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.
I was born into the House of Labor. My father was a Teamster who drove a truck for thirty-five years. He died with his first retirement check in his pocket, uncashed.
Everyone, from President Bush on down, seems to agree that major league baseball players are overpaid prima donnas who don't deserve the huge paychecks they get, let alone have a right to strike
The universe of online computer games is home to 200,000 players at any time. It's also where you can find the newest innovation in military recruiting.
It's only August, but I'll go out on a limb and congratulate the
Village Voice's Keith Harris for what I feel confident will stand
the test of time as the stupidest comment of the year. "Because his
vision of rock and roll is so grand, Springsteen requires a popular
consensus as surely as any invasion of Iraq. And as we've learned yet
again, nothing sparks phony consensus like national cataclysm. Maybe
that's why, for the past few days, a nagging thought has burrowed into
my brain that I wish was merely the snide aphorism I initially took it
for: If there hadn't been a September 11, Bruce Springsteen would have
had to invent one."
Like an Ann Coulter bestseller or a Rush Limbaugh radio rant, Harris's
review is idiotic but instructive. Aside from its self-evident (and
self-incriminating) silliness, what galls about the comment is its
willful forfeiture of the common cultural ground upon which Bruce
Springsteen plies his trade. Does 9/11 belong only to George Bush and
Donald Rumsfeld? Is American popular culture the exclusive preserve of
Spielberg, Bruckheimer and Britney?
While managing to keep both feet planted in the mainstream, Springsteen
has done more than any American artist to give voice to the American
"other" that pop culture would prefer to forget: the humiliated Vietnam
veteran, the fired factory worker, the hunted illegal immigrant, the
death-row inmate, the homeless person living beneath the bridge and
Amadou Diallo, a West African immigrant, accidentally murdered by
forty-one shots from New York's finest. With his 1994 AIDS ballad
"Streets of Philadelphia," Springsteen became the first heterosexual
rock star ever to sing in the voice of a homosexual man, in a work
that--as Ann Powers, who was then writing brilliant music criticism in,
uh, the Village Voice, observed--succeeded in crossing "the
barriers of class, race, and gender."
Springsteen is vulnerable to criticism on any number of grounds,
artistic and commercial, but his willingness to offer solace in troubled
times strikes me as pretty low on that list. Springsteen was literally
stopped in his car after 9/11 by someone who cried out, "We need you."
Monmouth County, where he lives, lost 158 people in the towers. He
played a couple of local benefits. He read, repeatedly, about the
meaning of his work to his fans in the New York Times's
"Portraits of Grief." He called a few widows, shared their stories and
made a record. It's what he does. "I have a sense of what my service to
my audience is going to be," he explains. "It's the true nature of work
in the sense that you're filling a place. And that place comes with its
blessings and its responsibilities." So sue him.
It is a separate question as to whether one thinks the art that emanated
from this impulse is wholly successful. With regard to The
Rising, I can argue the point either way. But to take issue with the
very idea that art can be a balm to those in pain--or, as Springsteen
puts it, "music is medicine"--is cynicism itself. And to the degree that
this is at all representative of leftist attitudes, it speaks for an
impotent and self-defeating left: too smug and self-satisfied to engage
the culture of the common people, preferring instead to smirk on the
Granting both its sincerity and its (inconsistent) genius, The
Rising does nevertheless raise some complicated questions about art,
politics and commerce. One has to go back to 1984--to Springsteen's own
Born in the U.S.A.--to find a rock record that was marketed as
energetically to mainstream America. After decades of relative
reclusiveness, Springsteen is suddenly everywhere in the mass media:
taking over the Today show in Asbury Park, on David Letterman two
nights in a row, ditto Ted Koppel, on MTV, Saturday Night Live,
simultaneous covers of Time and Rolling Stone; long
interviews with the New York Times, the LA Times and
USA Today. I half expected him to duet with Elmo or Big Bird over
breakfast. It should surprise no one that the record entered the charts
at No. 1 in eleven countries.
The problem arises--just as it did with Born in the U.S.A.--when
the work's cultural signification overwhelms its artistic essence; what
Nietzsche, in Twilight of the Idols, termed "the thing itself."
The dilemma for anyone who seeks to use popular culture to communicate a
message at odds with its market-driven heart of darkness is: who's using
whom? Did Springsteen accidentally empower Reaganism back in the
mid-1980s as he simultaneously denounced it? Is he somehow cheapening
the individual tragedies of which he writes and sings by performing
these haunting melodies at the ungodly hour of 8:30 am in the happy-talk
context of a Today show beach party?
Matt Lauer asked Springsteen whether he feared being accused of
exploiting the tragedy of 9/11, and Springsteen told him to listen to
the music and make up his own mind. The same might be said of his
willingness to embrace (and exploit) America's mighty mass-marketing
The answer has to be a personal one. In Asbury Park, I did some random
interviewing of people who had traveled many hours, and waited on
overnight lines, in the hope of seeing Springsteen perform four songs in
the Convention Hall for the Today broadcast. I spoke to a
firefighter who had gone into the burning buildings, a 16-year-old girl
who was repaying her mom for waiting ten hours on line to get 'NSync
tickets, a woman with her 5-year-old son, who, back in '85, enlisted her
entire family in a weeklong wait for tickets. Nobody mentioned Matt or
Katie. Nobody mentioned the marketing campaign. Nobody even complained
about the all-night wait and the uncertainty that they would be allowed
inside the hall. They were there for Bruce because Bruce was there for
them. In the midst of what Springsteen accurately terms "a theater of
humiliation on TV and on the radio, a reflection of self-loathing," they
had created a community around something better. This was their
(Don't forget, while those Nation folks are on vacation,
Privatization must be stopped, and water declared the common property of
In the 39 states that elect appellate judges, politicization of the
bench is growing.
The recent news about the harmful effects of hormone replacement was
played in the media as a health story, but it is much more than that. In
fact, it may be the hot-flashiest corporate scandal to date: Let's call
If other corporate scandals have been about fudging figures, this one
is about fudging science--something that seems to have been surprisingly
easy to do. And such is the corporate culture that we have apparently
preferred to believe the drug companies rather than the women's health
advocates who have been lobbying for decades simply to get the
scientific evidence to back the companies' claims. The director of the
North American Menopause Society (NAMS), Dr. Wulf Utian, called the bad
news about hormones a bombshell, but it really isn't. Information has
been slowly accumulating about hormone replacement therapy's risks, even
as Wyeth and other manufacturers have been pushing their product as an
elixir for a widening group of symptoms. In recent years, this
potentially carcinogenic drug has been marketed with the nonchalance of
a vitamin pill: HRT advertising suggests that almost no woman over 50
couldn't benefit from it somehow.
Estron is the latest in a long line of scandals pitting women's health
against the interests of Big Pharma--scandals like the sale of faulty
Dalkon Shield contraceptives, which caused infertility, and medications
like DES, which caused severe illnesses in users and their children.
What all these cases have in common is that--like the manufacturers of
menopausal hormones--the drug companies, in their rush for profits,
insufficiently tested their wares before selling them to millions. What
these scandals suggest is that somewhere in the swampy landscape of
medical research funding, unhealthy relationships incubate between
medical practitioners and the drug-company reps who manage to dazzle
them with quasi science and quasi truths. The industry spends around $15
billion a year to promote its products--more than it spends to develop
them. Clearly, even those doctors who resisted the
luxury-cruise-lectures approach to sales found themselves suckered in.
The manipulation of HRT's scientific credentials began back in the
mid-1960s, when Wyeth paid gynecologist Dr. Robert Wilson to extol its
new wonder drug, estrogen replacement. In an evocatively named book,
Feminine Forever, Wilson declared that by replacing the estrogen
lost at menopause, women would remain attractive and easier to live
with. Over the decades since, Wyeth and other hormone manufacturers have
revised dosages and combinations to fit new medical revelations and
poured billions into sophisticated propaganda to get their message out.
The message is that menopause is not a natural life stage but a
disease--estrogen deficiency--and it will make you old. HRT is the cure,
and it will keep you young.
In recent years the manufacturers have claimed protective qualities for
HRT way beyond its original ambitions. First, it promised (and
delivered) relief from menopausal symptoms. Next came claims for
protection against heart disease in women already affected, and then in
healthy women. Then came its role as a treatment against osteoporosis,
which, manufacturers warned (falsely), becomes an instant risk at the
moment of menopause (it's a gradual risk over many years).
The truth is that the manufacturers didn't exactly know what HRT did or
didn't do, because they never ran a big, randomized national study
stringent enough to meet medical standards. For more than twenty years,
the companies used observational studies showing that women who took
hormones were healthier, but they didn't look at why: Was it that the
hormones themselves made women healthier, or that health-conscious women
were more likely to take hormones to begin with? There were many other
uncertainties. Yet calls to answer these questions, from women's health
groups and even from prominent politicians like Pat Schroeder and
Olympia Snowe, went unheeded.
For all the hype, there has been plenty of evidence, both scientific and
epidemiological, that estrogen, named a carcinogen by the FDA two years
ago, is not a wonder drug for everyone. Thirty percent of prescriptions
for estrogen remain unfilled, and the growing search for alternative
menopause products shows that increasing numbers of women are
uncomfortable with the prospect of a lifetime of swallowing synthesized
horse urine. And for all the spin, there has also been accumulating
evidence of serious side effects. As early as 1975 the FDA identified
links between estrogen and higher rates of uterine cancer. (Wyeth
responded by adding another product, progestin, to offset the risk.) In
1990 the Nurses Health Study reported that women on estrogen faced a 36
percent greater risk of breast cancer. That same year the FDA refused to
approve Premarin as a treatment to prevent heart disease, because the
company's evidence didn't convince them. The 2000 HERS study, actually
funded by Wyeth, found that hormone therapy increased risks in heart
disease patients in the first few years. (Wyeth countered that
long-term, it works.)
And people have been trying to warn us. As far back as the mid-1990s,
The Menopause Industry, by Australian reporter Sandra Coney,
presented heavily researched evidence of uterine bleeding, gallbladder
disease and increased cancer rates in hormone takers. In 1997 breast
cancer specialist Dr. Susan Love's Hormone Book returned to the
link between HRT and increased breast cancer risk and came under attack
for raising an alarm. Earlier this year Cindy Pearson, executive
director of the National Women's Health Network, published The Truth
About Hormone Replacement Therapy, outlining many other
discrepancies between hormone hype and science. The medical
establishment barely paid attention.
Finally, the scientific evidence that we have now, based on two large
randomized trials, is definitive, according to one of the study's
leaders, Dr. Deborah Grady. The trials have shown that not only does HRT
do more harm than good for women with existing heart disease, but it
doesn't protect healthy women either; in fact, during the trial it
increased incidence of heart attacks, breast cancer, strokes and blood
clots--enough to have caused the study to be abandoned three years
early. And yet belief in the hormone was so strong that researchers
feared it would be unethical to put women on placebos.
How is this possible? Dr. Utian of NAMS has admitted that many different
parties--from the drug companies to their paid researchers and
spokespeople to the prescribing gynecologists--have had a vested
interest in the success of hormone replacement, and for them, he told
the New York Times, the issue is about more than data. For them,
Utian said, truth is opinion. But that seems a risky precept for
physicians to work with. It sounds like something Arthur Andersen would
Hot media news: Women want hard-hitting reports on issues that affect them.