Chakrubs Current 007: Reproductive Rights

March is Women’s History Month, an annual declaration of the impact and significance of women. Within this month, March 8 is designated as International Women’s Day to celebrate the social, economic, cultural, and political achievements of women around the globe. International Women’s Day also acts as a call-to-action, hoping to inspire changes that will carry into our everyday lives and lead to better outcomes for women.

This year’s campaign theme is #BalanceforBetter, which encourages individuals, governments, and organizations to take responsibility for creating a gender-balanced world. This extends to a range of issues, including gender bias, social justice, discrimination, violence against women, access to education, advancement to leadership, and wealth creation for women globally.

The Chakrubs mission is centered around women’s health and sexual wellness. We recognize how limited access to quality care, lack of comprehensive sex education, and societal messaging that promotes double standards of sexuality and pleasure can negatively impact one’s health and relationship to self. In honor of Women’s History Month and International Women’s Day, we’ll take a look at women’s reproductive rights around the world and how a reinvigorated anti-abortion movement is harming the world’s most vulnerable citizens.

Reproductive Rights Around the World

Reinstatement of Global Gag Rule

One of the most devastating blows to women’s health care came just three days after Donald Trump took presidential office, when he reinstated a global gag rule that cuts U.S. global health funding from organizations abroad that perform – or even talk about – abortions, including the International Planned Parenthood Federation. First implemented by Ronald Reagan in 1984, this rule has been rescinded by every Democrat to take office and reinstated by every Republican administration. However, the Trump administration has expanded this policy and for the first time ever, organizations that provide counseling, referrals, services or advocate for safe abortion with their own funding will be banned from all global health funding from the U.S. government.This rule applies to the entirety of US global health funding—nearly $9 billion— and the administration is actively working to redirect that money to faith-based, anti-abortion groups.

Numerous studies have shown this global gag policy to have the opposite of its intended effect, resulting in more abortions in countries that rely heavily on US aid. A 2011 study from Stanford University found that women in sub-Saharan Africa were twice as likely to have an abortion as a result of the global gag rule. A recent study published in November 2018 by Rutgers University confirmed these 2011 findings and also found that women in Latin America were three times more likely to have an abortion while the global gag rule was in effect.

“Conscientious Objections” Allow Providers to Deny Care

Another frightening trend has been the rise of healthcare providers denying sexual and reproductive health care based on “conscientious objections,” a concept historically associated with the right to refuse to take part in the military or in warfare on religious or moral grounds that has recently been co-opted by anti-choice movements.

In November 2018, a Trump-led Department of Health and Human Services (HHS) invoked this exemption with the release of two rules that allow employers to opt out of providing health insurance that covers birth control based on religious or moral objections. This is one step towards dismantling the contraceptive mandate in the Affordable Care Act, which required most employers to offer insurance that covers birth control. Religious employers could already seek an exemption to the mandate in the previous version.

A report from the International Women’s Health Coalition found that at least 70 jurisdictions around the world have “conscientious objection” provisions in place that allow doctors to opt out of abortion care due to claims that the procedure goes against their personal beliefs. Some areas require that providers inform national health officials that they will exercise their conscientious objection to avoid terminating a pregnancy. In Italy, 70 percent of gynecologists refuse to perform abortions based on their personal feelings. In Uruguay, 80 percent of OB-GYN’s won’t perform abortions. In America, pharmacists have cited moral objections for refusing to fill prescriptions for Plan B contraceptives and drugs to help complete miscarriages.

This refusal can result in the unintended continuance of a pregnancy or cause a patient to put themselves in jeopardy by resorting to an unsafe procedure. According to IWHC’s report, this refusal “compounds the effects of the many barriers women face in health care: discrimination, stigma, financial burdens, lack of information, transportation difficulties, and limited autonomy to make decisions about their own bodies.” The report notes that conscientious claims are being used more frequently in places where abortion laws are shifting towards decriminalization and legalization.

Domestic Gag Rule

In February 2018, the Trump administration attempted to make good on its campaign promise to defund Planned Parenthood and revised regulations that govern funding for the Title X family planning program — effectively instituting a domestic gag rule. Under the new rule, clinics that receive Title X funding will no longer be able to perform abortions in the same space where they see other patients. Abortion and other healthcare services will be required to be physically and financially separate entities. Title X participants will also no longer be able to refer patients to abortion providers, though they can mention abortion to their patients. According to HHS, about 20 percent of Title X providers would potentially have to renovate their clinics to meet the new guidelines — a cost that would likely run providers about $20,000 to $40,000 per facility.

Since Title X was established in 1970, the program’s funding has been restricted from going toward abortions. Though Planned Parenthood operates about 40 percent of the 4,000 Title X clinics nationwide, health departments, federally qualified health centers, and other Title X grantees that don’t offer abortion services will also be affected by this new rule. Title X funding is used to provide non-abortion health services such as cancer screenings and birth control on a sliding fee scale to low-income women. Title X also pays for staff, training, and community outreach.

Without Title X funding, some clinics might be forced to close and others will have to cut back on staff or reduce hours, all of which would reduce access to care.

Where do we go From Here?

All hope is not lost. Since the proposed rule to change who is eligible to receive Title X funding, a coalition of 20 states and California Attorney General Xavier Becerra announced separate lawsuits seeking to block changes to the program. On March 5, Planned Parenthood filed a joint lawsuit with the American Medical Association, arguing that the gag rule threatens the health of millions of people who receive care under the Title X family planning program. If the rule is not successfully stricken down in court, it will go into effect in May 2019.

The Trump administration’s constant attacks on women’s health care have also inspired innovative healthcare solutions that exist separately from big insurance companies and the government. Telemedicine options now provide clinical health care from a distance, increasing access to those with limited funds or in rural areas and allowing them to get medical advice from real physicians for little to no cost. Maven is the only virtual clinic dedicated to women’s health care and family planning and boasts the largest on-demand marketplace of women’s and family health practitioners. The Pill Club is a service that simplifies the process of prescribing and delivering affordable birth control. Nurx is a company that provides birth control, emergency contraception, HIV testing and PrEP prevention, in addition to at-home HPV testing through its online platform. Though telemedicine is a new field, it has the potential to disrupt our current healthcare system and shift it to a more patient-centered industry.

How Can I Help?

It’s important to understand why reasonable access to abortion and other reproductive services are necessary for a society that seeks better balance and equal opportunities for all its citizens. When we limit health care options, we take away a person’s right to choose what is best for them. Forcing someone to complete an unwanted or unviable pregnancy has dire implications on mental, emotional, and physical health and leaves an economic burden that one might carry for the rest of their life.

One way to help is to donate directly to Planned Parenthood and other organizations that provide similar services. If you cannot afford to donate, think about hosting a fundraiser event with proceeds going to Planned Parenthood.

Another way to be of service is to be volunteer as an abortion-clinic escort. Clinics are often targeted by anti-abortion activists and escorts can help those seeking abortions feel safer as they enter the building. You can visit Planned Parenthood’s volunteer page or look up your local health center to see what their specific needs are.

Keep speaking up! The only way to remove the taboo towards women’s health care is to keep talking about these issues. Don’t be ashamed or embarrassed to discuss menstruation, menopause, pregnancy, birth, abortion, or any of the other real life issues that women contend with everyday.

In addition to the steps listed above, you can contact your state and local representatives to let them know your position on abortion access and encourage them to challenge the Trump administration’s recent proposed change to Title X funding. Use ResistBot to easily find and contact your representatives.

If you are feeling triggered or upset about recent policy changes to women’s reproductive rights, I encourage you to set boundaries with the news you engage with online. Drink plenty of water and aim to get 7-8 hours of sleep per night — chances are you’ll feel more hypersensitive and reactive if those basic needs aren’t met. Self-pleasure can be a wonderful tool for returning to your body and reaffirming your right to feel good in it.

Reference Links and Further Reading:

https://broadly.vice.com/en_us/article/a3a9zk/doctors-deny-abortions-religious-beliefs

https://iwhc.org/wp-content/uploads/2018/06/IWHC_CO_Report-Web_single_pg.pdf

https://www.federalregister.gov/documents/2019/03/04/2019-03461/compliance-with-statutory-program-integrity-requirements

https://news.stlpublicradio.org/post/ferguson-birth-village-offers-black-mothers-safe-space-trust-and-support#stream/0

https://techcrunch.com/2019/03/06/tia-launches-a-clinic-that-places-the-menstrual-cycle-at-the-center-of-care/

https://news.crunchbase.com/news/u-s-telehealth-startups-offer-cures-to-healthcare-challenges/

https://www.commonwealthfund.org/publications/issue-briefs/2018/dec/womens-health-us-compared-ten-other-countries

https://www.huffpost.com/entry/planned-parenthood-lawsuit-abortion-gag-rule_n_5c7f0759e4b0e62f69e77689

https://www.theatlantic.com/health/archive/2019/03/trumps-title-x-rule-change-planned-parenthood/584005/

https://www.africanews.com/2019/03/06/ahead-of-international-womens-day-international-rescue-committee-violence-experts-reveal-five-most-dangerous-places-to-be-a-girl-right-now/

https://theconversation.com/abortions-rise-worldwide-when-us-cuts-funding-to-womens-health-clinics-study-finds-112491

https://inkstickmedia.com/abortion-politics-are-isolating-the-us-at-the-united-nations/

https://www.washingtonpost.com/health/2019/03/04/california-files-suit-block-trump-administrations-abortion-gag-rule-family-planning-program/?utm_term=.78b7fce0898f&wpisrc=al_news__alert-hse–alert-national&wpmk=1

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