Reproductive Rights Prof Blog

Health Insurance and Gender

Newsweek: The Cost of Being a Woman: Women Pay More than Men for Similar Insurance Policies. Is it Discrimination?, by Sarah Kliff:

At a recent Capitol Hill press conference on women and health care reform, Sen. Barbara Mikulski started things off with rallying cry: "Equal insurance for equal premiums!" Four female senators spent the event discussing disparities women face in the individual health-care market, where eight states and D.C. consider domestic abuse a preexisting condition and maternity coverage is often lacking. Chief among concerns about health-care discrimination is gender rating, the health-insurance practice of charging different premiums based on gender. Mikulski reiterated the point on Larry King last Thursday: "Just like we didn't get equal pay for equal work, we haven't got equal insurance benefits for equal insurance premiums."

But as is often the truth in politics, strong sound bytes betray a larger, more complicated issue. NEWSWEEK's Sarah Kliff tried to get the facts on what some call smart business, and others call outright discrimination....

Gender is among a set of characteristics, like age or smoking, that health-insurance companies routinely use to predict a consumer's costs and thus set the price of their premiums....

Women's-rights groups have become increasingly aggravated with the practice, which leaves some unable to afford a plan. They argue that the insurance company's decisions are more motivated by greed than by economics.. The issue came to head last year when the National Women's Law Center published a report finding widespread variation in gender pricing, with women charged inconsistently high rates, depending on company and state of residence.

Lawsuit Charges Illinois' Parental Notification Law Is Unconstitutional

Chicago Tribune: Lawsuit Challenges Illinois' Parental Notification Law for Abortions, by Sara Olkon:

A Chicago physician and a Granite City women's medical clinic have filed a lawsuit in Cook County Circuit Court charging that Illinois' parental notification law for abortions is unconstitutional and seeking to bock its start.

The law, set to go into effect Nov. 3, requires physicians to notify the parent of a girl younger than 18 before performing an abortion. A provision of the law allows girls to bypass parental notification by going before a judge, who would then have 48 hours to rule on the petition.

Moreover, no notice is required in case of a medical emergency or if the girl declares in writing that she is a victim of sexual abuse.

On Nov. 2, a Circuit Court judge is set to conduct a hearing on a temporary restraining order, said Lorie Chaiten of the American Civil Liberties Union, one of the attorneys representing the plaintiffs, the Hope Clinic for Women Ltd. and Dr. Allison Cowett, director of the Universtiy of Illinois at Chicago's Center for Reproductive Health.In the complaint, the plaintiffs argue that the notification law would harm minors by preventing them from obtaining safe abortions or force them to carry their pregnancies to term.

I wrote an op-ed on this law earlier this year.  See: JURIST: Abortion Parental Notice Laws: Irrational, Unnecessary and Downright Dangerous

Arizona Court Rules that Sheriff Cannot Block Inmates' Access to Abortion Care

ACLU News Release (10/20): Court Rules That Sheriff Arpaio Can Not Block Inmates Access to Abortion Care:

PHOENIX – In a case brought by the American Civil Liberties Union, an Arizona court found today that Maricopa County Sheriff Joseph Arpaio can no longer require inmates seeking abortion care to prepay their transportation and security costs before they can obtain an abortion.  

Earlier this year, as part of a partial settlement in an ACLU lawsuit involving the right of women prisoners to obtain timely, safe and legal abortions, Arpaio agreed to follow a 2005 court order prohibiting Maricopa County correctional facilities from requiring inmates to obtain a court order before an abortion. However, in the course of settlement negotiations, Arpaio decided inmates must prepay transportation and security costs associated with obtaining the procedure. In his ruling today, Judge Robert H. Oberbilling of the Superior Court of Arizona indicated that requiring inmates to prepay security and transportation costs could be more onerous than the court order Sheriff Arpaio previously required.

"We are so pleased that Sherriff Arpaio can no longer pull a bait and switch by requiring women prisoners to pay transportation and security costs before obtaining an abortion,” said Brigitte Amiri, a senior staff attorney for the ACLU Reproductive Freedom Project who argued the case today before the court. "Arpaio’s new prepayment requirement was yet another way for him to do an end run around the law and to interfere with a woman’s private decision about whether to end a pregnancy.”

In May 2004, on behalf of a woman inmate seeking an abortion, the ACLU challenged an unwritten Maricopa County Jail policy that required inmates to obtain a court order before officials would transport them for abortion care. The Maricopa County Superior Court struck down the unwritten policy in August 2005, holding that it violated women's reproductive rights and served “no legitimate penological purpose.” The Arizona Court of Appeals upheld that decision; both the Arizona and the United States Supreme Courts refused to hear the case. . . .

Pregnant Women Especially Threatened By Swine Flu

NY Times: Flu Story: A Pregnant Woman's Ordeal, by Donald G. McNeil Jr.:

WEST PALM BEACH, Fla. — The group most threatened by swine flu and most in need of the new vaccine, world health authorities agree, is that of pregnant women. . . .

On Oct. 1, the Centers for Disease Control and Prevention said 100 pregnant women had been in intensive care with swine flu and 28 had died. That is a tiny fraction of what are believed to have been millions of cases in the country. But it is the best argument, federal officials say, for the drawn-out, expensive effort to make a swine flu vaccine.

Pregnant women are particularly susceptible because they are in the younger age group most likely to catch this new virus, while those over 50 who have had more flus rarely catch it. Moreover, pregnancy suppresses the immune system to protect the fetus, and the growing baby makes it harder for a mother to clear her lungs.

All but a few of the pregnant women who have died or been near death from swine flu are unknown. Privacy laws prevent health departments from releasing their names, and few families come forward. . . .

Texas Lawsuit Challenges Practice of Jailing Women to Protect Their Fetuses

Austin American-Statesman: Jailed for being Pregnant? Court to Hear Arguments on Drug User's Incarceration, by Chuck Lindell:

Amber Lovill was almost six months pregnant and on probation when a mandatory drug test found high levels of methamphetamine in her system.

What happened next to the Corpus Christi woman — jail time followed by drug treatment in a secure facility for felons — prompted a legal challenge that will be heard this week by the state's highest criminal court.

Lovill argues that she was the victim of gender discrimination and heavy-handed prosecution. Her cause has been taken up by civil liberties and women's rights groups who complain that Lovill was treated more severely than a man or nonpregnant woman in the same situation....

Prosecutors say Lovill was targeted for violating her probation, not for being pregnant. But probation officers also were entitled to take action to protect the fetus from Lovill's drug use, said Doug Norman, Nueces County assistant district attorney....

A ruling, expected weeks or months later, could better define when — or if — the Texas criminal justice system can punish women in an effort to protect the health of their fetuses.

Anti-Choice Group Has a New Spokesperson: A Talking Embryo

Salon.com: Meet Judy, the talking embryo, by Tracy Clark-Flory:

The antiabortion group Choice Kills introduces a new spokesperson -- or should I say "spokesfetus"?

From her voice, you would think she was a toddler, but she is much, much younger. "Hi, I'm Judy," she squeaks in the video you'll find below. "All I want is to get out of here alive." You see, Judy is an embryo -- a virtual talking embryo with her very own YouTube channel. "One out of four of us don't make it," she explains from inside her mother's womb. Then, out of nowhere, what looks to be a machete is wielded before her, which causes Judy to yell: "Oh no! What's that? Please help me!" (And please help the woman who has an abortion performed with a machete.)

The video spot (which we found via Right Wing Watch) is the brainembryo of the antiabortion group Choice Kills, which is targeting the adorable little peanut toward young women who might consider terminating a pregnancy. Judy is the spokesfetus of the campaign . . . . .

Should Parents Lose Custody Because Their Children Are Morbidly Obese?

Time Magazine: Should Morbidly Obese Kids Be Taken from Their Parents?, by Gaelle Faure:

Should morbidly obese children be taken from their parents? That's the question an increasing number of countries are grappling with amid the Western world's obesity epidemic.

The latest case to make headlines concerns a Scottish couple who lost custody of two of their six children on the basis of what was, their lawyer claims, a failure to reduce the kids' weight following warnings from Scottish social services. The couple lost their Oct. 14 appeal in a case that is far from clear-cut — representatives of Dundee City say they would never remove children "just because of a weight issue." But obesity appears to be the primary reason South Carolina mom Jerri Gray lost custody of her 14-year-old, 555-lb. son in May. She was arrested after missing a court date to examine whether she should retain custody after doctors had expressed concern about her son's weight to social services. The boy is currently living with his aunt, and his mother is facing criminal child-neglect charges.

Several other cases in recent years — in California, New Mexico, Texas and New York, as well as Canada — have garnered attention because a child's obesity resulted in loss of custody. "It's happening more than the public is aware of, but because these cases are usually kept quiet [as a result of child-privacy laws], we have no record," says Dr. Matt Capehorn, who sits on the board of the U.K.'s National Obesity Forum.

What Health Care Reform Could Mean for Women's Health

Beacon Broadside: What Health Care Reform Could be for Women's Health, by Carole Joffe:

"I have seen the future and it works" goes the old saying. Well, this writer has seen how the future of health care in America should work. I recently attended a press briefing on women and health care reform held by four Democratic Congresswomen—Jan Schakowsky of Illinois, Gwen Moore of Wisconsin, Carolyn Maloney of New York and Lois Capps of California. All four have taken leading roles in the current health care debates on Capitol Hill and all support H.R. 3200, the main health care bill passed by the House.

The proposals supported by these legislators struck me as bizarrely reasonable. "Bizarrely reasonable" only because what exists currently in many health insurance plans is so breathtakingly unreasonable when it comes to women's health care needs. The current landscape of health insurance for women is one in which a past C-section, even a current pregnancy, can constitute a "pre-existing condition" that can disqualify one from obtaining coverage; a history of past domestic violence can similarly be grounds for exclusion; some policies do not cover maternity care or contraception. . . .

U.S. Bishops Threaten to Withdraw Support for Health Care Reform Over Abortion

USA Today: Bishops may pull health care support over abortion, immigrants, by Kevin Eckstrom:

WASHINGTON — The nation's Catholic bishops have threatened to pull their support for health care reform unless their concerns about abortion and access for immigrants are addressed by lawmakers.

The U.S. Conference of Catholic Bishops, which supports universal access to health care as a "basic human right," had been supportive of efforts to reform the health care system, but is concerned about taxpayer-funded abortions.

Spain's Plans to Liberalize Abortion Laws Draw Protesters

BBC NEWS: Big Anti-Abortion Rally in Spain

More than a million people are said to have taken part in a march in Madrid to oppose government plans to liberalise Spain's abortion law.

Several dozen centre-right opposition party joined the demonstration, which was backed by Roman Catholic bishops.

Socialist Prime Minister Jose Luis Rodriguez Zapatero wants to introduce abortion on demand.

At present, a pregnancy can only be terminated in mainly Catholic Spain under specific circumstances. . . .

"I Didn't Know I Was Pregnant" Continues for Second Season

Slate Magazine: Don't Throw the Baby Out With the Bathwater, by Troy Patterson:

I Didn't Know I Was Pregnant is a freak show in a family way

Now back for its second season, I Didn't Know I Was Pregnant (Discovery Health, Tuesdays at 9 p.m. ET) is a nonfiction series about women who didn't know they were pregnant practically until the moment that little Hunter or Ashlee was crowning. Do try to avoid any marathon screenings of it, those being invitations to waste an afternoon. The show isn't exactly brainless. Rather, it is purely visceral and satisfyingly formulaic—cheerfully undesirous of a brain.

Things must end miserably for the majority of women ignorant of their condition well into their third trimester, but this show is interested in misery only as a necessary test along a triumphant journey. Though some of the women profiled here give birth with ibuprofen as their only analgesic, though none of them enter the delivery room comforted by having studied Lamaze or raked in loot at a baby shower, all of the stories end with a glowing mom and her gurgling tomato. . . .

New Guttmacher Report on Increased Contraceptive Use and Declining Abortion Rates Worldwide

Guttmacher Institute news release: Abortion and Unintended Pregnancy Decline Worldwide as Contraceptive Use Increases:

Increases in global contraceptive use have contributed to a decrease in the number of unintended pregnancies and, in turn, a decline in the number of abortions, which fell from an estimated 45.5 million procedures in 1995 to 41.6 million in 2003. While both the developed and the developing world experienced these positive trends, developed regions saw the greatest progress. Within the developing world, improvement varied widely, with Africa lagging behind other regions, according to “Abortion Worldwide: A Decade of Uneven Progress,” a major new Guttmacher Institute report released today.

The decline in worldwide abortion occurred alongside a global trend toward liberalizing abortion laws. Nineteen countries have significantly reduced restrictions in their abortion laws since 1997, while only three countries have substantially increased legal restrictions. Despite these trends, 40% of the world’s women live in countries with highly restrictive abortion laws, virtually all of them in the developing world. In Africa, 92% of reproductive-age women live under highly restrictive abortion laws, and in Latin America, 97% do so. These proportions have not changed markedly over the past decade.

New Oklahoma Law Establishes Public Database of Women Who Had or Sought Abortions

Guardian News: A is for abortion, by Megan Carpentier:

Branding women with a 'scarlet letter' won't reduce abortions. As a global study shows, contraception and education are key

. . . A new law scheduled to take effect in Oklahoma would establish an online, publicly accessible database of information about every woman in the state who sought or had an abortion. While it would not require doctors to report the names and addresses of patients seeking or obtaining a legal medical procedure many conservative lawmakers think should be outlawed, the 37-question survey would (among other things) establish the women's race, age, education level and county of residence.

Women would be required to disclose if they are state employees and what method of insurance, if any, they are using for the procedure. It would require women to specify the number of pregnancies, children, miscarriages and previous abortions they've had. And it even asks for the length of the pregnancy and whether the women were using birth control when they conceived.

The surveys would all be sent to the Oklahoma health department, where state employees would aggregate the data into a searchable, sortable database and make it available to "researchers" online. . . .

The law is being challenged.  See Feminists for Choice: New Oklahoma abortion law being challenged

Unsafe Abortions Kill 70,000 Women Every Year

Reuters: Unsafe abortions kill 70,000 a year, harm millions, by Kate Kelland:

LONDON, Oct 13 (Reuters) - Increased use of contraceptives has pushed global abortion rates down, but unsafe abortions kill 70,000 women each year and seriously harm or maim millions more, a global report said on Tuesday.

Despite easier access to abortion with restrictions being relaxed in many countries, the number of abortions fell from an estimated 45.5 million in 1995 to 41.6 million in 2003, the report by the U.S.-based Guttmacher Institute said.

But the study found a stubbornly high number -- almost 20 million -- of unsafe abortions, mostly in poorer countries and often carried out by the women themselves using inappropriate drugs or herbal potions, or by untrained traditional healers.

Utah Court Rules Teenager Not Criminally Liable for Soliciting a Beating in Order to End Pregnancy

Salt Lake Tribune: Judge: abortion laws protect girl who sought pregnancy-ending beating, by Sheena Mcfarland:

A judge has released a 17-year-old Vernal girl from jail after ruling she did not commit a crime when she allegedly paid a man to beat her in an attempt to end her late-term pregnancy.

The release, which came after the girl's mother obtained a second opinion on her daughter's no contest plea, has incensed some lawmakers who argue the ruling skirts laws governing legal abortions in Utah.

"The judge is absolutely stretching," said Rep. Carl Wimmer, R-Herriman. "There's no way the judge believes the Utah Legislature left open this loophole. I guarantee it will be closed this next session."

Eighth District Juvenile Court Judge Larry Steele sided with attorney Rich King, who argued under Utah law and around the country women are not held criminally liable for soliciting an abortion.

Pink Baby, Blue Baby: Tiny Gender Gaps Grow Thanks to Parents' Influence

Wash. Post: The Tiny Differences in the Littlest Brains, by Emily Bazelon:

Book Review: PINK BRAIN, BLUE BRAIN: How Small Differences Grow Into Troublesome Gaps -- and What We Can Do About It, by Lise Eliot

In one of the eye-opening studies cited in Lise Eliot's masterful new book on gender and the brain, mothers brought their 11-month-olds to a lab so the babies could crawl down a carpeted slope. The moms pushed a button to change the slope's angle based on what they thought their children could handle. And then the babies were tested to see how steep a slope they could navigate.

The results?

Girls and boys proved equally adept at crawling and risk-taking: On their own, they tried and conquered the same slopes. But the mothers of the girls -- unlike the mothers of the boys -- underestimated their daughters' aptitude by a significant margin.

"Sex differences in the brain are sexy," Eliot writes. And so we tend to notice them everywhere. "But there's enormous danger," she says, in our exaggeration. It leads us to see gender, beginning at an early age, only in terms of what we expect to see, and to assume that sex differences are innate and immutable. We forget that the differences within each sex -- among girls and among boys -- are usually greater than the gaps between the two. . . .

More NY Times on 21st Century Babies: The Implications of Multiple Births

NY Times: Grievous Choice on Risky Path to Parenthood, by Stephanie Saul:

21st Century Babies

. . . The birth of octuplets in California in January placed the onus for large multiple births on in vitro fertilization, a treatment in which eggs are joined with sperm in a petri dish and returned to the womb for gestation.

But [intrauterine insemination] is actually the major cause of quadruplets, quintuplets and sextuplets — the most dangerous pregnancies for both mother and children. While less effective than IVF, intrauterine insemination is used at least twice as frequently because it is less invasive, cheaper and more likely to be covered by insurance, interviews and data show.

Multiples can occur when the high-potency hormones frequently used with the procedure overstimulate the ovaries and produce large numbers of eggs. Parents are then left with . . . tough choices . . . : whether to eliminate some of the fetuses or keep the babies and face extraordinary risks.

Anti-Choice "Street Activists" Tell Their Stories

NY Times: Abortion Opponents Tell of Their Journey to the Streets, by Damien Cave: 

OWOSSO, Mich. — Action means many things to abortion opponents. Lobbyists and fund-raisers fight for the cause in marble hallways; volunteers at crisis pregnancy centers try to dissuade the pregnant on cozy sofas.

Then there are the protesters like James Pouillon, who was shot dead here last month while holding an anti-abortion sign outside a high school. A martyr to some, an irritant to others, Mr. Pouillon in death has become a blessing of sorts for the loosely acquainted activists who knew him as a friend: proof that abortion doctors are not the only ones under duress, proof that protests matter, and a spark for more action.

“Jim suffered the persecution for us,” said Dan Brewer, who recalls swearing at Mr. Pouillon during one of his one-man protests in the ’90s, only to join him later after becoming a born-again Christian. “Now we just have to go out and do it.”

A national tribute is already planned. Anti-abortion groups are calling on protesters to stand outside schools with signs that depict abortion on Nov. 24 in 40 to 50 cities nationwide. . . .

NY Times Examines "21st Century Babies": IVF Brings Life, But Also Complications

NY Times: The Gift of Life, and Its Price, Stephanie Saul:

21st Century Babies

. . . An exploration of the fertility industry reveals that the success comes with a price. While IVF creates thousands of new families a year, an increasing number of the newborns are twins, and they carry special risks often overlooked in the desire to produce babies.

While most twins go home without serious complications, government statistics show that 60 percent of them are born prematurely. That increases their chances of death in the first few days of life, as well as other problems including mental retardation, eye and ear impairments and learning disabilities. And women carrying twins are at greater risk of pregnancy complications.

In fact, leaders of the fertility industry and government health officials say that twins are a risk that should be avoided in fertility treatments. But they also acknowledge that they have had difficulty curtailing the trend. . . .

Gender and Judicial Quality? Paper concludes: "Bring on the Women!"

Slate Magazine: Do Women Make Better Judges?, by Stephen Choi, Mitu Gulati, Mirya Holman, & Eric Posner:

Asked and answered—with data.

Justice Sonia Sotomayor's elevation to the Supreme Court brought to the surface a long-simmering controversy about the relationship between gender and judging. Are female nominees for judicial positions chosen based on affirmative action? If so, are women on the bench worse judges than men—or do they come with advantages that men lack? This controversy has legs. If Justice Ginsburg is forced to retire this term because of illness, reducing the number of female justices from two to one, there will be a great deal of pressure on President Obama to nominate another female jurist. Or if Justice John Paul Stevens retires, why not three women on the high court? . . . 

The claim that women are worse—or better—than men at judging should be susceptible to empirical investigation. There is no obvious way, however, to measure judicial quality; lawyers dispute endlessly whether cases are rightly or wrongly decided—and, ultimately, a good judge is just a judge who decides cases correctly. Still, we have come up with some indirect measures of judicial quality. These include productivity (how many opinions judges write), influence (how frequently other judges rely on their opinions), and independence (how often judges dissent from opinions written by judges who belong to the same political party). We looked at the performance of hundreds of judges over a number of years and working in different types of courts—state supreme courts, federal trial courts, and federal appellate courts. (Our paper is here.) . . . 

[O]ur basic point is this: The fact that female judges are selected from a shallower pool of talent does not imply that they are worse judges than men. In fact, the evidence suggests that they are at least as good as male judges, perhaps better. When she sat on the 2^nd U.S. Circuit Court of Appeals, Justice Sotomayor ranked among the most cited federal appellate judges in the country. Bring on the women!