(Washington, DC) – Nov. 13, 2014 – On October 31, 2014, Amazon.com, the world’s largest online retailer, abruptly and without explanation, halted sales of the most affordable brand of emergency contraception (EC), AfterPill. Amazon routinely sells hundreds of over-the-counter drugs, yet the company has frequently impeded online sales of AfterPill, despite its safety and over-the-counter (i.e., nonprescription) status. Though Amazon has consistently sold the brand name EC pill, Plan B One-Step, AfterPill’s lower cost may make it a preferable choice for customers (approximately $35.00 without shipping for Plan B One-Step compared to $25.00 without shipping for AfterPill).
Hoping to put pressure on the retailer, AfterPill went public with its struggle on November 11. AfterPill’s statement spurred reproductive health advocates to action, as groups and individuals blasted Amazon with emails, signed petitions, and took to social media to spread the word. Facing tremendous backlash for its decision, Amazon reinstated sales of AfterPill on November 13.
“Initially, women’s access to EC was blocked by politics, but these days, one of the largest barriers is cost. It is absolutely essential that competition among EC products be allowed to thrive in order to create market pressures to reduce the price of EC and make it affordable for women of all income levels,” said Jessica Arons, President and CEO of the Reproductive Health Technologies Project (RHTP). Arons also praised the quick work of the reproductive health community: “Amazon’s decision to restock AfterPill is a victory and a testament to what can be accomplished when advocates mobilize.”
Because EC’s efficacy depends on how soon it is taken after a contraceptive failure or unprotected sex, it is crucial that women have unobstructed access to EC. Online sales of EC are especially important given that online shopping is increasingly popular and provides greater privacy and that customers in rural or low-income communities may have limited access to EC at brick-and-mortar pharmacies.
For more information about EC, please visit RHTP’s website.
[From Jessica Mason Pieklo, Senior Legal Analyst, RH Reality Check, at RH Reality Check.]
The trial over a Wisconsin law that requires abortion providers to obtain admitting privileges at a nearby hospital or face prosecution came to a close last week, with federal District Court Judge William Conley expressing both frustration at the law and the inability of those challenging it to explain why area hospitals were not responding to admitting privileges requests.
Like admitting privileges requirements passed in states like Texas, Alabama, North Dakota, Mississippi, and Louisiana, supporters of the requirement in SB 206, which has been on hold since July, insist the law is necessary to protect patient safety.In support of that claim attorneys for the state offered the testimony of Lena Wood, an Oshkosh woman who claimed she was hospitalized after becoming ill following an abortion nearly 20 years ago and that her provider never followed up with her. Wood, an anti-choice activist, admitted under cross-examination that she did not understand her medical records, and there were no facts to back up her assertion that it was the abortion that had caused her hospitalization.
The state’s second witness in support of the law was James Linn, an obstetrician and gynecologist at Columbia St. Mary’s and advisor to Wisconsin Right to Life, the main group supporting the law. During his testimony, Linn said he hoped Affiliated Medical Services in Milwaukee—one the providers challenging the law—would close so that fewer legal abortions would be performed in the state. The clinic, the only one in the state that performs abortions beyond 19 weeks, faces closure under the law because its doctors have so far been unable to obtain the required admitting privileges. Judge Conley said he was “bewildered” by the fact that local hospitals had not yet stated whether they would grant privileges to Affiliated Medical Services providers and ordered the parties to continue to pursue privileges, indicating he would order the hospital to respond if they continued to evade the request. One of those providers, Dr. Dennis Christensen, testified he had been pursuing admitting privileges at two Milwaukee hospitals for months but had not had any response from the hospitals. Christensen testified he believed the lack of response from the hospitals is connected to the hospital credentialing officials’ demand for information on patients he has treated in a hospital. Christensen testified he has no such data to provide in response to their demand because he hasn’t treated an abortion patient in a hospital for at least a decade.
“The fact that we’ve managed to keep our patients out of the hospital appears to be a detriment to getting hospital privileges,” he said.
A ruling on whether or not the law will go into effect is not expected from Judge Conley for at least a month, and in the meantime he ordered the parties to continue to pursue obtaining hospital privileges. Should providers be able to obtain those privileges, it could resolve, at least temporarily, the legal challenge. That was the case in North Dakota, where the state’s only abortion clinic faced closure under the state’s admitting privileges requirement. But just as a trial over the constitutionality of North Dakota’s law was about to begin, Sanford Health, a Dakotas-based health-care system, granted admitting privileges to the providers, prompting attorneys for the state and those challenging the law to reach a settlement and end the legal challenge. At the close of last week’s trial, Judge Conley suggested a similar possibility for Wisconsin, noting he was troubled by the inflexibility of the law.
“I’m being asked to strike down a law,” said Conley. “I take no pleasure in that. If there’s a way to get privileges short of that you should do that.”
The stately Lady Justice sits beneath the Supreme Court inscription: “EQUAL JUSTICE UNDER LAW.”
Advocates at the national family planning conference visited our elected officials this week. As I passed Lady Justice, I thought about the pending case on contraceptive insurance coverage under the Affordable Care Act (ACA). Much of the public is weary of this seeming tedious and endless debate on women’s health and women’s rights. But if the court’s motto is not to become an epitaph for equality for women, individual constitutional rights in these most intimate and personal decisions must be upheld.
Several private for-profit corporations argue that bosses opposed to birth control methods for personal religious reasons, should be permitted to deny all contraceptive coverage to their employees.
“Equal justice under law” promises that each person before the court will have impartial and evidence-based judgment. The scales of justice declare that evidence will be weighed.
First the court must decide whether a for-profit corporation is even able to exercise religious liberty. An employee can claim religious rights, but it seems overreach to say that corporations with no religious purpose are able to deny equality of health care access to their employees to impose the religious beliefs of their owners.
Even if the court determines that for-profit corporations are able to exercise religious liberty rights, then it must say whether the requirement of the ACA is asubstantial burden. Actuarial studies have shown that the cost of providing contraceptive coverage is less than $2.00 per employee per month. With many exceptions and alternatives available for providing contraceptive coverage, the cost of the benefit is not substantial.
The burden, even if substantial, can nonetheless be justified. In this situation, the compelling argument is that preventing unintended pregnancies and their outcomes, including impacts on women’s health, children in poverty and even abortions, represent a national public health goal. These very corporations benefit from women participating fully in the work force including by reducing the substitution, replacement and productivity costs of family medical leave.
Contraceptive care is primarily used by women and has been shown to advance equality of opportunity – a national goal. Enabling a few employers to deny health care that others are guaranteed is contrary to foundational American separation of church and state.
Contraceptives prevent pregnancy. Some corporate owners may believe that contraception is equivalent to abortion, but under accepted medical, legal, and scientific standards it is not. Almost everyone understands that a woman cannot have an abortion prior to pregnancy. An employee whose employer offers health insurance cannot simply go to the ACA marketplace and get coverage. If the employer denies contraceptive coverage, the employee may not be able to afford themost effective or medically necessary method.
Regardless of what the court decides, family planning clinics in Wisconsin and throughout the country will continue to provide all approved methods of birth control confidentially to men and women. Insured or uninsured, rich or poor, in the face of persistent political and legal attacks, family planning programs will support equal justice and equal access under law.
On Tuesday, March 25, the Supreme Court will hear oral arguments for a case that would give bosses the right to deny their employees contraceptive coverage just because they oppose it.
With your help RWV fought hard to ensure women get contraceptive coverage with no cost sharing as part of the new health care law! Every major media outlet will be there, and we want reporters to see firsthand that the majority of voices outside the court don’t want bosses trying to impose their personal views on their employees.
Our coalition is organizing a banner to display outside of the Supreme Court to make sure our voices are heard. It will only make a strong statement to the media and the public if it’s signed by a lot of people. We are setting a goal of 200,000 names, and that means we need you to add your name.
PLEASE SIGN HERE.
The No Suprises Story outside Womankind Crisis Pregnancy Center in Appleton.
“Have Emergency Contraception (EC) BEFORE you need it,” is the message that the Family Planning Health Services (FPHS) “No Surprises Stork” is delivering to Wausau and throughout Wisconsin today. According to Lon Newman, FPHS executive director, the No Surprises Stork takes off from the Hope Crisis Pregnancy Center (CPC) in Wausau this morning and visits four other CPCs around the state. Newman says the stork is delivering two serious Valentine’s Day messages in a light hearted way:
- Worry less on Valentine’s Day by having EC on hand; and,
- Accurate information and access to emergency contraception prevents unwanted pregnancies.
Director of Reproductive Health Operations, Michele Paoli, RN, explained that every contraceptive method has a failure rate, and women of reproductive age should have emergency contraception on hand as a back-up method. “Plan B™ or Levonogestrel 1.5 is more effective the sooner it is taken after a method failure,” she said. “Most women experience method failures — they forget to take their pill or a condom breaks, or they miss a birth control appointment. Having EC on hand in-advance-of-need helps women take it sooner, when it is more effective, rather than later.”
Lon Newman explained why the stork is making appearances in front of Crisis Pregnancy Centers: “Many people don’t know that CPCs provide inaccurate and even deceptive information about emergency contraception to women. We want to express that the best approach to crisis pregnancies is to prevent them. The best way to prevent abortions is to prevent unwanted pregnancies. The best way to help women is to give them accurate information and access to health care so they are empowered to make informed decisions for themselves and their families.” Newman said this point of view is in stark contrast to the CPC’s approach of using misinformation to persuade women not to use contraception or not to have abortions. “By giving women inaccurate information, Crisis Pregnancy Centers may even increase unwanted pregnancies and abortions.”
“Young people are confused right now,” FPHS EC coordinator, Frances Irwin said, “about access to birth control and STD testing and treatment.” She said that confidential low-cost family planning services are available at clinics throughout Wisconsin. “Insured or uninsured — 90% of our patients have no out-of-pocket expenses.” she said. “Young men and women want to protect the right to confidential sexual health care, and family planning clinics are here to insure that our communities are able to prevent unintended pregnancies and sexually-transmitted infections. These are public health priorities.”
Paoli said that FPHS is expanding its Emergency Contraception services to offer on-line internet sales of Levonogestrel 1.5 and Plan B™ at www.EZEC.org. The agency offers web-based sales to help women have EC on hand before they need it because it is more effective if taken sooner after method failure or unprotected intercourse.
Newman explained that FPHS is putting out this “Plan ahead for Valentine’s Day message” so people are able to prevent unintended pregnancies and sexually transmitted infections “whether they are in rural areas, or urban underserved communities.”
The No Surprises Stork at the Crisis Pregnancy Center in Stevens Point, WI.
IN RESPONSE TO THIS ARTICLE.
Statement from HRA Pharma – Levonorgestrel EC label change
The effect of a women’s weight on levonorgestrel efficacy was first identified in 2011 during the development of an alternative emergency contraceptive product in the context of a clinical trial. As a result, HRA Pharma performed further analyses in 2012, which enabled it to put together a safety variation which was presented to European regulatory authorities at the start of 2013. By sharing the data in this manner, it demonstrates a clear obligation by the company to be transparent with the healthcare community and provide regulators with the most up-to-date information to inform women.
European authorities involved in the process decided to include the following statement in the levonorgestrel labeling: ?”In clinical trials, contraceptive efficacy was reduced in women weighing 75 kg or more and levonorgestrel was not effective in women who weighed more than 80 kg.”
HRA Pharma does not market levonorgestrel in the US, and is thus not involved in any process of label change for levonorgestrel in the US.
HRA Pharma recommends that women affected by the change in labeling be advised to discuss alternative emergency contraceptive options (IUD or alternative oral EC) with their doctor or pharmacist.
Chief Executive Officer
Women’s Equality Day is no time for a nostalgic look at past achievements. When Elizabeth Cady Stanton and Lucretia Mott linked arms in the streets of London at the 1840 World Anti-Slavery Convention, they bound themselves to an ongoing struggle: the march for recognition that women, as well as slaves, deserved full human rights with equality of social and economic participation.
American women at the Anti-Slavery Convention, separated from full participation in the conference by a strategically placed curtain, forged an alliance and planned a movement to win human rights for women. At the first women’s rights convention in American history in 1848 in Seneca Falls, New York, the gathering adopted Stanton’s “Declaration of Sensibilities,” establishing goals for the movement that won women the right to vote – including former slave women — 72 years later. In 1971, fifty one years after the right to vote victory, Congresswoman Bella Abzug (D-NY) led the way to passage of a law commemorating the civil rights struggle of women and declaring August 26th “Women’s Equality Day.”
Stanton, Mott, and Abzug never did and never would rest on battles already won. Although it is a day for reflection and recognition of heroines who led the way, it is most importantly a day for recommitment and continuing resolve to achieve full equality and participation.
On this day, let us think about our victories: the right to vote, equal property protections, the right to privacy in reproductive health, equality of employment opportunity, federal protections against sexual harassment in the workplace, federally protected access to safe abortion services, equality of opportunity in education, strong legal and service programs against domestic violence and sexual assault, and insurance coverage for women’s preventive care.
Let us also commit to the struggles confronting us. It might seem lately that on the long march to equality, we have been pushed back. On this Women’s Equality Day, it is especially important to remember that the road is long, the march goes on, and our American journey toward full participation continues.
Retrogression appears most consequential where it is most controversial–in reproductive rights and reproductive justice. Many states, including Wisconsin, have passed laws depriving women of access to preventive care and even mandating unjustified medical procedures to block access to safe and legal abortions. To achieve equality, every woman must be free from reproductive coercion, must have access to high quality health care and information, and must have the fundamental freedoms of self-determination as a human right.
Celebrate Women’s Equality Day, remembering the common roots of human rights begun 173 years ago with two women linking arms against slavery, fully aware that the march to equality for women, including the right to freedom from reproductive coercion, goes on. Today we can sing with activists like Sandra Fluke and Wendy Davis the civil rights refrain: “Ain’t gonna let nobody turn me around.”