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50 Reasons HHS Should Reverse its Decision on Emergency Contraception

1:40 pm in Uncategorized by RH Reality Check

Written by Soraya Chemaly for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

Here is a $12 billion problem we really can actually go a long way towards eliminating.

There are 62 million American women of childbearing age, 43 million of whom are “at risk” for unintended pregnancy. Women manage their fertility for an average of 30 years. “At risk” — like an unplanned pregnancy is something that just happens to you, out of your control. NOT. These pregnancies have consequences for all of us. Someone needs to introduce the Purity Bear to the $12 billion dollars worth of consequences. And that’s a conservative estimate.

Most girls and women (some of whom are part of a couple…) don’t get pregnant if they don’t want to when they have access to safe, affordable birth control, including emergency contraception. There are no medical or scientific reasons why girls and women need prescriptions for methods relevant to their needs. Just religious, shame-based ones based on stereotypes, control and fear. We should be scheduling birth control biotechnologies the way we do vaccines and they should not require prescriptions. That or we should start requiring prescriptions for condoms. Exactly how long do you think that option would fly with the Pecker Patrol?

The most obvious and immediate issue is the fact that emergency contraception, Plan B, is not available without a prescription and should be. The longer term issue is why American women are ill-informed about and therefore not using long-acting forms of reversible contraception.

It’s been almost exactly a year since, in an unprecedented move, Health and Human Services (HHS) Secretary Kathleen Sebelius, in an act of what some called scientifically unethical “national malpractice,” overruled a Food and Drug Administration recommendation and restricted access to emergency contraception long known to be safe and effective for all females of childbearing age. This was roundly condemned by reproductive health care advocates as a political act, contrary to good public policy, sound scientific reasoning and bad for women and their health.

Unplanned pregnancies pervasively affect us all: PersonallySocietallyEconomically. And I’m not only thinking about the “motherhood penalty,” direct medical costs or obvious expenses related to children. There are clear linkages to increases in other social ills: like crime, lower education levels, higher incidences of domestic abuse, increased pressure on the welfare system and more. Children who result from unplanned pregnancies are far likelier to experience developmental problems, poorer physical and mental health, to struggle in school. These steep costs exponentially exceed the cost of society’s providing easy, affordable access to birth control.

Here are 50 reasons to sign this petition urging Kathleen Sebelius to do the right thing, get us on the right track, and make safe and effective contraception, especially emergency contraception, available to all girls and women and couples who need it, when they need it.

50 Facts About Unplanned Pregnancies

  1. Rank of the US for unplanned teen pregnancies among developed nations: 1
  2. Rank of the US for abortions globally: Second
  3. Percentage of pregnancies in the US that are unplanned: 49%
  4. Percentage of women by the age of 45 who have experienced an unplanned pregnancy in the US: +50 percent
  5. Number of girls or women who can get pregnant: 43 million
  6. Number of boys or men who can get pregnant: 0 million
  7. Age at which a boy or man can independently acquire over the counter birth control that meets his needs and for which he is responsible: Any age, unrestricted access
  8. Average cost to a boy or man: About $1.34 per condom
  9. Average costs of birth control technologies to women: $15.00-50.00 for month of pills, or Handy-dandy calculator for other methods
  10. Average at which a girl in the United States is able to become pregnant: 12.6 years
  11. Average age at which a boy in the United States is able to become pregnant: Never
  12. Age at which a girl can get emergency contraception if the pharmacist doesn’t mislead her: 17
  13. Percentage chance of getting pregnant from one act of sex: 5% to 30% depending on where a woman is in her reproductive cycle
  14. Rank of condoms in terms of efficacy among four categories of contraception: 4th
  15. Reason given by a pharmacist in Topeka who refused to sell emergency contraception to an adult man : “I don’t feel comfortable with it.”
  16. No of states with “conscious clause” legislation allowing pharmacists to decline to fill birth control prescriptions because of their religious objections: 12
  17. Percentage of US women in their 20s whose pregnancies are unintentional: 69%
  18. Rate change in unintended pregnancy for high-income women since 1994: 29% decrease
  19. Rate change in unintended pregnancy for low-income women, or those beneath the poverty line, since 1994: 50% increase
  20. Percentage of unintended pregnancies in the US that end in abortions: approximately 38%
  21. Percentage of US adolescents today who have had sex: 46%
  22. Percentage of all teen births in the developed world that take place in the US: 71%
  23. Likelihood that a teenage who has sex without contraception becomes pregnant within a year: 90%
  24. Percentage decrease in chances of an abortion with birth control use: 46%
  25. Percentage of adolescents in the a recent survey given the wrong age for requirements for emergency contraception by pharmacists: >50%
  26. Percentage of American women currently living in states whose legislatures are hostile to Planned Parenthood: More than 50%
  27. Decline in unwanted pregnancies when free birth control (all kinds) were made availableto teen girls: from 34 per 1,000 teens nationally to 6.3 per 1,000 teens in the study group
  28. Rank of US for maternal mortality in the world: 50th in the world
  29. Rate at which the US maternal mortality has changed in the past 25 years: Doubled
  30. Rate at which African American women die due to maternity related issues compared to women of European descent in the US: 3.2 to 1
  31. Estimated reduction in maternal deaths due to increased contraceptive use: up to 35%
  32. Estimated number of pregnancies and abortions that would have been avoided if 65,000 women participating in a study had had easy, regular access to birth control pills: 1,300 publicly funded pregnancies and 300 abortions
  33. Chances that Emergency Contraception causes an abortion: 0%
  34. Chances that EC, when effective, prevents the need for an abortion: 100%
  35. State in which a rape victim was denied emergency contraception based on pharmacists objections: Oklahoma
  36. Number of women who get pregnant from rape every year: 32,000
  37. Percentage of rape victims who are under the age of 18: 15%
  38. Amount the federal government spent on abstinence programs since 1982:1.5 billion dollars
  39. Percentage of students who got pregnant that drop out of New Yorks public school system: 70%
  40. Percentage of boys who fathered babies who dropped out: Not measured.
  41. Percentage of parents who opted out of a New York City pilot program to provide contraceptives in school: 1-2%
  42. Percentage of teachers who think students should be taught about contraception: 90%
  43. Percentage of teachers in the US who are prohibited from teaching about contraception: 25%
  44. Grade that Florida received on The Population Institutes 2012 state-by-state report card on Reproductive Health and Rights: F (the others being AZ, LA, MS, NE, NV, ND, SD, TN)
  45. State in which a 14-year old girl faces life imprisonment because she did not want to tell her mother she was pregnant, delivered a baby in her bathroom and then killed it: Florida
  46. Amount inserted, so to speak, into our current budget for failed Abstinence Only programs: $50 million
  47. Number of states that applied for grants to these programs in 2010: 30 including Puerto Rico
  48. Percentage of US sex education programs that teach that abstinence is the only option “birth control” for unmarried, heterosexual couples: 35%
  49. A stated goal of Republican party leadership: defund Title X Family Planning Legislation
  50. Amount that every $1.00 spent on contraceptive access saves in Medicare expenses: $4.02

Many people still do not understand how Plan B works and think that it causes abortions, which they object to. This drug is safer than Tylenol, as easy to use and understand, and is not an “abortion pill.” You should consider sending this excellent explanatory video, along with a copy of Our Bodies, Ourselves as a holiday gift to your representative in Congress or your state legislature.

Objections seemed to hinge on the horror of young girls buying emergency contraception. I don’t understand this. First, boys can buy condoms and this pill is as easy to comprehend and easier to use than micro-thin latex. Object away if you must in equal measure. Second, concern centered (surreally) on a relatively small group: young girls who need emergency contraception. Being “concerned” at this stage — about an eleven year old seeking, by herself, emergency contraception, too little, too late. Asking her to get parental permission, possibly from the very person who impregnated her, is beyond contemptible and falls into the equally repugnant “lemons into lemonade” basket. It’s a desire to ignore and make worse horrible things happening every day to children. If an 11-year-old is seeking contraception there are many other things to be worried about. This is the point at which she needs not to get pregnantIt’s ridiculous to use this reasoning to deny the overwhelming number of girls and women who are not 11 years old access to emergency contraception.

But, beyond Plan B. Last week the American College of Obstetricians and Gynecologists (ACOG) endorsed over-the-counter birth control pills.

Allow yourselves to dream for a minute, ladies: Imagine not having to pay, with your time and money, for doctors visits to get prescriptions. Waiting for or dealing with a pharmacist, who may or may not have religious or other objections to your private decisions. Imagine being able to walk into a store and buy months worth of your contraception of choice by picking it up on a shelf and taking it to the cash register where some nice person smiles, takes your money, gives you change and puts your cute (or garish) little box in a bag, or you even casually drop it in your pocket, and make your way out.

And, men, day dream for them. Because, well, you know. There are some serious upsides that accrue for you guys. Not to mention just basic fairness. I mean, your boxes are so easy to get and even have the advantage of being thematically organized for maximal pleasure. Heck, you can even customize them.

“Fertility control” is more accurate term because it makes both of these words: “pregnancy intentions,” more relevant and important, and, last but not least, it shifts the focuses where it should be: on the people whose reproduction is at issue. Especially women. Who should be fully in control of their own fertility and are clearly NOT. I say women because a man — as described above — can currently control his fertility by walking into a drug store and buying a condom for $1.34. This is entirely unregulated, unlike women’s fertility. Which is regulated. And, of course, women can buy condoms. Which “reduce chances of pregnancy by 97 percent, [but] in reality fail five times as often because of improper use.” For many women, trusting their futures to a thin tissue of rubber just doesn’t cut it.  If ever there was a public health problem with long-ranging costs that we know how to solve this is IT.

And yet, we don’t. We make women jump through hoop after hoop after expensive, time-sucking, regulated fertility hoop. WHY on earth do we tolerate this from pro-natal legislators? And entertain Bishops who have no place in women’s health care. Ever. At all. Never. Forever and ever. Amen.

Birth control is even more reliable and effective if it is available at no cost. landmark study released in October, involving more than 9,000 women, revealed the totally unsurprising effects of providing free birth control: far fewer unwanted pregnancies and “dramatic reductions” in abortions. This study’s findings are echoed in the terrific fact that our teen pregnancy and abortion rates, while still ridiculously high, have been going down.You would think that these findings would make even the hoariest God-Fearing Patriarchs giddy. But, GFPs actually believe researchers, like voting machines, are colluding with entitled, lying harlots in order to dupe good Christian men and take away their magical powers. This isn’t happening due to the fact that teenage girls are using both hormonal and other forms of long-acting birth control (like IUDs) more effectively not opting to wait to have sex in exchange for the traditional “protections” of marriage.

We need to get birth control pills and emergency contraception into the hands of the people who need it, including teenage girls. These methods are safe and proven to work. But, if we are serious about reducing unplanned pregnancies, we also need to think about forms of birth control that are not popular in the US and not used by American women, many of whom are unaware of their options for reproductive health and fertility management. Many countries already make birth control pills available to girls and women at no or low cost, but, these girls and women also use long-acting, reversible forms of contraception – what the Contraceptive Choice project here calls “LARK Methods.”

The rates of success for some of these methods across the board are staggering, especially when women can choose among options to select what will work best for them. Family planning and birth control are critically important parts of modern life and successful modern economies. This is backlash taken to its most ridiculous and expensive extremes. Join the Reproductive Health Technologies Project and urge Health and Human Services Secretary Kathleen Sebelius to get us on the right track today and put women’s interests back into the women’s health equation.

“Emergency contraception needs to be on the pharmacy shelf between condoms and pregnancy test kits, available to women and couples without delay or hassle,” explains Kirsten Moore president and CEO of RHTP, which has led a coalition advocating for this very action for more than 10 years. “Doctors are leading the way saying that all contraception should move over the counter and be available to women of all ages. Politicians need to follow doctors’ lead and get the politics out of women’s health care once and for all.”

Despite The Evidence, Anti-Choicers Persist in Lying About Emergency Contraception

11:56 am in Uncategorized by RH Reality Check

Written by Amanda Marcotte for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

It’s an article of faith for the anti-choice movement that emergency contraception is an “abortifacient,” though it has never once been in dispute that it works by preventing pregnancy instead of terminating it. It was clear that anti-choicers were deliberately blurring the difference, because if they could soften up the public to the idea that one could abort a pregnancy before it begins, that opens the door to all sorts of restrictions on contraception. The excuse for this was anti-choice claims that emergency contraception works by killing fertilized eggs before they implant, even though a basic understanding of human biology and the actual scientific evidence made it clear that it works by suppressing ovulation. The excuse anti-choicers would hide behind when pressed on this point — the reason they always gave for why they “get to” lie about this issue — was that the FDA and other medical authorities allowed for the minor possibility that the pill could work this way if the primary mechanism failed, even though there was no evidence it did work that way.

The entire anti-choice case for conflating abortion and contraception was based on those incredibly shaky grounds. It will be interesting to see what new excuse they come up with now that those authorities are revising their guidelines in response to a New York Times article outlining research that makes it clear that emergency contraception does not work after fertilization. Labeling and information from these sources that suggested that the medication might prevent fertilization was never meant to be taken as definitive proof the way anti-choicers eagerly take it, but more as part of a larger tendency of drug labels to include every possible side effect that hasn’t been eliminated, no matter how unlikely. Now the FDA has removed claims that emergency contraception works on fertilized eggs from their website. A.D.A.M. has changed its entry on emergency contraception at Medline Plus, the NIH consumer information website, to make it clear that the only way that emergency contraception works is by suppressing ovulation.

In an ideal world, these kind of distinctions wouldn’t matter that much. A fertilized egg is a single cell, and a woman is an actual person whose needs trump those of an organism whose only function is replicating DNA. In our world, however, conservatives have successfully created a situation where invoking the word “abortion” creates all sorts of anxieties and causes legislators to fall all over themselves creating loopholes in policy so that abortion isn’t treated the same as other forms of health care. Anti-choicers haven’t been nearly as successful in demonizing contraception, though they clearly wish to do so. That’s why they’re so intent on blurring the distinction between abortion and contraception, starting with emergency contraception. It’s all about making contraception as taboo as abortion, laying the groundwork to restrict access to contraception as they have done with abortion.

Redefining contraception — especially female-controlled kinds and even more especially ones that can be used by women after they’ve “sinned” by having sex — as abortion is far too important to the anti-choice movement to expect that they’ll allow this relabeling effort to stop them. Most likely, they’ll do what they’ve done with inconvenient statistics that show that abortion doesn’t cause breast cancer or depression; they’ll just ignore the science and lie like they were getting paid per fib.

Indeed, initial responses to the New York Times article indicate that lying is the anti-choice back-up plan now that there’s no “maybe” to cling to when asserting that emergency contraception kills fertilized eggs. When confronted with the facts by the New York Times reporter, Richard Doerflinger, associate director of the Secretariat of Pro-Life Activities for the United States Conference of Catholic Bishops, said, “So far what I see is an unresolved debate and some studies on both sides,” after disingenuously claiming that he’d be relieved if he had to admit that emergency contraception only works by preventing conception, as his church’s stance against contraception hasn’t changed in the past week.

The problem with that statement is that it’s nonsense. As the Times article reported, there aren’t studies on “both sides,” and scientific consensus can safely be said to have been achieved. If Doerflinger really wanted to be relieved, he’d have been relieved five years ago, when researchers found that whether or not Plan B worked depended entirely on whether you took it before or after you ovulated. Women who took it before didn’t get pregnant. Women who took it after they ovulated got pregnant at the same rates as women who didn’t take it at all. The “maybe” that anti-choicers are hinging their anti-emergency contraception argument has basically vanished. Instead of the relief that we were promised that we’d get should we prove that fertilized eggs would survive emergency contraception, denial of the facts has hardened. 

Since contraception is a major issue in this campaign season, we’ll soon learn how married the anti-choice movement and conservatives are to the lie that emergency contraception is “abortion.” So far, conservatives have been trying to strengthen their claim that insurance coverage of contraception violates an employer’s “religious freedom” to try to control his employee’s sex life by tossing the word “abortion” around promiscuously. After all, without that emotion-raising word, it’s a lot easier to see that in fact, they’re attacking a women’s freedom not to have their employers discriminate against them in pay and benefits because of a difference in religious belief. I can’t imagine they’ll give it up, therefore, despite this rather headline-grabbing demonstration of how dishonest they’re being when they try to reclassify contraception as “abortion.”