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The Food and Drug Administration recently lifted restrictions on abortion pills to allow patients to get them through telemedicine.
 Katharina Staerck—Getty Images

The Biden Administration is removing restrictions on mailing abortion pills during the COVID-19 pandemic, a reversal from the Trump Administration’s policy that marks a new phase in the national debate over abortion rights.

The move temporarily changes longstanding Food and Drug Administration (FDA) rules governing mifepristone—one of two drugs used to terminate early pregnancies—that required patients to pick up the pills in-person from a medical provider. Acting FDA Commissioner Janet Woodcock sent a letter to the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine on Monday saying that her agency reviewed recent evidence and found that using telemedicine to provide abortion pills would not increase risks and would help patients avoid potential exposure to COVID-19.

The change only lasts through the public health emergency, and the FDA has not said how it will handle the requirement after the pandemic. But abortion pills have become the latest front in the heated battle over reproductive rights in the United States, and these medication abortions will continue to animate both sides of the issue even after the COVID-19 crisis recedes. As conservative states have passed hundreds of laws in recent years restricting all aspects of how people can obtain abortions, demand for the more convenient abortion pills has increased. Now as activists on all sides watch to see whether the conservative Supreme Court will curtail or overturn Roe v. Wade, looser rules around medication abortion could expand access far beyond traditional abortion clinics.

“Access to medication abortion is going to be really significant. Because if people in states where abortion is illegal can still readily get access to illegal but legal elsewhere medication, it’ll be very hard for states to enforce the laws,” says Mary Ziegler, a Florida State University law professor who studies abortion. “It’s important in the short term, but it’s also very important in the longer term when you’re imagining what a post-Roe landscape would look like.”

While the issue has received more attention over the past year due to COVID-19, the debate around medication abortion has been simmering for much longer. The FDA first approved medication abortion in 2000, and the pills have grown in use over the years. By 2017, about 40% of patients in the U.S. chose medication abortion, according to the Guttmacher Institute, a research organization that supports abortion rights. The FDA requires mifepristone to be dispensed in health clinics or hospitals, but reproductive rights advocates, doctors and medical professional groups including ACOG have said for years the restriction is medically unnecessary. Now they are hoping Biden’s FDA could permanently change the requirement.

Conservative groups and state lawmakers have already launched efforts to curb the pills’ expansion, with bills to ban or otherwise restrict the medication introduced in at least a dozen states so far this year. A state court recently blocked a ban on telemedicine abortion in Ohio, but Montana’s governor is expected to sign a similar bill soon. Others are making their way through legislatures in Alabama, Arkansas, Indiana, Iowa, Maryland, Oklahoma, Texas, Wyoming and West Virginia. Many of these bills have been championed by a group of conservative organizations led by the Students for Life of America and Susan B. Anthony List, which supports politicians who oppose abortion. Students for Life of America is also lobbying for bills that would ban abortion pills outright in several states, and plans to launch a documentary series this spring featuring Charlotte Pence Bond, the former Vice President’s daughter, aimed at raising more concerns about medication abortions.

Democrats in Congress have urged the Biden Administration to loosen the abortion pill restrictions beyond the pandemic, arguing that the in-person requirement creates barriers for people seeking access to abortions. HHS Secretary Xavier Becerra supported this position when he was California’s attorney general, leading other Democratic attorneys general to ask the FDA last year to remove the in-person requirement during the pandemic. But Republicans in Congress took the opposite tack, with both House and Senate lawmakers writing letters in the fall of 2020 to ask the FDA to remove the pill from the market completely and classify it as an “imminent hazard to the public health.”

ACOG sued to lift the in-person rule last year, but the Supreme Court sided with the Trump Administration in January to reinstate the requirement. A federal appeals court is currently hearing the case, and the Biden Administration asked for more time last month as it reviewed the restrictions. Its next court deadline is this week.

With the restrictions temporarily lifted, many patients will now be able to make an appointment to talk with a doctor over video or by phone and then receive abortion pills in the mail. Medication abortion consists of two pills: mifepristone, which the FDA regulates tightly, and misoprostol, which is not heavily regulated. Getting the pills by mail helps patients avoid exposure to the coronavirus in the current environment, doctors say, but it also eliminates obstacles that exist beyond the pandemic, such as traveling to an abortion clinic, taking time off work, arranging child care, and privacy concerns. Reproductive rights advocates also note that many of these barriers fall disproportionately on poor patients, people of color, and other already marginalized groups. “We want people seeking abortion care to be to be able to access it whenever they need it, and to really have the ability to access whatever type of abortion care they need,” says Destiny Lopez, co-president of All* Above All, a group that has pushed the Biden Administration to permanently loosen federal rules for abortion pills. “Medication abortion is part of that fight for abortion justice, because we know that the barriers that folks face are rooted in systemic racism and reflect ongoing inequities in our healthcare system.”

This flexibility is exactly what abortion opponents are concerned about. Kristan Hawkins, president of Students for Life of America, says her group got involved in the fight against medication abortion because it saw the pills expanding access and particularly being made available on college campuses. “It’s very clear with everything that’s been happening in the past few years within the abortion industry, that they’re trying to change the model,” she says. “Especially when you’re distributing these drugs on college campuses or via webcam, you don’t have to operate a facility that’s going to have people praying in front of it.”

Still, the increased availability of the pills doesn’t solve all abortion rights advocates’ problems. Abortion pills can only be taken in the first 10 weeks of pregnancy, when many people are still learning they are pregnant. And even with the FDA’s new decision, 19 states already have laws effectively prohibiting telemedicine for medication abortion. Taking the pills in states where they have been outlawed could be legally risky. While most abortion opponents say they do not want to punish the women seeking abortions and new state laws focus on restricting providers’ actions, some states have already prosecuted women for self-managed abortions.

The past year has given doctors a test run of how telemedicine works for medication abortion. A March article in the journal Contraception published findings from a long-term study by Gynuity Health Projects evaluating the use of telemedicine for medication abortion, which found that “direct-to-patient telemedicine service was safe, effective, and acceptable.” Planned Parenthood expanded its telemedicine offerings during the pandemic, and for the roughly six months that providers could use the method last year, many abortion clinics around the country prescribed medication abortions without in-person visits.

Researchers found similar success in the United Kingdom, where authorities loosened the in-person requirement for medication abortion when the pandemic began last spring. A new study published in the British Journal of Obstetrics and Gynecology examined more than 52,000 medication abortions and found that women waited an average of 4 days less to get telemedicine abortions and there was little difference in safety or effectiveness compared with in-person abortions. “I think we witnessed an innovation that will suddenly transform care and provide patients with much better quality, probably for the next generation,” says Dr. Jonathan Lord, co-author of the study and chief medical officer of nonprofit MSI Reproductive Choices, which performed more than 20,000 telemedicine abortions during the first year of the pandemic.

Advocates hope that this kind of evidence will help persuade Biden’s FDA to make the changes permanent. But even if that happens, they say, the fight over medication abortion is just ramping up.

“We know that they’re safer than most medications that you can buy over the counter, like Tylenol, for example. And yet, and still we see these onerous restrictions being put in place with the sole purpose of trying to limit access to abortion care,” says Dr. Jamila Perritt, an OBGYN and abortion provider in Washington, D.C. who is president and CEO of Physicians for Reproductive Health. “There is still work to do.”

Source: https://time.com/5954429/fda-biden-abortion-pills/?fbclid=IwAR26eoBCLRqkb0r4KwcPs8wCKimKtgwy8G7Pj25MENsSVpW72un4yg4Wmo4

Studies shows it’s safe to prescribe medication abortion via telemedicine during early stages of pregnancy and to distribute medication abortion pills by mail.

The Biden administration is allowing patients to receive medication abortion pills by mail for the duration of the COVID-19 pandemic.

As vaccinations roll out and some parts of the world start to reopen, we need to envision what the new normal will be. This means addressing existing inequalities illuminated during the pandemic, by looking at how we’ve adapted and bringing innovations into the future instead of reverting to how things were before. Making medication abortion readily available via telemedicine does both.

On Monday, the Biden administration took an important step in envisioning that new reality by announcing it was continuing to suspend a requirement that patients pick up abortion medications in-person during the pandemic.

Over the last year, the COVID-19 pandemic has created significant barriers to accessing basic health-care services, with women in the United States more likely to report experiencing major gaps in routine medical care, according to a survey.

But there is a silver lining: Research suggests telemedicine may improve access to health care and dismantle barriers to health-care services. While access to telehealth services has, to this point, been relatively limited in scope and unevenly available, the number of survey respondents who reported having a telehealth visit in the last year roughly tripled from pre-pandemic use. People who used telehealth reported high levels of satisfaction, meaning expansion of telemedicine could be a more permanent solution to gaps in access to in-person medical care—including reproductive health care.

Multiple countries have set up telemedicine services as a means of accessing abortion during the pandemic, with some temporarily allowing medication abortion pills to be distributed via mail. Still, the United Nations Population Fund estimated that 12 million women across 115 low-and middle-income countries lost access to contraception in 2020 due to the pandemic, leading to an estimated 1.4 million unintended pregnancies.

In August, a World Health Organization survey revealed family planning is one of the health services most frequently disrupted during the pandemic. Estimates last spring from the Guttmacher Institute painted a bleak picture: If 10 percent of safe abortions become unsafe because women cannot access services amid lockdowns and clinic closures, there would be an increase of 3 million unsafe abortions and 1,000 more maternal deaths. With major disruptions to national health systems caused by the need to respond to people affected by the virus, high-quality self-care interventions can provide an important alternative.Abortion is essential health care, and access to abortion plays a key role in reducing health inequities across socioeconomic groups.

Scientific evidence shows it’s safe to prescribe medication abortion via telemedicine during early stages of pregnancy and to distribute medication abortion pills by mail. A recent Scottish study concluded “telemedicine abortion without routine ultrasound is safe and has high efficacy and high acceptability among women.” An English study similarly concluded that a “telemedicine‐hybrid model for medical abortion that includes no‐test telemedicine and treatment without an ultrasound is effective, safe, acceptable and improves access to care.”

There’s a window of opportunity to make access to medication abortion more easily available, including through telemedicine. In the United Kingdom, where temporary rules installed during the pandemic allowed medication abortion to be prescribed via telemedicine, the English and Welsh governments are consulting the public about whether or not to make those rules permanent.

In the United States, more than 150 members of Congress filed an amicus brief in February, challenging the Food and Drug Administration’s in-person requirement for dispensing mifepristone during the COVID-19 pandemic. Democrats from the House Oversight Committee also sent a letter to acting FDA Commissioner Dr. Janet Woodcock urging the agency to lift the Risk Evaluation and Mitigation Strategy (REMS) requirement that medication abortion pills be obtained in-person from a health-care provider. The FDA listened: This week, Woodcock said the agency would stop enforcing the requirement and would allow patients to receive medication abortion pills by mail—for the duration of the COVID-19 pandemic.

Women should always be in control of their health and reproductive lives—not just during global pandemics. Abortion is essential health care, and access to abortion plays a key role in reducing health inequities across socioeconomic groups. While telemedicine doesn’t address all access issues—problems and inequities with telecommunications infrastructure mean we will always need in-person access to abortion care—measures taken during the pandemic to increase abortion access should remain in place post-pandemic.

Let’s stand up to political opposition and follow the scientific facts: Make medication abortion available via telemedicine to women around the world.

Source: https://rewirenewsgroup.com/article/2021/04/14/abortion-patients-get-big-win-from-the-fda/

Acting FDA Commissioner Janet Woodcock informed the American College of Obstetricians and Gynecologists that allowing patients to receive abortion pills through the mail will not increase risks. | Jose Luis Magana/AP Photo

The FDA concluded that allowing patients to receive abortion pills through the mail will not increase risks.

The Biden administration is lifting restrictions on dispensing abortion pills by mail during the Covid-19 pandemic, reversing a Trump administration policy that the Supreme Court backed in January.

Acting FDA Commissioner Janet Woodcock informed the American College of Obstetricians and Gynecologists in a letter Monday that her agency concluded that allowing patients to receive the pills via telemedicine and through the mail will not increase risks and will keep people safe from contracting the virus.

The decision marked the latest turn in a battle over longstanding FDA rules on the drug mifepristone that require people seeking medication abortions to obtain the pills in-person from a medical provider.

ACOG challenged the requirement last year but a short-handed Supreme Court following the death of Justice Ruth Bader Ginsburg in October declined to intervene. That allowed abortion clinics to continue dispensing the pills remotely, which they say has kept patients and staff safer during the pandemic.

The justices in January granted the Trump administration’s request to reinstate the rules, in a 6-3 decision that broke along ideological lines and marked the high court’s first major action on abortion since Justice Amy Coney Barrett was confirmed.

The Biden administration earlier this month asked an appeals court for more time to respond to ACOG’s lawsuit, and indicated that the FDA could decide to “exercise its enforcement discretion.”

ACOG’s Chief Executive Officer Maureen G. Phipps said Monday the lifting of the restrictions means “those in need of an abortion or miscarriage management will be able to do so safety and effectively by acquiring mifepristone though the mail — just as they would any other medication with a similarly strong safety profile.”

The move only covers the public health emergency and doesn’t spell out how the Biden administration will deal with the restrictions after the pandemic is over. Permanently lifting the curbs would vastly expand access to the drugs.

Demand for abortion pills has soared as conservative states have moved aggressively in recent years to restrict access to surgical abortions. In 2001, the drugs were used in just 5 percent of abortions in the U.S. By 2017, that jumped to 39 percent, according to the Guttmacher Institute, a research organization that supports abortion rights.

Scientists and doctors are increasingly supportive of medication abortions, which can only be used during the first 10 weeks of a pregnancy, and have long called for looser rules around how patients can obtain the pills. The pandemic brought the issue into high relief, as the government has moved to limit in-person dispensing and promote telemedicine.

Mifepristone “has very few risks at all,” said Jen Villavicencio, a health policy fellow with ACOG. “It is more safe than over-the-counter medications like ibuprofen and Tylenol. We know this medication can be safely administered via telemedicine because we’ve studied it.”

ACOG, along with the American Medical Association and other leading medical groups, has been lobbying the Biden administration and arguing in court that the federal rules for dispensing the pills should be loosened permanently. Their push has been echoed by Democrats in Congress, who have urged Biden to allow telemedicine abortions both during the pandemic and beyond.

But anti-abortion lawmakers and advocacy groups, anticipating Monday’s policy shift, have been working to preemptively ban the pills or make them more difficult to obtain.

A new ban on telemedicine abortions in Ohio that was set to take effect on Monday was blocked by a state court, while others are still advancing in Indiana, Arkansas, Iowa, Alabama, Texas, Oklahoma, Wyoming and West Virginia.

Source: https://www.politico.com/news/2021/04/12/abortion-pills-481092?fbclid=IwAR2NlZb_n_A-2RhU7B4a2hnRNCYWOrc8ZKws7uql6lt-9E0D0daKhgUhTt0

As a Black woman and physician who has provided the full range of pregnancy-related care, I have seen firsthand how our maternal health system is failing and how Black women are bearing the brunt of this failure.
 Getty Images

When abortion care is inaccessible, Black maternal health as a whole suffers.

This week, a community of organizations across the country are speaking out about the importance of supporting, trusting, and listening to Black women, as we mark the fourth annual Black Maternal Health Week.

As a Black woman and physician who has provided the full range of pregnancy-related care—including prenatal, delivery, postpartum, and abortion care—for thousands of patients, I have seen firsthand how our maternal health system is failing and how Black women* are bearing the brunt of this failure.

I have also seen how this failure is intimately tied to Black women’s lack of access to comprehensive reproductive health care, including access to abortion care. The same systems and structures that result in Black women experiencing higher rates of mortality, morbidity, and mistreatment when accessing pregnancy care are directly correlated to the experiences Black women face when seeking abortion care.

The commonality here is not race, but racism.

The racial uprisings over the last year have clearly shown us that the legacies of white supremacy, and its resulting violence and harm, are not behind us. And the convergence of these uprisings with a global public health pandemic proves that the medical system is not somehow unaffected. When health-care providers don’t listen to the lived experience and personal expertise of Black women, they are perpetuating harm. When Black women aren’t able to make decisions about building their families due to medically unnecessary restrictions on abortion care, the result is harm. Understanding the connection between these two is critical.

Abortion restrictions are part of a long legacy of attempts to exercise power and control over the bodies of Black women. Restrictions on access to abortion care, such as targeted regulations of abortion providers (TRAP laws), insurance coverage limitations, and gestational age bans, disproportionately impact Black women for many reasons. Black women are more likely to live in states where these restrictive laws have been passed and less likely to have access to insurance that provides coverage for abortion care.Black-led and Black-centered organizations like Black Mamas Matter Alliance advocate to shift culture in support of Black maternal health, rights, and justice.

Black women are also less likely to have quality, culturally responsive community-centered care during their pregnancy and the postpartum period and are three to four times more likely to die during pregnancy and the postpartum period than white women—meaning the decision to carry a pregnancy to term is a life-or-death decision for Black women. When abortion care is inaccessible, Black maternal health as a whole suffers because agency, autonomy, and self-determination are compromised.

While we continue to do the work as health-care providers to center and ground our care in trust and respect for individual agency and autonomy, we must also follow the lead of organizers across the country making meaningful impact on all aspects of maternal health, including abortion access. Black-led and Black-centered organizations like Black Mamas Matter Alliance advocate to shift culture in support of Black maternal health, rights, and justice. This includes advocating for policies that center Black pregnant people and supporting the work of the congressional Black Maternal Health Caucus, including the Momnibus bill, a comprehensive set of regulations and investments to address the crisis in maternal mortality and its disproportionate impact on Black women.

Our nation is in a moment of reckoning. We have an opportunity to actively lean into a liberatory framework that centers the health and rights of all people. In order to do that we must trust and follow the expertise of those who have been most impacted by these inequities in access and outcomes. The same is true for maternal health and abortion care. Our dreams for a future where Black pregnant and birthing people are thriving must include a world where all people, including Black people, can access the full range of pregnancy-related care—including abortion when and where they need it.

Source: https://rewirenewsgroup.com/article/2021/04/12/its-black-maternal-health-week-lets-talk-about-abortion-access/

DENVER, CO – JANUARY 14 : Photo taken House of Representatives Chamber of the Colorado state capitol building during 2nd day of the 73rd General Assembly of the Colorado State Legislature in Denver, Colorado on Thursday. January 14, 2021. (Photo by Hyoung Chang/The Denver Post)

Another bill would require insurers to cover prevention and treatment for sexually transmitted infections

Reproductive health care finds itself of some importance this year in the Colorado legislature, with bills that would make it easier to get contraceptives, abortions and prevention for sexually transmitted infections.

With Democrats in control of both chambers, the bills have a decent shot at passing, though lawmakers will have to weigh costs of bills during a session focused on economic recovery and stimulus post-COVID.

Republicans, meanwhile, tried again to ban abortions and also introduced a measure to track women’s personal information in a public database if they get an abortion. Both of those bills failed.

Here are some of the Democratic proposals introduced, all of which have passed the Senate Health and Human Services Committee.

Getting birth control through Medicaid

This bill would create a statewide health care program that would allow Medicaid patients to get a year’s supply of birth control like people can do through private insurers. It would also expand this to immigrants living in the country without legal permission who, if they were residents or on visas, would have been eligible for Medicaid.

Most Medicaid patients can get a one-month supply at a time, sometimes three, said Democratic bill sponsor Sen. Sonya Jaquez Lewis, who added it would be paid for through cost-sharing.

Although the bill carries a $4.1 million price tag for the first year, the Longmont Democrat said it will ultimately save the state more money and is similar to what California and Washington, D.C., have done.

The cost was a red flag for Republican Sen. Jim Smallwood of Parker, who voted against it.

“Like so many of these health care bills we see the other side bring, they come with a promise of lower costs potentially down the road but without any actuarial data to support that claim,” he said.

Abortion coverage through Medicaid for cases of rape or incest

Neither the federal Hyde Amendment nor Colorado law allow public money to be used for abortions except when a mother’s life is in danger or in cases of rape or incest. Colorado law also restricts where these abortions can take place — specific clinics and only by a physician.

Democrats are looking to open up where the services can be done, because patients often have to drive long distances before they can find an eligible physician or facility. The bill would also expand the types of providers who could provide abortion services, like nurse practitioners or physician assistants who are licensed by the state and trained in abortion procedures.

“I don’t think people realize that (some people) in Colorado have to drive seven hours over a mountain range with suitcases to access health care that they need,” Planned Parenthood of the Rocky Mountains spokesperson Jack Teter said.

Dr. Kristina Tocce, vice president and medical director of the Planned Parenthood branch, said Medicaid patients and even people from the public health department and other agencies may not realize the specifics and will often refer patients to Planned Parenthood.

Smallwood also voted against this bill because he believes it’s too broad and doesn’t put enough parameters on who can perform abortion services in the cases of rape and incest.

Preventive health care coverage

This bill that would require insurers to cover some preventive care and treatment has been getting the attention of anti-vaccine activists like Colorado Health Choice Alliance, because they claim it allows minors to consent to the HPV and hepatitis B vaccines without consent.

But backers of the bill say this isn’t a vaccine bill, and instead would put into state law measures that are already covered by the Affordable Care Act like obesity or alcohol screenings, as well as add additional services they believe should be covered like smoking cessation programs and sexually transmitted infection screenings and treatment.

Teter said Colorado law already allows minors to be treated for STIs and this wouldn’t override federal law on parental notifications for vaccines. The bill would still require permission for minors 13 and under and counseling to involve parents for care of STIs.

Rep. Kyle Mullica, a Northglenn Democrat and bill sponsor, said the proposal also looks to provide early prevention measures for a variety of health issues, in turn saving the state money.

But there’s disagreement among Republicans about funding and whether any treatment should be included in the bill aimed at preventive care. If passed, it’s estimated that it’ll cost almost $919,000 in its first year.

Other bills related to reproductive health care are making their way through the legislature, including covering family planning services for low-income households before pregnancy and reimbursement for maternal health care.

Source: https://www.denverpost.com/2021/04/05/birth-control-abortion-colorado-legislature-reproductive-health/?fbclid=IwAR3anAoLoCAhDOKLYKbY6UftF4KavVapCjh-HeYfg7mY_2GvEuO4CJd9PwM

Damon Winter/The New York Times

Some on the right want the Supreme Court to go beyond ending Roe.

The anti-abortion movement was never going to stop with overturning Roe v. Wade.

For years, Republicans have argued that their goal was to return the issue of abortion to the states. At no point was this believable; since 1984, the Republican Party platform has called for a constitutional amendment banning abortion. Having spent decades denouncing abortion as a singular moral evil, the anti-abortion movement will not be content to return to a pre-Roe status quo, where abortion was legal in some places but not others.

So it’s not that surprising that, with the possible end of Roe in sight, some opponents of abortion are thinking about how to ban it nationally. Last week my colleague Ross Douthat wrote about a debate within the anti-abortion movement sparked by a highly abstruse article by the Notre Dame professor John Finnis in the Catholic journal First Things. Finnis argues that fetuses are persons under the 14th Amendment, and that the Supreme Court should thus rule abortion unconstitutional. The political implication, wrote Douthat, is that just jettisoning Roe is “woefully insufficient.”

Finnis’s contention is radical, but apparently resonant. Damon Linker, a former editor at First Things and author of a book about the Catholic right, writes, “That is where the pro-life movement is headed — and the rest of the country better be ready for it.”

The threat isn’t immediate; it’s highly unlikely that this Supreme Court is going to adopt constitutional personhood. The justices are “not interested in reading the Constitution to protect life from the moment of conception,” said Nancy Northup, president of the Center for Reproductive Rights, a legal group. “It would make so many things so incredibly difficult to give a fertilized egg all the rights and protections of a born human being.”

But the embrace, by some, of Finnis’s proposition is the latest sign of the right’s disenchantment with democracy, and its dream of imposing on the American people a regime that a majority of them will never consent to. Even Mississippi, after all, rejected fetal personhood in a 2011 referendum.

The anti-abortion movement has always had authoritarian underpinnings; forcing women to give birth against their will would require police-state surveillance and coercion. (It’s certainly more intrusive than being made to wear a mask, which some conservatives regard as tyranny.) But as long as abortion opponents were fighting for the ability of state legislatures to pass laws their voters wanted, they could claim to be upholding democracy, albeit a form that traduced individual rights.

The 14th Amendment strategy, by contrast, is a plan to ignore voters altogether. It’s not surprising that it would gain currency at a moment when the right is going all-in on minority rule.

The argument Finnis made isn’t new; the scholar Nathan Schlueter made a similar case in First Things in 2003. What is new is how seriously it’s being taken. The notion that the 14th Amendment applies to fetuses seems, on the surface, preposterous. The amendment’s first sentence defines citizens as “all persons born or naturalized in the United States.” Back in 2003, Robert Bork wrote a dismissal of Schlueter’s argument rooted in originalism, the idea, once prevalent on the right, that the Constitution should be interpreted as it would have been understood when written.

The Supreme Court justice Antonin Scalia similarly rejected the idea that the 14th Amendment applies to fetuses: “I think when the Constitution says that persons are entitled to equal protection of the laws, I think it clearly means walking-around persons,” he said in 2008.

But many on the right have grown weary of originalist doctrine. As the reactionary Harvard law professor Adrian Vermeule wrote in The Atlantic last year, originalism “has now outlived its utility.” In a legal world dominated by liberalism, he wrote, originalism was a “useful rhetorical and political expedient,” but the conservative takeover of the judiciary has proceeded far enough that it can be dispensed with.

Instead, he endorsed what he called “common-good constitutionalism,” an understanding of constitutional law that, among other things, “does not suffer from a horror of political domination and hierarchy, because it sees that law is parental, a wise teacher and an inculcator of good habits.”

Douthat is hesitant about the 14th Amendment strategy because he believes that ending abortion in America — his goal — requires winning over the American people. He knows that supporters of abortion rights insist that legal abortion is a precondition for women’s well-being and equality. The anti-abortion movement, Douthat wrote, “needs to prove the pro-choice premise wrong.”

But the anti-abortion movement can’t do that, because, as the experience of every country that has ever banned or severely restricted abortion shows, the pro-choice premise is correct. In this sense, the people pushing for a Supreme Court declaration of constitutional personhood have a point. If your aim is a near-total abortion ban in a rapidly secularizing country with a younger generation that largely despises the right, democracy isn’t your friend.

Finnis acknowledges that if the Supreme Court does what he wants, it would “meet unimaginable resistance,” but he doesn’t seem to find this relevant. After all, that’s the point: People shouldn’t have a choice.

Source: https://www.nytimes.com/2021/04/05/opinion/us-abortion-bans.html?fbclid=IwAR2IO0acW59NjoyzmEjGGSjnDAsILf0egEayNjtQfxkF-FXtQghjP0-sak0

Santiago, Chile — In Chile’s arid Atacama desert, Tabita Daza Rojas is trying to scrape together enough money to finish construction on her home before her baby, due anyday, arrives.Eight hundred kilometers to the south, in La Pintana, a suburb of the capital Santiago, Cynthia González is nursing her 2-month-old boy. But she needs to buy milk to supplement her body’s supply, and is worried about how she’ll afford it.

Rojas and González come from different backgrounds, have different lives and ambitions. Yet they — and at least 170 other women at the time of writing — share a common reality: they all claim to have fallen pregnant while taking Anulette CD, an oral contraceptive pill manufactured by Silesia, a subsidiary of the German pharmaceutical company, Grünenthal.Without the option to legally terminate their pregnancies, if they wanted to, or any real accountability from the government or the drug companies, the women, represented by the Chilean sexual and reproductive rights group Corporación Miles, are preparing to file a class action lawsuit in the civil courts.In a region where barriers to women’s reproductive rights are the norm, CNN has identified a government health agency quick to shift the blame to these women, as well as a history of poor production quality and previous issues relating to oral contraceptives in Grünenthal’s Chilean factory — its gateway to Latin America.

Tabita Rojas’ story

In March 2020, after discovering an ovarian cyst her physician worried could have been caused by her contraceptive implant, Rojas’s doctor at her local health clinic advised she take the pill instead, prescribing Anulette CD.

Rojas didn’t give the switch much thought; she had taken oral contraceptives before and agreed it made sense for her health.Plus, after giving up her place on a forensic criminology program at 17 because she’d gotten pregnant, the now 29-year-old was once again excited about her future.

“I had to put all that aside and dedicate myself to my son,” said Rojas, who had a second child two years later, and provides for her family by doing seasonal work at a grape packing plant.By early 2020, however, things were changing. Her children — boys now aged 11 and 9 years old, both with learning difficulties — were more independent, and were spending more time with their father. As part of a government urbanization in her hometown Copiapó, Rojas had been given a small piece of land on which to build a house. She had been saving up money and planned to move out of the home she and her children had been sharing with three other family members.

And, she was in love.Early on in the relationship, Rojas and her boyfriend had decided not to have children together. “It was going to be impossible to provide for someone else,” she said.But in September 2020, just five months after Rojas began taking Anulette, she found out she was pregnant again. She would later learn, after seeing it posted on Facebook, that her tablets were from a batch that had been recalled by Chile’s public health authority, the Instituto de Salud Pública de Chile (ISP) the month before.

“I was about to finish the second [box of three prescribed] when I found out about the problem,” she said. By then she was already six weeks pregnant.

On February 21, 2021, Chile’s health authority wrote Tabita Rojas in response to her questions about the Anulette CD controversy. (R) The ISP’s August 24, 2020 alert recalling the first batch of defective Anulette pills. Source: Tabita Rojas, ISP

Rojas’ neo-natal ultrasound in September 2020 revealed she was approximately 6 weeks pregnant. Source: Tabita Rojas

The blister packs of the Anulette CD birth control pills Rojas had taken for nearly three months before finding out they had been recalled in August 2020. Source: Tabita Rojas

‘I was never happy with this pregnancy’

The details may differ but similar scenarios have been playing out across Chile.A mother of four, González, who had been on Anulette for eight months, got pregnant for the fifth time in May 2020.

She tells CNN that she took her contraceptive “religiously every morning,” before adding: “Because we women set an alarm for those kinds of pills.

“The news devastated her. Her personal life was complicated and her finances extremely limited after she lost the market stall where she sold second-hand clothes.”I was never happy with this pregnancy,” González said. “If you only knew all the nights I spent crying thinking that I didn’t want to [have the baby]. I had no options.

“Alluding to Chile’s strict abortion laws that forbid a woman from terminating a pregnancy except for three reasons (if the pregnancy is a result of rape, if the fetus is incompatible with life outside the womb, or if a woman’s life is at risk), González spoke about her upset and how she tried to conceal her growing tummy.”I hid the pregnancy for a long time, so that they wouldn’t ask me: ‘Hey, another child, and whose is it, because you are no longer with your husband’ — and having to explain that we were separated. It was already a complicated situation for me, let alone to go around telling everyone.

“Anulette CD is a 28-day combined oral contraceptive — one of the most common forms of birth control.It contains synthetic versions of the hormones estrogen and progesterone, which are produced naturally by the ovaries. The hormones work to prevent ovulation — meaning no egg is released by the ovaries — as well as thicken the lining of the cervix to make it harder for sperm to pass through. The pill also makes the lining of the uterus thinner so that if an egg is fertilized it cannot implant and begin to grow.

Pill regimens typically involve taking 21 “active” pills that contain the hormones and seven “non-active” or “placebo” pills, to maintain a daily routine, during which time a person bleeds.

How the contraceptive pill works

The menstrual cycle is the process by which the body prepares for pregnancy every month. Controlled by multiple hormones, including estrogen and progesterone, it is the time between the first day of a period and the day before the next period begins. On average the cycle lasts 28 days, but this can vary.

The cycle involves ovulation, where an egg is released from one of the ovaries.

Pregnancy happens when sperm enters a vagina, travels through the cervix and uterus (womb) to the fallopian tubes and fertilizes a released egg. Once fertilized, the egg starts to grow, traveling to and implanting itself into the lining of the uterus.

When an egg isn’t fertilised and pregnancy doesn’t happen, the egg is reabsorbed into the body and the thickened lining of the uterus sheds and exits the vagina as a period.

Birth control pills work by controlling the menstrual cycle, to prevent pregnancy. There are many different types of birth control pill but one of the most common is the 28-day combined oral contraceptive. With these, you take one pill every day, at the same time, for 28 days.

The first 21 pills are active, as they contain artificial versions of estrogen and progesterone. The remaining seven pills in the packet are inactive pills that contain no hormones, often referred to as “sugar pills” or “placebos.”

The 21 active pills prevent ovulation, meaning that no egg will be released from the ovaries.

They also help to prevent pregnancy by thickening the mucus around the entrance to the womb, making it harder for sperm to enter and reach an egg, and by making the lining of the uterus thinner, so if an egg is fertilised there is less chance of it implanting into the women and being able to grow.

In the case of the women in Chile – the pills that they were provided were defective according to the ISP. In one batch, the placebo (a blue pill) had been found where the active pills (a yellow pill) should have been, and vice versa. In another batch there were missing and crushed pills. Users say these instances resulted in unwanted pregnancies.

Source: American College of Obstetricians and Gynecologists, Healthline, Planned Parenthood, UK National Health Service (NHS)

The first batch — 139,160 packs of Anulette pills, according to its manufacturer — were recalled on August 24, 2020 after healthcare workers at a rural healthcare clinic complained that they had identified 6 packets of defective pills.

In them — based on information from the ISP — the placebo (a blue pill) had been found where the active pills (a yellow pill) should have been, and vice versa.In its online notice, published on August 29, the ISP said that the makers of Anulette CD, a company called Laboratorios Silesia S.A. (Silesia), had been made aware and were withdrawing the defective lot. The ISP then advised health centers to quarantine any packets they had from the affected batches.Then, a tweet was sent from the ISP account alerting its followers to the recall. But without a nationwide campaign to more directly inform the public, the recall went largely unnoticed.

A week after the first recall, on September 3, the same error was detected in 6 packets from a different batch at a clinic in Santiago. Here, tablets were also missing, but others were crushed, according to the ISP. By the time the problems were flagged, Silesia said it had already distributed 137,730 packs to health centers.This time the ISP said it would be suspending Silesia’s registration until the laboratory was able to improve its quality and production processes. But it was too little, too late.In total, according to the manufacturer’s own accounts, 276,890 packets of Anulette CD from the two defective lots — all with a January 2022 expiry date — had been distributed to family planning centers across Chile.

Surprisingly, on September 8, less than a week after Silesia’s suspension, the ISP issued another document reversing its earlier decision. In the memo, which was uploaded to its website, the health authority said Anulette CD could once again be distributed. It claimed that the flaws in the packaging could be easily detected, and passed the responsibility of doing so, and of informing users of the service, onto healthcare workers.The Ministry of Health told CNN in an emailed statement that they informed the public health service “to inform users of this situation and take pertinent actions,” and said that they provided support and counseling for reproductive health workers to support “women who may have been affected by problems in the quality of contraceptives.

“But Rojas said she was only informed by her local clinic about the defective pills after she went in for a prenatal checkup. And Rodriguez told CNN no one has contacted her.ISP director Heriberto Garcia defended the decision to put Anulette back on the market, saying in a video interview with CNN: “Just because it [one pack] belongs to the batch doesn’t mean it was bad.”

“We expect that there are many more women with this problem, especially because the State has not claimed any responsibility.”Laura Dragnic, legal coordinator at Corporación Miles

So, it was left to Chilean civil society to raise the alarm. The sexual and reproductive rights group, Miles, ran a social media campaign and used its networks to get the word out.

“It was after [posting on Instagram] when we started receiving emails from people saying that they were already pregnant because they were consuming Anulette,” said Miles’ legal coordinator Laura Dragnic.

By October 2020, some 40 women had gotten in touch. According to Miles, following multiple media appearances by its staff, another 70 women came forward. The number now stands at 170, but Dragnic expects it to grow as rural women or those without access to the internet or television are still to be reached.

“We expect that there are many more women with this problem,” she said, “especially because the State has not claimed any responsibility and has not made any statements or any serious compromises [to the abortion rules] for the affected women.

“Seven days after Dragnic spoke to CNN, and six months after the first recall, the health authorities announced that Anulette’s manufacturers had been charged a series of fines totalling approximately 66.5m Chilean pesos (approximately USD $92,000).

Miles and their partners are calling for the government to pay financial reparations to the affected women, and to provide access to safe and legal abortions for those who wish to terminate their pregnancy.

Multiple recalls at Grünenthal’s Santiago factory

Grünenthal, in whose Santiago factory Anulette CD is manufactured, began operating in Chile in 1979. The privately-owned German pharmaceutical company, which reported a €340 million (US $405 million) profit in the 2019-2020 fiscal year, is best known for its product tramadol, an opiate pain killer, classified as a controlled substance in numerous countries.In 2017, the company increased its Chilean investments by opening what it called “Latin America’s most modern women’s health products plant” — a US $14.5m facility. While only a small part of Grünenthal’s portfolio, the investment was enough to place it among “the three biggest pharmaceutical companies in Chile.

“But CNN has uncovered that production issues began soon after the factory opened, and have affected a range of oral contraceptives marketed not just by Silesia S.A. but also Grünenthal’s other Chilean subsidiary, Andrómaco.

In 2018, Tinelle, a contraceptive pill from Silesia’s portfolio, was voluntarily taken off the market after a decision to switch the sequence of the active and placebo tablets (keeping the same numbers of each but placing them in a different order) which — by the Grunenthal spokesperson, Florian Dieckmann’s admission — “confused [patients] about the new sequence of the pills.” Dieckmann said that the pills were put back on the market after Silesia “further clarified the instruction on the aluminium foil on how to follow the right sequence of tablets.

“Two further oral contraceptives, Minigest 15 and 20, manufactured by Andrómaco at the Grünenthal Chilean plant, were recalled in October 2020 after the public health authority, the ISP, said that they were found during stability testing to contain an insufficient amount of the active ingredient: the hormones.Grunenthal’s spokesperson said that at the time of packaging, the tablets had “the correct amount of active ingredient” in them, adding that the “tablets are exposed to excessive temperatures and humidity over the products entire shelf life under laboratory conditions” and that it is “unlikely that the tablets are exposed to these conditions for a long time in real world circumstances.

Based on a Freedom of Information request by Miles, which CNN then followed up on, the production of Anulette CD has had the most problems, according to the ISP’s own records.Between August 6 and November 18, 2020, health clinics across Chile reported a wide range of issues with the pills including small holes found in the tablets; pills that had orange and black spots; wet and crushed tablets; and packaging that wouldn’t release the entire pill effectively, leaving trace amounts of the pill stuck inside.

In total, the ISP received 26 different complaints about 15 different batches of Anulette pills, yet only 2 batches were recalled.”It is important to clarify that not all complaints of the products end in market recalls,” the ISP explained.

“Those that are withdrawn…are those in which critical defects are detected and this was the case of the recalled batches.

“Aside from publishing details of the above recalls on its website, the ISP allegedly did little else to notify women, and despite its apparent challenges, Grünenthal remains the Chilean government’s leading provider of oral contraceptives.According to the ISP, 382,871 women are prescribed Anulette CD, and between May 2019 and January 2020, Grünenthal secured at least US $2.2 million in contracts that CNN has seen.The Ministry of Health did not answer CNN’s written questions and declined an invitation to be interviewed.

The blame game

While no one is denying the production problems, Grünenthal, its Chilean subsidiaries and government representatives, all seem intent on shifting some of the blame away from the faulty packets of the pill and onto each other.

Dieckmann explained that the company discovered that the problems stemmed from an issue on the production line issue which caused some pills to move during the packaging process. That led to some packages with “empty cavities, some tablets misplaced or crushed tablets,” he said but stressed that the efficacy of the contraceptive had not been compromised.The spokesperson also pointed out that combined oral contraceptives are not 100% effective. According to the World Health Organization, the combined oral contraceptive pill every year results in less than 1 pregnancy in every 100, “with consistent and correct use.”

“So I think it’s important background, right?” Dieckmann said, noting that those statistics rise when the pill isn’t taken consistently or correctly.

I’m not trying to say that it’s the woman’s fault,” Dieckmann said, before adding that correct and consistent use was a “factor that I think we have to look at here.”

“Women say, ‘I was on the pill, I still became pregnant — why is that?’ That’s what’s happened,” he said, referencing the statistics.

The Grünenthal spokesperson told CNN that the company could not speak to their individual cases, as it has not been directly contacted by any of the affected women.

Addressing the controversy on the Chilean public broadcaster in December 2020, Silesia’s medical director, Leonardo Lourtau, said in addition to the company being responsible for visually checking the packaging, health officials should have also done so and, “obviously, the people who take the medicine as well.

“And Garcia of the ISP suggested it was important to look at how birth control efficacy might change when interacting in the body with other products, such as antibiotics, tobacco or alcohol. “I am not saying that she has drunk a lot of alcohol or that she is a smoker, but I am telling you the background.

“Despite Garcia’s assertions, most reproductive health experts widely agree that there is no evidence to suggest that smoking diminishes the effectiveness of the pill; that alcohol will only do so if a person throws up soon after taking it; and that only one type of antibiotic, those based on rifampicin, can affect oral contraceptives.

‘Systemic failures’

Drug recalls are not unusual, but it is hard for those campaigning on behalf of the women not to perceive an injustice here: Grünenthal continues to see its factory as the key to reaching 168 million women in Latin America, while the women who take its products have to remain vigilant or risk pregnancy. The risk is heightened, reproductive rights groups say, by the fact that these women, already poor and marginalized, can’t count on the robust support of the government should the undesired happen.

Paula Avila Guillen, Executive Director at the New York Women’s Equality Center, a not-for-profit that advocates for and monitors reproductive rights in Latin America, told CNN that if the recall was about bad meat, the entire country would have known immediately, and the product immediately taken off the market. “But when it comes to women and reproductive health, they just don’t care,” she lamented.

And so, Miles and its partners, writing to the Inter-American Commission on Human Rights and to the United Nations, have called the situation “a clear situation of systemic discrimination against women.

“Meanwhile, back in Copiapó, at 38 weeks pregnant, Rojas has now accepted her fate. She will once again have to put aside her dreams for the future of her child, another baby boy. They’ll name him Fernando.

Source: https://edition.cnn.com/2021/04/06/americas/chile-asequals-birth-control-intl/index.html?fbclid=IwAR2eCCbQ0Ll6Z6HQOw6VPh_FsIuc4pmwx336tzL6di_Xe4tNQ_Iky_dE8F8

Move Follows Submissions by the Center and Polish Organizations Urging Action

More than a decade after Poland failed to stop creating barriers to abortion access—as required by three seminal European Court of Human Rights (ECHR) rulings—the Committee of Ministers of the Council of Europe recently issued a resolution ordering the Polish government to comply with the rulings by the end of 2021.

The resolution follows joint submissions by the Center for Reproductive Rights and the Federation for Women and Family Planning urging the Committee of Ministers to act on the matter.

Since the ECHR rulings, not only has Poland failed to implement the changes ordered, but the government has also introduced new restrictions on abortion. Following developments in 2020 and 2021, there is now a de facto near-total ban on abortion in Poland.

“Poland has repeatedly failed to take effective steps to enable women’s access to lawful abortion care, contravening its human rights obligations,” said Adriana Lamačková, the Center’s Senior Legal Adviser for Europe. “We welcome the Committee’s resolution calling on Poland to take urgent action to ensure effective and timely access to lawful abortion services across the country.”

Committee of Ministers Calls for Long-Overdue Measures on Abortion 

The March 11 resolution issued by the Committee of Ministers calls on Poland to implement measures in order to comply with the Court’s judgments in three major cases: Tysiąc v. Poland (2007), R.R. v. Poland (2011), and P. and S. v. Poland (2013).

In each of these cases, the Court found Poland in violation of human rights, citing the government’s failure to ensure the accessibility in practice of legal abortion, as well as its failure to address medically unnecessary barriers and poor medical treatment faced by those seeking abortion care. The Committee of Ministers expressed serious concern that nearly 14 years after the first of these rulings, Poland has repeatedly failed to effectively address the judgments.

The joint communications issued by the Center and the Federation for Women and Family Planning in January and February 2021 to the Committee detailed Poland’s failure to implement the European Court of Human Rights’ judgments over many years and the chilling effect of recent regressive restrictions to further impede access to abortion care.

Access to Legal Abortion in Poland Should Exist as a Practical Right 

The three cases, while different, address overlapping issues regarding authorities’ failure to ensure that legal abortion in Poland is accessible in practice—not just a legal entitlement that exists in theory.  

As part of their communication to the Committee, the Center and the Federation for Women and Family Planning have urged Poland to adopt specific measures in order to comply with the Court’s judgments. These measures include the establishment of urgent procedures by which women can enforce their legal entitlements to abortion in a timely manner, guaranteed access to information about abortion for women and girls, the enhancement of patient data confidentiality, and strengthened enforcement procedures to hold health facilities and professionals accountable for failing to comply with legal obligations to provide reproductive health services and information.  

The judgments also state that a woman’s access to prenatal testing cannot be undermined, a right that has been further impacted by the Constitutional Tribunal’s regressive ruling last year.  

“Currently it is virtually impossible for women to secure access to legal abortion in Poland,” said Leah Hoctor, the Center’s Senior Regional Director for Europe “The narrow entitlements to abortion that exist under the current legal framework are wholly illusory in practice.” 

The March resolution of the Committee of Ministers requires Polish authorities to provide an update on the specific measures taken to implement these judgments by December 2021.  

A Wave of Attacks on Abortion Access in Poland 

Poland has long had one of Europe’s most restrictive abortion laws, and systemic attacks on women’s rights have only increased in recent years and months.  

Since 2015, the legitimacy of Poland’s Constitutional Tribunal—the top court overseeing the compliance with Poland’s constitution—has been undermined by the conservative ruling Law and Justice party. As a result, the Tribunal is no longer considered an impartial and independent court. 

In October 2020, the Constitutional Tribunal considered that abortion on grounds of severe or fatal fetal impairment is unconstitutional.As a result, already highly restricted access to legal abortion care has been further curtailed. Today abortion in Poland is almost fully inaccessible in practice. A new draft bill now seeks to introduce further prohibitions on abortion and to criminalize abortion in all situations. 

“Prior to these developments, Poland’s law on abortion was already one of only two remaining highly restrictive laws in the EU,” Hoctor said. “Now, Poland has the additional distinction of being the only EU member state in recent history to actually remove a ground for legal abortion. The actions of Polish lawmakers fly in the face of the overwhelming trend across the region in recent years, which has been to decrease restrictions on access to abortion and to adopt laws that protect women’s health and rights.”   

Increasing Threats to Defenders of Women’s Human Rights and Civil Society Organizations 

As attacks on reproductive rights and other women’s rights have intensified in Poland, so too have attacks against civil society organizations and women human rights defenders. In recent weeks, death threats and bomb threats have been received by a number of prominent activists and civil society organizations. It is vital that the Polish authorities provide protection and investigate the threats and ensure accountability of the perpetrators.  

In addition, as widespread protests have occurred across Poland in response to the government’s attacks on reproductive rights, Polish authorities have sought to crack down on the right to freedom of assembly and protest.

The Center stands in solidarity with protestors and human rights defenders and urges the Polish Government to respect the rights of peaceful protestors. 

Source: https://reproductiverights.org/poland-called-on-to-implement-long-overdue-abortion-measures/?fbclid=IwAR0b8PWcS4s-4LUAmLqh3lqdBMnoDCYx27ZopdNq7IyWRGZguU3OZkzbrVs

One study found 15 percent of women experiencing physical violence from a male partner also reported birth control sabotage.

Reproductive coercion isn’t widely recognized as domestic violence. In California, lawmakers are debating changing that.

In a Saturday Night Live sketch in 2018, Pete Davidson joked about switching out his then-fiancee Ariana Grande’s birth control with Tic Tacs, to uproarious laughter from the studio audience. But for all the tongue-in-cheek cultural jokes about poking holes in condoms or throwing away a partner’s birth control to coerce them to stay in a relationship, this behavior is rarely recognized for what it is: a prevalent act of abuse with violent ramifications for women and pregnant-capable individuals that can last a lifetime.

Birth control sabotage is just one form of reproductive coercion; it also includes “excessively pressuring the other party to become pregnant, deliberately interfering with access to reproductive health information, or using coercive tactics to control pregnancy outcomes,” said Jane Stoever, a law professor and director of the University of California, Irvine Domestic Violence Clinic and the university’s Initiative to End Family Violence. Stoever has often counseled survivors of domestic violence who don’t even realize they experienced sexual assault—because it was perpetrated by a long-term partner—much less that domestic violence includes their partner sabotaging access to birth control. Because society doesn’t often recognize this sort of reproductive coercion as abusive, survivors frequently don’t either.

That’s why SB 374, a first-of-its-kind bill that California state Sen. Dave Min—who is also Stoever’s husband—recently filed, is so important. The bill would include reproductive coercion in California’s statutory definition of domestic violence, allowing victims to get a restraining order against their abuser. Stoever’s research and advocacy efforts helped shape and inspire Min’s bill, which is currently being considered in the state senate.

But other than this recent legislative effort, acts of reproductive coercion aren’t widely recognized as domestic violence, even though forcing a person to carry an unwanted pregnancy can have long-term, devastating consequences. A person who is denied abortion care is four times more likely to experience poverty, and more likely to stay in an abusive relationship. Victims of reproductive coercion whose partners refuse to use a condom, or who remove the condom without their knowledge and consent, are also vulnerable to sexually transmitted infections.

“We have a societal conception of sexual violence as stranger violence, and it’s hard to comprehend when someone who says they love you is also someone who denies your autonomy and sexually violates you.”
– Jane Stoever, University of California, Irvine

Stoever has found the phenomenon of an abusive partner controlling their victim’s access to contraception or abortion care is unsettlingly common. One study found 15 percent of women experiencing physical violence from a male partner also reported birth control sabotage. And according to the American College of Obstetricians and Gynecologists, one quarter of adolescent girls have reported that their abusive male partners had attempted to nonconsensually impregnate them by interfering with their contraception. Among adolescent mothers on public assistance who experienced intimate partner violence, 66 percent also reported experiencing birth control sabotage by an abusive partner.

Yet legal protections and resources for victims of reproductive coercion are virtually nonexistent. These acts are often underreported, as many victims may not realize their partner’s actions constitute domestic violence.

“Reproductive coercion is typically not the only type of abuse experienced in a relationship in which intimate partner violence is present, and it can be challenging to reveal,” Stoever said. “Naming a problem is often the first step in addressing it. Naming the behavior enables and empowers survivors to identify what they have experienced as abuse.”

According to Stoever, formally adding reproductive coercion to legal definitions of domestic violence can give victims the ability to seek justice and legal recourse, and ensure judges recognize the severity of these acts.

“We have a societal conception of sexual violence as stranger violence, and it’s hard to comprehend when someone who says they love you is also someone who denies your autonomy and sexually violates you,” Stoever said. While acts of reproductive coercion like “stealthing,” a form of rape in which a sexual partner nonconsensually removes the condom during sex, can be perpetrated by strangers, other acts of reproductive coercion like birth control sabotage are often perpetrated by long-term romantic partners.

Reproductive coercion is less likely to be seen as violent in a rape culture that’s conditioned us to equate rapists and violent sexual partners with strangers—despite the fact that perpetrators of sexual violence are more likely to be people we know. As a result, reproductive coercion is often joked about and made light of in popular culture.

In addition, the constant barrage of anti-abortion legislation that bans, severely restricts or stigmatizes reproductive health care like abortion and birth control normalizes intimate partner violence. When state and federal lawmakers routinely attempt to control the bodies, lives, and reproductive health options of women and pregnant-capable people, this coercive behavior becomes culturally acceptable.

Recognizing reproductive coercion as a form of domestic violence not only helps victims seek legal protection, but can also prevent it from happening. One 2012 study found that clinic-based interventions—in which patients seeking contraception are asked whether their partner or someone in their home might interfere with their birth control, or whether their partner has ever forced them to do something sexually—can reduce pregnancy coercion by 71 percent among women experiencing intimate partner violence. Drawing clear connections between domestic violence and reproductive coercion, especially in clinical settings where someone is seeking reproductive health care, is crucial to prevent reproductive coercion, help victims identify the abuse they’re facing, and ensure they can safely get support.

The grim reality is that current available data on the prevalence of reproductive coercion might be just the tip of the iceberg. To truly begin to understand the scale of this invisible crisis and meaningfully support victims, we have to name and formally recognize reproductive coercion as abuse. That means updating our legal and cultural definitions of domestic violence.

Source: https://rewirenewsgroup.com/article/2021/04/06/when-your-partner-tries-to-control-your-reproductive-choices/?fbclid=IwAR2RBRzZTVUCjV1s-jDnV1ox-yAD19jOGEnagZIMjXTIUTe8fMOPhX1ByMA

When it comes to abortions, then-presidential candidate and current New York City mayoral candidate Andrew Yang said the quiet and stigmatizing part out loud.
 John Lamparski/Getty Images

I’m asking pro-choice politicians to evolve from this outdated mantra—it’s no longer serving you. It never served those of us who have abortions.

One thing I love about reproductive justice and other radical movements is the ability to evolve. We’re humans—evolution is natural and how we’ve survived. As organizers and political leaders, we have to evolve, learn from our past, and recognize when our good intentions fell short. But in order to do so, we have to shift our perspective and let go of things that no longer serve us.

Today, I am asking pro-choice politicians to evolve and let go of “safe, legal, and rare.” It is no longer serving you, and it never served those of us who have abortions. Let it go.

I was reminded of the outdated mantra recently when Virginia state senator and gubernatorial candidate Jennifer McClellan brandished her pro-choice values at a women’s forum hosted by NARAL Pro-Choice Virginia and Virginia’s List with all of the women candidates running for statewide office. “If we want to have abortions be safe, healthy, and rare,” she told the digital audience, “we have got to do more to prevent unwanted pregnancies.” McClellan went on to discuss the need to increase access to contraception and sex education—two critical goals I support. But I wondered: What was the point of stigmatizing abortion along the way?

Despite the Democratic Party dropping “safe, legal, and rare” from the party platform in 2012, politicians are still repeating it nearly a decade later to signal their moral superiority and supposedly commonsense position on abortion. Even Hillary Clinton, who, along with her husband President Bill Clinton, is credited with popularizing the phrase, eventually stopped saying it, opting for “safe and legal” during her 2016 presidential campaign. Yet some pro-choice politicians can’t let it go.

During an October 2019 Democratic presidential primary debate, Rep. Tulsi Gabbard of Hawaii proclaimed, “I agree with Hillary Clinton on one thing: Abortion should be safe, legal, and rare.” Soon after, ousted Planned Parenthood CEO Dr. Leana Wen seconded this view on Twitter, later doubling down while emphasizing an approach focused on preventing the need for abortion. In February 2020, at a presidential forum hosted by several reproductive rights organizations, then-candidate and current New York City mayoral candidate Andrew Yang said the quiet and stigmatizing part out loud:

I think we have to get back to the point where no one is suggesting that we be celebrating an abortion at any point in the pregnancy. That there was a time in Democratic circles where we used to talk about it being something that, like, you don’t like to see but should be within the freedoms of the woman and the mother to decide. And so to me I think there is a really important tone to set, on this, where you don’t just say like, “we’re absolutist about it,” though I have to say I am relatively absolutist on this, like I think it should be completely up to a woman and her doctor and the state should not be intervening all the way through pregnancy.

But it’s a tragedy, to me, if someone decides that they don’t want to have a child and they’re on the fence and that maybe at some point later, I mean it’s a very difficult and personal decision and it should be something that we’re very sensitive to. I think that celebrating children, family, like these are universal human values. And if we manage to lead on that and then we but also say we stand for women’s reproductive rights, I think we can bring Americans closer together on a really, really important issue.

It is truly disappointing that so many of us share our stories—about how abortion access was critical and necessary to our futures, families, and health—yet pro-choice politicians feel the need to shame us, with some—like members of the Biden administration—refusing to even mention the word “abortion” in statements praising its legality. And we’re supposed to be thankful?

Before you start abortionsplaining to me about what these politicians actually meant and why we should be working to make abortions “rare,” let me explain why you’re wrong. The very idea of abortion being “rare” isn’t real. It’s not actually a number, it’s an idea—and it’s not even factual. The myth of “rare” was created by politicians uncomfortable with abortion and sex. The truth is the recorded abortion rate has steadily dropped due to increased access to contraception, increased barriers to abortion access, and fewer people becoming pregnant in the first place. Yet somehow we’ve never achieved “rare” in these politicians’ minds. That’s because “rare” will never be an achievable thing so long as those of us who have abortions continue to do so for reasons politicians deem frivolous and “tragic.”

Demanding abortion be “rare” is stigmatizing at its core; it posits that having an abortion is a bad decision and one that a pregnant person shouldn’t have to make, and if they do, it must be in the direst of circumstances. This messaging tells those of us who’ve had abortions that we did something wrong to need an abortion, and we shouldn’t do it again. It unfairly stigmatizes people who will have more than one abortion, which is nearly half of abortion patients.

Making contraception free and widely available and increasing access to sexual health education won’t magically make abortion unnecessary. Contraception doesn’t work for everybody and fails for half of abortion patients. Pregnancies don’t progress as planned. Rape and reproductive coercion are real. Not everyone wants to put hormones in their bodies. There will be as many abortions as we need. Period.

“Safe, legal, and rare” is nothing but a mediocre talking point masquerading as a policy compromise, evidenced by the current status of decimated abortion access. Abortion will always be necessary, no matter what your campaign strategist tells you.

Making abortion “rare” or even “legal” isn’t the goal; like “rare,” “legality” is an arbitrary marker that allows for the criminalization of people who may choose to safely take medication abortion pills or herbs on their own. The goal is to make abortion decriminalized, accessible, supported, and as plentiful as necessary.

We need to change what it means to be a pro-choice champion. Organizations that rank candidates need to move beyond scoring votes only—words must count too. In order to be a true champion of an issue, politicians cannot stigmatize it at the same time. Champions don’t make the people they’re advocating on behalf of feel bad for needing care in the first place. Champions change their behavior and evolve their language as those who are most impacted speak out. Champions talk about their values and why they believe abortion access is critical health care and central to economic and racial justice.

True pro-choice champions make sure that people who have abortions feel loved and supported with their words. Champions say, “I love someone who had an abortion and I believe abortion is health care, which is why I will make it accessible to all of my constituents.”

This is a moment for bold leadership, policies, and language that reflects the care and compassion we have for people seeking abortions. You’ll never go wrong declaring your values and showing up for your constituents and their needs, including those who have abortions. But first you have to evolve. Let go of the stigma. It’s worth it, I promise.

Source: https://rewirenewsgroup.com/article/2021/04/05/dear-politicians-put-safe-legal-and-rare-in-the-dustbin/?fbclid=IwAR3RXMfCVJqDXA1i_ntdpyzsrEu6Hi6Sls0cVSlCeiiS8TJAXnnHMOEpXUM