Reproductive Rights Prof Blog

It's the 36th Anniversary of Roe v. Wade: Got Hope?

I am blogging for choice to celebrate Roe's anniversary.  The theme this year is our hopes for the new administration and/or Congress. 

We have much to celebrate this year as Roe v. Wade turns 36.  Our brand-new President is unabashedly pro-choice. President Obama took an immediate, important first step toward demonstrating that commitment by expressing his intention to withdraw or reconsider President Bush's last-minute, reproductive-rights-related regulations. 

I hope that Obama will continue to pursue common sense strategies to promote reproductive health and safety and to prevent unintended pregnancies.  But I hope for more than that.  Rhetoric is President Obama's forte.  I hope that he uses his eloquence to change the nature of the public conversation over women and pregnancy, and over women and abortion.  We need to stop accusing and shaming pregnant women; we must resist the impulse to judge women for making pregnancy-related decisions of which we disapprove. 

We need to learn to respect the rights of low-income women and women of color to bear children.  For a woman who desperately wants a child but cannot afford it, we must remember that an abortion is not a "choice" but a sad necessity.  We ought to provide more services and financial support for low-income pregnant women and mothers so they do not feel coerced by financial circumstances into ending wanted pregnancies.  We also need to understand that we can most help pregnant women who abuse drugs or alcohol by providing support and services, not by throwing them in prison. 

On the flip side, we must stop the public shaming of women who choose abortion.  Every one of us knows a woman who has had an abortion, whether we are aware of it or not.  These women are our mothers, our sisters, our daughters, our friends.  Yet the word "abortion" cannot even be uttered in a Hollywood movie today.  We need to learn to talk about abortion without shame, and to treat women who have abortions with respect. 

I am confident that President Obama will take take concrete steps as President to improve access to safe and comprehensive reproductive health services.  He can also help a great deal simply by talking about pregnant women and abortion with compassion and understanding, without judging women for the weighty, personal decisions that ultimately must be theirs to make.

Obama Revisits Last-Minute Bush Admin. Regs

The New York Times: Obama Will Ease Restraints on States' Health Insurance Programs for Children, by Robert Pear:

...Some of the policies may take more time to revise because they are in regulations that have already taken effect and have the force of law.

Mr. Obama has said, for example, that he objects to a last-minute Bush administration rule that grants sweeping new protections to health workers who refuse to help perform abortions, dispense contraceptives or provide other care because of their “religious beliefs or moral convictions.”

This “provider conscience regulation,” published on Dec. 19, takes effect on Tuesday, the day of Mr. Obama’s inauguration.

A 1983 Supreme Court decision suggests that the new administration would need to go through a formal rule-making process, with an opportunity for public comment, if it wanted to revoke this rule....

Mr. Obama is also expected to revoke the so-called global gag rule, a policy that prohibits organizations receiving federal money from performing abortions or supporting abortion as a method of family planning in other countries. Critics say that the restrictions — imposed by President Ronald Reagan, removed by President Bill Clinton two days after he took office and then reinstated by President Bush — also limit access to contraceptives and family planning services.

HAPPY INAUGURATION DAY!! I'm excited to be among the throngs observing the swearing-in today.

Federal Lawsuit Filed Against Nurse Practitioner for Removing IUD Without Permission

Courthouse News Service: Woman Says Anti-Abortion Nurse Removed IUD Without Permission, Then Lectured Her:

ALBUQUERQUE (CN) - A clinic nurse first removed her intrauterine birth-control device without permission, says the patient in a federal action, then told her that "having the IUD come out was a good thing," because "I personally do not like IUDs. I feel they are a type of abortion. I don't know how you feel about abortion, but I am against them."

The patient sued Presbyterian Health Services Rio Rancho Family Health Center and nurse practitioner Sylvia Olona in Federal Court.

H/T: Jennifer Klein Ayers

Pregnant Women in Developing Nations Face Grave Risks to Life and Health

Wash. Post/HealthDay News: Mothers, Newborns at High Risk in Developing World:

A pregnant woman living in one of the world's poorest countries is 300 times more likely to die during pregnancy or childbirth than women living in more affluent nations, a UNICEF annual report released Thursday shows.

The State of the World's Children report also estimates that infants born in developing nations have a 14-fold higher chance of dying during their first month of life compared to newborns in richer countries.

The health of infants is closely tied to that of their mothers, UNICEF noted.

Fire Strikes Nebraska Abortion Clinic

MSNBC/TheOmahaChannel.com: Fire Engulfs Lower Level Of Clinic Where Abortions Performed:

The physician who operates a health clinic where abortions are performed said a fire that broke out Friday morning in the clinic's basement is "very suspicious."

The physician, Dr. Leroy Carhart, said the fire started in the lower level where records are stored. He said there's nothing in the basement that could start a fire.

Further, Carhart said, the electrical circuit in the lower level is turned off when the clinic is closed.

Dr. Carhart was the plaintiff in two challenges to so-called "partial-birth abortion" bans decided by the Supreme Court: Stenberg v. Carhart (2000) (striking down Nebraska's ban); Gonzales v. Carhart (2007) (upholding federal ban).  In 1991, a fire destroyed Carhart's home and barn, killing seventeen horses, and a pet dog and cat.

Seven States Join Lawsuits Challenging Bush Health Care Denial Rule

Wash. Post: Lawsuits Filed Over Rule That Lets Health Workers Deny Care, by Rob Stein:

Seven states and two family-planning groups yesterday asked a federal court to block a controversial new federal regulation that protects health workers who refuse to provide care that they find objectionable.

In three lawsuits filed in U.S. District Court in Connecticut, the states and groups sought an immediate court order preventing the regulation from going into effect Tuesday and a permanent decision voiding the rule.

National Family Planning & Reproductive Health Association and ACLU Ask Court To Block Health Care Denial Rule

Via ACLU Press Release:

The National Family Planning & Reproductive Health Association (NFPRHA), represented by the American Civil Liberties Union, today filed a lawsuit in federal court challenging the Bush administration's Health Care Denial Rule....

According to today's legal papers, the rule significantly undermines the ability of millions of women and men in the United States to access essential family planning, reproductive and other health care services and information.  It expressly permits a broad range of health care workers and facilities to refuse to provide services, information, and counseling, potentially even in emergency situations.  At the same time, it fails to require refusing providers to either notify their employers or their patients of their objections to providing care....

During a 30-day comment period, HHS received more than 200,000 comments; the overwhelming majority opposed the rule, including comments from major medical associations such as the American Medical Association and the American College of Obstetricians and Gynecologists, women's health organizations, members of Congress, state governors and attorneys general, the Equal Employment Opportunity Commission, religious advocates, and the general public.

The final rule fails to address many of the concerns raised in these comments, including whether the rule prevents states from enforcing their own laws enacted to protect access to reproductive health care, whether the rule allows providers to refuse care even in emergency situations, and whether women seeking family planning services at federally funded health centers are still assured counseling for abortion care if they request it.

In addition to this legal challenge brought by NFPRHA, represented by the ACLU, the Connecticut Attorney General's Office and Planned Parenthood Federation of America with Planned Parenthood of Connecticut have filed separate legal challenges to the Bush rule.

The Department of Health and Human Services promulgated the rule on December 19, 2008; the rule is scheduled to go into effect on January 20, 2009.

The complaint is available at: www.aclu.org/reproductiverights/gen/38321lgl20090115.html

Read more about NFPRHA.

Naomi Cahn on "Test Tube Families"

Naomi Cahn (GW Law) has a new book out: Test Tube Families (NYU Press).  Here is the abstract:

The birth of the first test tube baby in 1978 focused attention on the sweeping advances in assisted reproductive technology (ART), which is now a multi-billion-dollar business in the United States. Sperm and eggs are bought and sold in a market that has few barriersto its skyrocketing growth. While ART has been an invaluable gift to thousands of people, creating new families, the use of someone elses genetic material raises complex legal and public policy issues that touch on technological anxiety, eugenics, reproductive autonomy, identity, and family structure. How should the use of gametic material be regulated? Should recipients be able to choose the best sperm and eggs? Should a child ever be able to discover the identity of her gamete donor? Who can claim parental rights?

Naomi R. Cahn explores these issues and many more in Test Tube Families, noting that although such questions are fundamental to the new reproductive technologies, there are few definitive answers provided by the law, ethics, or cultural norms. The regulatory void outside of minimal requirements for gametic testing and limited protection against deceptive marketing techniques used by fertility clinics creates thorny problems for all involved in the egg and sperm business.

Continue reading

Rebecca Kukla et al. on Women's Autonomy in Childbirth

Rebecca Kukla, et al., have posted Finding Autonomy in Birth on SSRN. Here is the abstract:

Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women choosing to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not seem adequate to capture concerns and intuitions that have a strong grip outside this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women's agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be for or against women's access to cesarean delivery in the absence of traditional medical indications and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach but, rather, taking the value of women's autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women's full inclusion in a safe and positive birth process.

Obama Expected to Ask Pro-Abstinence-Only AIDS Coordinator to Stay On

RH Reality Check: Obama to Keep Abstinence-Only AIDS Coordinator, by Jodi Jacobson:

Confirming month-old rumors, a high-level source reported last night that President-Elect Obama's transition team has asked Ambassador Mark Dybul to remain in place as Global AIDS Coordinator, despite strong opposition by treatment access, HIV prevention, and women's rights advocates across the global HIV and AIDS community, many of whom signed letters calling for a change in PEPFAR leadership at this crucial time.  While keeping Dybul on may be a stopgap measure for a new Administration dealing with huge problems across the board, it is a decision that signals we may not be getting "the change we need" in global AIDS policies.

Dybul, a medical doctor, is strongly associated with the failed policies of the President's Emergency Plan for AIDS Relief (PEPFAR), including those that flout both evidence and human rights, and that neglect the role of stigma, discrimination and gender equity in the spread of HIV.

Madoff Debacle Hits Reproductive Rights Advocacy Groups

Salon.com Broadsheet: How the Madoff mess hits women, by Nancy Goldstein:

For all the ink that's been spilled on the Madoff investment scandal, I've read nothing about its impact on funding for progressive women's causes -- which is considerable. Simply put, only a small pool of foundations are funding litigation and advocacy work related to criminal justice or constitutional rights; the pool that supports related programs targeted to women is smaller still. With the recent shuttering of two of Madoff's clients, the Picower Foundation and the JEHT Foundation, that pool has shrunk to a puddle.

Picower was one of a handful of foundations willing to stick their necks out and significantly fund the three organizations that handle virtually all major reproductive rights-related litigation and legal advocacy in the United States. Now the Center for Reproductive Rights needs to make up a $600,000 shortage in 2009; Planned Parenthood is out $484,000; the ACLU's Reproductive Freedom Project is off $200,000.

NY Times LTE: Abortion and Low-Income Women

The New York Times on Sunday published letters responding to the Jan. 5 article, For Privacy’s Sake, Risking Do-It-Yourself Abortion. See The Abortion Choices of Poor Women.  The letters include one from David Cohen (Drexel Law), pointing out that the federal Hyde Amendment means that in many states the government does not cover the abortions of low income women, calling into question the article's characterization of abortion as "inexpensive."  Another letter also addressed the high costs of abortion for women who must pay out of pocket.

ACLU Files Suit to Stop Religiously Based Restrictions in Federally Funded Trafficking Victims Program

ACLU Press Release: ACLU Asks Court To Stop Misuse Of Taxpayer Dollars In Trafficking Victims' Program:

BOSTON – The American Civil Liberties Union today asked a federal court to require the United States Department of Health and Human Services (HHS) to ensure that funds distributed through the Trafficking Victims Protection Act are not being used to impose religiously based restrictions on reproductive health services.  Since 2006, HHS has allowed the United States Conference of Catholic Bishops to limit, based on its religious beliefs, the types of services trafficking victims receive with taxpayer dollars.

"Human trafficking is basically a form of modern-day slavery," said Brigitte Amiri, staff attorney with the ACLU Reproductive Freedom Project.  "There are many organizations that are deeply committed to assisting trafficking victims; our government should ensure that these organizations can provide the full range of needed services, including reproductive health care."

Through the Trafficking Victims Protection Act, the federal government distributes funds to cover an array of services needed by the more than 14,000 individuals, predominantly women, who are brought into the United States annually and exploited for their labor, including in the commercial sex industry.  Many trafficking victims experience extreme violence and sexual assault at the hands of their traffickers.  Some become pregnant as a result of rape and some contract sexually transmitted infections, including HIV, according to today's legal papers.

Read the full press release here.  The complaint is available here.

Lawrence Gostin on Male Circumcision for HIV Prevention in Sub-Saharan Africa

Lawrence O. Gostin (Georgetown Law) has posted Male Circumcision as an HIV Prevention Strategy in Sub-Saharan Africa: Socio-Legal Barriers on SSRN.  Here is the abstract:

UNAIDS and WHO recommend safe, voluntary male circumcision as an additional, important strategy for the prevention of heterosexually-acquired HIV in men in areas with high HIV prevalence and low levels of male circumcision. Comprehensive male circumcision services should include HIV testing and counseling, partner reduction, and male and female condom use. Yet, male circumcision can have deep symbolic meaning that could pose barriers to implementation. In some parts of the world, it is a traditional practice with religious or cultural significance, in others it is a common hygiene intervention, and in yet others it is unfamiliar or foreign. Consequently, the proportion of men who are circumcised varies from <5% to >80%, with an estimated 30-40% of adult men circumcised worldwide.

Confirming a number of observational studies, three randomized controlled trials in Africa have shown that circumcision reduces the likelihood of female-to-male HIV transmission by 50-60%, leading WHO/UNAIDS to conclude that the evidence is "compelling." Male circumcision is a relatively simple, inexpensive one-time surgical procedure that is cost-effective, but raises a host of ethical, legal, and human rights challenges.

Thanks to My (Just-Married) Research Assistant!

Under the category of better late than never, I want to thank my research assistant, Christina Tenuta, for her helpful research for this blog during the fall semester of 2008, as well as to congratulate her on her recent wedding!

Antiabortion Groups Protest University of Wisconsin Plan To Provide Second-Trimester Abortions

Via Daily Women's Health Policy Report:

A pending University of Wisconsin plan to provide second-trimester abortions at its Madison Surgery Center is drawing criticism from antiabortion-rights groups, which are questioning the legality of the plan, the AP/Chicago Tribune reports. The Alliance Defense Fund, an Arizona-based antiabortion-rights group, sent a letter to university officials urging them to stop the plan, saying that performing abortion procedures at the surgery center might violate a state law that prohibits federal or state funds from being used to pay physicians or clinics that perform abortions. In the letter, ADF lawyer Thomas Bowman wrote that "[m]any ... employees" believe that performing abortion procedures at the center would "severely upset regular patients, disrupt the respected surgical practice that currently occurs there, decimate employee morale, require burdensome policy changes and compel direct or indirect staff participation" in the procedures....

Lisa Brunette, the university's health spokesperson, said that state physicians employed by the university would perform the procedures and that the procedures would be paid for by patients or insurance companies, not by public funding. Brunette also said that employees would be able to opt out of a procedure and that medical students would only be trained on the procedures if they elect to do so. Wisconsin state law prohibits employers from penalizing health care workers who refuse to "recommend, aid or perform" abortions because of moral objections. Brunette said the plan is awaiting final approval from the surgery center's board, which will meet later this month. The university's lawyers are confident that the plan is legal, she added.

Teen Birth Rates Increased in 26 States in 2006

USA Today: Teen birth rates up in 26 states, by Sharon Jayson:

The newest and most detailed data on teen birth rates shows significant increases in 26 states and represents most regions of the USA.

"To see 26 states with statistically significant increases is fairly remarkable," says Paul Sutton, a demographer with the National Center for Health Statistics, which released the data Wednesday. "We're seeing increases in both the number of teens having births and also the rate at which they are having births. Both of them are going up."

The federal data — largely from birth certificates — shows widespread statistically significant increases for 2006, the most recent year for which data are available. In the two previous years — from 2004 to 2005 and from 2003 to 2004 — only one state in each year (Tennessee and South Dakota) had a significant increase.

Utah: Plans to Push Abortion Ban Are on Hold

The Salt Lake Tribune: Conservative trio to wait on abortion ban, by Sheena McFarland:

Conservative legislators are backing away from costly plans to take on Roe v. Wade this year -- given Utah's tight budget -- but they want to start stockpiling donations for a future court fight against abortion.

"We are looking at wanting to ban abortion in Utah, period, end of story. However, we want to do it correctly," said Rep. Carl Wimmer, R-Herriman. "We're not going to back away from abortion. We're never going to let it die."

Wimmer is working with Rep. Ken Sumsion, R-American Fork, and Rep. Stephen Sandstrom, R-Orem, on a bill that would bar abortions except in the case of rape, incest or permanent physical harm to the woman.

But the legislators realize Utah doesn't have the estimated $2 million to $7 million it would take to defend such a ban in court. So they are putting off their anti-abortion bill and instead proposing legislation that would create a legal defense fund for a court showdown later.

HHS Midnight Reg Prompts 200,000 Opposing Comments

Chicago Sun-Times: 11th-hour abortion rule draws 200K protests, by David Templeton:

An 11th-hour rule from the U.S. Department of Health and Human Services is stirring national controversy by allowing people who provide reproductive health services to refuse information or procedures that violate their conscience....

Despite 200,000 comments opposing the action, HHS issued the new rule Dec. 18. It will take effect the day before President-elect Barack Obama takes office. Those supporting the new rule expect a battle with the Obama administration over its implementation.

Rules already are in place to protect any person, doctor or pharmacist from going against their conscience by providing abortion or contraception information or services to patients or clients. But current practice requires people to inform people that other options are available elsewhere.