Reproductive Rights Prof Blog

As the ADA Turns 31, Reproductive Rights Activists Note the Link Between the Two Battles

By Fallon Parker (Aug. 3, 2021)

Last week marked the 31^st anniversary of the Americans with Disabilities Act (ADA), which seeks to affirm and protect the rights of people with disabilities. Among other provisions, the act guarantees equal opportunity to person with disabilities in employment, transportation, services, accommodations, and other areas. While the ADA has resulted in significant changes for the disabled community, persons with disabilities who use reproductive healthcare still struggle to gain access to services.

Disability rights and reproductive justice have always been closely linked. Buck v. Bell, which has not been overturned, allowed for sterilization of institutionalized persons in order to benefit the “welfare of society.” Eugenics, which was espoused as a way to “improve society” and specifically targeted disabled persons, among other marginalized groups, motivated some early supporters of birth control.

Today, it is recognized that persons with disabilities have the same reproductive and sexual health needs as persons without disabilities, and yet studies show that persons with disabilities do not access reproductive care at the same rates as their peers. According to the National Council on Disability, disabled persons reported avoiding regular gynecological visits because they were difficult to obtain, and that healthcare workers often refrained from discussing contraceptives or STD screening with disabled persons and expressed surprise to learn disabled persons were sexually active. Persons with disabilities are also likely to have fewer pap tests and mammograms than persons without disabilities. Additionally, disabled persons are poorer on average than non-disabled persons, and income is directly related to ability to access reproductive services. And some disabled persons who rely on Medicaid do not have access to insurance coverage for abortion services.

Recently there has been an influx of attention to the intersection of disability rights and the reproductive justice movement. Britney Spears, the singer who has been under a conservatorship for 13 years, finally had her day in court and revealed, among other things, that her conservatorship forces her to wear an IUD. While the exact terms and genesis of the conservatorship are not public, it reportedly followed an involuntary temporary psychiatric hold filed on her 13 years ago based on an assessment that she was a possible danger to herself or others.

This year, Spears expressed to a court her desire to have more children and her frustration with not having any control over that decision. In response to Spears’s testimony, several websites have published accounts from disabled persons noting the similarities between Spears’s lack of bodily autonomy and the restrictions that disabled persons face daily. Sara Luterman, a journalist who is disabled, was interviewed for Slate and broke down how difficult it is for people to remove themselves from a conservatorship or guardianship. Luterman mentioned Ryan King, a man with an intellectual disability who could not remove his conservatorship, even though his conservators, who were his parents, asked the court to remove it. Like it is for King, Luterman fears it will be difficult for Spears to remove herself from her conservatorship.

Spears’s conservatorship and her fight for bodily autonomy highlight a common reality for many disabled persons, especially those with reproductive needs. While the ADA was a significant moment in the fight for disability rights, it has fallen short in providing reproductive justice for disabled persons. Within the mainstream reproductive justice movement, disabled persons are often left out of the conversation. The anniversary of this landmark legislation is an opportunity to reaffirm commitment to the importance of disability rights in the fight for reproductive justice and consider how the next 30 years can be used to ensure equitable access to reproductive healthcare for all.

California Mandates Reparations for Some Victims of Forced Sterilization

By K.A. Dilday (July 20, 2021)

On July 12, California governor Gavin Newsom, signed into law AB-1764, a bill to pay reparations to people who were forcibly sterilized in California during the years 1909 and 1979 when the state’s eugenic sanctions law (enacted in 1909 and honed throughout the years) was in place, and to people who were sterilized in the state's prison system after that time. California is the third state, following North Carolina and Virginia, that will compensate victims of forced sterilization.

The bill signed by Gov. Newsom is particularly noteworthy as both the issue of reparations and of forced sterilization figure prominently in national dialogue. Just last year, a nurse at a privately owned immigration jail in Georgia joined in a whistleblower complaint alleging that a doctor at the facility performed a high rate of hysterectomies on migrating women without “proper informed consent,” and bills proposing reparations for the descendants of enslaved Black Americans are regularly debated in the U.S. Congress.

According to the final text of California’s AB-1764, the forced eugenics law targeted people deemed afflicted with “mental disease,” “feeblemindedness,” and, “those suffering from perversion or marked departures from normal mentality or from disease of a syphilitic nature.”

During the 70 years that the law was in place, the reparations bill states, “more than 20,000 people were sterilized, making California the nation’s leader by far in sterilizations, a number that was more than one-third of the 60,000 persons sterilized nationwide in 32 states … between 1919 and 1952, women and girls were 14 percent more likely to be sterilized than men and boys. Male Latino patients were 23 percent more likely to be sterilized than non-Latino male patients, and female Latina patients were 59 percent more likely to be sterilized than non-Latina female patients.”

That law was finally overturned in 1979 after 10 Los Angeles women of Mexican origin brought a lawsuit in federal court against the Los Angeles County-USC Medical Center for involuntary or forced sterilization in Madrigal v. Quilligan (1978). While the judge ruled in favor of the defendants, ascribing the unwanted sterilizations to miscommunication and language barriers, the women of Madrigal v. Quilligan nonetheless reshaped history. The next year, the state legislature overturned the law. They did not win for themselves but they won for future Californians.

Or so it seemed, since, notably, while the formal eugenics law ended in 1979, a program of sterilization as birth control and for dubious medical reasons led to the sterilization of approximately 150 mostly Latina and Black women in California prisons between 2006 and 2010.

In 2014, the bill SB 1135 made sterilization for birth control in California prisons unlawful, and put in place safeguards to ensure that any sterilization deemed medically necessary for an imprisoned person actually is. However, no reparations for past sterilizations were mandated at that time. 

Eugenics-driven sterilization in the United States has always been directed at those deemed mentally infirm or undesirable, a characteristic that is often assigned to people of color and to imprisoned people. This practice was sanctioned federally by the notorious 1927 Buck v. Bell U.S. Supreme Court decision. While Buck v. Bell was discredited by the Supreme Court decision in Skinner v. Oklahoma (1942) that established procreation as a fundamental right protected by the U.S. Constitution, and has been chipped away by other protective laws, Buck v. Bell has never been overturned.

In addition to the eugenics programs in California, throughout the 19^th century and through the mid-20^th century there was mass forced sterilization of poor people (many black and Latino) in the South, Indigenous people in Western and middle-America, and of Puertoriquenos in Puerto Rico through the 1970s. But forced sterilizations were also performed on people who were deemed either mentally or morally unworthy, regardless of race.

California convened a "Task Force to Study and Develop Reparation Proposals for African Americans" this year, and while some may see AB-1764 as another step toward direct reparations, the bill only authorizes payment to individuals who were sterilized, thus avoiding the complex issue of generational injury. And, unless they adopted or had biological children before the procedure, many people who were sterilized likely do not have offspring, reducing the number of descendants who might protest the bill’s limits on eligibility to bring a claim.

The status of potential claimants who are undocumented is unclear.

The state has allocated $7.5 million to pay the victims. According to The New York Times, the limited number of living potential claimants means that each successful applicant is likely to receive approximately $25,000.

 

 

A New Survey Indicates ACA Increased Birth-Control Options but COVID-19 Threatens Gains

By Kelly Folkers (March 16, 2021)

Since President Obama signed the Affordable Care Act (ACA) into law almost ten years ago, increasing numbers of patients have been able to use their desired form of contraception, according to the results of a recent national survey of OBGYNs. One of the law's most popular provisions requires insurers and employer-sponsored plans to cover most FDA-approved contraceptive methods without charging a co-pay or co-insurance. But with the COVID-19 pandemic continuing into its second year and the future of the ACA pending in the Supreme Court, these important gains furthering reproductive autonomy hang in a precarious balance. 

The Kaiser Family Foundation reports that 63 percent of providers have seen contraceptive use significantly or somewhat increase after the implementation of the ACA's birth-control coverage mandate in 2012. Importantly, 69 percent of OBGYNs surveyed reported that the number of their patients able to select their desired method of contraception significantly or somewhat increased subsequent to the provision's implementation. 

Historically, access to contraception has led to a number of beneficial outcomes for women and people with uteruses. Since oral birth control pills became legal in 1965, more women have enrolled in college and earned higher wages. But like any type of health care, birth control is not a one-size-fits-all approach. Patients need a menu of birth control options available as some may cause unwanted side effects. 

Despite the ACA's important gains, the survey also revealed that lower-income patients, particularly those on Medicaid, face significant difficulty in affording and accessing sexual and reproductive healthcare. Though 78 percent of the OBGYNs surveyed accepted Medicaid, many noted barriers to enabling contraceptive choice like the need to get prior authorization or being limited to prescribing an initial contraceptive supply for only 30 days. While the survey provides important context to suggest that the ACA has significantly improved access to contraception nationwide, the survey respondents included, primarily, providers who practice in states with Medicaid expansion, in urban settings, and in private clinics.

At the same time, the ongoing COVID-19 pandemic has created new barriers to accessing care. According to the Guttmacher Institute, one third of women reported delays or cancellations in contraceptive or other sexual and reproductive healthcare. While physician accessibility has increased with the use of telemedicine, at least five states require that providers prescribe birth control in person. 

Without guaranteed, affordable access to one's desired birth control method, many patients may need emergency contraception or abortion. But several states have essentially used the pandemic as a pretext for almost completely curtailing abortion access. For example, early in the pandemic Texas banned all abortions that were not "necessary to preserve the life and health of the mother," essentially requiring any person seeking an abortion in Texas to travel out of state. In many red states, patients have had to rely on the support of community organizations to provide transport for an abortion, risking their life and health to exercise their constitutionally protected right to reproductive autonomy. 

While the ACA laid the foundation for increased access to reproductive health care, the Kaiser Family Foundation survey signals that access to the full array of FDA-approved birth-control options remains inequitable. Further, the pandemic has revealed the need for states to ensure reproductive autonomy and justice by guaranteeing coverage for the full array of contraceptive options for all and removing unnecessary barriers to accessing reproductive health care. 

Texas gave anti-abortion group millions for women's health, despite warnings

Houston Chronicle (Feb. 25, 2019): Texas gave anti-abortion group millions for women's health, despite warnings, by Jeremy Blackman:

In May 2016, Carol Everett sent an email to fellow anti-abortion activists detailing “an extraordinary pro-life opportunity.” Her nonprofit, the Heidi Group, she said, had spent the past year pushing for nearly $40 million in funding to help Christian pregnancy centers “bless many poor women” across Texas. The opportunity she was discussing? An application to become one of the state’s leading family planning providers as part of the Healthy Texas Women program, which offers free women’s health and family planning services to eligible, low-income women.

Everett had never contracted with the state and had no clinical background. Many of the pregnancy centers she cited don’t provide contraception, a core family planning service. Still, state health officials gave her significant public funding anyway, ignoring warning signs and overruling staff that recommended millions less in funding, according to a review of the contracting by the Houston Chronicle. When Everett’s clinics began failing, Texas delayed for months in shifting money to higher performing clinics and chose to devote vast amounts of time to support Everett and her small, understaffed team.

The Heidi Group was not the only contractor that struggled in Healthy Texas Women. By the end of the first year, others had met just 46 percent of their combined patient targets. They had spent just over a third of their proposed fee-for-service expenditures, the state’s preferred source because every expense can be tracked. Those excelling early on were established providers versed in the state’s complex billing procedures. For them, the program has been a boon from the beginning, increasing funding for equipment and staff, and adding reimbursements for a larger swath of health services. Still, many of the smaller, less-experienced clinics could not scale up quickly enough and felt they had not received adequate training on billing and enrollment delays.

The state's separate Family Planning program within HHS had twice the success rate, both in spending and patient targets. Though the 39 Healthy Texas Women contractors had access to more money in the first year, those in the Family Planning program outspent them by several million dollars, which the state said it could not immediately verify. Because of its less stringent eligibility requirements, Family Planning program providers say they can more easily meet need where it exists. And for many of them, that is with immigrant and undocumented families.

Though it’s impossible to say how many more women could have been served had the resources been shifted sooner, several competing clinics involved in Healthy Texas Women burned through their funding early in the grant cycle, surpassing their targets for both spending and patients treated. Had they been sent some of the $6.75 million sitting in wait for the Heidi Group, the door could have opened for thousands more women to receive access to contraception, STD screenings and breast exams.

“We would definitely have been able to serve more,” said Marcie Mir, the chief executive officer of El Centro de Corazon, which serves immigrant communities in East Houston.

The Houston Chronicle’s review included emails, internal records, and interviews with two dozen people, and found that the Texas HHS made repeated concessions, and not just to the Heidi Group. State health officials lowered the standards for applicants in two new women’s health programs, including Healthy Texas Women, and revised past patient counts, making it easier to show growth. Quality control measures were stalled, and only the Heidi Group received on-site clinical assessments in the first year, despite similar problems with other contractors.

At least one top Republican, Governor Greg Abbott, laid the groundwork for Everett’s selection, controlling her appointment to an influential committee helping to develop the new programs, according to records. The health official who allocated Everett's award has close personal ties to the conservative Texas Public Policy Foundation, whose founder, Dr. James Leininger, has been a key donor to the Heidi Group, as well as to Abbott.

Everett’s funding was revoked last fall after two years of poor performance, and auditors are reviewing whether the Heidi Group mishandled funds.

Despite an uptick in number of people served in 2017 from the previous year, Texas still served 100,000 fewer patients than in 2010, despite spending about $35 million more in 2017, including federal dollars.

What has happened in Texas may be a preview for the country at large. The Trump administration on Friday announced it is cutting family planning funding to abortion affiliates, a decision that further undermines groups like Planned Parenthood, which provide the bulk of non-abortion services to low-income women nationally. The move, much like the one in Texas years ago, is expected to direct millions toward faith-based providers.

Campus Vending Machines Offer Emergency Contraception Without the Stigma

The Verge (Feb. 11, 2019): Campus vending machines offer emergency contraception without the stigma, by Lux Alptraum:

Thirteen years after a heated battle resulted in over-the-counter approval for emergency contraception, the product is finally shedding some of its stigma, and college campuses are leading the charge toward normalization.

In the fall of 2018, Yale’s Reproductive Justice Action League proposed a new plan to improve the health and wellness of its student population: emergency contraception vending machines. Unfortunately, the university announced that it was halting the plan because of a little-known state law banning vending machines from being used to distribute over-the-counter medications.

Similar laws exist around the country and are currently being challenged. This week, a bill was introduced in Maine at the request of students at the University of Southern Maine that would allow some over-the-counter medications — including emergency contraception — to be sold in vending machines.

But more broadly, says Alptraum, "there’s no denying that our national conversation about [emergency contraception] has undergone a major shift toward normalization: emergency contraception is now available at health clinics, drugstores, and, yes, in vending machines."

For students on isolated college campuses, though, distance is an additional hurdle, says Rachel Samuels, the Stanford alumna who led the charge for more accessible on-campus emergency contraception. At Stanford, Samuels says, the nearest pharmacy is about a 25-minute walk away with no guarantee that emergency contraception will be in stock. On rural campuses, access to pharmacies is usually even more limited.

When Stanford students began petitioning for on-campus access to emergency contraception a few years ago, they looked to vending machines as a solution. The result of that organizing is a small, high-tech vending machine called a Vengo that is located in the all-gender restroom in Stanford’s student center. It allows students to confidentially access My Way brand emergency contraception (and condoms) at any hour of the day. The pill costs $25, which is less than the $26 that the student health center charges or the $40 or $50 Plan B tends to retail for at pharmacies, though that’s more than twice what the same brand retails for on Amazon.

Still, in 2018, the machines sold 329 units of emergency contraception, and Stanford plans to add a second Vengo machine on campus in 2019. Vengo machines have also started dispensing EC at Columbia University in New York and George Mason University in Virginia.

In Nigeria, Trump administration policies bite hard

Devex (Feb. 5, 2019): In Nigeria, Trump administration policies bite hard, by Paul Adepoju: 

Trump's policies limiting reproductive rights and funding for reproductive health and education services continue to wreak havoc on foreign initiatives aimed at promoting family planning, slowing population growth, and educating girls and women.

Nigerian hospitals and NGOs are facing severe shortages of reproductive health supplies since Trump both cut funding to the United Nations Population Fund (UNFPA) and implemented the "global gag rule," withdrawing funding from any agency that offers abortion-related education or services. 

Nigeria, a middle-income country facing a population boom, lost over 60% of its funding for family planning supplies and services in the year after Trump pulled UNFPA funding. "In 2016, when UNFPA got its last support from the U.S. government, it was able to spend $15,444,880 on family planning in Nigeria. In 2017, it spent just $6,132,632."

Trump justified these funding cuts by promulgating theories that the UNFPA cooperated with coercive abortions and involuntary sterilization, which the UNFPA categorically denies and is readily backed up by multiple human rights organizations.

The rate of contraceptive usage in Nigeria is already very low, and the African country also faces one of the highest maternal mortality rates in the world. 

Several organizations--including Generation Initiative for Women and Youth Network--are on-the-ground in Nigeria working to educate women and provide safe and reliable access to health care to shift these statistics. Their work, though, has been severely limited by the loss of funding as a result of U.S. policies under the Trump administration. 

Erin Williams, program officer for grantmaking and international partnerships at the International Women's Health Coalition, told Devex: 

As a result [of these policies], Nigerian health services will continue to fragment, deteriorate, and decrease, increasing the burden on vulnerable women and girls in search of comprehensive and quality health care. More women will look for contraceptive and pregnancy alternatives outside the medical and legal system.

While much of the justification for pulling U.S. funding relies on anti-abortion ideology, the implications of the policies are much farther-reaching than "just" abortion. Nigeria has slowed in its ability to address maternal health needs generally, including instances of gender-based violence, as well in its ability to address wide-reaching disease concerns like the spread of malaria and tuberculosis. Furthermore, the policy-shift has actually led to increased numbers of abortions throughout Sub-Saharan Africa in the countries hit hardest by the loss of funding. 

Congress this week is set to introduce the Global Health, Empowerment and Rights Act, which would repeal the global gag rule permanently and help to ensure consistent reproductive health care around the world. It is unlikely to be passed by the Republican-controlled Senate, however, or to be signed by Trump. 

More women in poor countries use contraception, says report

AP (Nov. 12, 2018): More women in poor countries use contraception, says report, by Ignatius Ssuuna and Rodney Muhumuza: 

A report released this week states that modern contraception is effectively expanding and becoming more commonplace in developing countries throughout the world.

The report--issued by Family Planning 2020, a U.N.-backed international advocacy group--cites that there are 46 million more users of contraception in the world's 69 poorest countries in 2018 than there were in 2012. 

Access to modern contraception helped prevent over 119 million unintended pregnancies and averted 20 million unsafe abortions between July 2017 and July 2018, although populations continue to soar across Africa and other low income countries, the report said.

'The best way to overcome this challenge of rapid population growth is by giving women and girls (the) opportunity to decide how many children they want to have,' Beth Schlachter, executive director of Family Planning 2020, told The Associated Press.

Many of the countries included in the report are in sub-Saharan Africa. The birth rate in this part of the world is about 5.1 births per woman, according to a recent U.N. global population report. "Over half of the global population growth between now and 2050 will take place in Africa, according to U.N. figures." Despite the growing fertility rates in Africa, contraceptive use is growing fastest in this region of the world as well. 

Options for various contraceptive methods--including short-term, long-lasting, emergency, and permanent--have significantly expanded in many of the countries analyzed in the report.

Many millions of people who wish to delay or prevent pregnancy, however, still do not have adequate access to birth control. Lack of information--including perceived side-effects of medications as well as societal disapproval--deter many from finding the right contraceptive method for them.

The goal of Family Planning 2020 is to bring contraception to "120 million more women and girls in developing countries by the year 2020." Donors have committed millions of dollars to meet this goal. 

 

What the Election Results Mean for Abortion in America

The Cut (Nov. 8, 2018): What the Election Results Mean for Abortion in America, by Irin Carmon:

"Tuesday’s results were messy and contradictory, just like the current reality of reproductive rights," writes Irin Carmon for The Cut.

With federal courts failing to protect abortion access, it will be up to the states to give and take away. “We made huge gains at the state level, which is going to be crucially important as we face the post-Roe reality,” says NARAL president Ilyse Hogue. Exit polls showed broad support for Roe v. Wade, but Republican voters in states like Indiana and North Dakota were motivated by Brett Kavanaugh’s nomination to vote Republican.

First, the bad: the Senate and the federal judiciary "are gone." Republicans took a firm majority in the Senate, which has the sole authority to select federal judges and Supreme Court justices. Should Donald Trump have the chance to make another pick for the Supreme Court justice, writes Carmon, "the impact would be catastrophic."

Plenty of damage has and still can be done by Trump-controlled federal agencies, too. Earlier this week, the Department of Health and Human Services issued rules to limit abortion coverage on insurance plans on the exchange and to grant employers broad ability to opt out of including birth control in their plans.

But the good news is that without Republican control of the House, no major legislation restricting access to contraception or birth control — including defunding Planned Parenthood or a ban on abortion at 20 weeks — is likely to go anywhere.

At the state level, pro-choice Democrats didn’t lose a single governor’s seat and actually picked up seven seats. Former governors in some of the those states — like Kansas, Michigan, and Wisconsin — were zealous in limiting abortion access, making the replacements especially significant. Blue states also saw a total of 300 state legislature seats flipping Democratic, paving the way for stronger protections for abortion access.

In New York, eight state Senate seats went to Democrats, after a concerted campaign highlighted Republican opponents’ refusal to a Reproductive Health Act that would safeguard abortion liberty in New York in the event that Roe v. Wade is overturned. Democrats now control the New York State Senate for the first time in a decade.

Some Republican supermajorities, which can override vetoes, were shrunk to simple majorities. Perhaps most promisingly, pro-choice champions won in red states, like Colin Allred in Texas. In Orange County, California, 31-year-old Katie Hill, who spoke openly about how her miscarriage at 18 had informed her support for reproductive freedom, bested the anti-abortion Steve Knight.

House Republicans Jam ‘Personhood’ Language Into New Tax Bill

Rewire.News (Oct. 1, 2018): House Republicans Jam ‘Personhood’ Language Into New Tax Bill, by Katelyn Burns: 

The U.S. House of Representatives last week passed a bill that would extend "the ability to count 'unborn children' as beneficiaries under 529 education savings plans."

The bill, referred to as the Family Savings Act, is a part of a current push for updated tax legislation. Anti-choice activists have promoted the addition of personhood language--effectively defining zygotes, embryos, and fetuses as persons with all the rights that entails--to legislation for some time. The cause is now embraced by many Congressional Republicans as well.

"Personhood laws" have consistently been rejected in ballot measures across the country. 

Representatives and activists alike warn lawmakers to be vigilant of the tactic of sneaking anti-choice provisions into larger bills. “This is how extremist views creep into the mainstream," said Rep. Diana DeGette (D-CO). "Provisions like this one should never become law—they can lead to limits on access to abortion and even birth control.”

Supporters of the legislation--personhood language and all--claim that it will "finally" allow expectant parents to begin saving for their future child's education through a 529 plan. Parents-to-be, however, "can already open a 529 plan listing themselves as the beneficiary before switching it over to the child once they are born."

The Family Savings Act is not expected to pass in the Senate ahead of the midterms, but this is not the first time--and surely not the last--lawmakers have tried to slip similar provisions into tax reform or other legislation.  

Women--and Robust Reproductive Rights--Are Key to Solving Climate Crisis

Sierra (Sept. 18, 2018): Climate Activists Say Women Are Key to Solving the Climate Crisis, by Wendy Becktold: 

Last week, San Francisco hosted the Global Climate Action Summit (GCAS). The three-day conference brought together heads of state, policy makers, scientists, and leaders from civil society to discuss clean energy and averting catastrophic climate change. One of the recurring topics focused on the necessity of investing in women's rights, including sexual and reproductive rights, in combating climate crises. 

Decades of research indicate that investing in women's rights can dramatically contribute to addressing both development and climate challenges around the globe. In particular, access to education and robust reproductive rights strengthens opportunities for women worldwide. Supporting women is proven to translate to more sustainable development including the promotion of clean energy over fossil fuels.

"Access to reproductive health services is...key to reducing pressure on natural resources." A lack of access to contraception, for example, leads to many millions of unplanned pregnancies, which in turn can prevent women from creating the productive and sustainable systems they would otherwise be able to contribute to. Better education can also reduce birth rates and further improve the livelihood of women around the world.

In poorer parts of the world, women produce 60-80 percent of food crops. Providing women with better education and resources such as access to small business loans (like their male counterparts often have) could could reduce the number of people who go hungry around the world by 150 million. 

Many summit conversations at the conference, in addition to countless side events, highlighted the shared frustrations of women around the world.

Some climate activists found the summit’s emphasis on high tech solutions exasperating. 'There’s often a focus on techno fixes,' said Burns [of the Women’s Environment and Development Organization], 'when for years, we’ve been saying that investing in women’s human rights is how we can address climate change. There is still this huge disconnect between the rhetoric and the solutions that are coming from feminists and frontline voices.'

"Women are also disproportionately affected by climate change," in part because global warming reaches the impoverished first and most people living in poverty are women. 

The conversations at the GCAS highlighted how integral reproductive rights and support of women's opportunities are to innumerable issues. The ripple-effect of guaranteeing sexual and reproductive rights, the research shows, extends far past simply being able to plan a pregnancy; such support builds up communities around the globe, reduces poverty, and has the power to fight behemoth challenges like climate change as well. 

Planned Parenthood’s Next President: An Immigrant Doctor of Color Who Grew Up on Medicaid

Slate (Sept. 12, 2018): Planned Parenthood’s Next President: An Immigrant Doctor of Color Who Grew Up on Medicaid, by Christina Cauterucci:

Planned Parenthood announced in September that its new president, Leana Wen, will start in November. Wen currently serves as Baltimore's health commissioner and is also an emergency room physician. She will be the second doctor to head the organization and the first one to do so in 50 years.

"In both her career and her lived experience, Wen is a near-perfect embodiment of the organization’s core concerns, client base, and trajectory." Wen left China for the United States as a political asylum-seeker when she was eight years old. Growing up in poverty in California, she relied on Medicaid and Planned Parenthood for her health care, and gave back as a medical student by volunteering with Planned Parenthood as well. 

In her current role as health commissioner of Baltimore, Wen has contributed both to reducing infant mortality and to fighting against disparate racial treatment in the health care system. 

After 10 years of leadership focusing on the political side of the organization under Cecile Richards, Wen is expected to emphasize the legitimacy of the medical branch of Planned Parenthood while also continuing to bolster PP's political activism. 

While the majority of Americans support Planned Parenthood, it's often considered a political body and branch of the Democratic party above all else. "Wen will be well-positioned to make the medical case for practices like telemedicine abortions," among other services Planned Parenthood offers and causes it supports. 

That Planned Parenthood chose as its next leader a young immigrant woman of color who grew up on Medicaid and has worked to combat health inequities is a testament to the organization’s semi-recent rebranding as one committed to not only reproductive choice but reproductive justice, an ethos that prioritizes equal access to care and includes related issues like mass incarceration and poverty. The organization came under fire in 2014 when several reproductive justice advocacy groups accused it of engaging in “the co-optation and erasure” of work done by women of color in the field by claiming the mantle of reproductive justice without crediting those who’d pioneered the framework. It has been working to shake that reputation ever since.

In hiring Wen, the organization seems to hope to cement their relevancy in the reproductive justice world, re-focusing on intersectionality in the movement as well as making the case for the medical necessity of Planned Parenthood in a country facing growing threats to reproductive rights. 

Kavanaugh 'abortion-inducing drug' comment draws scrutiny

CNN (Sept. 7, 2018): Kavanaugh 'abortion-inducing drug' comment draws scrutiny, by Ariane de Vogue & Veronica Stracqualursi:

Brett Kavanaugh's views on birth control drew scrutiny on Thursday as abortion rights advocates charged that the Supreme Court nominee referred to contraceptives as "abortion-inducing drugs."

The controversy came as Kavanaugh discussed Priests for Life v. HHS, a case involving the application of the Religious Freedom Restoration Act (RFRA) to the Affordable Care Act in which Kavanaugh wrote a dissenting opinion. The government's regulations included a requirement that all employers provide their employees with health insurance that covers all forms of FDA-approved birth control, including birth control pills, IUDs, and hormonal injections. In his dissent, Kavanaugh expressed sympathy for the religious challengers.

Asked about the case by Senator Ted Cruz (R-TX), Kavanaugh said he believed "that was a group that was being forced to provide certain kind of health coverage over their religious objection to their employees. And under the Religious Freedom Restoration Act, the question was first, was this a substantial burden on the religious exercise? And it seemed to me quite clearly it was."

"It was a technical matter of filling out a form in that case," he continued. "In that case, they said filling out the form would make them complicit in the provision of the abortion-inducing drugs that they were, as a religious matter, objected to."

Although no senators present at the hearing questioned Kavanaugh's usage of the term "abortion-inducing drugs," abortion rights advocates said Kavanaugh mischaracterized the case and also used a controversial term used by groups opposed to abortion.

"The argument for the lawyers of Priests for Life was that they objected to all birth control," Beth Lynk, a spokeswoman for Planned Parenthood Federation of America, said in a statement. "In Kavanaugh's testimony his description of their objection characterized all types of birth control as 'abortion inducing drugs.'"

 

"In reaching for a term to describe all types of birth control, the word he chose was 'abortion inducing drugs,"' she said.

 

"Saying 'abortion-inducing drugs' to describe contraception is straight out of the anti-choice, anti-science phrase book used to restrict women's access to essential health care," the Center for Reproductive Rights said on Twitter Thursday.

 

Kavanaugh used similar language to answer on Thursday to describe the Priests for Life position in his 2015 dissent.

 

"By regulation, that insurance must cover all FDA-approved contraceptives, including certain methods of birth control that, some believe, operate as abortifacients and result in the destruction of embryos," he wrote.

 

A California Abortion Pill Law Would Require Colleges To Offer Them

Bustle (Aug. 22, 2018): A California Abortion Pill Law Would Require Colleges To Offer Them, Thanks to These Activists, by Lani Seelinger:

California could require medication abortion pills to be available across all of the state's public college campuses if a bill that originated through student activism passes by the end of the month. Activists at the University of California-Berkeley were already focusing on promoting reproductive health care when they realized that expanding that care to include access to medication abortions on campus in particular would improve  many student lives. 

"Medication abortion is the process by which a woman can terminate her pregnancy by taking a series of pills within the first 10 weeks of her pregnancy." These procedures are considered very safe and efficient, and activists recognize that campus access could alleviate the logistical issues of accessing the medication. Often the stress of accessing a medication abortion can harm a student's emotional, academic, and financial well-being. Over 500 students a month on University of California (UC) and California State University (CSU) campuses seek medication abortions. 

The Women's Foundation of California--which fights for racial, economic, and gender justice--partnered with the students and alumni promoting the cause, and from there the effort spread from Berkeley throughout the state. California Senator Connie Leyva introduced the bill in the Senate earlier this year. It passed. Next, the bill must pass in the Assembly before August 31 in order to land on Governor Jerry Brown's desk.

The activists spearheading the campaign for the bill (SB320) are driven by the greater mission of de-stigmatizing abortion. 

Democratic governors warn: We'll pull our states out of Title X

July 31, 2018 (Politico): Democrats warn: We'll pull our states out of Title X, by Dan Diamond:

Three Democratic governors are threatening to pull out of the Title X federal family planning program if the U.S. Department of Health & Human Services (HHS) moves forward with its proposal to prohibit referrals for abortion care and make other changes that would exclude abortion providers from participating in the program.

Washington state Governor Jay Inslee, Hawaii Governor David Ige, and Oregon Governor Kate Brown said in separate statements that if the legal battle to prevent the Trump administration's Title X changes fails, their states would not be able to participate in the “unethical” Title X program.

“We would be left with no choice but to refuse to participate in an unethical Title X program," Inslee said in a statement Monday. “Hawai‘i will not accept federal funds for these programs if the proposed rules are implemented,” Ige said. “It would leave me no choice but to act in the best interests of the citizens of Oregon and our state law, and withdraw our state’s participation from an unethical, ineffective Title X program that reduces access to essential preventive health services,” Brown said.

New York Governor Andrew Cuomo issued a similar warning that his state's program would be "impossible" to continue, although he did not explicitly vow to pull New York out of the program.

The moves intensify a quickly escalating battle between the Trump administration and Title X program participants that also offer abortion care over the future of the family planning program. The deadline for public responses to the Trump administration's proposed changes was Tuesday, July 31.

Attorneys general from California, Connecticut, Delaware, Hawai'i, Illinois, Iowa, Maine, Maryland, Minnesota, New Jersey, New Mexico, North Carolina, and the District of Columbia on Monday also jointly issued a comment in opposition to the proposed rule, which can be found here.

HHS Refuses to Release Documents on the New Office of Civil Rights (OCR)

The Department of Health and Human Services (HHS) announced the opening of a new division in January of this year: The Office of Civil Rights (OCR). The OCR's primary mandate is to enforce refusal of care laws. 

Refusal of care laws essentially empower medical providers to deny care to patients if they disagree with the ethics of a particular procedure based on their religious grounds. The purported goal of these laws is to protect a healthcare provider from being forced into providing care that "violates their conscience." 

This is an Executive-ordered decision that does not require legislative or judicial approval to go into effect or to implement its new rules and regulations.

Critics of refusal of care laws express concern that these requirements do not simply "protect" health care providers consciences, but can instead seriously harm patients. These laws may lead to a pharmacist refusing to fill a birth control prescription, a doctor refusing hormone therapy to a transgender patient, limitations placed on services to LGBTQ persons and partners, and of course abortion services may also become more limited.

HHS does not require providers who refuse treatment to refer patients to other providers or provide any information at all on other providers.

The OCR further has authority to initiate compliance reviews of any organization receiving federal funding to ensure conformity to the new rules. 

Earlier this month, the Center for Reproductive Rights (CRR) and the National Women's Law Center (NWLC) filed a lawsuit against HHS for refusing to release records pertaining to the creation of the OCR. The organizations initially requested these records via a FOIA request in January 2018. The CRR and NWLC seek knowledge of why the new division was needed, how the OCR operates, allocates funding, and may be influenced by outside groups.

"We’re filing this lawsuit to force the Trump-Pence administration to justify why it’s using resources to fund discrimination, rather than to protect patients," said Gretchen Borchelt, NWLC Vice President for Reproductive Rights and Health. 

HHS's new Office of Civil Rights follows additional moves by the Trump administration to limit equitable access to reproductive health care, including promoting the "Global Gag Rule," its domestic counterpart, and establishing regulations aimed at severely limiting funding to Title X programs. 

As Cuomo Rallies for Abortion Rights, Nixon Questions His Bona Fides

The New York Times (Jul. 10, 2018): As Cuomo Rallies for Abortion Rights, Nixon Questions His Bona Fides, by Jesse McKinley: 

The New York primary season is heating up as incumbent Governor Andrew Cuomo and Democratic challenger Cynthia Nixon are both advocating, among other things, for hard line policies to protect the right to abortion and women's health services in New York State. 

Governor Cuomo told voters that New York needs to codify the right to abortion in Roe v. Wade on the state level and called on the State Legislature to pass the Reproductive Health Act to do so. He's previously put forth similar legislation, none of which made it through the State Senate's Republicans and "rogue," anti-abortion Democrats. Cuomo is also advocating for the decriminalizing of abortion--moving laws and regulations pertaining to the procedure over to the public health code instead. 

Nixon, in her primary campaign, has highlighted previous, unflattering statements by Cuomo about feminism and women as well as his failure to execute a comprehensive shift in New York reproductive policies in order to distinguish her own platform, which lies somewhat farther to the left and is endorsed by the New York Working Families Party. 

The stakes are clearly raised in in this year's Gubernatorial race in light of Trump's nomination of Brett Kavanaugh to replace Justice Kennedy on the Supreme Court and growing concerns that the fundamental rights to abortion and reproductive health will be formidably challenged under a much more conservative court.

 

Students sue University of Notre Dame for restricting access to some birth control

Washington Post (Jun. 27, 2018): Students sue University of Notre Dame for restricting access to some birth control, by Erin B. Logan: 

A Notre Dame alumna and three current student sued the university on Tuesday in the wake of Notre Dame's February 2018 announcement that it would deny access to "abortion-inducing" contraceptives. The lawsuit alleges violations of federal law and the First and Fifth Amendments. In addition to the university, the suit names the departments of Health and Human Services, Labor, and Treasury.

These health-care policy changes to Notre Dame's plan will affect undergraduate and graduate students as well as university employees and their dependents. The policy will go into effect on July 1 for employees and in August for students.

The roll-back of coverage by the university is a response to the U.S. Department of Health and Human Services' fall 2017 announcement that it would rescind the Obama-era rule mandating free contraceptive coverage in health plans. This requirement currently remains in effect, though, due to judicial injunctions. Notre Dame, however, carved out an exception for itself with the federal government after a 2013 suit against the mandate claimed a violation of its moral and religious convictions.

New York GOP Lawmakers Quash Contraception, Abortion Protections—For Now

Rewire.News (Jun. 8, 2018): New York GOP Lawmakers Quash Contraception, Abortion Protections—For Now, by Auditi Guha:

The Reproductive Health Act (RHA), or S 2796, was drafted four years ago and recently passed by the Democratic-majority New York Assembly. The RHA is intended to rectify some of the shortcomings of local abortion law. The bill "repeals criminal abortion statutes, permits abortion after 24 weeks when the pregnant person’s health is at risk or when the fetus is not viable, and expands current law so that nurse practitioners and physicians’ assistants can provide abortion services."

The Comprehensive Contraception Coverage Act (S 3668), also passed by the Assembly, "would expand contraceptive coverage to include all forms of FDA-approved contraception (including vasectomies), authorize pharmacists to dispense emergency contraception, and add coverage for contraceptive education and counseling."

Gov. Andrew Cuomo (D) supported incorporating the RHA’s changes into state law in his budget proposal this year, but it’s been a hard push in a state where Republicans decide what bills get to be voted on. Procedural glitches made the fight tougher this week for both the RHA and the Comprehensive Contraception Coverage Act as the senate ground to a halt, the New York Daily News reported.

Senate Democrats last week again tried to bring both the RHA and the CCCA to the floor for a vote, but Republican leadership ended the session without action.

“Both these bills are supported by the governor and have passed the Assembly," Sen. Krueger said in a statement. "The Senate Republicans should stop using procedural maneuvers to block these bills which would ensure that individuals would have control of their own reproductive health decisions.”

The president and CEO of Planned Parenthood Empire State Acts, Robin Chappelle Golston, told Rewire.News: “Obviously legislation as simple as making access to contraception widely available was too much for the majority of the Senate...And I think the best answer for that is that people need to go out and vote this fall.”

Bringing reproductive health care to Syria’s underserved Al-Tabqa

ReliefWeb (April 6, 2018): Bringing reproductive health care to Syria’s underserved Al-Tabqa, Report by European Commission's Directorate-General for European Civil Protection and Humanitarian Aid Operations: 

Seven months ago, the Syrian city Al-Tabqa was re-taken from the Islamic State. Displaced families are returning to the city in droves, and the population has increased close to 200% over the last year. 

Basic critical health care is still lacking in the city, though. Recently, UNFPA supported the development of a new health clinic, which opened in January 2018. 460 women received treatment in the first two weeks of the clinic's operations, including one 30-year-old Syrian woman's delivery of twins. 

Under the control of ISIL, contraceptives and other reproductive care were unavailable to women. The new clinic continues to face challenges in its liberation, too, as access to Al-Tabqa for those who wish to return or relocate has been hampered by destroyed infrastructure and lingering landmines. Various agencies are working to improve these conditions, but in the meantime, the Al-Tabqa clinic has managed to become fully-equipped, staffed, and ready to help serve the estimated 6,800 pregnant women in need of care. 

Pharmacists push to provide free contraceptive scheme in Ireland

Irish Times (Apr. 10, 2018): Pharmacists push to provide free contraceptive scheme, by Pat Leahy & Priscilla Lynch:

Pharmacists in Ireland are seeking to deliver an Irish state-funded free contraception service to women, including supplying contraceptive pills without prescription. The proposal by the Irish Pharmacy Union (IPU) has been made to the Department of Health.

 

The contraceptive pill, patches and rings would be made available without prescription and without charge, regardless of eligibility under the proposal, which would represent a major change to the current situation where women need prescriptions for these products. The IPU’s proposal states that pharmacists could directly provide women with oral hormonal contraception pills, patches, rings and injections. All these items currently require a prescription but could be reclassified to be directly dispensed by pharmacists, under set circumstances.

Ireland's Minister for Health Simon Harris has already established a women’s sexual health group in his department to formulate proposals on a program of free contraception for women.

The Irish government intends to implement a plan for a “massive increase in the availability of contraceptives – condoms basically”. However, changes to the way that oral contraceptive pills are provided to women would require legislation.

Pharmacists have directly provided the morning-after pill without the need for a prescription since 2011 – a move that was strongly opposed by general practitioners (GPs) in Ireland at the time. It is expected that the new IPU proposals will face similar strong resistance in the GP community.