Unable, apparently, to convince the public that women having sex without “consequences” is inherently bad for society, conservatives have taken to claiming that increasing access to contraception won’t actually prevent abortions. They’re wrong.
In his recent column in the New York Times, Ross Douthat argues that even though conservatives have failed in selling chastity to the public (even in solidly red states), a remedy he seemingly wants to offer for married couples too, ”the liberal narrative has glaring problems as well.” What, exactly?
To begin with, a lack of contraceptive access simply doesn’t seem to be a significant factor in unplanned pregnancy in the United States. When the Alan Guttmacher Institute surveyed more than 10,000 women who had procured abortions in 2000 and 2001, it found that only 12 percent cited problems obtaining birth control as a reason for their pregnancies. A recent Centers for Disease Control and Prevention study of teenage mothers found similar results: Only 13 percent of the teens reported having had trouble getting contraception.”
Douthat also cited high abortion rates in blue states as a sign of liberal failure, as if abortion rates wouldn’t naturally be higher in places where abortion tends to be more available and less legally restricted, or as if women don’t routinely travel to more accessible locations to have abortions. Meanwhile, syndicated columnist Rich Lowry cited the same CDC study and claimed that “by any reasonable standard, we are one of the most lavishly contracepted societies in the history of the planet.” He added, “Of all the causes of the explosion in illegitimate births, limited access to contraception can’t be high on the list.”
First, a crucial note about how we talk about limiting abortions. Perhaps it is a sign of rhetorical defeat when the strongest final flourish Douthat can come up with in a column opposing contraceptive access is that abortion “isn’t a pretty sight” (very few medical procedures are) or that only 12 percent had trouble accessing contraception. As Guttmacher’s senior public policy associate Adam Sonfield pointed out to me this morning, that 12 percent who had problems obtaining birth control translates into about “68,000 abortions, or about a 5 percent reduction in the total number of abortions in the country. That’s not small change.”
But it’s also worth reiterating, as Adele Stan did this weekend and reproductive rights activists have been saying for years, that if you’re more than nominally pro-choice, you cede important ground by embracing the “safe, legal and rare” formulation that Douthat cited as a consensus. As the National Network of Abortion Funds tweeted, ”Let’s reject ‘rare.’ If abortions are legal & accessible, number of abortions performed should = exactly the number of abortions necessary.” Contrast the following data points — the 87 percent of U.S. counties that lack an abortion provider, the financial barriers that right-wingers would like to increase with insurance bans, and the significant stigma around abortion — with the fact that almost half of all pregnancies are unintended. Suddenly, “rare” becomes more about a lack of real choice rather than choosing from an abundance of options. If, as a matter of public health policy, we are doing a terrible job of preventing unintended pregnancies, and some women want abortions and can’t have them, then the current rate is too low.
But even if you believe women have no right to terminate pregnancies in any circumstance, it requires serious, willful ignorance to argue that contraceptive access has nothing to with lowering the U.S.’ unusually high number of unwanted pregnancies, which is what we should really be talking about here. Douthat claims that ”if social conservatives haven’t figured out how to make all good things go together in post-sexual-revolution America, neither have social liberals.”
But, in fact, even “blue states” and “social liberals” have so far been unable to fully put into practice policies that might help make “all good things go together,” partly because of barriers put into place by Douthat and Lowry’s compatriots. That’s exactly what the Affordable Care Act guidelines they oppose are trying to do.
To a significant extent, contraception is already preventing unintended pregnancy, though not enough of them, for reasons I’ll explain. According to Guttmacher’s testimony last year in favor of the new Affordable Care Act guidelines:
The proportion using contraceptives among unmarried women at risk of unintended pregnancy increased from 80 percent in 1982 to 86 percent in 2002; this increase was accompanied by a decline in unmarried women’s unintended pregnancy and abortion rates over the same period, with the abortion rate for unmarried women falling from 50 per 1,000 women in 1981 to 34 per 1,000 in 2000.
Another study cited in the testimony found that improved contraceptive use among sexually active high school students was “responsible for 77 percent of the sharp decline in pregnancy among 15-17-year-olds between 1995 and 2002 (decreased sexual activity was responsible for the other 23%) and increased contraceptive use was responsible for all of the decline in pregnancy among 18-19-year-olds.” Even more recent data show teen pregnancy at a 40-year low.
But the U.S. still has the highest rate of unintended pregnancies in the developed world, and public policy has a lot to do with it, including lack of access to reliable sex education. (That same CDC study, after all, found that 31.4 percent of pregnant teens didn’t use contraception because they “thought they could not get pregnant at the time.”) Crucially, economic barriers to accessing healthcare can make all the difference. After all, for higher-income women, the rate of unintended pregnancy has declined since 1994 by 29 percent; unintended pregnancies among women living below the federal poverty line rose 50 percent in the same period.
This is about much more than just the average cost of birth control, although it is about that too. It’s about access to reliable information about sexuality and to the most effective forms of birth control, both of which conservatives are on record opposing. About half of unintended pregnancies and abortions occur among women using contraception inconsistently or incorrectly, Sonfield pointed out, but the same Affordable Care Act guidelines include education and counseling around contraceptive use and sexuality.
Public health experts are also hoping that the new insurance mandates will help women switch to the more effective forms of birth control they have told researchers they’d be interested in, like the IUD, the implant or sterilization. These have far lower failure rates — around 1 percent or less — than typical use of condoms, at 17 percent, or the pill, at 9 percent. (The one method the Catholic Church approves of, officially termed “fertility-awareness-based methods” has a failure rate of 25 percent.) Such forms may be better suited to women who have more disrupted lives and schedules, and are ultimately cheaper, but they’re more expensive upfront and harder to find providers for.
“It may be true that you can get a condom at a drug store,” Sonfield says, “but you just can’t come in and get an IUD.” In one 2004 study, a third of women said they would switch methods if they didn’t have to worry about cost, and if you give women the choice of any method, Sonfield says, two-thirds of them choose a long-acting method.
As for the claim that the United States is somehow more “lavishly contracepted” than anyone else ever (including those other industrialized countries with some form of universal healthcare), it’s tragically absurd. For one thing, the Title X program that some on the right, from Lowry to Foster Friess, have cited as proof that low-income women can get contraception is perennially under attack, either on political or budgetary grounds. “There’s certainly some irony there that politicians that have been foes of that program are trying to pretend that they support it as a way to attack a different policy,” says Sonfield.
That public funding does a lot: The Department of Health and Human Services says that annually, it “prevents about 1.94 million unintended pregnancies, including almost 400,000 teen pregnancies. Preventing these pregnancies results in 860,000 fewer unintended births, 810,000 fewer abortions and 270,000 fewer miscarriages.” All in all, since giving birth is expensive (not to mention that unintended pregnancies tend to be associated with greater health risks for both mother and baby) taxpayers save $4 for every $1 spent on family planning. But it’s not enough; the services are only free for women who are at the poverty line, and from there it’s on a sliding scale.
Spacing out and planning pregnancies (or avoiding them altogether) improves the overall health of women and babies; the federal Institute of Medicine’s own research has indicated that unintended pregnancy is linked “to a wide array of health, social and economic consequences, from delayed prenatal care and poor birth outcomes to maternal depression and family violence to a failure to achieve educational and career goals.” The new contraceptive coverage guidelines could be the single most significant pro-active policy tool to combat those consequences, and it already represents one of the few positive national developments in expanding reproductive rights, in a time where effective defense is considered victory.
The evidence overwhelmingly shows that contraception is good for society, even if you don’t believe that women have a fundamental right to determine their own destinies. Of course, it helps to ignore the former if you don’t want the latter.
When it comes to sex and reproduction, even the most mind-numbingly intuitive conclusions can be politicized or disbelieved. So they bear repeating and resubstantiation. Take this recent Guttmacher study on contraceptive knowledge. Surveying 1,800 men and women ages 18–29, the authors “found that the lower the level of contraceptive knowledge among young women, the greater the likelihood that they expected to have unprotected sex in the next three months, behavior that puts them at risk for an unplanned pregnancy.” In other words, access to factual information helps prevent risky behavior.
I’m holding myself back from saying “duh” here, but this still has to be reiterated at a time when abstinence-only education that doesn’t provide detailed information about contraceptive use, except occasionally to emphasize its limits, not only persists but recently got a federal stamp of approval. As an Advocates for Youth report on the impact of abstinence-only education noted, “Proponents of abstinence-only programs believe that providing information about the health benefits of condoms or contraception contradicts their message of abstinence-only and undermines its impact. As such, abstinence-only programs provide no information about contraception beyond failure rates.” That’s how you get terrifying statistics like this one from the Guttmacher report: In the survey, “60 percent underestimated the effectiveness of oral contraceptives and 40 percent held the fatalistic view that using birth control does not matter.” Overall, “more than half of young men and a quarter of young women received low scores on contraceptive knowledge.” It’s also how you get figures like the one from the CDC that found that 31.4 percent of pregnant teens didn’t use contraception because they “thought they could not get pregnant at the time.”
There are two reasons to be optimistic that some dent can be made in these depressing figures, and they both have to do with provisions of the Affordable Care Act. Much has been made of the mandate that insurance policies cover all FDA-approved contraceptive methods, but there’s another aspect that’s been relatively overlooked: the fact that the same provision includes free education and counseling about sex and contraception, at least for the insured. The second reason for optimism is that the mandate will make it far easier for women to get longer-acting and more effective forms of contraception like the IUD — which are also more expensive and which studies have shown women would be interested in if they could afford them. Incidentally, the recent Guttmacher study found that women who were using long-acting or regular hormonal contraception tended to score higher on overall knowledge.
It will be awhile before we know if these changes will move the needle on the nation’s unparalleled rate of unintended pregnancy. The women’s health provisions only go into effect for new plans in August 2012, and older plans will be initially grandfathered and eventually phased out. And of course, there’s another big fat if – whether the Supreme Court overturns all or part of the Affordable Care Act. The Obama campaign and its allies are keen to point out how such a move — or, perhaps, a legislative repeal down the line — will hurt women above all. The Center for American Progress recently released a report on “Women and Obamacare” (the campaign having officially embraced the derisively intended term). It declares Obamacare “the greatest legislative advancement for women’s health in a generation,” which may be true for reasons more depressing than inspiring: There have been very few advancements partly because there has been so much political defense played.
In addition to the reproductive health benefits, the report points to preventive care recommendations for which cost-sharing has already been cut: mammograms, pap smears, prenatal care and so on. According to the report, “close to 9 million women will gain coverage for maternity care in the individual market starting in 2014,” currently not covered in 78 percent of plans sold on the individual market. It notes that women are more frequent users of healthcare services than men, that they’re likelier to make the household decisions on healthcare and that they’re more vulnerable to losing coverage because they’re likelier to be listed as dependents on a partner’s plan. The Affordable Care Act also makes it illegal to engage in “gender rating” – charging women $1 billion more than men on the individual market – and bans states from discriminating on the basis of gender identity in their insurance exchanges.
The report does acknowledge two ways in which Obamacare falls short for women who were “left out of the law — undocumented and recent immigrant women and women who need abortion services.” It claims that “political compromises on abortion coverage were necessary to ensure passage of the Affordable Care Act” – still a bitter loss to reproductive rights groups, who memorably described women as having been “thrown under the bus” by Democrats – “but the work to obtain abortion coverage for all women continues.” The last part is particularly debatable, at least when it comes to any momentum on the funding issue from national Democrats, while Republicans in the states and federally have spent considerable energy trying to limit abortion coverage on even private insurance plans.
Still, if the Affordable Care Act is allowed to stand, the magnitude of having an actual, proactive reproductive health access policy shouldn’t be underplayed. Maybe we’ll get closer to a saner republic where hearing “birth control doesn’t matter” from people who don’t want to get pregnant is a quaint memory.
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It was an “anonymous informant,” Operation Rescue claimed last week, after someone slipped them the April records of 86 women who were treated at Central Family Medical. The clinic’s lawyer was blunter. “It certainly appears to me that a crime was committed,” Cheryl Pilate told the Kansas City Star. Though the clinic (which performs abortions) had already reported a break-in to a locked dumpster, Pilate said it wouldn’t have contained patient records, which are shredded. The “informant” must have gotten the documents – containing names, addresses and details of procedures – another way.
“Our concern is for the privacy of these women and for their health and safety, for which Central Family Planning has shown very little regard,” said Operation Rescue’s Troy Newman – while posting photographs of the documents, partially redacted in black marker, online.
Antiabortion activists want to create the impression that one way or another, a woman’s decision to have an abortion will be discovered and exposed. The Central Family Medical incident is only the latest skirmish in a decades-long effort to undermine the privacy of abortion patients and harass doctors. In the early ’90s, for example, at least one group of clinic protesters printed on their signs the names of women seeking abortions that day, alongside “don’t kill your baby.” Such actions, while failing to make abortion illegal, have nevertheless managed to cloak it in a stigma that belies the fact that one in three women will have an abortion before the age of 45. Now, activists are seeking new ways to shame women who seek abortions, from requiring them to hand over personal information to actually hacking into their medical records.
Kansas has been ground zero for this: Last year, the Kansas Board for Discipline of Attorneys recommended that former Attorney General Phill Kline, a hero to Operation Rescue, have his legal license suspended indefinitely for mishandling the records from murdered abortion provider George Tiller’s clinic. (The Kansas Supreme Court will make the final call.) But the zeal to keep, and sometimes steal, abortion records casts a wide net.
In Texas, the state Department of Health is trying to implement a failed legislative measure that would require abortion clinics to report far more information about their patients to the state. In Florida, voters will weigh in on a ballot measure that would exempt abortion from the privacy clause in the state constitution, with the short-term aim being to strip minors of a right to privacy that would preclude parental consent. The U.K. recently jailed a hacker who stole and intended to publish the records of 10,000 women who visited the country’s largest abortion provider.
“It promotes the idea that abortion – or your privacy, if you have any – is not safe,” says Katie Stack, a graduate student and activist who spoke out about her abortion on an MTV special, “No Easy Decision.” That put her in close contact with the “online ministry” – the name antiabortion activists have given their efforts to reach women considering abortions through the Internet.
This has been the unstated goal of many activists in the antiabortion movement — and, sometimes, the stated one. “This might sound a little strange,” said antiabortion activist Lila Rose at the Value Voters Summit in 2009, but “if I could insist, as long as they are legal in our nation, abortions would be done in the public square, until we were so sick and tired of seeing them that we would do away with the injustice altogether … maybe then we might hear angels singing when we ponder the glory of conception.”
Rose won’t get her wish any time soon, but antiabortion activists are trying to use the Internet to have a similar effect. Rose was recently on a panel at the International Pro-Life Youth Conference about social media and pro-life activism, where topics included targeting women who are seeking information about abortion online, whether through Yahoo Answers or YouTube commenters – including figuring out where they live and recommending a crisis pregnancy center nearby.
“Privacy is very important to women who have abortions,” says Kate Cockrill, program director of the Social and Emotional Aspects of Abortion project, at the University of California, San Francisco. She points out that abortion is traditionally underreported even in confidential surveys, “which is a good indication that women don’t want to be associated with abortion experience in the eyes of someone who’s gathering data, even if it’s anonymous.”
Cockrill recently conducted a survey, as yet unpublished, that seeks to measure the impact of social stigma on women who’ve had abortions. It asked 641 women who had had abortions about 61 items, including questions about the fear people would gossip about you, judge you or hurt you, or the fear that you would lose an important relationship.
So far, she’s found that the women who experienced the most stigma were worried about being judged more than they were about being hurt or harmed, that they feared loss of social status and the ruining of their public identity, that they felt isolated and guilty, and that they feared community condemnation.
But as with other abortion restrictions, which create extra burdens in the supposed service of changing women’s minds, it’s not clear that anyone’s mind is being changed.
“Lots of women who feel a lot of stigma about abortions have abortion anyway,” Cockrill says. “If it’s not doing what antiabortion people want it to do, which is reducing the number of abortions, is it doing something on the other end, [after the fact]?”
Cockrill and her team are going to be using their scale in a study next year to look at the relationship between stigma and poor coping after abortion. Given that antiabortion activists have added to their obsessions the alleged harm abortion causes to women, there’s reason to believe that this is a self-fulfilling prophecy.
Women who have abortions, Cockrill says, “have a huge range of political views.” In fact, in her survey, only 62 percent of the women identified as pro-choice. (Seven percent identified as prolife, and 18 percent described their position as “mixed or neither.”)
“A lot of women don’t experience their abortions as a political act,” Cockrill says, partly an extension of the fact that they don’t see it as constitutive of their identity.
Whether it’s political rhetoric or individual ambivalence, these women are highly sensitive about whom they tell they had abortions. Sixty-four percent of the women in the study said they’d “withheld information about my abortion to someone I’m close to,” and 45 percent said they’d “lied to someone I’m close to about my abortion.”
They may not see it as political, but that silence functions as a vicious circle that antiabortion activists happily seize upon and promote. Cockrill says, “Some people say, ‘We need to have more people come out about their abortions.’ But it’s impossible to get more women to talk about their abortions if they don’t feel supported. And it needs to be on women’s own terms.”
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It started around February, when Republicans were still eager to talk about contraception. The Obama administration, or so Mitt Romney charged in Colorado, was forcing religious institutions to provide “morning-after pills –in other words abortive pills — and the like, at no cost.”
It was, of course, a lie. Romney was conflating two different pills: emergency contraception, known as the morning-after pill, which prevents a pregnancy; and chemical abortion, or mifepristone, which ends a pregnancy of up to seven weeks’ gestation and isn’t covered under the new guidelines. Since both pills were marketed in the U.S. around the same time, even some pro-choicers have gotten confused. But Colorado happens to be the epicenter of people confusing them on purpose. It’s the birthplace of the Personhood movement and home to Focus on the Family, both of which have strategically called emergency contraception “abortion” on the scientifically unproven basis that they could block a fertilized egg from implanting.
There are a host of ironies here. Obama has earned the renewed support of reproductive-rights advocates by requiring health insurers to cover contraception, but the Center for Reproductive Rights is still taking him to court – with oral hearings being held this week before a New York federal court -– for overruling the FDA’s recommendation to lift the prescription requirement on emergency contraception for women under 17. That litigation has been winding its way through the system for over a decade, throughout the Bush-era politicization of the FDA, eventually resulting in a federal judge concluding that “the FDA repeatedly and unreasonably delayed issuing a decision on [the emergency contraception pill] Plan B for suspect reasons.” The FDA was ordered to explain why Plan B shouldn’t be available over the counter for girls 13 and up. When the Obama administration overruled the FDA’s recommendation to make it over the counter, U.S. District Judge Edward Korman suggested the Center for Reproductive Rights reopen its case.
“It seems to me that what we’re going through is a rerun of what happened before,” Korman remarked, referring to politics trumping the recommendations of medical professionals.
The Obama administration’s unspoken but unmistakable fear was of an election-cycle attack line that Michele Bachmann would use anyway: That teenage girls would be able to get Plan B from “the grocery store aisles next to bubble gum and next to M&Ms.” That was, in fact, an echo of the language President Obama himself used to invoke a highly unsupported bogeyman: that “a 10-year-old or 11-year-old going to a drugstore would be able to, alongside bubble gum or batteries, … buy a medication that potentially if not used properly can have an adverse effect.”
But there is another twist, so far mostly overlooked: Emergency contraception won’t be covered by insurance for everyone, since it’s available over-the-counter for those who can show I.D. proving that they’re 17 or older. They’ll still have to fork over around $50 a pop. But as long as girls 16 and younger need a prescription for the morning-after pill and they have insurance, it will be fully covered — effectively free. The same goes for women older than 17 who decide to jump through the hoops of getting a prescription, either for over-the-counter Plan B or the prescription-only generic and Ella versions.
As much as pro-choice advocates want to lift the barriers that make emergency contraception hard to get — because it’s more effective the faster you use it — one of those barriers, the prescription requirement, also mitigates another, the high cost. Said Adam Sonfield, a senior public policy associate at the Guttmacher Institute, of this catch-22, “It presents a tradeoff between cost and access.”
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Part of the reason people get confused about emergency contraception and abortion is because lots of people are confused about the basic biology of pregnancy: specifically, that it doesn’t necessarily happen instantaneously and that sperm can live in the body for several days, during which time a woman can ovulate and an egg can potentially be fertilized and implant. Regular use of hormonal contraception prevents ovulation and the chance for fertilization; emergency contraception essentially works the same way except that it’s taken after sex, by which point ovulation may have already happened. But according to recent studies, there is no evidence that taking emergency contraception after ovulation and fertilization will stop the egg from implanting.
But the misinformation and misunderstanding have created a contradictory public health picture when it comes to emergency contraception. In some ways, it’s become more accessible. In 2010, the U.S. approved a longer-acting French variant of Plan B, known as Ella, and there are scattered experiments in convenient delivery, from a birth-control vending machine at Shippensburg University in Pennsylvania to a new bike messenger service in London, both of which caused minor news sensations. The annual “Back Up Your Birth Control” campaign has been promoting the line “EC=BC,” emphasizing that emergency contraception is birth control, not abortion — just in case that is a barrier for women who are considering taking it. And the Center for Reproductive Rights’ petition did manage to lower the age restriction from 18 to 17.
But there are more disturbing suggestions that misinformation is triumphing. A recent Boston Medical Center study found that many pharmacists were still often misinformed about the age requirement and were even more likely to wrongly refuse emergency contraception to 17-year-olds in low-income neighborhoods, where the rate of unintended pregnancy is higher. In Honduras, the Supreme Court upheld the criminalization of emergency contraception, which means women who use it could be jailed. Personhood initiatives, which oppose the morning-after pill, have so far failed in Colorado, Mississippi and Oklahoma, but they’ve introduced false doubts by providing even more opportunities for pundits and candidates to say “the morning-after abortion pill.”
It’s a problem that dates back decades: When, throughout the ’90s, the U.S. considered approving a French chemical abortion pill known as RU-486, it was widely called the “morning-after abortion pill,” including, often, in the New York Times. The distinction wasn’t pressed by the pro-choice community itself. “At the time, the prevailing medical wisdom was that there is a continuum rather than a bright line between EC and mifepristone,” said Gloria Feldt, who was president of Planned Parenthood at the time, with the benefit providing more options for women who did not wish to be pregnant. “It was also assumed that a formulation of mifepristone would eventually be made for use as a true ‘morning-after’ pill.” The widespread belief, she recalled, was that a chemical abortion pill would “solve all the abortion debate problems and guarantee privacy.”
Another problem was that although doctors and non-professionals had been giving women high dosages of regular birth control pills for decades as a form of emergency contraception, the science of exactly how emergency contraception worked remained unclear. The medical definition of pregnancy remains “implantation of a fertilized egg,” but let’s say you believe, as the Catholic Church does, that fertilization itself creates a human life. Anti-choice advocates obsess over what would happen if a woman who took emergency contraception did happen to ovulate anyway and an egg potentially was fertilized, which is enough reason for some of them to call postcoital contraception “abortion.” They have claimed that hormonal contraception makes the lining of the endometrium inhospitable to a fertilized egg, constituting “murder.” Even the official packaging for Plan B, the single-step version of emergency contraception, suggests that “in addition” to blocking ovulation and fertilization, “it may inhibit implantation (by altering the endometrium).”
Except that we now know it doesn’t, even if you walk down the path of remote maybes, which requires you to believe that a zygote, which may not implant for unknowable reasons, has the same rights as a living woman who doesn’t want to be pregnant. As Princeton’s Kelly Cleland pointed out recently, “The science has evolved considerably in the last 13 years. Newer evidence, published since the Plan B label was approved, provides compelling evidence that levonorgestrel EC (LNG EC) works before ovulation, but not after.” The International Consortium for Emergency Contraception and the International Federation of Gynecology & Obstetrics also note that two new studies have shown conclusively that if a woman has ovulated and an egg has been fertilized, it’s too late for emergency contraception to work. They recommended that the language on the product labeling be changed.
Of course, scientific evidence has rarely had much place in this debate. In the meantime, even the most non-ideological news sources keep making the mistake alongside the ideologues. Last week, a furor erupted after the Associated Press reported that “Women seeking to take emergency contraception like the so-called ‘morning after’ pill would have to do so in the presence of a doctor under a bill before the Alabama legislature.” That is, until Erin Gloria Ryan from Jezebel read the actual bill and saw that it was, in fact, a law meant to limit chemical abortion, not emergency contraception. (A spokesperson for the AP said a correction was being prepared). “The confusion over this issue is probably one of the reasons emergency contraception hasn’t had as positive an impact as hoped when it comes to lowering the abortion rate,” wrote Amanda Marcotte at RH Reality Check. “If women think it is some kind of abortion-ish thing, they probably think taking it is a big deal, instead of thinking of it more like taking the pill, since it’s basically the same thing.”
But talk about moved goalposts. If ’90s-era advocates had hoped that the ability to end a pregnancy in the safety of your home with RU-486 — the actual abortion pill, not the morning-after one — would defuse the abortion debate, their more recent counterparts hoped to take it to the next technological level by providing “tele-med” abortions. They would involve doctors seeing a woman over webcam with a nurse practitioner physically present, helping women in remote areas with ever-dwindling options for safe abortions to access them. But four states have already passed requirements meant to undercut these options by forcing a doctor’s presence, and the bill the Associated Press misreported was aiming to add Alabama to the list. All in all, there have been fewer gamechangers, and more cases of one step forward, two steps back.
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From a proposed sex strike to mock legislation restricting access to Viagra, women are coming up with increasingly creative ways to respond to attacks on reproductive rights. Many of them are relying on something ladies are often said to be without: a sense of humor.
In case you didn’t catch on, the sex strike is tongue-in-cheek. Annette Maxberry-Carrara, founder of Liberal Ladies Who Lunch — the group that proposed the “Access Denied” protest — tells me with a laugh, “We’re not looking at it as a literal strike.” But they are making a serious political statement. The event’s tagline reads, “If our reproductive choices are denied, so are yours.”
You would have to be profoundly tone deaf to not recognize the satire in recent bills proposed by female lawmakers that proclaim “every sperm is sacred” and restrict access to the blue pill. Last month, Oklahoma state Sen. Constance Johnson offered a bill in response to Senate Bill 1433 — which seriously and nonsatirically holds that a fetus at “every stage of development” has “all the rights, privileges and immunities available to other persons, citizens and residents of this state.” Her proposal states, “[A]ny action in which a man ejaculates or otherwise deposits semen anywhere but in a woman’s vagina shall be interpreted and construed as an action against an unborn child.”
A handful of similar bills call for men to jump through hoops to obtain Viagra — a mandated cardiac stress test, a rectal exam, even being forced to watch a “horrific” video on the drug’s side effects. Some have managed to make a big statement without a bill: During a protest of Oklahoma’s Personhood measure, state Sen. Judy Eason McIntyre stood in front of the state Capitol with a grin on her face and holding a sign reading, “If I wanted the government in my womb I’d fuck a senator.”
It isn’t just these daring female lawmakers who are turning to humor to combat the anti-choice onslaught. Consider the scores of everyday women who have hijacked the Facebook page of Virginia state Sen. Ryan McDougle — a supporter of the state’s transvaginal ultra-sound mandate — with exquisitely detailed descriptions of their vaginas. For example: “Hey senator! just a quick hello to let you know that I’m currently ovulating! my vaginal discharge is thick and sticky and smells acidic (probably all the garlic i’ve been eating!).” In February, my Facebook news feed was filled up with repostings of a screenshot from “Morning Joe” showing an all-male panel criticizing an all-male Congressional panel on birth control. (The show certainly didn’t intend it as satire, but it read like a piece from the Onion, and women circulated it as such.) That’s not to mention recent biting commentary on the topic from comedians like Amy Poehler.
This isn’t entirely new, of course. Women have long used satire to make political points. Just look at suffragette Alice Duer Miller’s bulletpoint list of reasons why men should not be given the right to vote (a highlight: “Because men are too emotional to vote. Their conduct at baseball games and political conventions shows this, while their innate tendency to appeal to force renders them unfit for government”).
“There were a lot of women humorists in the 19th century who were going at the political system in a very similar way, and it had a very big effect on women getting the vote and being able to be admitted to colleges,” says humorist and feminist theory professor Gina Barreca. “Every generation of women sadly thinks they’re the first ones ever to do this because the tradition isn’t usually encoded.”
That said, it’s reached a fever pitch as of late. The recent comedy-infused pushback against the assault on reproductive rights builds on what Amber Day, author of “Satire and Dissent: Interventions in Contemporary Political Debate,” calls a “satirical renaissance” of the last decade. It’s a result, in part of the fact that “political debate has become so heavily stage managed that there is rarely any discussion of substance happening,” she says, and talking points are “repeated ad infinitum on the debate programs, with scarcely anyone bothering to fact check or to push through to the real substance of the matter.” Contemporary satire — from “The Daily Show” to “Saturday Night Live’s” Weekend Update — offer “us a way to satisfyingly break through the existing script.”
Women are turning to satire now “for many of the same reasons others have in the past,” Day says — it’s just that the current war on reproductive rights is more motivating for vagina-havers. “What much of the recent satire has demonstrated is that there is still a lot of sanctimonious language that gets used in discussions of women’s health and sexuality,” she says. “That language is revealed as ridiculous when applied to men’s sexuality.”
That was the aim of Missouri state Rep. Stacey Newman, a Democrat, who proposed a measure earlier this month that read in part, “A vasectomy shall only be performed to avert the death of the man or avert serious risk of substantial and irreversible physical impairment of a major bodily function of the man.” She tells me that attempts to restrict women’s reproductive rights are constant. “We deal with this all the time,” she says. “You feel like all you can do is sit there and bury your head and go, ‘Is anybody paying attention?’”
Maxberry-Carrara, of the faux sex strikers, was similarly aiming to get people’s attention, and her tongue-in-cheek protest did the trick — and the strike hasn’t even officially started yet. “What we wanted was to bring attention to the assault on women’s rights,” she says. Her hope is that by poking fun at these legislators, “the less seriously we can take them as candidates.”
Barreca, author of “It’s Not That I’m Bitter … : Or How I Learned to Stop Worrying About Visible Panty Lines and Conquered the World,” says women are turning to humor right now “because it’s so much more effective than weeping or banging your shoe on that table!” She says, “The point of satire is not only to illustrate the absurdity of things but to show what the world looks like when it’s turned upside down.”
Amanda Marcotte, a feminist commentator and author, says, “Things have just gotten to the point of absurdity that you can’t react without being absurd yourself.” Thanks to recent attacks on even contraception, “ordinary women who often don’t pay attention to politics are finally beginning to pay attention,” she says. “And I think that means more opportunities to communicate through humor instead of the typical outrage thing. Humor can be very clarifying.”
Meg Wolitzer, author of “The Uncoupling,” a fictionalized account of a sex strike, points out, there’s a long tradition, “starting with Aristophanes and continuing up through a strange episode of “Gilligan’s Island” that I remember from my childhood,” of sex strikes being used for comedy. “Desperate times do call for creative and vigorous responses, and the assault on reproductive rights today certainly qualifies as desperate times. I think women need to find lots of ways to speak out and act, and this is just one,” she says.
You might ask how effective it is in bringing about actual change. Day says, “Historically, satire has often been dismissed as never actually accomplishing anything, because it is extremely rare to be able to draw a straight line from a piece of satire to a substantive political response, like a bill being passed.” (Although she gives the example of Jon Stewart and the Zadroga Act; Stewart helped shame Republicans who filibustered against extending benefits to Sept. 11 responders who died of cancer or respiratory diseases.) But this is “an overly narrow way to think about political efficacy,” she says. “When satire is successful, it functions to shift the terms of the wider public discussion. And that, in itself, is a big deal.”
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Boy, am I tired of hearing from the women at the Democratic Congressional Campaign Committee. I am tired of Jennifer Crider (email yesterday: “Violence Against Women”), Diana DeGette (email the day before: “Vile”), Kelly Ward (last Tuesday: “How Much Worse Can It Get”), and even executive director Robby Mook, whatever gender Robby is (979,540 [names on petition against Republican War on Women]). Oh, the Republican War on Women. Give the Democrats your money, the emails say, and they’ll show those gender warriors it doesn’t pay to mess with Mother Nature, or any other female, for that matter.
I’d rather hear from the Nigerians with unclaimed millions in African banks than from anyone remotely associated with the Democratic campaign that insists women are the key to victory in 2012. At least at some point there was probably some money in some African bank. The last time women picked a federal government men didn’t want was the midterm election of Bill Clinton in 1996. And that was within the margin of error.
It’s probably not entirely the Campaign Committee’s fault. It takes a real imaginative leap to be a Beltway player and not believe the Washington Post and the New York Times when they tell you Republican misogyny is the Dems’ ticket to reelection. It’s not just an errant opinion column here and there, it’s a deafening drumbeat of wishful thinking. So many women, so many votes. On March 10, the Times “reported” that centrist women were disenchanted with Republicans. Within a day, a front page Times headline proclaimed, “Obama Plans Big Effort to Build Support Among Women.”
When actual pollsters sniffed around, the same week, they found that women were moving away from their erstwhile defenders at the Democratic estrogen-fest — even as the birth control debate was at its height. A CBS/NYT poll showed that while most women recognized the birth control ban as an issue of women’s health, women respondents nonetheless favored allowing employers to opt out on moral or religious grounds. If the New York Times had sampled women’s opinions other than by asking its 2012 friends and families it might have noticed the distinct lack of disenchantment with the Republicans among centrist women. Once in a while women affect elections. In the Alabama and Mississippi primaries last week, they formed the overwhelming majority of support for that well-known woman’s champion Rick Santorum.
The polls were a little weird. But they conform to a dispiriting insight. The Republicans don’t have a woman problem. It’s the Democrats who have the woman problem. Women aren’t fickle. Despite 30 years of trying (the gender gap first surfaced in polling in 1980) women don’t identify with the Democrats in numbers large enough to offset the Republicans’ overwhelming popularity with men. Democrats can’t even win a majority of white women in national elections. Legal abortion didn’t do it. At the moment even such a retrograde program as opposing contraception isn’t changing the numbers. If not birth control, then what? Breast cancer? The Violence Against Women Act?
There is no magic potion to unleash the mythic power of the female voter. As historian Michael Kazin so brilliantly describes in his book on the left, “American Dreamers,” like many liberal American social movements, feminism changed people’s behaviors and their beliefs about behavior. But, for a majority of female voters uninflected by race, feminism did not change their beliefs about the legitimate distribution of political power. Most women don’t grow up thinking they’re entitled to govern. Judging from their electoral behavior, most white women don’t care if the men they elect hope to deprive them of health insurance that includes birth control, if not keep them barefoot and pregnant. And without the jet fuel of anger and resentment, no social movement has ever changed elections.
I’m a pundit, so I will say that Barack Obama will probably win the 2012 election. He may even be the first president to win even while losing among men, technically a gender victory. (In 2008, the men split almost exactly in half.) But it will not be an estrogen tsunami, no matter how many hysterical emails the DCCC sends to hapless female Democrats out here in cyberspace.
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