Reproductive Rights Prof Blog

NY Times Magazine Cover Story Addresses The Effects of DNA Testing on Fatherhood

NY Times: Who Knew I Was Not the Father?, by Ruth Padawer:

It was in July 2007 when Mike L. asked the Pennsylvania courts to declare that he was no longer the father of his daughter. For four years, Mike had known that the girl he had rocked to sleep and danced with across the living-room floor was not, as they say, “his.” The revelation from a DNA test was devastating and prompted him to leave his wife — but he had not renounced their child. He continued to feel that in all the ways that mattered, she was still his daughter, and he faithfully paid her child support. It was only when he learned that his ex-wife was about to marry the man who she said actually was the girl’s biological father that Mike flipped. Supporting another man’s child suddenly became unbearable.

Abortion is Not the Only Moral Issue in Health Care

Newsweek Magazine: Abortion Is Not the Only Moral Issue, by Lisa Miller:

Our entire health-care system is filled with complex moral choices. We shouldn't make our health-care debate about just one.

We suffer, this week, from a moral myopia. Thanks to the passage in Congress of a health-reform bill, abortion is in the news again, but with the same old warriors brandishing their same old spears. Kate Michelman and Frances Kissling talk about how the current version of the health-care bill “risks the well-being of millions of women for generations to come.” The United States Conference of Catholic Bishops thanks the members of the House, “who took this courageous and principled step to oppose measures that would force Americans to pay for the destruction of unborn children.” Abortion, the pundits like to say, is a "complex moral issue." According to recent research by the Pew Forum, about half of Americans believe abortion is "morally wrong," yet half wish it to remain legal most of the time. Surely we and our representatives in Congress, who are able to hold such paradoxical views in mind, are not so deafened, cowed, or paralyzed by the screaming on both sides that we can't absorb a truer reality. Culture warriors are not the only arbiters of the great moral questions of the day, and abortion is hardly the only ethical component of the health-care debate. Our entire health-care system (and the proposed reform) is rife with "complex moral issues." To activate our consciences only in the realm of abortion relieves those consciences of too much responsibility.

Take a "complex moral issue" completely unrelated to fetuses. One in 10 Americans suffers from hearing loss—including more than a million children. Few private insurers cover hearing aids, which cost, on average, more than $2,000 each. Medicaid covers hearing aids for kids, but after 21, they're on their own. . . .

United States Ranks Poorly on Preterm Birth Rates

Time Magazine: Why the U.S. Gets a D on Preterm Birth Rates, by Alice Park:

For the second straight year, the U.S. earned dismal marks in its effort to reduce the national rate of premature births. The March of Dimes, which issues an annual state-by-state report card on the problem, gave the U.S. an overall D on Monday.

That grade was based on figures from 2007, which show that 12.7% of U.S. births were preterm. Those figures, which have remained constant in recent years, also earned the U.S. a D last year, when the March of Dimes began compiling its report card. The objective, set by federal health experts in the Healthy People 2010 program, is a preterm birth rate of 7.6%. Worldwide, the preterm birth rate is estimated at 9.6%, accounting for 12.9 million babies per year. "Preterm birth remains a very intractable problem," says Dr. Jennifer Howse, president of the March of Dimes Foundation. "It does not surprise me that we are not seeing any change [in the U.S.] — yet."

The rate of preterm births, which measures the proportion of babies born before 37 weeks' gestation, is a reflection of a number of factors, both biological and cultural. Starting in 2008, the March of Dimes began tracking three of the major contributors to the high preterm birth rate — lack of insurance among women of childbearing age, rates of cigarette smoking and the rate of babies born preterm, but at the tail end of pregnancy, between 34 and 36 weeks. . . .

Montana Mother Asks Court to Declare Unconstitutional the Denial of Medical Care to Pregnant Inmates

ACLU News Release: Montana Mother Asks Court To Remedy Mistreatment Of Pregnant Inmates By Detention Facility:

Missoula, MT – A Montana mother denied prescribed medication while serving time in jail for traffic violations asked a federal court today to require the Lake County Detention Facility to compensate her for the physical and emotional suffering she endured while in the facility’s custody and to declare unconstitutional the denial of needed medical care to pregnant inmates.  Bethany Cajúne is represented by the American Civil Liberties Union and the ACLU of Montana.

“I was afraid my baby might die because Lake County Detention Facility was denying me treatment,” said Bethany Cajúne.  “No one should go through what I went through.  I’ve brought this case to make sure it doesn’t happen to another woman.”

In March 2009, Cajúne voluntarily reported to Lake County Detention Facility to complete an outstanding short-term sentence for traffic violations.  At that time, she was approximately four to five months pregnant, raising five small children at home and attending GED classes four days a week.  She was also nearing a year of successful participation in a medication-treatment program for a diagnosed addiction to opioid drugs.  Despite attempts by Cajúne’s treating physician and drug treatment counselor to ensure that Cajúne continue receiving Suboxone, a medication that suppresses withdrawal symptoms, the facility denied her this care.  As a result, Cajúne suffered complete and abrupt withdrawal, experienced constant vomiting, diarrhea, rapid weight loss, dehydration, and other withdrawal symptoms, all extremely dangerous during pregnancy.  Despite repeated warnings of the serious risk abrupt withdrawal posed to her health and pregnancy, including miscarriage, the facility continued to deny Cajúne her medication.  It took the intervention of a public defender to secure Cajúne’s release after nine days of being denied care so that she could resume the treatment. . . .

To read the complaint: http://www.aclu.org/reproductive-freedom/cajune-v-lake-county-complaint

To watch a video about the case: http://www.youtube.com/watch?v=kdeZ7qHWJSA

Student Scholarship: Health Care Reform and Abortion Coverage

Jennifer M. Keighley (a student at Yale Law School) has posted Health Care Reform and Reproductive Rights: Sex Equality Arguments for Abortion Coverage in a National Plan on SSRN.  Here is the abstract:

The national health insurance reform effort threatens to reduce the number of women who have health insurance coverage for abortions. Instead of evaluating whether the Supreme Court would invalidate restrictions on coverage, I employ a model of legislative constitutionalism that presents arguments for why Congress must independently consider the constitutionality of imposing restrictions on abortion in national health insurance legislation. I argue that Congress’s debate over abortion coverage in a national health insurance scheme should recognize the ways in which state regulation of women’s reproductive capacities violates Equal Protection principles.

Jennifer Hendricks on a Feminist Theory of Reproductive Freedom

Jennifer S. Hendricks (University of Tennessee College of Law) has posted Pregnancy, Equality, and U.S. Constitutional Law on SSRN.  Here is the abstract:

This chapter will be part of a collection on international feminist constitutionalism, forthcoming from Cambridge University Press. The chapter proposes a feminist theory of reproductive freedom grounded in U.S. Supreme Court precedent and applies the theory to abortion rights and to parental rights in the context of surrogacy agreements.

Univ. of Nebraska Regents Consider Resolution to Limit Stem Cell Research to Cell Lines Approved by Pres. G.W. Bush

Omaha World-Herald: Right Now: Stem cell meeting, by Jeffrey Robb:

LINCOLN -- Omaha.com is providing live online updates as the University of Nebraska regents' decide whether to restrict embryonic stem cell research.

Four regents are co-sponsoring a resolution to restrict embryonic stem cell research to cell lines approved by then-President George W. Bush.

Keep checking Omaha.com for the latest comments and the regents' final decision.

NY Times: University Weighs Tighter Limits on Stem Cell Research, by Monica Davey:

LINCOLN, Neb. — In an unusual pushback against President Obama’s expansion of federal financing of human embryonic stem cell research, the University of Nebraska is considering restricting its stem cell experiments to cell lines approved by President George W. Bush.

The university’s board of regents is scheduled to take up the matter on Friday, and if it approves the restrictions — some opponents of the research say they have the votes, though others remain doubtful — the University of Nebraska will become the first such state institution in the country to impose limits on stem cell research that go beyond what state and federal laws allow, university officials say.

Pew Survey Shows Abortion Plays Minor Role in Driving Opposition to Health Care Reform

The Pew Forum on Religion & Public Life: Abortion Plays Small Role in Health Reform Opposition:

While most Americans oppose government funding of abortion, a new Pew Research Center survey finds that concern about abortion funding plays only a small role in driving opposition to the health care reform legislation under consideration by Congress.

When health care opponents are asked in an open-ended question to describe their main reason for opposing the congressional proposals, just 3% raise the issue of abortion funding.

Even when they are asked to choose among a list of reasons, fewer than one-in-ten (8%) opponents of health care legislation say the most important reason for their opposition is the possibility that government money might pay for abortions. Although a majority of health reform opponents (56%) cite the abortion issue as one of the major factors for them, far greater percentages cite concerns about big government, costs and the impact of reform on people's own coverage.

The full report and questionnaire are available here.

Health Officials Report that STD Rates Continue to Rise

Time Magazine: STDs Continued Record Increase in 2008:

(ATLANTA) — Sexually spread diseases continue to rise, with reported chlamydia cases setting yet another record in 2008, government health officials said Monday.

Last year there were 1.2 million new cases of chlamydia, a sometimes symptomless infection that can lead to infertility in women. It was the most ever reported, up from the old record of 1.1 million cases in 2007. See The Wellness Blog.

Better screening is the most likely reason, said Dr. John M. Douglas Jr. of the U.S. Centers for Disease Control and Prevention.

Syphilis, on the verge of being eliminated in the United States about 10 years ago, also has been increasing lately. About 13,500 cases of the most contagious form of the disease were reported in 2008, up from about 11,500 the year before.

Unlike chlamydia, health officials think syphilis cases actually are increasing. . . . 

New Guidelines Recommend Delaying First Cervical Cancer Screening Until Age 21

NY Times: Guidelines Push Back Age for Cervical Cancer Tests, by Denise Grady:

New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past.

The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.

Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, “long before the Obama health plan came into existence.”

She called the timing crazy, uncanny and “an unfortunate perfect storm,” adding, “There’s no political agenda with regard to these recommendations.”

See also: NY Times: Screening Debate Reveals Culture Clash in Medicine, by Kevin Sack:

This week, the science of medicine bumped up against the foundations of American medical consumerism: that more is better, that saving a life is worth any sacrifice, that health care is a birthright.

Two new recommendations, calling for delaying the start and reducing the frequency of screening for breast and cervical cancer, have been met with anger and confusion from some corners, not to mention a measure of political posturing.

Senate Advances Obama Pick for Seventh Circuit Court of Appeals

onPolitics (USA Today): Senate advances David Hamilton for appeals court:

The Senate voted 70-29 today to end a filibuster threat against one of President Obama's first federal judiciary appointees, David Hamilton of Indiana. 

Obama nominated Hamilton to the United States 7th Circuit Court of Appeals based in Chicago in March and the Senate Judiciary Committee approved his appointment in June. Hamilton was endorsed by Indiana's senior senator, Republican Richard Lugar. . . .

For more on David Hamilton, see: NY Times: Moderate Is Said to Be Pick for Court, by Neil A. Lewis.

Gail Collins on the "Breast Brouhaha"

NY Times Op-Ed Column: The Breast Brouhaha, by Gail Collins:

. . . [T]his week, a federal task force reported that most women don’t need annual mammograms. . .

The report triggered two immediate and inevitable responses. Doctors and patients began an animated discussion. And Republicans declared it was all a Democratic plot.

“I mean, let the rationing begin. This is what happens when bureaucrats make your health care decisions,” said Representative David Camp, the ranking Republican on the House Ways and Means Committee.

Representative Camp is definitely on to something. Whatever happens, we do not want the government conducting any studies on whether current health practices actually do any good. Let this continue and soon you will not be able to get your hands on a good leech when you need one.

There is no possible political advantage in coming out against medical testing, so the Obama administration scurried away from the report. The task force did not consider the matter of cost, but, of course, people like Representative Camp depicted it as the first step toward rationing. The current position of the Republican Party seems to be that it is not possible to spend too much money on medicine. Party on.

(Has anybody noticed that the people who darkly warn about government bureaucrats forcing insurance companies to cut back our coverage appear to be the same ones who just voted to force insurance companies to stop covering abortions? Where’s the sanctity of the marketplace when we really need it?) . . .

Task Force Clarifies Recommendations on Mammograms; Obama Administration Assures Federal Screening Policies Won't Change

Wall St. Journal: Task Force Clarifies New Mammography Guidelines, by Barbara Martinez, Shirley S. Wange, and Jonathan D. Rockoff:

The federally-funded task force that loosened breast-cancer screening guidelines this week clarified its position Thursday, in response to the intense backlash its new recommendations have prompted.

Seeking to dispel confusion over some aspects of the new guidelines, task force members said they never meant to convey that women in their 40s should not get mammograms, nor that they sought to discourage women from examining their breasts for signs of cancer.

Diana Petitti, vice-chair of the U.S. Preventive Services Task Force and a professor in biomedical informatics at Arizona State University, said she felt the task force's conclusions were misinterpreted. . . .

NY Times: Screening Policy Won’t Change, U.S. Officials Say, by Kevin Sack & Gina Kolata:

WASHINGTON — The Obama administration distanced itself Wednesday from new standards on breast cancer screening that were recommended this week by a federally appointed task force, saying government insurance programs would continue to cover routine mammograms for women starting at age 40.

A Comparison of the House and Senate Health Care Bills

The New York Times website offers an interactive feature that provides a look at how the House and Senate health care proposals compare on some key issues, including abortion.

NY Times: Comparing the House and the Senate Health Care Proposals:

Senate Democrats unveiled sweeping legislation Wednesday to overhaul the nation’s health care system. Earlier this month the House passed its own version. The proposals are broadly similar but differ on some major issues, such as on a new government insurance plan, abortion and immigration. Many provisions of the Senate bill, including the mandate for individuals to obtain insurance and the creation of insurance markets, would take effect in 2014, a year later than similar provisions of the House bill.

Senate Health Care Bill Less Restrictive on Abortion Than House Version

God & Country (US News & World Report): Senate Healthcare Plan Lacks House Bill's Strict Abortion Funding Ban, by Dan Gilgoff:

Now that Sen. Harry Reid has released the Senate version of the healthcare bill, the two main sides in the culture war—abortion rights advocates and foes—are back to their usual corners.

The House healthcare bill's strict ban on federally subsidized abortion coverage earned Democrats the wrath of their abortion rights allies and praise from abortion opponents. The Senate healthcare plan lacks the language of the House's Stupak-Pitts amendment, which prohibits abortion coverage in the public plan and from private plans receiving government subsidies; instead, it has language that hews closer to the House's scuttled Capps amendment, which allows abortion coverage in the public plan and in private plans receiving federal dollars as long as the money comes from pooled private premiums. (Abortion opponents call it an accounting trick.) . . .

See also: NY Times: Reid Says Saturday Vote on Health Care Bill Likely, by David Herszenhorn:

The majority leader, Senator Harry Reid of Nevada, scheduled the first crucial procedural vote on the major health care legislation for Saturday at 8 p.m., after what is expected to be two marathon days of initial debate on the Senate floor.

Mr. Reid, announcing his agreement with the Republican minority on Thursday afternoon, said debate on the $848 billion health care measure would begin Friday morning and continue until 11 p.m., and would pick up again on Saturday morning.

At 8 p.m., the Senate will take its first vote, a procedural hurdle that will require Mr. Reid to have all 60 members of his caucus unanimously in support of calling up the bill for formal floor debate. If he wins, the Senate will then recess for Thanksgiving.

Republicans Consider Filibuster of Obama Pick for Seventh Circuit; Obama Supporters Worry About Lag in Filling Vacancies

The Hill: Conservatives split over filibuster of Obama court pick, by Alexander Bolton:

Leading conservative activists are split over whether to filibuster Judge David Hamilton, whose nomination to the 7th Circuit will serve as a test case for President Barack Obama’s more controversial appellate court picks.

Twenty four leading conservatives have signed a memo urging Republican senators to filibuster Hamilton, setting the stage for the first protracted Senate fight over one of Obama’s judicial nominees.

Hamilton will likely receive an up-or-down vote because Democrats control 60 seats, but conservative and liberal advocates say a filibuster would be significant because it would serve as a precedent for Obama’s future judicial nominees. . . .

See also: NY Times: Obama Backers Fear Opportunities to Reshape Judiciary Are Slipping Away, by Charlie Savage:

WASHINGTON — President Obama has sent the Senate far fewer judicial nominations than former President George W. Bush did in his first 10 months in office, deflating the hopes of liberals that the White House would move quickly to reshape the federal judiciary after eight years of Republican appointments.

Mr. Bush, who made it an early goal to push conservatives into the judicial pipeline and left a strong stamp on the courts, had already nominated 28 appellate and 36 district candidates at a comparable point in his tenure. By contrast, Mr. Obama has offered 12 nominations to appeals courts and 14 to district courts.

Theodore Shaw, a Columbia University law professor who until recently led the NAACP Legal Defense and Educational Fund Inc., said liberals feared that the White House was not taking advantage of its chance to fill vacancies while Democrats enjoy a razor-thin advantage in the Senate enabling them to cut off the threat of filibusters against nominees. There are nearly 100 vacancies on federal courts. . . . 

Afghan Mullahs Get a Lesson on Birth Control

NY Times: Broaching Birth Control With Afghan Mullahs, by Sabrina Tavernise:

MAZAR-I-SHARIF, Afghanistan — The mullahs stared silently at the screen. They shifted in their chairs and fiddled with pencils. Koranic verses flashed above them, but the topic was something that made everybody a little uncomfortable.

“A baby should be breast-fed for at least 21 months,” said the instructor. “Milk is safe inside the breast. Dust and germs can’t get inside.”

It was a seminar on birth control, a likely subject for a nation whose fertility rate of 6 children per woman is the highest in Asia. But the audience was unusual: 10 Islamic religious leaders from this city and its suburbs, wearing turbans and sipping tea.

The message was simple. Babies are good, but not too many; wait two years before having another to give your wife’s body a chance to recover. Nothing in Islam expressly forbids birth control. But it does emphasize procreation, and mullahs, like leaders of other faiths, consider children to be blessings from God, and are usually the most determined opponents of having fewer of them.

It is an attitude that Afghanistan can no longer afford, in the view of the employees of the nonprofit group that runs the seminars, Marie Stopes International. The high birthrate places a heavy weight on a society where average per capita earnings are about $700 a year. It is also a risk to mothers. Afghanistan is second only to Sierra Leone in maternal mortality rates, which run as high as 8 percent in some areas. . . . 

New Guidelines Suggest Routine Mammograms Starting at Age 50, Not 40

NY Times: In Reversal, Panel Urges Mammograms at 50, Not 40, by Gina Kolata:

Most women should start regular breast cancer screening at age 50, not 40, according to new guidelines released Monday by an influential group that provides guidance to doctors, insurance companies and policy makers.

The new recommendations reverse longstanding guidelines and are aimed at reducing harm from overtreatment, the group says. It also says women age 50 to 74 should have mammograms less frequently — every two years, rather than every year. And it said doctors should stop teaching women to examine their breasts on a regular basis.

Just seven years ago, the same group, the United States Preventive Services Task Force, with different members, recommended that women have mammograms every one to two years starting at age 40. It found too little evidence to take a stand on breast self-examinations.

The group’s new guidelines, which are different from those of some professional and advocacy organizations, are published online in The Annals of Internal Medicine They are likely to touch off yet another round of controversy over the benefits of screening for breast cancer. . . .

RNC's Health Insurance Plan Covers Abortion

Time Magazine: RNC Health Insurance Plan Covers Abortion:

(WASHINGTON) — The Republican National Committee's health insurance plan covers elective abortions for its employees, an option Republicans strongly oppose in health overhaul legislation that Democrats are trying to push through Congress.

Republican Party Chairman Michael Steele learned of the policy's abortion coverage Thursday through a news report and immediately instructed staff to inform the insurance carrier that the RNC wanted to opt out of elective abortion coverage, RNC spokeswoman Gail Gitcho said. "Money from our loyal donors should not be used for this purpose," Steele said in a statement. "I don't know why this policy existed in the past, but it will not exist under my administration. Consider this issue settled." (See TIME's interactive graphic "New Fronts in the Abortion Arena.")

Gitcho said the policy has been in effect since 1991.

The GOP platform traditionally includes strong anti-abortion language. All House Republicans, except one, voted for an amendment imposing restrictions of coverage for abortions in the health care bill that passed the House last Saturday. Inclusion of the abortion restrictions prompted an angry backlash from liberal House Democrats, and some are now threatening to vote against a final bill if the curbs stay in. . . . 

Health Care Reform Bills Don't Require Contraceptive Coverage

Slate Magazine (Double X): Why Doesn't Health Care Cover Birth Control?, by Sharon Lerner:

Politicians won’t address the subject.

Nancy Pelosi made her wrenching choice between the health reform bill and abortion rights, and—unless Obama works some magic soon—American women will have to live with it. Since the House bill passed with just two votes to spare, the anti-abortion language in the Stupak amendment may have been essential for passing it. (The Catholic leadership, which had lobbied heavily against abortion funding all summer, gambled, correctly, that, despite Pelosi’s commitment to abortion rights, she wouldn’t abandon the bill on principle. The same, it should be noted, cannot be said of the bishops, who were willing to kill the whole deal—pediatric services and all—if all of their own demands were not met.)

Abortion, it seems, was lost to political horse-trading. But there are also deeper forces at work that will continue to affect the 10 million women who are expected to participate in a health care exchange—an infuriating irrationality that taints not just abortion, but many other health issues that are perceived to be connected to women’s sexuality.

The best example is birth control, which was also recently thrown under the health-reform train. So far, none of the three reform bills has required insurers to cover contraception, although it is almost universally used by heterosexually active women. Other preventive services, such as some counseling about sexually transmitted diseases and pelvic exams, didn’t make the cut, either. Nor have the bills protected these services from “cost sharing,” which means that women may well end up paying for much of their birth control out of their own pockets.

Women’s health advocates reported that some Democrats cited a fear of igniting controversy when asked to insert birth control and other preventive services for women into the minimum benefits package. What’s the controversy, exactly? It seems birth control has become a suddenly loaded political issue, a toxic sister to abortion, somehow resonant of irresponsible sex and women’s bodies. . . .