Thursday, January 31, 2013

Change to Ireland's abortion law

The Irish government is finally set to act. The New York Times and many other media outlets report that  Irish government officials are proposing to move from a total ban on abortion to one in which women can have an abortion "in cases where there is a real and substantial risk to a woman's life-- as distinct from her health" (New York Times).

I have written several times about what's going on in Ireland; to read, click on one or more of the 'labels' at the bottom of this post.

Ireland's debate over abortion demonstrates three things:

First, it demonstrates the power of the individual story to affect opinion and spur action. The move to (slightly) liberalize Ireland's total ban on abortion has been mandated since 1992 by the Irish Supreme Court and since 2010 by the European Court of Human Rights. The Irish government only got moving, however, after the tragic 2012 death of Dr. Savita Halappanaver, who died after suffering a miscarriage. Doctors in an Irish hospital refused to hasten the end of the miscarriage because the fetus was still alive (though inevitably dying). As a result of the delay in action, Dr. Halappanavar died from septicemia.

Second, it demonstrates the power of the Catholic Church and Catholic culture to resist change on abortion. For people who are pro-choice, the proposed legal change is a victory, considering the political and cultural conditions in Ireland, but only a victory of sorts, given how narrow the exception to a total ban is.  In the United States, pro-life activists can only dream of a time when American law would allow abortions only in cases of serious physical risks to a pregnant woman's life.

Third, it demonstrates that, regardless of time, place, or culture, many women want to have abortions. Ireland is often held up as a model pro-life country by activists. I can't recall where I saw it, but I watched a video of an American giving a speech in Ireland and telling his audience how wonderful Ireland was, given that no abortions take place there.

That speaker got it wrong. Abortions are likely taking place in Ireland, illegally, some safely (in the doctor's offices of the wealthy) and many more unsafely. Furthermore, there may be no abortions openly taking place in Ireland, but many Irish women are having abortions, in the United Kingdom, where they travel to have them, if they can afford it. The option for women (especially women of means) to escape the island and have a safe abortion in the UK serves as a kind of political pressure valve that allows the Irish government to keep an extremely restrictive ban on abortion in place with fewer political consequences, and preserve the fiction of Ireland as abortion free.


Article in The New York Times (December 18, 2012): Irish Government Set to Allow Abortion in Rare Cases

Article in The Christian Science Monitor (December 18, 2012): Ireland announces abortion law reforms, leaving no one satisfied

Wednesday, January 30, 2013

Three observations about the contraceptive mandate

The New York Times published  a good article  a few days ago that provides an overview of the storm of lawsuits over the contraceptive mandate.

When I read and think about this issue, I keep coming back to three things that seem to me quite salient but do not get as much play as I'd like:

First, before the ACA's contraceptive mandate, almost 30 states had similar mandates under state law. The Catholic Church and other organizations have already been living with this. Several Catholic  colleges and universities have supplied-- and supply-- coverage for birth control.  This idea that religious organizations and their followers can't live lives of religious freedom under a contraceptive mandate is clearly false! I don't understand why this fact does not get more attention-- and is not advertised more by the Obama Administration.

Second, the Catholic Church is fine with government involvement in religion when it swings their way. Did you know that in Germany, to take one example, citizens are assessed a religion tax that is then channeled to different religious organizations, including the Catholic Church? The Church is obviously quite comfortable influencing the state of policy in countries like Ireland, Malta, and Poland. And in the United States itself, millions of taxpayers dollars and many government resources are given each year to Catholic Church-affiliated organizations, such as Catholic charities and schools. Note that all of this money going to religious organizations directly or indirectly frees up the religious organizations' other money to pay for religious activities that might be in conflict with the beliefs of taxpayers, such as Church opposition to gay rights.

Third, many religious organizations self-insure. One of the accommodations provided by the Obama Administration is to require health insurers to pay for all contraceptive coverage in their health care plans, so that no religious employer money is directly paying for birth control. I think this accommodation is excellent and should quiet any qualms religious organizations have, if they don't want to be hypocritical (see point #2, above). The one major problem with this accommodation is that many organizations self-insure, so that there is no firewall between organization and insurer. Because of this problem, the Obama Administration needs to a) find some other type of accommodation, b) allow self-insured organizations to avoid providing birth control coverage, which would then allow religious organizations to self-insure and fully avoid the mandate, or c) stick to its guns but make point #1 more forcefully-- you say you can't live with this? You already have!

What do you think? Is there anything that you feel is underreported when it comes to the mandate fight?


Article in The New York Times (January 26, 2013): A Flood of Suits Fights Coverage of Birth Control

New news link on contraception and insurance coverage

If you look under our "News and opinion" links, to the right, you'll now see one labeled "NYT contraception and insurance coverage."

That is a link to a "Times Topic" page at The New York Times that is focused on the Affordable Care Act and the 'contraceptive mandate' and all of the controversy that goes along with it. It will be updated regularly.

Another nice thing about the NYT page is that it provides an excellent summary of the contours of the debate over the contraceptive mandate, assertions of religious liberty, and the resulting lawsuits. If you want to get caught up on what the fuss is all about, this is a great place to start.



New York Times Times Topic: Contraception and Insurance Coverage (Religious Exemption Debate)

Tuesday, January 29, 2013

Pregnant with an IUD

The pro-choice and pro-life movements love a good story. Like all political stories, narratives about pregnancy and abortion decisions are used to humanize abstract arguments, putting the reader in the shoes of someone with whom they can empathize.

I am coming to this story a little late-- it was published on December 3rd-- but it is worth a read.

Titled "Pregnant with an IUD: The Story of My Abortion," it is written by a woman who became pregnant despite having an IUD-- which is normally highly effective in preventing pregnancy. She writes a) about the shock of being pregnant unexpectedly and b) scheduling and obtaining an abortion.

The author portrays comfort at having an abortion and relief that a safe abortion option was available. The essay was published by RH Reality Check, which is a pro-choice media outlet, so the clear expectation of author and publisher was to make a pro-choice point.

One of the interesting, and perhaps rare, things about this essay, from my perspective, is that it could be used by a pro-choice person or a pro-life person to support their view. Both could read it and come away saying, "Exactly! This proves my argument!"

From the pro-choice perspective, one might derive the following: Life is complicated. Good contraceptives alone can't constitute the entire family planning toolkit. Abortion is no big deal as a medical procedure when it is available in good facilities.

From the pro-life perspective, one might learn the following lessons: All contraceptives fail, even IUDs, so sex is never consequence-free. Sex outside of a stable marital relationship can lead to pregnancies that are more likely to be unwanted, and therefore aborted. Being pro-choice comes down to desiring the entitlement to make 'selfish' choices.

Take a read. What do you think?


Article in RH Reality Check (December 3, 2012): Pregnant with an IUD: The Story of My Abortion

Monday, January 28, 2013

What are women willing to do to have an abortion?

Almost anything. Kate Manning reminds us of this in an op-ed in The New York Times, where she discusses some of the horrifying ways women have attempted to perform self-abortions.

If you've read even a little of the literature on the history of abortion, one knows a) that women have been attempting to control the number and spacing of their children for as long as women have gotten pregnant, b) before the contemporary era, abortion, in particular self-abortion, has been a dangerous and horrifying experience, and c) despite that, women have gone through hell to end pregnancies, often with tragedy as the result.

A cornerstone of the current American pro-life narrative is that women largely do not determine for themselves that they should have an abortion. Instead, pregnant women who have abortions are not murderers but are, like their 'unborn children,' victims to greedy 'abortion mills' and insensitive men-- husbands, boyfriends, etc.

So, for example, pro-lifers argue that being anti-abortion is a pro-woman stance, because the pro-choice way of thinking sells women a false bill of goods. Women are tricked by the pro-choice view (and by contemporary feminism in general) into thinking they are free and happy, when they are not. This rubs a lot of feminists the wrong way, as it implies that women lack the self-awareness and agency to make informed decisions about their own bodies and family planning.

To say that women can be pressured to make decisions against their interests by people close to them and the larger cultural atmosphere is not anathema to feminists, however. It is, in fact, one of the staples of second- and third-wave feminism-- for example, the toxic cultural push for women to be seen, and to see themselves, primarily as objects of sexual gratification. (For a great example of this kind of analysis, read Female Chauvinist Pigs: Women and the Rise of Raunch Culture by Ariel Levy.)

Regardless, works like Manning's are useful correctives to a the tidy American pro-life narrative. Manning's op-ed demonstrates that many, many women, under all kinds of situations, have been determined to end their pregnancies:
What is most striking about this history of probes and poisons is that throughout all recorded time, there have been women so desperate to end a pregnancy that they were willing to endure excruciating pain and considerable risk, including infection, sterility, permanent injury, puncture and hemorrhage, to say nothing of shame and ostracism. Where abortion was illegal, they risked prosecution and imprisonment. And death, of course.
Some women surely have been put in situations where they have been pressured to have an abortion, where they would have preferred to bring a child to term and receive support for that decision and its consequences. But there have also been many women, over time and across cultures, who have been determined to abort regardless of the wishes of others and the barriers in their way. The evidence is pretty clear that banning abortion does not eliminate abortions. It only increases the number of unsafe abortions and the difficulties of women already in difficult circumstances.


Op-ed in The New York Times by Kate Manning (January 21, 2013): Leeches, Lye, and Spanish Fly

Books that provide information and context on self-abortion, and its consequences, include a pair by John M. Riddle, discussing historical methods of abortion and contraception, Eve's Herbs: A History of Contraception and Abortion in the West, and Contraception and Abortion from the Ancient World to the Renaissance.

Also worth reading are the narratives of pro-choice doctors; so many pro-choice doctors got involved in providing abortions because of what they witnessed as young doctors in training at hospitals, namely, women brought in injured, dying, or dead from botched abortions or self-abortions. A good book of this type is Doctors of Conscience: The Struggle to Provide Abortion Before and After Roe v. Wade

Friday, January 18, 2013

Insight on the 40 Days for Life campaign

There are many wings of the pro-life movement, each with its own set of tactics regarding the best way to fight abortion in America. (The various wings or 'streams' of the contemporary pro-life movement are described in Ziad Munson's excellent book, The Making of Pro-Life Activists.)

One wing focuses on conducting activities around existing abortion clinics, to persuade pregnant women to not go through with intended abortions, and to change the hearts and minds of clinic workers. The best current example of the clinic-based pro-life movement is 40 Days for Life, whose signature event is to hold annual, coordinated 40-day prayer vigils outside of abortion clinics across the country.  When not holding their vigils, they organize supporters to have a regular presence around clinics, where they pray and attempt to engage clinic patients and employees.

The kind of activities conducted by 40 Days for Life are a much gentler version of the confrontational tactics used by Operation Rescue-types in the 1980s and 1990s. The most highly-publicized 40 Days for Life success story is Abby Johnson, the Planned Parenthood clinic director who became a pro-life activist. Ms. Johnson credits a lot of her 'conversion' to 40 Days for Life-affiliated activists who had a constant presence outside her clinic.

The primary metric that 40 Days for Life uses to measure the success of their efforts is the number of 'babies' that they estimate that they have 'saved' from abortion-- measured by counting the number of women who were going to have an abortion but changed their minds after encountering 40 Days for Life volunteers outside of a clinic. They also have an Abby Johnson metric: The number of clinic employees who have quit their jobs, presumably due to a 40 Days-influenced change of heart.

If you want to get some insight into the thinking of this wing of the pro-life movement, you can sign up to watch a 40 Days for Life webcast that will be shown on January 21. The webcast a promotion event for a book they are publishing that talks about their efforts and its effects. Obviously, the webcast and all related materials are very pro-40 Days for Life, but there is a lot to learn here about the pro-life movement.


40 Days for Life webcast homepage

Article (well press release-- the author, Shawn Carney, is a campaign director for 40 Days for Life) in (January 18, 2013): Book Tells How 40 Days for Life Saved 6,749 Babies From Abortion

Thursday, January 17, 2013

North Dakota State University, Planned Parenthood, and academic freedom

Apparently, having Planned Parenthood linked to your university research is not a good idea.

An article in indicates that North Dakota State University bowed to political pressure in killing a $1.2 million federal grant to scientifically study comprehensive sex education programs-- in other words, sex education programs that would include information about contraception. Two NDSU professors won the grant after state government officials declined to apply for it:
The professors, Brandy Randall and Molly Secor-Turner, planned to use the three-year grant for a sexual education program for at-risk teens in the Fargo area, programming developed in partnership with the region’s Planned Parenthood office.
North Dakota State's president froze the grant for legal review-- but telegraphed the eventual outcome, which would be to kill the grant-- after conservatives got wind of it and started complaining, arguing that it violated state law:
The state’s code forbids federal funds passing through a state agency to be used as “family planning funds” by an organization that performs abortion. But the grant clearly stated that it would not be used for family planning, and it falls under a part of federal law over which judges ruled the state law had no jurisdiction.
The grant also avoids violating a state law that requires abstinence-only sex education in public schools:
A state law requires North Dakota public schools to promote abstinence in sex education. The Planned Parenthood/North Dakota State program, which would have included information about contraception as well as abstinence, would have been based in the community, not in schools, and participants would have needed parental permission. 
The rhetoric used by one of the complaining state representatives is interesting:
Bette Grande, a Republican representative, criticized the university for going against the legislature’s wishes in allowing its faculty to apply for a grant that the state had turned down, and threatened to cut the university’s funding in retaliation. “When I see something that says this is Planned Parenthood -- they’re not even a part of the state of North Dakota, and they shouldn’t be a part of North Dakota,” Grande said. “They’re not a part of how we do business in this state."
Representative Grande denies the possibility that anyone in North Dakota could actually be pro-choice, let alone a Planned Parenthood supporter or member. Planned Parenthood is the Other.

I find this perspective particularly interesting given that North Dakota is currently experiencing a wave of migration to the state due to the oil and gas boom there. If many of those boom-time people end up staying, the definition of who is "a part" of North Dakota may change, and one may see a modification of the state's political culture as one has seen in Nevada, North Carolina, Virginia, and other "purpling" states.

This looks like a pretty clear violation of the First Amendment, so this is an academic freedom issue as much as it is a reproductive politics issue. Pro-lifers don't like sex education programs that include contraceptive education as a matter of principle, so the effectiveness of comprehensive sex education per se is besides the point for pro-lifers. That being noted, this is going to come off as another example of a conservative 'war on science': if we have ideological reasons for opposing X, we will fight any attempt to empirically study the problem if we think that a careful study might reveal something we don't like.


Article in (January 18, 2013): Planned Parenthood, Political Pressure

Article in (January 16, 2013): North Dakota Ends Partnership With Planned Parenthood

Wednesday, January 16, 2013

Movies and documentaries about abortion

I don't suppose that watching a movie or documentary about abortion is anyone's idea of lighthearted fun, but if you are interested in the topic and want to see something that will enlighten or challenge you (or perhaps both), I recommend the following five films, all available through Netflix:

  1. Lake of Fire (2006). In my opinion, this is the single best documentary about abortion in America, providing an unvarnished, emotionally complicated, and balanced view of personal and political decision-making about abortion.
  2. Unborn in the USA (2007). Available for streaming. This documentary examines the pro-life movement in America. I would say that the filmmakers have a pro-choice perspective, but it does not affect the quality of the film one way or the other. I found its coverage of efforts to train a new generation of college-age pro-life activists particularly interesting. 
  1. Citizen Ruth (1996). Available for streaming. This is a dark satire about the battle of pro-choice and pro-life activists over a drug-addled Laura Dern, who is pregnant and ordered by a judge to have an abortion. 
  2. 4 Months, 3 Weeks, and 2 Days (2007). Available for streaming. Set in communist Romania, this is the story of a college-age woman who tries to obtain an illegal abortion with the help of her best friend. It is one of those films that you will think about for a week afterwards.
  3. Vera Drake (2004). Available for streaming. This movie, set in 1950s England, is about a mild-mannered housewife who secretly performs illegal abortions. The movie works because of an unsettling performance by Imelda Staunton (perhaps best known now for her role as Dolores Umbridge in the Harry Potter movies).
There are many, many more films about abortion out there. Feel free to send me your top recommendations. 

Tuesday, January 15, 2013

Crisis Pregnancy Centers

I'm glad to be back from my long winter break. I hope you have enjoyed the holiday season and are ready to start discussing reproductive politics again.

I don't know if you came across this article in The New York Times on pregnancy centers (sometimes called "crisis pregnancy centers" or CPCs). It does a nice (and fairly sympathetic) job of describing the work of CPCs, which exist primarily to dissuade women from having abortions.

CPCs are run by pro-life activists. They advertise in billboards, in phone books, and on the Internet in a way that tries to reach women before they would contact or go to an abortion clinic (or an organization that offers abortion as one option or service of many, like Planned Parenthood). Just as an experiment, imagine you are a pregnant women thinking about having an abortion or considering other options (like adoption) and looking for information. Do a pretend search on the Internet. There is a very good chance that among the many results, right near the top, will be a link to a CPC (or "women's care center" or a similarly named organization). It will not necessarily be clear that you are being directed to a pro-life organization.

In towns with an abortion clinic, CPCs will often set up shop right next to the clinic, and use "sidewalk counselors" to try to persuade women entering the abortion clinic to go to the CPC instead.

People who work at CPCs use four basic tactics to dissuade women from having abortions:
  1. They provide an ultrasound examination to emphasize the humanity of the fetus.
  2. They provide information on alternatives to abortion, such as adoption. 
  3. They use standard pro-life talking points about the dangers of abortion, such as a post-abortion regret, links between abortion and breast cancer, medical complications from the abortion procedure, etc. 
  4. They offer to provide help to pregnant women through their pregnancy and possibly beyond (diapers and formula, for example). 
Pro-life activists fall into different camps, with different philosophies about how best to fight abortion. People who work at CPCs see themselves on the front lines, making concrete changes to women's lives and preventing abortions one at a time. 

In recent years, some state legislators have attempted to require pregnant women to receive their pre-abortion counseling from a CPC (rather than receive government-mandated counseling from a person at the abortion clinic itself). That kind of law has not passed yet, I believe, and it would almost certainly be unconstitutional. Some CPCs have also received government funding, in part because some offer abstinence-based birth control counseling. Most recently, CPCs have been in the news because pro-choice state legislators have attempted to require CPCs to more clearly disclose that a) they are pro-life organizations, and b) they do not provide abortion as one of their services. This legislation has run into opposition not just from pro-lifers but also free speech advocates. 


Article in The New York Times (January 4, 2013): Pregnancy Centers Gain Influence in Anti-Abortion Arena

For an excellent description of the various wings of the pro-life movement in the United States, read the following 2008 book by Professor Ziad Munson: The Making of Pro-Life Activists: How Social Movement Mobilization Works

Unpublished report by Professors Ziad Munson and Christopher  P. Scheitle on CPCs and their place in the pro-life universe (June 16, 2009): Crisis Pregnancy Centers: The Remaking of the Abortion Debate