contraception to their employees and students, thus making them complicit in sin. Their RFRA claim cannot succeed. RFRA requires that the contraception regulations impose a substantial religious burden and fail strict scrutiny, and neither requirement is met. First, filing paperwork to receive an exemption is not a substantial burden on the nonprofits’ religious exercise. The nonprofits’ claims to the contrary are based on a mistake of law, and while court must defer to the nonprofits’ interpretation of religious theology, courts should not defer to their interpretation of federal law. Second, the contraception mandate passes strict scrutiny: it advances compelling government interests in women’s health and equality, and the accommodation provided to objecting nonprofits is the least restrictive means of accomplishing those interests.
Tuesday, February 23, 2016
Atlantic (Feb. 19, 2016): The Muddled Future of Reproductive Rights, by Julie Rovner:
Prior to Justice Scalia's death, the Supreme Court frequently voted 5-4 votes on controversial decisions. Following Justice Scalia's death, there is a chance that the Court could deadlock, 4-4 in cases this term. When there is a tie vote, the appellate court's decision will stand, but it does not create national precedent.
This March the Supreme Court is scheduled to hear two reproductive rights cases, one on abortion and one on contraceptive insurance coverage. Whole Women's Health v. Hellerstadt challenges a Texas law that imposes restrictions on abortion clinics. The district court struck down the law, but the Fifth Circuit's decision reversed the district court and would allow the law to go into effect with minor changes. Zurbik v. Burwell challenges the religious accommodation that has been created for religious-affiliated institutions who wish to opt-out of contraceptive coverage. Current rules do not require that religious hospitals or schools contract for contraceptive coverage. Instead, they must inform the government who their insurer is so that the government can arrange for coverage. The lower courts in the cases consolidated in Zurbik found that the administration's rules don't violate religious rights.
Because appellate courts have ruled differently on both the contraceptive regulations and the constitutionality of laws like the Texas law challenged in Whole Women's Health, a tied Supreme Court decision would prolong Circuit splits. If the Supreme Court cannot reach a decision in the two cases, it can also hold them over and re-hear them next term.
RH Reality Check (Feb. 18, 2016): Pope Francis Suggests that Contraception May Be Acceptable for Catholics Fearing Zika Virus, by Jodi Jacobson:
The Zika virus, now found in 34 countries, may cause microcephaly in infants born to recently infected women. Some countries, including El Salvador, have responded to the recent increase in microcephaly by advising that women avoid pregnancy for up to two years. Last week, Pope Francis responded to questions about Zika virus, saying that it may be acceptable for Catholics to use contraception to avoid pregnancy when fearing possible infection.
Asked during a press conference whether abortion or birth control could be considered a “lesser evil” in response to the Zika virus, which appears to be linked to birth defects, the Pope replied that he believes abortion is a crime and is never acceptable, but that the use of modern birth control (“artificial contraception” in church parlance) may be permitted in exceptional circumstances.
Abortion “is an evil in and of itself” the Pope claimed. “On the other hand, avoiding pregnancy is not an absolute evil,” he said, referring to prior circumstances in which the church has sanctioned the use of birth control, such as in the 1960s, when nuns were subject to rape as a weapon of war in the Belgian Congo.
The Pope's statements may encourage Catholic countries to make contraceptives more readily available, thus avoiding increased birth defects due to Zka virus.
Saturday, January 23, 2016
Daily Beast (Jan. 20, 2016): Catholic Hospitals Are Blocking a Basic Form of Contraception, by Brandy Zadrozny:
Many women choose to have their tubes tied as a pregnancy preventative. Married women may choose this method of sterilization when they have finished growing their families. They sometimes desire to have this procedure performed at the same time they are in surgery for a Caesarean section.
But the belief that tubal ligation is intrinsically evil is a stance assumed by Catholic hospitals in many regions without alternative sources of medical care. A lawsuit brought by Physicians for Reproductive Health (PHR) against what may be the largest hospital provider in California charges violates of the state's anti-discrimination, business and health and safety laws. PHR is arguing that the religious refusal places an undue burden on women who have to travel to facilities often far away from where their physician practices or who are forced to submit to two separate surgeries. The group objects to the intrusion of Catholic doctrine in the doctor-patient relationship.
According to the ACLU and MergerWatch, the number of Catholic acute-care hospitals in the United States continues to rise.
Tuesday, January 12, 2016
SoctusBlog (Dec. 17, 2015): Symposium: Integrity, Mission, and the Little Sisters of the Poor, by Richard W. Garnett:
The current iteration of the religious-freedom challenge to the Affordable Care Act’s preventive-services mandate (not, as is sometimes suggested, to the act itself) is called Zubik v. Burwell. This is unfortunate. True, the caption choice improves the “optics” for the Obama administration and reduces the likelihood of awkward headlines and embarrassing talking points. However, calling the case – as I will – Little Sisters of the Poor better captures its bizarre core and character. Calling it by this name reminds us that the administration has not reluctantly stumbled into but has instead doggedly pursued a conflict with a religious community of Roman Catholic nuns over whether and how its employees will receive government-mandated, cost-free insurance coverage for prescription contraceptives. Regardless of how the Court rules, that this pursuit appears to have been for the administration a matter not merely of policy but also of principle is extraordinary.
Tuesday, January 5, 2016
RH Reality Check (Jan. 4, 2016): Attacks of Abortion Rights Continued in 2015 Ensnaring Family Planning Funding and Fetal Tissue Research, Rachel Benson Gold and Elizabeth Nash:
As discussed in previous posts, during the 2015 state legislative session, state legislatures adopted 57 new abortion restrictions. But the year was also memorable "because the politics of abortion ensnared family planning programs and providers, as well as critical, life-saving fetal tissue research."
At the same time, several states made important advances in 2015 on other sexual and reproductive health and rights issues. Some of the new provisions include measures that allow women to obtain a full year’s worth of prescription contraceptives at one time from a pharmacy, that allow a provider to treat a patient’s partner for an STI without first seeing the patient, that prohibit the use of “conversion therapy” with minors, and that expand access to dating or sexual violence education.
According to Guttmacher, in 2015, 11 states tried to cut funding for Planned Parenthood to any family family provider that also offers abortion. This could seriously impact family planning for low income women because Planned Parenthood health centers serve half or more of the women obtaining contraceptive care from safety-net health centers in two-third of the counties where they operate. Five states tried to exclude Planned Parenthood from the Medicaid program, although these efforts were blocked by federal courts. Ten states tried to regulate fetal tissue donation and research.
Wednesday, October 14, 2015
Last week, the Nuestro Texas campaign—a joint project of the Center for Reproductive Rights and the National Latina Institute for Reproductive Health—issued a report documenting a women’s human rights hearing held last March in the Rio Grande Valley. Lately, Texas has made front-page headlines because a challenge to HB 2 a Texas abortion statute is making its way to the Supreme Court. Abortion access was very much an issue at the hearing, but the testimony made it clear that the human rights problems in the Valley are much broader and deeper.
Friday, May 8, 2015
CNN: Survey says teens skip birth control because they fear parental judgment, by Kelly Wallace:
Parents, if the following finding doesn't make you sit up and take notice when it comes to talking to your kids about sex and birth control, I'm not sure what will get your attention.
In a recent survey, 68% of teens said they agreed with this statement: The primary reason why they don't use birth control or protection is because they're afraid their parents will find out. . . .
Thursday, April 30, 2015
The New York Times: Insurers Flout Rule Covering Birth Control, Studies Find, by Robert Pear:
Health insurance companies often flout a federal requirement that they cover all approved methods of birth control for women without co-payments or other charges, a major benefit of the Affordable Care Act, two new studies have found.
Responding to the reports, senior Democratic members of Congress prodded the White House on Wednesday to step up enforcement of the requirement. . . .
Tuesday, March 17, 2015
The Hill: Iran's War on Women, by Soona Samsami:
March 8 marked International Women’s Day, a day to reflect on the situation of women throughout the world. With all the talk about Iran’s nuclear program, little attention is being paid to the internal situation, particularly Iran’s ongoing war on women. . . .
The bill itself undermines the reproductive rights of women, and limits access to contraception among other restrictions. The law would block employment at certain jobs for Iranian women who choose not to have children, making it clearly discriminatory and unfair. . . .
The Guardian: Iran aims to ban vasectomies and cut access to contraceptives to boost births, by Saeed Kamali Dehghan:
Iran is seeking to reverse progressive laws on family planning by outlawing voluntary sterilisation and restricting access to contraceptives, in a move human rights groups say would set Iranian women back decades and reduce them to “baby-making machines”.
The Iranian parliament is considering two separate bills aimed at boosting the population. But Amnesty International warned in a report published on Wednesday that the proposals are misguided and, if approved, would “entrench discriminatory practices” and expose women to health risks. . . .
Sunday, March 8, 2015
Anti-Choice Legislators Oppose Successful Colorado Contraception Program by Conflating Birth Control and Abortion
NPR: Colorado Debates Whether IUDs Are Contraception Or Abortion, by Megan Verlee:
A popular contraception program in Colorado is receiving criticism from conservative lawmakers who say that the program's use of intrauterine devices, or IUDs, qualify as abortions.
More than 30,000 women in Colorado have gotten a device because of the state program, the Colorado Family Planning Initiative. An IUD normally costs between $500 and several thousand dollars. Through the program women could receive one for free. . . .
State health director Larry Wolk says that the program has largely been a success. "Our teen birth rate has dropped 40 percent over the last four years," says Wolk. "The decline in teen births has been accompanied by a 34 percent drop in abortions among teens." . . .
Oh dear. Contraception/abortion conflation strikes again. Recent research shows that IUDs' primary mechanism is pre-fertilization. For example, this article from American Family Physician advises:
. . . When discussing the mechanism of IUDs as part of the informed consent process, patients may be told that although prefertilization and postfertilization mechanisms may both contribute to the contraceptive effectiveness of IUDs, research suggests that the majority of effects occur prefertilization. . . .
Moreover, regardless of the mechanism, IUDs don't cause "abortions." Doctors define pregnancy as beginning at implantation, not before. That makes sense, especially given that about half of all fertilized eggs never successfully implant. (You don't see anti-choice advocates lamenting the loss of all of these "persons.")
Thursday, February 26, 2015
The Los Angeles Times: For contraception, U.S. women increasingly turn to IUDs and implants, by Karen Kaplan:
IUDs and implants are safe, reliable, long-acting and reversible forms of birth control. Now there’s a new attribute to add to this list: increasingly popular.
A new report from the U.S. Centers for Disease Control and Prevention shows that American women are embracing these contraceptive devices. In the last decade, their use has increased nearly five-fold, with 7.2% of women ages 15 to 44 now relying on them to prevent pregnancy. . . .
Tuesday, February 24, 2015
The Denver Post: Colorado House committee passes bill providing state money for contraception, by Joey Bunch:
A House committee gave its approval Tuesday to a bill to put state money behind a contraception program that supporters say has been a major contributor to reducing teen pregnancies in Colorado.
The bill would provide $5 million next year to continue to provide free or low-cost intrauterine contraceptive devices, called IUDs, to women ages 15 to 19 years at clinics across the state. . . .