My historical detective work on #Emergency Contraception coverage in New York Times

Over the past two weeks there has been a robust discussion on the International Consortium for Emergency Contraception listserv about reporting in the New York Times discussing recent findings on how emergency contraception works.  According to this article, “an examination by The New York Times has found that the federally approved labels and medical Web sites do not reflect what the science shows. Studies have not established that emergency contraceptive pills prevent fertilized eggs from implanting in the womb, leading scientists say. Rather, the pills delay ovulation, the release of eggs from ovaries that occurs before eggs are fertilized, and some pills also thicken cervical mucus so sperm have trouble swimming.

It turns out that the politically charged debate over morning-after pills and abortion, a divisive issue in this election year, is probably rooted in outdated or incorrect scientific guesses about how the pills work. Because they block creation of fertilized eggs, they would not meet abortion opponents’ definition of abortion-inducing drugs. In contrast, RU-486, a medication prescribed for terminating pregnancies, destroys implanted embryos.

The notion that morning-after pills prevent eggs from implanting stems from the Food and Drug Administration’s decision during the drug-approval process to mention that possibility on the label — despite lack of scientific proof, scientists say, and objections by the manufacturer of Plan B, the pill on the market the longest.”

I’ll let scientists comment on the emerging scientific consensus on this and comment on what this says about historical research. While researching my book, I’ve spent countless hours reading and re-reading FDA transcripts and I have no recollection of any such objections from the manufacturer of Plan B, which at that time was Women’s Capital Corporation.  Shortly after this article appeared,  Newsweek Senior Editor Sarah Blustain contacted me to find out more about the FDA’s decision. She asked whether this was a political compromise imposed on the manufacturers of Plan B by FDA.  I told her that I didn’t recall any of this so went back and looked at the transcripts available on the FDA website.  I couldn’t find anything in the original New Drug Application for Plan B filed by Women’s Capital Corporation.  After some further digging, I found the relevant discussion in a transcript from a joint meeting of the FDA Non-prescription Drug Advisory Committee (NDAC) and the Advisory Committee for Reproductive Health Drugs (ACRHD) held on December 16, 2003. However, I didn’t find any objections from scientists who presented on behalf of the manufacturer of Plan B.  The relevant section starts on page 288 of the PDF version.  First, Dr. Joseph Stanford, a member of the ACHRD asks:

“I understand, again, that the data that we have on mechanism of action for Plan B is imperfect, incomplete, but I think it’s a
critical issue for those women who want to understand how it works and have informed consent for use. So along those lines I have a question from Appendix 6 from the sponsor’s book. They list all of the answers to Question 7 about — after they
showed the women the package, they said, “Without looking at the label, tell me what Plan B is used for,” and then classified answers as either correct and acceptable or correct but not acceptable or not correct and not acceptable, and they list them
verbatim. And among the ones that are listed as correct and acceptable are a number of women who said that — one of them is, for example, an abortion type  thing for the day after. One was them was to kill a fertilized egg, and basically showing that some women had that understanding, and it was classified by the company as a correct and acceptable understanding of
what the product is for. And so I’m just wondering for the FDA did they also classify those particular answers as correct
and acceptable for what the product is for.”

NDAC chairman Louis Cantilena  then called Karen Lechter from FDA Dr. Leonard Segal answered, “Dr. Lechter unfortunately had to leave, and I don’t know that I can actually specifically address how she did hercalculation in her review on that particular issue. My assumption is though that she probably followed the sponsor’s categorization.” Chairman Cantilena answers, “There were a few tables that she showed in her presentation where she had asterisks where there was, you know, a difference between her, you know, assessment and the sponsors. But I don’t recall if that specific issue was asterisked or not.”

Dr. Valerie Montgomery Rice from ACRHD says, “I think that one of the things that Dr. Stanford is getting to — and you can tell me if I’m wrong — is a matter of informed consent such that the patient is as fully informed as possible based on all of the information that we know about how this product works.

So I guess I would ask the sponsor first.  When you’ve done surveys, if you have — and you may not have this information — in women who have taken emergency contraception and then you’ve asked them the question of how they  perceive, first of all, the medication worked, besides one of these studies because during that time, I think when you are dealing with that immediate issue of needing emergency contraception or even within the first couple of weeks while you’re waiting for that cycle to come, your perception of how it works may be different than when you sit down and really think about it.  So I think that’s one point.

And then, you know, even with my background, having a lot of experience with infertility and giving a lot progesterone, et cetera, and I’ve reviewed the literature, there is some data out there that really does suggest at very high dosages that there may be the possibility that you’re interfering with the implantation.

And so I guess my comfort level would definitely — I would definitely be a lot more comfortable making sure that the patient or the woman who makes that decision is as informed as possible that there potentially is a possibility that still gives that woman enough information to make an informed decision and not dilute any of her rights in deciding to proceed with this medication.”

Dr. Carole Ben-Maimon, one of the physicians presenting on behalf of Women’s Capital Corporation, answered:

“We are very sensitive to the fact that there are differing views not only of how this could potentially work, but also when pregnancy begins.  And so there are actually statements in the labeling with regard to the implantation issue in order to provide women information so that they understand and that they know that this could potentially prevent implantation.

Again, we believe the data is overwhelming.  We believe the medical definition, which is that pregnancy starts at implantation, is a critical point to keep in mind, but we are sensitive to the issues that others — the opinions of others.”

In other words, not only was there no objection from those representing Women’s Capital Corporation, they actually provided the information about possible effects on implantation that went into the label for Plan B. Now, this doesn’t meant that there weren’t objections from someone either from WCC or elsewhere — but I can’t find this in the official record.

So what’s the point here?  Well, what bugs me about the New York Times coverage is that it grossly oversimplifies the FDA approval process and assumes that anyone who worked for FDA or served on its advisory committees were only there to enforce the political will of the Bush administration.  In fact, the committee members mentioned above are respected members of the reproductive health community who were asking important, nuanced scientific and ethical questions that had nothing to do with the culture wars over reproductive rights.  (Dr. Montgomery Rice, for example, is Dean of Morehouse School of Medicine who has worked extensively on health issues affecting women of color — and we historians of women’s health all know how poorly women of color were and sometimes still are treated by medical researchers — e.g. the field trials for the original contraceptive pills in Puerto Rico and Haiti).  So, naturally informed consent would be a critical concern for her.

I would be interested to find out whom the NYT reporter interviewed for this story. I don’t think anyone is purposely trying to rewrite history but they may have selective memories.


#EmergencyContraception Past, Present, and Future

Rutgers University Press book exhibit at 2012 American Association for the History of Medicine annual meeting

via RH Reality Check and my book pictured at left. Actually, the title of the RHRC post has the name of a specific emergency contraceptive product and shows a video produced by NARAL ProChoice NY for their Champions of Choice 2012 awards luncheon. The organization, “honored the visionaries behind Plan B. From Sharon Camp, who pioneered this emergency contraceptive product and even founded a pharmaceutical company to bring it to market, to Teva Women’s Health, which not only stands behind the current product but has pushed the FDA to increase access by making it available over-the-counter for all ages.”

This is an excellent video but because it celebrates a particular product it has its limits.  First, it’s not true that no pharmaceutical company was interested in creating an emergency contraceptive for the U.S. market — Roderick Mackenzie created the now defunct company Gynetics specifically for that purpose and got the no longer produced drug Preven approved by FDA first.  Second, the story is framed rather narrowly by the ongoing culture wars over contraception and reproductive rights — e.g. in the repeated use of the phrase “politics trumping science.”  Although important, this framework ignores the ways in which the public shapes what “counts” as scientific knowledge. It also overlooks the specific historical circumstances that lead to the production of new knowledge, especially when this involves a politically controversial health topic such as birth control. Most importantly, this claim treats “the public” as though it were a homogenous entity, ignoring the multiple constituencies who have contributed to reproductive health policy in the United States and the ways in which their positions have changed over time.

Okay, now that I’ve addressed the past and the present (sort of), what about the future?  Well, historians aren’t in that business but I’ll offer some thoughts based on my book’s conclusions. Since the early 1990s, emergency contraception has served as a bridge issue that brought together former adversaries, including feminist health organizations, population and family planning
people, and groups representing women of color who were the main targets of attempts to control the so-called “population crisis” in the United States. In order to bring more radical groups onboard, mainstream population organizations and reproductive health professionals had to overcome much bad faith generated by sexism in the medical profession and the often coercive policies of the population movement during the first half of the twentieth century. A narrow focus on purely technological solutions to
the complex social problem of pregnancy prevention tends to dissolve this fragile alliance. Therefore, as experts and activists develop policies on making new contraceptive options available to all women; it is imperative that the language of rights
and reproductive choice continue to remain at the forefront of these deliberations.

2012 National Back Up Your Birth Control Day of Action

via Back Up Your Birth Control and RH Reality Check

Today is the 11th annual Back Up Your Birth Control Day of Action sponsored by the the National Institute for Reproductive Health.  So, once again I’m helping them spread the word by blogging about emergency contraception.  This year the campaign has asked us to combat the misinformation about emergency contraception that misleadingly equates emergency contraception with mifepristone (aka RU-486) which is used to induce medical abortion.  To combat this misinformation, this year’s theme is EC=BC, “emphasizing that EC is a form of contraception that prevents pregnancy even though it’s taken after sex.”

Misinformation about the mechanism of action of EC dates back to the origins of this birth control technology in the 1960s.  Two of the researchers who developed the first oral contraceptive pill — Gregory Pincus and Min Chueh Chang — first described their work on what they called a postcoital contraceptive in 1966.  Yet the third “father” of the pill — physician John Rock, a devout Catholic — falsely claimed that this “morning-after pill” was an abortifacient.  This erroneous statement has stuck despite efforts by Pincus, Change, other scientists and activists to set the record straight.

[for more on this fascinating history, see my book,  The Morning After: A History of Emergency Contraception in the United States.  You can find out more about it at the Rutgers University Press  website,]

Here are other ways you can join the Day of Action:

  • Share the images on our EC = BC tumblr with your networks! We posted many more new images today. Follow and reblog on tumblr, post our images on Facebook, and tweet or mention them on Twitter!
  • Get creative and submit your own images to the EC = BC tumblr! We’ll circulate your images on social media throughout the day.
  • Get an EC coupon for Plan B One-Step® and ella® on the Back Up Your Birth Control website! Use them to purchase EC for yourself, send them to your friends, and let others know they can buy it in advance so that they are always prepared.
  • Blog for EC! Help us dispel the misinformation by clarifying that emergency contraception is a safe and effective form of birth control that prevents pregnancy after sex, but only works if you are not pregnant.
  • Follow us on Twitter at @NIRHealth and @ProChoiceNY, retweet our #ECfacts, and spread the word about EC using the #ECBC hashtag!
Visit the Back Up Your Birth Control website for more information. If you have questions about the campaign, contact Nicole Grafilo at ngrafilo@nirhealth.org.

Review of Leslie Reagan, Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America

via H-Disability

Leslie J. Reagan. Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America. Berkeley: University of California Press, 2010. xv + 372 pp. $27.50 (cloth), ISBN 978-0-520-25903-4.

Reviewed by Heather Munro Prescott (Central Connecticut State University)
Published on H-Disability (March, 2012)
Commissioned by Iain C. Hutchison

Prescott on Reagan

This book continues the compelling story of the history of abortion in the United States that Reagan began in her award-winning book, When Abortion Was a Crime (1998). The title Dangerous Pregnancies refers not to pregnancies that were dangerous to the lives or health of mothers, but to the “dangers” to home, family, and society posed by the birth of “defective” babies. Focusing on the responses to the German measles epidemic in the United States during the early 1960s, Reagan shows how fears of disability helped lend legitimacy to the abortion rights movement.

Reagan goes beyond her earlier work by linking the history of reproductive rights to two other fields of scholarship: the history of epidemics and infectious disease; and the history of representations of people with disabilities. She shows that in marked contrast to earlier epidemics, the German measles outbreak did not single out nonwhite or other stigmatized groups as sources of infection. Nevertheless, race was at the center of media representations of the disease. Responses to the epidemic highlighted how the birth of a disabled child wrecked havoc on the status of white, middle-class, heterosexual, nuclear families. The epidemic came closely after alarming reports about severe birth defects in infants born to women who had taken the sleeping pill thalidomide while pregnant. Although the U.S. Food and Drug Administration had not approved the drug, some American women were able to obtain the drug from overseas. The story of Sherri Finkbine’s efforts to obtain an abortion after she discovered she had taken thalidomide while pregnant with her fifth child, helped transform attitudes towards abortion in the United States. During the pronatalist 1940s and 1950s, media coverage emphasized the deviant nature of abortion and of the women who sought these procedures. Finkbine’s story, along with that of other white, middle-class mothers who had contracted German measles while pregnant, transformed the image of abortion “from a shameful, thoughtless, and sick action to an ethical and responsible one” that protected families from the “burden” of raising a severely disabled child (p. 104).

Despite these changing attitudes towards abortion, significant barriers remained even for those who sought to terminate “dangerous pregnancies.” Reagan contrasts the cases of Barbara Stewart and Sandra Gleitman, who with their husbands filed “wrongful birth” cases against the hospitals that refused to provide abortions after the women had been exposed to German measles while pregnant. Both cases showed that hospital abortion committees were fickle and arbitrary. For the Stewarts, an African American couple, race posed an additional hurdle. While they had private health insurance, racial discrimination denied them access to physicians who had connections to hospital abortion review committees. By demonstrating the central role that race played in these deliberations, Reagan answers Chris Bell’s suggestion that disability studies scholars need to pay more attention to the experiences of “people of color.”

Reagan is less successful in showing how the German measles epidemic contributed to the emerging disability rights movement. She describes the work of “rubella parents”–most of whom were white and middle class–who fought for and won the right to public education for children with physical, sensory, and intellectual impairments. These parents were successful largely because rubella and its effects were not confined to the poor or to “people of color,” and because their arguments focused on the core middle-class value of access to education. Reagan also periodically mentions persons with congenital rubella syndrome and other disabilities, including those who objected to the “humane” and “merciful” reforms that made it easier for women to abort fetuses with birth defects. Reagan claims that even the suits filed by the Stewarts and Gleitmans reflected an aspect of this rights movement, since their aim was to get resources for their children. Yet Reagan underestimates the countervailing power of terms like “therapeutic abortion” and “wrongful birth” to reinforce prevailing beliefs that disability is a fate worse than death. Rubella immunization campaigns weakened the disability rights perspective even further. They used sentimental images of “pathetic” rubella children and played into popular notions of disability as a “tragedy” that could be prevented through universal vaccination against German measles.

Reagan shows how the rhetoric about “dangerous pregnancies” backfired during the 1980s and 1990s. Opponents of vaccination have seized on these same fears by alleging that vaccines cause autism, and that by refusing to vaccinate their children, they are saving themselves from the “heartbreak” of raising a disabled child. The discovery of fetal alcohol syndrome and other defects caused by environmental factors “erased” the history of women fighting for accurate information about potential threats to their babies and the right to abort “defective babies.” Public health campaigns by the March of Dimes and other organizations recast pregnant women themselves as risks to the unborn. Reagan rightly concludes that German measles acted as a “crucible for change” by prompting dialogue about reproductive rights, civil rights, and disability rights, but this change was incomplete. Abortion rights are increasingly under assault, and stigmatizing language about disability and misconceptions about persons with disabilities remain with us today.

If there is additional discussion of this review, you may access it through the list discussion logs at: http://h-net.msu.edu/cgi-bin/logbrowse.pl.

Citation: Heather Munro Prescott. Review of Reagan, Leslie J., Dangerous Pregnancies: Mothers, Disabilities, and Abortion in Modern America. H-Disability, H-Net Reviews. March, 2012.
URL: http://www.h-net.org/reviews/showrev.php?id=33916

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.

Silent Sentinels Past and Present

via Maddow Blog.  Here are photos of demonstrators outside the Virginia state capitol earlier this week. They are protesting a bill that would require women seeking an abortion to first undergo a medically unnecessary transvaginal ultrasound.

According to their Facebook page:

The Capitol ground rules say that we cannot assemble, hold signs, chant, yell or protest. We think silence in the face of this struggle and their unconstitutional rules presents the strongest response to their assault on women. Please come out and stand up for our rights and for the rights of all women in VA to choose the best reproductive route for themselves. These people are used to signs, yelling, chanting etc. It is not new. They are not used to silently being stared at and having to look us in the eye. It gives us the power.

I’m about to do my annual screening of the HBO film “Iron-Jawed Angels” that describes the actions of the “silent sentinels” by the radical women’s suffrage organization the National Women’s Party:

 

#Komen sucks, support @BCAction

Posted by Lorraine Tipton on Susan G. #Komen Facebook page: http://pic.twitter.com/rHfK54KK

via Huffington Post

As you all saw in my Twitter feed, I’m mighty upset with the Komen Foundation for their decision to no longer provide funding to Planned Parenthood for preventive cancer exams for low income women.

I’ve been a Komen “grumbler” for years but usually bite my tongue and shell out money when folks ask me to contribute “for the cure.”   My gripes include Komen’s support companies that “pinkwash” — i.e. sell products that have been linked to breast and other cancers and save face by selling pink stuff.  They spend a lot of the money they raise on administrative costs (e.g. the VP who pulled the plug on Planned Parenthood funding makes a six-figure salary), and there are doubts about whether the organization “raising awareness” really does anything to improve the survival rate of women with breast cancer.

So, if you really want to support an organization that truly cares about women’s health and is far more effective in fighting the breast cancer epidemic, then give your money to Breast Cancer Action (and Planned Parenthood because they need it.)

Blog for Choice Day 2012

via NARAL Pro-Choice America

Today is the 39th anniversary of Roe v. Wade  and the seventh annual Blog for Choice day. This year we’re being asked to give our thoughts on the following question: What will you do to help elect pro-choice candidates in 2012?

One of the main things I plan to do is to try to overcome my students’ complacency on this issue. The talk I just gave at the Dittrick Museum was very well-received and there were a lot of students in the audience (there is an active Planned Parenthood campus affiliate at Case Western). I reminded them that the ground is shifting beneath them and anti-choice groups are chipping away at reproductive rights by going after the most vulnerable groups (e.g. adolescents, the poor, i.e. folks who don’t or can’t vote). I plan to do the same with my students this semester.

I was relieved that HHS Secretary Kathleen Sibelius, along with President Obama, finally showed some back bone and required insurance companies to cover contraception without mandating co-pays, just like any other preventive service. Of course, this has angered Catholic leaders, and Fox News, among others.  They haven’t quite redeemed themselves in my book, but they certainly are better than any of the Republican candidates.

Related note — I went to the Rock and Roll Hall of Fame while in Cleveland.  The Women Who Rock exhibit wound up being rather one-dimensional, i.e. lame, (does every exhibit about women have to be pink?!)  Still it was worth it to see Joan Jett’s black leather jacket with all the pro-choice and anti-rape buttons on it (where can I find one that says “Pro Fucking Choice”).  So, I guess another thing I’ll do to help pro-choice candidates get elected, I’ll ask myself whenever I see some anti-choice b.s. come my way, What Would Joan Jett do?

Thought Science Would Trump Politics under President Obama? Think Again.

via Reproductive Health Technologies Project, which just sent around the following disappointing news:

“Statement from FDA Commissioner Margaret Hamburg, M.D. on Plan B One-Step

The U.S. Food and Drug Administration (FDA) has been carefully evaluating for over a decade whether emergency contraceptives containing levonorgestrel, such as Plan B One-Step, are safe and effective for nonprescription use to reduce the chance of pregnancy after unprotected sexual intercourse.

Plan B One-Step is a single-dose pill (1.5 mg levonorgestrel tablet) which is effective in decreasing the chance of pregnancy if taken within 3 days after unprotected sexual intercourse.  The product contains higher levels of a hormone found in some types of daily use oral hormonal contraceptive pills and works in a similar way to birth control pills.

Plan B One-Step was originally approved in July 2009 for use without a prescription for females age 17 and older and as a prescription-only option for females younger than age 17.  In February 2011, Teva Women’s Health Inc. submitted a supplemental application seeking to remove the prescription-only status for females younger than age 17 and to make Plan B One-Step nonprescription for all females of child-bearing potential.

The Center for Drug Evaluation and Research (CDER) completed its review of the Plan B One-Step application and laid out its scientific determination. CDER carefully considered whether younger females were able to understand how to use Plan B One-Step.  Based on the information submitted to the agency, CDER determined that the product was safe and effective in adolescent females, that adolescent females understood the product was not for routine use, and that the product would not protect them against sexually transmitted diseases. Additionally, the data supported a finding that adolescent females could use Plan B One-Step properly without the intervention of a healthcare provider.

It is our responsibility at FDA to approve drugs that are safe and effective for their intended use based on the scientific evidence.  The review process used by CDER to analyze the data applied a risk/benefit assessment consistent with its standard drug review process.  Our decision-making reflects a body of scientific findings, input from external scientific advisory committees, and data contained in the application that included studies designed specifically to address the regulatory standards for nonprescription drugs.  CDER experts, including obstetrician/gynecologists and pediatricians, reviewed the totality of the data and agreed that it met the regulatory standard for a nonprescription drug and that Plan B One-Step should be approved for all females of child-bearing potential.

I reviewed and thoughtfully considered the data, clinical information, and analysis provided by CDER, and I agree with the Center that there is adequate and reasonable, well-supported, and science-based evidence that Plan B One-Step is safe and effective and should be approved for nonprescription use for all females of child-bearing potential.

However, this morning I received a memorandum from the Secretary of Health and Human Services invoking her authority under the Federal Food, Drug, and Cosmetic Act to execute its provisions and stating that she does not agree with the Agency’s decision to allow the marketing of Plan B One-Step nonprescription for all females of child-bearing potential.   Because of her disagreement with FDA’s determination, the Secretary has directed me to issue a complete response letter, which means that the supplement for nonprescription use in females under the age of 17 is not approved.  Following Secretary Sebelius’s direction, FDA sent the complete response letter to Teva today.  Plan B One-Step will remain on the market and will remain available for all ages, but a prescription will continue to be required for females under the age of 17.”

Kirsten Moore, President and CEO of RHTP, told Ms. Magazine:  “We are outraged that this Administration has let politics trump science. There is no rationale for this move. This is unprecedented as evidenced by the Commissioner’s own letter. Unbelievable.” In the same story, Dr. Susan Wood, who resigned from the FDA over the Bush Administration’s decision to Plan B and is currently the former FDA Assistant Commissioner for Women’s Health and associate professor of Health Policy and Director of the Jacobs Institute at the GW School of Public Health and Health Services, issued the following statement: “This decision is stunning. I had come to believe that the FDA would be allowed to make decisions based on science and the public’s health. Sadly, once again, FDA has been over-ruled and not allowed to do its job. I cannot understand why Secretary Sebelius would reach in and overturn the FDA’s decision to allow timely access for all those who need safe and effective emergency contraception.”

In her letter to FDA Commissioner, Secretary Sibelius said that there were “significant cognitive differences” between older adolescents and younger ones So, if Teva’s application were approved, then the drug would be available without prescription or other point of sale restrictions for even the youngest girls of reproductive age (the average age of menarche in the U.S. is 11.1 years). Never mind that only 1% of all 11 year old’s have been sexually active (and for those, “sexually active” usually means rape or incest).

According to what I’ve read and heard from others in the EC world, this is an unprecedented move by an HHS secretary — i.e. none of her predecessors has ever overruled the FDA on a drug application.   (during the George W. Bush administration, the problem was the FDA Commissioner).  Is Secretary Sibelius acting on her own, or is she fronting for someone else? We’ll see.

Update:  If you want to take action on this issue, please sign the petitions at

 

In addition, here is a statement from Catholics for Choice:

For Immediate Release
December 7, 2011
Media Contact: Adrianne Burke
+1 202 986 6093

Obama Administration Rejects Scientific Evidence and FDA Advice in Maintaining Restrictions on Emergency Contraception

Continues Barriers for Women Seeking to Prevent Unplanned Pregnancy

 

In a stunning setback for women’s access to healthcare services, President Obama’s Department of Health and Human Services (HHS) has ignored the advice of the Food and Drug Administration (FDA) to ease the restrictions on the sales of Plan B, a method of emergency, or after-sex, contraception. In a rare sign of public dissent within the administration, the FDA commissioner, Margaret Hamburg MD, wrote, “I reviewed and thoughtfully considered the data, clinical information, and analysis provided by CDER, and I agree with the Center that there is adequate and reasonable, well-supported, and science-based evidence that Plan B One-Step is safe and effective and should be approved for nonprescription use for all females of child-bearing potential.” The HHS decision to override this recommendation means that the proposal to remove the pills from over-the-counter status, and permit pharmacies to place them on shelves like other safe and effective oral medications, cannot now take place.

 

The president of Catholics for Choice, Jon O’Brien, said, “We know that conservative pharmacists around the country have treated women condescendingly, expressed contempt and even denied them access to a safe and legal contraceptive for no medical reason. Now, the HHS has overruled the scientifically and medically sound advice from the FDA that it was perfectly OK to move these pills to OTC status for all women. This is a deeply disappointing decision from an administration that promised us it would follow science and sound medical information in making policy decisions. Increasingly, on issues that women care deeply about, the Obama administration seems intent on taking us back to the future.”

Blog Carnival: #HERVotes against the Bishops

via Feminist Majority Foundation Blog.  Today the FMF is launching their sixth #HERVotes Blog Carnival to combat efforts by Catholic Bishops to convince President Obama and HHS Secretary Sibelius to expand the refusal clause “to allow some institutions to refuse, under the Affordable Care Act, birth control coverage without co-pays to students and employees of  hospitals, universities, and other institutions, or other religious affiliated or connected institutions such as Catholic Charities.”  This exemption would mean that at least six million women with health insurance will lose their contraceptive coverage benefit simply because of where they work or go to school.

Lest anyone misconstrue this Blog Carnival as “Catholic bashing“, let’s keep in mind that the vast majority of American Catholics support birth control despite the official church position.    In other words, many Catholics believe that reproductive rights are human rights —  like their counterparts mainline Protestant churches (e.g. the  Episcopal Church of the USA) and Jewish congregations, are engaged in the “sacred work” of securing reproductive justice for women.  (this work has a long history — One of the “fathers” of the birth control pill, John Rock, was a devout Catholic; protestant chaplains, and even a few Catholic ones, helped college students gain access to birth control on campuses).

So, take action and help spread the word:  no way to birth control co-pays!

Thoughts on Bachmann’s “Viral Politics”

via Student Activism(among many others).  At Tuesday night’s CNN/Tea Party Republican presidential debate, Michelle Bachmann chastized Texas governor Rick Perry  for his 2007 support of a mandatory state program vaccinating girls against Human Papilloma Virus — a sexually-transmitted virus that can lead to cervical cancer.  during the debate, Bachmann called the vaccine  a “government injection,” and Perry’s decision as “a violation of a liberty interest.” She also suggested that Perry’s support of mandatory vaccination was payback for Merck’s support of his campaign (Perry’s former chief of staff was a lobbyist for Merck). After the debate, Bachmann went even further:

“When you have innocent little 12-year-old girls,” she said, “that are being forced to have a government injection into their body — this is a liberty interest that violates the most deepest personal part of a little child. … A little girl doesn’t get a do over — once they have that vaccination in their body, once it causes its damage, that little girl doesn’t have a chance to go back.”

Student Activism says he was “gobsmacked by the language itself — the use of such heavily loaded molestation imagery to describe a non-invasive, voluntary medical procedure.”

I wasn’t going to get mixed up in this but because I contributed to the volume picture at left, and I’ve been getting links to articles about this asking for my thoughts, I’ve decided to weigh in after all.

I agree that Bachmann’s rhetoric is outrageous (especially since she shows little  concern for women who have been sexually assaulted, or those who need basic reproductive health care like pelvic exams or cervical cancer treatment).

Even the conservative paper  Wall Street Journal has condemned Bachmann’s “viral politics” and demagoguery, calling this “the kind of know-nothingism that undermines public support for vaccination altogether and leads to such public health milestones as California reporting in 2010 the highest number of whooping cough cases in 55 years.”

Wow, it’s not often I agree with the WSJ!  It’s also not often that the WSJ critiques a Republican candidate — obviously Backmann is beyond the pale (and I bet Perry’s ties to Big Pharma is a plus for the pro-business publication).

At the same time, I’m going to plug my and my colleagues’ work in Three Shots of Prevention and suggest critics get it and learn about the multiple moral, ethical, and scientific questions regarding HPV vaccines.

Update:  I’m addressing Dr. Pete’s comments here rather than in the comments section.  First, I and others who work on adolescent health issues acknowledge that there is a qualitative difference between young children and teenagers.  One of the keys to successful adolescent health care is involving teenagers in the process (and as they age, asking Mom and Dad to step out of the room). In other words, girls (and boys) who are being offered the HPV vaccine should be part of the conversation about whether or not to receive it.  So individual liberty includes teenagers too, not just parents. The imagery used by Bachmann in her remarks does not acknowledge the developmental differences between teenagers and younger children.