Author: Jen R

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Drawing Connections: Intimate Partner Violence, Poverty, and Abortion

Jen R

[Author’s note: this article was originally published in Life Matters Journal, Volume 2, Issue 1.]

The consistent life ethic is traditionally seen as a way to draw connections among issues that do not seem related at first glance, such as war, the death penalty, and abortion. However, the connections between forms of violence and injustice are sometimes more immediate. Recent research, including a study published in August 2012 by the Guttmacher Institute, has highlighted connections between intimate partner violence, poverty, and abortion.

Intimate partner violence and abortion

Multiple studies from countries around the world have established a link between intimate partner violence (sometimes also known as domestic violence) and unintended pregnancy and abortion.[i],[ii],[iii],[iv]

The increased abortion rate among women who have experienced intimate partner violence begins with an increased prevalence of unintended pregnancy. A health survey in Massachusetts found that 40% of women who reported being abused had experienced one or more unintended pregnancies in the past five years, compared to 8% of non-abused women.[v]

Women in abusive relationships who become pregnant face numerous pressures to abort. These include fear of being punished if their partner doesn’t welcome the pregnancy, fear that the child will be abused, and the belief that having a child will make it impossible to leave the abusive partner for good. Among women who had abortions in the United States in 2008, about 7% reported having been physically or sexually abused by their child’s father, compared with about 1% of women in the general population who report experiencing physical or sexual abuse in the previous 12 months.[vi]

Reproductive coercion

In 2010, University of California-Davis researcher Elizabeth Miller and colleagues conducted the largest study to date of a phenomenon Miller has termed reproductive coercion[vii]. Miller’s team surveyed women aged 16-29 seeking reproductive health services in five clinics in northern California. Of these women, 53% had ever been physically or sexually abused by a partner. Nineteen percent had experienced pregnancy coercion, defined as a male partner using emotional or physical pressure or threats to get a woman to agree to become pregnant. Fifteen percent had experienced birth control sabotage, in which their partner had deliberately interfered with their efforts to use birth control. Miller uses the umbrella term reproductive coercion to cover pregnancy coercion and birth control sabotage.

Reproductive coercion is often associated with intimate partner violence and may partly explain why intimate partner violence is associated with high rates of unintended pregnancy.

Guttmacher study of “disruptive life events” and abortion

In August 2012, the Guttmacher Institute published a study in the Journal of Family Planning and Reproductive Health Care about the circumstances under which women have abortions. The researchers surveyed 9493 women who had abortions, and found that most had experienced at least one “disruptive life event” in the last year, such as unemployment, divorce or separation from a partner, getting behind on the rent or mortgage, moving two or more times, or having a baby.[viii]

The women in the study who were living in poverty experienced more disruptive life events – and hence, more abortions – than the women who were making greater than poverty incomes. Women living in poverty were also more likely to report having been physically or sexually abused by their partners.

In addition to the quantitative survey, researchers conducted in-depth interviews with 49 women. Nearly half of these women said that disruptive events interfered with their ability to use contraception consistently. Women reported losing health insurance and having trouble affording prescription contraception and getting to doctor’s appointments. Consistent use, not simply any use of contraception, is key to preventing unintended pregnancy. Poverty and disruptive life events appeared to make consistent use more difficult.

There were no questions on the quantitative survey about reproductive coercion, but six of the 49 women interviewed in-depth reported experiencing it.

Conclusions

Intimate partner violence and poverty both make it more difficult for women to avoid unintended pregnancy and to carry to term if they become pregnant.

For pro-life advocates who are working to reduce the demand for abortion, these data suggest two courses of action. The first is working to end poverty and abuse themselves, and ensuring a strong social safety net to buffer against the effects of disruptive life events. Second, it is also important to ensure that women currently experiencing poverty and abuse have the information and health care access they need to prevent unintended pregnancy, as well as social and material support if they do conceive.

Mitigating the effects of injustice and working to end the injustice itself are not mutually exclusive approaches. As one example, Elizabeth Miller and colleagues reported in 2011 on a pilot program that tested a new harm reduction intervention for women experiencing abuse or reproductive coercion.[ix] Their intervention enhanced standard intimate partner violence counseling with information on reproductive coercion and strategies for minimizing the risk of unintended pregnancy by using birth control methods that were concealable or hard to tamper with. The enhanced intervention both reduced the incidence of reproductive coercion and increased the likelihood that women would leave abusive male partners.

Protecting lives that are threatened by poverty and intimate partner violence also turns out to be a way to protect lives that are threatened by abortion.

 

[i] Christina C. Pallitto, Claudia García-Moreno, Henrica A.F.M. Jansen, Lori Heise, Mary Ellsberg, Charlotte Watts, on behalf of the WHO Multi-Country Study on Women’s Health and Intimate partner Violence, Intimate partner violence, abortion, and unintended pregnancy: Results from the WHO Multi-country Study on Women’s Health and Intimate partner Violence, Int J Gynecol Obstet 2012. Published online in advance of print September 6, 2012. Available at: http://dx.doi.org/10.1016/j.ijgo.2012.07.003. Accessed September 17, 2012.

[ii] Lockart I, Ryder N, McNulty AM. Prevalence and associations of recent physical intimate partner violence among women attending an Australian sexual health clinic. Sex Transm Infect 2011; 87(2): 174-176.

[iii] Alio AP, Salihu HM, Nana PN, Clayton HB, Mbah AK, Marty PJ. Association between intimate partner violence and induced abortion in Cameroon. Int J Gynecol Obstet 2011; 112(2): 83–87.

[iv] Fanslow J, Silva M, Whitehead A, Robinson E. Pregnancy outcomes and intimate partner violence in New Zealand. Aust N Z J Obstet Gynaecol 2008; 48(4): 391–397.

[v] Futures Without Violence. The Facts on Reproductive Health and Partner Abuse. Available at: http://www.knowmoresaymore.org/wp-content/uploads/2008/07/The-Facts-on-Reproductive-Health-and-Partner-Abuse.pdf. Accessed September 17, 2012.

[vi] Jones RK, Moore AM, Frohwirth LF. Perceptions of male knowledge and support among U.S. women obtaining abortions. Women Health Iss 2011; 21(2):117-23.

[vii] Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, Schoenwald P, Silverman JG. Pregnancy coercion, intimate partner violence and unintended pregnancy. Contraception 2010; 81(4):316-22.

[viii] Jones RK, Frohwirth L, Moore AM. More than poverty: disruptive events among women having abortions in the USA. J Fam Plann Reprod Health Care 2012; published online in advance of print August 20, 2012. Available at: http://dx.doi.org/10.1136/jfprhc-2012-100311. Accessed September 17, 2012.

[ix] Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, Schoenwald P, Silverman JG. A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion. Contraception 2011; 83(3):274-80.

 

Blog Posts

I respectfully decline your condescending lecture

Jen R

A column by Thomas Friedman titled “Why I Am Pro-Life” is making the rounds. I’d been ignoring it because I have a policy of ignoring anything Thomas Friedman writes, but after about the 1,926th time this thing crossed my path, I got fed up. I am 100% on board with criticizing the hypocrisy of people who claim to respect life but oppose universal health care, oppose life-saving environmental care, and hawk war and guns. But criticizing those people isn’t a free pass to avoid examining your own inconsistency.

The term “pro-life” should be a shorthand for respect for the sanctity of life. But I will not let that label apply to people for whom sanctity for life begins at conception and ends at birth.

Wonderful! I agree! But you will let that label apply to people for whom sanctity of life begins at birth. You will sneer at the notion of wanting to protect “every fertilized egg in a woman’s ovary” (since corrected, but a handy reminder that ignorance about how reproduction works is not confined solely to the far Right). “What about the rest of life?” you ask, but I could ask you the same question: what about the life you minimize and deride and don’t consider part of the human family?

I’m getting pretty tired of people who divide the world into two groups — those who only care about protecting human life before birth, and those who only care about protecting it after — and congratulate themselves on their superiority for being in the latter.*

What about being pro-everyone’s-life? Funny how that possibility never arose in Friedman’s column, or in any of the smug tweets and Facebook shares and blog comments using it as a club to beat those horrible pro-lifers with.

Finally, as someone who actively opposed the Iraq War for which he was a cheerleader, I decline to accept a lecture on the sanctity of life from Thomas Friedman, thank you very much.

*(Edited to add, because I want to be clear: I don’t think a person has to be for banning abortion to respect prenatal life. But I do think they have to talk about that life as one of us. They have to treat its destruction like it matters and is more than simple personal choice. They have to favor trying to prevent abortion, in every just way, because it ends a human life. If you’re doing all those things but identify as pro-choice because you don’t think legal bans are the answer, you’re not who I’m talking about here.)

Blog Posts

In the news: family planning

Jen R

Yesterday, the New Evangelical Partnership held an event at the National Press Club to unveil a statement called “A Call to Christian Common Ground on Family Planning, and Maternal, and Children’s Health.”

The statement makes three main points:

  1. Family planning strengthens families and creates more stable and healthy communities worldwide.
  2. Family planning protects the health of women and children.
  3. Family planning reduces abortion.

We agree wholeheartedly, of course, and are pleased to have the New Evangelical Partnership as part of the movement for family planning freedom.

You can watch the whole event on YouTube. I recommend at least watching Rev. Jennifer Crumpton’s presentation of the NEP statement, starting at about 8:15 in, Dr. Mark Hathaway’s talk at 19:00 about the medical benefits of family planning for women and children, and Katherine Marshall’s talk at 28:10 about the international context of family planning.

Speakers at the NEP event referred more than once to a study recently conducted by Washington University in St. Louis. The project provided women and teens at high risk of unintended pregnancy with the contraceptive method of their own choice at no cost. The results were dramatic. The abortion rate fell to 6 per 1,000 women, compared with a national average of 20 per 1,000 women. The teen birth rate from to 6.3 per 1,000, compared with 34.1 per 1,000 nationwide.

Imagine the impact of cutting the abortion rate in the U.S. by almost two thirds.

As the Agence France write-up of the study noted: “If the same results were replicated across the United States, free birth control could prevent 1,060,370 unplanned pregnancies and 873,250 abortions a year.”

Yes, that’s a big “if.” [Edited to add: as the researchers pointed out, the sample of women who participated in this study is not generalizable to the total population of women of reproductive age in the United States. That said, they likely bear a great deal of similarity to the population of women at the highest risk for unintended pregnancy and abortion.] And of course, there are important caveats. Women’s consent must be free and fully informed. Women must never be coerced into using long-acting contraception because other people think it would be better for them not to reproduce. It must always, always be the woman’s choice to use contraception. In addition, protection against HIV or other STDs is vital, and the forms of contraception chosen by most women in the study did not provide that protection.

But imagine it. Imagine 873,250 fewer unborn human beings destroyed every year. Imagine 873,250 fewer women going through abortions. Imagine 1,060,370 fewer women having to experience unplanned pregnancy, and instead being able to bear children at a time when their age, health, and life situation are better suited for motherhood — or being free to choose a different life path than motherhood.

Earlier this month, a Republican-appointed federal judge in the United States District Court for the Eastern District of Missouri rejected a lawsuit brought against the U.S. Department of Health and Human Services by an employer in a secular industry (mining, metals, & ceramics) who, due to his own religious beliefs, doesn’t want to provide his employees with insurance that covers contraception.

Judge Carol Jackson noted that employers already pay their employees a form of compensation that could be used to purchase contraception: their salaries. This is an argument I’ve made in the past. The full ruling is online here.

The burden of which plaintiffs complain is that funds, which plaintiffs will contribute to a group health plan, might, after a series of independent decisions by health care providers and patients covered by OIH’s plan, subsidize someone else’s participation in an activity that is condemned by plaintiffs’ religion. This Court rejects the proposition that requiring indirect financial support of a practice, from which plaintiff himself abstains according to his religious principles, constitutes a substantial burden on plaintiff’s religious exercise.

RFRA is a shield, not a sword. It protects individuals from substantial burdens on religious exercise that occur when the government coerces action one’s religion forbids, or forbids action one’s religion requires; it is not a means to force one’s religious practices upon others. RFRA does not protect against the slight burden on religious exercise that arises when one’s money circuitously flows to support the conduct of other free-exercise-wielding individuals who hold religious beliefs that differ from one’s own…

Just as in Mead, plaintiffs must contribute to a health care plan which does not align with their religious beliefs. In this case, however, the burden on plaintiffs is even more remote; the health care plan will offend plaintiffs’ religious beliefs only if an OIH employee (or covered family member) makes an independent decision to use the plan to cover counseling related to or the purchase of contraceptives. Already, OIH and Frank O’Brien pay salaries to their employees—money the employees may use to purchase contraceptives or to contribute to a religious organization. [emphasis added] By comparison,the contribution to a health care plan has no more than a de minimus impact on the plaintiff’s religious beliefs than paying salaries and other benefits to employees.

And once again, despite the claims in this and similar lawsuits that the HHS mandate forces them to cover abortifacients, the belief that emergency contraception is abortifacient has not been borne out by the evidence. I’m going to keep repeating that until new evidence comes to light or people stop making this claim, so get used to it.

Blog Posts

World Contraception Day 2012

Jen R

Today is World Contraception Day 2012. In recognition, I’d like to call your attention to a sample of our writings discussing the ways in which the freedom to choose whether and how to prevent conception can save and improve the lives of women and their children.

We are also participating in discussions on Twitter using the hashtags #sheparty and #WCD2012. Join us!

Pro-lifers: demand better (photo by nigsby on Flickr)
Blog Posts, Past Actions

Pro-lifers: demand better

Jen R

So Todd Akin, who thinks that pregnancy resulting from rape is “really rare” because “If it’s a legitimate rape, the female body has ways to try to shut the whole thing down,” announced yesterday that he is staying in the Missouri Senate race. I hardly know where to start. I guess a grounding in reality is the first order of business: Yes, of course women become pregnant as the result of rape. No, it’s not “really rare” — although few studies exist, the best available evidence indicates that the conception rate for rape is roughly equal to that for the average act of consensual PIV intercourse. No, there is no “certain secretion” that kills sperm when a woman is raped. That’s made up. No, it is not true that women who are “truly” raped can’t get pregnant because “the juices don’t flow.” That’s made up. No, even though ongoing stress can make conception and carrying to term more difficult for some women, the stress of being raped does not in itself make conception impossible or highly unlikely.

I think a lot of people don’t fully understand what the problem is with Akin’s statement. That a public figure is blithely, proudly ignorant about subjects on which he proposes to legislate is appalling. (I feel like I have to say that, because I’m not sure that’s something on which we agree as a country. Akin serves on the House Committee on Science, Space, and Technology, after all.) But it’s so much more than that.

Women who have been raped automatically fall under suspicion in a way that virtually no other crime victims do. When was the last time you discussed a theft, and someone felt the need to disclaim that the victim might have actually wanted to give the thief money, or might be lying about the whole incident ever happening? That happens in virtually every discussion of rape outside of explicitly feminist and anti-rape spaces, even though evidence points to false accusations of rape being no more common than false accusations of other crimes, at between 2-8%.

So when Todd Akin and the people defending him claim that pregnancy due to “legitimate” rape (as Akin later clarified, he means “legitimate” as opposed to those cases where women are lying) is rare or impossible, they are doing two things. First of all, by accepting the double standard on the need for the “legitimate” qualifier, they are tacitly promoting the falsehood that women who say they have been raped are to be trusted less than people who report other crimes.

It gets worse. If a person believes that pregnancy due to rape is extremely rare, but lying about rape is common, what are they likely to believe when a woman says her pregnancy resulted from rape? That she’s lying. That she doesn’t need help, that she is someone who is trying to hurt others and not someone who has herself been hurt. If you think that what Akin said is OK, could you please try to imagine yourself in the shoes of that woman for just one minute?

By contributing to the suspicion that rape victims already face far too much of, Akin and those who defend his claims about pregnancy due to “legitimate” rape make it more likely that women will not report their rapes or will not be believed if they do. They make it more likely that rapists will get away with it and rape again. They also make it harder for women who have become pregnant as a result of rape to carry to term and raise their children. If a woman knows that she will be suspected of lying about her rape if her pregnancy becomes known, and might even have to share custody or allow visitation by her rapist, how much weight must that add to the abortion end of the scale?

This is rape culture. It hurts women. It hurts children conceived as a result of rape. It’s unacceptable.

What’s also unacceptable is all the apologism from groups saying we should ignore Akin’s “unfortunate” choice of words because he’s such a staunch defender of the unborn, and the only reason anyone would get so worked up about what he said is because they’re pro-abortion.

Missouri Right to Life apparently had no comment on the substance of Akin’s remarks, and would say only that they support him.

Connie Mackey, head of the Family Research Council’s PAC, said “I don’t know anything about the science or the legal implications of his statement. I do know politics, and I know gotcha politics when I see it.”

And worst of all, the Susan B. Anthony List, which disgracefully continues to use the name of one of America’s most prominent feminists, called Akin an “excellent partner in the fight for the unborn” and claimed that “Abortion supporters like Sen. Claire McCaskill are trying to use this issue as a smokescreen to hide from their radical, pro-abortion records.” As though there was no other reason to oppose Akin’s ignorant, harmful views.

Public Policy Polling found that only 9% of Missourians found Akin’s comments appropriate. (That’s somewhat cheering news, anyway.) I strongly doubt that 91% of Missourians are just trying to get Claire McCaskill elected.

Even if your idea of what “pro-life” means revolves solely around electing politicians who will vote for restrictions on abortion, one doesn’t have to support McCaskill to demand a better candidate than Akin. Akin can still withdraw in the next five weeks and be replaced. Is there really nobody better available? Are there no pro-life candidates who are knowledgeable and sensitive about women’s lives? And if not, if this is truly the best “pro-life” can muster, why would any decent human being want to identify with “pro-life”? About 75% of the time I don’t want to apply that label to myself, and these people are the reason. (The other 25%, I want to reclaim it.)

Even if the pro-life establishment can’t bring itself to demand better than ignorance and misogyny from its representatives, we can. We can contact Todd Akin’s office and explain to him how his comments hurt women. We can contact Missouri Right to Life and the Family Research Council and the Susan B. Anthony List and tell them that the cause of protecting human life before birth is not helped by spreading hurtful lies about women. We can tell them that hurting women is anti-life. We can tell them that we won’t stand for being represented by people like Todd Akin, and they shouldn’t either.

Pregnant Workers Fairness Act protects life, health, and jobs (photo by wunkaiwang on Flickr)
Blog Posts, Past Actions

Pregnant Workers Fairness Act protects life, health, and jobs

Jen R

Representatives Jerrold Nadler (D-NY), Carolyn Maloney (D-NY), Jackie Speier (D-CA), Susan Davis (D-CA) and George Miller (D-CA), and a total of 78 co-sponsors have introduced the Pregnant Workers Fairness Act. PWFA would require companies to provide pregnant employees with the same types of accommodations that are required for disabled workers under the Americans with Disabilities Act. According to Nadler’s office:

The Pregnant Workers Fairness Act will accomplish this by requiring employers to make reasonable accommodations for pregnant workers and preventing employers from forcing women out on leave when another reasonable accommodation would allow them to continue working.  The bill also bars employers from denying employment opportunities to women based on their need for reasonable accommodations related to pregnancy, childbirth, or related medical conditions.

In recent and startling examples, Heather Wiseman, a retail worker in Salina, Kansas, was fired because she needed to carry a water bottle to stay hydrated and prevent bladder infections; Victoria Serednyj, an activity director at a nursing home in Valparaiso, Indiana, was terminated because she required help with some physically strenuous aspects of her job to prevent having another miscarriage; and Peggy Young, a delivery truck driver in Landover, Maryland, was forced out on unpaid leave because she had a lifting restriction and was denied light duty.  For the well-being of pregnant workers, and for the sake of the economic stability of American families, our laws must be updated and clarified.

The National Women’s Law Center has more information in their PWFA factsheet.

Preventing pregnant mothers from having to choose between the jobs they need to provide for their families on one hand, and their own health and the health of their unborn children on the other, seems like the least a country that aspires to be “pro-family” can do. If you agree and you are in the U.S., please contact your Representative to ask him or her to cosponsor the Pregnant Workers Fairness Act, H.R. 5647.

Blog Posts

Welcome!

Jen R

All Our Lives is proud to unveil our new web site! Our new design features a new look, important and timely articles at a glance on the front page, easier to find actions and resources, and last but not least — membership!

Yes, now you can join All Our Lives! Your support will help us to reach out to more people to advocate for the interconnected human rights of nonviolent choice and life. With your help, we can transform the often toxic public conversation around abortion to something truly affirming of the lives and intrinsic value of both women and children, before and ever after birth. Thank you, and please enjoy the new site.

Blog Posts

That’s what we’ve been saying!

Jen R

The New York Times ran a story today explaining that the best available scientific studies have found no abortifacient effect for emergency contraception. The evidence won’t be news to those who have been reading this site, but it’s a good layperson’s overview. It was also interesting to read about how the supposed anti-implantation effect made it onto the Plan B label in the first place. Spoiler alert: it wasn’t because there was any evidence for it.

Blog Posts

Notes on the Notre Dame lawsuit

Jen R

The University of Notre Dame has filed a lawsuit against the Departments of Health and Human Serivces, Labor, and the Treasury. They object to HHS’ inclusion of contraception as one of the core preventive services that must be provided in health insurance plans without cost sharing, on the grounds that covering contraception (and, they claim, abortifacients, but we’ll get to that later) is against their religious beliefs and the exemption for religious employers isn’t broad enough. I’m not a lawyer, so I’m not going to claim that Notre Dame has zero points in its favor in this lawsuit, but its arguments have some problems.

80. “Other commenters noted that ‘preventive care’ could not reasonably be interpreted to include such practices. These groups explained that pregnancy was not a disease that needed to be ‘prevented,’ and that a contrary view would intrude on the sincerely held beliefs of many religiously affiliated organizations by requiring them to pay for services that violate their religious beliefs.”

Whether or not evidence shows a practice to be ‘preventive care’ has nothing to do with anyone’s sincerely held religious beliefs about that practice’s morality. Pregnancy is not a disease, but it is a tremendous exertion, and the ability to plan it for those times when a woman is best prepared is beneficial to both the mother’s and the child’s health.

OK, you might say, we’ll grant for the sake of argument that contraception can be considered preventive care, but making Notre Dame include it in their employee health plans still violates their right to practice their religion. Just how far does Notre Dame want to extend this ability for employers to simply not offer coverage for medical treatments they disapprove of? They’re hoary old examples, but they keep getting trotted out because they are still relevant: Should employers who are Christian Scientists be able to refuse to provide any health insurance? Should employers who are Scientologists be able to refuse to provide insurance that covers mental health care? What about employers with a sincerely held belief that vaccines are dangerous and shouldn’t be considered “preventive care”? Do all of these employers get to offer nonstandard health benefits that conform to their religious beliefs, or just the more numerous and more politically powerful anti-contraception employers? And do the conscience rights of employees with regard to how they use their own health insurance have any weight at all?

I would also argue that in most cases, employers are not paying for contraception, or for any other particular procedure or service. They are taking part of their employees’ compensation and using it to pay premiums so that the employee will have affordable access to health care. Then the employee and her doctor decide on what health care the employee needs, and then the insurance company takes money from the pool of all of its clients’ premiums and pays the claim. The employer is no more directly involved in the supposed evil of contraception than if the employee went out and bought condoms with her paycheck — and no employer gets to stipulate that wages can’t be used to buy contraception. I’ll grant that Notre Dame’s situation is a little different, because it’s self-insured for its employees’ health plans. I think that if the Administration was going to have this compromise saying that religious employees could punt responsibility for contraception coverage to the health insurance companies, it probably should have thought a little harder about what self-employed companies would do. Of course, Notre Dame also wants to make sure that its students, who are insured through Aetna, can’t access contraception with that insurance either (despite Aetna having all the responsibility of informing students of the benefit and paying for it), so the suit doesn’t exactly hinge on that distinction.

87. FDA-approved contraceptives that qualify under these guidelines include drugs that induce abortions. For example, the FDA has approved “emergency contraceptives” such as the morning-after pill (otherwise known as Plan B), which operates by preventing a fertilized embryo from implanting in the womb, and Ulipristal (otherwise known as HRP 2000 or Ella [sic]), which likewise can induce abortions of living embryos.”

As we have pointed out many times, Plan B has been shown to have no mechanism of action besides the prevention of implantation [edit: I can’t believe this was up so long before I noticed this mistake — of course it should read “no mechanism of action besides the prevention of fertilization.”]. The mechanism of action of ella has not been fully explicated, and a contragestive effect can’t be ruled out at this time, especially since large or repeated doses of ulipristal acetate can be abortifacient. However, I have been able to find no studies in which a single dose of 30mg, as used in ella, has been shown to prevent implantation or to harm embryos after implantation. This paragraph is factually incorrect with regard to Plan B and presents speculation as fact with regard to ella. Arguments relying on the information in this paragraph should be discounted accordingly.

157. Furthermore, the U.S. Government Mandate is not narrowly tailored to promoting a compelling governmental interest. Even assuming the interest was compelling, the Government has numerous alternatives to furthering that interest other than forcing Notre Dame to violate its religious beliefs.

158. For example, the Government could provide or pay for the objectionable services through expansion of its existing network of family planning clinics funded by HHS under Title X or through other programs established by a duly enacted law. Or, at a minimum, it could create a broader exemption for religious employers, such as those found in numerous state laws throughout the country and in other federal laws.

Except that creating broad exemptions undermines the government’s interest in setting a minimum standard that all insurance policies must meet. This isn’t a new concept; the government sets minimum standards for many products, to protect consumers. And not including family planning as preventive care when evidence points to its usefulness in improving women’s and children’s health undermines the government’s interest in being able to shape its health care policy according to what actually works.

184. The religious employer exemption is based on an improper Government determination that “inculcation” is the only legitimate religious purpose.

Actually, the regulation does not say that organizations with a “legitimate religious purpose” will receive an exemption and then set out to define legitimate religious purpose. The regulation, quite properly, does not have anything to say about legitimacy. The limitations on the exemption appear designed to grant exemptions in those cases where employees can reasonably be expected to share the religious views of their employers, and therefore are less likely to be deprived by the exemption of a benefit that they might otherwise take advantage of.

Notre Dame then attemps to show that the mandate is not a neutral law of general applicability:

198. The Government has also crafted a religious exemption to the U.S. Government Mandate that favors certain religions over others. As noted, it applies only to plans sponsored by religious organizations that have, as their “purpose,” the “inculcation of religious values”; that “primarily” serve individuals that share those religious tenets; and that “primarily” employ such individuals. 45 C.F.R. § 147.130(a)(iv)(B)(1).

That does not favor particular religions over others. Notre Dame and other religiously-affiliated organizations are not, themselves, religions. Frankly, if anything the exemption favors religion over non-religion, but it does not favor any one religion over another. It distinguishes between organizations in which there is likely to be a difference of belief between the employer and the employees, and organizations in which there is less likelihood.

199. The U.S. Government Mandate, moreover, was promulgated by Government officials, and supported by non-governmental organizations, who strongly oppose Catholic teachings and beliefs regarding marriage and family. For example, on October 5, 2011, after Defendants announced the interim final rule but before they announced the final rule, Defendant Sebelius spoke at a fundraiser for NARAL Pro-Choice America. Defendant Sebelius has long been a staunch supporter of abortion rights and a vocal critic of Catholic teachings and beliefs regarding abortifacients and contraception. NARAL Pro-Choice America is a pro-abortion organization that likewise opposes many Catholic teachings. At that fundraiser, Defendant Sebelius criticized individuals and entities whose beliefs differed from those held by her and the other attendees of the NARAL Pro-Choice America fundraiser, stating: “Wouldn’t you think that people who want to reduce the number of abortions would champion the cause of widely available, widely affordable contraceptive services? Not so much.”

We live in a country in which government officials have the right to criticize the policy positions of religious organizations, especially when those policy positions have negative implications for people who do not share the beliefs of said organizations. This is not evidence of discrimination.

200. Consequently, on information and belief, Notre Dame alleges that the purpose of the U.S. Government Mandate, including the narrow exemption, is to discriminate against religious institutions and organizations that oppose contraception and abortifacients.

Notre Dame can only make this allegation because it refuses to acknowledge the validity of the evidence in favor of the health benefits of family planning, or to consider those health benefits a sufficiently compelling reason for the government to include family planning as part of its standards for health insurance plans. Notre Dame can only make this all about them by denying that their employees have any valid interest in being able to use the health insurance they earn to access health care services according to their own beliefs.

Notre Dame, not everything is about you.

Blog Posts

News briefs, May 19 2012

Jen R

It’s been a very busy week and I’ve mostly been working behind the scenes on the new web site, but I didn’t want to let these news items pass unremarked:

  • In Honduras, the president of the Congress declared on Wednesday that he has decided not to move forward on the bill that would have made use of the emergency contraceptive Plan B a crime subject to jail time. This bill was based on the mistaken belief that Plan B causes abortions.

  • The U. S. House of Representatives voted on H.R. 4970, a re-authorization of the Violence Against Women Act that contains none of the updated protections for LBGT people, Native Americans, or immigrants that were contained in the bill passed by the Senate. Advocates for victims of domestic violence considered H.R. 4970 a “fake VAWA” and promise to continue to work toward a final bill that contains the updated provisions.

  • Good news: New Report: Fewer Women Dying in Pregnancy, Childbirth

    The number of women dying in pregnancy and childbirth, worldwide, has decreased by almost half, over a twenty year period (from 1990 – 2010), according to a new report. It’s good news, says Dr. Babatunde Osotimehin, Executive Director of UNFPA. But there’s a lot more work to do. […]

    “We know exactly what to do to prevent maternal deaths: improve access to voluntary family planning, invest in health workers with midwifery skills, and ensure access to emergency obstetric care when complications arise. These interventions have proven to save lives and accelerate progress towards meeting the Millennium Development Goal 5,” said Dr. Osotimehin.

    Via Impatient Optimists, the blog of the Bill and Melinda Gates Foundation. I highly recommend the blog to anyone concerned about maternal and child health and family planning. You can subscribe directly to the Maternal, Newborn and Child Heath topic using this RSS feed.

  • More good news: Education, Not Abortion, Reduces Maternal Mortality, Study Suggests

    A scientific analysis of 50 years of maternal mortality data from Chile has found that the most important factor in reducing maternal mortality is the educational level of women. “Educating women enhances women’s ability to access existing health care resources, including skilled attendants for childbirth, and directly leads to a reduction in her risk of dying during pregnancy and childbirth,” according to Dr Elard Koch, epidemiologist and leading author of the study. […]

    One of the most significant findings is that, contrary to widely-held assumptions, making abortion illegal in Chile did not result in an increase in maternal mortality. In fact, after abortion was made illegal in 1989, the MMR continued to decrease from 41.3 to 12.7 per 100,000 live births (69.2% reduction). “Definitively, the legal status of abortion is unrelated to overall maternal mortality rates” emphasized Koch.

    For those of us who consider abortion violence against a human being, it is always encouraging to see recognition of nonviolent ways to solve the problems that abortion is meant to solve. Educating women is the key to women’s health, their ability to care for themselves and children, their economic security, and even their countries’ development. Holding women back from education and self-care — including family planning if they desire it — is unjust and wasteful. It’s a disservice to individual women and their families, and to the entire world.