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Reproductive Freedom



All Reason.com articles with the "Reproductive Freedom" tag.



Published: Thu, 23 Nov 2017 00:00:00 -0500

Last Build Date: Thu, 23 Nov 2017 07:19:32 -0500

 



Ban on Abortion Because of Down Syndrome Clears Ohio Legislature

Fri, 17 Nov 2017 12:12:00 -0500

(image) Both houses of the Ohio General Assembly have approved making it illegal for women to get abortions because a fetus is found to have Down Syndrome. If the law, as expected, is approved by Republican Gov. John Kasich, Ohio will become the third state to do so.

"Do we want in the state of Ohio to have people making a decision that someone is less valuable because of a chromosomal disorder that they have," state Sen. Frank LaRose (R-Hudson), who recently lost his bid to become Ohio secretary of state, asked during an explanation of his sponsorship of the senate measure for WOSU radio.

Laws like the one LaRose championed are largely symbolic measures (like state bans on sex-selective abortion). Women aren't required to provide a reason to terminate a pregnancy and doctors aren't required to test for Down Syndrome, or anything else, before performing an abortion.

Choosing to abort fetuses found to have genetic abnormalities does not, despite LaRose's grim takeaway, mean that people place less value on the lives of people with these conditions. Many potential parents know they don't have the financial, emotional, or other resources required to raise a special-needs child. And without people lining up to adopt or otherwise take care of these children, that's what we're asking prospective parents of fetuses with Down Syndrome to do.

It's admirable that many families do choose to do it (and of course for many people, religious or moral beliefs mean there's no other option for them). But it's not the state's place to impose this choice on pregnant women and their families. Forcing it on people does not seem likely to produce healthy outcomes or situations in the best interest of the children involved.

Three Ohio Republican senators joined their Democratic colleagues in voting against the Down Syndrome abortion ban. Republican Sen. Matt Dolan (R-Chagrin Falls) told WOSU that he thinks the bill is constitutionally questionable and will also have unintended consequences.

"If we're going to introduce law that says the patient and doctor's conversation with each other could lead to some liability, I think what we're going to see is reduced conversation," Dolan said.

Democrats added two amendments included in the Senate bill: one saying that no public money would go to defending the ban it court should it be challenged and one saying women should not have to say why they are getting an abortion. "It's ironic," said Sen. Charleta Tavares (D-Columbus), "that those who claim they believe in limited government are once again choosing to insert themselves in a relationship that is sacred between that practitioner and their patient."

Disability advocates have had mixed reactions to the bill. Some are opposed because singling out Down Syndrome, but allowing abortions motivated by other genetic conditions or fetal abnormalities, suggests the lives of people with those conditions are less valuable.




Supreme Court to Weigh Rules for Anti-Abortion Pregnancy Centers in California

Tue, 14 Nov 2017 11:45:00 -0500

(image) The U.S. Supreme Court has agreed to hear a case involving California's regulations for "crisis pregnancy centers." These generally religious, always anti-abortion centers have come under fire in the past for misrepresenting themselves as comprehensive reproductive health clinics while providing little in the way of medical services. But in trying to stop some centers from fraudulent advertising, the state of California passed legislation that may violate their First Amendment rights.

According to NARAL ProChoice America, California has around 170 crisis pregnancy centers, with around 40 percent licensed as medical clinics.

Under a law that took effect in January 2016, California pregnancy centers are required to disclose whether they are licensed medical providers or merely offer ancillary services (such as counseling or a clothing bank) to pregnant women. That part isn't controversial. But the law also requires crisis pregnancy centers that are licensed health clinics to notify patients about state programs that can help low-income women pay for prenatal care, contraception...and abortions. Clinics that fail to post the required state notice face civil penalties.

Naturally, the anti-abortion crowd running most of California's crisis pregnancy centers doesn't want to be forced to provide pregnant women with this information. In October 2015, two centers—A Woman's Friend Pregnancy Resource Clinic of Marysville, California, and the Crisis Pregnancy Center of Northern California—filed a suit challenging the law.

The groups, represented by the Pacific Justice Institute, claim the law "unconstitutionally compels [crisis pregnancy centers] to speak messages that they have not chosen, with which they do not agree, and that distract, and detract from, the messages they have chosen to speak." In addition, "disseminating the mandated state message...is inconsistent with plaintiffs' religious convictions." The suit says the regulations violate both freedom of religion and freedom of speech.

Since then, several other groups have brought lawsuits challenging the same law. On Monday, the Supreme Court agreed to hear one of these cases (National Institute of Family & Life Advocates v. Becerra).

The Supreme Court's review will focus on whether "the disclosures required by the California Reproductive FACT Act violate the protections set forth in the Free Speech Clause of the First Amendment, applicable to the States through the Fourteenth Amendment." Previously, both the district court and the U.S. Court of Appeals for the 9th Circuit sided against the National Institute of Family & Life Advocates pregnancy center.




No Forced Childbirth for Undocumented Immigrant Teen in Federal Custody

Thu, 26 Oct 2017 00:01:00 -0400

In April, the Trump administration took a stand against the brutal methods used to enforce China's one-child policy. The U.S. Conference of Catholic Bishops denounced China for "acts of violence" against pregnant women, including "coerced sterilizations and forced abortions," and praised the president for cutting off funds for U.N. family planning efforts. This administration does not try to force pregnant women to have abortions. Just the opposite: It tries to forces pregnant women to have babies. And its methods bear an uncanny resemblance to those employed by the Chinese government. The evidence is on view in the case of an unaccompanied 17-year-old from Central America who was detained after entering the country illegally in September. On Wednesday morning, after a furious legal battle, she got an abortion. But that outcome came only after weeks of efforts by the administration to prevent her from doing so. She has been held in a federally funded shelter since she was picked up. After discovering her pregnancy, she went through the process required under Texas law for a minor to get an abortion. A state court ruled she was "mature and sufficiently informed" to decide for herself. The Supreme Court has ruled that the constitutional right to privacy protects the right to abortion. Given those two realities, the case should have been closed. But the administration doesn't like to be constrained by laws or the Constitution. It preferred that "Jane Doe," whose identity is protected, carry her pregnancy to term, and it did all it could to make her comply. The Office of Refugee Resettlement sent her to an anti-abortion "pregnancy crisis center," where she was urged to change her mind. It told her mother about the pregnancy even though the girl said her parents had severely abused her. The government refused to let her leave the shelter to get an abortion—though it offered to let her leave for medical treatment if she agreed to give birth. At each stage, it found ways to block her access. It may be argued that because the teenager is here without authorization, the Constitution doesn't apply to her. But the Supreme Court has never taken such a position. It has ruled that even undocumented immigrants enjoy constitutional protection, including "due process of law." The Justice Department said that because she is a minor and here illegally, it is entitled to impose its own preferences on her. If she wanted to have an abortion, it said, she had the option of returning to her home country—though she said that doing so would expose her to more abuse. The district judge ruled in her favor, and on Tuesday, an appeals court agreed. In her opinion, Judge Patricia Millett concluded that Doe, "like other minors in the United States who satisfy state-approved procedures, is entitled under binding Supreme Court precedent to choose to terminate her pregnancy." The administration said it should not be required to "facilitate" a procedure it finds abhorrent. But that was a bogus claim. The girl was not asking the government to pay for the operation, provide a doctor, or transport her to the clinic. The only thing her lawyers asked of the government was "to stop blocking the door." But the facilitation argument wouldn't stand up regardless. If she were an adult, Doe would be in the custody of Immigration and Customs Enforcement, which permits detainees to get abortions. If she were in federal prison, she would be allowed to get an abortion. Doe asked for far less—and the Trump administration tried to deny her even that. Absent this court ruling, she'd have been confined and required to go to term, even though continuing her pregnancy presented much greater risks to her health than ending it. This was a simple choice: Compel the girl to give birth or let her get an abortion. The fact that she is undocumented doesn't change that reality. As Judge Millett wrote, "Surely the mere act of entry into the United States without documentation does not mean that an immigrant's body is no longe[...]



Does Reproductive Freedom Mean Forcing People to Sin?

Wed, 11 Oct 2017 00:01:00 -0400

Last Friday the Trump administration unveiled regulations that let a wider range of employers claim a religious exemption from the Obamacare mandate requiring health plans to cover birth control. Rep. Nita Lowey (D-N.Y.) responded by invoking The Handmaid's Tale, the Margaret Atwood novel, now a Hulu series, set in a patriarchal dystopia where the government controls women's bodies and forbids them to read, write, or work outside the home. Lowey is not the only critic of the new regulations who conflates freedom from coercion with a right to forcibly extracted subsidies. Such overwrought reactions obscure the real issue raised by religious exceptions to the contraceptive mandate: When does respect for religious freedom require relieving some people of the obligation to obey rules that everyone else has to follow? Never, according to the Supreme Court, which in 1990 ruled against Alfred Smith and Galen Black, who were denied unemployment benefits after being fired from their jobs as drug rehabilitation counselors because they used peyote in Native American Church ceremonies. Writing for the majority, Justice Antonin Scalia said letting the First Amendment's guarantee of religious freedom trump a "neutral, generally applicable law" such as Oregon's peyote ban would create "a system in which each conscience is a law unto itself." That decision rejected the approach that the Court had taken in earlier cases, which required the government to justify substantial burdens on religious freedom by showing that they were the least restrictive means of serving a compelling state interest. The peyote ruling provoked strong criticism from across the political spectrum and inspired the Religious Freedom Restoration Act (RFRA), which Congress passed nearly unanimously in 1993. RFRA restored the compelling-interest test that the Supreme Court used until 1990. Although the Court ruled in 1997 that RFRA cannot be constitutionally applied to state and local laws, it is still binding on the federal government, and it was the main basis for legal challenges to the contraceptive mandate. The American Civil Liberties Union, which immediately filed a lawsuit against the new, broader religious exemption, supported RFRA. Later the ACLU, whose Oregon chapter helped represent Smith and Black, successfully argued that RFRA required religious exceptions to the federal ban on the psychedelic dimethyltryptamine and the U.S. Army's dress and grooming rules. More recently, however, the ACLU has soured on RFRA, which it describes as "a sword to discriminate against women, gay and transgender people, and others." The organization's birth control lawsuit, which argues that the new rules "give employers license to discriminate against women," does not even mention RFRA. When it comes to religious liberty, it seems, the ACLU draws the line at beliefs that offend progressive sensibilities. The ACLU claims the new birth control regulations let businesses, nonprofit organizations, and universities "impose their religious beliefs on their employees and students." New York Times columnist Gail Collins likewise thinks beneficiaries of the exemption "are trying to impose their own personal theology on Americans who don't share it." Contrary to these formulations, employers who do not want to be complicit in what they believe to be sin are not trying to impose anything on anyone. They are trying to avoid the government's imposition of a legal obligation that violates their religious beliefs. It is hard to see how that imposition can be justified as the least restrictive means of serving a compelling state interest, as RFRA requires. In fact, the Supreme Court already has ruled that it can't, at least with respect to "closely held" private businesses. Still, Scalia had a point: The government cannot and should not accommodate every religious belief. A sincere belief in the religious necessity of human sacrifice, to use a hoary example, does not require an exception to the definition of mu[...]



Do Abortion Rules Violate Satanists' Religious Freedom? Missouri Supreme Court to Decide

Tue, 10 Oct 2017 10:35:00 -0400

The Supreme Court of Missouri has agreed to hear an interesting religious and reproductive liberty case. Brought by "Mary Doe," a member of the Satanic Temple, the case challenges an "informed consent" law requiring a 72-hour waiting period, an ultrasound, and support for statements like "life...begins at conception" before a woman can get an abortion. "The case would be the first of its kind to be heard by either the Missouri Supreme Court or U.S. Supreme Court," notes the Kansas City Star. Doe claims the requirements violate her right to religious freedom, as Satanists do not believe that life begins at conception. The first court to hear the case rejected Doe's constitutional claims, but an appeals court last week decided Doe's claims might have merit. It presents "a contested matter of right that involves fair doubt and reasonable room for disagreement," the Western District Court of Appeals ruled unanimously, ordering the case be transferred to the jurisdiction of the Missouri Supreme Court. Missouri regulations require that any woman seeking an abortion must first view an active ultrasound, wait 72 hours after an initial doctor's visit, and sign papers declaring that they have read and understand state-mandated statements that personhood begins at conception and that abortion at any stage terminates "the life of a separate, unique, living human being." "The sole purpose of the law is to indoctrinate pregnant women into the belief held by some, but not all, Christians that a separate and unique human being begins at conception," wrote the appeals court. "Because the law does not recognize or include other beliefs, [Doe] contends that it establishes an official religion and makes clear that the state disapproves of her beliefs." Despite its provocative name, the Satanic Temple doesn't actually worship Satan. There's no ritual sacrifice or other trappings of Satanic lore. It's more of a mischievous and high-concept anti-religion, opposed to the tenets of organized Christianity and their infiltration of American laws. Its description of its mission actually sounds mighty libertarian, as well as steeped in traditional morality: to "encourage benevolence and empathy among all people, reject tyrannical authority, advocate practical common sense and justice, and be directed by the human conscience to undertake noble pursuits guided by the individual will." "The first conception was in response to George W. Bush's creation of the White House Office of Faith-Based and Community Initiatives," one of the Satanic Temple's founders told The New York Times in 2015: "I thought, 'There should be some kind of counter.'" He hit on the idea of starting a faith-based organization that met all the Bush administration's criteria for receiving funds, but was repugnant to them. "Imagine if a Satanic organization applied for funds," he remembered thinking. "It would sink the whole program." Both founders consider themselves "atheistic Satanists," with no more literal belief in Satan than they do in a literal God. To them, Satanism represents "the solidarity of outsiders, those judged and excluded by the mainstream," explains the Times. In addition to challenging religiously motivated abortion regulations, the Satanic Temple has also been active in fighting things like prayer in public schools, prayer at City Council meetings, a biblical statute on Oklahoma statehouse grounds, courthouse Nativity Scenes, and public schools distributing the Bible to their students.[...]



House Passes Bill Making Abortion After 20 Weeks a Federal Crime

Tue, 03 Oct 2017 08:36:00 -0400

(image)

Update: On Tuesday afternoon, the bill passed the House 237 to 189.

Third time's a charm? The U.S. House of Representatives is considering "The Pain-Capable Unborn Child Protection Act," a bill to ban abortion after 20 weeks, for the third time since 2013. But this time, the White House has signaled full support for the bill.

Under the new legislation (H.R. 36), abortion after 20 weeks pregnancy would be a crime except in cases where the life of the mother is at risk or the pregnancy is a product of rape or incest. Pregnant women who find out after the cutoff that they are carrying an nonviable fetus (i.e., one that cannot survive outside the womb) would still be forced to carry the fetus to term.

While women seeking an abortion after 20 weeks would not be criminalized under federal law, anyone who performed or agreed to perform an abortion on someone more than 20 weeks pregnant would face five years in federal prison, a fine, or both. "A woman who undergoes a prohibited abortion may not be prosecuted for violating or conspiring to violate the provisions of this bill," it states.

The failure to directly criminalize women may seem like a bright spot. But in this way the bill not only restricts women's control over their own bodies and reproductive futures but also takes a pass at their agency, declaring us too morally or intellectually inferior to know what we are doing and be held responsible for our decisions. In fact, under Republicans' new proposal, a woman who seeks out an abortion after 20 weeks and finds a doctor to do it may then sue the abortion doctor in civil court.

From a philosophical standpoint, it's bullshit—but from a political point, it makes sense. Republicans know that if they start throwing women in jail for terminating their pregnancies, they would lose a lot of centrist support; not so if they can make this about punishing evil "abortionists" that prey on poor pregnant women.

In a statement Monday, the Trump administration said it "strongly supports H.R. 36, the Pain-Capable Unborn Child Protection Act, and applauds the House of Representatives for continuing its efforts to secure critical pro-life protections."

But while conservative representatives and President Trump may be enthused about the proposed abortion ban, the Senate has indicated that now is not the time. On Monday, Republican Sen. John Cornyn (R-Texas) said taking up the abortion bill was "not a near-term priority."




Bullied By the State, Toledo Abortion Clinic Takes Its Fight to Remain Open to the Ohio Supreme Court

Thu, 14 Sep 2017 11:20:00 -0400

A Catch-22 in Ohio abortion law came before the state's Supreme Court this week. The case addresses the attempted shutdown of Toledo's only remaining abortion clinic and a pair of state regulations that make it legally impossible for some clinics to stay open, even if they have done nothing wrong. Ohio has long required all outpatient surgical centers, including abortion clinics, to have a formal transfer agreement with a local hospital. In general, such regulations are pretty pointless, as surgical center patients with complications can be treated at nearby hospitals regardless of whether such an agreement exists. But they didn't post much of a problem for reproductive freedom in Ohio until 2013. That year, as part of the state's budget bill, legislators forbade public hospitals from entering into transfer agreements with any abortion provider. For Toledo's Capital Care Network, the new rule meant losing its transfer agreement with the University of Toledo Medical Center. The clinic proceeded to secure a transfer agreement with the University of Michigan Health System, 50 miles away, but it was told this was too far to qualify as local. In 2014, the Ohio Department of Health ordered the clinic to close. Capital Care Network pushed back with a lawsuit. Two lower courts have sided with the clinic, which has thus far been able to remain open. At the Supreme Court on Tuesday, justices were interested in whether the clinic's closure would pose an "undue burden" on Ohio women seeking to terminate a pregnancy—a standard often used in judging the constitutionality of state abortion restrictions. Capital Care Network is the only remaining abortion provider in the greater Toledo area, after the city's other clinic was forced to close in 2013 upon losing its transfer agreement with a public hospital. Assistant Attorney General Stephen P. Carney told the justices that if the Capital Care Network closed, the closest clinics available to women in the Toledo region would be in Detroit or Ann Arbor, Michigan. "Surely you just didn't just say the undue burden is met if we tell women you can't have an abortion in Ohio but you can certainly go to Michigan?" Justice William M. O'Neill replied. But undue burden isn't really the issue in this case, because Capital Care Network is not challenging the constitutionality of the regulation per se. Rather, it objects to the way it was passed, as part of the state's 2013 budget bill. Under the Ohio Constitution, legislation shall not "contain more than one subject, which shall be clearly expressed in its title." The idea is to ensure transparency and time for public comment and debate. Capital Care Network lawyers told the Court that passing the transfer agreement ban as part of the budget bill violated this rule, because the regulation "has nothing to do with appropriations." The state contended that it didn't violate the rule, because "it involves how we operate government." If the state's argument flies, that would seem to negate the entire point of one-subject rule, since any rulemaking the government undertakes could be said to relate to "how we operate government." And at least one justice wasn't having it: "That's a pretty broad statement to say it pertains to the operation of state government," Justice Maureen O'Connor replied. Publicly funded hospitals in Ohio are not prohibited from contracting with any specific type of outpatient surgical center other than abortion clinics. In 2014, a Cincinnati clinic was forced to close after the new law caused it to lose its transfer agreement with nearby public hospitals and the private Catholic hospitals in the area declined to pick up the slack. The clinic applied for a waiver, which the state denied, leaving the Cincinnati area with only one abortion clinic. The state is currently seeking to shut down the Women's Med Center in Dayton, 45 minutes north of Cincinnati, over the transfer [...]



'Free' Abortions for Everyone in Oregon

Thu, 06 Jul 2017 16:55:00 -0400

A measure on its way to Gov. Kate Brown requiring health-insurance plans to include "free" coverage for elective abortions and an array of other pregnancy-related services for all insured, regardless of their gender identity, is certain to reverberate far beyond the state of Oregon. The bill, sponsored by state Rep. Julie Fahey (D-West Eugene), is a response to Republican shenanigans in Washington, which could soon end Obamacare's provision that health insurers cover a list of preventative services with no deductibles or co-pays. Fahey's measure would ensure that many of these services—such as cervical and breast cancer screenings and birth control—remain mandatory benefits under Oregon insurance plans and add abortion and vasectomies to the list. It would also set up a fund for covering abortion procedures for undocumented immigrant women, who are not eligible for state-funded health coverage otherwise. "In some states such as New York, abortions are cost-free if they're deemed medically necessary," ABC News reports. "The Oregon bill is unique, however, in that patients would have access to the procedure for virtually any reason, at any time." The Hill called the bill "a rare bright spot for abortion rights advocates at a time when opponents have advanced restrictions in other states." I disagree. The goal of the reproductive-freedom movement is ensuring safe, widespread access to things like contraception, abortion, and maternity care. And, in theory, the Oregon measure does that. But it does so by acting on the same authoritarian impulses abortion foes are so fond of, guaranteeing inevitable and lengthy legal battles from folks who feel their conscience rights are being abridged. The bill contains some exemptions for churches and religious non-profits as required by federal law. Insurance companies with religious objections can also apply for a waiver. But the category of people who oppose abortion for religious reasons extends far beyond religious institutions and insurance-company execs. As with Hobby Lobby and the Obamacare contraception mandate, there will certainly be owners of private, for-profit companies who object to providing employee health-care coverage that funds something they find morally abhorrent. I don't find abortion morally abhorrent. I share in the liberal fight to not just keep abortion legal and clinics open but also to ensure that anyone who needs to terminate a pregnancy can afford to do so. But we have got to get beyond this idea that securing this access must involve mandates and government funding. Inevitably, such requirements will interfere with civil liberties, stymie innovation that could bring better and cheapter care to more people, and drive up the cost of care for everyone. If we are securing abortion access even for those who can't afford it, why not go at it directly, instead of through sixteen layers of bureacracy? Making every health-care plan include abortion coverage doesn't just rile religious objectors and raise insurance costs (which will be passed on to plan recipients indirectly), it ignores some of the most vulnerable populations. Not only undocumented immigrants who may lack health insurance coverage altogether. Homeless women, women fleeing violent partners, teen runaways, drug addicts, and others who are unlikely to be insured are also likely to be targets of sexual violence and to have unintended pregnancies. How is a health-insurance mandate going to help them? Abortion providers will no longer have an incentive to keep costs as low as possible or find innovative models for care because they can count on insurance reimbursement and don't need to deal directly with patients about the expense. Rather than requiring one-size-fits-all insurance plans, we'd do better to look to places like Carafem, which opened in the D.C.-area in 2015 and offers first-trimester, pill-induced ab[...]



Should the Government Limit What Women Can Learn from Non-Invasive Prenatal Testing?

Fri, 26 May 2017 13:15:00 -0400

(image) As they develop, fetuses shed their DNA into the bloodstreams of pregnant women. Several companies now offer a blood test that can provide genetic information about a fetus nine weeks into a pregnancy, when it is the size of a grape. The process is called non-invasive prenatal testing (NIPT) because—unlike earlier tests, such as chorionic villus sampling or amniocentesis—cells are not taken directly from the placenta or the amniotic fluid surrounding the fetus.

NIPT is used to identify genetic abnormalities, such as those involved with Downs Syndrome and Klinefelter Syndrome. The test can also identify the sex of a fetus. Researchers are now working on ways to sequence entire fetal genomes, so in the future NIPT will be able to identify genetic variations, such as those that confer a greater risk for cancers and neurological diseases.

Whenever a new fetal test technology comes along, bioethicists always feel compelled to call for restrictions on women's access to information about their fetuses. Take the Nuffield Council on Bioethics, which in March issued a report called Non-invasive prenatal testing: ethical issues.

To its credit, the report states that women should be able to access testing for "significant" medical conditions or impairments in the fetus. But it also concludes that NIPT "should not be used to reveal information about a fetus relating to less significant medical conditions or impairments, adult onset conditions, carrier status, sex or other non-medical traits, and [that] whole genome or exome sequencing normally should not be offered. Any restrictions on access to information about the fetus would also need to apply to whole genome or exome sequencing, otherwise these restrictions could be by-passed."

Consequently, the council urged the British government to put a moratorium on whole genome NIPT. It also recommended that the government prohibit NIPT providers from telling women the sex of their fetuses. Why? Because it worried that women might then be tempted to have sex-selective abortions.

Unfortunately, attempts to limit what women are allowed to learn from advanced prenatal testing are not confined to Britain. In January, Rep. Trent Franks (R-Arizona) introduced the Prenatal Nondiscrimination Act, which aims to outlaw "discrimination against the unborn on the basis of race or sex." During a congressional hearing last year on an earlier version of the bill, Miriam Yeung of the National Asian Pacific American Women's Forum called that "duplicitous," because it frames itself as an "attempt to address racial and gender discrimination while actually intending to chip away at abortion rights."

For now the U.S. has no legal restrictions on what women can learn about their fetuses from genetic testing. Let's keep it that way.




The Tyranny of 'Reproductive Freedom'

Wed, 10 May 2017 00:01:00 -0400

President Trump says an executive order he signed last Thursday protects religious freedom, while his critics say it undermines reproductive freedom. If both freedoms are understood as rights that must be respected, someone has to be wrong here, and for once it isn't Trump. The executive order tells federal officials to "consider issuing amended regulations" addressing "conscience-based objections" to an Obamacare mandate requiring employers to provide health coverage that includes all FDA-approved contraceptives. For religious reasons, some employers do not want to be implicated in subsidizing, encouraging, facilitating, or condoning either contraception in general or the methods they view as tantamount to abortion. Because of such concerns, the Obama administration exempted churches and related organizations involved in exclusively religious activity from the contraceptive mandate. But any religious organization that offers social services or engages in other nonsectarian activities has to notify its insurer if it objects to the contraception requirement, at which point the insurer is supposed to provide the coverage independently, at no additional cost to the employer or employee. For groups such as Little Sisters of the Poor, a Roman Catholic order that runs homes for low-income elderly people, that workaround is unacceptable, because they believe the form they must send to insurers makes them complicit in sin. Trump's order is largely aimed at addressing that complaint. The order could also help religious business owners. In the 2014 case Burwell v. Hobby Lobby, the Supreme Court said the Religious Freedom Restoration Act requires the government to accommodate the objections of "closely held for-profit corporations" whose owners balk at the contraceptive mandate for religious reasons. What might these religious accommodations look like? Last year a unanimous Supreme Court suggested one likely possibility in response to the legal challenges brought by Little Sisters of the Poor and other faith-based organizations. Instead of forcing employers to express their religious objections in forms filed with their insurers or the government, the Court proposed, why not treat their purchase of health plans that do not include contraceptives as the signal for insurers to provide that coverage separately? The Court, while sending the cases back to the appeals courts for further consideration, said such an approach, which both the plaintiffs and the government agreed was feasible, "accommodates petitioners' religious exercise while at the same time ensuring that women covered by petitioners' health plans 'receive full and equal health coverage, including contraceptive coverage.'" If Trump's order results in a solution along these lines, it will have no perceptible impact on women's contraceptive coverage, even if it includes businesses as well as religious organizations. But you could be forgiven for thinking otherwise if you saw the alarmist statements issued by the order's critics. "President Trump's executive order discriminates against women and robs them of essential preventive care," claimed Nancy Northup, president of the Center for Reproductive Rights. "Without health coverage of contraception under the ACA, countless women will lose their basic right to prevent pregnancy and plan when they have children." Donna Lieberman, executive director of the New York Civil Liberties Union, warned that the executive order will "encourage employers to use religion as a pretext to deny women the care they need." Amanda Klasing, a researcher at Human Rights Watch, said "this order will take away many women's access to affordable family planning options." Such comments not only grossly exaggerate the practical consequences of accommodating religious objections to the contraceptive mandate. They [...]



The State Wanted to Treat Her Like a 'Handmaid.' She Fought Back

Wed, 03 May 2017 14:15:00 -0400

When Tamara Loertscher was a teenager, radiation treatment left her unable to produce thyroid hormones, subjecting her to depressive spells and fatigue when she wasn't on medication. The condition also made it difficult to impossible for her to become pregnant—or so she thought. But at age 29, Loertscher found herself facing a positive pregnancy test. The timing was bad, to put it mildly. Earlier that year—2014—Loertscher lost her job, leaving her unable to afford the thyroid medication. Depression kicked in, and then a methamphetamine habit. She began using meth two or three times a week to "help her get out of bed in the morning," as she put it. She also sometimes drank alcohol or smoked marijuana. After the first pregnancy test, in early July, Loertscher "cut back" on the drugs but didn't quit entirely, according to what she told hospital staff. Loertscher would later contend that she didn't believe the first pregnancy test was accurate. But when a second test, taken on July 30, showed the same result, Loertscher "believed for the first time that she might actually be pregnant." Two days later, she showed up at the Eau Claire, Wisconsin, Mayo Clinic Hospital in pursuit of an official pregnancy confirmation, thyroid medication, and "psychiatric care," according to court documents. She also wanted confirmation from a doctor that the baby would be OK despite her hypothyroidism and prior drug use. A urine test revealed that she was indeed pregnant—about 14 weeks—and also showed "unconfirmed positives" for marijuana and meth. Loertscher told the emergency room doctor that she wanted to stop the drugs, take care of herself, and have a healthy baby. She willingly signed herself into the Mayo Clinic Behavioral Health Unit that evening, and the next morning met with a psychiatrist, to whom she stressed that the drug use had been before she knew she was pregnant. The good news was that the fetus seemed fine, a Mayo obstetrician confirmed. Nonetheless, two days later, while Loertscher was still (voluntarily) hospitalized, a Mayo clinic social worker contacted local authorities to report that a pregnant woman had tested positive for drugs. What followed was a scene right out of The Handmaid's Tale, the 1985 Margaret Atwood novel turned 2017 Hulu series in which women are broadly discriminated against based on sex, with a certain subset relegated to a birther caste (the handmaids). In one scene from the new series, handmaid Ofglen (Alexis Bledel) is brought before a court on charges of being a "gender traitor," or lesbian—charges the state has already determined apply, and to which she can proffer no defense. As in the show, Loertscher was only summoned before government adjudicators once they had already decided she was guilty and knew how they planned to deal with it. Her request for legal representation was ignored, even while her fetus had been appointed its own attorney. Eventually Loertscher would wind up in solitary confinement, denied prenatal care, all in the name of protecting her unborn. But this tale has a happy ending: last week, the U.S. District Court for the Western District of Wisconsin sided with Loertscher. "Cocaine Moms" and Kangaroo Courts Loertscher's plight was enabled by Wisconsin's Unborn Child Protection Act, passed in 1997 in the midst of "cocaine mom" panic. An amendment to the state Children's Code, it stipulated that "unborn children" at any gestational age could qualify as a child in need of state protection if the "expectant mother's habitual lack of self-control in the use of alcohol beverages, controlled substances, or controlled substance analogs, exhibited to a severe degree, [poses] a substantial risk" of harm to the embryo or fetus. "Anti-abortion organizations used popular but scientifically disproven myths abo[...]



Why Is Planned Parenthood So Popular? Because Government Thwarts Alternatives

Tue, 21 Mar 2017 15:30:00 -0400

A provision in the Republican health care bill would bar Medicaid patients from choosing Planned Parenthood clinics for covered care. The idea, ostensibly, is to curtail abortion by driving Planned Parenthood out of business. Some folks also argue that the move is fiscally responsible. But contrary to conservative talking points, terminating Medicaid's relationship with Planned Parenthood would neither drive down costs for the publicly-funded health insurance program nor reduce dependence on abortion, as I note in today's Los Angeles Times. If, as Republicans insist, patients can seek all the same services elsewhere, Medicaid costs will remain unchanged. The move won't necessarily affect Planned Parenthood's ability to provide abortions, since it doesn't rely on Medicaid reimbursements for this service. At the same time, less access to contraception and family-planning services could lead to greater demand to terminate pregnancies. Presently, the U.S. health care scene is totally ill-equipped to handle the influx of low-income, reproductive- and sexual-health care patients we would see if we simply strip Planned Parenthood from patient options. America is already experiencing a shortage of obstetricians and gynecologists, many private providers won't see Medicaid patients, and community health centers are stretched thin as it is. Meanwhile, more than half of the approximately 2.8 million patients Planned Parenthood sees annually cover their visits via Medicaid. Like it or not, Planned Parenthood—which provides everything from cervical cancer screenings and urinary tract infection treatment to emergency contraception, prenatal care, and vasectomies—is currently a crucial part of the medical care and family-planning ecosystem. Want to reduce dependence on Planned Parenthood? Look at why it's so popular among Medicaid patients in the first place, what alternatives currently exist (not a lot), and how we can remedy this dearth of alternatives. In many cases, government rules are to blame. But simple changes—allowing birth control pills to be sold over-the-counter; clearing the regulatory way for telemedicine; rethinking scope-of-practice rules that prevent nurse practitioners, pharmacists, and midwives from performing tasks they're perfectly capable of; and repealing regulations that prevent non-traditional providers (like mobile or retail health care clinics) from setting up shop in medically underserved areas, for starters—could go a long way toward making it so Planned Parenthood isn't the only OB-GYN option for many. And as I argue in the Times, Helping bring more medical options to marginalized populations is a worthy goal for even the most ardent Planned Parenthood supporter. Whether one's underlying goal is ensuring access to vital reproductive and sexual healthcare, reducing women's need for abortions, or reducing publicly funded healthcare expenditures, focusing on breaking down barriers to innovative, independent and cost-effective care in underserved areas will make a world more difference than micromanaging where poor women can get birth control pills. Read the whole thing here.[...]



Tomi Lahren, Pro-Choice Conservative, Not 'Incoherent' on Abortion

Mon, 20 Mar 2017 12:30:00 -0400

Conservative starlet Tomi Lahren is facing a heap of backlash from her usual supporters after an appearance on ABC's The View in which she defended the decriminalized status of abortion. Lahren, who hosts a popular show (Tomi) for Glenn Beck network The Blaze and is a frequent guest on Fox News programs, said that as someone who "loves the Constitution" and believes in limited government she can't support the government "decid[ing] what women do with their bodies." "I'm pro-choice," Lahren admitted, calling it hypocritical to profess support for small government yet want to ban abortion. "I'm for limited government, so stay out of my guns, and you can stay out of my body as well." Contra Lahren's critics, this is a perfectly coherent position, and one that was once perfectly respectable within the mainstream conservative movement. There's only tension between believing abortion should be legal—which is all being "pro-choice" means—and the Constitution's prescription of "life, liberty, and property" protection for all if you believe that personhood begins at conception. But one needn't believe this, nor even be a Christian at all, in order to champion conservative political philosophy. And even if one does believe that abortion is an immoral practice, it doesn't necessarily follow that one must wish it banned completely. There are plenty of pro-life Americans who believe a blanket ban on abortion is not the best way to end the practice, given how black markets work. They instead strive to end abortion through changing hearts and minds, advocating better pregnancy-prevention methods, working to expand adoption options, and things like that. Again, this might seem horrific to people who believe that aborting an eight-week old fetus is the exact same as murdering a 2- or 20- or 80-year-old, but that's a matter of moral or religious perspective. Many others who believe abortion is wrong are simultaneously able to hold that it's not the same degree of wrong as ending a life outside the womb, or that the competing rights of pregnant women make abortion morally justifiable in some circumstances. Listen, I am not glorifying abortion. I don't personally advocate for it. I just don't think it's the government's place to dictate. https://t.co/qRjbAtJdo7 — Tomi Lahren (@TomiLahren) March 19, 2017 These are all positions that can convey coherent internal logic and political/moral belief systems. You may think folks like Lahren—who says she is personally against abortion, even though simultaneously pro-choice—are wrong, and that abortion is always the gravest of transgressions or never so, but it's erroneous and unfair to brush aside their beliefs as simple stupidity, hypocrisy, opportunism, or cowardice. It's exactly this kind of reflexive dismissal of differing beliefs and moral gray areas that keeps us locked in the stupidest kind of culture war over abortion, one that manifests in it being the most important litmus test for acceptance into political movements on the right and left and results in a host of high-profile, symbolic battles that all lead back to the same status quo. Anyway, a lot of conservatives have been calling for Lahren's head since her View appearance, insisting it's an embarrassment and an outrage that such a pro-choice harpy could be a public face of Republicanism. As with Milo Yiannopoulos—who said all sorts of horrible things about women, Muslims, transgender people, etc., but was only ousted from polite conservatism after joking about pedophilic priests—it's telling (if predictable) that tepidly pro-choice views are the dealbreaker for the right with Lahren, while things like calling Black Lives Matter activists "the new KKK," referring to the Middle East as a "sandbox" th[...]



Trump Brings Back Ban on Funds for Groups That Promote Abortion, While Congress Reconsiders Global Anti-Prostitution Pledge

Mon, 23 Jan 2017 15:00:00 -0500

On his first Monday in office, Donald Trump signed executive orders instituting a hiring freeze for all federal government positions outside the military and reinstating a ban on international aid going to nonprofits that provide abortions or promote information on them, regardless of what other services they offer. The contentious abortion rule represents a back and forth that's been taking place under Republican and Democratic administrations since the 1980s. Known as the "Mexico City Policy," it was instituted under President Ronald Reagan, reversed by Bill Clinton, restored by George W. Bush, and again reversed by Barack Obama. Not to be confused with the 1973 Helms Amendment, which bans groups from using U.S. government funds directly for abortion services abroad, the Mexico City Policy targets broader conduct, requiring that "as a condition of their receipt of federal funds," groups must agree to "neither perform nor actively promote abortion as a method of family planning in other nations." A diverse group of more than 100 public health, women's issues, and civil liberties organizations have already issued a statement opposing the return of the Mexico City Policy, which they refer to as "the global gag rule." "The global gag rule ... interferes with the doctor-patient relationship by restricting medical information healthcare providers may offer, limits free speech by prohibiting local citizens from participating in public policy debates, and impedes women's access to family planning by cutting off funding for many of the most experienced health care providers who chose to prioritize quality reproductive-health services and counseling over funding that restricts care and censors information," it says. Groups endorsing the statement include the American Civil Liberties Union, the American Congress of Obstetricians and Gynecologists, Amnesty International USA, the National Organization for Women, the Alliance to End Slavery & Trafficking, the Unitarian Universalist Women's Federation, the International Medical Corps, New York University's Global Justice Clinic,and Human Rights Campaign. The Mexico City Policy is one of several federal aid conditions that have been contingent on controversial social issues. Since 2003, the U.S. has banned groups that get grants to fight HIV/AIDs and/or human trafficking from supporting the decriminalization of prostitution. Referred to as the anti-prostitution pledge, the policy was proposed for anti-HIV groups as part of Bush's "Emergency Plan for AIDs Relief," passed by Congress in May 2003 as the "United States Leadership against HIV/AIDS, Tuberculosis, and Malaria Act." It stipulated that no grant money could be used "to promote or advocate the legalization or practice of prostitution or sex trafficking" nor to "provide assistance to any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking." The anti-prostitution pledge was also part of the bipartisan 2003 reauthorization of the Trafficking Victims Protection Act (TVPA), which stated that no federal money "may be used to promote, support, or advocate the legalization or practice of prostitution" and no funds "may be used to implement any program" by an organization that "has not stated in either a grant application, a grant agreement, or both, that it does not promote, support, or advocate the legalization or practice of prostitution." Many public-health and human-rights groups opposed these policies on the grounds that decriminalizing prostitution is often supported as a means to stop the spread of sexually-transmitted infections and sex trafficking by force, fraud, or coercion. The pledge was initially applied only to foreign nonp[...]



Less Than One-Third of Americans Want to See Roe v. Wade Overturned

Tue, 03 Jan 2017 09:30:00 -0500

(image) President-elect Donald Trump has promised to appoint Supreme Court justices who will overturn Roe v. Wade, the seminal 1973 case affirming a right to legal abortion across America. If it happens, it won't be a popular move. According to a new poll from the Pew Research Center, less than one-third of Americans think that Roe should be overturned.

In the Pew poll, conducted November 30 through December 5, 2016, just 28 percent of respondents said they hoped the historic ruling would be history, while 69 percent—including a majority of Republicans—said the Supreme Court should leave Roe alone. Among Democrats or Democratic-leaning respondents, 84 percent said they did not want to see Roe overturned, while 53 percent of Republican respondents agreed.

Among respondents who described themselves as "moderate" or "liberal" Republicans, only 27 percent supported overturning Roe, ccompared to 57 percent of those who described themselves as "conservative" Republicans.

"Public opinion about the 1973 case has held relatively steady in recent decades, though the share saying the decision should not be overturned is up slightly from four years ago," Pew notes. In January 2013, 63 percent said that Roe should not be overturned. In 2003, it was 62 percent and, in 1992, just 60 percent.

Republican opinion remains little-changed since 1992, when 52 percent of GOP respondents told Pew they support Roe v. Wade. At that time, just 66 percent of Democrats said the same.

Men were slightly more likely to support overturning Roe than were women (30 percent, versus 26 percent). And contra claims that America is getting less pro-choice, those age 50 or older were more likely than their younger counterparts to say Roe should go (33 percent, versus 24 percent).

Education was also associated with a divide on Roe, with 35 percent of respondents who had a high-school education or less saying it should be overturned but just 23 percent of those with a college degree and 12 percent of those with a post-graduate degree saying so. And while Catholic and Protestant support for overturning Roe was roughly equal—34 percent and 35 percent, respectively—nearly half of white, evangelical Protestants said they think Roe should be overturned.