"We are in a funding emergency today," read the e-mail from the New York
Abortion Access Fund.
Thirty years later, abortion's political terrain is more complicated than ever.
Bush's handpicked delegates disrupt global conferences on women's
In Hicksville, Long Island, on any given Sunday afternoon, pierced and
tattooed teenagers in black clothing gather to listen and watch as
groups of kids like themselves tear their fingertips on
The night after the Bush Administration announced its refusal to grant the United Nations Population Fund $34 million dollars, Jane Roberts was so outraged she couldn't sleep.
In some parts of China, local officials keep track of women's menstrual periods. We haven't come to that, but anyone who thinks women's reproductive and sexual privacy is secure in America wasn't following the news this summer.
The one thing that activists on every side of the abortion debate agree
on is that we should reduce the number of unwanted pregnancies.
America's rate of unwanted pregnancy is a huge public health scandal,
but five years after being approved by the FDA, emergency
contraception--the use of normal birth control pills to block pregnancy
within seventy-two hours of unprotected sex--has yet to fulfill its
potential. Part of the problem has to do with the difficulty of getting
EC in time; many doctors don't want the hassle of dealing with walk-in
patients, many clinics are closed on weekends and holidays (times of
peak demand) and some pharmacies, like Wal-Mart's, refuse to stock it.
That anti-choicers falsely liken EC to abortion and tar it as a
dangerous drug doesn't help.
The main barrier to EC use, though, is that most women don't know what
it is. To spread the word, Jennifer Baumgardner and I have written an
open letter explaining how EC works, how to get it and why women should
even consider acquiring it in advance. If every Nation
reader with access to the Internet forwards it to ten people and one
list, and those people do the same and on and on, it could reach
thousands, even millions of women. Like ads for Viagra, only not spam.
Activism doesn't get much easier than this!
An Open Letter About EC
The one thing that activists on every side of the abortion debate agree
on is that we should reduce the number of unwanted pregnancies. There
are 3 million unintended pregnancies each year in the United States;
around 1.4 million of them end in abortion. Yet the best tool for
reducing unwanted pregnancies has only been used by 2 percent of all
adult women in the United States, and only 11 percent of us know enough
about it to be able to use it. No, we aren't talking about
abstinence--we mean something that works!
The tool is EC, which stands for Emergency Contraception (and is also
known as the Morning After Pill). For more than twenty-five years,
doctors have dispensed EC "off label" in the form of a handful of daily
birth control pills. Meanwhile, many women have taken matters into their
own hands by popping a handful themselves after one of those nights--you
know, when the condom broke or the diaphragm slipped or for whatever
reason you had unprotected sex.
Preven (on the market since 1998) and Plan B (approved in 1999), the
dedicated forms of EC, operate essentially as a higher-dose version of
the Pill. The first dose is taken within seventy-two hours after
unprotected sex, and a second pill is taken twelve hours later. EC is at
least 75 percent effective in preventing an unwanted pregnancy after sex
by interrupting ovulation, fertilization and implantation of the egg.
If you are sexually active, or even if you're not right now, you should
keep a dose of EC on hand. It's less anxiety-producing than waiting
around to see if you miss your period; much easier, cheaper and more
pleasant than having to arrange for a surgical abortion. To find an EC
provider in your area, see www.backupyourbirthcontrol.org,
www.not-2-late.com or ec.princeton.edu/providers/index.html.
Pass this on to anyone you think may not know about backing up their
birth control (or do your own thing and let us know about it). Let's
make sure we have access to our own hard-won sexual and reproductive
The Things You Need to Know About EC
EC is easy. A woman takes a dose of EC within seventy-two hours of
unprotected sex, followed by a second dose twelve hours later.
EC is legal.
EC is safe. It is FDA-approved and supported by the American College
of Obstetricians and Gynecologists.
EC is not an abortion. Anti-choicers who call EC "the abortion
pill" or "chemical abortion" also believe contraceptive pills,
injections and IUDs are abortions. According to the FDA, EC pills "are
not effective if the woman is pregnant; they act primarily by delaying
or inhibiting ovulation, and/or by altering tubal transport of sperm
and/or ova (thereby inhibiting fertilization), and/or altering the
endometrium (thereby inhibiting implantation)."
EC has a long shelf life. You can keep your EC on hand for at least two
EC is for women who use birth control. You should back up your
birth control by keeping a dose of EC in your medicine cabinet or purse.
What You Can Do to Help
Forward this e-mail to everyone you know. Post it on lists, especially
those with lots of women and girls. Print out this information,
photocopy it to make instant leaflets and pass them around in your
community. Call your healthcare provider, clinic, or university health
service and ask if they provide EC. Spread the word if they do. Lobby
them (via petitions, meetings with the administrators, etc.) to offer EC
if they don't.
Make sure that your ER has EC on hand for rape victims and offers it to
them as a matter of policy. Many hospitals, including most Catholic
hospitals, do not dispense EC even to rape victims.
Get in touch with local organizations--Planned Parenthood, NOW, NARAL,
campus groups--and work with them to pressure hospitals to amend their
If you can't find a group, start your own. Submit an Op-Ed to your local
paper or send letters to the editor about EC.
Make sure your pharmacy fills EC prescriptions. Some states have
"conscience clauses" that exempt pharmacists from dispensing drugs that
have to do with women's reproductive freedom.
The Nation reported on Dr. Pendergraft's troubles in
"Abortion on Trial" by Hillary Frey and Miranda Kennedy, June 18, 2001.
Let's say I'm a Jehovah's Witness, and I get a job in an understaffed
emergency room where, following the dictates of my conscience, I refuse
to assist with blood transfusions and try my best to persuade my fellow
workers to do the same. How long do you think I'd last on the job? And
after my inevitable firing, how seriously do you think a jury would take
my claim that my rights had been violated? Five minutes and not very,
right? A similar fate would surely await the surgeon who converts to
Christian Science and decides to pray over his patients instead of
operating on them, the Muslim loan officer who refuses to charge
interest, the Southern Baptist psychotherapist who tells his Jewish
patients they're bound for hell. The law rightly requires employers to
respect employees' sincerely held religious beliefs, but not if those
beliefs really do prevent an employee from performing the job for which
she's been hired.
Change the subject to reproductive rights, though, and the picture gets
decidedly strange. In 1999 Michelle Diaz, a born-again Christian nurse
who had recently been hired by the Riverside Neighborhood Health Center,
a public clinic in Southern California, decided that emergency
contraception, the so-called morning after pill that acts to prevent
pregnancy if taken within seventy-two hours of unprotected intercourse,
was actually a method of abortion. She refused to dispense it or give
referrals to other providers; the clinic offered her a position that did
not involve reproductive healthcare, but when she told temporary nurses
at the clinic that they too would be performing abortions by dispensing
EC, Diaz, who was still on probation as a new hire, lost her job. She
sued with the help of the American Center for Law and Justice (ACLJ),
the religious-right law firm headed by Jay Sekulow. At the end of May a
jury agreed that her rights had been violated and awarded her $47,000.
Excuse me? A nurse at a public health clinic has the right to refuse to
provide patients with legally mandated services, give out misleading
health information in order to proselytize her co-workers to refuse as
well, and keep her job? The low-income women who come to Riverside
desperately in need of EC and abortion referrals are flat out of luck if
they happen to turn up when the anti-choicers are on shift? Riverside is
the largest public health clinic in the county, serving 150-200 patients
a day, but it operates with a staff of four nurses--should those four
people decide what services the clinic can offer? What about the
patient's right to receive standard medical care? Or the clinic's
responsibility to deliver the services for which they receive government
Some states, California among them, have "conscience laws," permitting
anti-choice healthworkers to refuse to be involved in abortions. EC,
however, is just a high dose of regular birth control pills that
prevents ovulation and implantation. It is not abortion, because until a
fertilized egg implants in the womb, the woman is not pregnant. A long
list of medical authorities--the American Medical Association, the
American Medical Women's Association, the American College of
Obstetricians and Gynecologists and Harvard Medical School--agree that
EC is not an abortifacient, and a 1989 California court decision itself
distinguishes abortion from EC. There are lots of mysteries about the
Diaz case, ranging from why Diaz took a job she knew involved practices
she found immoral in the first place, to how the jury could possibly
have come up with a decision so contrary to law and public policy. Did
Diaz take the job with the express intention of disrupting services? Was
the jury anti-choice? Interestingly, the jury pool was partly drawn from
San Bernardino County, which last year unsuccessfully tried to bar its
public health clinics from dispensing EC.
Whatever the jury's thinking, the Diaz case represents the latest of
numerous attempts by the anti-choice movement to equate EC with abortion
and move it out of normal medical practice. Pharmacists for Life
International, a worldwide organization that claims to have some 1,500
members, calls it "chemical abortion" and urges pharmacists to refuse to
dispense it. The ACLJ is currently litigating on behalf of one who did.
Wal-Mart refuses to stock it at all. Anti-choicers in Britain made an
unsuccessful attempt to prevent EC from being dispensed over the counter
by placing it under an archaic law that prohibits "procuring a
miscarriage." Some anti-choicers have long argued that not just EC but
conventional birth-control methods--the pill, Norplant, Depo-Provera and
the IUD--are "abortifacients": In northern Kentucky anti-choice
extremists are campaigning to force one local health board to reject
Title X family-planning funds; according to the Lexington
Herald-Leader, the board's vote, scheduled for June 19, is too
close to call.
Although secular employers are expected to make reasonable
accommodations to religious employees--or even, if the Diaz verdict is
upheld, unreasonable ones--religious employers are not required to
return the favor. On the contrary, the Supreme Court, in The Church
of Jesus Christ of Latter Day Saints v. Amos, permits them to use
religious tests to hire and fire personnel as far from the sacred
mission as janitorial workers; if a Methodist church wants to refuse to
hire a Muslim security guard, it has the blessing of the Constitution to
do so. As often noted in this column, religious organizations can and do
fire employees who violate religious precepts on and even off the job. A
pro-choice nurse could not get a job at a Catholic hospital and declare
that her conscience required her to go against policy and hand out EC to
rape victims, or even tell them where to obtain it--even though medical
ethics oblige those who refuse to provide standard services for moral
reasons to give referrals, and even though Catholic hospitals typically
get about half of their revenue from the government.
According to the ACLJ, however, secular institutions should be sitting
ducks for any fanatic who can get hired even provisionally. The
Riverside clinic has asked the judge to set aside the Diaz verdict. If
that bid is unsuccessful, it will appeal. I'll let you know what