“State Sanctioned Rape”: When States Abuse Women
Here’s what a woman in Texas now faces if she seeks an abortion.
Under a new law that took effect three weeks ago with the strong backing of Gov. Rick Perry, she first must typically endure an ultrasound probe inserted into her vagina. Then she listens to the audio thumping of the fetal heartbeat and watches the fetus on an ultrasound screen.
She must listen to a doctor explain the body parts and internal organs of the fetus as they’re shown on the monitor. She signs a document saying that she understands all this, and it is placed in her medical files. Finally, she goes home and must wait 24 hours before returning to get the abortion.
“It’s state-sanctioned abuse,” said Dr. Curtis Boyd, a Texas physician who provides abortions. “It borders on a definition of rape. Many states describe rape as putting any object into an orifice against a person’s will. Well, that’s what this is. A woman is coerced to do this, just as I’m coerced.”
“The state of Texas is waging war on women and their families,” Dr. Boyd added. “The new law is demeaning and disrespectful to the women of Texas, and insulting to the doctors and nurses who care for them.”
That law is part of a war over women’s health being fought around the country — and in much of the country, women are losing. State by state, legislatures are creating new obstacles to abortions and are treating women in ways that are patronizing and humiliating.
Twenty states now require abortion providers to conduct ultrasounds first in some situations, according to the Guttmacher Institute, a research organization. The new Texas law is the most extreme to take effect so far, but similar laws have been passed in North Carolina and Oklahoma and are on hold pending legal battles.
Alabama, Kentucky, Rhode Island and Mississippi are also considering Texas-style legislation bordering on state-sanctioned rape. And what else do you call it when states mandate invasive probes in women’s bodies?
“If you look up the term rape, that’s what it is: the penetration of the vagina without the woman’s consent,” said Linda Coleman, an Alabama state senator who is fighting the proposal in her state. “As a woman, I am livid and outraged.”
States put in place a record number of new restrictions on abortions last year, Guttmacher says. It counts 92 new curbs in 24 states.
“It was a debacle,” Elizabeth Nash, who manages state issues for Guttmacher, told me. “It’s been awful. Last year was unbelievable. We’ve never seen anything like it.”
Yes, there have been a few victories for women. The notorious Virginia proposal that would have required vaginal ultrasounds before an abortion was modified to require only abdominal ultrasounds.
Yet over all, the pattern has been retrograde: humiliating obstacles to abortions, cuts in family-planning programs, and limits on comprehensive sex education in schools.
If Texas legislators wanted to reduce abortions, the obvious approach would be to reduce unwanted pregnancies. The small proportion of women and girls who aren’t using contraceptives account for half of all abortions in America, according to Guttmacher. Yet Texas has some of the weakest sex-education programs in the nation, and last year it cut spending for family planning by 66 percent.
The new Texas law was passed last year but was held up because of a lawsuit by the Center for Reproductive Rights. In a scathing opinion, Judge Sam Sparks of Federal District Court described the law as “an attempt by the Texas legislature to discourage women from exercising their constitutional rights.” In the end, the courts upheld the law, and it took effect last month.
It requires abortion providers to give women a list of crisis pregnancy centers where, in theory, they can get unbiased counseling and in some cases ultrasounds. In fact, these centers are often set up to ensnare pregnant women and shame them or hound them if they are considering abortions.
“They are traps for women, set up by the state of Texas,” Dr. Boyd said.
The law then requires the physician to go over a politicized list of so-called dangers of abortion, like “the risks of infection and hemorrhage” and “the possibility of increased risk of breast cancer.” Then there is the mandated ultrasound, which in the first trimester normally means a vaginal ultrasound. Doctors sometimes seek vaginal ultrasounds before an abortion, with the patient’s consent, but it’s different when the state forces women to undergo the procedure.
The best formulation on this topic was Bill Clinton’s, that abortion should be “safe, legal and rare.” Achieving that isn’t easy, and there is no silver bullet to reduce unwanted pregnancies. But family planning and comprehensive sex education are a surer path than demeaning vulnerable women with state-sanctioned abuse and humiliation.
By: Nicholas Kristoff, Op-Ed Columnist, The New York Times, March 3, 2012
The Republican “War Against Women”: Pre-Abortion Transvaginal Sonograms Make Their Way Into Law
As a bill requiring transvaginal sonograms passes in Virginia, Texas goes about implementing the version that it passed last year.
The Virginia Legislature has been busy passing legislation to limit abortion and promote pro-life agendas. I wrote Tuesday how the state House passed a bill changing the legal definition of “person” to include fetuses starting at conception. But the body also passed a measure requiring women seeking an abortion to first have a sonogram 24 hours ahead of time. The state Senate already passed an identical measure and the state governor has said that he supports the initiative—which means it will almost definitely become law.
The measure requires a medical professional to administer the sonogram and then offer the woman the chance to hear the fetal heartbeat and listen to a description of the fetus. Because abortions occur early in pregnancies, these ultrasounds aren’t the ones most people imagine with a bit of jelly smeared on a woman’s stomach. No, these require a more invasive procedure: a transvaginal sonogram. A probe—with a lubricated condom covering it—is inserted into a woman’s vagina. The probe is attached to a monitor to show images in real time. While the bill allows woman to say they don’t want to see the images, in many cases, the monitor will generally be showing the images right next to her.
Not surprisingly, the debate got fairly brutal. One Republican delegate said most women seeking abortions do so for “lifestyle convenience.” In a statement later, he said he regretted the choice of words. Ultimately the bill passed the House by a vote 62 to 36, with six Republicans voting no.
As I wrote earlier, the personhood measure raises many questions regarding implementation, since Virginia would be the first state to successfully pass such a law. But such is not the case with the sonogram bill. Oklahoma and North Carolina have passed similar laws that are currently winding their way through the court system. And Texas’ measure is already in place, both in law and in clinics across the state.
Texas began enforcing its version of the sonogram requirement last week, after the 5th U.S. Circuit Court of Appeals overturned a temporary ban and issued an opinion that the law is constitutional. While a lawsuit against the law makes its way through the courts, clinics are already reporting logistical difficulties. The measure requires a 24 hour waiting period between the sonogram and the abortion procedure, a requirement which was also included in the Virginia bill, which forces women to arrange for two days of medical appointments. (Both states allow women who must travel a significant distance to have the sonogram only two hours ahead.) However, in Texas, the doctor performing the abortion must also be the one to perform the sonogram. That requirement has produced many problems for clinics, as sonograms are often performed by other medical professionals. Virginia’s measure has no such requirement. Similarly, Texas law requires that women hear a description of the sonogram procedure, whether or not they want to, a caveat that isn’t in Virginia’s law.
Don’t think that makes Virginia’s law less stringent though: unlike Texas, the bill offers no exemption for victims of rape or incest, who would also have to have the transvaginal sonogram and then be asked if they want to hear descriptions of the fetus and listen to the fetal heartbeat. It will also mean victims of rape will be forced to have a probe inserted into their vagina. Only in cases of medical emergencies can the requirement be waived.
By: Abby Rapoport, The American Prospect, February 16, 2012
A Progressive Defense Of The White House On Plan B
I get the reasons for liberal outrage at the Obama administration’s Plan B decision. But I can’t quite join in the indignation. I know that I am a man—a fact I’ve been aware of for some time—and so readers male and female can factor that in here as they wish. But it seems to me that to call this merely a case of politics cynically trumping science is way too dismissive of some concerns that parents with all kinds of political views might have about their teenage daughters buying this pill without their knowledge.
Much of the opposition to allowing underage girls to buy the pill over the counter amounts to straw-man arguments. There’s the line that taking the pill amounts to abortion. Watch this lurid ad by a right-to-life group and think about what sort of cacophony must be raging inside the mind that could even come up with such an egregious thing. Outside the realm of anti-abortion fanaticism, I don’t think most of us would equate the prevention of a pregnancy with the removal of an existing fetus. It’s called “emergency contraception” because it’s contraception, not abortion.
There’s also an argument about harmful effects on young girls of the pill’s heightened progesterone levels. I am far from being an expert on such matters, but unanimous view of the scientific community appears to be that the pill is safe for all females of child-bearing age, and that’s good enough for me.
Those are ideological issues, and ones that can be dismissed easily. But it seems to me that there is a fair issue here, and it has to do with parents having a right to know about and be involved in what their kids are up to. You simply don’t have to be a right-winger to have concerns about your 14- or 15-year-old daughter having easy access to such a pill.
That is not a political question per se. A parent’s view on that matter will be partially informed by politics, but only partially (and in some cases not at all, since lots of people have no political views to speak of). Parents’ opinions on this will be informed most of all by the parent-child relationship; by the parents’ views about sexuality and morality; by the parents’ feelings about their authority vis-a-vis their child’s autonomy. These areas might have a lot to do with a parent’s political views, but they might not. We all know people who are politically conservative but sexually libertine, or politically liberal and as chaste as Mother Teresa.
In other words, this is less about appeasing the right than acknowledging reality in all its complications out there in the country, where many people probably have mixed feelings. I’d be fascinated to see some polling on this, and I expect we will soon.
In an ideal world, parents would rationally support the idea of their daughters having every means available to them to correct an error (or, obviously, to override a violation) that happened a day or two prior. But parents don’t always think rationally about these things. That makes these issues sensitive by definition, and it’s hardly illegitimate for a government to take such matters into consideration. I’d have had more respect for Kathleen Sibelius in this situation if, instead of that blather about 11-year-old girls not being able to follow instructions and take the pill properly, she’d just said: “Look, I respect the science, but this raises ethical and moral questions about what is the proper age for access to emergency contraception, in addition to the scientific ones. And that’s a public debate we ought to have more of before we pull this trigger.”
Such pills are generally available in other advanced countries, but there are some limits. In England, you have to be at least 16 to buy them. In Finland, 15. In Quebec, you have to consult a pharmacist. In Italy, it requires a doctor’s prescription.
So advanced societies haven’t yet made an across-the-board decision that all girls from 11 up should be able to buy this pill, and the United States always lags behind in these things, for all the reasons we know.
I wouldn’t doubt that the administration feared the development of a narrative here. Newt Gingrich in particular is very adept at that sort of thing: This election, he’d have announced with his usual fanfare, is a contest between traditional values and 13-year-old girls having no-consequences sex. It’s hard to know the extent to which that would have taken off.
But I doubt this was just politics. It was only in August that this same “anti-woman” administration issued new standards requiring insurance companies to cover all government-approved contraceptives for women, without co-payments or other fees. That will take effect, under the new health-care law, in January 2013 and should go a long way toward lowering the cost barriers to birth-control services for insured women. If the administration so lives in fear of political fallout from the cultural right, then why did it do that?
So maybe there was something more going on here. Maybe we should have a longer debate about the appropriate age at which this pill should become available. And maybe the right answer, an answer that much, but not all, of the advanced world has agreed on, is that there shouldn’t be a limit. The science says it’s safe, and it will undoubtedly prevent unwanted pregnancies—and, in an irony that the anti-abortionists never grasp, it will prevent abortions, too. But it’s now the job of advocates to make the culture catch up to the science.
By: Michael Tomasky, The Daily Beast, December 9, 2011
Restrictions On Birth Control Hurt Everyone
Restricting women’s access to birth control hurts everyone. It hurts women by limiting their ability to get an education or become self-sufficient, and risks their health when they can’t plan or space their pregnancies. It hurts children born into families not ready or able to care for them. And it hurts families by robbing them of the ability to decide whether and when to have a child.
That is why independent physicians, nurses, and other health professionals agree that providing access to contraception is good medical and economic policy. And yet – surprisingly – birth control is under attack. Anti-women groups, and some members of Congress, are pressuring the Administration to roll back some of provisions of the Affordable Care Act (ACA). The ACA guarantees access to important preventive health services without expensive co-pays. This includes contraception for women. But if anti-women forces get their way, thousands of employers will be allowed to refuse to cover contraceptives in their employer-sponsored health plans. These forces are attempting to directly interfere with the individual health needs of millions of women by limiting the type of care they can get.
A woman already knows how important family planning is to her health and well-being. She knows that the decision of whether and when to have a child is extremely personal, and she makes that decision based on many factors, including: her age, the presence of a partner, the size of her family, her physical and mental health, and her personal values.
A woman knows that if she has a chronic disease, pregnancy prevention is critical in reducing poor birth outcomes. She knows, for example, that she risks her health and the health of her fetus if she has diabetes and becomes pregnant before getting her glucose levels under control. She knows that if her blood pressure is uncontrolled during pregnancy, she could develop Pre-Eclampsia, a condition that can require immediate delivery even if the fetus is not full-term. And she knows that if she becomes pregnant while taking any number of commonly prescribed medications contra-indicated for pregnancy, fetal development may be impaired.
That’s why women overwhelmingly support birth control. Indeed, contraceptive use is nearly universal: 99 percent of women 15-44 years of age who have ever had sexual intercourse with a male have used at least one contraceptive method. The overwhelming majority of sexually active women of all religious denominations who do not want to become pregnant are using a contraceptive method.
Refusal clauses fly in the face of women’s needs, scientific evidence, and medical standards of care. Refusal clauses undermine and ignore the personalized decisions that all people make about their health.
The Administration should respect the decisions of women and their families, and hold firm on its commitment to improve the health of all Americans by basing its health care decisions on science and medical practice – not politics.
By: Emily Spitzer, National Health Law Program, The Hill Congress Blog, November 24, 2011
New Health Insurance Rules Would Let Consumers Compare Plans In “Plain English”
What would your health insurance cover if you got pregnant? How much could you expect to pay out of pocket if you needed treatment for diabetes? How do your plan’s benefits compare with another company’s?
Starting as soon as March, consumers could have a better handle on such questions, under new rules aimed at decoding the fine print of health insurance plans.
Regulations proposed by the Obama administration on Wednesday would require all private health insurance plans to provide current and prospective customers a brief, standardized summary of policy costs and benefits.
To make it easier for consumers to make apples-to-apples comparisons between plans, the summary will also include a breakdown estimating the expenses covered under three common scenarios: having a baby, treating breast cancer and managing diabetes.
Officials likened the new summary to the “Nutrition Facts” label required for packaged foods.
“If you’ve ever had trouble understanding your choices for health insurance coverage . . . this is for you,” Donald Berwick, a top official at the Department of Health and Human Services, said at a news conference announcing the proposal.
“Instead of trying to decipher dozens of pages of dense text to just guess how a plan will cover your care, now it will be clearly stated in plain English. . . . If an insurer’s plan offers subpar coverage in some area, they won’t be able to hide that in dozens of pages of text. They have to come right out and say it.”
Industry representatives said complying could prove onerous for insurers. “Since most large employers customize the benefit packages they provide to their employees, some health plans could be required to create tens of thousands of different versions of this new document — which would add administrative costs without meaningfully helping employees,” Robert Zirkelbach, press secretary for the industry group America’s Health Insurance Plans, said in a statement.
Insurance shoppers would also have to keep in mind that their actual premiums could change after they finalized their application, particularly in the case of plans for individuals, which can continue to adjust benefits based on detailed analysis of members’ health history over the next three years. (After 2014, the health-care law will essentially limit insurers to considering only three questions about applicants: how old they are, where they live and whether they smoke.)
The regulation, which is subject to a 60-day public-comment period, essentially fleshes out details of a mandate established by the the health-care law. But it also clarifies a question that the law left somewhat ambiguous: How soon into the application process can shoppers get the summary from insurers?
The regulations would require insurers to provide the summary on request, rather than waiting until someone applies for a policy or pays an application fee, a position that drew praise from consumer advocates.
“If consumers are really going to be able to compare their options, they should be able to easily get this form for any plan that they would like to consider,” said Lynn Quincy, senior health policy analyst for Consumers Union, the nonprofit publisher of Consumer Reports.
In addition to supplying the summary on demand, insurers would have to automatically provide it before a consumer’s enrollment, as well as 30 days before renewal of their health coverage. Plans must also notify members of any significant changes to their terms of coverage at least 60 days before the alterations take effect.
The summary form, which can be sent by e-mail, must be no longer than four double-sided pages printed in 12-point type. In addition to listing a plan’s overall premiums, co-pays and co-insurance amounts, it must include charts specifying the out-of-pocket costs for a range of specific services. A copy can be viewed at www.healthcare.gov/news/factsheets/labels08172011b.pdf.
By: N. C. Aizenman, The Washington Post, August 17, 2011
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