So, Laura and Steve Karlen who run VFL, issued the following description of the young woman with direction to call if she were spotted:

Have you seen the pregnant mom? The young pregnant woman, probably in her 20?s, had a darker complexion with dyed red hair and tattoos on her neck and right shoulder. She also had some facial piercings. The woman looked obviously pregnant. We pray that she will never decide to come back to Planned Parenthood. Please let us know immediately if you have seen a woman with this description.

Lisa Subek of NARAL Pro-Choice Wisconsin had the opportunity to share this email with Madison Police Chief, Nobel Wray.  Subek said in an email, “According to [Wray], it is legal to send such an email but could be considered harassment if the individual who is the subject of the email told the so-called “sidewalk counselors” she didn’t want further contact from them. She could have filed a complaint regarding the email.”

So, does this mean one must opt out of harassment by radical anti-choice zealots?  That we must be clear with those “sidewalk counselors” that scream at us as we enter a woman’s health clinic that we don’t want them to stalk us?

Subek said Wray did understand the concern of such an email, but continued, “I’m not surprised by this answer, but it certainly makes me think about our legal definition of harassment and how we do not do enough to prevent it or to protect victims.”

Wisconsin code defines harassment in the following way:

Striking, shoving, kicking or otherwise subjecting another person to physical contact; engaging in an act that would constitute abuse under s. 48.02 (1), sexual assault under s. 940.225, or stalking under s. 940.32; or attempting or threatening to do the same. (b) Engaging in a course of conduct or repeatedly committing acts which harass or intimidate another person and which serve no legitimate purpose.

Vigil for Life certainly has the ‘no legitimate purpose’ part nailed.

According to Wisconsin state filings, VFL was incorporated in 2009.  They are currently delinquent filing a state required annual report.  VFL’s website, the Karlens’ began “coordinating” Vigil for Life after the 2009 40 Days for Life campaign.

Vigil for Life protests in front of Madison clinics Monday through Friday.   They are also affiliated with Pro Life Wisconsin and boast such followers as Ralph Lang, the man who was planning an attack on Planned Parenthood to, “lay out abortionists because they are killing babies.”  Lang attended several of VFL’s “vigils.”

Pro Life Wisconsin is currently pushing a personhood amendment in the state.   Green Bay State Representative, Andre Jacque introduced Joint Resolution 77 on November 16.

This is on the heels of Mississippi’s failed personhood amendment and is among scores of new personhood legislation being introduced throughout the country.  In order for any amendment to be added to the ballot, it must pass two consecutive sessions of congress.  So, even if the personhood amendment passed the legislature in 2012, it must then pass in 2013 to make the ballot for the following statewide Wisconsin election in 2014.

Emails to Vigil for Life and a call to Mrs. Karlen weren’t returned.

I also directly contacted the Madison PD – the district which from what I could tell is near the Planned Parenthood and Vigil For Life CPC.  Here is the email response I got:

Andy – I am unfamiliar with the email to which you are referring. Please send it to me at this address, and we will take a look.

Cameron S. McLay, Captain of Police

North Police District Commander

City of Madison Police Department

(608)245-3652

Concealed in the jargon of the 144-page bill is an equally serious issue—a threat to silence public voice on Medicaid and Medicare coverage issues by deferring all policy decisions regarding Medicare into hands of a legislative committee’s co-chairs and the Governor—without public debate.

In Wisconsin, family planning services—including access to birth control—fall under the Medicare umbrella. I and many of my female friends use birth control and I am willing to boldly make the generalization that relying on men for birth control does not result in a 100% success rate. Like many of my female friends, I also must rely on a subsidy to help alleviate the cost of birth control.

Governor Walker proposes to take the fate of Medicaid and my access to birth control into his hands and the hands of his committee co-chairs without any public input. Three people could be deciding the future of access to family planning for the sixty-five thousand participants who rely on the program now.

Governor Walker is not only proposing to take our voices away, he is proposing to take away the control we have over our bodies too.

Eliminating the subsidy that countless numbers of women receive for birth control will prevent women from using many birth control methods. The Guttmacher Institute, a non-profit which focuses on advancing sexual as well as reproductive health, published a brief on family planning which states that “Women who had an unmet need for effective contraception account for 82% of all unintended pregnancies”. The result of having access to birth control cut off will be more unplanned pregnancies as many women would be unwilling to restructure their sex lives. Whether these pregnancies are carried to term or terminated, the costs are high. The average costs of carrying a child to term ($5,791) are much higher than the average annual cost of supplying birth control (approximately $200). Cutting the family planning services to Wisconsin women and men is fiscally irresponsible and would add to the deficit that Governor Walker is purporting to lower with his budget “repair” bill.

Changing the legislative administrative rule process by implementing undemocratic transactions is a gross overreach of power that could let three out-of-touch old legislators mute my voice and take away the health care that empowers me to advance my education and make responsible choices. That is unacceptable. Attacks on women’s reproductive rights in Washington, D.C.—and across the United States—are increasing in number and intensity. Now Governor Walker proposes to silence the voices of women and their representatives in the “debate”.

I urge women across Wisconsin to make their voices heard now in any and every way possible. Write letters to the editor of your local newspapers. Use social networks—Facebook and Twitter. Call your legislators. Protect your right to speak and protect your right to control your body. Just like I am not willing to rely on men for my birth control, I am not willing to rely on Governor Walker and the chairs of the joint legislative committee to control family planning decisions for women across Wisconsin.

Kirsten Crowhurst, Student at UW-Madison

“What are they doing out there?” is the question I am most often asked about the picketers standing in front of our family planning clinic.

What they are doing by holding signs that say “The Pill Kills” and “Stop Chemical Abortion,” is misinforming and misleading the public. They give the misimpression that we provide abortion services; or drugs that terminate a pregnancy; or that using hormonal birth control is a deadlier health risk than unplanned pregnancy.

Sometimes, what they are doing is intimidating our clients – especially the young women and children coming for WIC services. The most dangerous picketers have physically blocked entrances and exits and pushed literature at people walking past or driving through.

But “What are they doing out there?” isn’t really a question about effects, it’s about motivations — and I’m giving up mind-reading and name-calling for Lent, so I won’t interpret or judge them. Still, I have questions about whether the picketers are reasonable. Many of our neighbors have lost their jobs and their health insurance.  Many have seen their income reduced or lost their bargaining rights as workers.  Some are in danger of losing their Medicaid and Medicare benefits and we are all losing environmental protections and the constitutional right to see the Wisconsin legislature when it is in session. Around the world, people are struggling to win the right to elect their leaders and they are too often killed, imprisoned, and beaten. Our world neighbors and friends have been lost to earthquakes, tsunamis, to floods and storms; and in nearby Haiti, cruel and corrupt dictators return triumphantly to the crime scene in the midst of catastrophic events and an election.

That’s why I am troubled and unsettled by what the self-styled ‘prayer warriors’ are doing. There are so many struggles for freedom, social justice, and disaster relief right now, that I do not think it is justifiable to be blocking access to health care for our uninsured neighbors who want to delay childbearing so they can finish school or take a new job or even wait to have children until they can afford them.

Publicly-funded family planning saves millions of taxpayer dollars while improving public health, yet the picketers demand to know why their tax dollars should pay for STD testing, birth control, and cancer screening. They oppose hormonal contraception to prevent a high risk pregnancy or even (maybe especially) a teen pregnancy.  The picketers disagree with these services and even sexual health education, so they demand that others be denied them (if only this argument would work for oil company subsidies or middle-east military interventions.)

Recently, former State Senator Walter John Chilsen, in a statewide radio program said; “The use of contraceptives does not prevent unwanted pregnancies. I think you could even make the argument that it increases them.” The program’s host quickly changed the subject – leaving the claim unchallenged.

The scientific truth and the medical fact is that contraceptives prevent unwanted pregnancy. The primary cause of abortions is unwanted pregnancy and both the abortion rate and the unintended pregnancy rate have been falling for a generation.  FPHS changed our banners on the building from “Condoms Save Lives” to “Birth Control Prevents Abortion” because the persistent campaign of misinformation puts our services and our community’s health at risk. It’s time to be more direct.

It is within the rights of the picketers to argue that birth control and reproductive health care should not be available, but I believe it is unethical and wrong to do it.

BY LINDSAY BEYERSTEIN | POSTED 03/15/2011 AT 08:32 AM

Kirsten Powers of Fox News took to The Daily Beast to make the bizarre case that birth control doesn’t prevent abortions. In an attempt to show that abortion rates had remained suspiciously constant over the past decade, she accidentallycompared the same 10-year-old study to itself. “I am deeply sorry for the error, which invalidates my piece,” Powers later admitted in an author’s note.

Anti-contraception cranks often cite research on populations to show that rates of contraception and abortion can rise in tandem. Then they use those studies to argue that birth control doesn’t generally prevent abortions. But without a control group, you never know whether the abortion rate would have been even higher without birth control.

An estimated 85 percent of couples who are having regular intercourse without birth control will get pregnant within a year. Whereas, the typical use failure rate for birth control pills is 3 percent and the perfect use failure rate is .1 percent. The efficacy rates of major birth control methods have been rigorously tested, so we can make causal claims about how many unplanned pregnancies a particular method prevents, relative to unprotected sex.

About half of all unplanned pregnancies end in abortion in the U.S., no matter how many hurdles the anti-choicers put between women and the constitutional rights.

If you take 100 healthy couples who are having sex, but who aren’t planning to get pregnant, and let them go at it for a year without birth control, you can expect about 85 pregnancies, and 42 abortions. If those same couples were using the Pill in the basically conscientious but slightly imperfect way that most people do, you’d expect about 3 unplanned pregnancies and 1.5 abortions. 42 is greater than 1.5. QED.

Obviously, birth control doesn’t work if you don’t use it, and the further you deviate from perfect use, the less reliable it is. Powers cites a study of women getting abortions as evidence that access to birth control doesn’t decrease the abortion rate. Only 12 percent of women who weren’t using birth control when they got pregnant cited lack of access as a reason why not. Powers claimed that not a single woman cited lack of access, but she got that wrong and The Daily Beast still hasn’t fixed her mistake, despite my request for a correction. That relatively low percentage suggests that organizations like Planned Parenthood are doing a good job providing birth control to those who want it, regardless of their ability to pay.

As Amanda Marcotte points out at RH Reality Check, self-reports of reasons for not using birth control may not tell the whole story. There are all kinds of systemic barriers and hassles that discourage contraceptive use, or push typical use further from perfect use, and thereby increase the unintended pregnancy rate — but which the average person probably wouldn’t describe as an absolute lack of access. Having legal access to something in principle is not the same as having ready access to it at an affordable price.

There’s an even deeper logical flaw in Powers’ analysis, however. If you only look at women who are getting abortions, you only see cases in which birth control didn’t work or wasn’t used. You will miss the millions of people who successfully use birth control and therefore never need abortions.

For someone who already admitted that her entire argument is invalid, Powers got awfully defensive on twitter when Marcotte pointed out even more flaws in her reasoning.

For some who can’t afford contraception and reproductive exams, the state and federally funded programs provide coverage for these services. These programs save a phenomenal amount of taxpayer dollars by preventing unintended pregnancies. They reduce the numbers of abortions because there are less unintended pregnancies. They reduce poverty for women, children and families.

The “straight white-guys” who oppose these programs want to deny the cost-savings and health enhancing outcomes of these programs. Don’t let them do it. Call them on it each time you hear or see them attacking family planning services.

Editor’s Note: This post was originally published on RH Reality Check.

By Amanda Marcotte

When it comes to the world of feminist writer/activists, I definitely fall on the “writer” side of the line. Most of my life is researching, conducting interviews, pitching pieces, and, of course, staring at my computer, trying to think of a verb that’s dynamic but not pretentious. I love giving speeches, but they’re usually of the 20-60 minute long variety meant to educate, analyze and entertain (and there’s always a Q&A), and I’m always on a roster with journalists and academics. So how was it that Saturday afternoon, I found myself standing outside with feet growing numb in the cold amongst actors, musicians, organizers and oodles of politicians, trying to think of what I could say in 120 seconds that would be meaningful to the crowd of thousands of people waving signs and periodically erupting into chants?

Well, mostly I was there because Planned Parenthood of New York City graciously asked me to speak at a rally in support of Title X funding, which has been zeroed out by the House of Representatives in the continuing resolution to fund the government, a move that can be stopped by the Senate and President. I said yes because while drum-beating and sign-waving is really outside of my comfort zone, I consider this issue too important not to grab opportunities to speak out. For years I’ve been writing about something that most of the media tragically ignores, which is the growing radicalism of movement conservatism regarding women’s sexual health. Anti-choice is also about resisting birth control and any other health care that relates to sexual activity, on the grounds that women who have sex should face “consequences”, i.e. be punished. (As a good example, I saw my friend Katie Halper fighting some guy on Twitter over whether or not Planned Parenthood offers breast exams, something anti-choicers are trying to deny because, as Katie put it, “I guess even the most heinous distortion of punitive conservatism can’t make breast cancer a woman’s fault.” Notice that they’re not trying to deny that Planned Parenthood does a million cervical cancer screenings a year, but I guess they don’t care about those lives, since cervical cancer is usually caused by HPV, and they can convince themselves those women brought their deaths on themselves.) Even though we’ve seen evidence of the anti-choice movement pushing for abstinence-only education and fighting the HPV vaccine and emergency contraception, in most of the media, the discussion is still incorrectly framed as fetus-centric.

And now the anti-choice has scored a major victory in the war on women’s health, amongst many other programs that help people that conservatives disapprove of, such as people who want to have more energy-efficient homes and women who have to work for a living and therefore can’t play unpaid preschool teacher to their kids. So I had to speak out. Conservative activists are dropping the word “abortion” a lot, because it performs well as a conversation-stopper that allows them to continue working against women without suffering too much investigation into their real aims, but this time, people aren’t fooled. Pap smears and condoms aren’t abortion. The anti-choice resistance to them makes it clear that the concern for fetuses is actually a concern that women are having sex without facing sadistic punishments that, in the past (and sadly still today) left them traumatized, mutilated, and often dead.

That era isn’t far enough in the past that women today really can take for granted all that we have, but I thought the best way to speak out against the encroachments on women’s rights was to talk about all the ways our lives have been quietly saved by doctors, nurses, and educators who give us the tools to be, as women always have been before us, sexually active without giving up our health and dreams. For most of us, having to live without birth control would have meant drastically different, sadder lives. How better than to highlight the radical nature of this move against Title X than to instigate a speak-out about how the biggest target — Planned Parenthood — helped us, usually in ways that the vast majority of the country finds completely non-controversial?

For this purpose, I started the Twitter hashtag #thanksPPFA, where people could talk about how Planned Parenthood had improved their lives. And for this purpose, when I stood up at the rally Saturday, what I did was tell a (very short) story: I had gone to a Catholic university, and the health center didn’t offer birth control. (Boooooo!, said the crowd, surprising me and then making me laugh.) So I went to Planned Parenthood, where I could afford it, and that clinic basically was my doctor for the next five years. And I spoke briefly about the stories that came out on Twitter, 140 characters at a time: women who finished school, married the right guy, had kids when they were ready, all because of Planned Parenthood. Women who are still with us, because their cervical cancer was caught by Planned Parenthood’s routine screening. Lives are saved every day, and it’s usually not remarked on, because most of us expect it will always be there.

But if the conservative movement gets its way, it won’t be there.

While Planned Parenthood is the touchstone for this outrage, people are standing up for more than just this one large organization. We’re standing up because we believe that women, gay people, poor people, people of color, young people, and people who fall outside the gender binary are just as much people as the rich straight white guys that dominate the ranks of those trying to shut down access to sexual health care. And as people, we have the same rights as those rich straight white guys to our health, to our hopes and dreams, to our relationships, and yes, to our sexual pleasures as they do. Planned Parenthood offers substantial services that save lives every day, but they’re also a symbol in this war over who gets to decide if The Rest Of Us are people, too. In the 21st century, are we going to expand the rights of man to all of us, or are we going to slide backwards to a time when only the few got access to what we all deserve?

As of last month, a Republican majority controls the House of Representatives, and it has already launched significant attacks on women’s sexual and reproductive health and rights at home and abroad. We wanted to share with you CHANGE’s thoughts on what’s happening and what’s to come, both the challenges and the opportunities.

What Does a Republican Majority in House of Representatives Mean for Women’s Health?

• Republicans now set the agenda, make the rules, and lead the committees. In addition, the majority of representatives in the current House, both Democrat and Republican, oppose international family planning and reproductive health funding and services. This means the Republican majority is now poised to set an anti-women’s health agenda that could muster enough votes to pass in the House and move on to the Senate. They have already started—Rep. Chris Smith (R-New Jersey) recently introduced a bill that significantly limits access to safe abortion in the United States (take action here). CHANGE expects this trend to continue during the tenure of the Republican leadership.

• Republicans now Lead all Committees and Subcommittees: Many of these new leaders pose significant threats to international family planning and reproductive health funding and services. Some committee leaders to watch include:
  • Rep. Kay Granger, R-12th/Texas. Rep. Granger is the new chairwoman of the House Appropriations Subcommittee on State, Foreign Operations and Related Programs. In this role, she oversees spending on U.S. foreign aid, which includes global women’s health programs. She defines herself as a supporter of maternal health, but is anti-choice. 
  • Rep. Ileana Ros-Lehtinen, R- 18th/Florida. Rep. Ros-Lehtinen is the new chairwoman of the House Foreign Affairs Committee. She has already stated that her top priority is to cut foreign assistance funds, including funding for global women’s health. She also defines herself as a supporter of maternal health, but is anti-choice.
  • Rep. Chris Smith, R-4th/New Jersey. Rep. Smith is chairman of the House Foreign Affairs Subcommittee on Africa and Global Health. He is also among the most extreme anti-choice members of Congress, and is responsible for H.R. 3, the previously mentioned bill that will limit access to safe abortion. While Smith is seen by some as an ardent supporter of women’s and human rights because of his anti-trafficking work, his track record in Congress is consistently anti-women’s health. Legislation that is introduced in the House pertaining to global health will have to pass through his subcommittee.

The good news: Anti-choice leaders can only take their agenda so far. The Senate and administration limit the chances of hostile legislation becoming law. Legislation that passes the House must also pass the Senate, which maintains a slim pro-women’s health majority. President Obama must also sign legislation before it becomes law, and his administration remains solidly in support of women’s health and rights, domestically and internationally. 

What can you do? Gear up for action!
We will need you this year! CHANGE expects the Global Sexual and Reproductive Health Act will be re-introduced in the new Congress, which will be an essential tool for education and advocacy. We need to show anti-choice leaders our strength. We have support for our issues in the administration, and will continue our advocacy with members of Congress. We will depend on you to raise your voice at pivotal moments and support international family planning, maternal health, and HIV/AIDS funding and services for women worldwide!

Please do not hesitate to contact us if you have any questions.

Dear Mr. Butler:

Recently it came to my attention that The Great Dane provided a charitable donation seen as inappropriate by some in our community.  The donation was to NARAL Pro-Choice Wisconsin.  This came to my attention on Facebook, from friends who posted this link: http://blog.prolifewisconsin.org/2011/02/02/the-great-danes-defense-of-supporting-naral/ from Pro-Life Wisconsin’s blog, which included your letter.

All I can say is thank you.  Thank you for supporting organizations that make our communities better places to live.  Thank you for using your business to demonstrate your commitment to ensuring that our future has as much promise as our past.  Thank you for living JFK’s charge of “Ask not what your country can do for you – ask what you can do for your country.”  Thank you for your courage and conviction.

I have always enjoyed visiting The Great Dane for the great food, drink and atmosphere.  As a result of your response to this challenge, I am please to tell you that I now consider myself a proud patron of your establishment.  I very much look forward to my next visit to The Great Dane and will definitely bring a friend.

Sincerely,

Frances Irwin

Wausau, WI

P.S.  I’m having a Ladies’ Night In later this month.  I was just going to make desserts and mull some wine.  Now I’m adding appetizers from The Great Dane and a growler to the menu in appreciation of your trust in women!

President Obama formed the National Prevention, Health Promotion, and Public Health Council in June 2010. The council posted a draft plan for moving “from a focus on sickness and disease to one based on wellness and prevention.”  The goals include healthy communities, preventive clinical efforts, and empowered individuals. The four Cross-cutting Strategic Directions include:

• Healthy Physical, Social, and Economic Environments
• Eliminate Health Disparities
• Prevention and Public Health Capacity
• Quality Clinical Preventive Services

Complementing those Strategic Directions are six Targeted Strategic Directions:

• Tobacco-Free Living
• Reduce Alcohol and Drug Abuse
• Healthy Eating
• Active Living
• Injury-Free Living
• Mental and Emotional Wellbeing

You know what is missing. The National Healthy People goals for 2020 include specific objectives for family planning, sexually transmitted infections, maternal and child health, and adolescent health. In Wisconsin, our Healthiest Wisconsin 2020 goals include normalizing sexual health as well as objectives to reduce maternal and child health disparities related to sexual health risks and access to care.

But in the National Prevention, Health Promotion, and Public Health Council draft, we have a “Waist-up Wellness” model that seems timid about even mentioning sex. There are a few references to HIV/Aids and STD testing and treatment, but they are imbedded in the subsections.  If, as the plan asserts, we are going to “expand and connect prevention-focused health care and community prevention efforts,” and if we are going to “empower and educate individuals to make healthy choices,” then reproductive health and family planning clinics and providers must be a component of the transition.

By “Component” I don’t mean a sub-goal vaguely referenced. How about a specific and explicit Targeted Strategic Direction titled “Sexual Health and Wellbeing”? Paraphrasing a few recommendations from the existing targeted strategic directions, the recommendation for Sexual Health and Wellbeing might include:

• Use media and social support (e.g., social networks, shared space) to empower individuals to make responsible and well-informed choices about sexual health.
• Expand opportunities for health within communities and populations at greatest sexual health risk.
• Conduct research on promising strategies including research on reducing unintended pregnancy rates and measureable results for community-based and other types of reproductive health services.
• Establish and maintain clinical practice standards for preventive reproductive health services to encourage continuous improvement and collaboration across health care provider entities and types.
• Expand interoperable health information technology, including telemedicine and patient health records that are affordable to community-based primary prevention clinics and accessible to patients in rural areas.
• Strengthen capacity to control and prevent sexually transmitted infections and to effectively respond to outbreaks in communities.
• Protect the right of patients to choose a willing and qualified provider for the sexual health and family planning care they want and need.
• Link community-based reproductive health prevention services with clinical care, acknowledging that technological innovation will increasingly integrate patient health records and telemedicine so that for a patient, a “Medical Home” is not a place, but a care coordination concept. In sexual health, the patient is probably the best coordinator.

These are the four main points of consideration that I am inviting you to emphasize to our decision-makers and within our community of advocates and health care providers:

1)    The right to confidential reproductive health doesn’t mean very much without access to confidential, affordable, comprehensive, competent, and willing health care providers.

2)    When it comes to providing sexual health care, the realities are: sectarian provider institutions — gaps in insurance coverage — practitioners exercising a ‘right of conscience’ over their patient’s need for comprehensive care — and established institutions looking for ways to limit access to a full range of reproductive health care.

3)    While the Patient Protection and Affordable Care Act will help, the right to choose a willing and capable sexual health care provider is still best left in the hands of the patient and not the private HMO, government regulation, or a hospital’s health information network. On a broader scale, the realities of a primary preventive health care delivery system with an existing and predictably continuing shortage of practitioners with extensive reproductive health care training and experience demands that we protect the existing infrastructure of family planning clinics and use technology to link it with other primary care providers.

4)    Sexual health has been uniquely constitutionally-protected because reproductive self-determination is a core human right and because sexual behavior and decision-making is an extremely personal matter. Forty years ago, when legislators permitted Medicaid to establish managed care organizations, the regulations protected the right of patients to choose an out of plan reproductive health care provider. Sexual health lends itself to care models (such as individual Patient Health Records) which enable and empower patients to make their own choices. Advocates, community health providers, and public health policy-makers, must recognize that upholding the right of a patient to choose her own community provider or her own method or her own nurse practitioner is not only good policy — it leads to the best health results.

I hope you will take a few minutes before January 13^th and go to http://www.hhs.gov/news/reports/nphps.html. Read the National Prevention and Health Promotion Strategy draft. Pick up that Boehner-sized mallet and help me drive that stake home

We recognize that the “Forty Days for Life” protests in front of our clinic bring us a lot of attention that can be put to good use. The picketing has resulted in many expressions of community support for Family Planning Health Services (FPHS) as well as a much higher level of visibility for the health care services we provide. On the other hand, the anti-abortion signs persistently misrepresent what FPHS actually does – confusing the public about whether FPHS provides abortion (we do not and we are prohibited by our grant contracts from even making referrals). FPHS provides contraceptive services, provides all-options information, and we are prochoice. That seems to be enough to draw the sanctimonious “prayer bullies” to our street corner . . . and soon they’ll be on yours.

These protests take place on the street corners of our nation, not just in our Central Wisconsin community, and it is important that the public and other health care providers know that they are opposed to contraception as well as abortion – that’s why they are picketing in Wausau.

Understanding that there is a need to connect the local to the state and the state to the national, FPHS is proudly supporting the newly launched “Forty 4 Forty” joint fund raising campaign of the Wisconsin Religious Coalition for Reproductive Choice and Pro-Choice Wisconsin. FPHS, because we are clearly not an abortion provider, can play an important role for all primary health care providers that the picketers are anti-contraception as well as anti-abortion.

The Forty4Forty campaign begins this week. A sign to solicit pledges for Forty 4 Forty will go up on our Wausau building tomorrow morning.

Last week, when one of the protestors said to me; “If they’re intimidated, that’s their problem,” he told me all I need to know.

Lon Newman
Executive Director
Family Planning Health Services

“A defender of the church,” proclaimed the Milwaukee Journal Sentinel headline for an extensive story about the new Archbishop-designate, Jerome Listecki. The subtitle for the article was: “Archbishop designate Listecki vows collaboration, but unafraid of debate.” The subtitle was probably derived from the bishop’s description of how he planned to participate in the political process. He said: “If we don’t challenge one another’s statements, then we’re relinquishing our responsibility to the common good.”

The following month, young Catholics for Choice (yCFC – a Washington D.C. based organization) and Family Planning Health Services (FPHS – an agency with family planning clinics in eight Wisconsin counties) formed a unique sectarian-secular advertising partnership, produced informational ads for broadcast, and then embarked on a two-day Wisconsin “road-trip” to draw media attention to their campaign and to build public (including the Catholic public) awareness and knowledge about emergency contraception.

The purpose of the joint media campaign was two-fold; 1) to inform the public about how Plan B works so they would have it on hand in advance of need and, 2) to inform Catholic women of reproductive age that the United States Conference of Catholic Bishops health care directives permit the use of emergency contraception to prevent pregnancies resulting from rape.

In the January 2010 issue of the Journal of the Catholic Health Association of the United States, Ron Hamel, Ph.D., makes it very clear that the ethics of access to emergency contraception for Catholics needs to be fully examined and explained. Professor Hamel’s article and the YCFC/FPHS EC campaign are an effort to fulfill that responsibility when there is significant resistance.

The campaign succeeded in getting a response from the Archbishop-designate and thus succeeded in its secondary purpose. The headline on the Christmas Eve edition of the La Crosse Diocesan newspaper is: “Bishop Rejects Young Catholics for Choice Message.” The front page column ran adjacent to the departing bishop’s message. But what he rejected so prominently: “ . . . that Catholics can disregard Church teaching on contraception, abortion, and human sexuality in general and remain Catholics in good standing,” was only weakly connected to the message that yCFC and Family Planning Health Services (FPHS) were promoting.

Bishop Listecki, like most of the Catholic protestors in front of the FPHS clinic, will allow “no room for interpretation,” once the bishop’s authority has been invoked. Many within the church see the bishop’s pattern of authoritarian rebukes, condemnations, and admonitions as futile efforts to suppress dissent and they understand they are not the views of other Catholics or even the other American bishops.  Just as importantly, the denials and condemnations are not solely inflicted on the faithful. The prayer vigil protestors’ and Bishop Listecki’s efforts to eliminate access to emergency contraception, if they succeed, would apply to women regardless of their faith.

Erik Cieslewicz and Brooke Sperry have produced a documentary about the joint campaign that will be released February 17^th, 2010.  The web-posting will occur on the same day that another Lenten prayer vigil outside an FPHS clinic (which does not provide abortion services) begins in central Wisconsin. The video shows the challenge as well as the fun of the effort to educate the public in the face of consistent efforts to suppress and to misinform. Earlier, “40 Days for Life” prayer vigils played a large part in motivating FPHS and yCFC to cooperate in the advertising effort to correct misinformation being spread by their opponents.

Enjoy the video!

Our share of these costs comes out of our paychecks before we receive them. Are we paying attention to how much it is costing to provide health insurance for families in 2009?

These numbers jumped out of the page when I read Drew Altman’s article on the cost of employer provided health insurance. The projection for those costs to rise in the next 10 years reinforced for me the need for health care reform NOW.

Simple Arithmetic by Dr Drew Altman

This week we put out our annual benchmark survey of employer health coverage and costs. Two numbers jumped off the pages.

The first number was the average cost of a family health insurance policy in 2009: $13,375. To put that number in context, if you are an employer, you can hire an employee at the minimum wage for about $15,000 per year. If you are a consumer, you can rent an average two-bedroom apartment nationwide for $11,136 per year (though it is quite a bit more here in Menlo Park, California where our Foundation is based). You can also buy a new Chevy Aveo for $12,000, and it gets 35 miles per gallon on the highway.

The other result that jumped off the page was the stark contrast between increases in health insurance premiums and overall inflation in the general economy. Premiums went up 5% and prices overall fell 0.7% (mainly driven by a big drop-off in energy prices).

The 5% increase we found in premiums is moderate by long-term historical standards. For example, two different times during the last decade premiums increased by 13% a year, in 2002 and 2003. This year’s increase continues a multi-year period of relative moderation in premium increases. Still, over the last ten years premiums have increased by 131%, while wages have grown 38% and inflation has grown 28%. Consider this: If people (and businesses) are as concerned as they are now about rising health care costs in a period when they are actually moderating, how much more concerned will they be when rates of increase return to historic averages?

Let’s do some very simple arithmetic. Start with a fairly conservative assumption: If we assume that premium increases over the next ten years will average what they did over the last five (about 6.1% per year), the average premium for a family policy in 2019 will be $24,180. That’s a big number. On the other hand, if we assume increases revert to the average of the last ten years—an average annual increase of about 8.7% and a very plausible scenario—premiums in 2019 will average a whopping $30,803, a very scary number (Figure 1).

Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Hard Times in the Heartland provides insight into the current state of health care in rural areas and the critical need for health care reform.

Health Care and the Rural Economy

High poverty rates and job loss in the current economic
recession highlight the challenges of accessing health care
and rising health care costs in rural areas.

Rates of poverty are higher, with 15% of people in rural areas
living below the poverty level compared to 12% of people in
urban areas.1
The rural economy is dominated by small businesses,
which are struggling as the cost of health care continues to skyrocket.

In the current recession, the rural economy is losing jobs
at a faster rate than the rest of the nation, and loss of jobs
can lead to loss of health coverage. In particular, rural
communities dependent on manufacturing have lost nearly
5% of their jobs since the recession began – and these are jobs
that offer some of the best benefits.3

Limited Coverage and Burdensome Costs

Many rural residents work part-time, seasonally, or for
themselves, making them less likely to have private,
employer-sponsored health care benefits.

A multi-state survey of farm and ranch operators found that
while 90% of farmers have insurance coverage, one-third
purchased it directly through an insurance agent (compared
to the national average of 8%).4
Nearly one in five of the uninsured – 8.5 million people –
live in rural areas. This problem is worse for rural minority
populations, the rural poor, and those with less than a high
school education.5
Rural residents spend more on health care out of pocket
than their urban counterparts. Indeed, one in five rural
residents spends more than $1,000 out of pocket in a year,6
and rural residents pay on average for 40% of their health
care costs out of their own pocket, compared with the urban
share of one-third.7
The high costs of health care hit farmers particularly hard.
In a multi-state survey, one in five insured farmers had
medical debt,8 and in one state, farmers who purchased an
individual health plan spent an average of $2,117 more than
their colleagues who were able to purchase through a group
plan.9
As a result, rural adults are more likely than urban adults
to report having deferred care because of cost (15%
versus 13%). This problem is worse among rural minority
populations, who are twice as likely to have deferred care in
the past year as rural whites.10

The Need for More Health Care Providers

Along with comprehensive and affordable coverage,
access to high quality providers is also a key component
of obtaining high quality care. Rural areas continue
to suffer from a lack of diverse providers for their
communities’ health care needs.

There were 55 primary care physicians per 100,000
residents in rural areas in 2005, compared with 72 per
100,000 in urban areas.  This decreases to 36 per 100,000 in
isolated, small rural areas.11
There were half as many specialists per 100,000 residents in
rural areas compared with urban areas, and a third as many
psychiatrists.12
For persons of all ages who visited their usual care provider,
travel time was longer for rural than for urban patients.
Fourteen percent of rural patients traveled more than 30
minutes, while only 10% of urban patients did so.13
The problems of a thin provider workforce can be expected
to worsen if action is not taken. Rural areas have a higher
percent of physician generalists nearing retirement than
urban areas, and recruitment and retention continue to be a
challenge.14

Disparities in Health Need To Be Addressed

A scant provider network, lack of adequate and affordable
health coverage, and difficulty accessing high-quality care
can lead to worse health among rural populations.

The percentage of diabetes patients who received all three
recommended exams for diabetes is lower for patients in rural
areas than in metropolitan areas (32% versus 42%). Perhaps
as a result, rates of admissions for uncontrolled diabetes are
higher among residents of rural areas.15
Rural women are less likely than urban women to be in
compliance with mammogram screening guidelines (71%
versus 78%), and are less likely to have had a pap smear done
within the past three years (86% versus 91%).16
Rural residents are more likely to report fair to poor health
status than urban residents,17 and are more likely to have
experienced a limitation of activity caused by chronic
conditions than urban residents.18
Obesity is more common among rural residents (27%) than
urban residents (24%), as are diabetes,19  heart disease, and
high blood pressure.20

Comprehensive health reform is needed to bring affordable,
high quality health care to these populations that need it
most.

Sources

Report Prepared By

Meena Seshamani, MD, PhD
Joan Van Nostrand, PhD
Jenna Kennedy, BA
Carrie Cochran, MPA

Analysis and support provided by the Rural Health Research Centers

Report Production by the HHS Web Communications and New Media Division
1 DeNavas-Walt, C., Proctor, B. D., and Smith, J. C. (2008.) U.S. Census Bureau. “Current
Population Reports, P60-235, Income, Poverty, and Health Insurance Coverage in the United
States: 2007.” Washington, DC: U.S. Government Printing Office.
2 Ziller, E. C., Coburn, A. F., & Yousefian, A. E. “Out-of-pocket health spending and the rural
underinsured.” Health Affairs, Nov/Dec 2006; 25(6), 1688-1699.  See also “Helping the Bottom
Line:  Health Reform and Small Business” (2009). U.S. Department of Health and Human
Services. http://www.healthreform.gov/reports/helpbottomline/
3 Drabenstott, Mark and Moore, Sean. (March 2009). “Rural America in Deep Downturn: A RUPRI
Rural Economic Update.” RUPRI Center for Regional Competitiveness: Kansas City, MO.
4 The Access Project. (Sept. 2007). “Issue Brief: 2007 Health Insurance Survey of Farm and Ranch
Operators.” http://www.accessproject.org/adobe/issue_brief_no_1.pdf
5 Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality,
Medical Expenditure Panel Survey, 2006.
6 Ziller, E. C., Coburn, A. F., & Yousefian, A. E. “Out-of-pocket health spending and the rural
underinsured.” Health Affairs, Nov/Dec 2006; 25(6), 1688-1699.
7 Ziller, E. C., Coburn, A. F., & Yousefian, A. E. “Out-of-pocket health spending and the rural
underinsured.” Health Affairs, Nov/Dec 2006; 25(6), 1688-1699.
8 The Access Project. (Sept. 2007). “Issue Brief: 2007 Health Insurance Survey of Farm and Ranch
Operators.” http://www.accessproject.org/adobe/issue_brief_no_1.pdf
9 Dohogne, Aaron. (Sept. 2008).  “Survey recommends remedies for farmers’ high insurance rates.”
The Missourian. http://www.columbiamissourian.com/stories/2008/09/26/missouri-farmers-
paying-more-individual-healthcare-insurance/
10 Bennett, K. J., Olatosi, B., & Probst, J.C. (2008). “Health Disparities: A Rural – Urban Chartbook.”
South Carolina Rural Health Research Center.
11 Fordyce MA, Chen FM, Doescher MP, Hart LG. (2007). 2005 physician supply and distribution in
rural areas of the United States. Final Report #116. Seattle, WA: WWAMI Rural Health Research
Center, University of Washington.
12  Fordyce MA, Chen FM, Doescher MP, Hart LG. (2007). 2005 physician supply and distribution in
rural areas of the United States. Final Report #116. Seattle, WA: WWAMI Rural Health Research
Center, University of Washington.
13 Agency for Healthcare Research and Quality, 2006 Medical Expenditure Panel Survey.
Calculations By Maine Rural Health Research Center.
14 WWAMI Rural Health Research Center. Aging of the rural generalist workforce. Seattle, WA:
WWAMI Rural Health Research Center, University of Washington; in press.
15 Health Care in Urban and Rural Areas, Combined Years 2004-2006. Update of Content in MEPS
Chartbook No. 13. Agency for Health Care Policy and Research, Rockville, MD. http://www.ahrq.
gov/data/meps/chbook13up.htm
16 Bennett, K. J., Olatosi, B., & Probst, J.C. (2008). “Health Disparities: A Rural – Urban Chartbook.”
South Carolina Rural Health Research Center.
17 Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality,
Medical Expenditure Panel Survey, 2006.
18 Bennett, K. J., Olatosi, B., & Probst, J.C. (2008). “Health Disparities: A Rural – Urban Chartbook.”
South Carolina Rural Health Research Center.
19 Bennett, K. J., Olatosi, B., & Probst, J.C. (2008). “Health Disparities: A Rural – Urban Chartbook.”
South Carolina Rural Health Research Center.
20 Pleis JR, Lethbridge-Çejku M. Summary health statistics for U.S. adults: National Health Interview
Survey, 2006. National Center for Health Statistics. Vital Health Stat 10(235). 2007.

This axe will certainly fall, but a new incarnation in the form of a redefined pitch for federal funding for “Abstinence-centered” programs is already in play.  In fact, repackaged “Abstinence-centered” programs are busily developing marketing approaches and preparing grant proposals for the President’s new teen pregnancy prevention initiative – the one that supposedly displaced Abstinence-only-until-marriage funding. On May 11th on Wisconsin Public Radio, Wisconsin’s Abstinence Coalition executive director and member of the National Abstinence Education Association (NAEA) board, Sally Ladky, expressed the national strategy to maintain their federal funding stream.

The strategy is to co-opt the language of comprehensive sex education and the reincarnation is already complete.  Here are the major marketing elements as Ms. Ladky expressed them:

• “We’re about risk-avoidance.”
• “We are evidence-based.”
• “We’ve never called ourselves ‘abstinence-only’. We’re abstinence-centered. . . We do talk about contraception.”
• “Comprehensive sex education just talks about the physical – we’re more holistic than that.”

A November 2008 NEAE letter to then President-elect Obama prophesies the transfiguration as evidence-based, risk avoidance, abstinence-centered, holistic sex education that includes contraception.  (That’s a pretty good description of programs that I’ve been supporting for thirty years.)

When the Department of Health and Human Services removes the abstinence-only restrictions from the federal funds and instead requires evidence-based medically accurate teen pregnancy prevention applications, the agencies sending in the Requests for Proposals will include the same agencies which are now receiving abstinence-only-until-marriage funds:

1. The crisis pregnancy centers that refuse to give out information about emergency contraception;
2. The ‘virginity pledges;’
3. The abstinence clown’
4. The folks who carefully explain the failure rates of condoms and contraceptives without explaining the infection and pregnancy rates when they’re not used.

As frustrating and perplexing as the reincarnation of abstinence-only-until-marriage programs will be, the principle of competition for grant funds is time-honored and broadly accepted. We would like to believe that the cards will be unmarked and the deck will not be stacked against comprehensive sex education. But if the NAEA has its way, there won’t be a fair deal.  In the May 11th WPR interview, Ms. Ladky says: “We’re looking for funding parity.  We think that each of us should have one-half of the funds.”

The advocates for abstinence-only-until-marriage programs argue that family planning funding, especially Title X, which provides medical services related to contraception, cancer prevention, and STD testing and treatment should be put into the pot with the sex education funds.  In other words, family planning funds should be added to the pot and the abstinence programs should be guaranteed half of the winnings before the cards are dealt.

Equating Title X family planning health care services with community and school-based sex education is problematic and unworkable.  Hundreds of thousands of women and men would potentially lose access to primary preventive reproductive health care. It is a cynical ploy to take funding away from Planned Parenthood and other family planning programs. The monumental irony in the “abstinence-centered” faithfuls’ request that half of the stakes be set aside for them before the game begins is that if abstinence-only-until-marriage and comprehensive sex education are both evidence-based and medically accurate – if both program models include risk reduction instruction such as contraceptive methods and condom use – on what distinction would the parity division of money be based?

It was simpler when comprehensive sex education advocates refused these funds and worked  to eliminate them because they are sectarian and because they have been ineffectively used. After Congressman Obey carries out the Presidential budget sentence, advocates on both sides will compete for the redefined “common ground” teen pregnancy prevention funds — and it will require an act of faith to tell them apart.

It happened again with a different person today — another donation because protesters were standing in front of the family planning clinic in Wausau.

It has been hard for FPHS staff, myself included, to understand the protests outside the clinic because we know that we provide caring, compassionate voluntary contraceptive care that prevents unintended pregnancy (and care that helps people take responsibility for their reproductive health including planning for healthy pregnancies when they are ready.)

Having two supporters take the time and make a gift to show their support for us and our services, makes all of us feel appreciated. I’d like to invite all of you to drive through (maybe pick up some condoms) or, if there’s no line, just tell the staff at the window that you support family planning.

I’m sure that there are many times when people speak up for access to birth control when it isn’t easy. To those who do, “THANK YOU!!”

A few examples of what these damaging amendments propose:

* Require doctors to disseminate information that is not supported by science to women seeking pregnancy-related care, including abortion.
* Require parental consent for students who get services at school-based clinics.
* Violate patients’ rights and erode clinicians’ duties to their patients by encroaching on the right to receive health services and information, including contraception, fertility services and other health care necessary to meet established medical standards of care.
* Impose barriers to health care for immigrants by requiring that they be citizens for five years before participating in certain programs.
* Establish a program to promote crisis pregnancy centers that withhold full, accurate information about options from women facing an unintended pregnancy, and in some cases use deceptive, inaccurate and even intimindating tactics to influence their decisions.
* Scale back substantially the effort to strengthen and restore authority to the Office of Women’s Health that we depend on to provide leadership, expertise and guidance on women’s health concerns within the Department of Health & Human Services.

TAKE ACTION  Please urge the members of the Senate HELP Committee to vote against all amendments that threaten women’s health. Contact them as soon as possible, so your thoughts may be considered during the mark-up process.

Email your comments to help_comments@help.senate.gov and we encourage copying your own congressional delegation on the message as well. In addition, please copy info@raisingwomensvoices.net  so we know how many of you have raised your voices for quality, affordable health care that meets women’s needs!
Let them know that you want their leadership in establishing quality, affordable health care for all women and that you want to see the bill go forward without damaging amendments like the ones being offered by Senators Coburn, Enzi and Hatch.

Written by Elizabeth Alexander of the ACLU’s National Prison Project. 

Shackling pregnant women during active labor and childbirth is, unfortunately, all too common in our nation’s prisons and jails. One such victim of this practice was Shawanna Nelson, who entered the Arkansas prison system when she was six months’ pregnant, with a short sentence for a non-violent crime. When she went into labor, the correctional officer accompanying her shackled her legs to opposite sides of the bed, and removed the shackles only long enough for the nurses to examine her. Ms. Nelson remained with both her legs shackled to the bed until she was taken to the delivery room, and she was re-shackled immediately after the birth of her son, who weighed almost ten pounds. The shackles caused Ms. Nelson to suffer cramps and intense pain, as she could not adjust her position during contractions. After childbirth, the use of shackles caused her to soil the sheets, because she could not be unshackled quickly enough to get to a bathroom. The correctional officer knew that Ms. Nelson was not a flight risk, and knew that the restraints caused pain and unsanitary conditions. According to expert obstetricians, shackling women during labor is inherently dangerous.

A federal district judge ruled that a jury should decide whether Ms. Nelson’s treatment violated the Eighth Amendment, but the defendants appealed to the 8th Circuit Court of Appeals. A three-judge panel reversed the district court and dismissed Ms. Nelson’s case. With the help of the ACLU’s National Prison Project (NPP), Ms. Nelson was able to persuade the court of appeals to grant rehearing before the entire court and in September 2008 NPP staff argued on Ms. Nelson’s behalf that her case should go to trial. We await a decision.

Meanwhile, the ACLU works to persuade prisons and jails to end this barbaric practice. The National Prison Project, together with the ACLU’s Reproductive Freedom Project, the Women’s Rights Project, and many of our state affiliates are part of a national coalition advocating for changes in policy and law at the federal and state level. To date, the Federal Bureau of Prisons and the U.S. Marshals’ Service have both issued policies severely limiting the shackling of pregnant women and several state legislatures are now considering bills to limit or end the practice. Our policy and advocacy work continues to raise national awareness about efforts to ban shackling of pregnant women prisoners across the country. In addition we continue to negotiate with Immigration and Customs Enforcement to ensure that pregnant women held as immigration detainees in federal, state and local facilities are not subject to this cruel and degrading practice.

Learn more about how pregnant women prisoners are treated in your state.

For almost a year now, Pro-Life Wisconsin (PLW) has maintained a protest campaign at our family planning and WIC clinics in Central Wisconsin. PLW activities have included a ‘verbal hijacking’ of our Raising Women’s Voices “Speak Out” on women’s health care so that those who wished to speak on issues unrelated to abortion or contraception were by-and-large unheard in the auditorium. Over the Lenten season, PLW and its local supporters participated in the “40 Days for Life” national campaign — conducting a ‘continuous’ prayer vigil outside our clinic offices.  When asked by local reporters why they were participating in this effort, they said it was to stop abortion.  We do not perform abortions at any of our facilities.  As the 40 Days effort has come to an end, we want to share what we have learned.

The 10 Suggestions:

I.    Publicly express sincere concerns about patient and public safety.
We wrote an editorial which focused on traffic conditions near the clinic and how patients had been affected by the protestors. After the editorial was printed, the protestors stopped harassing patients and obstructing visibility for drivers.
II.    Leave the religious debate to religious organizations.
We spoke with supportive local parishioners of many denominations and asked for their help. The Wisconsin Religious Coalition for Reproductive Choice held a news conference that received front page coverage and many church leaders explained that their religious traditions do not oppose family planning or, in many cases, abortion.
III.    Respect the rights as well as the responsibilities of the protesters.
We consistently and publicly expressed our respect for the right to protest, but we also reported any obstruction of clinic entrances or exits (a violation of federal law).
IV.    Maintain Security and Surveillance.
We used digital cameras and recorders to record video covering the entrances and exits at all time.  We also took routine photographs of the protesters. We reported the minor acts of vandalism, entrance and exit obstruction, and harassment to local law enforcement and were able to provide the computerized records as well.

V.    Act don’t React and have a sense of humor.
We hung three large red, white, and blue banners with one word on each one: Condoms Save Lives. When the local newspaper took photos of the protestors, the banners provided a public health message. We also ran general awareness ads on television talking about the services we provide and the value to women’s health. I put up a shadow box with a stone inside, a mallet on the side, and had the glass inscribed “The First Stone – John 8:1-11.” Someone in a hooded sweatshirt stole the mallet, but they left the stone where it was.
VI.    Keep your eyes on the majority.
Quantity matters in the political world, where public policy is decided.  Support for contraception and sex education is growing, even within the parishes recruiting protesters. There is no need to belittle our opposition or demean ourselves.
VII.    Stay focused on facts, evidence, and your mission.
We resisted temptations to be diverted from scientific evidence, provable facts, and the mission of our organization.  Ours is a health services mission of universal access to maternal and child health including reproductive care.  The mission of our opponents is theological and political, so we invited others to speak from those perspectives whenever possible.

VIII.    Follow the law and enforce the law.
One of the opponents complained to city zoning officials that the “Condoms Save Lives” banners intruded over the public right-of-way. We moved them to comply and showed the officials photographs of protestor signs placed in violation of the same ordinance. We asked for equal enforcement.
IX.    Thank contributors and supporters.
You can never express too much appreciation to your supporters, contributors, and your employees.  Use the opportunity to express appreciation and to network.

X.    Let them speak!
The opposition has been unsuccesful persuading even their parishioners(Catholics and Choice) on contraception and sex education. Since their position is fundamentally faith-based and authoritarian, it is unlikely to look rational from other perspectives. At the Women’s Health Speak Out, at our news conferences, in web-postings, in letters-to-the-editor, and even standing in front of our clinics, they communicate quite clearly.  Most people see them as they are and most people disagree with their beliefs and with their tactics.

This week is an exciting week for me.  Through my work at Below The Waist, work I love to do by the way, I am getting the chance to go to New York City and attend the national “Speak Out” hosted by Raising Women’s Voices for the Health Care We Need.

I will be in New York City for the rest of the week and will have a chance to meet and learn from som of the greatest leaders and advocates in this field. I really could not be more excited for the chance. 

Through Below The Waist, I have been lucky enough to have had a chance to meet with and interview some of the true luminaries, the inspirational forces in this movement.  Now to get a chance to be around what I would call a tremendous concentration, well that is like adding a scoop of ice cream to a well frosted cake of greatness.

We have been working in partnership with RWV for a while now, and are going to launch a sister site to include the stories we have heard over the months.  Look for that coming soon.

For more information on the event, take a look at the agenda.  If you would like to meet up, please find me on Twitter at twitter.com/belowthewaist.  I look forward to seeing you.

Today we had some of the world’s smallest, happiest, and politest protesters. Everyone should smile for the camera.

Even American Catholics practice a fundamental, and not fundamentalist, right to reproductive self-determination. During the 2008 campaign, most Catholic voters ignored the sacramental threats of shepherds like Reverend Jay Scott Newman, who told his parishioners that their souls were at risk if they voted for pro-choice candidates. (Catholics voted for Obama with a 54 to 45 percent margin.) As Kathleen Kennedy Townsend and Patrick Whelan pointed out, voters may have noticed that abortion rates declined more under the Clinton administration’s policies than under Reagan’s or under either of the two Bush’s. Voters may have decided that there are higher priority pro-life issues; such as economic desperation, unending war, and global environmental degradation.
For some, positions on abortion and birth control are simply not susceptible to earthly persuasion. More than forty years ago, when a majority of a Vatican commission on birth control seemed ready to support a reversal of the church’s ban, Father Marcelino Zalba fervently asked the members what would happen “with the millions we have sent to hell” if previous teaching was invalidated. Commission member Patty Crowley responded: “Father Zalba, do you really believe God has carried out all your orders?”
Nancy Belden, a Washington-based public opinion researcher, recently showed that one side of the abortion debate is unlikely to change the hearts and minds of the other. Her polling demonstrated that support or opposition to legal abortion has moved a few polling points one way or the other in the last thirty-five years, but in 2007 56% favored legal access and 40% opposed – a return to 1973. American families have made up their minds and for the most part, they ignore the arguments and the arguers on the other side.

President Obama frequently demonstrates a pragmatic and realistic approach to reproductive health policy: rescinding the theological stem-cell federal funding restrictions; removing the ‘Global Gag Rule’ (Mexico City Policy) that penalized international family planning agencies for supporting reproductive rights, and; rolling back the Bush administration’s ideological 11th hour “conscience protection” regulations. While the President has reached out to listen to fundamentalist members of Congress and to interest groups who disagree, most of the time he has tried to set policy based on practical scientific decision-making instead of partisan crowd noise.
The new Congress and the new Administration must continue on this course of providing leadership on the principle that reproductive health care policy will be based on two foundations of American democracy – reason and science. We must not be distracted from that principle by battles over who holds the high moral ground. Instead, we must keep our attention on developing reproductive health care policy that is down to earth.

I found this exchange ironic on many levels.

This year over 1400 people attended the Health Fair. FPHS had condoms to give away and condom key chains. We had approximately 500 people stop at our booth to talk. People who usually might not have stopped did stop this year. They asked us how we were holding up due to the picketers that have been demonstrating outside of the Wausau FPHS clinic since Ash Wednesday. We said we were doing okay. They asked us if we thought that people were not coming in for services since the picketers were there. We said we still have people coming in for WIC and for reproductive health services and haven’t really seen a decrease in visits. Of course, we don’t know if there are people who aren’t coming in, because they aren’t coming in. The Bridge Community Clinic told us in February that if we have someone who needs services and is too fragile to face walking in here in front of picketers, that they would see those clients for us. We thanked them for offering back-up for our clients. We are grateful for their support.

The next thing that visitors to the booth at the Health Fair did was voice their support for our services and stated their disagreement with the people picketing at our birth control clinic. “Picketing against abortion is one thing, but you guys prevent abortions by preventing unintended pregnancies. You don’t do abortions. Thank you for all you do. Keep up the good work.”

When Dino came on duty to staff the booth at the Health Fair, I went to get some lunch. In the hour I was gone, he said he had 50 people come up to him and say the same things they’d been saying to me all morning. He said it was so great to hear their support. “It was so positive. It really helped me recognize the support FPHS has out in the community.”

It was a positive event with very good turnout and we loved meeting the people and talking about FPHS.

In his first week in office, President Obama announced his intention to work with Congress to restore U.S. funding for UNFPA in order to “join the 180 other donor nations working collaboratively to reduce poverty, improve the health of women and children, prevent HIV/AIDS and provide family planning assistance to women in 154 countries.” 

Now, with the enactment of the fiscal year 2009 appropriations bill, it appears that the first U.S. contribution to UNFPA will arrive just as experts from around the world prepare to gather at the United Nations for a global review of population and development priorities. The review, an annual meeting of the Commission on Population and Development, will take place on March 30–April 3 in New York City. It is the first of several United Nations events that will mark the 15th anniversary of the International Conference on Population and Development held in Cairo in 1994.

At the conference, the United States and 178 other member states signed on to an ambitious 20-year plan for international development. The plan was guided by the principle that stabilizing population growth and fighting poverty are fundamentally interrelated goals, neither of which can be achieved without investing in the rights of women.

In 2000, an even larger group of countries, including the United States, reaffirmed this commitment by signing on to the Millennium Development Goals (MDGs). While the United States has honored parts of that pledge, largely through the efforts of the U.S. Agency for International Development, it has fallen far behind other developed countries’ investments in the developing world. In fact, among developed countries, the United States is tied for last place in the percentage of gross national income it devotes to foreign assistance.

Reinstating funding for UNFPA and rescinding the anti–family planning “global gag rule” are excellent first steps by the Obama administration to make up for ground the United States has lost over the past decade. But much more remains to be done to restore U.S. leadership on global sexual and reproductive health issues. With “Cairo plus 15” as a central theme, the upcoming United Nations meeting is a prime opportunity for the United States to reassert its commitment to fulfilling the promises made in 1994.

As part of the proceedings, the Guttmacher Institute and UNFPA will convene representatives from the British, Norwegian and U.S. international aid agencies in a parallel session to discuss priorities in funding for population and development. The panelists will also explore how the donor agencies can work together to maximize investments in global sexual and reproductive health. 

Click here for information on:

What the United States can do to restore its leadership in global sexual and reproductive health policy 

What the Obama administration has done so far to promote global health and development 

A look back at “Cairo plus five” and “Cairo plus 10”

Today we had to ask one of the protesters to move his truck out of our parking lot. I understand that it’s inconvenient to have to walk a few blocks, but I’d rather inconvenience him than the parents coming into our WIC clinic who need to negotiate strollers and car carriers. This time of year, you never know when the temperature is going to change and the sidewalks will suddenly turn into skating rinks. I’m very grateful that to date this is the largest inconvenience we’ve encountered. I’m hopeful things will continue to be respectful.

It is somewhat surprising the number of families we’ve seen praying outside the clinic. Prior to the campaign, we saw one family on a regular basis, but now there are a few. I’m a little challenged when it comes to the issue of the kids. This summer one of the children was quite adamant about not wanting to be protesting (praying) because it was boring. These kids seem to be praying, but I have to repress the desire to bring them some hot tea and a basketball.

What: Women’s Health Speak Out

When: January 29, 2009; 7 p.m. – 9 p.m.

Where: 1st Floor Lecture Hall of the David R. Obey Health Sciences Building at Northcentral Technical College (1000 W. Campus Dr., Wausau, WI)

We hope you’ll join us.  Call 1-800-246-5743 if you need more information.  If you can’t make it, keep your eyes on BelowtheWaist because we’ll post follow up here.

Across the country, low-income women and families are facing potential state cuts to Medicaid funding as Governors cope with budget deficits. The federal government can help by temporarily increasing the amount of federal matching funds (known as FMAP) sent to states.  

The Senate Finance Committee is convening TODAY to determine the funds allocated for FMAP.  The committee is considering cutting back on the amount they originally had considered so please take a minute RIGHT NOW and urge members of the Committee to support at least $100 billion for FMAP!

Simply call and say “Our state needs enhanced FMAP funding.  I urge you to commit at least $100 billion for FMAP.”

For contact information for Senate Finance Members, please go to the website link below, scroll down, click on the Senator’s name, call his/her office, and ask to speak to the HEALTH staff. http://www.congress.org/congressorg/directory/committees.tt?commid=sfina 

2) Children’s Health Insurance that includes immigrant children

While you’re on the phone with the office of Senate Finance Committee members, urge swift action on the State Children’s Health Insurance Program, with an additional step to include legal immigrant children. SCHIP is the same program President Bush vetoed twice last year. This legislation expands health care for kids who are in working families that make too much to qualify for Medicaid, but who don’t make enough to afford private insurance.

It is anticipated that the House bill, which will include lifting the 5-year ban on health health care for documented immigrant children, will move quickly and pass. While hopeful, passage in the Senate will be more difficult.  A major stumbling block is the Senate Finance Committee where there is disagreement over the issue of documented immigrant children.  

According to our colleagues at NILC, under current law, legal immigrant children and pregnant women must wait five years before they become eligible for federally funded Medicaid and SCHIP. Americans believe this waiting period is wrong and want it eliminated. Congress can address this inequity by including the Legal Immigrant Children’s Health Improvement Act (ICHIA) in the 2009 SCHIP reauthorization bill.  Moreover, in these difficult economic times, Congress should be finding ways to help America’s working families and states with tight budgets. ICHIA would provide fiscal relief to families as well as states and would be a key component of a strong health reform foundation.   Congress needs to pass ICHIA now, and demonstrate its commitment to children and a health care system that works for all Americans.
 
Senate Finance Committee members and their positions on reauthorization of SCHIP including documented immigrant health care provision:

Supportive and will vote yes:
Jeff Bingaman, NM
John D. Rockefeller, WV
John Kerry, MA
Blanche Lincoln, AR
Charles E. Schumer, NY
Maria E. Cantwell, WA
Olympia Snowe, ME

Supportive in the past, no confirmation given this year:
Max Baucus, MT
Kent Conrad, ND
Ron Wyden, OR
Debbie Stabenow, MI
 
Position not yet determined:
Ken Salazar, CO
Jon Kyl, AZ
Jim Bunning, KY
Mike Crapo, ID
John Ensign, NV
John E. Sununu, NH
 
Will oppose the bill with documented immigrant health care provision included:
Chuck Grassley, IA
Orrin G. Hatch, UT
Pat Roberts, KS
 
Thanks to our colleagues at the National Health Law Program, Families USA, Community Catalyst and Faithful Reform for the information used in this alert!

Dear Mr. Corvino,

As you may know, on December 11, 2008, an advisory committee at the U.S. Food and Drug Administration (FDA) voted unanimously to grant pre-market approval to the FC2 female condom–the Female Health Company’s second generation female condom.  This was a victory for women’s health, and means the FC2 is one step closer to obtaining FDA approval, which is likely to happen in the next few months.  At this time, HIV prevention and women’s rights advocates have a critical window to let the FDA know we support full access to female condoms.

Learn more about the FDA FC2 review and female condom advocacy

The Center for Health and Gender Equity, the National Women’s Health Network, and the AIDS Foundation of Chicago invite you to participate in an upcoming teleconference on January 7, 2009 at 3:00pm Eastern about the FDA FC2 review and continued female condom advocacy.

What: “FDA FC2 Review and Female Condom Advocacy Strategy Call.” Agenda items include:

Recap of FDA FC2 advisory committee review, including key speakers, outcomes and next steps in the approval process (Amy Allina, Program and Policy Director, National Women’s Health Network)
FDA-targeted female condom advocacy and ideas for future advocacy efforts (Kimberly Whipkey, Advocacy and Outreach Associate, Center for Health and Gender Equity)
Female condom media activities (Jessica Terlikowski, Policy Manager, AIDS Foundation of Chicago)
Questions, comments, discussion
When: Wednesday, January 7, 2009, at 3:00pm Eastern/2:00pm Central/1:00pm Mountain/12:00 Noon Pacific.

RSVP: Space is limited, so we ask that you register for the call.  Please click here and complete the registration form.

Important details: The call-in number will be emailed shortly after registration and is toll-free for participants in the U.S. and Canada.  However, please note that those who dial-in internationally will be charged their standard long-distance rate.  While we strive to make this call as accessible as possible, we regret that we are not able to provide a toll-free number to international participants.

We ask that you sign-up for the call no later than 12:00 Noon on Wednesday, January 7, 2009.

We look forward to your participation.  Please don’t hesitate to contact me (kwhipkey@genderhealth.org ) with any questions regarding the teleconference.

In solidarity,

Kimberly Whipkey
Advocacy and Outreach Associate
Center for Health and Gender Equity (CHANGE)
1317 F Street NW, Suite 400
Washington, D.C. 20004

Connecticut Attorney General Richard Blumenthal (D) on Friday said that he plans to challenge the new HHS provider “conscience” rule, which he said could override a Connecticut law that requires hospitals to provide emergency contraception to women who have been raped, the AP/New Haven Register reports (AP/New Haven Register, 12/20). The rule, which will take effect on Jan. 18, 2009, allows employees of entities that receive federal grants to refuse to provide medical information and services they object to based on moral or religious beliefs. The more than 584,000 entities that the rule will affect have until Oct. 1, 2009, to submit written certification of their compliance or risk losing federal funding (Daily Women’s Health Policy Report, 12/19).

Blumenthal said that his actions could include a letter, a petition or a court challenge that would argue that the rule violates states’ and patients’ rights. “We went through a very lengthy, painstaking, contentious process to reach our statute in Connecticut and it has worked well for everyone,” he said, adding, “This administration’s new regulation threatens to blow apart that very significant balance of interests and compromises” (Becker, Hartford Courant, 12/20). The Connecticut law, which took effect in 2007, requires hospitals to offer EC to rape survivors, although a third party can be designated to administer the drug. Hospitals also are permitted to conduct a pregnancy test before prescribing EC, but they may not administer other tests — such as ovulation tests — as a condition of prescribing the drug. The Catholic Church opposed the law for two years, but a few days before it was to take effect, Catholic Bishops of Connecticut and Catholic hospital leaders issued a statement saying that “since the teaching authority of the church has not defnitively resolved this matter, and since there is serious doubt about how Plan B pills work,” Catholic hospitals would be allowed to provide EC to rape survivors without first administering ovulation tests. Four of the state’s 30 hospitals are Catholic (AP/New Haven Register, 12/20).

Blumenthal called the new federal regulation “the outgoing Bush administration’s latest and last swipe at women’s health” and said that it upsets the balance between patients’ rights and providers’ beliefs. “This rule is an appalling insult and abuse — a midnight power grab to deny access to health care services and information, even to victims of rape,” he said (Hartford Courant, 12/20).

Listening to the spokesperson for Pro-Life Wisconsin as he defended the new ‘right of conscience’ regulations on Wisconsin Public Radio last week reminded me of the wisdom of the tale.

For 30 years, regulations and federal laws have struck a delicate balance between the rights of patients to receive health care and the rights of health care providers. The new regulations, issued by Health and Human Services Secretary Leavitt, expand the rights of health care providers so extensively that the rights of the patient to receive care are obliterated. The new regulations give the right to refuse to provide health care to all virtually all employees for any health care service they might ‘morally object to.’

Matt Sande, speaking on behalf of Pro-Life Wisconsin, defended the broadest possible right to refuse saying: “These rights aren’t qualified in any way. That’s as it should be. We just have to work around it. We may not understand or agree with an individual’s objection, but we must protect and defend them. . . If we pick and choose which rights we protect, then we won’t have rights for anyone.”

Would this right to refuse apply to physicians who provide abortion services in South Dakota who have been required by state law to inform their patients that terminating a pregnancy is ending a separate, unique human life and that consequences may include depression and suicide? These physicians certainly have moral objections to the content of that message. Health and Human Services Secretary Leavitt has said that, where state laws and the rights of conscience regulations are in conflict, the federal government will help “bring the state into compliance.”

Would volunteers at federally funded abstinence-only “crisis pregnancy centers” have federal civil rights protection for refusing to give out inaccurate and incomplete information [Waxman Report] about the effectiveness of condoms to prevent pregnancy and HIV transmission? As he described patients who ‘may have to go somewhere else,” Mr. Sande said; “One person’s convenience should not trump another person’s right of conscience.”

The moral of the fable is that we are often the source of our own destruction.

The first weakness of the ‘rights of conscience’ regulation expansion is an assumption that only anti-abortion and anti-family planning advocates have moral convictions. The probability that health care employees will refuse to comply with anti-choice or anti-contraception requirements has been overlooked.

The second weakness is a faith-based denial that absolute rights do not exist on this earth. Individual rights require constant, vigilant, rational and empathic balancing. Whether it is the right of a patient to informed consent or the right of the state to protect a fetus, purity is an impossible standard.

The Obama administration must immediately refuse to enforce these regulations and Congress must immediately begin the process to rescind them. In this case, ideologues have given their enemies the means of their own destruction and the regulations must be brought to earth.

“Condoms save lives,” continues Newman. “FPHS will be giving away one dozen condoms free to visitors at all of our clinics from now until the close of business on December 23, 2008. Additionally, we challenge the new Congress, the new Administration, and all leaders to provide principled leadership on HIV/AIDS awareness and treatment by promoting health care policy based on two pillars of public health and American government – science and reason.  We need accurate sexuality education to be taught consistently throughout our nation.”

As the global community marks World AIDS Day on December 1, advocates and policy experts welcome the promise by the incoming Obama administration to put sound scientific evidence at the forefront of the U.S. global AIDS program (PEPFAR). President-elect Obama’s campaign Web site states that the “first priority is…to ensure that best practices—not ideology—… drive funding for HIV/AIDS programs.” And indeed, both the new administration and the incoming Congress will have opportunities next year to do just that.

In August 2008, the U.S. government reauthorized the PEPFAR program, committing $39 billion over five years to the global fight against HIV. The new PEPFAR law features many improvements over the law that guided the program’s first five years; however, it, too, falls short in terms of HIV prevention policy.

What PEFPAR will actually look like on the ground later next year will depend largely on the new administration. In 2009, the incoming administration will develop a plan to implement the reauthorized PEPFAR that could remedy or at least mitigate some of the law’s shortcomings. It will make a host of crucial decisions, from how best to prevent the sexual transmission of HIV to how to better integrate HIV prevention and reproductive health services.

Backed by a growing body of evidence, policies at the global level already recognize the importance of linkages between HIV and reproductive health services. But the United States remains a major obstacle to effective integration, and the PEPFAR law is silent on the importance of linkages. That the U.S. government has failed to join and actively support the global integration consensus is exacerbated by the erosion of U.S. support for international family planning programs.

The issue of better integrating HIV and reproductive health services is especially important in countries with high rates of HIV infection, which often are impoverished and have poor health infrastructures. It makes eminent sense to offer women the services they need—whether related to HIV or to reproductive health—in settings they already frequent. For instance, PEPFAR should pay for HIV testing, counseling and referral at sites that women already visit regularly to obtain family planning services. In turn, women should be able to obtain contraceptives to avert pregnancies they themselves don’t want at sites they already visit to receive HIV services.

Embracing proven interventions that promote HIV–reproductive health service linkages, along with promoting needed increases in international family planning assistance, would allow the United States to begin reclaiming its role as a leader in international sexual and reproductive health.

Click here for more information on:

Making crucial changes to U.S. global HIV prevention policy

The urgent need for better HIV–reproductive health service linkages

The role of contraception in preventing HIV

The role of reproductive health providers in preventing HIV

Meeting the sexual and reproductive health needs of people living with HIV