Abortion, contraception, and discrimination

HHS regulatory change and what it means

| Staff Columnist

Earlier this summer, a friend of mine sent me a message on Facebook alerting me to a document leaked by the Department of Health and Human Services (HHS) “proposing that all forms of birth control, regardless of the manner in which they actually work, should be classified as abortifacients.”

I read it, and thought it was ridiculous—the definition of pregnancy we’re taught in health class in, like, fifth grade is that pregnancy occurs when an egg is fertilized and implanted in a woman’s uterus; contraception prevents both fertilization and implantation, ergo with contraception there is no pregnancy, ergo there can be no pregnancy aborted. Yes, there is a religious argument that contraception is immoral because the purpose of sex is reproduction and contraception alters that purpose, but that contraception is explicitly an abortifacient? No.

I also thought, “this will never get any traction.” Aside from the American Medical Association and the American College of Obstetricians and Gynecologists, both of whom define pregnancy as I have just done and consequently distinguish between contraception and abortion, there’s also the National Organization for Women (NOW), Planned Parenthood and innumerable other women’s lobbies operating on the national, state and local levels. I know the Bush Administration caters to the religious right, but, having worked for an energy lobbyist all summer, I also know the power of a pissed off lobbyist. I trusted that the issue would be dropped before it ever made it to the policy level.

Well, apparently I was wrong.

President Bush has just issued a regulatory change in HHS policy allowing health care providers to define what constitutes abortion, to the inclusion of many forms of contraception now on the market (for example, oral contraceptive pills, patches, IUDs, etc). The effect of this change is that those health care providers can now refuse, under federal law, to provide patients with access to contraception. The Weldon and Church Amendments protect the right of physicians and pharmacists not to participate in or facilitate abortion or abortive procedures; by allowing for an independent classification of what constitutes abortion, the HHS has effectively extended that protection to cover the refusal to provide contraception.

Why is this a big deal? Well, leaving aside arguments on reproductive rights, which I’m sure many others will get into, the fact cannot be escaped that this policy is discriminatory. Defining discriminatory as “manifesting partially” (this is textbook), all negative consequences are visited upon women; there is no talk of policy or legislation limiting access to, say, vasectomies (arguably the male equivalent of an IUD), or erectile dysfunction drugs (which similarly promote “unnatural” sex and can facilitate relations outside of wedlock). This policy targets women and women only.

It also seriously jeopardizes women’s access to adequate healthcare. Because, while contraceptives do prevent pregnancy, they are also used to treat any number of women’s health conditions. Oral contraceptive pills, for example, are used to treat recurrent ovarian cysts, problems with the tissue and lining of the uterus (endometriosis and adenomyosis, for example), irregular bleeding, painful menstruation and more. Use of OCPs has further been shown to reduce the risk of certain cancers by up to 50 percent. To deny access to medication because of what amounts in these cases to a reproductive side effect—an effect that is completely independent from the primary purpose of the prescription, which is the treatment of the women’s health condition—is outrageous.

A 15-year-old girl, sexually inactive, with ovarian cysts, now might not be able to treat them. A 37-year-old woman, married, might now have to suffer intense pain and fainting once a month, because the pharmacist in her small town has reservations.

The comment period for this policy ends Sept. 25, meaning that unless enough of a public outcry is voiced to HHS, the policy change will be active thereafter. If you agree that this policy is discriminatory, if you support not even reproductive rights but equal rights and a universal right to healthcare, please, be part of that outcry.

To find out more on the issue, and to find out how you can contact HHS to voice your opinion, please visit www.ppaction.org/ppaction/home.html.

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