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Surrogacy and Baby-Selling in a Globalizing World: What’s Next?

7:23 am in Uncategorized by RH Reality Check

"Intracytoplasmic sperm injection (ICSI)" by Maurizio De Angelis. Wellcome Images, on flickr

"Intracytoplasmic sperm injection (ICSI)" by Maurizio De Angelis. Wellcome Images, on flickr.

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

The FBI’s press release begins with the title “Baby-Selling Ring Busted.” When it comes to press relations, word choice is everything and there is nothing more loaded than “Baby-Selling!” Sadly child sales are not a particularly new phenomenon, but the mode of carrying out the crime is intriguing. The scenario includes the use of fertility technology in the Ukraine intersecting with unsuspecting American families with the resources to pay over $100,000 for a child. For me, someone interested in adoption ethics and emerging global surrogacy schemes, this particular case struck me as just one more manifestation of what is possible when people will spend unimaginable sums to secure a healthy infant.

The story goes something like this. A well-known surrogacy attorney in California used her networks and well-financed practice to dupe families into paying over $100,000 for a child based on a fraudulent scenario. Basically, those looking to secure a child were told that a surrogacy arrangement had fallen apart—the intended parents backing out of the arrangement. This was false and a story constructed for fraud. The unsuspecting customers (prospective parents) were given the opportunity to secure the unborn child without adoption procedures. The attorney then worked with surrogate mothers women who were impregnated with a donated egg and sperm and thus not a biological child of the surrogate mother. And yes, it appears that the egg and sperm donors were unaware of the child’s birth and entanglement into a child sales scheme. Read the rest of this entry →

International Human Rights Court Says Governments Must Ensure Timely Access to Maternal Health Services

9:22 am in Uncategorized by RH Reality Check

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

In 2002, Alyne da Silva Pimentel, a 28-year-old Afro-Brazilian woman, died after being denied basic medical care to address complications in her pregnancy. Her death might be like any one of the other hundreds of thousands of women who die of complications of pregnancy or unsafe abortion each year worldwide, but for one thing: It was taken to court.

Maternal mortality in Brazil is high, especially for a country of its relative wealth and level of development. It is even higher among women who, like Alyne, are of Afro-descent, indigenous, and/or low-income. Alyne died of complications resulting from pregnancy after her local health center mis-diagnosed her symptoms and delayed the emergency care she needed to live.

On November 30, 2007, the Center for Reproductive Rights, with Brazilian partner Advocaci, filed Alyne da Silva Pimentel v. Brazil, brought the first ever maternal mortality case before the UN’s Committee on the Elimination of Discrimination Against Women (CEDAW). The Center’s petition argued that Brazil’s government violated Alyne’s rights to life, health, and legal redress, all of which are guaranteed both by Brazil’s constitution and international human rights treaties, including CEDAW. 

“Alyne’s story epitomizes Brazil’s violation of women’s human rights and failure to prevent women from dying of causes that, by the government’s own admission, are avoidable,” said Lilian Sepúlveda, the Center’s Legal Adviser for Latin America and the Caribbean. “We filed this case to demand that Brazil make the necessary reforms to its public health system—and save thousands of women’s lives.”

In its brief, the Center asked the Committee to require Brazil to compensate Alyne da Silva Pimentel’s surviving family, including her 9-year-old daughter, and make the reduction of maternal mortality a high priority, including by training providers, establishing and enforcing protocols, and improving care in vulnerable communities.

This week, the case was decided in a historic decision by CEDAW, establishing that governments have a human rights obligation to guarantee that all women in their countries—regardless of income or racial background—have access to timely, non-discriminatory, and appropriate maternal health services.

“Sadly,” said a statement from CRR, “Alyne’s story is one of thousands in Brazil, and all around the world, in which women are denied, and in some cases refused, basic quality medical care to address common pregnancy complications. And the countless lives lost unnecessarily as a result mean that today’s victory can only be regarded as bittersweet.”

Nonetheless, continued the statement, “today marks the beginning of a new era. Governments can no longer disregard the fundamental rights of women like Alyne without strict accountability. And while nothing can reverse Alyne’s fate, today’s decision means that Alyne’s mother and daughter will finally see justice served—and women worldwide will benefit from the ruling issued in her name.”

Colorado Maternity Care Mandate Raises Pro-choice Hackles

6:36 am in Uncategorized by RH Reality Check

Written by Wendy Norris for – News, commentary and community for reproductive health and justice.

While Congress and the White House dither on healthcare reform, state lawmakers across the country grapple with the practicalities of the uninsured, discriminatory gender rating and mandated care.

In Colorado, a seemingly feel-good bill to require insurance plans to cover maternity care and contraception is fraught with problems that could have and should have been solved by the long-delayed federal legislation.

However, in today’s highly charged political realm with spiraling state budget deficits and the lingering effects of a recession that just won’t quit, even motherhood and apple pie can’t get a unanimous vote in a crucial election year.

A reproductive healthcare mandate bill passed its first major hurdle on a largely party line 37-27 vote Tuesday in the Colorado House with some surprising defections by pro-choice lawmakers.

A peek behind the legislative sausage-making curtain exemplifies the deep political divisions being created with incremental approaches by states to fix an intractable and unsustainable national healthcare crisis.

Emilie Ailts, executive director of NARAL Pro-Choice Colorado, laid down a pre-vote challenge to conservative lawmakers to channel their much ballyhooed family values:

Will the anti-abortion, anti-birth control, anti-comprehensive sex education politicians vote their purported values, which they claim are about healthy babies and healthy families? House Bill 1021 provides a clear opportunity for these anti-choice lawmakers to enact responsible policies that can reduce the need for abortion by ensuring women have access to the prenatal care they need for healthy pregnancies.

Twenty-six of the "no" votes were cast by GOP members. None of the dozen Republican House members with longstanding anti-choice records who voted against the bill, including some who amended and approved it in committee days before, returned calls for comment. The amendments that significantly watered down the bill and specifically noted that abortion care was not covered were eventually thrown out by the House after flexing its 11-vote majority.

However, the biggest danger with the bill is the caustic stew of ideological posturing, political gamesmanship and over-promised and under-delivered healthcare reform that could leave a bitter taste in the mouths of an increasingly surly mid-term electorate.

Two unexpected opposition votes from pro-choice lawmakers are especially telling about the skittish local mood.

Concerns about insurance affordability for rural women

Rep. Ellen Roberts, a moderate Republican from rural southwest Colorado, expressed reservations about how the bill was being fast tracked through committee and ultimately voted against it.

"It’s not content specific," said Roberts explaining her pained vote against maternity care. "I’ve always been a strong supporter of women’s issues."

Roberts primary beef is the already limited options for rural communities to buy into healthcare plans. Few insurance carriers offer individual or small group plans in remote regions of the state. That’s coupled with broad public perceptions that a coverage mandate — even a widely popular one like maternity care — would increase premiums to the point of becoming unaffordable

"My constituents are contacting me seriously two to three times a week telling me ‘no more mandates’ because we are going to have to drop our insurance," said Roberts.

Those with the gold make the rules

The Durango Republican was also miffed that House Democratic leaders knuckled down and bypassed the state’s Commission on Mandated Health Benefits which provides nonpartisan cost benefit analysis to lawmakers.

"That’s the kind of information I need to make an educated vote," said Roberts acknowledging that both Republicans and Democrats alike have ignored the cumbersome committee when pushing though legislation. The 11-member commission of insurance experts, health policy advocates and consumers has been widely criticized for its slow pace in reviewing bills often introduced at a breakneck pace during the state’s three-month legislative session.

Roberts co-sponsored legislation with fellow Western Slope lawmaker Rep. Kathleen Curry, U-Gunnison, to reform the commission created by state statute in 2003 and which is set to expire in July.

They proposed handing the mandate review process to the nonpartisan Legislative Council and implementing a one-year timeout on any new state mandates while Congress sorts out its overdue national healthcare reform plan. The internal bickering over the mandate process at the state capitol became so heated that Curry, a staunch pro-choice Democrat, resigned from the party in December.

As expected, at the behest of statehouse leadership, their bill was killed in committee.

"Obviously in a political year you don’t enjoy making some of these votes because it will be used against you in the campaign cycle." said Roberts. "I can’t be guided by that. I have to try to do the right thing."

While Roberts and Curry duke it out over a seemingly obscure policy issue the state legislature risks losing two stalwart pro-choice voices. Roberts is term-limited and is seeking a Senate seat in a evenly partisan district. Meanwhile, Curry, who voted to support the maternity mandate bill, is now an unaffiliated candidate. She must petition onto the ballot to seek reelection in 2010. And she’s already drawn a conservative, anti-choice Republican challenger.

Solomon’s choice for a pro-choice Dem

The decision to vote against the mandate was also a difficult one for Rep. Jim Riesberg, chairman of the House Health and Human Services Committee.

"Primarily, I’m in support of what this bill is trying to do," explained Riesberg, a pro-choice Democrat from rural Greeley. "But what I’m more concerned about is the 700,000 people in Colorado who have no insurance whatsoever, many of whom are women."

Riesberg claims 85 percent of insured Colorado women already have access to maternity care in their policies. Yet, on the flipside, he said he would have supported a bill to solely mandate coverage of contraceptive care since that’s less likely to be covered by insurance than childbirth expenses.

"I’m very concerned that an insurance company would pay for a pregnancy but wouldn’t to tie a woman’s tubes," he said elaborating on his vote conundrum. "I mean that doesn’t make sense to me. I just hate to expand coverage for those who have something instead of expanding coverage for those who have nothing."

Riesberg also confirmed that the maternity care mandate will effect a very small number of women because many health insurance plans are not subject to Colorado law. About half of insured Coloradans have policies regulated by the federal Employee Retirement Income Security Act (ERISA), such as self-funded employer insurance plan and publicly-funded programs, like Medicare, Medicaid and federal employee benefits.

Even the Colorado Division of Insurance can’t pinpoint the precise number of women with private insurance policies the mandate could potentially benefit. But both Roberts and Riesberg echoed the same concern: it’s likely that few women could afford to maintain their coverage with reproductive health mandates since premiums for individual plans are already skyrocketing with annual double-digit increases.

Despite Roberts and Riesberg’s concerns, the bill now moves to the Democratically-controlled Colorado Senate where the upper chamber co-sponsor predicts easy passage.

Senate sponsor vows to fight

"It’s a good strong health care bill for families that buy individual policies," remarked Sen. Joyce Foster. "For me, it’s my most important bill this session. This bill is long overdue."

Foster’s co-sponsor is Sen. Betty Boyd, a veteran lawmaker with a strong history of passing pro-choice, pro-family bills through the contentious chamber.

Foster is undaunted by the prospects of going up against a fierce ultra-conservative bloc of Republican senators whose anti-choice antics are legendary. Colorado Springs Sen. Dave Schultheis last year said the HIV testing of pregnant women encourages sexual promiscuity. Not to be outdone, a week later, Sens. Larry Liston and Kevin Lundberg raised the old, tired canard that oral contraception is just a fancy word for abortion.

"Bring ‘em on," she taunted.