Nancy Northup's blog

EC Still Inaccessible for Military Women

2009-04-01T08:00:00-04:00

For years, reproductive rights advocates have argued that when it came to policy decisions around women's health, the Bush administration was driven by politics, not science. Well, just last week, in complete vindication of those arguments, a federal court found that the Food and Drug Administration, under President Bush's leadership, had been improperly influenced by "political considerations" in its decision-making around Plan B, the drug commonly known as the morning-after-pill. The U.S. District Court for the Eastern District of New York ordered the FDA to reconsider its 2006 decision to allow only women 18 and older to get Plan B without a prescription. The court also ordered the agency to make Plan B available without a prescription to 17 year olds within in 30 days.

The judge in the case said that the FDA had over the years unjustifiably delayed issuing a determination on whether the contraceptive should be sold over-the-counter, and when the agency was finally pushed into a political corner, it approved Plan B only for 18 and older, despite their own scientists having found it safe and effective for all age groups. With this ruling we have succeeded in expanding access and hope to ultimately make it fully available to all women.

But emergency contraception is still difficult to access for many groups of women, including the more than 200,000 women serving in the Armed Services. It's excluded from the list of what military facilities, including the primary stores where families shop, are required to stock. That can be particularly challenging for women and families who are based overseas and rely solely on those facilities to buy over-the-counter drugs. More than 160,500 American female soldiers have served in Iraq, Afghanistan, and the Middle East since the war began in 2003. According to a 2007 Department of Defense Report, there were 2,688 reported sexual assaults involving military personnel in 2007. Why would the government limit these women's ability to prevent unintended pregnancies?

This is undoubtedly another example of the Bush administration playing politics with women's health. In 2002, the Department of Defense, relying on its technical experts, initially approved emergency contraception for its Basic Care Formulary, which would have required that it be stocked at all military treatment facilities. That approval was quickly rescinded when it reached the radar of political appointees. Uncannily, it sounds like what was going on at the FDA: scientists support access to emergency contraception and political pressure shuts it down. Now, it's available only at those military health facilities that decide to make it available. In the meantime, the lack of the contraceptive doubly victimizes servicewomen who experience sexual assault - some of whom suffer from trauma serious enough to impair their military careers.

In the last Congress, then-Senator Hillary Clinton (D-N.Y.) and Rep. Michael Michaud (D-Maine), introduced legislation that would have required full access to emergency contraception for servicewomen at all U.S. military health care facilities around the world. We no longer, however, need to wait for Congressional action to right this wrong. President Obama has promised to restore scientific integrity to government actions in his administration.

Join me in calling on President Obama to direct Robert Gates, the Secretary of Defense, to make Plan B available to our servicewomen. Click here to send President Obama a message.

Rewriting Science Fiction: Politics Out of Plan B

2009-03-24T08:00:00-04:00

Editor's note: The United States District Court ruled yesterday that the FDA acted improperly and unreasonably in its failure to issue a timely decision, back in 2006, on allowing emergency contraception ("Plan B") to be available without a prescription. The court decision also ordered the FDA to make emergency contraception available to women 17 years old and older within 30 days, as well as to reconsider the availability of emergency contraception to all women.

Science was glaringly absent the past eight years in policies created by the Bush administration's federal agencies, such as the Environmental Protection Agency and the Department of Health and Human Services. Increased emissions of the most significant forms of air pollution were touted as "clear skies." The birth control pill was defined as abortion, and receptionists in health-care facilities were empowered to turn women away for reproductive medical treatment simply because they disapproved.

With President Obama in office, we are seeing welcome change. He proposed to repeal Bush's eleventh-hour HHS regulation which gives health care workers personal views over medical care. In a recent directive, President Obama declared that politics would no longer play a role in U.S. science policy, stating "we make scientific decisions based on facts, not ideology." And he nominated former New York health commissioner Margaret Hamburg as the head of the Food and Drug Administration. Dr. Hamburg has rejected the idea of having abstinence be the main focus of HIV education, saying that "only the best medical and scientific information" should dictate the curriculum not "moral judgment."

A fitting next step for the new administration in reversing Bush policies based in fictional science would be for the FDA, under Dr. Hamburg's leadership, to take a fresh look at the agency's restrictive over-the-counter policy on the emergency contraceptive Plan B to ensure that the policy is based on medical evidence, not ideology.

The journey of Plan B's 2003 application for over-the-counter status--mired in years of inexplicable delay, unprecedented White House involvement, and decisions that run contrary to the agency's own scientific experts--reads like a story of intrigue and conspiracy. The plotline would make for compelling entertainment if the stakes weren't the health and lives of women throughout the U.S. The Bush administration's complete disregard of objective scientific evidence played a starring role, with FDA leadership stacking a reproductive health advisory committee with "operatives" and radically departing from typical agency practice. The story ends with unfounded age restrictions for Plan B--the first time age has ever been used to restrict a non-prescription drug.

Access to Plan B is critically important for women who want to avoid pregnancy. But it's most effective the sooner it's taken--within 72 hours after sex it reduces the risk of pregnancy by 89%, and the odds are even greater when it's used in the first 24. The FDA has deemed the contraceptive safe and effective, but it's not always readily available despite its recognized value and the importance of timely access.

Since 2003, Plan B's manufacturers have tried to make the drug available without a prescription for women of every age, only to be repeatedly rebuffed by the FDA for no scientific reason. In 2005, the Center for Reproductive Rights, on behalf of women's health organizations and individuals, filed a federal lawsuit arguing that the FDA was not only ignoring the science in its foot-dragging on Plan B, but also violating the law. The government tried to get the case dismissed a number of times, but the judge overseeing the case refused, even remarking that the inertia on Plan B smacked of "an administrative filibuster."

Finally in 2006, the FDA announced that it would approve the distribution of Plan B without a prescription, but only for women 18 or older and only behind pharmacy counters. It didn't matter that the medical evidence overwhelmingly supported over-the-counter use for every age, or for that matter, that overwhelming scientific opinion within the FDA recommended as much. As one agency scientist puzzled, the FDA never "distinguished the safety and efficacy of Plan B and other forms of hormonal contraception among different ages of women of childbearing potential, and I am not aware of any compelling scientific reason for such a distinction in this case."

In the meantime, months of testimony in the federal case uncovered a web of deceit behind-the-scenes--replete with high-level FDA officials kowtowing to outside political influence, circumventing agency regulations, and ultimately, conspiring to grant only limited access to Plan B. Court testimony revealed that one official confessed to his coworker that he had to reject the Plan B application for fear of losing his job. Another told a colleague that the plan was for the agency to postpone making any decision on the drug for as long as possible, and when push came to shove, approve it with an age restriction--all in order to "appease the [Bush] administration's constituents." During the case, the judge has said more than once that there was a "strong showing of bad faith" on the part of the FDA, but at this time, we are awaiting a decision.

At the beginning of the year, the CDC released data showing significant increases in teen birth rates in most of the country. Was that supposed to be part of the Bush administration's storyline? While Plan B's road to over-the-counter status has had many twists, turns and set-backs, the story can have a happy ending. The new administration can save the day by re-instating science as the underlying narrative at the FDA.

This post first appeared on Huffington Post.

How to Restore America's Position as a Leader on Reproductive Rights

2009-01-08T08:00:00-05:00

With the election of Barack Obama, women around the world can heave a collective sigh of relief and look forward to an end to the Bush administration's relentless assault on women's reproductive health and rights. It's been a very long and destructive eight years. While the rest of the world has been moving forward in a growing recognition of reproductive rights as human rights, the United States has moved backwards.

In the past two years, the United States Supreme Court -- with two new Bush justices -- issued Gonzales v. Carhart , a decision that Justice Ruth Bader Ginsburg called "alarming," which she said represented antiquated and rejected notions of a woman's place in the family. At the same time, the Constitutional Court in Colombia said that protecting reproductive rights is a direct path to promoting the dignity of all human beings.

We need to get back on that direct path. Under the leadership of President-elect Obama, the United States has the opportunity to again take the world stage as a leader in promoting women's reproductive health, equality and human rights.

Make no mistake, our country's new vision for reproductive rights and health needs to go further than simply undoing the policies of the previous administration. The Obama administration must work toward a nation and world in which all women are free to decide whether and when to have children, where all women have access to quality reproductive health care, where all women can exercise their choices without coercion or discrimination, and where all women can participate with full dignity as equal members of society.

President-elect Obama is a strong supporter of reproductive rights and understands the values that underscore them – human dignity, self-determination, equality and non-discrimination. These principles are embodied in the United States Constitution, one of the world's earliest human rights documents, as well as the Universal Declaration of Human Rights. He also understands, however, that the mere recognition of rights is not enough: they must improve the lives and health of women.

Access to comprehensive information, contraception, abortion and prenatal care are critical. To take just one example, we cannot meaningfully address the high rates of adolescent pregnancy in this country while at the same time denying comprehensive sexuality education and supporting ineffective abstinence-only programs. In order for this country to reduce high rates of unintended pregnancy, sexually transmitted infections and maternal mortality, and to eliminate the shameful racial disparities in reproductive health, we must recognize a broader vision, guided by human rights principles, grounded in science and not ideology and reflecting the understanding that access to reproductive health care will improve the lives of women and families.

We urge President-Elect Obama to lead the nation toward that vision, beginning with three positive changes that cry out for immediate action.

Create a policy climate guided by science and not ideology: Strike funding for abstinence-only sex education and appoint federal agency directors -- beginning with the FDA -- who respect scientific data.

Appoint federal judges committed to constitutional rights and the objective review of evidence: This begins with the U.S. Supreme Court, whose decision last year upholding the federal abortion ban ignored finding of fact made by lower courts and based on sound medical evidence, and deferred to Congressional ideology.

Support reproductive rights at the U.N. and in U.S. foreign assistance programs: Repeal the Global Gag Rule and restore funding to the United Nations Population Fund. Ensure that our nation is represented around the world by people who respect women's human rights.

The United States can once again become a leader in supporting reproductive rights and ensuring access to this critical health care. It's not only change we can believe in, it's change we must demand. Our daughters and granddaughters' futures depend on it.

This post previously appeared on Alternet.

Will Anti-Choice Forces Take Advantage of Bush Legacy?

2008-11-18T08:00:00-05:00

The election of Barack Obama heralds at long last a season of promise and opportunity: the chance to improve the lives of millions of Americans and people throughout the world by ending the Bush administration's horrific war on women and making reproductive health a priority for U.S. law and policy. Yet earlier this fall, I said that no matter who won in November, those of us on the front lines of the fight for reproductive rights and health care would have our work cut out for us.

Clearly we have reason to rejoice the recent sound defeat of two state ballot initiatives designed as attacks on Roe v. Wade and the California initiative mandating parental notification. These outcomes send an unambiguous message to our elected officials that our government should not interfere with personal and private decisions about our health and families. There is no doubt that backers of the South Dakota abortion ban and Colorado's "personhood" amendment had their sights on the U.S. Supreme Court and overturning Roe. The stakes were high not only for women and families in these states, but for women throughout the country.

Fortunately, the voters in South Dakota, Colorado and California have made it clear that they put the health, safety and privacy of the women in their states first, above abortion politics. Proponents of both of these measures would be wise to follow the electorate's wishes and put these issues to rest.

But even with these victories, and even with this election, individual state legislatures remain dangerous arenas in which we struggle to preserve every woman's rights to choose whether or not she will bear children, and to have the broadest access to contraception, abortion, health information and pregnancy care. Every year, our opponents introduce more than 600 anti-choice measures in the states. Just last month in Oklahoma, the Center for Reproductive Rights filed suit immediately to block a law that would force a woman to listen to a doctor describe an ultrasound image of her fetus. And, in a bizarre Alice through the Looking Glass twist, the same law would prevent a woman from suing if her doctor intentionally withholds other information about the fetus, such as severe abnormalities. Fortunately, we won an order temporarily blocking the law while we prepare for trial.

We know that this coming January will be equally bad or even worse as our opponents rush to take advantage of the Bush administration's dangerous judicial legacy: the current Supreme Court and President Bush's judicial appointees, which make up more than one-third of sitting federal judges and the most conservative in modern history.

We have suffered under the yoke of an Administration that has suppressed science to the detriment of health and has done damage to constitutional and human rights values. Federal court decisions have undermined the protections established by Roe v. Wade, funding for basic reproductive health care is inadequate and maternal mortality rates among women of color remain shamefully high. At the U.N., the United States has undermined protection for reproductive rights and health, and restrictions that the U.S. places on foreign assistance hamper rather than promote progress. All this flies in the face of the United States' historical role as a world leader in championing equality and human rights and of supporting access to essential reproductive health care around the world.

In sharp contrast to the erosion of protection for reproductive rights in U.S. law, the global trend within United Nations', regional and national jurisprudence has been towards recognition of reproductive rights as human rights. Recent decisions by the United Nations Human Rights Committee and the European Court of Human Rights have found that denying women abortions in certain circumstances violated human rights guarantees. In addition, in the last twenty years, 16 countries have liberalized their abortion laws. At a time when the world is moving towards greater recognition and protection of these rights, the United States should also be advancing and not retreating.

Our new administration must take quick and decisive action to create a policy climate guided by science and not ideology, starting with striking funding for abstinence-only sex education and the appointment federal agency directors-beginning with the FDA-who respect scientific data. President-elect Obama must appoint federal judges committed to constitutional rights and the objective review of evidence. The U.S. must once again support reproductive rights at the U.N. and in U.S. foreign assistance programs by repealing the Global Gag Rule and restoring funding to the United Nations Population Fund. And we must ensure that our nation is represented around the world by people who respect women's human rights.

Now that a pro-choice administration is about to move into the White House, it may be tempting to think that we no longer have to "worry" about women's reproductive rights. But we must resist that temptation and instead pledge to seize this moment to make sure that this most fundamental and enduring principle is enshrined in law: At the heart of a free society is our ability to form the personal beliefs and make the intimate decisions that chart our destinies and define who we are.

Because of, Not In Spite of, My Faith

2008-10-14T08:00:00-04:00

Editor's Note: This article is part of a pre-election series featuring leading voices in sexual and reproductive health advocacy, showing how shared American values underpin their support for sexual and reproductive health, rights, and justice. Read them all here.

I was born in the heartland - Kokomo, Indiana - and my family's eight moves took me to places as different as Temple, Texas, New York City, and a small town in the Sacramento Valley. I sold Girl Scout cookies and earned merit badges. I marched down Main Street playing the flute in my green band uniform. I was co-captain of my cheerleading squad, pledged allegiance to the Flag, sang "God Bless America," and went to church on Sunday. I still go to church on Sunday. My religious faith informs everything that I do in my life, including my chosen work as an advocate for reproductive rights as a basic human right. I became a lawyer in large part because my faith called me to fight for social justice and the equality and dignity of all people.

Some people may be surprised that this bio belongs to such a visible and vocal voice for reproductive health. We're used to hearing such biographical attributes for those on the other side of the debate, but my Unitarian Universalist faith has long affirmed that laws that proscribe abortion are an affront to human life and dignity. We are not alone; major religious denominations representing millions of Americans (including the Episcopal Church, Presbyterian Church, United Methodist Church and Reform and Conservative branches of Judaism) support the legal right to abortion.

The attempt to legislate one set of religious beliefs about women's ability to control their reproductive lives is an offense to a bedrock commitment of America's constitutional democracy: freedom of religion and separation of church and state.

Yet growing fundamentalist influence over U.S. domestic and foreign policy is making the nation forget its commitment to religious freedom. This fundamentalist belief--that everyone must follow one set of religious truths--battles against a more open view that respects differences of religious beliefs and ethical positions.

It's human nature to want everyone to agree with one's religion or personal moral code. I understand that well. I taught Sunday school each week out of the desire to pass along my religious faith and traditions to the next generation. But I also accept that there will always be vast differences among religious and secular perspectives on life. And I understand, and firmly believe, that government should not help me or anyone else spread our religious beliefs. The government is not a Sunday school.

In Roe v. Wade, the Supreme Court grounded the right to privacy in the protection of personal liberty guaranteed by the Due Process Clause of the Fourteenth Amendment, and it recognized a notion of liberty that includes a woman's right to make fundamental decisions affecting her destiny, such as whether or not to terminate a pregnancy. Since then, the Court has recognized again and again that religion stands staunchly on both sides of the abortion issue, and that women and men of good conscience disagree about its moral implications. As the Supreme Court wrote in Planned Parenthood v. Casey, "reasonable people will have differences of opinion about these matters."

Given the different opinions that clearly exist on both sides, what I find most disturbing about the public debate on reproductive health, especially in an election year, is that the moral case for reproductive decision-making isn't injected into the argument by those who support a women's right to choose. While I've heard many politicians say that they are pro-choice despite their religious beliefs, I don't think I've heard anyone say that he or she supports reproductive health because of his or her faith. Perhaps it's because they feel those who oppose reproductive health have already claimed the moral stronghold, and that the public can't accept that there could be religious grounding on both sides of the debate.

As Americans we'll never agree on the validity of religious texts, but most of us agree that the Constitution is sacrosanct. Religious liberty is tied inextricably to Constitutional values. While the Constitution dictates that religion should not be legislated or imposed by government, it also allows that we should have the right of conscience in making personal decisions about when and whether to have a child. As Supreme Court Justice Anthony Kennedy wrote in Casey: "At the heart of liberty is the right to define one's own concept of existence, of meaning, of the universe, and of the mystery of human life." This is precisely why more of us should be talking about why our faith leads us to protect the health and lives of women and their families. We can't protect rights that we don't talk about.

The Supreme Test: Will the Roberts-Led Court Follow Established Law And Protect Women's Health?

2006-11-03T09:26:38-05:00

Nancy Northup is the President of the Center for Reproductive Rights.

We have been down this road before. And we really shouldn't be going down this road again. Let me start with this term, "Partial-Birth Abortion." There is no such medical procedure as "Partial-Birth Abortion." It is a political soundbite.

The Center for Reproductive Rights brings casesSpecial Series both in the United States and around the world and works with women's health advocates to strengthen laws protecting women's reproductive health. And we don't deal with this issue of "Partial-Birth abortion" anywhere else in the world. And that is because it was created as a political soundbite here, for American politics.

This case is about second-trimester abortions. That is all that this case is about. Second-trimester abortions. Babies are not born in the second trimester. Third trimester abortions are outlawed in most states around the United States, as long as there is a constitutional protection for women's life and health. So this is not about babies about to be born.

It is about safe procedures for women's abortions in the second trimester. And what this case, at heart, is about - because we've been down this road before - is about whether the new Roberts-led Supreme Court is going to follow established law, that "settled law" we heard so much about in the Supreme Court nomination hearings. It is about whether or not they're going to affirm that women having abortions in the second trimester have to be able to have the safest procedures for them.

I said we'd been down this road before. One of our clients, Dr. LeRoy Carhart, has literally been down this road before. He's a doctor in Nebraska; he challenged the Nebraska' so-called "partial birth abortion ban" and took it to the Supreme Court six years ago. And, just six years ago, in Stenberg v. Carhart, the Supreme Court said, "Doctors must be able to use the safest procedures with their patients."

In Stenberg v. Carhart, the Supreme Court made two very important determinations. They took a look at the Nebraska statute and said; "This is drafted so broadly that it would cover almost all abortion procedures in the second trimester. And therefore it's an undue burden on women's right to access abortion in the second trimester."

And secondly, the Court said that even if you were only talking about intact D&E's - and that's a medical term - that you would still need to have an exception for women's health, because there was substantial medical evidence that for some women it is a safer way to proceed with a second-trimester abortion

So, in essence, what the Supreme Court said, and Justice O'Connor was very clear in her concurrence, was that you might be able to draft a constitutional ban on intact D&E's if you did two things. One, you use medical terms. The majority said that it would have been a simple matter for Nebraska to have used medical language that doctors understand when you're hitting them with a criminal law. Two: Justice O'Connor said that you have to have a health exception. If you write these two things into the law you could probably draft a constitutional statute.

So that was the Stenberg case in 2000. Congress gets their hands on this issue and we're walking down this road again. Congress said to the Supreme Court "We don't care what you say about the constitutional requirements for women's health. We don't care. What we're going to do is pass a statute that is going to be a deliberate attempt to gut the protections of Roe."

And in fact, the Chief Senate Sponsor, Senator Santorum, during the process of the hearings, said, and I quote: "I hope the justices read this record. Because I am talking to you. There is no reason for a health exception."

Senator Santorum was saying "I don't care that you just said that women need to have the safest procedures. We, the Congress, are deciding that we do not want those guarantees for women's health." And so Congress passed the law once again. And, even though the Supreme Court had said, "It's a simple matter - if you're making criminal laws about medical procedures, use medical terms," Congress again used the political soundbite, "Partial-Birth abortion."

And this is a federal criminal statute. For a number of years I was a prosecutor in the U.S. Attorney's office in the Southern District of New York. I know full well what it means to bring the power of the federal government into the lives of people when you're investigating crimes. To think about the power of the federal government going into doctor's offices and into the intimate details and decisions of medical care, I have to say, as a former prosecutor, is frightening.

The federal statute has the same flaws as the Nebraska law. The Act is so vaguely worded - because they didn't do the simple thing and use medical terms but used the political soundbite - that it covers abortions as early as 12 to 15 weeks, and it covers the majority of second-trimester abortions. And there's no health exception as promised by Senator Santorum. All the district and circuit courts found it to be unconstitutional. And they did so because they could easily follow the Supreme Court's established law. So if the Supreme Court reads its case law as well as the lower courts did, this should be an easily decided case.

This law, this political sound-bite, is part of the agenda to overturn Roe v. Wade. The Court should be guided not by the changing political winds, but by a higher principle, the protection of individual rights. The Supreme Court in this case should send a clear message to Congress that settled law, and particularly settled law for 30 years going back to Roe that established a bright line rule that pregnant women's health may not be subordinated to opposition to abortion. That should be affirmed.