Reproductive Rights Prof Blog

LA Times: Her embryos or his?

Kevin Sack reports for the LA Times:

Advances in assisted reproduction have created a legal landscape that judges and lawmakers could hardly have envisioned before 1984, when an Australian baby became the first created from a frozen embryo (the first U.S. birth came two years later). Since then, in vitro fertilization, or IVF, has become an immensely popular solution to fertility problems worldwide....

Embryo storage and maintenance has become a huge headache for fertility clinics, which often cannot coax couples into either destroying or donating them to research or to other couples....

And with some regularity, couples separate without clear agreements about embryo disposition.

Because there is no federal precedent for settling such disputes, state courts have been left to make Solomonic decisions on embryo custody. To date, the top courts of six states have ruled in such cases. While the case particulars have varied, a trend has emerged. In general, the courts have held that the right of one ex-spouse to not procreate trumps that of the other to procreate.

Research shows pregnant woman's stress harms fetus

Via The Guardian (UK):

Stress experienced by a woman during pregnancy may affect her unborn baby as early as 17 weeks after conception, with potentially harmful effects on brain and development, according to new research. The study is the first to show that unborn babies are exposed to their mother's stress hormones at such an early stage in pregnancy.

The findings, published in the journal Clinical Endocrinology, come after separate research on animals showed that high levels of stress in a mother during pregnancy could affect brain function and behaviour in her offspring, and other evidence suggesting that maternal stress in humans can affect the developing child, including lowering its IQ.

Oregon Gov. signs bill to provide prescription drug coverage for birth control

Via KOIN News 6 (Portland, OR):

Gov. Ted Kulongoski signed a bill Wednesday that requires private health insurers to provide prescription drug coverage for birth control. ...

The act will go into effect Jan. 1. Health insurance plans would be obligated to offer the same level of coverage for birth control as they do other prescription drugs.

Nearly 90% of California Parents Support Comprehensive Sex Education in Schools

Via the Kaiser Daily Women's Health Policy Report:

Eighty-nine percent of California parents -- regardless of their political and religious views, level of education and residence -- support comprehensive sex education programs in schools, according to the first statewide survey on the subject released on Thursday, the McClatchy/San Jose Mercury News reports. Comprehensive sex education includes information about contraception, sexually transmitted infections and abstinence, according to the McClatchy/Mercury News. ...

The researchers found that 96% of California parents oppose abstinence-only sex education requirements in schools. No subgroup by region, religion, income, education or political party fell below 80% support for comprehensive sex education, the study showed. Eighty-six percent of self-identifying evangelical Christians said they supported comprehensive sex education programs, while those who identified themselves as "very conservative" responded with the lowest rating of 71% support for the programs. "We were astonished by how universal this support is for comprehensive sex education," lead study author Norman Constantine of the PHI's Center for Research on Adolescent Health and Development said.

National and statewide polls have long shown that parents support comprehensive sexuality education.  Moreover, abstinence-only education doesn't work.  So why exactly are we continuing to develop and fund abstinence-only programs?

Song Lyrics About Unintended Pregnancy and Abortion

A film about illegal abortion just won the Palme d'Or at the Cannes Film Festival.  Abortion and the diverging views about it pervade popular culture, and song lyrics are no exception.  I'll be periodically posting lyrics that address abortion or unintended pregnancy.  Do you have a favorite song addressing these issues?  I'll start with "Lost Woman Song," by Ani DiFranco (from the album "Ani DiFranco"), which addresses the issue unflinchingly.  In other songs the reference may be ambiguous, or more obscure.

lost woman song

-for lucille clifton

i opened a bank account
when i was nine years old
i closed it when i was eighteen
i gave them every penny that i'd saved
and they gave my blood and my urine a number
now i'm sitting in the waiting room
playing with the toys
i am here to exercise my freedom of choice
i passed their hand held signs
i went through their picket lines
they gathered when they saw me coming
they shouted when they saw me cross
i said why don't you go home
just leave me alone
i'm just another woman lost
you are like fish in the water
who don't know that they are wet
but as far as i can tell
the world isn't perfect yet
his bored eyes were obscene
on his denimed thighs a magazine
i wish he'd never come here with me
in fact i wish he'd never come near me
i wish his shoulder wasn't touching mine
i am growing older waiting in this line
but some of life's best lessons
are learned at the worst times
under the fierce fluorescent
she offered her hand for me to hold
she offered stability and calm
and i was crushing her palm
through the pinch pull wincing
my smile unconvincing
on the sterile battlefield that sees
only casualties
never heros
my heart hit absolute zero
lucille, your voice still sounds in me
mine was a relatively easy tragedy
the profile of our country
looks a little less hard-nosed
but that picket line persisted
and that clinic has since been closed
they keep pounding their fists on reality
hoping it will break
but i don't think that there's one of them
who leads a life free of mistakes

© 1990 ani difranco / righteous babe music

Read Lucille Clifton's The Lost Baby Poem.

Peter Singer: "Treating (or Not) the Tiniest Babies"

The controversial Peter Singer contributes a not-very-controversial op-ed to the current issue of Free Inquiry (published by the Council for Secular Humanism).  Singer contrasts the attitudes of Australian health care professionals who offer intensive care to premature infants with those of their American counterparts.  A workshop held in Australia addressing this issue revealed that the Australian providers do not feel morally obligated to try to save every infant no matter the chances for survival or the long-term prognosis:

[I]nstead of trying to set a rigid cut-off line, the workshop defined a “gray zone” within which treatment might or might not be given, depending on the wishes of the parents. If the parents of an infant born at twenty-three weeks did not want their baby treated, every participant would accept that request. There was consensus that, although the possibility of active treatment could be discussed, it would be discouraged. Even at twenty-five weeks, 72 percent of the participants would not initiate treatment if the parents did not want it. By twenty-six weeks, however, the consensus was that the infant should be treated, except in unusual circumstances.

In contrast, Singer asserts, in the United States the view is prevalent that no effort must be spared in trying to save a premature infant.  Singer is concerned that in this climate, parents are not adequately informed or engaged in the decision whether to try to save their baby:

Instead of openly discussing the options with parents, some doctors will instead say that treatment is “futile” and “nothing can be done.” In fact, in these cases, active treatment would often prolong life, but there would be a high probability of severe disability. In this situation, to say that treatment is “futile” is to make the ethical judgment that life with such a high level of disability is either not worth living or not worth the effort required by the parents and the community to make it possible for the child to live. Other doctors believe that all human life is of infinite value and that it is their duty to do everything possible to save every baby, irrespective of the likelihood that the baby will be severely disabled. In neither of these situations are parents given the chance to participate in the decision about their child. While that may relieve them of the heavy burden of responsibility, it also denies them the opportunity to say how precious this child is to them and whether or not they could love and welcome into their home a child with a severe disability.

Singer concludes by advocating a stronger role for parents in the decision whether to try to save babies born in the “gray zone,” where survival is uncertain and the risk of serious, permanent disability is high.

Justice Ginsburg Again Bemoans Court's Lack of Regard for Women's Equality

Poor, lonely Justice Ginsburg.  In today's Washington Post, Robert Barnes reports on Justice Ginsburg's frustration with the Supreme Court's decision yesterday making it more difficult for workers to sue for unequal pay:

The decision moved Justice Ruth Bader Ginsburg to read a dissent from the bench, a usually rare practice that she has now employed twice in the past six weeks to criticize the majority for opinions that she said undermine women's rights.

Speaking for the three other dissenting justices, Ginsburg's voice was as precise and emotionless as if she were reading a banking decision, but the words were stinging.  "In our view, the court does not comprehend, or is indifferent to, the insidious way in which women can be victims of pay discrimination," she said.

Last month, Ginsburg rebuked the same five-justice majority for upholding the federal Partial Birth Abortion Ban Act and for language in the opinion that she said reflected "ancient notions about women's place in the family and under the Constitution -- ideas that have long since been discredited."

Read the decision in Ledbetter v. Goodyear Tire & Rubber Co.  Read Justice Ginsburg's dissent in Gonzales v. Carhart (addressing the federal abortion ban).

Mozambique considers legalizing abortion

Via IRIN:

Citing a high rate of maternal deaths due to illegal, unsafe abortions, Mozambique policymakers are considering legalising the procedure. The country may eventually become one of only a handful in Africa where abortion is available upon demand.

The push for the new legislation, officially introduced earlier this year, has come from the Mozambican health ministry, arguing that unsafe abortion is the third leading cause of death among pregnant women in the country. Mozambique also has one of the highest maternal death rates in the world.

NY Times: "For the Tiniest Babies, the Closest Thing to a Cocoon"

In today's New York Times, Christine Hauser reports:

Kimberli Johnson’s baby was born much too soon, trading the serenity of the womb after 24 weeks of gestation for the chaotic world of a neonatal intensive care unit....

In the six months that Mrs. Johnson sat by Ellie’s isolette, she began to understand firsthand the jarring discrepancy between the aquatic nest that her daughter had left too early and the new environment into which she had been thrust and was now expected to grow.

Parents of other babies stopped and gawked. Alarms went off at adjacent isolettes. Monitors beeped, instruments clattered and lights glared. Sometimes, a wail of grief from parents learning of the death of their fragile baby added to the cacophony.

But after Ellie left the hospital, Mrs. Johnson used her experiences to join what has become a growing trend in the care of premature babies by helping design private rooms in neonatal intensive care units, or NICUs, that strive to replicate the qualities of the womb: its darkness, relative quiet and full entanglement with the mother’s biological rhythms.

LA Times: "Hundreds get abortions in Mexico City"

Héctor Tobar reports for the L.A. Times:

Women's groups praise officials for moving quickly to put a new law into effect.

About 700 women have requested abortions at public hospitals here in the month since legislators legalized abortion in this capital city, and hundreds more have received abortions at private clinics, according to government officials and abortion rights groups.

Women's groups have praised city officials for moving quickly to put the law into effect after its April 24 approval by the Mexico City legislature. Abortion remains illegal in the rest of Mexico. This capital city, along with Puerto Rico, Cuba and Guyana, are the only places in Latin America where abortion is legal. Illegal abortions are common, however.

See also these related posts: Abortion is legal in Mexico City but questions and critics remain and Mexico City Legalizes Abortion.

Brazil to Subsidize Birth Control Pills, Despite Criticism from the Pope

Stan Lehman reports for the Associated Press:

Just weeks after Pope Benedict XVI denounced government-backed contraception in a visit to Brazil, the president unveiled a program Monday to provide cheap birth control pills at 10,000 drug stores across the country.

President Luiz Inacio Lula da Silva said the plan will give poor Brazilians "the same right that the wealthy have to plan the number of children they want."

Flags courtesy of ITA's Flags of All Countries used with permission.

Romanian Film Addressing Illegal Abortion Takes Top Prize at Cannes

Via the Toronto Star, by movie critic Peter Howell:

A graphic movie about an illegal abortion took the Palme d'Or last night at the closing of the 60th edition of the Cannes Film Festival.

Titled 4 Months, 3 Weeks and 2 Days, a realistic drama Romanian director Cristian Mungiu said he almost didn't make due to lack of ideas and funds won the prize that is second only to Oscar's Best Picture for film glory. His film beat 21 competitors, including ones made by such international heavyweights as Joel and Ethan Coen, Quentin Tarantino and Wong Kar-wai....

Mungiu called the win a victory for small filmmakers the world over. Set in a small Romanian town before the fall of Communism, a time when abortion was punished by harsh jail sentences, the movie makes no judgments but spares no sensibilities; every stage of the procedure is shown.

It unspools in what seems like real time, as a young university student seeks to end an unwanted pregnancy despite the ban against the procedure and her risky decision to wait beyond the first trimester. The student and her female roommate become the prey of the male abortionist who exploits them.

Via the New York Times, by Manohla Dargis and A.O. Scott:

In its closing ceremony on Sunday the festival bestowed two of its most important prizes on Romanian films, affirming the vitality of this recently emerging cinema. The top award, the Palme d’Or, went to Cristian Mungiu for “4 Months, 3 Weeks and 2 Days,” an unsparing yet humane look at life during the dictatorship of Nicolae Ceausescu. Additionally the jury for Un Certain Regard, a sidebar to the main competition, gave its highest honor to “California Dreamin,’ ” a first feature by Cristian Nemescu set in Romania during the Kosovo war of 1999. It was a poignant victory, because Mr. Nemescu died in an automobile accident last year at the age of 27.

The audience in the Palais des Festivals was audibly delighted by Mr. Mungiu’s victory. His film, shown early in the festival, had enjoyed ardent critical support from the start. It follows the ordeal of two female university students as one tries to help the other obtain an illegal abortion. Harrowing and brilliantly acted, the movie presents a stark image of life under totalitarian rule without political grandstanding or sentimentality. At times it feels like a horror movie. Through meticulous formal control, Mr. Mungiu generates almost unbearable suspense and also shows, in sometimes graphic detail, the consequences of abortion and also of banning it.

The New York Times also has links to podcasts from the festival (this page may be accessible to subscribers only).

Jeffrey A. Parness on the Role of Paternity

Jeffrey A. Parness (Northern Illinois University) has posted Lost Paternity in the Culture of Motherhood  on SSRN.  It will be published in the Valparaiso University Law Review. Here is the abstract:

In her recent Columbia Law Review article, "Infant Safe Haven Laws: Legislating in the Culture of Life," Professor Carol Sanger shows that American safe haven laws, viewed "within a larger political culture," promote the "goal of the culture of life: the reversal of Roe v. Wade." Their effectiveness in that pursuit, she correctly notes, depends on whether judges and others recognize the "strong differences" between varying culture of life settings. Like Professor Sanger, I see differences between safe haven abandonment and abortion. Unfortunately, Professor Sanger fails to note that American safe haven laws, within a larger political culture, also significantly promote the culture of motherhood, that is, the unconditional respect for relatively exclusive maternal decisionmaking about newborns, regardless of children's best interests, of any legal paternity interests, and of the strong social policy favoring two parents for each child born alive as a result of consensual sex. As with culture of life settings, there are "strong differences" in culture of motherhood settings.

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Menstruation, Fake Periods, and Womanhood

It's been very interesting to read all the male speculation on the emotional benefits (or not) of menstruation, musings prompted by the FDA's approval of Lybrel, the birth control pill that purportedly eliminates periods (although it is more accurate to say that, unlike traditional pill regimens, it does not induce gratuitous monthly, non-menstrual bleeding -- more on that below).  William Saletan (see yesterday's post) says he'll "stay out of the fight over womanhood."  Eugene Volokh, though, leaps right in, devoting a whole post to the issue, first laying out his assumption that most women must hate their periods but then seeking input from "people who have actually menstruated."

Some female bloggers (see here and here) have found the speculation offensive, or at least condescending.

At this post, KipEsquire asks, "How soon before radical feminists, neo-hippies and other professional anti-progress malcontents decry Lybrel and praise menstruation as a noble, to-be-celebrated part of the "female experience"?"  Hmm... why so sarcastic?  I guess he knows better than any "radical feminist" what the "female experience" is really all about.

I suppose I fall into the "radical feminist" camp, but my own reaction to all the uproar over suppressed menstruation can't be summarized quite that neatly.  In debating the benefits and drawbacks of periods in the context of Lybrel, most people seem to miss what to me is the most important point: that any "period" that occurs when a woman is on the pill isn't a period at all.  I personally felt snookered when I learned years ago that the (male) inventors of the birth control pill, Gregory Pincus and John Rock, had no medical reason for including a week of placebo sugar pills to induce a fake "period," but instead did so because they assumed that women (and the public) would more readily accept the pill if women appeared to continue to menstruate every month. 

While I can imagine that some women, for a variety of reasons, might welcome a biological period, it's hard for me to understand why they would welcome a male-invented, apparently medically unnecessary, pretend period.  Being on the pill interferes with a woman's reproductive cycle by stopping ovulation (and, along with it, all real menstruation).  Given the numbers of women who take the pill, people seem comfortable with that, so I'm puzzled at how introducing a monthly week of gratuitous bleeding makes the situation any more "natural."  I worry that the decades in which women (and men) have become accustomed to these fake, monthly periods have shaped perceptions about what is beneficial or normal for women. Or maybe for many women it's just that they've been misinformed or misled about what is really happening when they continue to bleed every month while on the pill.

For more on this, see The Well-Timed Period (Lybrel Approved and I Offer Marketing Advice to Wyeth Via a NYT Critique), which also has a helpful post explaining the difference between menstruation and the "withdrawal bleeding" induced by placebo pills (or a week without taking pills) in ordinary birth control regimens.

NPR Examines Controversy over Lybrel

NPR: 365-Day Birth Control Pill Stirs Controversy:

A new birth control pill that eliminates women's monthly periods gained Food and Drug Administration approval this week. The contraceptive, called Lybrel, is the first form of birth control that's taken every day, 365 days a year.

Will Saletan, national correspondent for the online magazine Slate, talks with Madeleine Brand.

Listen to the segment.  See also William Saletan's Period. The End?, which appears in this Sunday's Washington Post:

Since the dawn of hormonal contraception, women have debated the wisdom of suppressing their periods. Crunchy feminists think it's unnatural; techno-feminists think it's liberating. I'm a guy, so I'll stay out of the fight over womanhood. But I'll say one thing about nature and liberation: Pharmacology is dissolving them. Menstruation as we know it isn't exactly natural. And for some women, abolishing it isn't exactly liberating.

Judith Warner: "Words that Wound the Working Mother"

On her Domestic Disturbances Blog (New York Times), Judith Warner decries the persistent, and in her view uniquely American, negative public opinion about working mothers.  She discusses the issue in the context of media coverage of the disappearance of British 3-year-old Madeleine McCann:

In the United States, only People magazine has so far given Madeleine’s abduction the kind of front-page play it has garnered in Britain. ...

But then People went on to do something very American. The writer, Bill Hewitt, said: “Those closest to the McCanns described Kate as a devoted mother who had scaled back to working only a day and a half a week as a general practitioner (Gerry is a cardiologist) so that she could be with her children.” He went on to quote Aunt Philomena: “She’s working to keep her career up but spends the majority of her time with the kids.”

Message: Kate McCann is a Good Mother. Hence – unlike some other mothers – she didn’t even remotely deserve to have terrible things happen to her.

It’s at times like this that I just hate being a mother in America.

Caroline Bettinger-Lopez and Susan Sturm on Litigation-Centered Mobilization and Fetal Protection Policies

Caroline Bettinger-Lopez and Susan Sturm, both of Columbia Law School, have posted International Union, U.A.W. v. Johnson Controls: The History of Litigation Alliances and Mobilization to Challenge Fetal Protection Policies on SSRN. The article will be included in Civil Rights Stories, a book edited by Myriam Gilles and Risa Goluboff that will be published by the Foundation Press this year. Here is the abstract:

The Supreme Court's decision in Johnson Controls is the culmination of a long legal campaign by labor, women's rights, and workplace safety advocates to invalidate restrictions on women's employment based on pregnancy. This campaign powerfully demonstrates the use of amicus briefs as opportunities to link the efforts of groups with overlapping agendas and to shape the Supreme Court's understanding of the surrounding empirical, social and political context. But Johnson Controls also provides important lessons about the narrowing effects and fragility of litigation-centered mobilization. The case affirmed an important anti-discrimination principle but ironically left women (and men) with the "right" to work in unsafe workplaces. The national coalition that had organized in support of the Johnson Controls plaintiffs did not stay together to address these complex issues after the case was won. Instead, the coalition disbanded and its members moved on to pursue diverse and separate agendas.

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Marijuana-Like Chemicals Guide Fetal Brain Cells

Via Scientific American, by J.R. Minkel:

Molecules may help young brain cells forge the right connections—but only at the right time and place

Natural marijuanalike chemicals may direct key brain cells to make proper connections while in the womb, according to a new study. Researchers report that the molecules, called cannabinoids, serve as guideposts for young cells in the attention and decision-making parts of fetal mouse brains.

The finding may help explain studies showing that the children of mothers who smoked marijuana during pregnancy are slower to process information than their peers (although they are just as intelligent overall). Tetrahydrocannabinol (THC), the active ingredient in marijuana, might knock the cell-guiding machinery off course by overstimulating the brain. Researchers, however, say they are still a long way from determining exactly what effects endocannabinoids and THC have on developing human brains.

Poland May Appeal European Human Rights Court Ruling On Abortion

Via the Post Chronicle:

Poland could appeal verdicts pronounced by Europe's rights court declaring Warsaw authorities violated abortion and gay rights.

Marek Jurek, of the Polish Right group, suggested Poland should appeal the two rulings, which he said violated rights guaranteed by Polish law, Radio Polonia reported Thursday.  Jurek said the Polish government should defend the right to life in the case of abortion....

In March, the court awarded compensation to a Polish woman whose eyesight was severely damaged during childbirth after the Polish government denied her permission to have an abortion.  See this related post:  Europe's Human Rights Court Orders Poland to Compensate Woman Denied an Abortion

Flags courtesy of ITA's Flags of All Countries used with permission.

La. House approves ban on abortion procedures

Doug Simpson reports for the Associated Press:

The state House unanimously approved a ban on a late-term abortion procedure Thursday, even though a federal ban already exists.

Rep. Gary Beard's bill would create criminal penalties for doctors who perform the so-called "partial-birth" abortions: fines of between $1,000 and $10,000, and jail terms of between one and 10 years.

"This is a crime of violence committed against children just minutes from their birth," said Beard, R-Baton Rouge.