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Abortion Is the Battle, but Women’s Health Is the War

Dr. Boyd shows two different ultrasound devices.

SOURCE: AP/LM Otero

Dr. Curtis Boyd explains the two different ultrasound devices used to examine pregnant women's developing fetus at his clinic in Dallas, Texas.

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This article contains corrections as of August 27, 2012.

The recent comments by Rep. Todd Akin (R-MO) alluding to an unfounded theory that there might be a medical mechanism in women’s bodies that prevents pregnancy in the case of “legitimate” rape—and the subsequent frenzy among Democrats and Republicans alike—is the latest in a series of events trying to undermine women’s right to health care.

Rep. Akin’s comments are shocking, to be sure. The offensive implications of his comments are that there is a difference between “legitimate” and “illegitimate” rape—reminiscent of House Republicans’ efforts in 2011 to distinguish rape from “forcible rape” when determining exemptions for coverage of abortion, such as in the case of rape or incest or a pregnancy that threatens the life of a woman. The idea that there could be such a thing as illegitimate or nonforcible rape has led a range of people, from President Barack Obama to Tony award winner Eve Ensler to some Republican congressional leaders, to denounce Rep. Akin’s comments.

Unfortunately, Rep. Akin is not the first policymaker to make such allegations, and considering the track record, he’s probably not going to be the last one, either. This week the Republican party has once again included making abortion illegal, with no exceptions, to the campaign platform to be voted on next week at the Republican National Convention—even though some younger Republicans think this view is outdated and out of touch with reality.

The larger issue at stake here, though, is American women’s right and ability to have adequate access to health care—including contraception and preventive services—and to be able to make their own decisions about their health and their bodies. Abortion is only a portion of the broader war being waged against these fundamental rights for women.

‘Don’t cover contraception’

Since January 20 of this year, when President Obama announced that under the Affordable Care Act, employers would have to start including no-cost preventive services such as contraception in their health care plans, contraceptive coverage has been in the limelight. Many conservative groups protested the president’s announcement, arguing that this provision violated the right to religious freedom since it didn’t exempt all religiously affiliated institutions that do not approve of contraceptive use.

When the president announced an accommodation for these religious nonprofit employers three weeks later (on top of a prior exemption for houses of worship), some critics were silenced. Others, however, such as Sen. Roy Blunt (R-MO) were not satisfied. Sen. Blunt introduced an amendment in the Senate that, if it had passed, would effectively have allowed employers to not cover any services or medication to which they morally objected.

In the months that followed, at least nine state legislatures have considered laws or ballot initiatives to undermine contraceptive coverage. These efforts would either reject the federal regulation to cover contraceptives or would work to weaken state regulations for contraception coverage.

Then there were the congressional hearings earlier this year regarding the contraception provision under Obamacare. In at least one of these hearings, the testimonies came solely from men, and when a woman, Sandra Fluke, wanted to testify before Congress, she was viciously vilified and attacked by conservative lawmakers and pundits such as Rush Limbaugh, who asserted that Fluke was a slut and a prostitute for wanting contraceptive coverage.

Margaret Sanger, the founder of Planned Parenthood, once said, “No woman can call herself free until she can choose consciously whether she will or will not be a mother.” Access to birth control is vital to each woman’s ability to pursue her rights to life, liberty, and the pursuit of happiness guaranteed in the Constitution, as well as her right to thrive economically and ensure that she can have a safe, healthy pregnancy when and if she decides she is ready to have a child. Creating obstacles to accessing these services does a disservice to society as a whole.

‘Eliminate Title X and Planned Parenthood funding’

Another big push in the fight against women’s health both on the national and state levels has been to defund Title X of the Public Health Service Act, which is our nation’s family planning program, as well as Planned Parenthood. The supporters of ending funding for these entities say that government money should not go toward providing abortions, but that is a misleading argument, and the real effect is far-reaching.

Family planning, cancer screenings, pelvic and breast exams, sexually transmitted infection testing and treatment, contraception coverage, and much more would be lost in the event that Title X and Planned Parenthood lose their funding. Abortion services only amount to about 3 percent of Planned Parenthood’s activities (and are supported by private funds), compared to 16 percent of total activity for cancer screening and prevention, and 35 percent of total activity for STD testing for men and women.

Title X began in 1970 with bipartisan support—then-President Richard Nixon said that, “no American woman should be denied access to family planning because of her economic condition”—as a program that gave federal grants to provide comprehensive health care coverage for women, regardless of their economic status.

The clinics supported by this program provide almost 5 million women with contraceptives and other preventive services, such as breast exams and Pap smears. Many of these women go to Title X centers because they can’t afford health care in other places—6 in 10 women who obtain care at a Title X–supported center consider it to be their usual source of medical care, according to a Guttmacher Institute study. Title X funds, however, are strictly prohibited from being used for abortion services.

Nearly half of all pregnancies in the United States are unplanned, and approximately 40 percent of those result in abortion. Perhaps opponents of funding Planned Parenthood and Title X ought to recognize the need for family planning and education for men and women about safe sex practices that these two entities provide. Maybe then, fewer unplanned pregnancies, and fewer abortions as a result, would occur.

If the idea behind defunding Title X and Planned Parenthood is solely to prevent abortions then the argument is fundamentally flawed. Supporting Planned Parenthood and Title X means more women would have access to contraceptives and family planning—and fewer women would have accidental or unwanted pregnancies leading to abortion. As the Milwaukee Journal-Sentinel editorial board once wrote, “Defunding Planned Parenthood to prevent abortions is a lot like outlawing umbrellas to prevent rain.” It doesn’t make sense.

‘Send it to the states’

In 2011 House and Senate Republicans threatened to shut the government down unless Planned Parenthood didn’t receive any funding from the federal government. In fact, 230 House Republicans and 10 House Democrats voted to defund both Planned Parenthood and Title X. Calling it a deficit issue, they said cutting this funding would lower our national debt. But in reality, enabling access to preventive services would save the government—and taxpayers—money from not having to pay the real, substantial costs associated with unwanted pregnancies and trips to the emergency room for preventable conditions. Every $1 spent on family planning services saves $4 in Medicaid spending on costs related to unintended pregnancies.

This battle is now being waged in the states. Texan officials vowed to cut all funding for Planned Parenthood—which offers cancer screenings and other preventive services but not abortions to women in the state’s Women’s Health Program—after the Texas legislature passed a law banning funds to organizations linked to abortion providers. The law was under an injunction, which would’ve kept funding for the program until October, but a judge recently overruled the injunction—The New York Times called this ruling “the furthest thing” from a win for Texas.

Many other states have considered so-called personhood amendments, which would restrict a woman’s right to get an abortion, as well as ban many forms of birth control and some forms of fertility treatments, by defining life as beginning at the “moment” of conception. And some states, such as Virginia, have proposed forcing women who try to get an abortion to first get an invasive transvaginal ultrasound before getting the procedure done. Ultimately, the state ended up passing legislation that mandates women get abdominal ultrasounds before abortions regardless of medical need.

Other states, among them Alabama, Arizona, Idaho, Indiana, Kansas, Louisiana, Nebraska, North Carolina, and Oklahoma, passed legislation outlawing abortion after 20 weeks, even though  complications are sometimes discovered after this point in a pregnancy that could cause serious harm to the woman. In those states, a woman would be forced to continue the pregnancy, no matter the risk to her health.

These laws are extremely dangerous to women. They turn back the clock and erase all the progress women have made thus far to allow for healthy pregnancies—or for legal and safe channels for abortions if necessary. Making abortion illegal won’t make it stop happening, but it will force women to use dangerous, illegal, and shady channels to get an abortion instead of visiting a licensed physician who can do the procedure in a safe, sterile environment.

President Obama said when reacting to Rep. Akin’s comments, “We shouldn’t have a bunch of politicians, a majority of whom are men, making health care decisions on behalf of women.” He’s right. A majority of the lawmakers making important decisions about contraceptive coverage, preventive services, and abortion rights have no way of knowing or even imagining how it would affect their daily lives simply because they aren’t women—as men, they just have no way to completely relate.

It’s clear that Rep. Akin’s opinion is not his alone—this has actually been debated many times over by social conservatives across the country in federal, state, and local offices. Women’s health—and creating barriers to accessing it—is going to be a huge election issue this year, as women are one of the largest voting blocs (55 million registered, and growing at a rate of 1 million more each year) and even some Republican women are questioning their party’s orthodoxy.

Abortion is just one battle being fought in the war to protect women’s health and safety, along with contraception coverage and Planned Parenthood and Title X funding. How many more will there be before women are given their right to health care without question or judgment?

Emilie Openchowski is an Assistant Editor at the Center for American Progress.

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