Monday, September 19, 2016
Linda Greenhouse and Reva Siegel have posted their analysis of Whole Woman's Health v. Hellerstedt to SSRN. The abstract follows:
This essay offers a brief account of the Supreme Court’s most recent abortion decision, Whole Woman’s Health v. Hellerstedt, and its implications for the future of abortion regulation. We draw on our recent article on health-justified abortion restrictions — Casey and the Clinic Closings: When “Protecting Health” Obstructs Choice, 125 Yale L.J. 1428 (2016) — to describe the social movement strategy and the lower court rulings that led to the decision. We show that in Whole Woman’s Health the Court applies the undue burden framework of Planned Parenthood v. Casey in ways that have the potential to reshape the abortion conflict.
In Whole Woman’s Health, the Court insisted on an evidentiary basis for a state’s claim to restrict abortion in the interests of protecting women’s health, and found none in the Texas law under review. The Court instructed judges how to assess the asserted health benefits of regulations that predictably will force clinics to close: it required judges to balance the demonstrated benefit of the law against the burden that a shrunken abortion infrastructure will have on the ability of women to exercise their constitutional rights.
As we show, Whole Woman’s Health clarifies the law defining what counts as a burden and what counts as a benefit to be balanced within the Casey framework. Particularly notable, even unexpected, is the Court’s capacious understanding of “burden” as the cumulative impact of abortion regulation on women’s lived experience of exercising their constitutional rights. The decision thus offers a robust reaffirmation of the right to abortion and of the need for judges to protect access to the right. By clarifying what counts as a burden and what counts as a benefit to be balanced within the Casey framework, the decision constrains regulations explicitly aimed at protecting fetal life as well as those ostensibly intended to protect women’s health.
Thursday, September 15, 2016
New York Times (Sept. 13, 2016): Italy's 'Fertility Day' Ads Anger Women Stymied by Lack of Support, by Gaia Pianigiani:
Italy has one of the lowest birth rates in the world. The declining birthrate has led to fears that as the population ages, there will be insufficient people in the workforce. A recent government sponsored campaign to promote Sept. 22 as "Fertility Day" has led to anger because of its failure to address the lack of government and employer support for families. One woman remarked " The government encourages us to have babies, and then the main welfare system in Italy is still the grandparents."
The Italian family size has been shrinking for some time, but also coincides with the recent economic slowdown. Many women fear that their jobs will be in jeopardy if they have children. Although France also has suffered from a bad economy, it has far more generous social security programs, including day care and subsidies for families with children. In France women have an average of two children. In Italy, the birth rate is 1.37.
Italy's current government has tried to help families, instituting a baby bonus of 80 to 160 euros for low and middle income families and approving labor laws that give more flexibility on parental leave, but Italy's allocation of 1 percent of its GDP on social protection benefits is still half the European average.
Wednesday, September 14, 2016
Salon (Sept. 10, 2016): Phyllis Schlafly and the global right, by Jonathan Zimmerman:
Following Phyllis Schlafly's death last week, most articles have focused on her opposition to the Equal Rights Amendment, promotion of family values and traditional gender roles and opposition to abortion, gay rights and sex education in the U.S. While these conservative values are often associated with opposition to internationalism, Schlafly was also part of an active global conservative movement.
In its early iterations, this international movement focused mainly on Christians in the West. But it took a truly global turn in the 1990s, when activists like Schlafly began to coordinate with conservatives in Asia, Africa and Latin America. They coalesced around opposition to the 1994 International Conference on Population Development in Cairo, which endorsed “reproductive rights,” including access to contraception and sex education, for all human beings.
Five majority Muslim countries, two mostly Catholic countries and the Vatican dissented from the Cairo resolution. Following the conference, the right created its own global networks including the World Congress of Families, which brought together religious conservatives across national boundaries and faiths. The Congress continues to be active today at the U.N. and other international forums.
Tuesday, September 13, 2016
Huffington Post (Sept. 9, 2016): Obama Moves To Protect Planned Parenthood Funding, Permanently, by Laura Bassett:
The Obama administration is proposing a new Health and Human Services Regulation, which provides that states cannot withhold Title X federal family planning money for any reason other than the provider's "ability to deliver services to program beneficiaries in an effective manner." This would prohibit states from defunding Planned Parenthood because some if its clinics also provide abortions.
Title X is already limited to the provision of preventative health care and family planning and cannot be used for abortions. Still, politicians in 11 states have proposed blocking funds to Planned Parenthood because it also provides abortions. Currently, Planned Parenthood serves about a third of Title X recipients, who are low income women - 85% of Title X recipients have incomes below $23,500. Title X funds are used to subsidize contraceptives and cancer and sexually transmitted disease screenings,
Monday, September 12, 2016
The Nation (Sept. 8, 2016): The Story Behind the Maternal Mortality Rate in Texas is Even Sadder Than We Realize, by Katha Pollitt:
A recent report found that the state of Texas has the highest maternal mortality rate in the developed world. Opinion writers have noted that the maternal mortality rate doubled from 2011-14 after Texas slashed its family planning budget, closing many family planning clinics that provided the first line of reproductive health care to low-income women. But, Pollitt notes that the cuts were a contributing factor to a deeper problem - the lack of medical care for low income women.
Most Texas women who died post-pregnancy didn’t do so in the delivery room, but six weeks or more after childbirth. The three top causes: cardiac events, drug overdoses, and hypertension.
This suggests that the health care that women receive both before and after pregnancy has a strong impact on maternal mortality rates. Texas is one of 19 states that declined to expand Medicaid eligibility under the Affordable Care Act, and women who qualify for coverage under the state emergency Medicaid program lose coverage 60 days after birth.
Structural racism is also a major factor in maternal mortality rates:
In Texas, the maternal-mortality rate for white women is in step with their pregnancy rate; for Hispanic women, it’s actually lower. But black women are 11.4 percent of all pregnant women in the state and a whopping 29 percent of those who die.
The maternal mortality statistics in Texas should be a wake up call to re-evaluate the state's health policies. Instead, the state recently allocated $1.6 million of its women's health care funding to an anti-abortion group that has no experience providing health services. Unless the state starts putting health care ahead of politics, we will not see a significant improvement in maternal mortality rates.
Saturday, September 10, 2016
Vox (Sept. 6, 2016): Obamacare was supposed to make all birth control free. As a doctor, I see that is not happening, by Tracey Wilkinson:
This article by Tracey Wilkinson examines the gap between the promise of free birth control under Obamacare and the realities for women seeking insurance coverage for contraceptives. She writes:
Too often, I have patients return or call my office telling me that their insurance didn’t cover the birth control I prescribed, that there was a copay they could not afford or some roadblock has appeared that effectively denied them the method of contraception we had discussed.
Although Obamacare requires that insurance companies cover 18 different types of FDA approved contraception, it does not mean that insurers must cover all drug within those categories. For instance the 18 types of contraception include three types of oral contraceptive pills, but there are over 100 contraceptive pills on the market. Insurers need only cover one of each type of pill and can change the drug they cover without notice. Even if the doctor prescribes the medication covered by a woman's insurance, her pharmacy might not stock it.
Also insurance companies can require that women try a cheaper option before it covers a more expensive form of contraceptive or require that the doctors complete a waiver or exemption process to justify the prescription of certain contraceptives.
The Kaiser Foundation recently issued a report documenting these types of administrative barriers in 5 states. The report found a wide variety of contraceptive coverages. Perhaps more concerning, the researchers noted that it was difficult to compile the information for the report because coverage information "was not always easy to find, readily available, or even known by the insurance company employees. This highlights again how challenging this is for a consumer or clinician."
Dr. Wilkson laments the de facto restrictions on contraceptive access. In addition to the burdens on doctors and patients, she notes that there is no benefit to withholding contraception. She states:
What is most frustrating about the current state of contraceptive coverage is that it’s hard to determine who, if anyone, benefits from this restricted access. Unplanned pregnancies are very expensive not only to society but also to insurance companies. The cost of paying for contraception for a year (or even 10 years) is significantly cheaper than paying for prenatal care and subsequent labor and delivery. The estimated costs of unplanned teenage pregnancies in the United States each year is $9.4 billion.
In addition to the financial costs of restricting access to contraception, she notes that "[e]vidence exists showing that removing barriers to contraceptive use is effective and leads to a sharp decline in unplanned pregnancy, birth, and abortion rates."
Thursday, September 8, 2016
If/When/How, in collaboration with the Center for Reproductive Rights and U.C. Berkeley School of Law's Center for Reproductive Rights and Justice is accepting submissions for the twelfth annual Sarah Weddington Writing Prize for New Student Scholarship in Reproductive Rights.
The suggested theme is: Balancing Burdens and Benefits after Whole Woman's Health v. Hellertstedt. However, the Writing Prize invites submissions on all reproductive rights and justice topics. Please refer to the attached Call for Submissions for guidance on the suggested theme, as well as additional requirements.
Winning authors will receive cash prizes: $750 (1st place), $500 (2nd place), or $250 (3rd place). The first place winner will also have a chance at publication with the NYU Review of Law and Social Change. All winning authors will also receive copies of Melissa Murray's and Kristin Luker's Cases on Reproductive Rights and Justice.
The deadline for submissions is Monday, February 27, 2017.
Information about the Sarah Weddington Writing Prize is available here: http://www.ifwhenhow.org/resources/2016-writing-prize-call-for-submissions/
Wednesday, September 7, 2016
Rewire (August 30, 2016): Patients 'Throwing Up in the Parking Lot' Under Ohio Abortion Law, by Nicole Knight:
A new study analyzing an Ohio law regulating medication abortion found that "[t]here is no evidence that the [law] led to improved abortion outcomes. Indeed, our findings suggest the opposite." In 2011, Ohio passed a law requiring that abortion providers adhere to FDA guidelines from 2000 when administering drugs for a medication abortion. It is common for doctors to prescribe medication "off label," and at the time Ohio passed the law, the FDA guidelines were actually inconsistent with prevailing medical standards of care. In March, the FDA changed its guidelines to make it consistent with medical best practices.
The study compared the medical charts of women in the years before and after the Ohio law went into effect. The study found that after the law was passed, the number of medication abortions declined 80% and the patients that had medication abortions under the state requirements suffered more side effects and paid more for the two-drug regime. Under the Ohio law, doctors are required to administer three times the dose of mifepristone than is advised by current medical evidence. The increased dosage and a state required extra visit to the abortion provider drove the cost of the procedure up 29%.
Despite the changes to the FDA protocol earlier this year, the Ohio law still remains in effect.
Tuesday, September 6, 2016
Anti-choicers get even weirder: After losing in the Supreme Court, abortion foes turn to desperate distortion
Salon (August 17, 2016): Anti-choicers get even weirder: After losing in the Supreme Court, abortion foes turn to desperate distortion, by Amanda Marcotte
In the wake of the landmark victory of Whole Women's Health v. Hellerstedt, Amanda Marcotte argues that the anti-choice movement has been "sent back to the drawing board" and their two new tactics are spins on old classics: "first, trying to trick people into thinking embryos are babies and then trying to trick people into thinking abortion is too medically dangerous to be allowed." Some newly proposed regulations in Texas, Louisiana and Indiana require women to have a funeral for the 'remains' of a miscarriage or abortion. So far the regulations have been held up in the court.
While these regulations are said to have been "quietly" proposed, anti-choice advocates are a little louder about making claims that abortions are dangerous. Their problem is that statistics published by places like the CDC and Guttmacher show that abortion is extremely safe. Rather than changing their claims, anti-choice supporters argue that they just need more statistics. While these claims seem ridiculous, Marcotte argues that there's a silver lining:
Considering the lengthy history of anti-choice violence against medical providers, this kind of behavior is deeply worrisome.But it also shows the depths of desperation of the anti-choice movement. More data collection will just prove how safe abortion is, and funerals for embryos just remind everyone what kind of sick fantasy lives anti-choice activists have.
Monday, September 5, 2016
Fast Company (August 15, 2016): Patagonia's CEO Explains How To Make On-Site Child Care Pay For Itself, by Rose Marcario:
Patagonia CEO Rose Marcario explains that many businesspeople ask how companies can afford the plethora of family centered benefits similar to those offered to Patagonia employees: "company-paid health care and sick time for all employees; paid maternity and paternity leave; access to on-site child care for employees at our headquarters in Ventura, California, and at our Reno, Nevada, distribution center; and financial support to those who need it, among other benefits." Marcario writes that while paid leave should be favored because it is the ethically responsible thing to do, it is also an effective business model, with an-in depth look at the tax benefits, employee retention, and employee engagement fostered by Patagonia's policies. This is something Patagonia has done since its inception, and current leadership maintains a staunch commitment to these values:
For 33 years, Patagonia has provided on-site child care—a mandate from our founders, who believed it was a moral imperative. Even in times of economic struggle the program was never cut, because they believed in providing a supportive work environment for working families. Taking care of our tribe is part of our culture and our commitment to helping our own people live the way they want. It’s true, there are financial costs to offering onsite child care, and they can be expensive if you offer high-quality programs or subsidize your employees’ tuition when onsite care is not available.
But the benefits—financial and otherwise—pay for themselves every year. As a CEO, it’s not even a question in my mind. Business leaders (and their chief financial officers) should take note.
New York Magazine (August 22, 2016): How New York City Is Fighting the Growing Threat of Zika, by Charley Lanyon
With Zika on the rise in places further South like Florida, New York City is taking note of the failure of adequate preparation in other states to avoid the spread of the virus. While the common carrier of the virus, the Aedes aegypti mosquito, generally doesn't fly as far up as New York City, the related Asian Tiger mosquito does bite in New York, and some are worried that they too could become carriers of the virus. New York wants to target mosquitos in a different and more aggressive way, and intends to use a significant portion of its budget to do so:
Thus, the city is going after the Asian tiger mosquito hard, with large-scale predawn insecticide sprayings from the backs of pickup trucks and smaller more-targeted assaults from teams of exterminators with backpacks full of mosquito poison that focus on areas believed to be especially high-risk.
Even with all of the precautions, city officials are quick to reiterate that there has not been a single case of mosquito- transmitted Zika in New York City, and they are hopeful that there will never be one. The biggest danger for catching Zika in the city is through unsafe sexual contact with an individual who has been infected abroad. So at least for now, the ability to control the spread of Zika in New York lies as much with the individual as the city. Be safe.
Sunday, September 4, 2016
New York Magazine (August 12, 2016): New York City Buildings Are Now Required to Have Lactation Rooms, by Laura June
A bill requiring some New York City-run buildings to have rooms allocated specifically for lactation as of July 2017 was passed unanimously by the City Council and signed by Mayor de Blasio. There will be no restroom facilities in the rooms, but they will be equipped with electrical outlets for pumps. New York job center buildings, medical centers, and borough offices owned by the City are just some of the buildings protected by the new law.
Mayor de Blasio said in a statement, "This bill is about fairness, access, and health — no new mother should be unable to breast-feed because she can’t find a private space." He added that the "bill takes our city one step toward being a place where all women feel comfortable breast-feeding whenever they need to, wherever they need to.”
Friday, September 2, 2016
New York Times (Aug. 31, 2016): Review: "The Art of Waiting," What to Expect When You're Still Not Expecting, by Jennifer Senior:
In this book review of Belle Boggs's "The Art of Waiting: On Fertility, Medicine, and Motherhood," Senior describes the book as a dispeller of myths. Myths about infertility abound: it is primarily a while, upper-middle-class problem, it is a woman's problem, it is rare and unnatural. None of these myths is even remotely true. The psychological experience of infertility and the attempts to treat it are harrowing:
There is always one more treatment to try or redo, provided she’s willing to spring for it or disappear into a canyon of debt. There’s adoption to consider; there’s also the simple possibility of giving up, of deciding there’s another kind of life to be lived. Ms. Boggs did that for a while. It was both horrible and a great relief. “I felt split in two,” she writes. “The person I had hoped to become was torn away, leaving only the person I had always been.” She eventually resumes trying.
Apart from the psychological devastation of trying and failing to have children is the crushing social isolation. As Senior puts it, "There’s something truly challenging, if not excruciating, about being out of step with your cohort."
At times the book seem hermetic because Boggs focuses primarily on her mileu of artists and writers. Nonetheless, concludes Senior, Boggs's has given "a cold, clinical topic some much-needed warmth and soul."
Thursday, September 1, 2016
The Center on Applied Feminism at the University of Baltimore School of Law seeks paper proposals for the Tenth Anniversary of the Feminist Legal Theory Conference March 30-31, 2017.
The conference will examine law through the lens of multiple identities. It will explore how intersecting identities inform -- or should inform -- feminist legal theory and justice-oriented legal practice, legal systems, legal policy, and legal activism. Beginning in 1989, Kimberlé Crenshaw identified the need for law to recognize persons as representing multiple intersecting identities, not only one identity (such as female) to the exclusion of another (such as African American). Intersectionality theory unmasks how social systems oppress people in different ways. While its origins are in exploring the intersection of race and gender, intersectionality theory now encompasses all intersecting identities including religion, ethnicity, citizenship, class, disability, and sexual orientation. Today, intersectionality theory is an important part of the Black Lives Matter and #SayHerName movements. For more information, see https://www.washingtonpost.com/news/in-theory/wp/2015/09/24/why-intersectionality-cant-wait/.
We welcome proposals that consider the following questions from a variety of substantive disciplines and perspectives: What impact has intersectionality theory had on feminist legal theory? How has it changed law and social policy? How does intersectionality help us understand and challenge different forms of oppression? What is its transformative potential? What legal challenges are best suited to an intersectionality approach? How has intersectionality theory changed over time and where might it go in the future?P
Please submit an abstract by Friday October 28, 2016 to firstname.lastname@example.org. Your abstract must contain your full contact information and professional affiliation, as well as an email, phone number, and mailing address. In the “Re” line, please state: CAF Conference 2017. Abstracts should be no longer than one page. We will notify presenters of selected papers in November. Please indicate at the bottom of your abstract whether you are submitting (1) solely to present or (2) to present and publish in the University of Baltimore Law Review symposium volume. Authors who are interested in publishing in the Law Review will be strongly considered for publication. For all presenters, working drafts of papers will be due no later than March 3, 2017. Please contact Prof. Margaret Johnson at email@example.com if you have further questions. For additional information about the conference, please visit law.ubalt.edu/caf.
Tuesday, August 30, 2016
New York Times (Aug. 30, 2016): Chinese Women Head Overseas to Freeze Their Eggs, by Carolyn Zhang:
A growing number of single Chinese women are traveling abroad to freeze their eggs. They want the option to become mothers even if busy careers and the lack of a stable partner cause them to delay having children. Single women need to travel because China tightly controls access to assisted reproduction. Infertility treatments for unmarried women are completely banned, making travel abroad necessary. Even heterosexual couples must present proof of their marriage, proof of infertility, and a license to give birth. Reproductive rights in this domain are trumped in China by concerns that reproductive technologies will have a negative impact on its population policies and will create a black market for human eggs. It is also against China's moral code for unmarried women to bear children. Nonetheless, the interest among unmarried women is high. Brokerage firms have begun matching them with clinics abroad. Continuing the trend, some American infertility clinics have opened offices in Chinese cities.
Friday, August 26, 2016
International Business News (Aug. 23, 2016): Potent New Fertility Technique Prevents Side-Effects of In-Vitro Fertilisation for Women, by Léa Surugue:
A new method of in-vitro maturation of eggs promises to improve infertility treatment for some couples pursuing in-vitro fertilization. IVM frees women from having to take as many hormonal injections as they prepare their ovulation cycles for the rigors of IVF. Eggs are removed from their ovaries before the eggs are completely mature. They are matured in the laboratory before being fertilized. The new technique treats the harvested eggs with sythetic cumulin, a substance that is produced when women use hormones to boost their egg production as they prepare for IVF. It appears the method could lead to more successful pregnancies than standard IVF. In the meantime, more tests will have to be conducted before the new method can be offered to patients.
Thursday, August 25, 2016
Human Reproduction (July 7, 2016): Is Underage Abortion Associated with Adverse Outcomes in Early Adulthood? A Longitudinal Birth Cohort Study up to 25 Years of Age, by Suvi Leppälahti, et al.:
Wednesday, August 24, 2016
New York Times (Jul. 25, 2016): One Woman’s Crusade for Her Husband’s Sperm, by Tamar Lewin:
Sarah Robertson, a Californian who lost her husband to a rare disease at the age of twenty-nine, desired to have a child using the sperm he had stored in an infertility clinic. But when she went to retrieve it, she was told it had vanished. Aaron had been a carrier of a Marfan syndrome, and there is a fifty per cent chance that the diseases will be passed along to any children created with his sperm. In vitro fertilization will be required to ensure that any of her embryos chosen for gestation do not carry the genes linked to the disease. Robertson worries that the clinic may have misappropriated vials of her husband’s sperm and sold them to unwitting women and couples. She wants the clinic to warn those who purchased sperm from the clinic and to pay for testing and treatment of any children born. Attempts at mediation and negotiation have led nowhere. Robertson has now filed suit.
Tuesday, August 23, 2016
New York Times (Jul. 19, 2016): Winning the Campaign to Curb Teen Pregnancy, by Tina Rosenberg:
It is common knowledge that girls who get pregnant have a range of difficulties. They have trouble finishing school and often have babies at risk for health problems and who themselves will experience academic difficulty and incarceration. The birthrate for teenage mothers in the United States has hit a new low. It is now even lower than it was in the 1950s. No one knows the cause of the drop in the birthrate, but it appears not to have to do with an increase in abortions (that rate has also dropped) but with an increase in contraceptive use.
The drop in the birth rate may also have to do with the show “16 and Pregnant.” After it began airing on MTV in 2009, teen pregnancy rates dropped three times as fast as previously. Such declines were most remarkable in regions where more teenagers were watching MTV. Google searches for “how to get birth control” spiked on days following an episode’s airing.
Colorado appears to have embraced the data. The state offers long-acting reversible contraceptives cost-free to women and girls. These “set and forget” methods have become the most reliable forms of birth control. Some of the cost to the state is subsidized by Obamacare and Medicaid. The Medicaid program saves on the cost of unwanted births and the medical care of children in poverty. Colorado’s experiment has been a success. Now the challenge lies in convincing other states to follow suit.
Monday, August 22, 2016
New York Times (Aug. 9, 2016): Four Lesbians, Suing, Say New Jersey Rule on Fertility Treatment is Discriminatory, by Megan Jula:
Couples who need infertility treatment to have children often do not have the resources to pay for it. Insurance is an important resource for filling the gap between the cost of treatment and a couple’s finances. Some states have laws that require insurers to provide coverage for some infertility treatment. By and large, though, the mandates cover only those who can demonstrate failure to conceive after two years of unprotected heterosexual intercourse. This leaves gay and lesbian couples without mandated coverage.
Two lesbian couples in New Jersey have sued the state, “claiming the mandate discriminates against their sexual orientation—essentially forcing infertile lesbian couples to pay for costly procedures to try to become pregnant.” They seek to recover the cost of their treatments, including artificial insemination and in vitro fertilization.
California and Maryland’s mandates have been updated to require fertility coverage without regard to sexual orientation.