Vocapedia > Health > Sexual Health, Contraception, Birth control
By Michael McParlane
Catholics and Condoms
- broken URL
people's sexual health matters UK
sexual health services
birth control and family planning
health provider > Planned Parenthood
male contraceptive pill / male pill
oral contraceptive > pill
UK / USA
over-the-counter birth control pills
contraceptive pill > morning-after pill
contraceptive pill > morning-after pill
Plan B (Contraceptive)
Plan B One-Step,
also known as
the morning-after pill,
is an oral contraceptive.
It is available
without a prescription
to women 17 and older;
those 16 and younger
need a prescription.
contains 1.5 milligrams
of a synthetic version
of the female hormone
that is found in lower doses
in daily contraceptive pills.
It should be taken
as soon as possible after sex
since it gradually
which is why advocates
have pushed for years
to make it available
The drug’s principal effect
is to prevent ovulation,
but it may also make
the lining of the uterus
to a fertilized
This latter effect
— shared by all hormonal
and intrauterine contraceptives —
makes it anathema
to anti-abortion activists.
Plan B has no effect
on established pregnancies,
and it is not an abortion pill
nor is it related to RU-486.
Updated: Dec. 9, 2011
Food and Drug Administration FDA USA
pill / birth control pill
transmitted infections STIs
sexually transmitted diseases
/ sex diseases UK
human papillomavirus HPV
Obama Weighs Steps
to Cover Contraception
JULY 4, 2014
The New York Times
By ROBERT PEAR
and ADAM LIPTAK
WASHINGTON — The Obama administration, reeling from back-to-back
blows from the Supreme Court this week, is weighing options that would provide
contraceptive coverage to thousands of women who are about to lose it or never
had it because of their employers’ religious objections.
The administration must move fast. Legal and health care experts expect a rush
to court involving scores of employers seeking to take advantage of the two
decisions, one involving Hobby Lobby Stores, which affects for-profit
businesses, and the other on Wheaton College that concerns religiously
affiliated nonprofit groups. About 100 cases are pending.
One proposal the White House is studying would put companies’ insurers or health
plan administrators on the spot for contraceptive coverage, with details of
reimbursement to be worked out later.
Another would give the administration itself a larger role in
offering cost-free coverage to women who cannot get it through their employers,
although the option for a new government entitlement appears unrealistic for
financial and political reasons.
The White House is under such pressure that no one has been able to work out
details of how the alternatives would be financed or administered.
Administration officials said they were determined to ensure the broadest
possible coverage of contraceptives for the largest number of women without
requiring employers to violate their religious beliefs.
Mark L. Rienzi, a lawyer who represented both Hobby Lobby and Wheaton College,
said the administration had the tools to make an alternative solution work. “The
government can find other ways to deliver contraceptives to people without
forcing nuns and religious colleges to participate,” he said.
That is not the way Justice Sonia Sotomayor looks at it. In her dissent in the
Wheaton College case on Thursday, she said the challenge facing the government
was “daunting — if not impossible.”
Still, the administration has another motivation to act as quickly as possible:
It is eager to court the votes of women dismayed by the rulings. The Democratic
National Committee is already urging voters to fight back against the Hobby
Lobby decision and to “stand up for Obamacare” in the November elections. The
Supreme Court said that family-owned for-profit corporations like Hobby Lobby
were not required to provide coverage of contraceptives if they objected on
Whatever the choice, no plan can be turned around in two weeks, or two months.
It took more than two years for the administration to figure out how to provide
contraceptive coverage for women at nonprofit groups that have religious
objections. That arrangement allowed religious organizations to fill out a form
that would transfer the delivery of free coverage under the Affordable Care Act
But many of the nonprofit groups say that even notifying an insurer of their
objections through the opt-out form would make them complicit in a moral wrong.
Some consider all contraception to be wrong; others object only to devices and
drugs like the so-called morning-after pill that they believe may cause
abortions. One such objector was Wheaton College, a Christian liberal arts
school in Illinois, and the Supreme Court granted it a temporary exemption in
the ruling on Thursday.
That move divided the court along gender lines, with Justices Ruth Bader
Ginsburg and Elena Kagan joining Justice Sotomayor’s unsparing dissent. They
said the court majority had endorsed the opt-out form just three days earlier in
the Hobby Lobby case, in which Justice Stephen G. Breyer joined the three female
justices in dissent in the 5-to-4 ruling.
The court’s conservative majority — all men — was sanguine about the
availability of other ways for the administration to deliver coverage for every
form of birth control approved by the Food and Drug Administration.
Yet officials are struggling to make sense of a sunny sentence in the court’s
order on Thursday exempting Wheaton from the opt-out form. “Nothing in this
interim order affects the ability of the applicant’s employees and students to
obtain, without cost, the full range of F.D.A.-approved contraceptives,” the
majority said in the unsigned opinion.
It said Wheaton could merely notify the government of its religious objections
in writing rather than send the opt-out form to its coverage providers.
The difference sounds trivial. But it could create quite a roadblock for the
Department of Health and Human Services, Justice Sotomayor wrote in dissent.
“Does the court intend for H.H.S. to rely on the filing of lawsuits by every
entity claiming an exemption?” she asked. She questioned whether the government
was supposed to create “a database that tracks every employer’s insurer or
third-party administrator nationwide.”
Wheaton said it would have no difficulty sending a notice to the secretary of
Health and Human Services.
The contraceptive coverage requirement is just one of many provisions in rules
adopted under the Affordable Care Act, but it has become one of the most
significant, both politically and symbolically, overshadowing many other
In early 2011, Obama administration officials said they wanted to require
insurers to offer contraceptives to women free of charge.
The administration has made progress toward its goal, as millions of women have
gained access to birth control without co-payments or other charges. But in the
process, the administration has become entangled in scores of court cases,
fighting with priests and nuns and other religious believers over details of the
health insurance coverage they provide and receive.
The battles are sure to continue for a year or more, with religious objectors
emboldened by victories this week. Justice Samuel A. Alito Jr., in writing the
majority opinion in the Hobby Lobby case, said it seemed likely that the cost of
providing the four drugs and devices that many religious groups object to “would
be minor when compared with the overall cost” of the health care law.
Justice Alito wrote approvingly of the idea of shifting contraceptive costs to
insurance companies, calling it “an approach that is less restrictive than
requiring employers to fund contraceptive methods that violate their religious
But on Thursday the majority made the cost-shifting much harder to accomplish.
The general idea is to require insurance companies and plan administrators to
deliver coverage when they are told about an employer’s religious objections.
They would bear the costs or receive reimbursement from the government.
The situation is more complicated when employers self-insure. There, the
administration says, outside plan administrators may obtain a “compensating
reduction” in the fees paid by insurers to participate in the insurance
exchanges established by the health care law. Those adjustments, the
administration has said, will not cost much.
Some religious organizations are using that arrangement. But employee benefits
experts said it was not working well, in part because insurers and third-party
administrators have had to foot the bill for contraceptive coverage without any
immediate offset or reimbursement.
“They are not being paid, and they have no prospect of being reimbursed,” said
Christopher E. Condeluci, a lawyer for the Self-Insurance Institute of America.
The Obama administration says the cost of providing contraceptives will be
offset by savings that result from greater use of birth control, “fewer
unplanned pregnancies” and improvement in women’s health. But, Mr. Condeluci
said, “It may be years before the savings are realized.”
A version of this article appears in print on July 5, 2014,
on page A1 of the
New York edition with the headline:
Obama Weighs Steps to Cover Contraception.
Obama Weighs Steps to Cover Contraception,
The Contraception Battle
July 1, 2013
The New York Times
By THE EDITORIAL BOARD
saw two major developments in the legal and political battle over the Obama
administration’s sound decision to require most employers to provide free
insurance coverage of contraceptives for women under the new health care law —
one of them positive and the other a blow to the mandate and to religious
The contraceptive coverage is an important advance in public health. Standing up
to resistance from religious organizations, the Obama administration issued a
final, simplified rule on Friday that allows houses of worship to exclude
contraceptive coverage from their health plans for employees and their
dependents. Other nonprofit religious and church-affiliated organizations like
hospitals, universities and charities that object to contraceptive coverage on
religious grounds will not have to contract, arrange or pay for the coverage.
Instead, insurance companies or third-party administrators will have to arrange
separate no-payment plans for contraceptive services.
Details of how this will work remain to be ironed out. But the administration
has gone further than fairness or the First Amendment require to reach a
compromise that respects the concerns of some religious entities without
sacrificing an employee’s right to make her own decisions regarding
contraceptives and not to conform to the religious beliefs of her employer.
Unfortunately, that vital principle of individual religious liberty was lost on
the United States Court of Appeals for the 10th Circuit, in Denver. In a ruling
issued on Thursday, it bought the argument that requiring the health plan of a
private for-profit employer to cover birth control without a co-pay violated the
The case was brought by the owners of Hobby Lobby, a craft store chain that
describes itself as “a faith-based company.” The First Amendment does not exempt
religious entities from complying with neutral laws of general applicability,
like the contraceptive mandate, much less private profit-making corporations.
Yet, in an en banc ruling, the appellate court blocked the government from
imposing fines on Hobby Lobby for not complying and allowed its challenge to the
mandate to proceed, finding merit in its religious freedom claim.
Hobby Lobby argued that the contraception mandate violates the Religious Freedom
Restoration Act, a 1993 federal statute that bars the federal government from
taking actions that “substantially burden a person’s exercise of religion”
unless that action advances a compelling government interest and is the “least
restrictive means” of achieving it. The mandate’s promotion of women’s health
and autonomy is plainly a compelling interest.
But the court should never have reached that question. Contrary to the majority
opinion, a corporation like Hobby Lobby is plainly not a “person” covered by the
Restoration Act. In any case, the contraceptive rule still leaves the company’s
owners free to rail about the different forms of birth control to which they
object and to try to convince employees not to use them. As the Justice
Department cogently argued, the burden imposed on any religion is trivial in
allowing employees to make their own independent decisions to obtain free
Marci Hamilton, a professor at Cardozo School of Law and an expert on the
Restoration Act, rightly called the 10th Circuit’s interpretation of the law “a
fantasy” that badly undermines rules forbidding corporations from discriminating
on the basis of religion.
The Contraception Battle,
The New York Times
Taking Note - The Editorial Page Editor's Blog
By DAVID FIRESTONE
administration has tried everything it can think of to accommodate religious
groups that don't want to pay for their employees' birth control.
First, it eliminated the requirement for churches. Then church-affiliated groups
like universities and hospitals said they didn't want to pay for birth control
either, so last year the administration said insurance companies would have to
foot the bill. Next the groups said they didn't want even a dollar of their
insurance premiums to go toward contraception, so on Friday the administration
announced a new plan to make sure that won't happen.
The plan is based around the idea that insurance companies benefit from
increased use of contraception, because they don't have to pay for as many
births or the complications of pregnancy. Several studies have found that there
is virtually no cost to an insurance company of paying for birth control because
of those offsetting reductions.
Under the plan, insurance companies must offer separate policies, covering only
birth control, directly to employees of religious non-profits, free of charge.
In the case of religious affiliates that self-insure, a third-party
administrator will arrange for the birth-control-only policies. Insurance
companies that participate will get a break on the fees they have to pay to sell
their policies in national health insurance exchanges.
The danger in the third-party scenario is that taxpayers or others paying
insurance premiums might wind up subsidizing a few religious employers who want
to impose their own doctrines on their employees, whether or not the employees
agree. That's not an issue of religious freedom; if anything, some groups want
to restrict the freedoms of their employees, who may be of a different religion.
What's clear, though, is that the administration has gone far enough in its
accommodations. Now the test will be put to the religious groups: was their
objection really about who pays a few extra dollars to insurance companies? Or
did they simply object to the administration's demand for widespread, free
access to birth control? Their response to today's plan will provide the answer.
Contraception Compromise, NYT, 1.2.2013,
Fights Coverage of Birth Control
The New York Times
By ETHAN BRONNER
In a flood
of lawsuits, Roman Catholics, evangelicals and Mennonites are challenging a
provision in the new health care law that requires employers to cover birth
control in employee health plans — a high-stakes clash between religious freedom
and health care access that appears headed to the Supreme Court.
In recent months, federal courts have seen dozens of lawsuits brought not only
by religious institutions like Catholic dioceses but also by private employers
ranging from a pizza mogul to produce transporters who say the government is
forcing them to violate core tenets of their faith. Some have been turned away
by judges convinced that access to contraception is a vital health need and a
compelling state interest. Others have been told that their beliefs appear to
outweigh any state interest and that they may hold off complying with the law
until their cases have been judged. New suits are filed nearly weekly.
“This is highly likely to end up at the Supreme Court,” said Douglas Laycock, a
law professor at the University of Virginia and one of the country’s top
scholars on church-state conflicts. “There are so many cases, and we are already
getting strong disagreements among the circuit courts.”
President Obama’s health care law, known as the Affordable Care Act, was the
most fought-over piece of legislation in his first term and was the focus of a
highly contentious Supreme Court decision last year that found it to be
But a provision requiring the full coverage of contraception remains a matter of
fierce controversy. The law says that companies must fully cover all
“contraceptive methods and sterilization procedures” approved by the Food and
Drug Administration, including “morning-after pills” and intrauterine devices
whose effects some contend are akin to abortion.
As applied by the Health and Human Services Department, the law offers an
exemption for “religious employers,” meaning those who meet a four-part test:
that their purpose is to inculcate religious values, that they primarily employ
and serve people who share their religious tenets, and that they are nonprofit
groups under federal tax law.
But many institutions, including religious schools and colleges, do not meet
those criteria because they employ and teach members of other religions and have
a broader purpose than inculcating religious values.
“We represent a Catholic college founded by Benedictine monks,” said Kyle
Duncan, general counsel of the Becket Fund for Religious Liberty, which has
brought a number of the cases to court. “They don’t qualify as a house of
worship and don’t turn away people in hiring or as students because they are not
In that case, involving Belmont Abbey College in North Carolina, a federal
appeals court panel in Washington told the college last month that it could hold
off on complying with the law while the federal government works on a promised
exemption for religiously-affiliated institutions. The court told the government
that it wanted an update by mid-February.
Defenders of the provision say employers may not be permitted to impose their
views on employees, especially when something so central as health care is
“Ninety-nine percent of women use contraceptives at some time in their lives,”
said Judy Waxman, a vice president of the National Women’s Law Center, which
filed a brief supporting the government in one of the cases. “There is a strong
and legitimate government interest because it affects the health of women and
She added, referring to the Centers for Disease Control and Prevention,
“Contraception was declared by the C.D.C. to be one of the 10 greatest public
health achievements of the 20th century.”
Officials at the Justice Department and the Health and Human Services Department
declined to comment, saying the cases were pending.
A compromise for religious institutions may be worked out. The government hopes
that by placing the burden on insurance companies rather than on the
organizations, the objections will be overcome. Even more challenging cases
involve private companies run by people who reject all or many forms of
The Alliance Defending Freedom — like Becket, a conservative group — has brought
a case on behalf of Hercules Industries, a company in Denver that makes sheet
metal products. It was granted an injunction by a judge in Colorado who said the
religious values of the family owners were infringed by the law.
“Two-thirds of the cases have had injunctions against Obamacare, and most are
headed to courts of appeals,” said Matt Bowman, senior legal counsel for the
alliance. “It is clear that a substantial number of these cases will vindicate
religious freedom over Obamacare. But it seems likely that the Supreme Court
will ultimately resolve the dispute.”
The timing of these cases remains in flux. Half a dozen will probably be argued
by this summer, perhaps in time for inclusion on the Supreme Court’s docket next
term. So far, two- and three-judge panels on four federal appeals courts have
weighed in, granting some injunctions while denying others.
One of the biggest cases involves Hobby Lobby, which started as a picture
framing shop in an Oklahoma City garage with $600 and is now one of the
country’s largest arts and crafts retailers, with more than 500 stores in 41
David Green, the company’s founder, is an evangelical Christian who says he runs
his company on biblical principles, including closing on Sunday so employees can
be with their families, paying nearly double the minimum wage and providing
employees with comprehensive health insurance.
Mr. Green does not object to covering contraception but considers morning-after
pills to be abortion-inducing and therefore wrong.
“Our family is now being forced to choose between following the laws of the land
that we love or maintaining the religious beliefs that have made our business
successful and have supported our family and thousands of our employees and
their families,” Mr. Green said in a statement. “We simply cannot abandon our
religious beliefs to comply with this mandate.”
The United States Court of Appeals for the 10th Circuit last month turned down
his family’s request for a preliminary injunction, but the company has found a
legal way to delay compliance for some months.
These cases pit the First Amendment and a religious liberty law against the
central domestic policy of the Obama administration, likely affecting many tens
of thousands of employees. The First Amendment says that “Congress shall make no
law respecting an establishment of religion, or prohibiting the free exercise
thereof,” and much attention has been focused in the past two decades on the
issue of “free exercise,” meaning preventing governmental interference with
Free-exercise cases in recent years have been about the practices of small
groups — the use of a hallucinogen by a religious group, for example — rather
than something as central as the Affordable Care Act.
The cases also test the contours of a 1993 law known as the Religious Freedom
Restoration Act. The law prohibits the federal government from imposing a
“substantial burden” on any religious practice without a “compelling state
interest.” The burden must also be the least restrictive possible.
Professor Laycock of the University of Virginia said: “The burden is clear
especially for religious organizations, which ought to be able to run themselves
in accordance with their religious teachings. They are being asked to pay for
medications they view as evil.” He added that because the health care law had
many exceptions, including for very small companies, the government might find
it hard to convince the courts that contraception coverage is, in fact, a
But William Marshall, a First Amendment scholar at the University of North
Carolina Law School, said the Supreme Court asserted in a 1990 opinion by
Justice Antonin Scalia that religious groups had a big burden in overcoming “a
valid and neutral law of general applicability.”
“You could have an objection of conscience to anything the government wants you
to do — pay taxes because they will go to war or to capital punishment, or
having your picture on your driver’s license,” Mr. Marshall said. “The court has
made clear that religious groups have no broad right for such exceptions.”
Mr. Laycock said that while judges are supposed to be neutral, they too can get
caught up in the culture wars. Judges sympathetic to women’s sexual autonomy
would probably come down on one side of the dispute, and those more concerned
with religious liberty on the other, he said.
“There is a lot of political freight on this issue,” he said.
A Flood of Suits Fights Coverage of Birth Control, NYT, 26.1.2013,
Health Care at Risk
The New York Times
A wave of mergers between Roman Catholic and secular hospitals is threatening to
deprive women in many areas of the country of ready access to important
reproductive services. Catholic hospitals that merge or form partnerships with
secular hospitals often try to impose religious restrictions against abortions,
contraception and sterilization on the whole system.
This can put an unacceptable burden on women, especially low-income women and
those who live in smaller communities where there are fewer health care options.
State regulators should closely examine such mergers and use whatever powers
they have to block those that diminish women’s access to medical care.
Gov. Steve Beshear of Kentucky, for example, recently turned down a bid by a
Catholic health system to merge with a public hospital that is the chief
provider of indigent care in Louisville. He cited concerns about loss of control
of a public asset and restrictions on reproductive services.
The nation’s 600 Catholic hospitals are an important part of the health care
system. They treat one-sixth of all hospital patients, and are sometimes the
only hospital in a small community. They receive most of their operating income
from public insurance programs like Medicare and Medicaid and from private
insurers, not from the Catholic Church. They are free to deliver care in accord
with their religious principles, but states and communities have an obligation
to make sure that reproductive care remains available. This should be a central
goal for government officials who have a role in approving such consolidations.
As Reed Abelson wrote in a recent report in The Times, these mergers are driven
by shifts in health care economics. Some secular hospitals are struggling to
survive and eager to be rescued by financially stronger institutions, which in
many cases may be Catholic-affiliated. By one estimate, 20 mergers between
Catholic and non-Catholic hospitals have been announced over the past three
years and more can be expected.
The 2009 “Ethical and Religious Directives” issued by the United States
Conference of Catholic Bishops warns that Catholic institutions should avoid
entering into partnerships “that would involve them in cooperation with the
wrongdoing of other providers.” Catholic hospitals have refused to terminate
pregnancies, provide contraceptive services, offer a standard treatment for
ectopic pregnancies, or allow sterilization after caesarean sections (women
seeking tubal ligations are then forced to have a second operation elsewhere,
exposing them to additional risks).
In one case, the sole hospital in a rural area in southeastern Arizona announced
in 2010 that it would partner with an out-of-state Catholic health system, and
would immediately adhere to Catholic directives that forbid certain reproductive
health services. As a result, a woman whose doctors wanted to terminate a
pregnancy to save her life had to be sent 80 miles away for treatment. A
coalition of residents, physicians and activists campaigned against the merger
and it was called off before it was finalized.
Over the past 15 years, MergerWatch, an advocacy group based in New York City,
has helped block or reverse 37 mergers and reached compromises in 22 others that
saved at least some reproductive services. As mergers become more common, state
and local leaders would be wise to block proposals that restrict health
Women’s Health Care at Risk, NYT, 28.2.2012,
The ‘Safe, Legal, Rare’ Illusion
February 18, 2012
The New York Times
By ROSS DOUTHAT
AMID the sound and fury of the latest culture-war battles —
first over breast cancer dollars and Planned Parenthood, and then over the White
House’s attempt to require that religious employers cover contraception and
potential abortifacients — it’s easy to forget that there is at least some
common ground in American politics on sex, pregnancy, marriage and abortion.
Even the most pro-choice politicians, for instance, usually emphasize that they
want to reduce the need for abortion, and make the practice rare as well as safe
and legal. Even the fiercest conservative critics of the White House’s
contraception mandate — yes, Rick Santorum included — agree that artificial
birth control should be legal and available. And both Democrats and Republicans
generally agree that the country would be better off with fewer pregnant
teenagers, fewer unwanted children, fewer absent fathers, fewer out-of-wedlock
Where cultural liberals and social conservatives differ is on the means that
will achieve these ends. The liberal vision tends to emphasize access to
contraception as the surest path to stable families, wanted children and low
abortion rates. The more direct control that women have over when and whether
sex makes babies, liberals argue, the less likely they’ll be to get pregnant at
the wrong time and with the wrong partner — and the less likely they’ll be to
even consider having an abortion. (Slate’s Will Saletan has memorably termed
this “the pro-life case for Planned Parenthood.”)
The conservative narrative, by contrast, argues that it’s more important to
promote chastity, monogamy and fidelity than to worry about whether there’s a
prophylactic in every bedroom drawer or bathroom cabinet. To the extent that
contraceptive use has a significant role in the conservative vision (and
obviously there’s some Catholic-Protestant disagreement), it’s in the context of
already stable, already committed relationships. Monogamy, not chemicals or
latex, is the main line of defense against unwanted pregnancies.
The problem with the conservative story is that it doesn’t map particularly well
onto contemporary mores and life patterns. A successful chastity-centric culture
seems to depend on a level of social cohesion, religious intensity and shared
values that exists only in small pockets of the country. Mormon Utah, for
instance, largely lives up to the conservative ideal, with some of America’s
lowest rates of teenage pregnancies, out-of-wedlock births and abortions. But
many other socially conservative regions (particularly in the South) feature
higher rates of unwed and teenage parenthood than in the country as a whole.
Liberals love to cite these numbers as proof that social conservatism is a flop.
But the liberal narrative has glaring problems as well. To begin with, a lack of
contraceptive access simply doesn’t seem to be a significant factor in unplanned
pregnancy in the United States. When the Alan Guttmacher Institute surveyed more
than 10,000 women who had procured abortions in 2000 and 2001, it found that
only 12 percent cited problems obtaining birth control as a reason for their
pregnancies. A recent Centers for Disease Control and Prevention study of
teenage mothers found similar results: Only 13 percent of the teens reported
having had trouble getting contraception.
At the same time, if liberal social policies really led inexorably to fewer
unplanned pregnancies and thus fewer abortions, you would expect “blue” regions
of the country to have lower teen pregnancy rates and fewer abortions per capita
than demographically similar “red” regions.
But that isn’t what the data show. Instead, abortion rates are frequently higher
in more liberal states, where access is often largely unrestricted, than in more
conservative states, which are more likely to have parental consent laws,
waiting periods, and so on. “Safe, legal and rare” is a nice slogan, but liberal
policies don’t always seem to deliver the “rare” part.
What’s more, another Guttmacher Institute study suggests that liberal states
don’t necessarily do better than conservative ones at preventing teenagers from
getting pregnant in the first place. Instead, the lower teenage birth rates in
many blue states are mostly just a consequence of (again) their higher abortion
rates. Liberal California, for instance, has a higher teen pregnancy rate than
socially conservative Alabama; the Californian teenage birth rate is only lower
because the Californian abortion rate is more than twice as high.
These are realities liberals should keep in mind when tempted to rail against
conservatives for rejecting the intuitive-seeming promise of “more condoms,
fewer abortions.” What’s intuitive isn’t always true, and if social
conservatives haven’t figured out how to make all good things go together in
post-sexual-revolution America, neither have social liberals.
At the very least, American conservatives are hardly crazy to reject a model for
sex, marriage and family that seems to depend heavily on higher-than-average
abortion rates. They’ve seen that future in places like liberal, cosmopolitan
New York, where two in five pregnancies end in abortion. And it isn’t a pretty
The ‘Safe, Legal, Rare’ Illusion, NYT,
Courts Step In
The New York Times
In three new rulings, federal judges in different states have acted to block
immediate enforcement of measures that restrict abortion rights and women’s
access to affordable contraception, lifesaving cancer screenings and treatment
for sexually transmitted diseases. These rulings are important victories for
women’s health and reproductive rights.
On June 24, Judge Tanya Pratt of the Federal District Court in Indianapolis
issued a preliminary injunction blocking enforcement of a new Indiana law
banning the use of Medicaid funds at Planned Parenthood clinics, which provide
essential health services to low-income women. The mean-spirited law is part of
a Republican-led national campaign to end public financing for Planned
Parenthood. The Obama administration promptly told Indiana, and other states
weighing similar legislation, that the measure violated federal law by imposing
impermissible restrictions on the freedom of Medicaid beneficiaries to choose
health care providers. Judge Pratt agreed with that assessment in her decision.
In another ruling six days later, a federal trial judge in South Dakota issued a
preliminary injunction blocking, on constitutional grounds, a deeply intrusive
state law requiring women to wait at least 72 hours after an initial doctor’s
visit before terminating a pregnancy — the longest waiting period in the nation.
This law also requires that women seeking abortions endure counseling at
so-called pregnancy help centers run by antiabortion activists with the aim of
“Forcing a woman to divulge to a stranger at a pregnancy help center the fact
that she has chosen to undergo an abortion humiliates and degrades her as a
human being,” Judge Karen Schreier wrote in her decision.
On July 1, Judge Carlos Murguia, a federal district judge in Kansas, blocked
immediate enforcement of a new Kansas licensing law and health department
regulations imposing extensive, medically unnecessary requirements on the
state’s three remaining abortion providers — like mandating 50 square feet of
storage space for janitorial supplies — with the obvious goal of shutting them
While these rulings are preliminary, each is a determination that enforcing the
law would cause irreparable harm and that the plaintiffs are likely to prevail
at trial. They do not, however, address other threats to women’s health. Those
include the slashing of state support for family-planning services by governors
like Chris Christie of New Jersey, and attacks from Congress like the bill
Republicans pushed through the House in May that would use the nation’s tax
system as a weapon to end abortion insurance coverage in the private market.
Still, these rulings serve as a reminder that courts have a vital role to play
in blocking the extreme anti-abortion, anti-family-planning movement
accelerating in the states and in Washington.
The Courts Step In, R, 13.7.2011,
Reproductive Choices Women Face
The New York Times
To the Editor:
Re “The Unborn Paradox” (column, Jan. 2):
Ross Douthat seems to be suggesting that women with unintended pregnancies
should bear children rather than have abortions because infertile women want
babies. In doing so, Mr. Douthat ignores the serious health risks that
pregnancies sometimes incur. Should women with unwanted pregnancies be compelled
to take those risks?
Consider New Year’s Eve, a typical night on my obstetrics floor. Several
pregnant women were suffering from complications. Two needed emergency surgery.
One was 19 years old and 20 weeks pregnant with an abnormal fetus. She had
decided to see the pregnancy through. But the amniotic sac ruptured five months
early. We had to stop the heavy bleeding and infection that followed. Her baby
Abortion opponents would impose all the risks of pregnancy on women who wish to
end their pregnancies. Instead, let’s make sure that everyone on the
socioeconomic ladder can prevent and plan conception.
New York, Jan. 3, 2011
The writer, an obstetrician, is medical director of Physicians for Reproductive
Choice and Health.
To the Editor:
I have supported abortion rights for as long as I can remember, but nothing
cemented my commitment to women’s reproductive freedom like my own very much
wanted pregnancy nine years ago.
As I grew increasingly delighted about both my experience of pregnancy and
planning for a life with twin babies, I imagined how differently I would feel in
other circumstances. What if I were 14 rather than 34? What if my partner and I
had as many children as we could handle, or more? What if one or both of us were
How might our thrill at the short-term changes in my body and the long-term
changes in our lives transform into dread, depression and anxiety?
Moreover, just because expectant parents are able to think of the fetus as a
baby does not mean it actually is one, and that abortion is the same as the
taking of an actual life, rather than a fantasized one.
Sarah E. Chinn
Brooklyn, Jan. 3, 2011
To the Editor:
Ross Douthat provides an eloquent analysis of the abortion conundrum. We embrace
the humanity of our “wanted” babies while we strip the human rights from those
whose conception was unplanned and unwanted. And yet, the circumstances of
conception don’t change the fact that a child in the womb is a separate and
unique human being, morally and ethically entitled to the same rights as you and
Mr. Douthat also points out that adoption has become an unlikely choice for
young mothers like Markai Durham, the subject of an MTV show, who says she
couldn’t bear to give up a child she carried in her womb for nine months, and
opts, instead, to kill that child.
Did anyone along the way point out the deadly flaw in her thinking? Markai and
the million-plus babies who fall into the “unwanted” category every year deserve
to be given a choice that doesn’t involve murder. (Rev.)
National Director, Priests for Life
Staten Island, Jan. 3, 2011
To the Editor:
What MTV depicted in its documentary “No Easy Decision,” and what Ross Douthat
does not acknowledge in his column, is that Markai Durham and thousands of women
like her are capable of sensitively and wisely weighing the decisions that have
consequences of life or death.
Mr. Douthat offers no evidence that fewer abortions would mitigate complex
fertility treatments or the enormous amount of bureaucratic red tape surrounding
the adoption process. Many studies in fact suggest that, in a culture that
treasures biological children, prospective parents opt first for fertility
treatments and then, if at all, pursue adoption.
A thoughtful look at reproductive decision-making is always welcome, but a
broadside that once again seeks to demonize and make guilty those women who
elect to terminate their pregnancies is not adding to the civil discourse.
Conflating fertility, adoption and abortion in no way alleviates the myriad
challenges involved in deciding whether or not to become a parent.
President and C.E.O.
Planned Parenthood of New York City
New York, Jan. 3, 2011
To the Editor:
I disagree with Ross Douthat’s appraisal of adoption as an answer to unplanned
pregnancies and infertility. I have worked with many pregnant teenagers and
young adult women in my 25 years as a director of an adoption agency, and
adoption is only a small part of the solution.
While I am obviously sympathetic to the desire of infertile couples to become
parents, their needs can never supersede those of pregnant women who are not
prepared to be parents.
Research has shown that abortion very rarely leads to long-term negative
psychological consequences for those women who choose it (myself included).
Yes, of course there is regret and sadness for some women, but carrying a baby
to term and placing him or her for adoption more often than not leads to a
lifetime of pain and sadness, regardless of how right the situation may seem. It
is the right choice for the very few.
Abortion and adoption are two ends of the same spectrum — women having choices
about their reproductive lives. But the agony of a woman placing a child for
adoption cannot be understated.
San Francisco, Jan. 3, 2011
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