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Join the World March of Women 2000!
Photos from the march above!
On October 15, 2000, women from all over the world will march in Washington, D.C., calling for the leaders of the United States to work harder to eliminate violence against women, to end poverty, and to ensure equality between women and men. Join us!
Unite with women around the world in a march for women's rights and equality. This will be the final march before October 17, 2000, when U.N. Secretary General Kofi Annan will be presented with thousands of postcards calling for equality between women and men.
The Center for Reproductive Rights is co-sponsoring the World March of Women 2000, and is specifically asking the U.S. government to put an end to the Global Gag Rule. The Global Gag Rule restricts most foreign non-governmental organizations that receive family planning funds from the U.S. Agency for International Development (USAID) from using their own money to provide legal abortion services or to advocate for changes in abortion laws.
Come and join the the Center for Reproductive Rights delegation, which will assemble on October 15 at 11:00 am at Freedom Plaza (13th Street and Pennsylvania Avenue, N.W.)
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"Upon hearing our fee, some women tell me that they are going to self-abort," says Marne Greening, administrator and part-owner of the Indiana Women's Pavilion.
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Beaten by the System: Low-income Women and Medicaid Funding
Even some anti-choice legislators recognize that it's unfair to deny a woman a medically necessary abortion simply because she can't afford it. Last June, conservative Governor George Ryan of Illinois angered anti-abortion groups when he vetoed a bill that would have eliminated Medicaid funding for abortions that are necessary to preserve the woman's health. Ryan reasoned, "All I can tell you is, as a father of five daughters and nine granddaughters, I don't know how we can't be concerned about the health of the mother."
Although women in the U.S. have the right to an abortion, the reality is that many women cannot afford one. Federal law requires that all states provide Medicaid funding for abortions for women if they are pregnant as a result of rape, incest or, sometimes, if their life is at risk. But Illinois is one of only 19 states to offer financial assistance for an abortion when the woman's health is at stake.
Even when Medicaid funding is federally required, as in the case of rape, incest or life endangerment, many states fail to pay up, either by denying legitimate claims or by failing to send payments to providers. Desperate women and frustrated doctors are then left to find their own solutions.
"Upon hearing our fee, some women tell me that they are going to self-abort or are going to have to carry the pregnancy to term simply because they are unable to afford the cost of the procedure," says Marne Greening, administrator and part-owner of the Indiana Women's Pavilion. She says women often use money set aside for rent or groceries to pay for an abortion, and some even prostitute themselves to make the payment.
Furthermore, studies have concluded that impoverished women delay their abortions longer than their higher-income counterparts in order to gather the necessary funds. This delay results in an increased number of second trimester abortions among low-income women, procedures that are even more expensive and less safe.
"The purpose of Medicaid is to provide needed health care to low-income people," says Janet Benshoof, Center for Reproductive Rights president. "The abortion funding restrictions actually defeat the state's objective by preventing women from obtaining doctor recommended medical treatment."
Fortunately, abortion providers routinely offer free or subsidized procedures to patients who are in crisis, knowing that if they turn them away the results could be tragic. Susan Derwin, Assistant Administrator at A Clinic for Women in Indianapolis, helps find funding for women who cannot afford abortions. She remembers one patient who was almost completely healed from a severe and painful abdominal injury when she discovered she was pregnant.
"Her physicians told her that if she continued her pregnancy, it would likely cause her extensive injuries to reoccur," Derwin recounts. But because the woman's condition was not considered "life threatening," and since Indiana law does not fund medically necessary abortions, three organizations had to pitch in funds to pay for her abortion when Medicaid would not. Derwin's clinic, along with several other providers, is represented by the Center for Reproductive Rights in its ongoing legal battle to restore state funding for medically necessary abortions in Indiana.
When abortion was first legalized in 1973, federal funds were available to low-income women seeking medically necessary abortions. But just four years later, in 1977, Representative Henry Hyde (Rep-IL) sponsored a bill that eliminated federal funding for abortion except when necessary to save the woman's life. Even Democratic President Jimmy Carter, who was anti-choice, gave his support for the Hyde Amendment, saying, "As you know, there are many things in life that are not fair, that wealthy people can afford and poor people can't."
The Hyde Amendment has been renewed by Congress annually ever since and has included varying restrictions over the years. Since 1993, the amendment has permitted Medicaid funding for cases of rape and incest, in addition to the life-saving exception.
This limitation of Medicaid coverage to rape, incest or "life-saving" abortions creates a dangerous situation for low-income women. For even when a woman's health is jeopardized by her pregnancy to the extent that it will leave her incapacitated, unable to care for her children or hold down a job, she is still not eligible for Medicaid funding for an abortion if the odds are she will survive the ordeal.
This was tragically apparent in the case of Michelle Lee, a Louisiana woman denied a Medicaid-funded abortion by Louisiana State University Medical Center (LSUMC). In spite of her life-threatening heart condition that was worsening during the pregnancy, doctors at that facility denied her request for a Medicaid-funded abortion after deciding that her risk of death was not greater than 50% if she carried the pregnancy to term.
Lee, a mother of two, was told that she would have to continue the pregnancy or pay for an extremely expensive hospital abortion necessitated by her medical condition. Fortunately she was able to raise private funds for an abortion. She is currently represented by the Center for Reproductive Rights in her suit against the LSUMC, its doctors, the Louisiana Department of Health and Hospitals, and other state officials with authority over LSUMC policies.
Because state constitutions frequently offer greater privacy protection than the federal Constitution, the Center for Reproductive Rights has chosen to fight many Medicaid restrictions at the state level. Since states fund virtually all medical procedures that are considered "medically necessary," including those associated with childbirth, Center for Reproductive Rights lawyers contend that states cannot summarily exclude abortion from that list.
The Center for Reproductive Rights recently represented the Arizona abortion providers who successfully challenged that state's Medicaid funding restrictions in the case Simat Corp. v. AHCCCS, thereby securing funding for medically necessary abortions for low-income women in that state as of June 6, 2000. Until then, Arizona's Medicaid-based healthcare program, AHCCCS, offered fully-funded prenatal, delivery and postpartum services, yet systematically denied low-income women with serious medical conditions, such as cancer, diabetes, and epilepsy, the much less expensive and medically indicated option of an abortion. "As a result, some poor women for whom abortions were medically necessary were unable to obtain the medical treatment they needed and saw their health worsen, a result at odds with the purpose of the AHCCCS program," says Bebe Anderson, the Center for Reproductive Rights attorney who argued the Arizona case.
But even in cases where state law requires Medicaid coverage of medically necessary abortions, there is still the remaining problem of "the check is in the mail." Providers from certain states reported in a Center for Reproductive Rights survey that they no longer seek Medicaid reimbursement for abortions, even in cases of rape, incest or life endangerment, because they know from experience that state checks will never arrive. It is difficult to ascertain exactly why states required to make Medicaid reimbursements for abortions fail to do so. One possible explanation is bureaucratic inefficiency; another is a misguided anti-choice sentiment manifesting itself in government practices.
President Carter was right, there will always be some things that the rich can afford and the poor must forgo. It remains for the courts to decide if adequate reproductive healthcare and family planning options will be among them.
- Jill Molloy
Medicaid is a joint federal-state program designed to provide medical care to the poor. After states have paid for medical services under their plans, the federal government reimburses them for a portion of those costs. The federal government generally provides reimbursement for all medical services that are provided to eligible individuals and are medically necessary.
Under the current version of the Hyde Amendment, federal funds may only be used to pay for abortions if the pregnancy is the result of rape or incest or if the procedure is necessary to save a woman's life and her life is endangered by a physical disorder, physical injury, or physical illness. The Hyde Amendment establishes a federal floor regarding the provision of abortion services - any state enrolled in the Medicaid program at a minimum must cover those abortions for which federal funds are available. States can go beyond the Hyde Amendment and fund abortions that are not federally reimbursable.
Pioneer of Women's Rights Movement Joins Center for Reproductive Rights
In 1978 Rosemary Dempsey was thrust into the glare of the national media. Divorced from her husband for almost five years and living in a lesbian relationship that included her and her partner's combined five children, Dempsey woke up one day to a custody suit. Her ex-husband and her partner's ex-husband were both trying to wrest custody of the children on the grounds that, because Dempsey and her partner were lesbians, they were unfit mothers.
But in a precedent-making decision, a New Jersey judge allowed Dempsey to maintain custody. "As far as I know, it was the first time that any judge legally recognized two women in a loving relationship living together as a family with their children," says Dempsey proudly. "The judge went on to state in his opinion that there was not a ‘scintilla of evidence' to demonstrate that the best interests of the children were not being served by remaining in this ‘alternative and loving family.'"
Inclusion is important to Dempsey. As the former Vice President for Action of the National Organization for Women (NOW), she watched in the early 1990's as the Center for Reproductive Rights held firm in its determination that the Freedom of Choice Act include young and low-income women, despite other organizations' willingness to compromise on these groups of women to ensure the bill's passage. "That made a strong impression on me," says Dempsey. "The Center for Reproductive Rights was unwilling to leave anyone behind."
Today it is the Center for Reproductive Rights that is proudly announcing the inclusion of Dempsey within its ranks. As the new director of the Washington D.C. office, Dempsey will lead the Center for Reproductive Rights' federal and state political and policy efforts to promote the reproductive rights of women within U.S. borders and around the world.
To her credit, Dempsey is already a familiar figure within the feminist movement, largely due to her involvement with NOW, which goes back thirty years. Dempsey was on board during that watershed moment when NOW played a leading role spearheading the movement for the Equal Rights Amendment. While the amendment ultimately failed to be ratified, the ERA movement proved to be a major catalyst for inspiring women everywhere to advance toward their fuller potentials. "Hundreds of thousands of people came to work on the equal rights amendment movement," she recalls.
Early on, Dempsey served as the NOW New Jersey President and has also held the positions of N.J. State Legislative Coordinator, National Board Member, Chair of the National Lesbian Rights Committee and Regional Director of the eastern states. Her last position at NOW was Vice President for Action of the national organization, which she held from 1990 to 1997. And while we have yet to see a Constitutional amendment recognizing the equality of women, Dempsey insists that "until you get into that Constitution, you're at risk. Even today, members of Congress still don't understand where reproductive rights stand under the Constitution."
As is the case with many other activists, Dempsey's political roots were spawned in the sixties during the Vietnam anti-war movement. In 1967, while working on her B.S. in Sociology at the College of New Rochelle in New York, Dempsey initiated the school's first chapter of the leftist organization Students for a Democratic Society. Around the same time she helped organize the first campus strike at that college after administrators fired a popular philosophy teacher. "I was very lucky to be young and alive at that time," says Dempsey, "when so much was going on and we believed that we could change the world, that everything was on the table."
However, what she soon discovered was that everything actually wasn't up for grabs, at least insofar as women were concerned. She watched as enactment of the Civil Rights Act of 1964 bypassed women. "Only one woman from my 1967 class went right on to medical school after college. None went to law school."
Violence against women was also largely invisible in society's eyes. "No one talked about wife abuse 30 years ago," says Dempsey, who witnessed the women's movement pull that issue out of the closet around the same time that she helped found "Womanspace," a battered women's shelter in New Jersey.
In 1978, Dempsey did surmount the discrimination surrounding her youth to get a law degree from Rutgers Law School. She is a founding partner of the feminist law firm McGahen, Dempsey and Young, and a former trustee of the women's rights section of the New Jersey Bar Association. Right now Dempsey is thinking a lot about how to maximize the Center for Reproductive Rights' legal and policy expertise both inside and outside the beltway. "I want to see the Center for Reproductive Rights name known everywhere, so that even people in small towns know where to call when they see or experience an injustice."
-Ann Farmer
Prescription Drug Plans Discriminate Against Women
June 7 marked the 35th anniversary of the landmark U.S. Supreme Court decision, Griswold vs. Connecticut, that legalized the use and distribution of contraceptives. While this decision paved the way for access to contraceptives, today's widespread denial of contraceptive insurance coverage sets up a roadblock to that access.
Although almost all traditional fee-for-service plans now offer general prescription drug coverage, fewer than half fully cover prescription pregnancy prevention. The leading reversible prescription methods - IUD, diaphragm, hormonal implants like Norplant or injectables such as Depo Provera - receive no coverage from such insurers, and only about a third of such plans fund oral contraceptives, according to a study by the Alan Guttmacher Institute. Even though HMOs tend to provide better contraceptive coverage, only 39% of such plans cover all the major reversible methods.
Some policies exclude coverage even if a contraceptive is prescribed for a medical condition other than birth control. Such policies also deny coverage for the so-called morning after pill, when emergency contraception is used to prevent pregnancy up to 72 hours after unprotected sex.
This failure of coverage is irrational and inconsistent. If you have high blood pressure or depression, you can seek treatment, take medication and be covered. If you are infertile, you can be prescribed multiple and expensive drugs and insurers often don't balk at reimbursing you. You can take Viagra and chances are your plan will cover it. But if you're a woman who needs contraception, chances are you're out of luck.
Why this glaring omission? At the heart of such lopsided coverage is the bottom line. While it clearly costs far more to provide pre-natal and delivery costs than the estimated annual $20 per employee to provide contraceptive coverage, there is more to the equation.
What insurers know, and women have proven, is that when denied coverage, women will choose to absorb the cost of contraception themselves rather than risk an unplanned pregnancy. No wonder women's out-of-pocket costs average 68% more than men's and amount to $300 per year for oral contraceptives. Women are giving insurance companies a free ride.
Ironically, women in poverty who rely on Medicaid have contraceptive coverage superior to many women with employer-sponsored prescription drug plans. Medicaid-eligible women receive full coverage for all five reversible contraceptive methods. In some cases, Medicaid recipients receive even further coverage for contraceptives than they do for other prescriptive drugs and devices.
Twelve states currently mandate that insurance companies offer contraceptive coverage when providing prescriptive drug plans. These states have gotten it right. The time has come for the federal government to mandate that private insurers follow suit.
More than two decades ago, Congress took similar steps to erode employment discrimination on the basis of pregnancy. In 1978, the Pregnancy Discrimination Act established that women could not be discriminated against on the basis of "pregnancy, childbirth or related medical conditions." Today, there is a strong argument that employers who likewise refuse to provide contraceptive coverage are illegally discriminating against women on the basis of sex and "pregnancy related" conditions.
We have remained acquiescent for too long to this blatant form of discrimination by prescription. The best way to celebrate the anniversary of the legalization of contraceptives is to insist that insurance companies provide equal coverage for women.
- Julie F. Kay
Therapy by Hazing?
"Sidewalk counselor" seems to be the anti-choice nom du jour these days. In North Dakota, a self-styled "sidewalk counselor" is suing a clinic for what she calls false advertising. And in Florida, anti-choice "sidewalk counselors" are attempting to pervert the real intention of the Freedom of Access to Clinic Entrances Act (FACE), which was designed to protect abortion clinic clients and personnel from violence or the threat of it.
Protestors Attempt an "About FACE"
"It's amazing how ridiculously creative these people can be," says Florida attorney Charlene Carres, who is currently defending a number of Florida clinics and clinic workers against anti-choice advocates who are suing on grounds that their alleged right to conduct so-called sidewalk counseling outside reproductive health care clinics is protected by FACE.
The FACE statute specifically states that an action can only be brought "by a person involved in providing or seeking to provide…services in a facility that provides reproductive health services," but, Carres explains, anti-choice plaintiffs are attempting to skew the interpretation of a facility to include the sidewalk (even the entire county in one instance), and twist the definition of a reproductive service provider to include self-proclaimed anti-choice "sidewalk counselors."
One such case, brought by protestor and "sidewalk counselor" Meredith Raney against the Aware Woman Center for Choice, Inc. in Orlando (which was represented by attorney Susan England), came to a close on August 30, 2000. The decision by the U.S. Court of Appeals for the Eleventh Circuit, which reads as follows, may bring an end to these types of lawsuits:
"By requiring that the person bringing a FACE action be seeking or providing reproductive health services in a facility, Congress recognized the difference between trained professionals who work in credentialed facilities and unregulated volunteer counselors who are not attached to recognized providers of reproductive healthcare. On each of the three occasions when Raney was arrested for violating the Madsen injunction [that prohibits anti-abortion protestors from entering a specified 36 foot buffer zone], he was standing on a sidewalk outside of the Woman Center clinic. He therefore can claim neither that he was in a facility nor that he was offering the type of reproductive health services to which the FACE Act protects access."
Protestors Press Breast Cancer Ploy
Meanwhile, in North Dakota, Center for Reproductive Rights Staff Attorney Linda Rosenthal is facing off with another self-proclaimed "sidewalk counselor." In this case, anti-choice protestor Amy Jo Mattson has filed a lawsuit against the Red River Women's Clinic charging it with false advertising for publishing, in a brochure, three sentences that dispute the theory (expoused by anti-choice advocates) that a link exists between breast cancer and abortion. On August 25, Rosenthal successfully blocked an effort by the plaintiff's attorneys to obtain a temporary injunction to prevent the clinic from distributing its brochure. The three disputed sentences read:
"Some anti-abortion activists claim that having an abortion increases the risk of developing breast cancer. A substantial body of medical research indicates that there is no established link between abortion and breast cancer. In fact, the National Cancer Institute has stated, ‘[t]here is no evidence of a direct relationship between breast cancer and either induced or spontaneous abortion.'"
Epidemiologist Polly A. Newcomb, Ph.D., who has been conducting research since 1988 on the causes of breast cancer, responded (in an affidavit submitted to the North Dakota state court) to the plaintiffs' misuse of research indicating that women who have babies in their teens and early twenties gain a long-term protective effect against breast cancer. "Representing that there is a cause and effect relationship [between breast cancer and abortion] is frankly deceptive. It would be like saying that using condoms causes breast cancer because it prevents pregnancy."
"This breast cancer scare campaign is just the latest in a long line of tactics to intimidate the women of this state from exercising their right to choose," says Jane Bovard, the administrator of the Red River Women's Clinic.
As the first person to open a full service women's reproductive health care clinic in North Dakota, Bovard's pretty much seen it all.
For instance, she remembers when anti-abortion advocates took out a phone listing for a business named Women's Help. "Women seeking abortions would call the number and be tricked into believing that they were scheduling an appointment for a procedure. But when they arrived, they would instead be subjected to anti-choice propaganda."
Deceitful as that was, Bovard believes the phony cancer link is even more insidious. "It's a very public attempt to scare women. There have been billboards put up, sponsored by the Catholic Church, saying that abortion causes breast cancer. And similar ads placed in college newspapers."
But despite all the misleading publicity, Bovard says that women don't seem to be buying it. "Anyone I've talked to thinks it's absurd."
-Ann Farmer
Give Choice a Chance: New Report on Guatemala
What good are laws that purport to give a woman the right to family planning if the reality is she can't afford to buy contraceptives, she can't get access to them, her husband doesn't want her to use them, or she has never been taught how her menstrual cycle works anyway?
That's the reality for many women in Guatemala, where Center for Reproductive Rights Staff Attorney Bonnie Scott Jones spent several months in late 1998 researching the country's reproductive health care network. Her meetings with indigenous women, traditional birth attendants, NGOs and government officials revealed an appalling lack of support by the Guatemalan government for promoting and protecting its citizens' right to family planning information and services. Jones's research is reported in the new Center for Reproductive Rights publication, An Unfulfilled Human Right: Family Planning in Guatemala.
Many Guatemalan women say they want to limit the number of children they have and space out their births. Yet many rural, indigenous women routinely have to walk at least two hours to reach the nearest public health facility and, once they arrive, often no family planning services are offered.
As a result, many Guatemalan women turn to traditional birth attendants (TBAs) for help. One of Jones's earliest encounters with a TBA was during a visit to one of the rural areas, where the majority of the population lives, mostly in poverty. "She lived in a one-room, dirt floor structure," says Jones, "that contained a couple of hammocks. And she had a little bag tucked away that held a couple of condoms, a pack of birth control pills, and that was about it. And she was the only source for contraception in that town."
While many Guatemalan women could better control their fertility with just a clearer understanding of how their reproductive system functions, education is also largely out of reach, especially for girls.
The Center for Reproductive Rights' new, 100-page report surveys the country's reproductive laws and policies, and examines them in a historical context. "What this human rights analysis shows," says co-author and Center for Reproductive Rights International Program Deputy Director Kathy Hall Martinez, "is that despite Guatemala's Constitution, which recognizes the right to family planning, successive governments have refused to integrate family planning services into the public health system and to provide reproductive health information to women so they can make informed choices and avoid unwanted pregnancies."
Because of the recent, disastrous 36-year civil war in which 200,000 Guatemalans disappeared or were killed (the vast majority of whom were Mayan), many indigenous Guatemalans, according to Jones, view contraceptives suspiciously, seeing them as a further mechanism to undermine their race.
Even some TBAs, she says, don't want to give contraceptives to women who haven't had at least two children. "They are concerned about maintaining their ethnic ranks," says Jones. "But this attitude can and does undermine the choices of individual women."
The Catholic Church also holds immense sway in this patriarchal society. When the Guatemalan government gave its 1994 report to the U.N. Committee on the Elimination of Discrimination Against Women, its representative recited the Church's usual opposition to family planning -- saying that it leads to the breakdown of society and the family.
While there are some positive indicators that the new government, elected in December 1999, is more willing to change its policies, it's still too early to tell. Meanwhile, maternal mortality rates are high. Unwanted pregnancy rates are high. Extreme poverty rates are high. And family planning access remains out of reach for most.
See here for information on ordering the Guatemala Report.
Traditional birth attendants in Guatemala
- Ann Farmer
Louisiana "Choose Life" License Plates Blocked
Current Status: A federal judge issued a preliminary injunction on August 29, 2000, which blocks the production and distribution of Louisiana's special "prestige" license plates bearing the motto "Choose Life." Judge Stanwood Richardson Duval, Jr., agreed with the plaintiffs' contention that the Louisiana statute authorizing the license plates violates the First Amendment because the State has failed in its obligation to provide a "viewpoint-neutral" forum for speech on abortion.
"The right to an abortion is an extremely controversial issue and is the focus of a national debate," wrote Judge Duval in the decision to grant the injunction. "To provide through legislation for only one viewpoint to be expressed on such a polemical topic is very likely an unconstitutional restraint of free speech as it restricts the forum to only one view." No trial date has been set.
Background: The Center for Reproductive Rights filed a lawsuit in federal court on July 31, 2000, seeking to declare unconstitutional a Louisiana statute that authorizes the Department of Public Safety and Corrections to issue the "Choose Life" plates.
Enacted last year, Louisiana House Bill 2082 mandates that proceeds from the sale of the special license plates be deposited into a "Choose Life Fund," which would be made available to qualifying nonprofit organizations that provide counseling to expectant mothers. The law stipulates that no money shall be distributed to organizations that counsel women to consider abortion, provide referrals to abortion clinics, provide abortions or advertise for abortion services.
The statute also requires the establishment of a "Choose Life Advisory Council" to design the license plates and decide which non-profit organizations will receive funds generated from sale of the plates. The Council must be comprised of a representative from each of the following anti-choice organizations: The American Family Association; the Louisiana Family Forum; and Concerned Women for America.
The Act requires that state taxpayer dollars be used to make and distribute the license plates; establish and maintain the Council; and establish and maintain the Fund.
Plaintiffs in Henderson v. Stalder (No. 00-2237) include Russell Henderson, Doreen Keeler (a car owner who would like a pro-choice license plate), Rabbi Robert H. Loewy and the Greater New Orleans Section of the National Council for Jewish Women. Simon Heller and Brigitte Amiri of the Center for Reproductive Rights represent the plaintiffs along with William Rittenberg, an attorney with the firm of Rittenberg and Samuel in New Orleans.
- Suzanne Grossman
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