Department of Defense Judged "Cruel" for Refusing Abortion Coverage

On May 29, U.S. District Judge Nancy Gertner ruled that the U.S. Department of Defense violated the constitutional rights of Maureen Britell when it denied her medical coverage for an abortion. Britell's fetus was diagnosed as anencephalic, or lacking a forebrain or cranium. Such a fetus has no chance of survival outside the womb.

"Through [its] funding power, the government seeks to encourage Britell and women similarly situated to suffer by carrying their anencephalic fetuses ... to a certain death," Gertner wrote in her decision. "This rationale is no rationale at all. It is irrational, and worse yet, it is cruel."

The decision is the first of its kind to challenge abortion coverage under military health insurance. Activists hope it won't be the last.

"This decision recognizes the crucial role abortion plays in women's health," said Brigitte Amiri, lead counsel in the case and a staff attorney at the Center for Reproductive Rights.

She added, "This case opens the door to more challenges of restrictions on federal funding for abortion."
Maureen Britell

The decision requires the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to pay Britell $4,000 for expenses associated with her 1994 abortion at the New England Medical Center. Britell was 20 weeks pregnant when her fetus was diagnosed with a lethal abnormality. At the time, she had health insurance through her husband, an officer in the Air National Guard.

Britell filed a federal lawsuit against CHAMPUS in 1999 after repeated attempts to get reimbursed for her abortion. Britell is currently the Executive Director of Voters for Choice.

Federal Court Finds Oklahoma's Adolescent Abortion Law Unconstitutional

On June 14, U.S. District Court Judge Claire V. Eagan struck down an Oklahoma law requiring an adolescent to secure the consent of one or both of her parents before having an abortion. The case was brought before the court by the Center for Reproductive Rights.

The court found the law unconstitutional because it failed to comply with the Supreme Court's requirement that parental consent laws include an exception for a medical emergency as well as some means for adolescents to obtain abortions without the involvement of their parents. The court also said the law was vague because it did not provide doctors with any specific guidelines regarding compliance.

"The court's decision prioritizes the health of young women," said Bebe Anderson, lead counsel in the case and a staff attorney for the Center for Reproductive Rights. "By ignoring young women who face physical or emotional abuse by a parent or those suffering from a medical emergency, the state violated the constitutional rights of its young citizens."

The Oklahoma law mandated that abortion providers be held financially liable for any post-abortion medical treatment if the procedure was performed on a minor without "parental consent or knowledge." The law did not limit the amount of damages for which a physician could be liable or the time in which he or she could be sued. The law also exposed doctors performing abortions to financial liability regardless of whether or not the doctor followed medical codes of conduct. Governor Frank Keating signed the law in June 2001.

Currently, 32 states enforce laws requiring a minor to obtain the consent of a parent or notify one or both parents prior to an abortion. The Center for Reproductive Rights is currently challenging parental involvement laws in Florida and Alaska.

Studies have shown that the majority of young women choose to involve their parents in decisions regarding abortion. According to Nova Health Systems, the Center for Reproductive Rights' client in the case, 90% of minors seeking abortion at its clinic came with a parent prior to the passage of the challenged law.

Special Report

Crisis Pregnancy Centers Seek Public Funds and Legitimacy

When Nneka Washington learned that she was pregnant, she dropped into Milwaukee’s Pregnancy Help Center to find out what her options were. But rather than help her deal with an unplanned pregnancy, Washington was told that she had the devil inside her. She was then bombarded with graphic images of disfigured babies and aborted fetuses.

In May, Washington filed a lawsuit against the Pregnancy Help Center for emotional and physical injuries. She alleges that a staff member from the clinic scratched her, pulled her hair and forcefully held her down.

This story is one of many emerging from so-called "crisis pregnancy centers" (CPCs), a growing network of anti-abortion facilities throughout the U.S. whose sole purpose is to prevent pregnant women from obtaining abortions. CPCs have been in existence since the Supreme Court made abortion legal with its 1973 Roe v. Wade decision. But the clinics are now seeking to enhance their credibility and effectiveness by attracting funds from a wide range of federal and state programs such as abstinence-only initiatives, "Choose Life" license plates and discretionary state funds. Some states are even re-appropriating funds to directly support these centers.

"The fact that federal, state and local governments are subsidizing the anti-abortion agenda of crisis pregnancy centers sets a terrible precedent for women," said Priscilla Smith, acting director of the Center for Reproductive Rights' domestic program. "The government needs to get out of the business of sponsoring groups that mislead and lie to women about their reproductive choices."

Ideology not Medicine

Although a few CPCs provide women with unbiased information about abortion, most serve the sole purpose of promoting an anti-abortion agenda.

In many states, the centers outnumber legitimate abortion providers by ten to one. Anti-abortion groups boast that CPCs in the U.S. now exceed 4,000.

The success of CPCs in luring women to their facilities is due, in part, to their stealth tactics. In telephone books and ads, they promote themselves as women’s health clinics that offer the full range of reproductive health services from pregnancy testing to information on abortion.

They use deceptive names such as "Women’s Resource Center," "First Resort," "Abortion Alternatives" or "Emergency Pregnancy Services." Sometimes, they can even be found on the same street or floor as an abortion clinic.

"I suppose there was some sense that women were to some degree misled into believing this was an abortion clinic," said Reverend David Trosch, an anti-abortion activist, in a 1995 article in Mademoiselle. "We’re concerned with innocent human life in the womb. The rationale is to get [women] in there so we can convince them not to have an abortion."

But what pregnant women can expect when they enter these centers is far from unbiased counseling. CPC counselors regularly claim that abortion increases a woman’s risk of breast cancer –- a claim that neither the National Cancer Institute or the American Cancer Society have concluded exists. CPCs also try to scare women by referring to a "post-abortion syndrome," another claim with no medical basis that the centers often rely on to dissuade women from choosing abortion.

Other centers have told women that an abortion leads to sterility and permanent psychological damage. Some CPCs have even been charged with misrepresenting the results of pregnancy tests in an effort to prevent women from obtaining an abortion.

In recent years, CPCs have begun purchasing ultrasound equipment to pressure women into carrying their pregnancy to term. Anti-abortion members of Congress have also supported the efforts of CPCs to acquire ultrasound equipment. In February 2002, Representative Cliff Stearns (R-FL) and Senator Jim Bunning (R-KY) introduced bills authorizing the U.S. Department of Health and Human Services (HHS) to provide $3 million in grants to nonprofit organizations, such as CPCs, seeking to purchase ultrasound equipment (S.1984, H.R. 3686).

In 1993, Ohio Attorney General Lee Fisher was the first to charge CPCs with false advertising when he identified five centers that called themselves medical clinics though they provided no medical services and were not staffed by medical personnel. In January 2002, New York Attorney General Elliot Spitzer followed suit and subpoenaed documents from nine CPCs under investigation for false advertising. So far, only one of the centers has agreed to disclose that it does not provide contraceptives, abortion services or referrals.

Meanwhile, some 200 CPCs have transformed themselves into full-blown medical clinics, according to the National Institute of Family and Life Advocates, an anti-abortion group that helps CPCs become medical clinics.

"Choose Life" License Plate Funds

Beyond their deceptive tactics, CPCs are inching towards legitimacy by increasing their share of federal and state funds. One of the most successful fundraising platforms for CPCs is the "Choose Life" license plate program adopted in several states. Motorists purchase the license plates and proceeds are funneled into CPCs across the state. The "Choose Life" scheme prohibits funds raised by the program from being distributed to groups that provide or counsel for abortion services.

Anti-abortion advocates have established "Choose Life" schemes in six states: Alabama, Florida, Louisiana, Mississippi, Oklahoma and South Carolina. Alabama is planning to print the plates once 1,000 motorists have signed up. At least 13 other states are considering legislation to create similar programs.

The Center for Reproductive Rights has challenged the constitutionality of laws governing "Choose Life" programs in Florida and Louisiana. Florida is the only state that has begun to distribute these funds. So far, the state has raised $1 million for CPCs through the "Choose Life" program. A number of counties in Florida have designated CPCs or Catholic Charities to oversee distribution of the funds.

Many of the CPCs in the area continue to deceive women. For example, the Brandon Crisis Pregnancy Center in Florida, which has received "Choose Life" funds, says that it offers "information on abortion, alternatives to abortion." And Pregnancy Resources, Inc., the lead agency for distributing "Choose Life" funds in Florida’s Brevard County, claims to provide "Information on Abortion, Adoption, and Alternatives." Neither center, however, provides information on how to obtain abortion services.

The Abstinence-only Money Pit and Direct State Funding

Last July, HHS dispersed $17.1 million in grants for community-based abstinence-only education. These grants support programs that, among other restrictions, ban any discussion of contraceptives.

Among the 49 organizations and local health departments that received these grants, at least five were listed as CPCs on anti-abortion websites. In sum, CPCs received more than $1.8 million of the total amount distributed by HHS. The grants will be used to support abstinence-only education programs over a three-year period.

CPCs have also become eligible for money through the Special Projects of Regional and National Significance (SPRANS), a federal program that funds abstinence-only education programs, and other specialized federal programs. In 2001, CPCs received $3 million of the $20 million in SPRANS funds for abstinence-only education programs, according to the National Abortion and Reproductive Rights Action League (NARAL).

Federal support for abstinence-only education may increase in 2003 if the Bush administration has its way. The administration wants to increase federal spending for local abstinence-only education grants from their 2002 level of $40 million to $73 million in 2003.

Beyond the well-oiled coffers of state and federal anti-choice programs, states are also pouring funds directly into CPCs. Pennsylvania takes half of every dollar designated for women’s health services—roughly $4 million annually—and distributes it to CPCs, according to the Pennsylvania chapter of NARAL. Missouri and Delaware also support CPCs. The Alan Guttmacher Institute estimates that in 2000, Missouri allocated $1 million in state funds to CPCs, including money received from settlements with tobacco companies.

In June, the Louisiana state legislature passed an amendment to the state’s budget to move $1.5 million away from education programs for incarcerated parents to the state’s Department of Social Services for the purpose of supporting "abortion alternative services administered by pregnancy crisis centers."

Pro-choice Movement Answers Back

The pro-choice movement has been able to expose CPCs for misleading women about reproductive choice and the services they provide.

In 1994, a California trial court prohibited San Diego Pregnancy Services from presenting itself as a medical facility that provides pregnancy testing services or abortion counseling. The Center was prohibited from listing itself in phone directories under "abortion service providers" or "family planning information."

That decision also required the center to tell women that it does not perform abortions, provide abortion referrals, distribute birth control, or provide written pregnancy verifications. The center is now obligated to state that its volunteers counsel from a Biblical, "anti-abortion perspective."

In 1987, an injunction was issued against three CPCs in New York to prohibit them from advertising in the phone directory as "Clinics," "Medical Services," or "Abortion Services." The injunction also required the CPCs to "state in advertisements that they are abortion alternative organizations that provide only natural family planning methods."

In 1999, the California chapter of NARAL exposed First Resort, a CPC, which deceived medical providers at HMO Kaiser Permanente into referring women to them who were seeking abortion counseling.

In addition to legal challenges, many pro-choice activists are also working to ensure that any CPCs receiving state or federal funds be required to provide women with accurate information about abortion.

Worldwide

Switzerland Liberalizes Abortion Laws

In June, Swiss voters passed a referendum that recognizes a woman's right to choose abortion during the first 12 weeks of pregnancy.

Swiss women can now undergo the procedure by filing a written request stating that they will face "distress" if they carry their pregnancy to term. Under the new law a woman is suppose to receive counselling from her doctor and be informed that she can meet with counselling services but no longer needs a second opinion from an authorized physician. Girls under the age of 16 must visit a counselling center to have a legal abortion.

A woman seeking a second or third trimester abortion must produce a doctor's note stating that her "physical integrity" is at stake or that she will face "profound distress" if she does not undergo the procedure. A woman who violates the law can face a jail term of three years, while a doctor could receive a five-year sentence.

Though Switzerland has had a restrictive abortion law since 1942, enforcement has been lax for the past forty years. None of the country's physicians have been convicted of an abortion-related crime since 1980. The number of prosecutions dropped to just a few in 1971 when a public debate emerged about decriminalizing abortion. Hundreds of women and doctors were prosecuted in the 1960s. The Swiss government estimates that a total of 13,000 abortions are now performed every year.

Christina Zampas, legal advisor for Europe at the Center for Reproductive Rights, says the new Swiss law follows a liberalizing trend in Europe.

In July, France extended the period during which a woman could obtain an abortion, on any grounds, from ten to twelve weeks from the date of conception.

Many other European countries, however, have a long way to go. Abortion is banned in Portugal and Spain, except in cases of rape, incest, fetal impairment, or danger to a woman's health (including mental health) or life. In Ireland, abortion is illegal except to save a woman's life.

"Ireland, Portugal, and Spain must follow Switzerland's example and liberalize their abortion laws," says Zampas.

The Swiss government has not yet decided when the new law will go into effect.

Argentina, Mexico and Peru Fall Short on CEDAW Obligations

In June, lawyers visiting the Center for Reproductive Rights from Argentina, Mexico and Peru spoke about their country's non-compliance with the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). The briefing was held for members of the Committee appointed to ensure the full implementation of CEDAW by state parties that have ratified the document. The governments of Argentina, Mexico and Peru will formally report to the CEDAW Committee in August.

CEDAW is the only international treaty that focuses exclusively on protecting women against discrimination. One hundred and sixty-nine countries have ratified the Convention, including all industrialized countries except the U.S., which held briefings on the treaty in June.

The Center for Reproductive Rights has submitted shadow letters to the CEDAW Committee documenting the failure of Argentina, Mexico and Peru to decriminalize abortion or even make the procedure safe and available to women in the limited circumstances in which it is legal. Large numbers of women throughout Latin America are hospitalized or die from complications resulting from unsafe abortion. In Mexico, government statistics estimate that unsafe abortion is the fourth leading cause of maternal mortality while other sources suggest that it may rank second or third. In Argentina and Peru, 31% and 22% of maternal deaths, respectively, result from complications relating to unsafe abortion.

"Argentina's lack of any kind of national reproductive health and sexual education policies, combined with the criminalization of abortion, has undermined women's reproductive health," said Carolina Fairstein, Center for Reproductive Rights legal intern from Argentina. She added, "Too many Argentine women are dying because they have been forced to seek clandestine and unsafe abortion."

In 1998, the CEDAW Committee reported that Peru's anti-abortion laws were not only failing to reduce the number of abortions performed in the country, but also making the procedure more dangerous for women.

In Mexico, women who are legally entitled to an abortion in cases of rape or life endangerment are being denied the procedure. The Center for Reproductive Rights is currently arguing a case before the Inter-American Commission on Human Rights on behalf of Paulina Ramirez, a 13-year-old rape victim who was denied not only an abortion but also emergency contraception (EC) which could have prevented her pregnancy.

"The Mexican government should take steps to distribute and educate women about emergency contraception," said Regina Tames, Center for Reproductive Rights visiting legal fellow from Mexico. "At a minimum, the government should require that health and law enforcement officials inform and offer EC to sexual assault victims."

Access to contraception for women in all three countries is minimal. A Mexican plan to provide contraceptives to low-income women excludes the country's vast rural sectors, many of whose residents cannot afford the subsidized contraceptives.

In Peru, the government is expanding healthcare benefits, but will not cover contraception. And though EC has been approved for use in public health care facilities, the Ministry of Health has not included the pills on its list of acceptable contraceptives.

Though Argentina has legalized EC, the country's Supreme Court has prohibited the sale of one brand of EC that happens to no longer be available in the country. Attorneys from the Center for Reproductive Rights say the Supreme Court ban could have a domino effect resulting in similarly successful challenges of all forms of EC, brand by brand.

The Center for Reproductive Rights has also raised concerns that recent political changes in Mexico and Peru, along with the enduring financial crisis in Argentina, may further diminish the importance of women's reproductive rights. This year, Peru began to consider dissolving the Ministry for the Promotion of Women and Human Development and the Women and Development program of the Ministry of Health. Either change is sure to signal a major setback for women.

"Peru took a big step forward for women's rights when it created the Ministry of Promotion of Women and Human Development," said Marcela Huaita, a Center for Reproductive Rights visiting legal fellow from Peru. "Dissolving this ministry would send a message that the Peruvian government is not concerned about protecting women's reproductive health and rights."

Support the Release of Women Imprisoned for Abortion Offenses in Nepal

On March 14, the Nepali parliament reversed a longstanding and draconian criminal ban on abortion that has yet to be signed into law by the King. The expected passage of the law, however, does not free women currently serving prison sentences for abortion and related offences. Many Nepalese who have had abortions have been falsely accused of infanticide, which remains a crime. The Center for Reproductive Rights has organized a petition to persuade the country's Prime Minister to immediately release women imprisoned for undergoing an abortion.

Sign the petition

BushWhacked!

European Parliamentarians Denounce Global Gag Rule before Congress

In June, European parliamentarians from the Netherlands, Denmark, Russia and the U.K. held a congressional briefing on the dangers posed by the Bush administration's reinstatement of the "global gag rule" (GGR). The group spoke at a panel sponsored by the Center for Reproductive Rights, the International Planned Parenthood Federation-European Network and the Planned Parenthood Federation of America.

The parliamentarians called the GGR an affront to family planning policies in their countries and said it jeopardized their attempt to curb unwanted pregnancies and improve women's access to reproductive health care and information around the world.

"[The global gag rule] severely curtails the effectiveness of already limited overseas development in the area of family planning and reproductive health," said Ans Zwerver, a senator from the Netherlands. "By denying women access to information, contraception and ways to prevent STIs and HIV/AIDS, [the GGR] is contributing to the declining health of women in the developing world."

The GGR, reinstated by President Bush on his second day in office, limits foreign non-governmental organizations (NGOs) from using their own funds for abortion services, lobbying, referrals and reform. European parliamentarians say the policy is undermining their foreign assistance programs by preventing them from working with foreign NGOs that receive U.S. funding.

In the case of the Netherlands, the Dutch government can no longer work with U.S.-funded NGOs to provide contraception and safe abortion services, which are cornerstones of their foreign assistance strategy for reproductive health.

Panel members said the GGR is also limiting the ability of European governments to decrease the number of women dying from complications related to unsafe abortion, pregnancy and childbirth. Every year, some 80,000 women die as a result of unsafe abortion and more than 500,000 women die during pregnancy and childbirth.

"I would ask you to change your threatened directions," said Tony Worthington, a member of the British House of Commons who predicted that pregnancy-related deaths are sure to increase under the GGR.

Other parliamentarians, such as Mikhail Rafaelovitch Rokitzsky from Russia, said the GGR was a basic denial of free speech -- something the U.S. government has long championed. "Restrictions on speech is what my country faced under the Communist regime," said Rokitzsky. "We've spent the past decade struggling to overcome this in our country. The [GGR] undermines that struggle and it calls into question the U.S. government's credibility as an advocate of democracy around the globe."

"It is time for President Bush to listen to his allies and repeal the GGR," said Christina Zampas, Center for Reproductive Rights legal advisor for Europe.

On the Hill

House Reintroduces Flagrantly Unconstitutional Abortion Ban

On June 19, Representative Steve Chabot (R-OH) re-introduced a bill that allegedly bans so-called "partial-birth abortions" despite a Supreme Court ruling two years ago that judged a similar ban to be unconstitutional.

The House bill (HR4965) is almost identical to a Nebraska law banning "partial-birth abortion." Both the new bill and the Nebraska law seek to prohibit women from obtaining the safest and most common methods of abortion. The Nebraska law was found to be unconstitutional by the Supreme Court in a decision handed down in June 2000 in the case of Stenberg v. Carhart. The case was brought before the Court by the Center for Reproductive Rights.

"Partial-birth abortion" is a term concocted by anti-abortion extremists. Courts have determined that the term has no factual, medical, or legal meaning.

The new federal bill also fails to include an exception for women's health. In Carhart, the Supreme Court reaffirmed that any woman who chooses abortion should have the safest method available to her as determined by her physician.

In the Court's majority opinion in the Carhart case, Justice Stephen Breyer noted that a substantial body of medical evidence demonstrated the benefits of giving women and their doctors the freedom to choose the safest and most appropriate abortion method.

"It's as if the anti-choice leadership in the House is trying to wish away the U.S. Supreme Court's decision finding almost identical legislation unconstitutional," said Priscilla Smith, acting director of litigation for the Center for Reproductive Rights and co-counsel in the Carhart case.

The new bill calls for a maximum two-year prison term and unspecified fines for any doctor who performs a "partial-birth abortion."

"Partial-birth abortion" bans and similar laws have been passed by 31 states. Legal challenges to these laws have been brought in 21 states. In March, Virginia passed a "partial-birth abortion" ban that was later vetoed by the governor because it violated the Carhart decision.

"This resurrected bill is a desperate attempt to rehash issues settled by the Supreme Court two years ago," said Smith.

Senate Overturns Ban on Military Abortion Funding

On June 21, the U.S. Senate voted 52 to 40 to overturn a six-year-old ban preventing American military women stationed overseas from using their own funds to pay for an abortion at a U.S. military hospital. The ban was presented as an amendment to an appropriations bill for the Defense Department. Last month, however, the House voted 215 to 202 against overturning the ban for the seventh year in a row.

Abortion is not provided by U.S. military hospitals except in cases of rape, incest, or life endangerment. Those women who fall outside these narrow exceptions are forced to obtain an abortion in host countries where health facilities are often inadequate or English-speaking personnel are unavailable.

"This regulation, which is not imposed on American civilians, is a violation of the constitutional rights of our armed forces personnel," said Julia Ernst, legislative counsel for the Center for Reproductive Rights.

Senator Patty Murray (D-WA) has said that the abortion ban in the military deprives the 100,000 military women and their dependents of a basic right enjoyed by women at home.

The ban on abortions at military hospitals has been in place since 1979. In 1988, the Reagan administration extended the ban to cover abortions that women paid for with personal funds. President Clinton lifted the ban in 1993, but Congress overturned that decision in a 1996 Defense Department bill.

Correction

Emergency Contraception for Sexual Assault Victims

The June issue of Reproductive Freedom News incorrectly reported that New York has passed a law mandating the provision of emergency contraception to rape victims treated in hospital emergency rooms. In fact, the law has not been passed by the state legislature and is currently being deliberated in legislative committee.

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