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REPRODUCTIVE JUSTICE
— recommendations
The Democratic Party has steadfastly
defended a woman's right to choose to have an abortion.
However, the Bush Administration and their allies on the
radical right have undermined the rights of all citizens
to have access to proper reproductive healthcare by using
bad science and specious labels such as "pre-born person"
to elevate the rights of the fetus above those of women
and men (1). Instead
of an autonomous person in control of her body, a pregnant
woman is relegated to the status of "receptacle"
for a fetus. "Fetal rights" have stopped critical
stem cell research, resulting in unnecessary pain and death
for thousands of men and women suffering from Parkinson's,
diabetes and heart disease. Confusion between contraception
and abortion, again meant to protect the "pre-born
person," has denied women access to emergency contraception,
resulting in unwanted pregnancies, also, ironically, additional
abortions. It is no longer enough to talk about abortion
rights or even women's rights. It is time to recognize the
human right of reproductive justice and to take all necessary
steps to protect it.
The Right to Accurate, Science-Based,
Reproductive Health Information
By invidiously promoting religious goals at the expense
of sound health practices, the Bush administration has funded
the use of inaccurate, judgmental and incomplete sexual
education materials in our public schools. Under three separate
federal programs, states receive public money for sex education
curricula that promote only "abstinence-before-marriage."
Other means of contraception or disease prevention can be
discussed only in terms of their failure rates. A study
undertaken on behalf of Representative Henry Waxman has
found that 11 out of 13 curricula studied contained distortions,
false and misleading information about the risks of abortion
and sexual activity and outdated stereotypes of male and
female behavior. Further, they blurred the line between
religion and science, in addition to containing gross scientific
errors (2). Unsurprisingly,
students who have been subjected to this non-education are
more likely to be at risk for pregnancy and sexually transmitted
diseases (STD), recklessly placing our young men and women
in jeopardy (Id. at 4, note 15).
Furthermore, the use of these religious-based materials
clearly infringes on our right to religious choice and decimates
the constitutional separation of church and State.
To counteract this dangerous trend, Senator Frank Lautenberg
(D-NJ) and Representative Barbara Lee (D-CA) introduced
the Responsible Education About Life Act (REAL). The purpose
of REAL is to "provide for the reduction of adolescent
pregnancy, HIV rates and other sexually transmitted diseases"
by funding Family Life Programs that are age-appropriate,
medically appropriate, and based on scientifically accurate
information " [H.R. 768, §3 (b)].
While stating that abstinence is the most effective form
of contraception and disease prevention, REAL recognizes
that our children need, and deserve, reliable and accurate
information before making major life decisions.
The Right to Access to Contraception
Contraception can save lives. Unwanted pregnancies can
pose a serious health risk to women that they shouldn't
be forced to take. Further, contraception can prevent the
spread of STDs among both men and women. Even more important,
however, contraception allows women the right to determine
the course of their own lives, rather than being enslaved
by their biology. It is a basic component of reproductive
health.
The right to have access to contraception has been enshrined
in a long line of cases starting with Griswold v. State
of Connecticut. However, not all women have access
to contraception because of cost. As of June 2005, only
23 states required health insurance coverage for contraception
(3). But these laws
frequently have opt-out clauses for religious or moral reasons,
or else they do not apply to self-insuring companies.
And of course, they afford no help at all to the millions
of women without health insurance. For that, many women
have to look to Title X clinics.
Title X clinics provide a broad range of health services,
including family planning, to millions of women, regardless
of ability to pay. These clinics have been especially important
in preventing teen pregnancy. According to the Alan Guttmacher
Institute, without these services an additional 385,800
teenagers would become pregnant each year. Of these, 154,700
would have given birth, increasing the number of teen births
by one-quarter. A total of 183,300 teenagers would have
had abortions, increasing teen abortions by 58% [NARAL,
Pro-Choice America Foundation, Title X Family Planning Services,
http://www.ProChoiceAmerica.org].
Yet Congress has never fully funded Title X clinics, and
the Bush Administration has repeatedly recommended level-funding
the program, and once even recommended an $8 million decrease
[The National Women’s Law Center,
Slip-Sliding Away: The Erosion of Hard-Won Gains For
Women Under the Bush Administration and an Agenda for Moving
Forward, April 2004, p. 36]. According to NARAL,
If Title X funding had increased at only
the rate of inflation from its FY’1980 funding level
of $162 million, it would now be funded at more than $643
million. Title X’s funding level is less than half
that amount $288 million. At a minimum, Title X needs
to be funded at $350 million to maintain the quality services.
Notwithstanding, the Bush administration requested that
Title X funding remain at $278 million for FY '05. [Title
X: The Nation's Cornerstone Federal Family Planning Program,
at p.8.]
As it turned out, Congress funded Title X at $288 million
in FY '05, well below what is required [Title
X Family Planning Services, p. 2], and just above
what Bush proposed for "abstinence" programs the
same year [The Content of Federally Funded
Abstinence-Only Education Programs, p.1.]. Furthermore,
the Bush administration has proposed changing the federal
employees' health program to remove contraception from covered
expenses in an effort to deny access to contraception to
even more women.
Assuming that a woman has sufficient cash, health insurance,
or access to a fully functioning Title X clinic, there is
still no guarantee that she will still be able to fill her
prescription for it. The overwhelming majority of Americans
believe that pharmacists should be required to fill prescriptions
for contraception, regardless of the pharmacists' moral
beliefs. The radical right has encouraged pharmacists to
refuse to fill prescriptions for contraception, especially
emergency contraception, deliberately misleading people
to believe that they are preventing abortions. "Pharmacists
for Life," an anti-choice organization, has been urging
states to pass "conscience clause" laws that would
enable pharmacists to refuse to fill prescriptions for contraception
on moral grounds, in the erroneous belief that they are
preventing abortions (7).
However, according to Scientific American, emergency
contraception, "by medical definition" blocks
pregnancy and does not terminate it [Scientific
American.com, October 2005, editorial at http://www.sciam.com/article.cfm?chanID=sa006&colID=2&articleID=000D528C-A545-1330-A54583414B7F0000].
Ironically, and tragically, the logical result of such a
refusal will be increased abortions (8).
Several Democratic lawmakers have introduced the Access
to Legal Pharmaceuticals Act [http://www.house.gov/maloney/press/109th/20050414ALPHA.htm
for Representative Diane Maloney.]. This law would
enable individual pharmacists to refuse to fill prescriptions,
but require the pharmacy in which they work to fill the
prescription within the same timeframe in which it would
normally be filled. Further,
Pharmacists cannot prevent or deter an
individual from filling a legal prescription for drugs
or devices. Refusing to return or transfer a prescription
is prohibited under the Access to Legal Pharmaceuticals
Act. The pharmacist cannot harass, humiliate or intentionally
breach the confidentiality of the individual attempting
to fill the prescription for birth control [Id.].
It is questionable whether this law would be enforceable
in small rural communities that might have only one pharmacist,
but at least the federal law would enshrine a right of access
to legal pharmaceuticals. Of course, the simple solution
to the moral dilemma before the objecting pharmacist is
to make emergency contraception available over the counter
to all women (9). This
has been the recommendation of the FDA's medical advisory
board since December, 2003. However, on 26 August 2005 the
FDA again postponed approval of the plan, saying instead,
for purely political and nonscientific reasons, that it
needs to investigate further whether emergency contraception
should be non-prescription for women aged 16 or more and
remain prescription-only for those 16 and under [See
FDA Statement, http://www.fda.gov/bbs/topics/news/2005/NEW01223.html].
Obviously, the Bush Administration has declared war on the
right to have access to contraception. It is equally obvious
that Democrats must fight just as hard to keep contraception
accessible to all women.
The Right to a Safe Abortion
It is not easy to have an abortion [See,
NARAL Pro-Choice America, Clinic Violence and Intimidation,
http://www.ProChoiceAmerica.org].
Each abortion is the result of a painful decision-making
process between a woman and her physician. There are probably
as many reasons to have an abortion as there are women who
have had abortions. Sometimes it is to preserve the health
or life of the mother. Sometimes it is because the child
is the result of rape or incest. Sometimes it is the result
of a sad but wise recognition that a woman is not ready
to have a child or cannot hope to support one because of
her economic situation. Whatever the reason, the Supreme
Court has enshrined a woman's right to an abortion. However,
ever since Roe v. Wade, the radical right has been
whittling away at that right, with sometimes deadly results.
Since 1993 seven clinic workers—including three doctors,
two clinic employees, a clinic escort, and a security guard—have
been murdered in the United States [NARAL
Pro-Choice America, Clinic Violence and Intimidation, http://www.ProChoiceAmerica.org].
Abortion providers are subjected to bombings and arsons,
shootings, anthrax threats and other acts of violence and
vandalism [Id.]. Although the Freedom
of Access to Clinic Entrances Act (FACE), passed in 1994,
has resulted in decreases in offenses against clinics, particularly
blockades, there are still persistent trends of crimes against
abortion clinics [National Abortion Foundation,
About Abortion: Clinic Violence, http://www.prochoice.org/about_abortion/myths/index.html].
Law officials at state and federal levels must take seriously
their responsibility to enforce FACE and other related laws.
But assuming that it is safe to go to an abortion clinic,
there is no guarantee that there will be a doctor available
to perform an abortion [http://www.prochoice.org/pubs_research/publications/downloads/about_abortion/access_abortion.pdf]
According to the most recent survey by the Alan Guttmacher
Institute, 87% of counties in the United States have no
identified abortion provider; in rural areas, that figure
rises to 97%. Of course, threats of violence is a powerful
deterrent to practitioners; others include is the lack of
training in first trimester abortions for new doctors.
Of course, without insurance, it is difficult to finance
an abortion. But more than two-thirds of women must pay
for their abortions themselves. Medicaid funds cannot be
used to pay for abortions, and only 13% of procedures are
covered by private insurance at the time of the abortion.
Four states "restrict insurance coverage of abortion
in private insurance plans to cases in which the woman's
life would be endangered if the pregnancy were carried to
term. Additional abortion coverage is permitted only through
purchase of an additional rider and payment of an additional
premium." Eleven states restrict abortion coverage
in plans for public employees.
In addition to these barriers, 29 states require that women
receive counseling before an abortion may be performed.
Six states also require that specific "information"
must be given, including misinformation on a purported "link"
between abortion and breast cancer. Twenty-three states
also require waiting periods.
These barriers to abortion chip away at the rights inunciated
in Roe v. Wade. More important, they are contrary
to mainstream medical opinion. The American Medical Association,
the American College of Obstetricians and Gynecologists
and the American Medical Women's Association have all opposed
these artificial barriers to safe and legal abortion. These
respected medical bodies recognize that limiting access
to abortions places women’s health and lives at risk.
But assuming that it is safe to go to an abortion clinic,
there is no guarantee that there will be a doctor available
to perform an abortion. According to the most recent survey
by the Alan Guttmacher Institute, 87% of counties in the
United States have no identified abortion provider; in rural
areas, that figure rises to 97% [National
Abortion Foundation, Access to Abortion, http://www.prochoice.org/pubs_research/publications/downloads/about_abortion/access_abortion.pdf].
Of course, threats of violence is a powerful deterrent to
practitioners; others include is the lack of training in
first trimester abortions for new doctors (10).
Without insurance, it is difficult to finance an abortion.
More than two-thirds of women must pay for their abortions
themselves [Id.]. Medicaid funds
cannot be used to pay for abortions, and only 13% of procedures
are covered by private insurance at the time of the abortion
[Id.]. Four states "restrict
insurance coverage of abortion in private insurance plans
to cases in which the woman's life would be endangered if
the pregnancy were carried to term. Additional abortion
coverage is permitted only through purchase of an additional
rider and payment of an additional premium." [Guttmacher
Institute, State Policies in Brief: Restricting Insurance
Coverage of Abortion, October 1, 2005 http://www.guttmacher.org/statecenter/spibs/spib_RICA.pdf.]
Eleven states restrict abortion coverage in plans
for public employees [Id.].
In addition to these barriers, 29 states require that women
receive counseling before an abortion may be performed [Guttmacher
Institute, State Policies in Brief: Mandatory Counseling
and Waiting Periods for Abortion, October 11, 2005.].
Six states also require that specific "information"
must be given, including misinformation on a purported "link"
between abortion and breast cancer [Id.].
Twenty-three states also require waiting periods [Id.].
These barriers to abortion chip away at the rights enunciated
in Roe v. Wade. More important, they are contrary
to mainstream medical opinion. The American Medical Association,
the American College of Obstetricians and Gynecologists
and the American Medical Women's Association have all opposed
these artificial barriers to safe and legal abortion
[NARAL Pro-Choice America, Leading Medical Groups Oppose
Obstacles to Abortion]. These respected medical
bodies recognize that limiting access to abortions places
women's health and lives at risk.
Two cases before the Supreme Court will have a critical
impact on the right to abortion. The first, Ayotte v.
Planned Parenthood of New England, will determine the
constitutionality of a state abortion law that contains
no exception allowing an abortion when a woman’s health
is at risk. It will also determine whether a woman must
sustain actual harm to her health before raising the issue
before a court. It will also hear Scheidler v. National
Organization for Women and will determine whether abortion
clinics can sue anti-abortion protesters under federal anti-racketeering
laws (RICO). If the Court rules against abortion rights
in either of these cases, Democrats must be ready to take
whatever legislative action is necessary to reverse their
holdings.
Furthermore, the Bush Administration has escalated its
war against abortion even beyond national borders. Ronald
Reagan instituted the Global Gag Rule, officially known
as the Mexico City Policy, in 1984. Under the policy, the
United States refused to fund international family planning-related
agencies if they provided abortion services (even including
directing the women to another agency) in cases not involving
rape, incest, or danger to the life of the mother, or lobbying
for the legalization of abortion in their country. This
outrageous intrusion in other nations’ sovereignty
was continued by the first President Bush, overturned by
President Clinton, and re-instated by George W. Bush on
his first day in office. The lack of funding, as well as
loss of technical assistance and US-donated contraceptives,
including condoms, has directly contributed to the millions
of unsafe abortions performed around the world, the spread
of HIV and other STDs, and the birth of millions of unwanted
children [World Choking on the Gag Rule,
September/October 2005 Resist Newsletter, lhttp://www.resistinc.org/newsletter/issues/2005/09/index.html].
It is time for Democrats to take a stand to strip away
these barriers. It is not enough to espouse a belief in
a right; it is necessary to defend it. Democratic legislators
at federal and state level should be encouraged to pass
laws that strengthen the rights embedded in Roe v. Wade.
Insurance companies should be required to cover abortion,
just as they cover all other aspects of women’s reproductive
health. Doctors and other reproductive health workers need
to be safe in their clinics and their homes. Unnecessary
waiting limits and requirements for misleading information
need to be abolished. Only when these things are accomplished
can there be a real right to abortion.
The Right to a Healthy Childhood
A right to reproductive health includes the right to a
healthy childbirth experience. This means that all women,
regardless of ability to pay, should have access to excellent
health care before, during, and after their pregnancy. Furthermore,
their children should have the right to adequate medical
care, nutrition, education and housing. This isn’t
merely altruism; for the sake of our nation, we need a healthy,
educated citizenry. However, the Bush Administration, in
order to finance its tax cuts, has slashed the very programs
that promote these rights. And after Katrina, the situation
will only get worse, as Congressional Republicans use hurricane
disaster funding as an excuse to further cripple basic social
programs (11). Democrats
must be firm in their resolve to defend the rights of our
most vulnerable citizens.
Recommendations
for action by the Democratic party
