By Caryl Rivers
Wednesday, January 21, 2009
Clearing out the underbrush of Bush-era rules and regulations that rolled back reproductive rights is a big job because it entails so many federal agencies. Caryl Rivers' advice to the new U.S. president: Start now and stay on it.
(WOMENSENEWS)--As Barack Obama begins his first days in office, he's got a lot on his plate, from the ailing economy to the war in Gaza.
But the damage done to women's reproductive rights under the Bush administration has been vast and the necessary repair work cannot be allowed to drop to the lower depths of the president's "to do" list.
In Bush's waning days he took one last swipe at women's reproductive health. The "right of conscience" rule, issued by the Department of Health and Human Services under the agency's rule-making authority, went into effect yesterday.
The federal rule with the force of law permits workers at more than 584,000 U.S. medical facilities that receive federal funding to refuse to provide care or administer procedures with which they disagree, including emergency contraception, known as Plan B. The rule could hamper states from enforcing laws that require hospitals to offer those treatments, such as the morning-after pill for rape victims.
"In just a matter of months, the Bush administration has undone three decades of federal protections for both medical professionals and their patients," Nancy Northup, president of the Center for Reproductive Rights, said in a statement Jan. 8. "It replaced them with a policy that seriously risks the health of millions of women, then tried to pass it off as benevolent."
House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid have said the Democrats are considering a number of ways to repeal the conscience rule, and state attorneys general in seven states, including Massachusetts, Connecticut, California and New Jersey, filed a lawsuit last week to block it.
Reid and other lawmakers reintroduced the Prevention First Act on their first day back to work. The bill would increase access to both contraception and comprehensive sex education, as well as reduce unwanted pregnancies.
But clearing away the underbrush of laws, rules and policies harmful to women that Bush leaves will be a tough job, given how tangled up they are with an array of federal agencies.
The Food and Drug Administration was an early target. On Christmas Eve, 2002, in a stealth move, Bush named four members to an FDA standing advisory committee on reproductive health who had a record of opposing approved reproductive drugs. Dr. David Hager, chair of the panel, was known for viewing oral contraceptives as marriage-destroying, promiscuity-promoting potions and writing a book with his wife that recommends Bible readings and prayers for such ailments as premenstrual syndrome.
Surprise, surprise: Hager led the charge against over-the-counter access for emergency contraceptive pills that turned into a bare-knuckles political battle with health advocates that lasted two years.
In 2004, the Bush administration reversed a 23-4 vote in favor of the measure taken by its own FDA panel of scientists, who found the morning-after pill a safe, effective way to prevent hundreds of thousands of abortions. Plan B only became legal over the counter--and even then only for women over 18--after two female senators, Hillary Clinton of New York and Patty Murray of Washington, flexed their political muscle and told Bush in no uncertain terms that his nomination for a new FDA head would languish until he relented.
Under Bush, information about contraception evaporated. The administration ordered the Centers for Disease Control and National Institutes of Health to remove from their Web sites information about the effectiveness of condoms, replacing it with pro-abstinence propaganda. The Council for Research on Women found the new CDC statements inaccurately claiming that condoms could not protect against sexually transmitted diseases.
The Bush administration spent like a drunken sailor (more than a billion dollars) on "abstinence only" programs that not only don't work, but may even raise the chances of unwanted pregnancies and sexually transmitted diseases. In 2005 the Guttmacher Institute reported that over 88 percent of adolescents taking "virginity pledges" break them before marriage. The really bad news is that teens who take such pledges don't use contraceptives when they do have sex.
Pledging teens have the same rate of sexually transmitted diseases as non-pledgers. In fact, Human Rights Watch found that abstinence-only programs "deny children basic information that could protect them from HIV/AIDS infection
. . . what they don't know may kill them."
A congressional staff analysis found in 2005 that abstinence-only programs gave out "false, misleading or distorted information." Eighty percent of the abstinence-only curricula studied contained false or misleading information. In particular, they blur religion and science; treat gender stereotypes as scientific fact; and contain serious scientific errors, such as the notions that abortion leads to sterility and suicide, that pregnancy can result from touching someone's genitals and that oral sex can give you cancer.
Under Bush, the department of Health and Human Services changed the definition of when pregnancy begins. Both the National Institutes of Health and the American College of Obstetricians and Gynecologists define it as the time when the fertilized egg is implanted in the uterine wall; usually about five or six days after fertilization.
In the past, the federal government had accepted this definition. But Bush's HHS gave a nod to the position of anti-choice advocates, who argue that the birth control pill and the IUD are not contraception, but abortion, because they possibly could block the implantation of an egg. HHS veered far to the right by saying "both definitions of pregnancy inform medical practice." This language opened the door to a possible repeal by a conservative Supreme Court of the 1965 Griswold decision that legalized contraception, including condoms and the pill.
Under the Bush administration, a virtual war on birth control made great advances.
In many states, pharmacists and others can refuse to dispense legal contraceptives. Four states--Arkansas, Georgia, Mississippi and South Dakota--have passed laws allowing a pharmacist to refuse to dispense emergency contraception drugs. Other states have their own "conscience laws" allowing health care workers, including pharmacists, to refuse to provide contraception--or even information--if they have a moral objection to birth control. Among these states are Maine, South Dakota and Tennessee.
High on the Obama administration's agenda should be protection of a woman's right to receive birth control when she wants or needs it. It's unthinkable that in some states today, a woman who has been a rape victim can be denied emergency contraception by her pharmacist.
The Bush administration also played politics with kids and health. In 2002, it issued rules allowing states to define a fetus as a child eligible for subsidized health care under the Children's Health Insurance Program. But the administration said the program could not be used to provide postpartum services or follow-up care to a woman after delivery. Fetuses, 1; mothers, 0.
Some of these issues could be resolved quickly by executive order, such as putting information back on federal Web sites and undoing a ban on funding to any overseas group that performs or even offers information on abortion. But hunting down and ripping out all the rules, policies, directives and bureaucrats that attacked women's reproductive rights under Bush will be a big job.
To get it done, the new administration needs to start right away and keep on it.
Caryl Rivers is a professor of journalism at Boston University and the author of "Selling Anxiety: How the News Media Scare Women."
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