Please note this article is from the August 2005 issue of Self.com magazine, so some of these laws might be outdated by now. If you are curious about some of these laws, I encourage you to do your own research and see which ones are still current and which ones have been changed (if any).]
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Birth Control Lockdown
Laws that let pharmacists deny you the Pill. Tax dollars used to pay for anticondom TV ads. Emergency contraceptives held hostage by politics. Why, in 2005, is our access to birth control being threatened?
Remember where there was no such thing as the Pill? Unless you’re over 50, you probably don’t. You also weren’t around in the 1920s, when condoms were available only to men and only by prescription. Back then, women’s leading contraceptive choice was douching, and police could arrest a woman for talking publicly about diaphragms.
No, if you are one of the 38 million American women who use contraceptives, you probably think that condoms, birth control pills and the IUD will always be there if you want them. And you take for granted that, in a pinch, you could always pick up the “morning after” pill. Abortion may always be controversial, but in 2005, you assume that birth control is not.
But that wasn’t quite the case in Denton, Texas, where a woman sought emergency contraception after being raped, only to have 3 different pharmacists refuse to fill her prescription. Or in Menomonie, Wisconsin, where a pharmacist refused to refill a college student’s birth control pill prescription. The new front line in the battle over reproductive rights is not in abortion clinics but in your local drugstore, as extremists work to impede access to various contraceptive methods, arguing that they encourage irresponsible sexual behaviour – and in some cases, are tantamount to abortion.
In the view of Karen Brauer, president for Pharmacists for Life International in Powell, Ohio, blocking the implantation of a fertilized egg –something that could occur with most hormonal contraceptives- amounts to taking a life. “We support the human right of a pharmacist to be able to choose not to kill a human purposely,” says Brauer, who was fired by a Kmart in Delhi, Ohio, for refusing to dispense oral contraceptives.
Had she done so today in Arkansas, Georgia, Mississippi or South Dakota, Brauer might not have been punished. These states now protect pharmacists who take a stand of “conscientious refusal,” and 12 other states have considered similar measures this year. Under these laws, pharmacists are not required to inform women promptly that their prescription won’t be filled and refer them to someone else, actions called for under ethical guidelines of the American Pharmacists Association in Washington, D.C. In the case of emergency contraception –which is more effective the sooner after sex you take it- even a referral to another pharmacist might cause enough delay to make the pills worthless.
The 1,500 members of Pharmacists for Life International are a tiny portion of the nation’s estimated 200,000 pharmacists, but the birth control backlash is gaining momentum far beyond them. State legislatures have passed laws that could be used to redefine some contraceptives as abortion. Public school curriculas spread misinformation about failure rates and side effects. The FDA has blocked over-the-counter to emergency contraceptive pills, and some federal officials are disparaging condom use for the prevention of HIV/AIDS and other diseases. “Women should be really scared,” says Jill Morrison, a senior counsel at the National Women’s Law Centre in Washington, D.C., a non-profit that has created a brochure to help women protect their rights to services including birth control. “It sounds radical, but when you start seeing the inroads being made, you know there’s a real threat.”
Turn the page Scroll down to find out more. And as previous generations could have told us, don’t count on your contraceptives.
The Condom Cops
No one would blame the people who live in McLennan County, Texas, for being wary of using condoms. In recent years, they’ve been assaulted by a TV ad that flashed “condoms fail” in neon green, over and over again. The ad campaign was produced by the McLennan Country Collaborative Abstinence Project – a federally funded organization.
According to the National Institute of Health report, condoms break or slip up to 3.6% of the time and don’t always protect against STDs. Used improperly, they fail to prevent pregnancy 15% of the time. Still, the American Public Health Association in Washington, D.C., calls condoms one of our best public health tools. They are cheap, about 98% effective if used correctly, and the only device that helps prevent transmission of HIV/AIDS.
That’s not the view of some federal officials, who increasingly endorse only abstinence for STD prevention. Another tack: As a member of the Presidential Advisory Council on HIV and AIDS, recently elected senator Tom Coburn, M.D. (O-Okla.), pressed the FDA to require a warning on condoms that they cannot prevent the spread of human papilomavirus (HPV), an infection linked to cervical cancer. Condom use is less effective against HPV than HIV, the Centers for Disease Control and Prevention in Atlanta reports, but it may help lower the risk for cervical cancer. Condoms are already a hard sell, argues Debra Hauser, vice president of the sex-health group Advocates for Youth in Washington, D.C. “If there is any doubt at all, people use it as an out. They think, ‘If condoms don’t work, why should I use them?’”
Fact: 11 states, including Arizona, Iowa, Nevada, Oregon, Texas and Utah, spend no state money on family planning.
They’re Teaching What?!
None of the major abstinence-only curricula funded by the federal government (to the tune of $170 million in 2005) provides information on choosing or using a birth control method. What they do provide: misleading –sometimes downright inaccurate- information about preventing pregnancy and STD’s.
What’s taught: “Imperfections in the contraceptive not visible to the eye could allow sperm, [STDs] or HIV to pass through.”
What’s true: According to the Centre for Disease Control (CDC), latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens.”
What’s taught: “Contraception, technology’s despairing answer to adolescent sexual activity, has intensified the loneliness, frustration and emptiness of our young people.”
What’s true: Several studies suggest young women who don’t use birth control are more likely to have poor mental health, including depression, anxiety and low self-esteem.
What’s taught: “The chemical forms of birth control damage the inside of a young girl’s body in ways that can affect her fertility later on.”
What’s true: The Pill does not cause damage that leads to infertility, says medical texts, and may lower the risk for pelvic inflammatory disease (PID), a fertility threat.
Three Men Who Control Birth Control
Some federal officials holding the key to family planning access seem hostile to the very idea of contraception.
Quote:
“Any form of contraception [has] detrimental effects on marriages and even nonmarital relationships.”
- Joseph B. Stanford, M.D., outgoing member of the FDA’s Advisory Committee for Reproductive Health Drugs, which examines whether to approve new birth control methods. Dr. Stanford has also said that the Pill “could act as an abortifacent,” contradicting accepted science.
Quote:
“We have been subjected to the propaganda of the safe-sex lobby. They would have us believe that more contraceptives are the answer to the problems of sexually transmitted disease and unwanted pregnancy.”
- Representative Joe Pitts (R-Pa.), member of the sub-committee that oversees contraceptive research at the National Institutes of Health and federal funding for family planning under the Medicaid and Title X programs.
Quote:
“Americans are increasingly turning away from marriage as a lifelong committment. Why? ... The widespread availability of contraception helped encourage sex outside of marriage and nonmarital cohabitation.”
- Wade Horn, assistant secretary for children and families at the US Department of Health and Human Services, who directs funding for federal abstinence-promotion programs.
Best and Worst States for Birth Control
Worst: Mississippi
- Pharmacists can deny customers contraception without informing them prompty or making a referral.
- Schools aren’t required to cover pregnancy or STD prevention in “sex ed,” and must promote abstinence until marriage.
- Family planning funding is down 14% since 1994.
Best: Washington
- Pharmacists can dispense emergency contraception to women without a doctor’s prescription.
- Hospitals must offer emergency contraception to women who have been raped.
- Private insurance plans are required to cover birth control.
Your Rx, Denied
A 40-year-old cancer survivor with two young children, Lauren Gaines had recently gone off the Pill when she had her husband came up against their worst-case scenario: a broken condom. Gaines knew she had a 72 hour window in which emergency contraceptive pills would be most effective. (EC is a higher dose of one of the hormones in oral contraceptives’ it’s not to be confused with the so-called abortion pill, mifepristone.) She quickly got her doctor to call in a prescription to Kerr Drugs in raleigh, North Carolina, where she went nearly every day and knew most of the staff. But when she arrived at the drive-through window, the pharmacist, James Morgan, told her he wouldn’t fill her prescription on “religious grounds.”
Gaines, a Republican and a nonpracticing Catholic who describes herself as spiritual, cried as her children listened silently from the backseat. Her husband, Jonathan, took the prescription to another drugstore, which filled it one day later. Then, the couple got angry: He confronted the manager at Kerr, and they complained to the state pharmacy board. Kerr Drugs fired Morgan. A spokeswoman told Self its policy is to make sure every valid prescription is filed in a timely manner.
Gaines “felt completely and totally judged,” she says. “It was horrible that he had power over me. I made that decision with my doctor, and as far as I was concerned he had no business being in on it.”
EC: It’s Still MIA
In the Drugstore: Last year, the FDA ignored the advice of its own advisory panel and rejected an application to make Plan B, a brand of emergency contraception, available over the counter. The American College of Obstetricians and Gynecologists in Washington, D.C., called the action “morally repugnant” and “a dark stain” on the agency’s reputation. At press time, the FDA was sitting on a new bid to allow sales of Plan B to anyone age 16 or older, and senators Hillary Clinton (D- N.Y.) and Patty Murray (D – Wash.) planned to block the appointment of proposed FDA chief Lester Crawford in protest.
In the Pharmacy: Some states aren’t waiting for the FDA decision: In Alaska, California, Hawaii, Maine, New Hampshire, New Mexico and Washington, women can pick up EC from a pharmacist without a doctor’s prescription. 4 states rejected similar commonsense proposals this year.
In the Hospital: An estimated 25,000 women become pregnant each year after a rape. Yet only about half of women at risk were given emergency contraception in the emergency room, according to a 2002 study in the Annals of Emergency Medicine. Laws in California, New Jersey, New Mexico, New York, South Carolina and Washington require hospitals to offer emergency contraception in the ER, but do they? A report by the New York city council found nearly 1 in 4 public clinics were ignoring a similar rule. Worse, when US Department of Justice officials issued guidelines for treatment of women who have been raped, they omitted any mention of emergency contraception.
Fact: Since 2002, the Bush Administration has withheld all support for the UN Population Fund, which helps women overseas prevent unplanned pregnancy and HIV/AIDS.
Conception Confusion
Most major medical groups, and the US government, define a pregnancy as beginning at implantation, when a fertilized egg comes to rest in a woman’s uterine lining. But according to the Alan Guttmacher Institute, a sex-health research group in New York city, 18 states (Alabama, Arizona, Illinois, Kentucky, Louisiana, Massachusetts, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, Ohio, Oklahoma, South Carolina, Texas, Wisconsin and Wyoming) have quietly defined terms such as conception, fetus and unborn child as beginning, instead of fertilization, the moment when sperm meets egg, usually about a week before the fertilized egg implants. (If it ever does: A large percentage of fertilized eggs never implant and are washed out of the system.)
It’s not a matter of mere semantics. If pregnancy begins at fertilization, then methods that sometimes stop implantation – EC, the Pill, patches, IUDs and the vaginal ring- could be a considered a way of terminating, not preventing, a pregnancy. “There’s a recasting of what birth control is in this country. To opponents, it’s abortion under a different moniker,” says William Smith, vice president for public policy at the Sexuality Information and Education Council of the United States in New York City.
In Virginia, family planning supporters felt threatened enough to introduce the Birth Control Protection Act, a bill stating that “contraception does not constitute abortion.” The state legislature has failed to endorse this seemingly simple distinction for 3 years running.
[Nikolita edit: As this article is from 2005, there have been a few articles in the news and online about birth control-related issues that have roots highlighted in this article.]
