Tag: Contraception

How Limiting Women’s Access to Birth Control and Abortions Hurts the Economy

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Source: AlterNet

Author: Michele Gilman/the Conversation

Emphasis Mine

Reproductive health isn’t just about abortions, despite all the attention they get. It’s also about access to family planning services, contraception, sex education and much else.

Such access lets women control the timing and size of their families so they have children when they are financially secure and emotionally ready and can finish their education and advance in the workplace. After all, having children is expensive, costing US$9,000 to $25,000 a year.

And that’s why providing women with a full range of reproductive health options is good for the economy at the same time as being essential to the financial security of women and their families. Doing the opposite threatens not only the physical health of women but their economic well-being too.

The Supreme Court acknowledged as much in 1992, stating in Planned Parenthood of Southeastern Pennsylvania v. Casey:

The ability of women to participate equally in the economic and social life of the nation has been facilitated by their ability to control their reproductive lives.

However, it seems that state and federal legislators, certain politicians running for president as well as some conservative Supreme Court justices have forgotten the meaning of this sweeping language.

As a consequence, the right to control their reproductive health has become increasingly illusory for many women, particularly the poor.

The Economics of Contraception

With some conservative politicians dead set on limiting access to abortion, you’d assume that they would be for policies that help women avoid unintended pregnancies. But conservative attacks on birth control are escalating, even though 99 percent of sexually active women have used some form such as an intrauterine device (IUD), patch or pill at least once.

In addition to its widely recognized health and autonomy benefits for women, contraception directly boosts the economy. In fact, research shows access to the pill is responsible for a third of women’s wage gains since the 1960s.

And this benefit extends to their kids. Children born to mothers with access to family planning benefit from a 20 to 30 percent increase in their own incomes over their lifetimes, as well as boosting college completion rates.

Not surprisingly, in a survey, 77 percent of women who used birth control reported that it allowed them to better care for themselves and their families, while large majorities also reported that birth control allowed them to support themselves financially (71 percent), stay in school (64 percent) and help them get and keep a job (64 percent).

Still, there is a class divide in contraception access, as evidenced by disparities in the 2011 rate of unintended pregnancies. While the overall rate fell to 45 percent (from 51 percent in 2008), the figure for women living at or below the poverty line was five times that of women at the highest income level (although also decreasing).

One reason for this disparity is the cost of birth control, particularly for the most effective, long-lasting forms. For instance, it typically costs over $1,000 for an IUD and the procedure to insert it, amounting to one month’s full-time pay for a minimum wage worker.

These costs are significant, given that the average American woman wants two children and will thus need contraception for at least three decades of her life. Unfortunately, publicly funded family planning meets only 54 percent of the need, and these funding streams are under constant attack by conservatives.

Not surprisingly, health insurance makes a difference, and women with coverage are much more likely to use contraceptive care. The Affordable Care Act is responsible for part of the drop in unintended pregnancies—it expanded contraception coverage to around 55 million women with private insurance coverage.

Yet this coverage is also at risk for millions of employees and their dependents who work for employers claiming a religious objection. In Burwell v. Hobby Lobby, the Supreme Court concluded that a for-profit company cannot only profess religious beliefs but also impose those beliefs on their employees by denying them certain forms of contraception. The Obama administration has issued regulations allowing religious employers to opt out of offering contraceptive coverage. Affected employees are then covered directly by their insurers.

This is not enough for some. In March, the Supreme Court heard oral arguments in the case of Zubik v. Burwell, in which several religious nonprofits assert that even the act of seeking an accommodation from the law burdens their religious consciences.

These religious groups argue in part that women can get their birth control from other sources, such as federally funded family planning centers. Yet at the same time, conservatives are on a mission to slash that funding, particularly for Planned Parenthood, which provides sexual and reproductive health care to almost five million people a year.

This makes no economic sense. Publicly funded family planning programs help women avoid about two million unintended pregnancies a year and save the government billions of dollars in health care costs. The net savings to government are $13.6 billion. For every $1 invested in these services, the government saves $7.09.

Sex Education and the Economic Ladder

Another key to reproductive health—and one that isn’t discussed enough—is sexual education for teenagers.

For years, the public has spent over $2 billion on abstinence-only programs, which not only fail to reduce teen birth rates but also reinforce gender stereotypes and are rife with misinformation. Low-income minority teens are particularly subject to these programs.

Teens without knowledge about their sexual health are more likely to get pregnant and less likely to work, spiraling them to the bottom of the economic ladder.

President Obama’s proposed 2017 budget would eliminate federal funding for abstinence-only sex education and instead fund only comprehensive sexual education, which is age-appropriate and medically accurate. However, Congress has rejected the president’s prior proposed cuts and the same result is likely for 2017.

Access to Abortion

Then there’s the issue of abortion. Let’s start with the cost.

Half of women who obtain an abortion pay more than one-third of their monthly income for the procedure.

Costs rise significantly the longer a woman must wait, either because state law requires it or she needs to save up the money—or both. Studies show that women who cannot access abortion are three times more likely to fall into poverty than women who obtained abortions.

In addition to the financial burden, many states are enacting laws designed to limit abortion access. These laws hit low-income women particularly hard. From 2011 to 2015, 31 states have enacted 288 such laws, including waiting periods and mandatory counseling sessions.

Moreover, 24 states have enacted so-called TRAP laws (targeted regulation of abortion providers), which medical experts say go far beyond what is needed for patient safety and impose needless requirements on doctors and abortion facilities, such as requiring facilities to have the same hallway dimensions as a hospital.

In March, the Supreme Court heard arguments in a case challenging a Texas TRAP law, Whole Women’s Health v. Hellerstedt. If the court upholds the law, the entire state of Texas will be left with only 10 abortion providers.

A lower federal appeals court stated in the Texas case that travel distances of more than 150 miles one way are not an “undue burden” and are thus constitutional. This, I would argue, shows a complete lack of understanding regarding the difficulties that poverty—especially rural poverty—imposes. Traveling long distances adds additional costs to an already expensive medical procedure.

The court’s decision is expected in June. Observers fear that the court could split 4-4, which would leave the Texas law intact.

The Hyde Amendment

Another way in which U.S. policy on abortions exacerbates economic inequality, especially for women of color, is through the ban on federal funding—which some aspiring politicians seem to have forgotten is still in place.

It has been so since the 1976 enactment of the Hyde Amendment, which prevents federal Medicaid funds from being used for abortions except in cases of rape, incest or when the life of the mother is at risk. The Affordable Care Act does many wonderful things for women’s health, but it also extends the Hyde Amendment through its expansion of Medicaid, and it allows states to ban abortion coverage in their private exchanges.

Denying poor women coverage under Medicaid contributes to the unintended birth rates that are seven times higher for poor women than high-income women.

Economic and Reproductive Health

Politicians cannot promise to grow the economy and simultaneously limit access to abortion, birth control and sexual education. Our nation’s economic health and women’s reproductive health are linked.

And as Hillary Clinton correctly noted recently, it’s an issue that deserves more attention in the presidential campaign—and hasn’t received enough.

Michele Gilman is a venable Professor of Law, University of Baltimore and is affiliated with the ACLU of Maryland and the Women’s Law Center of Maryland.

 

See: http://www.alternet.org/gender/how-limiting-womens-access-birth-control-and-abortions-hurts-economy?akid=14217.123424.vApA3m&rd=1&src=newsletter1055746&t=18

U.S. courts shut down Catholic employers’ campaign against contraceptives

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Source: LA Times

Author: Michael Hiltzak

Emphasis Mine

Ever since the federal government mandated that health insurance cover birth control under the Affordable Care Act without cost-sharing--that is, no co-pay charges or deductibles–Catholic employers have been trying to undercut the requirement.

Fortunately, they’ve been batting zero at the appeals court level, most recently before the 2nd Circuit U.S. Court of Appeals in New York, which last week knocked down an assertion by two Roman Catholic high schools and two Catholic healthcare systems that their religious rights are violated by even the requirement that they put their objections to contraception on the record so the government, their insurers, and their employees can make other arrangements.

The 2nd Circuit thus joins six other appeals courts in finding that the notice requirement doesn’t impose a burden on their religious exercise. No appeals court has ruled the other way. The 2nd Circuit ruled that “the only obligation actually imposed on plaintiffs is identifying themselves as religious objectors” through “a modicum of paperwork,” and that doesn’t come close to a burden on their religious observance. Since the plaintiffs in these lawsuits include many Catholic institutions operating in the secular world, including the University of Notre Dame and Wheaton College, it’s proper to examine how far they’ve been willing to go to try to impose their own religious views on thousands of employees and students who may not share them–even when the institutions are exempt from the mandate itself.

At issue in these cases is the “accommodation” the Obama administration provided to the religious employers objecting to the contraception mandate. According to the accommodation, religious employers that didn’t want to provide these services to employees via their health plans merely had to file a form with their insurers and the Department of Health and Human Services stating that they objected. That filing would make the insurers, not the employers, responsible for providing the contraceptives–in some cases with profitable funding from the federal government.

Yet some employers thought even that procedure made them complicit with a sin. So the government offered a further accommodation: they merely had to send a letter identifying themselves as objectors. That still wasn’t enough. Sending the letter, Notre Dame asserted, still made it a “conduit” between the health plans it contracted with and its employees and students. The law forced it to “contract with a third party willing to provide the very services Notre Dame deems objectionable.”
The judges in these cases take the sincerity of the plaintiffs as, well, gospel. But as Appellate Judge Richard Posner of the 7th Circuit observed in May, their lawsuits aim to extend the reach of their religious objections awfully far–imposing them on private corporations (Aetna and its other insurers) and even on the federal government. No dice, Posner ruled in the Notre Dame case; the accommodation actually serves to “lift a burden from the university’s shoulders.”

His words were echoed last week by the three-judge appellate panel in New York, which found that the burden on the high schools and other plaintiffs was “merely one of notification, equivalent to the burden historically placed on draft registrants to indicate their conscientious objections to military service.” Once they opt out, the law doesn’t require them to play any role whatsoever in providing birth control to their female employees.

From the inception of the Affordable Care Act, the government has leaned over backward to meet the objections of Catholic employers. First it offered its accommodation to religious entities such as churches, then extended it to secular employers with religious affiliations, like Notre Dame. When some of these objected to submitting a government form attesting to their objections to the mandate, they were permitted to just send a letter. The Supreme Court, meanwhile, extended the rights of religious-affiliated employers to private companies owned by people claiming religious scruples.

The plaintiffs have moved from asserting their own right to not provide contraceptive services to asserting their right to prevent any entity with which they have even a tenuous business relationship from providing these services to their employees, and then to preventing the U.S. government from doing so in their stead. What’s next? Asserting that employees who cash their paychecks shouldn’t be allowed to buy contraceptives with their money?

The courts are right to call a halt to this trend. But the battle isn’t over; although so far every circuit is in accord, nothing stops the Supreme Court from deciding to weigh in. Then all bets will be off, once again.

Keep up to date with the Economy Hub. Follow @hiltzikm on Twitter, see our Facebook page, or email michael.hiltzik@latimes.com.

 

See: http://www.latimes.com/business/hiltzik/la-fi-mh-catholic-campaign-against-contraception-20150811-column.html

Ideology Subsumes Empiricism in Pope’s Climate Encyclical

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Source: Scientific American

Author: Lawrence Krauss

Emphasis Mine

Religion and science are at best strange bedfellows, as the Catholic Church has found since the time of its unfortunate experience with Galileo. So it is significant that Pope Francis, who has shown great appetite for departing from some of the harsh rhetoric and methods of his predecessors, is issuing an encyclical on the environment at a time when the world’s leaders are once again considering a global approach to dealing with climate change.

Whenever religious figures enter into a debate on policy issues that have a strong scientific basis there is a slippery interplay between the desire to do good by addressing real problems, and the constraints that ideology and dogma impose upon the ability to do so objectively. Pope Francis’s encyclical follows this pattern.

Laden with detail, it is perhaps the most scientific document to come out of the Vatican since John Paul II discussed evolution in 1996. As a result, many in the environmental community have praised the encyclical, which affirms that human activity causes climate change and delineates many of the impacts, especially the disproportionate impact it is likely to have on the world’s poor. While calling on people of all religions to take action, however, the pope rejects, on a purely theological basis, some of the most propitious solutions on the table.

The evidence-based discussion of climate change in the encyclical resulted in part from prolonged interaction with the scientific community. The language in many places reads like a treatise from the Intergovernmental Panel on Climate Change (IPCC). Consider, for example, this excerpt:

There is a very consistent scientific consensus indicating that we are in the presence of a disturbing heating of the climate system. In recent decades, this warming was accompanied by the constant rising of the sea level, and it is also hard not to relate it with the rise in extreme weather events… It is true that there are other factors (such as volcanism, the changes in the orbit and the axis of the Earth, the solar cycle), but numerous scientific studies indicate that most of the global warming in recent decades it is due to the large concentration of greenhouse gases (carbon dioxide, methane, nitrogen oxide and others) mainly emitted due to human activity. Their concentration in the atmosphere prevents the heat of the solar rays reflected from the Earth to be dispersed in space. This is especially enhanced by the model of development based on the intensive use of fossil fuels, which is at the center of the global energy system. It is also affected by the increase of the practice of changing land use, mainly by deforestation for agricultural purposes.

The synopsis of the impacts of climate change is equally empirical:

… the heating has effects on the carbon cycle. It creates a vicious cycle which aggravates the situation even more and which will affect the availability of essential resources like drinking water, energy and agricultural production in the hottest areas, and will result in the extinction of a part of the planet’s biodiversity. The melting of polar and high altitude ice threaten the leakage of methane gas which carries high risks, and the decomposition of frozen organic matter could further accentuate the emission of carbon dioxide. In turn, the loss of tropical forests makes things worse, since these help to mitigate the climate change. The pollution produced by carbon dioxide increases the acidity of the oceans and affects the marine food chain.

Perhaps of most importance to the Pope himself, who has always expressed solidarity with the poor, the document makes it clear that the impacts of climate change are disproportionate, with the poorest countries likely to bear the largest burden. It castigates climate-change deniers in wealthy nations who “seem to focus especially on masking the problems or hiding the symptoms”.

These are timely and welcome remarks by someone who is viewed as a spiritual guide by billions of Catholics. An encyclical wouldn’t be an encyclical without theology however, and that is where problems arise. In a chapter entitled “Gospel of Creation” Francis ruminates poetically on the nature of man, the mystery of the cosmos (my own area of study) and the special duty Christians have to respect nature, humanity and the environment. It’s beautifully presented and sounds good in principle. However, his biblical analysis leads to the false conclusion that contraception and population control are not appropriate strategies to help a planet with limited resources.

Here, ideology subsumes empiricism, and the inevitable conflict between science and religion comes to the fore. One can argue until one is blue in the face that God has a preordained plan for every zygote, but the simple fact is that if one is seriously worried about the environment on a global scale population is a problem. A population of 10 billion by 2050 will likely be unsustainable at a level in which all humans have adequate food, water, medicine and security. Moreover, as this pope should particularly appreciate, the environmental problems that overpopulation creates also disproportionately afflict those in poor countries, where access to birth control and abortion is often limited. Ultimately, the surest road out of poverty is to empower women to control their own fertility. Doing so allows them to better provide for themselves and their children, improves access to education and healthcare and, eventually, creates incentives for environmental sustainability.The problem with basing a public policy framework on outmoded ideas that predate modern science and medicine is that one inevitably proposes bad policies.

No one can fault Pope Francis’s intentions, which are clearly praiseworthy, but his call for action on climate change is compromised by his adherence to doctrines that are based on revelation and not evidence. The Catholic Church and its leaders can never be truly objective and useful arbiters of human behavior until they are willing to dispense with doctrine that can thwart real progress. In this sense, the latest encyclical took several steps forward, and then a leap back.

The views expressed are those of the author and are not necessarily those of Scientific American.

See: http://blogs.scientificamerican.com/guest-blog/ideology-subsumes-empiricism-in-pope-s-climate-encyclical/

The Medical Facts About Birth Control and Hobby Lobby—From an OB/GYN

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Source: New Republic

Author: Jen Gunter

If you’ve read the Supreme Court’s ruling in Hobby Lobby or the reaction to it, then you know what sparked the lawsuit. The Affordable Care Act says that employer-provided insurance must include essential health benefits, including all medically authorized forms of contraception. The owners of Hobby Lobby objected to this requirement, because they believe that four common forms of birth control—two versions of the “morning-after pill” and two kinds of intrauterine devices (IUDs)—are “abortifacients.” In other words, the owners of Hobby Lobby think these contraceptives end pregnancies rather than prevent them. And they believe that is tantamount to ending a life.

The claim, which you can find on virtually any conservative website, has been making the rounds for a long time. It’s stuck because the science on how these particular drugs and devices work wasn’t that great. But recent advances in medical diagnostics and some ingenious studies have changed that. We know a lot more about how the contraceptives work. We can be very confident that three of the four contraceptives do not lead to abortion, even using the conservative definition of when life begins, and we can be almost (although not quite) as sure that the fourth does not, either.

There are essentially six ways to prevent pregnancy:

  1. Make the cervical mucus inhospitable (sperm can’t get to the egg)
  2. Inhibit ovulation (prevent the release of an egg)
  3. Affect fertilization (the ability of the sperm to meet up with and/or penetrate the egg).
  4. Affect the fertilized egg (prevent implantation)
  5. Create an inhospitable uterine environment (prevent implantation)
  6. Affect the implanted embryo

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As far as the medical establishment is concerned, pregnancy doesn’t begin until implantation. (In fact, 80 percent of fertilized eggs never implant.) So under this “medical” definition of pregnancy, only method #6—that is, doing something to the implanted embryo—would constitute a form of abortion. But religious conservatives hold that pregnancy and life itself begin at the moment an egg is fertilized. Under the “religious” definition of pregnancy, methods 4, 5 and 6 would all constitute forms of abortion.

What does that mean for the four types of contraception at issue in the Hobby Lobby case? Let’s consider each one.

Birth Control or "Abortifacient"?

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Plan B, which is one form of the morning-after pill, clearly wouldn’t. It works by inhibiting ovulation when given during a specific 48 hour window of the cycle. It has no other method of action. This is undisputed scientific fact. (Plan B is one of the best studied of all the methods of contraception).

Ella (the manufacturer uses a lower case “e”) is another version of the morning-after pill. It too works by inhibiting ovulation, only it is better at it than Plan B. The 30 mg of ulipristal in ella has no effect on sperm quality, a fertilized egg, or the lining of the uterus. Higher doses affect the uterine lining, potentially creating a hostile environment that could stop a fertilized egg from implanting. But a 30 mg dose has the same impact on uterine lining as a placebo—in other words, it has no effect. The only gray area is if a woman were to take ella not realizing that she is already a few weeks pregnant (an unrecognized pregnancy). The impact of ella in early pregnancy is currently unknown.

Mirena, one of the IUDs, changes cervical mucus. It also inhibits ovulation for a small percentage of women in the first year of use, but that is unlikely a major method of action. The Mirena IUD does thin the lining of the uterus, but there is no evidence to suggest this impacts implantation of a fertilized egg.

That leaves the ParaGard, which is a copper IUD. The copper in the device damages sperm and eggs, affects how the sperm and egg travel to meet, and may affect implantation. Some very complex studies suggest that a very small percentage of cycles with a copper IUD (around 1%) may result in a fertilized egg that fails to implant. But, as physician Aaron Carroll noted recently at The Upshot, that’s also the normal failure rate of the IUD. The bulk of the studies do not support a post-fertilization effect.

The only caveat is that if either IUD fails (and while rare, they do fail about 1 percent of the time) the resulting pregnancy has a higher risk of miscarriage.

The facts are summarized in the table above. There is no evidence that Plan B, Ella, or the Mirena cause abortion by any definition. The evidence that the ParaGard might affect implantation for a small percentage of women, thus leading to what some conservatives would call abortion, is thin. But we don’t have the information to discount it completely.

Is that a rational basis for refusing to pay for these contraceptives—and reducing the reach of a health care initiative that provides enormous benefits? Religious conservatives think so. And thanks to the Supreme Court, they will get their way.

Dr. Jen Gunter is an OB/GYN and a pain medicine physician based in California. She blogs at drjengunter.com and authored the book, The Preemie Primer, a guide for parents of premature babies.

Emphasis Mine

See: http://www.newrepublic.com/article/118547/facts-about-birth-control-and-hobby-lobby-ob-gyn?utm_source=Sailthru&utm_medium=email&utm_term=TNR%20Daily%20Newsletter&utm_campaign=TNR%20Daily%20Zephyr%20with%20LiveIntent%20-%20July%207%2C%202014

Finally, A Poll Gets the Contraception Question Right

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From: RD

By: Sarah Posner

“As I’ve been discussing over the past couple of days, polls are all over the place in attempting to assess public opinion on the contraception coverage requirement under the Affordable Care Act, because the questions are framed in such disparate ways. But today Public Religion Research Institute is out with a new poll that shows widespread support for the policy, based on the most lucid and accurate question on the matter.

  • PRRI asked the question this way:should employers“be required to provide their employees with health care plans that cover contraception or birth control at no cost?”PRRI broke down the question for different types of employers, a methodology that gets to the heart of the various ways the opponents of birth control coverage have framed their objections. Support rises the more attenuated the relationship is with a church or house of worship: churches and other houses of worship (42%) ; religiously affiliated social service agencies (52%); privately owned small businesses (53%); religiously affiliated colleges (54%); religiously affiliated hospitals (57%); and publicly held corporations (62%).

    According to PRRI’s data, “Catholics overall are generally more supportive than the general public of the contraception coverage requirements.” The flock isn’t following the Bishops, whoyesterday pledged to continue their opposition to the policy and to what they claim are other threats to the religious liberty. The Bishops, though, have non-Catholic supporters: “White evangelical Protestants are the only religious group that opposes requiring any type of employer to provide their employees with no cost contraception coverage:”

    Insurance Mandate e1331743980662 Survey | Majority of Americans Do Not Believe Religious Liberty is Under Attack

    At the heart of the evangelical opposition, I think, is their belief that the separation of church and state means the government shouldn’t interfere with the affairs of the church, rather than the government should avoid endorsing or imposing a particular religious view. There’s evidence the Bishops believe this as well, but that hasn’t translated into a a cultural movement among Catholics that promotes this idea. (The survey also asked if separation of church and state is being threatened in America. Forty five percent of respondents said yes, while 48% said no.)

    Also, according to the poll, a majority of Americans do not believe that religious liberty is threatened in America. Still, though, 39% do believe this to be true, although only 6% of those identified the contraception mandate as the way that liberty is being threatened. That obviously doesn’t capture the full measure of opposition to the requirement, but it does shed light on how little the right-wing talking point about it has failed to rise to the hysteria some politicians obviously hoped it would.

Emphasis Mine

see:http://www.religiondispatches.org/dispatches/sarahposner/5798/