The same Congress that failed to popularize rape, can’t stop themselves from attacking immigrants, and votes to shut down government funds for food stamps and cut Medicare while shoveling subsidies to agribusiness and drug companies – they have a new plan to divide and conquer: the 20 week abortion ban. What could be wrong with that? Plenty!

It aggravates obstacles to critical health care services while it stigmatizes and criminalizes the small number of women who need late term abortions, erodes the legal right to abortions for everyone, and sets policy based on myths and bad math instead of trusting science – and trusting women. It’s an opportunity for women and men across the social spectrum to get the scoop and short circuit this latest cynical scheme.

1. Only 1.3% of abortions occur after 20 weeks. The two main reasons for late term abortions are lack of access to better, earlier care and biology. A 20 wk abortion ban would make both problems worse by criminalizing them.

2. The ban would hurt the most vulnerable in our society. Women who had abortions after the first trimester in 2008 were more likely to be black, and/or to be young, less educated and living in poverty. They were also more likely to have experienced violence at the hands of the man who got them pregnant and to have dealt with at least three serious life events in the last year. The ban won’t help. What would: Better access to the full range of health care services, including contraception and timely abortion, as well as safe communities and a vibrant economy.

3. The other group more likely to have a later abortion are older, higher income women and those paying with health insurance. Pregnancy is riskier for women over 35. Amniocentesis, the test for fetal anomalies, is not done until 15-18 weeks, and ultrasounds for congenital malformations are done at weeks 18-20. Women from Rep. Jackie Speier to the general public public have spoken up about the medical needs for late term abortions. After getting the results, women need time to find a provider (see point 4 below), and often to arrange for money, transportation, and child care.

4. Abortion is already stigmatized. Late abortion is worse. My experience after a conclusively negative amniocentesis in my early 40s was a case in point. Though abortion was still covered by my federal employee health plan and I lived in a major metropolitan area with plenty of medical facilities, the environment for performing a 2nd-trimester abortion was already so poisoned that we found only two doctors in the area who would do it. One had previously lost his license. The doctor we chose punished me by refusing to provide anesthesia as mild as Valium, on the pretext that I was not his regular patient. I was sad about that abortion, but I never felt badly about my decision. I’ll remain bitter til I die about how I was treated.

5. Bad Math. It’s hard to know when a pregnancy really starts. That’s why it’s best left to a physician to assess when a fetus is viable. Here are the metrics:

Doctors generally calculate a pregnancy as beginning 2 weeks after the first day of a woman’s last menstrual cycle. (Women stop getting their periods once they are pregnant.)

The proposed ban would start the count differently, from the date of fertilization.

But, surprise! Women’s periods and fertility cycles vary! The time between periods can be different from month to month. Ovulation can occur soon after, or even during, the bleeding phase of a woman’s menstrual cycle. Sperm can survive for up to a week to connect with an egg. (This is why couples who rely on timing fertility cycles as a form of birth control are often called “parents.”)

6. Math challenge: If you believe a pregnancy lasts 9 months: A month typically has 4.33 weeks so a 9-month pregnancy would last about 39 weeks. If you believe a pregnancy lasts 36 weeks: 36 / 4.33 = 8.33 months. So which date/standard should the law adopt?

7. A fetus inside the womb does not feel pain before 26 weeks according to the American College of Obstetricians and Gynecologists (ACOG) and is not a person. This is one misleading premise for proposing a 20 week ban.

8. States can presemtly ban abortions after a fetus is determined to be “viable,” that is, able to survive outside of the womb.  Viability is generally considered at 27 weeks; with medical advances, survival is possible but unlikely at 24 weeks, though probably with significantly compromised health. Viability of the fetus is increasingly challenged as a standard for limiting women’s rights to abortion.

9. We don’t need more restrictions on abortion. We have enough. Many states already limit abortions by the numbers of weeks of pregnancy, relying on a rigid construct based on specific weeks of gestation or trimester.

10. The Supreme Court’s Roe v Wade decision in 1973 also guaranteed the constitutional right to an abortion to save the mother’s life, a right also recently recognized in Ireland. This proposal contains exceptions for women whose lives are in danger as well as some rape and incest victims who can prove that they reported their assaults to criminal authorities, but it contains no exceptions for severe fetal anomalies or situations in which the woman’s health is threatened by her pregnancy.

Want to stick up for yourself and your community? Join with the Trust Women/Silver Ribbon Campaign to pledge that you Trust Women to figure out what kind of health care they need, and don’t need an ignorant assembly of bullies telling you how to manage your body or your family.

by Colleen McCullough, Lisa Kernan Social Justice Fellow, Trust Women/Silver Ribbon Campaign

The pro-choice majority in Texas reaffirmed the power of effective democracy and grassroots activism June 26. Drawn by state Senator Wendy Davis’ (D) heroic 11-hour filibuster, activists swarmed the Senate gallery, successfully blocking a draconian omnibus anti-abortion bill that would have closed down approximately 80% of all abortion clinics in Texas.

This victory, while momentous, is already facing another challenge.  Gov. Rick Perry plans to call another special session on July 1. But the people of Texas showed a groundswell of support in conquering this bill, reminding the Texas senate, in-person, that women’s bodies will not be so easily policed. Hundreds camped out at the capitol, gave testimony on the House floor and made a successful fuss from the senate gallery when Republicans attempted to force the vote. Regardless of how SB 5 progresses from here, the reproductive justice movement has found a beacon of light, a shining example of effective advocacy and outrage in Texas’s victory. The movement has found a much-needed rallying point around which to mobilize and engage national public attention.

Another, more ominous lesson to be learned from the Texas case is the horrific insight into the creative and cunning ways in which anti-choice politicians push anti-women legislation through the Senate. An omnibus bill comprised of previously unsuccessful anti-abortion legislation, a special session called specifically to pass a bill that negatively impacts women’s lives and health in a direct way, a suspension of the rules to ensure the passage of such a discriminatory law? Texas Republicans, like many politicians across the country, are manipulating the system to deliberately strip women of their reproductive rights. We need to be aware of this manipulation and hold these politicians accountable, not only for denying us reproductive and other civil rights, but also for wasting precious time and taxpayer money to enact draconian measures that literally benefit no one.

How it Happened

Wearing a back brace and pink running shoes, Davis filibustered on the Senate floor for more than 11 hours against SB 5.  As advocates tweeted the news (including a message from Pres. Obama), supporters flocked to the Senate. Right before the 12 midnight deadline for the end of the special  Senate session, Lieutenant Governor Dwight Dewhurst sustained the third and final challenge to Davis’ filibuster and called for a vote, inciting outrage from hundreds in the gallery. Amidst the uproar, the Texas Senate attempted to vote on the bill, and Republicans initially claimed it had passed 19-10. But Texas Tribune’s Becca Aaronson later reported that an official Senate timestamp showed the final vote approving SB 5 was taken at 12:02 A.M, two minutes after the special session’s deadline. Around 3am on Wednesday, the Senate confirmed that the vote was invalid, and that the bill had not passed – this time.

SB 5 combines several pieces of anti-abortion legislation that failed to advance during the regular session. More than 24 anti-abortion bills were proposed in the Texas legislature this year but under a two-thirds rule, none of the bills passed. However, on June 10th, buckling under continued pressure from Republican legislators, Gov. Rick Perry (R) forced a vote on SB 5 in a special 30-day session. Lt. Gov. Dewhurst suspended the two-thirds rule for the special session, essentially ensuring that SB 5 would pass.

But Texas wasn’t going down without a fight. More than 700 Texans descended on the Capitol building last Thursday, sharing testimony and delaying the House vote of the bill for 12 hours. Democrats continued to delay the vote on Sunday for another 15 hours, but around 4am on Monday, Texas House Republicans cut off the debate and forced a vote. The last chance to stop SB 5 in its tracks was a Democratic filibuster in the Senate that would have to last until 12 midnight Tuesday night.

Senator Davis rose to the challenge, and to her feet, standing for nearly 12 hours without drinking, eating, using the bathroom or even leaning on a desk per Texas Parliamentary filibuster rules. When Republicans finally managed to silence Davis, protesters in the wings took over, causing enough “ruckus and noise” (in Dewhurst’s words) to delay the vote, thus blocking the bill.

The Latest – from Ellie Smeal at Feminist Majority:

We just learned that Texas Gov. Rick Perry plans to hold another special session.

His plan? To pass SB5 and negate Sen. Wendy Davis’ 12-hour-long fillibuster to defeat a TRAP law that would have closed the majority of her state’s abortion clinics.

We’re pissed off. Help us tell Gov. Perry that the fight has just begun.

He’s planning to start the next special session July 1. That means we have four days to flood his office and social media feeds.

Tweet at him using #PissedAtPerry. Email him. Post on his Facebook page. Flood his office with calls.

We won in Texas Tuesday night, thanks to Sen. Davis and all of her strong supporters. But Gov. Perry is determined to make that victory short-lived. Let’s show him who he’s dealing with.

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Dr. Yen’s TedX Bay Area Women video with info on EC from 2010 (start at2:22go to8:19):

http://bit.ly/10cvKTk

Sophia Yen, MD MPH is an adolescent medicine specialist whose research interest is Emergency Contraception knowledge, awareness and practices of adolescents and physicians. She is a co-founder of the Silver Ribbon Campaign to Trust Women, and an Assistant Professor at the Stanford School of Medicine and works at Lucile Packard Children’s Hospital in their Teen and Young Adult Clinic. She is board certified in pediatrics and in Adolescent Medicine. She is the immediate past president of the N. CA Society for Adolescent Health and Medicine. Her goal in life is to prevent all teenage pregnancies – “No teenager should want to get pregnant – she should have better things to do during her teen years and no teenager should get pregnant (she should have access to comprehensive sex education and confidential reproductive health care).”

She adds: Thank you Judge Korman for siding with science and calling out the politics that blocked access to backup birth control!

Great Resources on EC:

http://ec.princeton.edu/  – website on emergency contraception – has basic information and if you enter your zip code, where you can get it.

General IUD resource: http://maybetheiud.org/

http://www.acog.org/~/media/For%20Patients/faq114.pdf?dmc=1&ts=20130611T1754589001 ACOG fact sheet on EC

http://www.acog.org/Resources%20And%20Publications/Committee%20Opinions/Committee%20on%20Health%20Care%20for%20Underserved%20Women/Access%20to%20Emergency%20Contraception.aspx ACOG committee opinion on EC 2012

Click Below to Sign!

http://trustwomen.civicactions.org/twsilverribbon/all_women_need_ready_access_to_emergency_contraception

The accommodation would mean that at least 1.1 million employees at Catholic hospitals, charities, primary schools and secondary schools, along with more than 930,000 students at Catholic universities and colleges, would be left to wonder if they will receive the same access to contraception as everyone else.

In opposition to the exemption

The NPRM elaborates on the Administration’s proposal of 2012 to entirely exempt churches, synagogues and mosques from the requirement to cover contraception for their employees.  However, it retreats from the definition of these entities proposed in 2012.  Those definitions asserted in part that employees of these institutions could be presumed to share the same faith as their religious employer, and its tenets. By the accounts of the institutions themselves, as reported in the Federal Register (p. 8459), they “may not know the religious belief of those they serve or hire, and … employment discrimination laws may prohibit them from inquiring about the religious beliefs of their employees.” As suggested above, abstinence from contraception is in any case neither a shared belief nor a shared practice by the vast majority of Americans regardless of religious affiliation.

The Departments ask whether the remaining definition, referring to the tax code, unduly expands the universe of employers who would have the right to an exemption.  It might.

More pertinent, the new definition makes it crystal clear that the determination to exempt religious employers from the coverage requirement privileges the discriminatory, minority views of certain religious employers over the known preferences of employees, and is thus a violation of employees’ autonomy and right to equal treatment.

Religious employers should not enjoy the legal right to deny or interfere with coverage for contraception.  To the extent that they do now, it is time stop providing the privilege to deny others their rights.

In opposition to the accommodation

The NPRM also expounds on the definition of another category of religiously-affiliated institutions such as schools and hospitals, which are to be offered an accommodation requiring their employees to receive contraceptive coverage, while shielding the employers from the allegedly contaminating activities of financial transactions associated with effectuating such coverage.

Extending legal protection for segregating contraception coverage puts employees’ rights at the mercy of their employers’ discriminatory views.  Every person who depends on health insurance through employment has the right to personal autonomy, and to equal treatment under the law.  The financial relationship between a person and her employer does[asa1]  not compromise her rights or autonomy.  The fact that religious institutions, when acting as employers, distribute funds earned by employees to pay for health benefits does not grant them the power to impose their doctrinal beliefs upon those employees, or to put those employees at risk for less effective coverage. In fact. the funds were earned by and belong the employees, who should direct their disposition.

Requiring employers to notify employees about their benefits, but not to transfer funds to pay for those benefits, is a complication without a fundamental purpose. The employer would be required to cooperate with actions to inform employees that the coverage is available. The arrangement would have to involve the employer, though to a minor extent, while placing a potentially cumbersome barrier to employees receiving the benefit of coverage.

Subsequent rounds of regulations are slated to determine how these employees can gain access to individual contraception coverage through a convoluted system relying on insurers and other third parties to pick up the tab. But inevitably, some women will lose out[asa2] .

Opposition by religious employers to covering contraception is discriminatory and violates the affected employees’ 14th Amendment rights to personhood and autonomy.

Opposition to contraception is discriminatory, and contradicts public health principles regarding sexual health.  Imposing that opposition on employees, particularly on those who do not share that view, abridges their rights to autonomy.  It is the wrong choice.

For these reasons, legal precedents by and large do not support exemptions from contraceptive coverage for religious employers. However, any legal precedents that may suggest separate treatment for the financial assets of religious institutions on this matter should not be perpetuated.

Polling by the National Latina Institute for Reproductive Health found that women and men of all races and religions spoke out overwhelmingly in the recent election, through votes and in opinion polls, rejecting attacks on reproductive health care.

On Jan. 21, 2013, President Obama in his inaugural address paid respects to Seneca Falls, Selma, and Stonewall, key fights for the rights of women, African Americans, and LGBTQI people. This recognition should be backed by policies that respect all of our rights.

Ellen R. Shaffer PhD, Director Sophia Yen MD, Co-Founder Silver Ribbon Campaign to Trust Women ershaffer@twsr.org

Joseph E. Brenner MA, Co-Director Center for Policy Analysis joeebrenner@gmail.com

Mona Sarfaty MD MPH Professor, Jefferson University Mona.Sarfaty@jefferson.edu

Arlene Ash PhD UMass Boston arlene.ash@umassmed.edu

Lin Wang, MD Albert Einstein College of Medicine, Doctors for America linfanw@gmail.com

Rosalind Hinton rosalindhinton@me.com

Somer Loen, President San Francisco National Organization for Women somer@pocketgems.com

TWSR on NPRM contraception coverage 4-2013

Women and men of all races and religions turned out in droves in November to reject ignorant bigoted candidates who professed that God sanctions rape.  After 2 years of attacks in Congress and the states on birth control and abortion, we showed that many voters respond positively to hearing about coverage for abortion.

We’ve won some shifts in policy in 2013: We forced Congress to enact an improved and expanded Violence Against Women Act.  It’s great to hear the Administration speak approvingly of pay equity, and the basic human right to choose “whom we love.”

But the sex and gender-based attacks have continued almost without missing a beat. Arkansas is just the latest state to hurl breath-taking restrictions at abortion services,  and to ban funding for Planned Parenthood.

The Obama Administration has proposed a regulation on birth control that treats us like the property of our employer.  We need to help them to a more respectful posture.

The Affordable Care Act covers preventive health care services without co-payments and deductibles. Scientists and other experts at the independent Institute of Medicine have recommended to the Department of Health and Human Services (HHS) designating contraception as a preventive service that helps keep women healthy. In fact, nearly 99% of all women have relied on contraception at some point in their lives, but more than half of all women between the ages of 18 and 34 have struggled to afford it.

The proposed rule would grant a wide range of religiously-affiliated employers an exemption from this rule, and the right to deny their employees coverage that is identical to what they’d get in any other health plan.  The latest round of the proposed regulations specifies different categories of religiously-affiliated employers.

Subsequent rounds of regulations are slated to determine how these employees can gain access to individual contraception coverage through a convoluted system relying on insurers and other third parties to pick up the tab.  Inevitably, though, some women will lose out.

Equally importantly, this concession continues to stigmatize both women, and birth control.

Few groups would take this fight head-on last year, when the gravest threat came from a party united behind overturning Roe v Wade entirely.  It’s time to stop dancing a minuet with the Administration, and determine how to shield employees of all faiths or none who happen to work for a tax-exempt religiously affiliated university or hospital from the delusional patriarchal fantasies of their employers about human reproduction and biology.

The opposition enjoys the sway of many people’s emotional ties to religious organizations that have in fact lurched to the right in recent decades. It’s important to seek a path that distinguishes respect and reverence for the institutions, from allegiance to discriminatory beliefs and practices There is also ample corporate funding. There are more deceptive “crisis pregnancy centers” in the U.S. than there are abortion providers.

But these views challenge women’s ability to be full, equal, constitutional persons in the United States of America.

Comments for regulations on this issue are due on April 8.  Sign our petition here, or write your own.

It’s time to stand and fight. Fair and equal coverage for birth control must be our next victory of 2013.

The Obama Administration is seeking comments by April 8, 2013, on proposed rules to cover birth control under the Affordable Care Act.*

The rules would permit religiously-affiliated non-profit organizations like hospitals, universities and charities, as well as churches, to withhold coverage for contraception.  They can self-declare that they are religious institutions that oppose providing coverage for contraception. Employees would be issued individual insurance plans that cover contraception at no additional cost.

The proposed rules continue to stigmatize contraception, which is widely used and accepted, but too often inaccessible, especially to lower-income women. They would leave millions of women – and their families – subject to as-yet poorly defined financial and administrative arrangements, dependent on the compliance and goodwill of private health insurance plans.

* If link does not work, copy and paste into your bowser:

 http://www.ofr.gov/OFRUpload/OFRData/2013-02420_PI.pdf

From Catholics for Choice:

“The Obama Administration did the right thing the wrong way. According to the proposed rule, some women whose employers have a religious objection to providing contraception will still be able to get access through a  third party provider.

“That’s the good news, but the proposed rule’s expansion of which employers can be exempted from providing comprehensive preventive healthcare, including contraception, is appalling.  Women who work at Catholic schools, hospitals and social service agencies are wondering whether they’ll be able to get the same coverage as millions of other women, or if their healthcare just isn’t as important to the president as their bosses’ beliefs about sex and reproduction.

“It’s obvious that once again, the administration listened to the lobbyists for the Catholic bishops and their big business interests, instead of Americans of every faith and of none who support the separation of religion and state and believe that public policy should not impose or privilege any religious viewpoint. Allowing such a wide exemption gives religious extremists carte blanche to trump the rights of others, based merely on the assertion of a belief about contraception even if that belief runs contrary to science or the widely-held convictions of co-religionists.

“While protecting contraceptive access under the ACA is a win for women, the administration’s caving in to lobbying from conservative religious pressure groups is a loss for everyone. American Catholics who support contraceptive coverage, who believe in the separation of church and state and who were hoping for change in Washington are disappointed today.”

In addition:  NLJ Home > News > Seventh Circuit stays contraception insurance mandate in second case

Seventh Circuit stays contraception insurance mandate in second case. A federal appeals court has issued a second ruling staying the health care reform law’s requirement that health insurance plans cover contraception and related services.

From the Obama Administration:  Women’s Preventive Services Coverage and Religious Organizations

Thanks to the Affordable Care Act, most health plans cover recommended women’s preventive services, including contraception, without charging a co-pay or deductible.  The scientists and other experts at the independent Institute of Medicine provided recommendations to the Department of Health and Human Services (HHS) regarding which preventive services help keep women healthy and should be covered without cost-sharing. The IOM recommended covering contraception without a co-pay or deductible because there are tremendous health benefits for women that come from using contraception. In fact, nearly 99% of all women have relied on contraception at some point in their lives, but more than half of all women between the ages of 18 and 34 have struggled to afford it.

Today, the Obama Administration moved forward to continue to implement provisions in the health care law that would provide women contraceptive coverage without cost sharing, while taking into account religious objections to contraceptive services by certain religious organizations. The Notice of Proposed Rulemaking (NPRM) released today reflects the public feedback from comments on the Advance NPRM issued in March 2012.

Today’s proposals build on the ideas we laid out last year to provide women with coverage for recommended preventive care, including contraceptive services, without cost sharing, while also ensuring that non-profit organizations with religious objections won’t have to contract, arrange, pay, or refer for insurance coverage for these services to their employees or students.

Details on these proposed policies are outlined below.  The Administration is seeking comment on these proposals and welcomes feedback from all Americans through April 8, 2013.

Exemption for Religious Employers
Group health plans of “religious employers” are exempted from having to provide contraceptive coverage, if they have religious objections to contraception.

Today’s NPRM would simplify the existing definition of a “religious employer” as it relates to contraceptive coverage.

The NPRM would eliminate criteria that a religious employer:

1. have the inculcation of religious values as its purpose;
2. primarily employ persons who share its religious tenets; and
3. primarily serve persons who share its religious tenets.

The simple definition of “religious employer” for purposes of the exemption would follow a section of the Internal Revenue Code, and would primarily include churches, other houses of worship, and their affiliated organizations, as defined by Section 6033(a)(3)(A)(i) or (iii)

This proposed change is intended to clarify that a house of worship would not be excluded from the exemption because, for example, it provides charitable social services to persons of different religious faiths or employs persons of different religious faiths.  The Departments believe that this proposal would not expand the universe of employer plans that would qualify for the exemption beyond that which was intended in the 2012 final rules.

Creating Accommodations for Non Profit Religious Organizations

Consistent with the Advance NPRM, the NPRM proposes accommodations for additional non profit religious organizations, while also separately providing enrollees contraceptive coverage with no co-pays.  An eligible organization would be defined as an organization that:

1. opposes providing coverage for some or all of any contraceptive services required to be covered under Section 2713 of the PHS Act, on account of religious objections;
2. is organized and operates as a nonprofit entity;
3. holds itself out as a religious organization; and
4. self-certifies that it meets these criteria and specifies the contraceptive services for which it objects to providing coverage.

Under the proposed accommodations, the eligible organizations would not have to contract, arrange, pay or refer for any contraceptive coverage to which they object on religious grounds.

In addition, under the proposed accommodations, plan participants would receive contraceptive coverage through separate individual health insurance policies, without cost sharing or additional premiums.  The issuer would work to ensure a seamless process for plan participants to receive contraceptive coverage.

With respect to insured group health plans, the eligible organization would provide the self-certification to the health insurance issuer, which in turn would automatically provide separate, individual market contraceptive coverage at no cost for plan participants.  Issuers generally would find that providing such contraceptive coverage is cost neutral because they would be they would be insuring the same set of individuals under both policies and would experience lower costs from improvements in women’s health and fewer childbirths.

With respect to self-insured group health plans, the eligible organization would notify the third party administrator, which in turn would automatically work with a health insurance issuer to provide separate, individual health insurance policies at no cost for participants.  The costs of both the health insurance issuer and third party administrator would be offset by adjustments in Federally-facilitated Exchange user fees that insurers pay.

The NPRM also proposes that an eligible religious non profit organization that is an institution of higher education that arranges for student health insurance coverage may avail itself of an accommodation comparable to that for an eligible organization that is an employer with an insured group health plan.

The NPRM on women’s preventive services coverage is available here: http://www.ofr.gov/inspection.aspx.

For more information on women’s preventive services coverage, visit:  http://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html.