Reproductive Rights Prof Blog

Fertility Industry Under New Scrutiny

NY Times: Questions Grow for Fertility Clinics, by Stephanie Saul:

Pictures of children, his trophies, decorate Dr. Tien Chiu’s office.

Three smiling newborns, he says, were the first Japanese-American triplets conceived in a laboratory, while the robust-looking quadruplets were born after sperm was injected into their mother’s eggs with a needle.

To the couples who turned to Dr. Chiu to have families, the babies were special gifts. To the government and fertility industry, though, such large multiple births have begun to look like breakdowns in the system. The issue has taken on renewed scrutiny since a California woman, Nadya Suleman, who already had six children conceived through in vitro procedures, gave birth to octuplets near here last month.

FDA Requires Pharmaceutical Company to Clarify Birth Control Ads

NY Times: A Birth Control Pill that Promised too Much:

As part of an unusual crackdown on deceptive consumer drug advertising, the Food and Drug Administration and the attorneys general of 27 states have required Bayer to run these new ads to correct previous Yaz marketing.

Regulators say the ads overstated the drug’s ability to improve women’s moods and clear up acne, while playing down its potential health risks. Under a settlement with the states, Bayer agreed last Friday to spend at least $20 million on the campaign and for the next six years to submit all Yaz ads for federal screening before they appear...

The F.D.A. first moved against the Yaz campaign last October, with  a warning letter to Bayer saying that two television ads overstated the drug’s benefits while understating its risks. By giving consumers the impression that Yaz was generally a drug for acne and general mood problems, the company’s ads ran afoul of federal laws against promoting the unapproved uses of a drug, the F.D.A. said. The agency approved Yaz in 2006 as a birth control pill that has a side benefit in treating mood-related psychological problems called premenstrual dysphoric disorder.

Hastings Constitutional Law Quarterly Symposium on Roberts Court and Facial Challenges

I had the honor of participating in a fascinating and timely symposium Friday (2/6) at UC Hastings, on the Roberts Court and facial challenges.  David Faigman (Hastings) and David Franklin (DePaul) also presented papers. Kevin Walsh (Villanova) responded to Professor Faigman's piece and Maya Manian (USF) reponded to mine.  Ashutosh Bhagwat (Hastings) moderated.  Ayotte v. Planned Parenthood and Gonzales v. Carhart featured prominently, for obvious reasons.  All of the articles and responses are forthcoming in the Hastings Constitutional Law Quarterly.

State Legislatures Consider Ultrasound Legislation

The Associated Press published an article yesterday listing twelve states currently considering bills to offer or mandate ultrasounds before abortion.  The article is available here.

Congress Extends Health Insurance for Low Income Children

NY Times: Obama Signs Children's Health Insurance Bill, by Robert Pear:

The House gave final approval on Wednesday to a bill extending health insurance to millions of low-income children, and President Obama signed it this afternoon, in the first of what he hopes will be many steps to guarantee coverage for all Americans....

The program, created with bipartisan support in 1997, is intended for children in families that earn too much to qualify for Medicaid, but too little to afford private health insurance....

In a major change, the bill allows states to cover certain legal immigrants — namely, children under 21 and pregnant women — as well as citizens.

Until now, legal immigrants have generally been barred from Medicaid and the State Children’s Health Insurance Program for five years after they enter the United States. States will now be able to cover those immigrants without the five-year delay.

Anne Donchin on Assisted Reproduction Policy

Anne Donchin (Indiana University/Purdue University Indianapolis) has posted Toward a Gender Sensitive Assisted Reproduction Policy on SSRN. Here is the abstract:

The recent case of the UK woman who lost her legal struggle to be impregnated with her own frozen embryos, raises critical issues about the meaning of reproductive autonomy and the scope of regulatory practices. I revisit this case within the context of contemporary debate about the moral and legal dimensions of assisted reproduction. I argue that the gender neutral context that frames discussion of regulatory practices is unjust unless it gives appropriate consideration to the different positions women and men occupy in relation to reproductive processes and their options for autonomous choice. First, I consider relevant legal rulings, media debate, and scholarly commentary. Then I discuss the concept of reproductive autonomy imbedded in this debate. I argue that this concept conflates informed consent and reproductive autonomy, thereby providing an excessively narrow reading of autonomy that fails to give due regard to relations among individuals or the social, political and economic environment that shapes their options. I contrast this notion of autonomy with feminist formulations that seek to preserve respect for the agency of individuals without severing them from the conditions of their embodiment, their surrounding social relationships, or the political contexts that shape their options. Taking these considerations into account I weigh the advantages of regulation over the commercial market arrangement that prevails in some countries and suggest general guidelines for a regulatory policy that would more equitably resolve conflicting claims to reproductive autonomy.

Obama to Expand Faith-Based Initiative

NY Times: White House Faith Office to Expand, by Jeff Zeleny & Laurie Goodstein:

President Obama signed an executive order Thursday to create a revamped White House office for religion-based and neighborhood programs, expanding an initiative started by the Bush administration that provides government support — and financing — to religious and charitable organizations that deliver social services.

“No matter how much money we invest or how sensibly we design our policies, the change that Americans are looking for will not come from government alone,” Mr. Obama said. “There is a force for good greater than government.”

In announcing the expansion of the religion office, Mr. Obama did not settle the biggest question: Can religious groups that receive federal money for social service programs hire only those who share their faith?

The Bush administration said yes. But many religious groups and others that are concerned about employment discrimination and protecting the separation of church and state had pushed hard for Mr. Obama to repeal the Bush policies.

Justice Ginsburg Undergoes Surgery for Pancreatic Cancer

NY Times: Justice Ginsburg Undergoes Surgery for Pancreatic Cancer, Court Says,by Adam Liptak:

Justice Ruth Bader Ginsburg underwent surgery at the Memorial Sloan-Kettering Cancer Center in New York on Thursday for what was apparently early-stage pancreatic cancer, according to a statement released by the Supreme Court.

The surgery followed the discovery of a lesion during an annual checkup in late January at the National Institutes of Health in Bethesda, Md. A scan revealed a small tumor, approximately one centimeter across, in the center of the pancreas, the court’s statement said.

Dr. Murray F. Brennan, the attending surgeon, said Justice Ginsburg would most likely remain in the hospital for 7 to 10 days, the statement added. A spokeswoman for Sloan-Kettering declined to elaborate.

Justice Ginsburg was treated for colon cancer in 1999 and did not miss a day on the bench. The court next hears arguments on Feb. 23.

Obama's Potential Impact on the Supreme Court

The New York Times: To Nudge, Shift or Shove the Supreme Court Left, by Adam Liptak:

...The vacancies that are likely to open up in the early years of the Obama presidency will, if the conventional wisdom holds, arise from the retirements of one or more of the court’s liberals — Justice Stevens, Justice Ginsburg or Justice David H. Souter. 

If that is so, Mr. Obama will not be able to put a new liberal vote on the court. But he can, if he wants to, add a big liberal voice....

According to a study last year by William M. Landes, who teaches law and economics at the University of Chicago, and Judge Richard A. Posner of the federal appeals court there, four of the five most conservative justices to serve on the court since 1937, of a total of 43, are on the court right now: Chief Justice John G. Roberts Jr. and Justices Scalia, Clarence Thomas and Samuel A. Alito Jr. The fifth was Chief Justice William H. Rehnquist, whom Chief Justice Roberts replaced in 2005.

Study Explores Reproductive Health Care Preferences and Perceptions Among Different Racial & Ethnic Groups

Guttmacher Institute: Reproductive Health Service Preferences and Perceptions of Quality Among Low-Income Women: Racial, Ethnic and Language Group Differences, by Davida Becker & Amy O. Tsui:

Although racial and ethnic disparities in reproductive health outcomes are well documented, there is limited research assessing how patients' racial and ethnic backgrounds influence their perceptions of and experiences with reproductive health care. In fact, a review of published literature revealed only one previous study on the topic, with the exception of studies related to prenatal care. Patients' perceptions are important because their views can affect their satisfaction with care, adherence to therapies, likelihood of returning and health outcomes, according to the authors...

The findings suggest that "ensuring access to a female clinician at reproductive health visits and ensuring clinician continuity across visits are important," particularly for Latinas. The finding that English-speaking Latinas and black women preferred receiving reproductive health services where general health care services also are available is "noteworthy" because it "conflicts with how women's health care is currently organized," the researchers write. They continue that the fragmentation of reproductive services and non-reproductive services "may not be ideal in many women's minds." In addition, improving client-clinician communication through interventions, such as translators, should be a "[h]igh priority." The researchers conclude that research to investigate racial, ethnic and language group differences in service delivery preferences and service quality perceptions should continue, adding that "because differences in reproductive health care experiences may underlie disparities in reproductive health outcomes, future research should try to better understand the link between service quality and reproductive health outcomes."

Commonly Used Chemicals Found to Lower Fertility

Wash. Post/HealthDay News: Common Chemicals May Delay Pregnancy, by Steven Reinberg:

Chemicals known as perfluorinated chemicals, which are pervasive in food packaging, pesticides, clothing, upholstery, carpets and personal care products, may delay pregnancy, a new study suggests.

These chemicals are being phased out in the United States because of their toxic effects, and are expected to be completely gone by 2010. However, they remain in the environment and in the body for decades, and have been linked to developmental problems.

"These widespread chemicals apparently lower the fertility in couples trying to get pregnant," said lead researcher Dr. Jorn Olsen, chairman of the Department of Epidemiology at UCLA's School of Public Health.

Danish women in the study who had with high levels of perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) took longer to get pregnant, Olsen said.

Octuplets' Birth Raises Questions About Fertility Treatment Policies

TIME: Octuplets Fallout: Should Fertility Specialists Set Limits?, by Bonnie Rochman:

Just about the time that eight babies began growing inside a California woman's womb, some nationwide policies about fertility treatment were being codified. In June, the American Society for Reproductive Medicine issued updated "Guidelines on Number of Embryos Transferred." Women under 35 — the octuplets' mom is reportedly 33 — should attempt to transfer no more than two, and preferably only one, fertilized embryo at a time. Women over 40 should attempt no more than five.

How the California woman, apparently a single mother who already has six young children, including a set of twins, got pregnant is the subject of rampant speculation. But regardless of whether the octuplets are the result of in vitro fertilization (IVF) or fertility drugs — with the latter having historically been available on the cheap in Mexico — there is little doubt that from a medical and ethical perspective, something went very wrong. And fertility specialists now find themselves on the defensive, trying to fend off the perception that theirs is an undisciplined, irresponsible profession.

Conference on ART and the Politics of Reproduction

Via the Barnard Center for Research on Women:

The Scholar & Feminist Conference XXXIV
THE POLITICS OF REPRODUCTION:
New Technologies of Life

Saturday, February 28, 2009
Barnard College
3009 Broadway (at 117th St)
New York, NY 10027

Increased demand for assisted reproductive technology (ART) and transnational adoption has been propelled by a number of factors, including the development of new technologies and changes in familial form—such as childrearing in second or third marriages; lesbian, gay, and transgendered families; and delays in childbearing and subsequent difficulties in conception—that make ART helpful. Other relevant factors include environmental changes that have negatively affected fertility levels, new levels of transnational migration and interaction that have fueled awareness of babies available for and in need of adoption, and concerns about genetic diseases and disabilities. Effectively, the various imperatives and the desires, both cultural and personal, that the use of ART fosters and responds to, have created a "baby business" that is largely unregulated and that raises a number of important social and ethical questions. Do these new technologies place women and children at risk? How should we respond ethically to the ability of these technologies to test for genetic illnesses? And how can we ensure that marginalized individuals, for example, people with disabilities, women of color, and low-income women, have equal access to these new technologies and adoption practices? And, similarly, how do we ensure that transnational surrogacy and adoption practices are not exploitative? These questions and many others on the global social, economic and political repercussions of these new forms of reproduction will be the focus of this year's Scholar and Feminist Conference.

The conference is open to the public and admission is on a sliding scale (students are free). 

Click here to register.

Women's Law Project Launches Blog

The Women's Law Project has started a blog.  Here is a recent post:

Family Planning and the Stimulus Package

Earlier this week, the House of Representatives passed an economic stimulus package. A previous version of the bill had included provisions for supplying contraception to low-income women on Medicaid. When House Republicans objected to the provision, President Obama asked the Democratic House leadership to remove the family planning provision from the package, which they did. The bill passed on Wednesday night without the family planning provision, and without a single Republican representative voting for the package.

If you’re wondering what all the fuss was about, Time magazine has a good rundown of exactly what happened. The family planning provision - which would not have included any abortion services, thanks to the Hyde Amendment, simply contraceptives - would have been a stimulus measure by reducing health care costs. From the article:

The Guttmacher Institute, which advocates for abortion rights, estimates that every dollar of publicly funded family-planning services saves $4 in state and federal dollars. And when the Congressional Budget Office looked at a very similar provision in 2007, it estimated that the federal savings would have totaled $200 million over five years and $400 million over 10.

It’s disappointing that the leadership in Washington did not commit to helping all women, regardless of their income, make the reproductive choices for themselves right now. But feminists are hopeful that funding for family planning for low-income women will be passed soon.

Planned Parenthood Decries Removal of Family Planning Provision from House Stimulus Package

Politico: Planned Parenthood v. Obama, by Josh Gerstein:

President Obama’s only been in office for eight days and some of his friends are already steaming mad at him.

The president of Planned Parenthood Action Fund, Cecile Richards, just sent an “urgent” email to supporters decrying Obama’s decision to jettison a family planning provision from the nearly $900 billion economic stimulus package to be voted on in the House Wednesday.

Obama spokesman Robert Gibbs confirmed Tuesday that Obama called House Energy and Commerce Chair Henry Waxman (D-CA) and asked him to drop the provision. The president “believed that the policy of increased funding for family planning was the right one.... He didn’t believe that this bill was the vehicle to make that happen,” Gibbs said.

“I’m stunned,” Richards wrote in the e-mail. “Removing this provision is a betrayal of millions of low-income women, and it will place an even greater burden on state budgets that are already strained to the breaking point.”

Senate Stimulus Bill Includes $400 Million in STI Prevention

The Washington Times: Stimulus bills include STD prevention, by Stephen Dinan:

The two sides of Capitol Hill appear to be engaging in a bidding war to see who can put more money toward the prevention of sexually transmitted diseases in its version of the economic stimulus bill.

The House included $335 million in its package. But the Senate, not to be outdone, provided $400 million in STD spending in its bill...

"Senate big spenders will never be overbid in wasting tax dollars. But how in the world does STD research create jobs? Wait. ... Don't answer that. I don't want to know," said Wesley Denton, an aide to Sen. Jim DeMint, South Carolina Republican.

But the Senate bill, on page 138 of the 431-page measure, directs $400 million to the Centers for Disease Control and Prevention "for the screening and prevention of sexually transmitted diseases, including HIV."

The Senate is expected to begin floor debate on its stimulus bill next week.