The Final Title X Regulation Disregards Expert Opinion and Evidence-Based Practices
February 26, 2019
Washington, D.C. – The Department of Health and Human Services has released a final regulation that will significantly limit the health care available to patients under Title X of the Public Health Service Act (Title X). Leading women’s health care provider groups, medical organizations, and physician leaders representing more than 4.3 million health care providers are alarmed by the new regulation which disregards the expertise of the medical and scientific community and evidence-based standards.
[BPWNC opposed the draft regulation, submitting formal comments to HHS in July, 2018. The regulation is just as harmful to women’s health and choice in its final form. You can read the Department’s own summary at https://www.hhs.gov/about/news/2019/02/22/fact-sheet-final-title-x-rule-detailing-family-planning-grant-program.html.]
“As the only federal program exclusively dedicated to providing low-income patients, including adolescents, with access to family planning and preventive health services and information, Title X plays a vital role in the fabric of America’s family planning safety net. The final regulation is the latest of numerous recent decisions—from rolling back insurance coverage for contraceptives to attempting to eliminate funding for evidence-based teen pregnancy prevention programs—that unravel the threads of this safety net. Together, these decisions compound, leaving women and families with increasingly fewer options for obtaining medically accurate, affordable, and timely access to contraception and preventive care.
“The new regulation weakens existing standards requiring that family planning programs funded through Title X offer a range of evidence-based contraception options. It also conditions federal funding for family planning services on a requirement that providers omit certain information in counseling patients and seeks to exclude qualified providers from Title X.
“This regulation will do indelible harm to the health of Americans and to the relationship between patients and their providers. By forcing providers to omit critical information about health care and resources available, the final regulation directly undermines patients’ confidence in their care.
“There is no room for politics in the exam room. For the health of the American people, every individual must have access to comprehensive, affordable care in a safe and timely fashion, just as every provider must be able to deliver medically accurate information and care. The administration should retract this regulation and consider the record volume of comments from the medical, scientific, and patient advocacy communities. Family planning policy should be driven by facts, evidence, and necessity, not politics and ideology.”
THE HEARTBEATS OF WOMEN
by Lynn Wenzel
Reprinted with permission from The Union newspaper
Yes, indeed, Ms. McLaughlin, heartbeats should be heard—those of the millions of women across this country who also have a right to life, health, safety, legal protection—all those things you demand for unborn fetuses. I lived through the pre-Roe v. Wade years. I sat with women weeping from botched, back-alley abortions who would never be able to give birth. I talked with women who cried because their birth control had failed—again—and who now had to figure out how to support another child on not-enough-money, but were told, “You’ll figure it out.” And, I have known women who absolutely do not regret their decision to have a legal abortion at all—who felt only immense relief and the freedom that comes with being an adult human being.
I cannot let McLaughlin stack the deck against us one more time. (See the Union, Saturday, February 16, 2019) She ratchets up emotion and distorts facts to make it appear that callous women march blithely into a doctor or a hospital with a full-term baby in their body and say, “Kill it, I don’t care.” (By the way, a full-term ending of pregnancy is called childbirth, Ms. McLaughlin, not abortion.) She twists the truth to support an unsupportable thesis—that women are heartless beings who decide to get an abortion at the spur of the moment, or who decide that, after 40 weeks they “just don’t want to take this on.” She claims that the Reproductive Health Act (RHA) recently passed in New York which states that “a health care practitioner [such as a PA or NP who do not do surgical abortions, only pharmaceutical] …may perform an abortion” means that otherwise intelligent women with so much choice will be running “to their podiatrists” to end their pregnancies. C’mon. It is true this bill ends the requirement that two doctors in addition to the woman’s own physician, must certify that a third-trimester abortion is necessary to prevent the woman’s death or mental impairment. Good. Women are not stupid. And neither are doctors. It is an insult to a woman’s private physician to say that he alone is neither fit nor capable of making a medical decision with his patient.
Next, McLaughlin asserts that those who support safe and legal abortion are practitioners of fetal infanticide. Really? How about the woman whose fetus has been medically adjudged to be able to live outside her body only 15 suffering minutes, or one agonizing day, so she decides to have it legally removed? Is she practicing infanticide? Should she be arrested and jailed? Predictably, McLaughlin brings up the one existing example of Dr. Kermit Gosnell who murdered babies after they were born and who is now serving a life prison term. As if he represents multitudes. There will always be evil among us. But to compare that heinous behavior with that of women using their legal right to terminate a pregnancy is equally heinous—and cruel.
The creation of legal framework for the idea that a fetus is a person, conceivably with more rights than the woman who carries it, has been the work of the anti-choice movement for over 47 years. Its drive to make abortion a deeply divisive emotional issue that could motivate evangelical voters and divide the electorate has resulted in rights being extended to clusters of cells and the erosion of the existing prerogative of an entire class—women. Women charged with pregnancy-related “crimes” are often poor, nonwhite, without resources or access to education, health care or decent job opportunities. Women with access to money could always find a way to terminate a pregnancy, even by traveling overseas. So it is that a class system is formed and then encoded into law. And there are also the many stories of women who, because they were black, and poor were railroaded into sterilization thereby losing rights to their individual freedom.
What I find “morally repugnant and repulsive” Ms. McLaughlin is the rhetoric that opposes women controlling their own health care while anti-choice voices increasingly support funding cuts in birth control availability and the social safety net. If you really care about human babies then you should be supporting freely available and affordable child care; you are, I hope, speaking out against the genocide of children in Yemen, warfare and poverty, supporting raising the minimum wage so women can feed their living children, and advocating universal healthcare for women and their families.
So many states are now enacting or have enacted fetal rights laws that Roe is being rendered moot. And if the Supreme Court ever rules that a fetus has “personhood” rights, all abortions would be illegal—even in states that strongly support a woman’s right to choose her own destiny. What happens to individual freedom then? If a woman becomes pregnant, does the state step in and take over her life, enforcing rules about what she can and cannot eat or drink, what medical decisions she can and cannot make, such as treating a cancer that might save her life but will kill her fetus? “Fetal personhood” might call into legal question birth control methods such as the pill, IUDs and the morning-after medication. And then we are all on the path to state-sanctioned forced pregnancy.
I have given birth during my long life and had a miscarriage. I am quite clear on what it means to raise a child and grieve a pregnancy. Women are not monsters. We have no desire to harm our babies or, unthinkingly, terminate a pregnancy; some of us remember with great sadness a pregnancy ended due to maternal health issues. We all live in our own realms of regrets and decisions made and not made. But one thing I do know. If there is a fetus growing inside us it is us, not the state, with the authority to judge what is best for our health, our families and our futures. Any woman who values her freedom should think long and hard before ceding her body’s legitimacy to the dominion of government. Then, there will be no choice. It will be too late.
Lynn Wenzel lives in Grass Valley.