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Funding by the United States for family planning has a giant positive impact. With the White House releasing its budget request for fiscal year 2014 and the budget debates heating up, now seems like a good time to look at what investments in reproductive health enables.
A total of $610 million was allocated to family planning and reproductive health services in the 2012 budget according to the Guttmacher Institute:
§ 31.6 million women and couples receive contraceptive services and supplies;
§ 9.4 million unintended pregnancies, including 4.1 million unplanned births, are averted;
§ 4 million induced abortions are averted (3 million of them unsafe);
§ 22,000 maternal deaths are averted;
§ 2.8 million fewer healthy years of life (DALYs) are lost among women; and
§ 96,000 fewer children lose their mothers.
Increasing spending will expand access and services and cuts will lead to declines. It is as simple as that. A mere $10 million in the budget for family planning means
§ 520,000 fewer women and couples would receive contraceptive services and supplies;
§ 150,000 more unintended pregnancies, including 70,000 more unplanned births, would occur;
§ 70,000 more abortions would take place (of which 50,000 would be unsafe);
Former President Bill Clinton has successfully engineered a partnership that has resulted in cutting the cost of long term birth control for women in developing countries in half, proving that while there may be a term limit on the American presidency, there’s no term limit on kicking ass. (If there was a movie about super hero ex-Presidents, that would totally be the tag line.) Unfortunately, the birth control that will now be available to millions of women is… sort of crappy.
The deal was announced yesterday, according to the AP, and will benefit 27 million women in developing countries. Clinton’s foundation estimates that improved access to Jadelle progesterone implants (which are also known as Norplant) will prevent 30 million unplanned pregnancies and save a quarter of a billion dollars in costs associated with unplanned births. Further, 30,000 maternal deaths and 280,000 child deaths will be prevented by the initiative.
Jadelle is no longer sold in the US (more on that in a bit), but it works similarly to Implanon. A small incision is made on the inside of the upper arm of a woman interested in remaining unpregnant for the foreseeable future and two thin capsules are inserted just below the surface of the skin. Because this birth control method doesn’t contain estrogen, women who might otherwise be disqualified from using hormonal birth control are able to use Jadelle. It’s effective starting 24 hours after insertion and remains effective for up to 5 years. Women who decide they want to have more children can also have the implant removed. Yay, right?
But the drug isn’t all fun and games; the reason Norplant is not available in the United States is that unsatisfied users sued the shit out of Wyeth Pharmaceuticals in the 90′s after users of the implants reported horrible side effects — headaches, nausea, depression, and the dreaded Forever Period. The pharma never admitted wrongdoing, but ended up paying more than 30,000 angry, crabby users $1,500 apiece in an out of court settlement. Overall, more than 50,000 women sued Wyeth over the drug.
The Clintonian partnership negotiated with Jadelle’s manufacturer to cut costs in half in exchange for a 6-year purchasing agreement. Let’s hope women in developing countries don’t hate it as much as women in America did. Then again, given the alternative, birth control and a headache is probably better than nothing and a baby.
[This came to us today from the US Conference of Catholic Bishops. We felt we should run it unedited.]
United for Religious Freedom
A Statement of the Administrative Committee
Of the United States Conference of Catholic Bishops
March 14, 2012
The Administrative Committee of the United States Conference of Catholic
Bishops, gathered for its March 2012 meeting, is strongly unified and intensely focused
in its opposition to the various threats to religious freedom in our day. In our role as
Bishops, we approach this question prayerfully and as pastors—concerned not only with
the protection of the Church’s own institutions, but with the care of the souls of the
individual faithful, and with the common good.
To address the broader range of religious liberty issues, we look forward to the
upcoming publication of “A Statement on Religious Liberty,” a document of the Ad Hoc
Committee for Religious Liberty. This document reflects on the history of religious
liberty in our great Nation; surveys the current range of threats to this foundational
principle; and states clearly the resolve of the Bishops to act strongly, in concert with our
fellow citizens, in its defense.
One particular religious freedom issue demands our immediate attention: the nowfinalized rule of the U.S. Department of Health and Human Services that would force
virtually all private health plans nationwide to provide coverage of sterilization and
contraception—including abortifacient drugs—subject to an exemption for “religious
employers” that is arbitrarily narrow, and to an unspecified and dubious future
“accommodation” for other religious organizations that are denied the exemption.
We begin, first, with thanks to all who have stood firmly with us in our vigorous
opposition to this unjust and illegal mandate: to our brother bishops; to our clergy and religious; to our Catholic faithful; to the wonderful array of Catholic groups and
institutions that enliven our civil society; to our ecumenical and interfaith allies; to
women and men of all religions (or none at all); to legal scholars; and to civic leaders. It
is your enthusiastic unity in defense of religious freedom that has made such a dramatic
and positive impact in this historic public debate. With your continued help, we will not
be divided, and we will continue forward as one.
Second, we wish to clarify what this debate is—and is not—about. This is not
about access to contraception, which is ubiquitous and inexpensive, even when it is not
provided by the Church’s hand and with the Church’s funds. This is not about the
religious freedom of Catholics only, but also of those who recognize that their cherished
beliefs may be next on the block. This is not about the Bishops’ somehow “banning
contraception,” when the U.S. Supreme Court took that issue off the table two
generations ago. Indeed, this is not about the Church wanting to force anybody to do
anything; it is instead about the federal government forcing the Church—consisting of its
faithful and all but a few of its institutions—to act against Church teachings. This is not a
matter of opposition to universal health care, which has been a concern of the Bishops’
Conference since 1919, virtually at its founding. This is not a fight we want or asked for,
but one forced upon us by government on its own timing. Finally, this is not a Republican
or Democratic, a conservative or liberal issue; it is an American issue.
So what is it about?
An unwarranted government definition of religion. The mandate includes an
extremely narrow definition of what HHS deems a “religious employer” deserving
exemption—employers who, among other things, must hire and serve primarily those of their own faith. We are deeply concerned about this new definition of who we are as
people of faith and what constitutes our ministry. The introduction of this unprecedented
defining of faith communities and their ministries has precipitated this struggle for
religious freedom. Government has no place defining religion and religious ministry.
HHS thus creates and enforces a new distinction—alien both to our Catholic tradition and
to federal law—between our houses of worship and our great ministries of service to our
neighbors, namely, the poor, the homeless, the sick, the students in our schools and
universities, and others in need, of any faith community or none. Cf. Deus Caritas Est,
Nos. 20-33. We are commanded both to love and to serve the Lord; laws that protect our
freedom to comply with one of these commands but not the other are nothing to
celebrate. Indeed, they must be rejected, for they create a “second class” of citizenship
within our religious community. And if this definition is allowed to stand, it will spread
throughout federal law, weakening its healthy tradition of generous respect for religious
freedom and diversity. All—not just some—of our religious institutions share equally in
the very same God-given, legally-recognized right not “to be forced to act in a manner
contrary to [their] own beliefs.” Dignitatis Humanae, No. 2.
A mandate to act against our teachings. The exemption is not merely a
government foray into internal Church governance, where government has no legal
competence or authority—disturbing though that may be. This error in theory has grave
consequences in principle and practice. Those deemed by HHS not to be “religious
employers” will be forced by government to violate their own teachings within their very
own institutions. This is not only an injustice in itself, but it also undermines the effective
proclamation of those teachings to the faithful and to the world. For decades, the Bishops have led the fight against such government incursions on conscience, particularly in the
area of health care. Far from making us waver in this longstanding commitment, the
unprecedented magnitude of this latest threat has only strengthened our resolve to
maintain that consistent view.
A violation of personal civil rights. The HHS mandate creates still a third class,
those with no conscience protection at all: individuals who, in their daily lives, strive
constantly to act in accordance with their faith and moral values. They, too, face a
government mandate to aid in providing “services” contrary to those values—whether in
their sponsoring of, and payment for, insurance as employers; their payment of insurance
premiums as employees; or as insurers themselves—without even the semblance of an
exemption. This, too, is unprecedented in federal law, which has long been generous in
protecting the rights of individuals not to act against their religious beliefs or moral
convictions. We have consistently supported these rights, particularly in the area of
protecting the dignity of all human life, and we continue to do so.
Third, we want to indicate our next steps. We will continue our vigorous efforts at
education and public advocacy on the principles of religious liberty and their application
in this case (and others). We will continue to accept any invitation to dialogue with the
Executive Branch to protect the religious freedom that is rightly ours. We will continue to
pursue legislation to restore the same level of religious freedom we have enjoyed until
just recently. And we will continue to explore our options for relief from the courts,
under the U.S. Constitution and other federal laws that protect religious freedom. All of
these efforts will proceed concurrently, and in a manner that is mutually reinforcing.Most importantly of all, we call upon the Catholic faithful, and all people of faith,
throughout our country to join us in prayer and penance for our leaders and for the
complete protection of our First Freedom—religious liberty—which is not only protected
in the laws and customs of our great nation, but rooted in the teachings of our great
Tradition. Prayer is the ultimate source of our strength—for without God, we can do
nothing; but with God, all things are possible.
CAN we still be arguing about a woman’s ability to control her own fertility? Almost 50 years ago in Griswold v. Connecticut, the Supreme Court struck down state restrictions on contraception because they violated a right to privacy. But the issue has not gone away. Rick Santorum injected it into the presidential race by indicating that Griswold should be overturned so that states could ban contraception altogether. And the Senate just voted down a Republican effort to allow employers and health insurance companies to refuse coverage for contraceptives if they had moral or religious objections.
Why are issues that the courts decided so long ago still unresolved? Maybe it is time to recognize that law alone is not enough to effect social change. It must be linked to social activism on behalf of women’s rights.
I should know. Fifty-five years ago, I had an opportunity to take a stand in favor of the right of women to control their fertility — and I did so through the courts.
It was 1957, and fresh out of the University of Wisconsin I enrolled in the Yale Law School — one of only six women in my graduating class. In my second year at Yale, several of our professors asked my husband and me to join a lawsuit challenging Connecticut’s birth-control law, which outlawed the sale and use of contraceptive materials and prohibited a doctor from prescribing birth control even to married women. One goal of the lawsuit was to remove the statutory obstacle to opening Planned Parenthood clinics in Connecticut so that poor families could have access to family-planning services.
I immediately agreed to join the case. Others did as well, but my husband and I were the only ones to use our real names. Because people used pseudonyms, the lead case came to be called Poe v. Ullman, but there was a companion case called Trubek v. Ullman. Poe raised a variety of grounds for challenging the statute and eventually landed in the Supreme Court.
I was proud to put my name on the case. To serve as a plaintiff, though a largely passive role, suited my vision of my future as a social justice lawyer. I supported Planned Parenthood. I believed women should have access to birth control so they could have both a career and a family. I wanted those things for myself. I was no sexual radical: I was married, a “good girl” uninterested in sexual freedom, and I thought of abortion as frightening. But I was planning to have a family and a career as a lawyer. I believed I should be free to choose the timing of my children’s births so I could do both.
Poe was thrown out by the Supreme Court on a technicality. To force the issue, Planned Parenthood opened a clinic, leaving the state with no choice but to close it down. This landed the issue back in the Supreme Court — this time with different plaintiffs, as Griswold v. Connecticut — which found the statute an unconstitutional intrusion on marital privacy.
The privacy argument in Griswold led to the legalization of contraception. But it also had a much larger impact: the privacy doctrine played a central role in Roe v. Wade (1973), which declared some barriers to abortion unconstitutional; was used by the court in Lawrence v. Texas (2003), which struck down bans on consensual same-sex sexual activity; and has been cited in state court decisions upholding same-sex marriage.
We can celebrate Griswold, Roe and all the cases that stemmed from the Poe litigation. They are important landmarks in American jurisprudence. But as I look back I am dismayed by how few of the issues I was fighting for at the time of Poe are resolved. To be sure, we have important rights and more legal privacy. But we still have not provided all the support women need to combine rewarding careers and healthy families. Planned Parenthood is under siege and poor women who are seeking comprehensive reproductive care are still at risk. Presidential candidates can get away with saying that all contraception should be outlawed. Comprehensive child care services are difficult to locate, and fully financed family and medical leave is still controversial.
In short, we won the legal battle but not the war. Women are still not guaranteed control over their lives, because the necessary social supports were never secure. The initial goal of Griswold was to help women — and even though the precedent has helped with same-sex marriage laws, those initial needs, especially of poor women, have been left largely unmet.
The universal coverage plan outlined in President Obama’s Affordable Care Act is a good step forward, and we should do all we can to ensure it. Perhaps if activism had been linked to the lawsuits, the aims I fought for would have been secured, and we would be spared the spectacle of Republican candidates threatening, yet again, a woman’s right to control her own fertility.
Louise G. Trubek is a public interest lawyer and an emerita professor at the University of Wisconsin Law School.
WASHINGTON— The United States Conference of Catholic Bishops (USCCB) sees initial opportunities in preserving the principle of religious freedom after President Obama’s announcement today. But the Conference continues to express concerns. “While there may be an openness to respond to some of our concerns, we reserve judgment on the details until we have them,” said Cardinal-designate Timothy Dolan, president of USCCB.
“The past three weeks have witnessed a remarkable unity of Americans from all religions or none at all worried about the erosion of religious freedom and governmental intrusion into issues of faith and morals,” he said.
“Today’s decision to revise how individuals obtain services that are morally objectionable to religious entities and people of faith is a first step in the right direction,” Cardinal-designate Dolan said. “We hope to work with the Administration to guarantee that Americans’ consciences and our religious freedom are not harmed by these regulations.”
For Immediate Release: February 10, 2012
Contact: Planned Parenthood Media Office, 212-261-4433
Statement by Cecile Richards, President of Planned Parenthood Federation of America, on Obama
Administration Announcement on Birth Control Coverage Benefit:
“In the face of a misleading and outrageous assault on women’s health, the Obama administration has
reaffirmed its commitment to ensuring all women will have access to birth control coverage, with no
costly co-pays, no additional hurdles, and no matter where they work.
“We believe the compliance mechanism does not compromise a woman’s ability to access these critical
birth control benefits.
“However we will be vigilant in holding the administration and the institutions accountable for a
rigorous, fair and consistent implementation of the policy, which does not compromise the essential
principles of access to care.
“The individual rights and liberties of all women and all employees in accessing basic preventive health
care is our fundamental concern.
“Planned Parenthood continues to believe that those institutions who serve the broad public, employ
the broad public, and receive taxpayer dollars, should be required to follow the same rules as everyone
else, including providing birth control coverage and information.
“As a trusted health care provider to one in five women, Planned Parenthood’s priority is increasing
access to preventive health care. This birth control coverage benefit does just that.
“The birth control benefit underscores the fact that birth control is basic health care, and is fundamental
to improving women’s health and the health of their families.
“That’s why women have consistently applauded the Obama administration for one of the greatest
expansions for women’s health in decades.
“Unfortunately there are significant and immediate threats to women’s health and access to birth
control in the House and Senate that would completely take away access to birth control and severely
undermine women’s health.
“One bill, the Rubio-Manchin bill, would allow any business or corporation, on the basis of personal
religious belief or moral conviction, to take away birth control coverage from their employees.
“Employers should not be allowed to impose their personal beliefs on employees regarding birth control
coverage or basic health care. “Another bill, sponsored by Senator Blunt (R-MO), would d
WASHINGTON, DC (February 10, 2012) – The following statement is being released by Sr. Carol
Keehan, DC, president and chief executive officer of the Catholic Health Association of the United
States (CHA):
The Catholic Health Association is very pleased with the White House announcement that
a resolution has been reached that protects the religious liberty and conscience rights of
Catholic institutions. The framework developed has responded to the issues we identified
that needed to be fixed.
We are pleased and grateful that the religious liberty and conscience protection needs of
so many ministries that serve our country were appreciated enough that an early
resolution of this issue was accomplished. The unity of Catholic organizations in
addressing this concern was a sign of its importance.
This difference has at times been uncomfortable but it has helped our country sort
through an issue that has been important throughout the history of our great democracy.
The Catholic Health Association remains committed to working with the Administration
and others to fully implement the Accountable Care Act to extend comprehensive and
quality health care to many who suffer today from the lack of it.
