Coercion and Reproductive Justice

An essential piece of the reproductive justice and sexual rights movement is the right of all women to make reproductive choices free from coercion.

According to the Guttmacher Institute, coercion in any form is wrong and compromises choice. Coercion violates women’s right to decide freely if and when to have a child and the right to have the government respect her decision.

The Guttmacher report condemns coercion in the form of U.S. state legislatures passing increasingly restrictive abortion restrictions to keep women from ending an unwanted pregnancy. Parental notification or consent, mandatory waiting periods, and inaccurate and biased counseling exist under the guise of “preventing coerced abortion”. Rather, these TRAP laws aim not so much to inform women about the abortion procedure, as to dissuade them from choosing an abortion in the first place.

Increasingly, these laws prevent women from making decisions about how and when to give birth, posing a risk to all pregnant women, including those who want to stay pregnant.

Roe v. Wade gave women the right to choose abortion. Roe v. Wade also gave women the right not to choose abortion.

In the United States, a dark history of forced sterilization and present day controversies about the rights of the disabled remind us that as much as women have a freedom to abortion, if she chooses to continue a pregnancy, she has the equal right to do so.

Coerced abortion occurs in many forms. In January 2014, a Florida man was sentenced  to nearly 14 years in prison for tricking his pregnant girlfriend into taking Cytotec, a brand-name version of misoprostol, which causes miscarriage. Further complicating the issue, he was initially charged with first-degree murder under the Unborn Victims of Violence Act, punishable by life in prison, but he pleaded guilty to lesser charges of product tampering. The fetus was estimated to be at seven weeks.

In 2013 in Texas, a pregnant 16 year old girl claimed her parents were pressuring her to have an abortion when she wanted to continue the pregnancy and get married. When the pregnancy was confirmed, the teenager’s father allegedly became angry and insisted that she have an abortion and it was his decision.  Texas is one of the states that requires parental or judicial permission for a minor to obtain abortion; in this case, the minor had to obtain judicial permission not to have an abortion.

Coerced abortion compromises reproductive justice and often results from broader issues such as domestic and sexual violence, birth control access and tampering, economic disadvantage, education expectations, and religious convictions. Abortion is not the problem. The prevention of choice is the problem.

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2014 North American Forum on Family Planning

Last month, several of our Section faculty and staff traveled to Miami for the 2014 North American Forum on Family Planning.

The Forum gathered nearly 700 clinicians, researchers, and clinical staff to present, discuss, and learn the latest on family planning and how evidence can inform both policy and practice.

The agenda included daily panels covering sexual and reproductive health and justice issues. Section Chief Dr. Melissa Gilliam served on the panel, Addressing disparities in Family Planning: Why provider diversity matters. Dr. Gilliam also moderated a panel that covered Reproductive Justice, health disparities, and incarcerated women in the U.S  This session echoed our policy brief on this topic — that a right to abortion while behind bars is meaningless without access. As a panelist said, “What happens to women behind bars is a microcosm of the politicization of reproduction in our society.”

Dr. Gilliam also contributed to a timely and important discussion, The continuing debate on the Medicaid sterilization policy: The advocacy community’s perspective. This session took into account the full, diverse experiences of women seeking to end fertility and reminders to support reproductive autonomy.

Other Forum sessions from Section faculty included a presentation by Dr. Amy Whitaker called Postpartum IUD insertion: From research to reality.

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Dr. Sabrina Holmquist and Clinic Administrator Brie Anderson presented at the Ryan Program meeting.

 

Many of our faculty and staff had posters accepted at the Forum as well.

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Dr. Whitaker’s poster presented her research on motivational interviewing to improve post-abortive uptake of LARC methods. Dr. Whitaker’s research shows that motivational interviewing is a promising approach to address health behavior issues, including repeat abortion and contraceptive counseling, as it is theory based, directive, and patient centered. Click here to view a PDF of the poster.

 

Section faculty Dr. Julie Chor’s poster discussed her research on the prevalence and correlates of women presenting for abortion having a regular provider. julieforumDr. Chor’s study found that a history of abortion did not increase the likelihood of a woman having a regular  provider, and so an abortion visit is a good opportunity to engage women in the healthcare system. Click here to view a PDF of the poster.

 

Other posters presented at the Forum included:

  • Shared negative experiences with long-acting reversible contraception and their impact on contraception counseling: A mixed methods study (Authors include OBGYN resident Dr. Benjamin Brown and Dr. Amy Whitaker). Click here for PDF.
  • Risk Factors for Feelings of Shame and Guilt at the Time of Abortion (Authors include Dr. Julie Chor, Dr. Amy Whitaker, and Policy Coordinator Lee Hasselbacher). Click here for PDF.
  • Reproductive health characteristics associated with unwanted or ambivalent first sexual experience among reproductive-aged men in the United States: An analysis of the National Survey of Family Growth, 2006-2010 (Authors include Dr. Melissa Gilliam, Dr. Amy Whitaker, and former fellow Dr. Elisabeth Woodhams). Click here for PDF.
  • Also spotted: Is LARC for everyone? Socio-cultural perceptions and barriers to contraception among refugees in Ethiopia.  Dr. AuTumn Davidson conducted this research during her fellowship in family planning. Authors include Dr. Gilliam and Research Specialists Dr. Camille Fabiyi, Dr. Brandon Hill, and Erin Jaworski.

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Call for Submissions: 2nd Annual Sexual & Reproductive Justice Graduate Student Working Conference

The 2nd Annual Sexual & Reproductive Justice Graduate Student Working Conference invites submissions on questions concerning sexuality, reproduction, and justice. This conference is co-sponsored by Section partner Ci3 (the Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health) and the Center for the Study of Gender and Sexuality (CSGS). The purpose of this working conference is to provide a forum for graduate students (including law students and medical students and residents) to receive critical feedback on their ongoing projects from other graduate students across disciplines working on similar questions of sexuality, reproduction, and justice.

Abstract deadline is January 24. The conference will be held April 11 at The University of Chicago’s Center for the Study of Gender and Sexuality. More details here.

Rethinking “Gendered” Violence

For Day 15 of the 16 Days of Activism, guest blogger Amanda Blair presents a thoughtful post on gendered violence and justice.

The inclusion of women’s human rights into international law signifies a global shift from historical subordination to the recognition of women’s experiences. National, transnational, and international advocacy movements have been successful in including women’s human rights as a topic on the political agenda, as well as obtaining special legal protections specifically designed to accommodate the needs of women. However, regardless of the advancements made concerning women’s human rights in international legal frameworks, women continue to experience violence and be discriminated against for biological (during pregnancy and childbirth), gender (as mothers and nurturers), and sexuality (non-heteronormative sexual behavior) based differences (Miller 2000, and Edwards 2010, 19).

The 16 Days of Activism Campaign highlights the ubiquity of gender-based violence, and calls for individuals and communities to mobilize and address the shortcomings of international law. Through local, national, regional, and international efforts the goal is for women’s human rights to be recognized and respected at all levels of society.

Three major feminist movements challenged the notion that gender-based violence was a private or domestic concern, and argued, rather, that issues of gender-based violence are of public or political concern and require legal protections. First, starting in the 1970s, U.S. feminist activists worked to include crimes of domestic violence, sexual assault, and sexual harassment into penal code. In 1993, the last state, North Carolina, removed the spousal exemption for crimes of sexual assault, marking the end of a two-decade movement.

1970's feminists

Image: uconn.edu

The second major campaign grew out of the United Nation’s world conferences on women, which advanced the claim that women’s rights are human rights. The result was the ratification of the Convention to Eliminate All Forms of Discrimination against Women (1979) and Optional Protocol (2000), and the creation of the UN Special Rapporteur on Violence Against Women position to monitor violence against women worldwide.

UN talks

Image: humanrightsfoundation.org

The third major advocacy movement was in response to large-scale perpetration of sexual violence during the armed conflicts in former Yugoslavia and Rwanda in the early 1990s. Feminist legal advocates insisted that women’s experiences of sexual violence during armed conflict be included into existing humanitarian law. The movement successfully generated three United Nations Security Council Resolutions (1325, 1820, and 1888), which address the specific needs of women and girls in armed conflict, and during peace negotiations and processes of post-conflict reconstruction. Additionally, international criminal tribunals and transitional justice mechanisms prosecuted sexual violence as a war crime, as a crime against humanity, and as a component of genocide.

Rally

Image: wikipedia.org

The achievements of these movements are commendable. Each movement successfully employed gender strategizing based on sustained sexual difference. In other words, these movements emphasized that women experience violence differently than men, and that legally, it should be recognized as such. Sex-specific agendas upheld that women were disproportionately victims of sexual violence compared to men, and designated crimes of sexual violence as a violation of women’s human rights (Quinjano 2012, 155-67).

However, we know that women and girls are not the only victims of gender-based violence, and it is “impossible to confirm without comparable data on the victimization of men and boys” whether women and girls comprise the majority of victims (Carpenter 2005, 296). Framing gender strictly as sexual difference excludes the reality that men and boys are also victims of gender-based violence, including sexual violence. In additional to sexual difference, gender is socially and culturally constructed, and organized in power and control relationships that privilege particular individual and collective identities over others. For violence to be gendered, it mustn’t always imply sexual or sexualized violence; gender-based violence includes all forms of violence that disproportionately affect men or women, or in other words have a gender bias.

Gendered violence

Image: ctfathersrights.com

Men and boys are subjected to gender-based violence in intimate relationships, in custodial institutions, in the military, during armed conflict, etc., and experience violence perpetrated by both men and women. While forced pregnancy, maternity, and abortion are forms of gender-based violence that are also sex-specific to women, other forms of gender-based violence such as torture, mass killing and death, forced recruitment, and selective detention, disproportionately affect men.

While participating in the 16 Days of Activism campaign, it is crucial that we remember that gender-based violence does not equal violence against women, and it is extremely contradictory to exclude male victims when advancing claims about gendered justice.

**TRIGGER WARNING**

Video: Gender Against Men 

(An advocacy-oriented documentary exposing the hidden world of sexual and gender based violence against men in the conflicts of the Great Lakes Region of Africa. Produced by the Refugee Law Project.)

(Click here to watch the full version.)

Amanda H. Blair is a fourth-year doctoral student at The University of Chicago specializing in the field of Comparative Politics. Her current research focuses on the discursive constructions of conflict-related rape in the Sierra Leone civil war and the Rwandan Genocide, and effects of the exclusion of male victims and female perpetrators from armed conflict analyses of rape.

“Beyond Safe and Legal” – Lack of Access to Abortion as a Form of Gendered Violence

For Day 13 of the 16 Days of Activism, guest blogger Claire McKinney writes about abortion restrictions as gendered violence.

The past two years have been witness to a prodigious amount of new and pernicious abortion restrictions across the United States. According to the Guttmacher Institute, over 162 restrictions have been enacted over the past two and a half years. Many of these restrictions have taken the form of Targeted Regulation of Abortion Providers, or TRAP laws. These laws operate under the guise of making abortions safer for women by creating more stringent requirements for abortion providers, including upgrading facilities to the level of ambulatory surgical centers, requiring doctors who perform abortions to have hospital privileges, and by prohibiting telemedicine, or the provision of medical services over the internet, of use for many rural residents. The regulations have shuttered dozens of clinics across the United States, eliminating access to abortion for countless women, especially poor women in non-urban settings.

This past summer, the Texas legislature’s attempt to pass several of these restrictions in a single bill reached national attention when Wendy Davis, a representative from Fort Worth, filibustered the bill in the closing days of a special session which had been called for the express purpose of passing incredibly restrictive abortion laws that would close the doors of all but five of Texas’ abortion clinics, forcing some women in rural areas to drive anywhere up to 500 miles to reach a provider. Because the filibuster rules of the Texas legislature require that all speaking must be germane to the bill in question, all 10 hours of Davis’ filibuster worked as justifications to reject the abortion restrictions being proposed.

Wendy Davis

Wendy Davis. (Image: huffingtonpost.com)

The testimony Davis introduced, from members of various medical communities as well as from Texas constituents who were barred from testifying during the public hearings on the bills, displayed the full range of justifications for having full access to abortion providers. From a women’s health perspective, what is troubling about these new restrictions is the co-option of the language of women’s health to justify new restrictions. Opponents of abortion have learned to speak that language of science and women’s health without any concern for the validity of their claims. They claim that these laws are necessary to guarantee the safety of abortion, readily ignoring that abortion is safer than childbirth in terms of complications and risk of mortality. When those who object to new restrictions demand evidence for the need for hospital privileges or clinic standards that are only necessary for complicated surgeries demand to see evidence to support these restrictions, the only response is silence. And yet the bad faith co-option of women’s health continues to ensure that women will be refused the care that is medically necessary and socially desirable.

Concerns for women’s health, for women’s citizenship status, and for unjustified interference in medical practice repeatedly echoed through many parts of the testimony. What is striking that often is not present in thinking through the need for access to abortion is how lack of access contributes to gendered violence and is itself a form of economic violence.

In 2012, Karuna Chibber of the Bixby Center for Global Reproductive Health at the University of California San Francisco found that women who were denied abortions were significantly more likely to experience intimate partner violence than women who had safely procured an abortion. It would be easy to speculate how coerced parenthood places women into vulnerable positions in relation to partners such that they could not leave such partnerships, even if they turn violent. Chibber’s work provides a new way of understanding access to abortion to be an issue not only of a choice of one’s life goals but also a crucial resource for women to avoid situations of intimate partner violence. The right to abortion is also the right to be free from violence.

Roe v. Wade anniversary

Image: salon.com

The economic violence associated with lack of access to abortion is more well established and has been a thread of concern for establishing a right to access to abortion since the movements of the 1960s. Many women who seek abortions do so because they know an additional child will place an unsustainable economic strain on themselves and their family. Women lose opportunities such as the time and resources to attend school and to advance or even hold employment when they cannot afford childcare, ensuring that a cycle of poverty will either begin or persist for these women and their families. Furthermore, women in poverty are those who are mostly likely to lose access to abortion providers by the increased restrictions on abortion. Women with financial needs can travel long distances with relative ease, while these restrictions work to create an economic underclass, whose rights are less than those of the wealthy. The differential health results are themselves a form of violence against women that demands that access to abortion remains part of the activist agenda for women’s empowerment.

Davis’ filibuster delayed the passage of the abortion restrictions in Texas, but only by a couple of weeks. Since their passage, they have been held as constitutional by the Texas Court of Appeals and the Supreme Court has refused to hear the constitutional challenge against such laws. Relying on legislative and judicial forums to protect access to abortion has proven to be less than effective. Instead, protecting and expanding access to abortion requires organizations and individuals to articulate demands not only in the language of health which has become too susceptible to cooption, but also in the language of women’s citizenship and right to be free from violence.

Claire McKinney is a PhD candidate in Political Science at The University of Chicago. Her dissertation develops a concept of medicalized citizenship and the centrality of the language of health in the history of and in present day abortion politics. 

New Research on Transgender Issues in the Military

Brandon J. Hill, PhD, joined Ci3 as a Research Professional with an extensive background in transgender research. Hill recently received a two-year grant to study transgender issues in the military, a subject that’s been especially newsworthy of late but actually has a long history. 

In the following Q&A, Dr. Hill discusses his research experience and what he hopes the new study will accomplish for transgender individuals in military service. 

Dr. Brandon Hill (right), Joshua Trey Barnett, and former Navy SEAL and Author of Warrior Princess, Kristin Beck (photo by Christine Grost).

Dr. Brandon Hill (right), Joshua Trey Barnett, and former Navy SEAL and Author of Warrior Princess, Kristin Beck (photo by Christine Grost).

Can you talk a bit more about your background in transgender research?

I have a relatively broad background in research that includes gender, sexuality, and transgender studies. My main focus has been on the ways in which individuals understand their body as sex or gendered. But this has led to a wide array of research topics, into which I have delved deeper.   My current project examines transgender medical accommodation and care in the U.S. military. The goal of this project is to assess the need for medical accommodation for transgender service men and women, and determine in what ways the inability to “come out” as transgender while serving in the military may actually increase distress and have negative health implications for these service members. Given that the Department of Veterans Affairs [VA] is now covering the cost of transition-related counseling and hormone therapy, it is like dangling a carrot in front of active members’ noses. This disjuncture in policy just seems unfitting and out of sync with the current Standards of Care for transgender health. However, given the current military’s policies on “gender related disorders” there is not good data on how many transgender service men and women are currently serving. Thus, this project looks at both active members and veterans who identify as transgender.

In the recent press coverage of Chelsea Manning (f/k/a Bradley Manning), the disgraced soldier who’s been sentenced to 25 years in federal prison and is transitioning from male to female identity, what have you found the most unsettling and why?

The main thing that I find unsettling in this case is that that some coverage seems to be ahistorical forgetting that there have been many publicized US military personnel who have transitioned after serving in the military. For instance one of the earliest transgender identified U.S. veterans, Christine Jorgensen, was met with newspaper titles like “Ex-GI Becomes Blonde Beauty” in 1952. And there are many others. As other transgender activists like Jenny Finney Boylan have expressed, this case is not the only narrative on transgender individuals and the military.

You just received a grant from the Palm Center (funded by Col. Jennifer N. Pritzker) to study transgender issues in the U.S. military. What do you hope to accomplish with this research?

With this commissioned study, we hope to gather the stories of transgender service men and women and veterans to try our best to fill in the gap where there has been so little research attention. My collaborator, Joshua Trey Barnett, and I hope to highlight the challenges and complexities of transgender service members and veterans who have transitioned during active duty or have accessed medical treatment and care from either the VA and/or private healthcare providers after military service, and evaluate what the VA already accommodates medically, and the usage and perceived quality of care of services for transgender mental healthcare and cross-sex hormone therapy.  We hope that the findings from this study have broader implications and build on the Palm Center’s initiative to enhance the quality of scholarly information available for understanding the interaction of transgender medical accommodations and the U.S. military.

What do you think the increased awareness of the relationship between trans* individuals and the military (the Manning case, former Navy SEAL Kristin Beck, etc) means for the prison system, society and trans* individuals themselves?

I think that increased visibility combined with sound evidence-based research like the one we are hoping to complete has direct implications for potential changes in policy. Though the focus of the current project is within the U.S. military, in any system in which policy is out of sync with contemporary identities, an evidence-based approach with sound research is likely to inform policy change.

Dr. Hill will present “Supra-Natural: Genderventions and Genitalia” at The University of Chicago Center for the Study of Gender and Sexuality on Tuesday, November 12 from noon-1:30 p.m.

Policy Trends and Research Updates on the 40th Anniversary of Roe v. Wade

On January 22, 1973, the Supreme Court of the United States decided the landmark case Roe v. Wade, which established the right to abortion.  Forty years later controversy still surrounds this decision and attempts to restrict and regulate abortion care have continued. In 2011 and 2012, the United States saw more regulation of abortion care and access at the state level than in the past 40 years, making it more and more difficult for women to exercise their rights.[1]

State lawmakers are continuing to find new avenues through which to restrict access to abortion; 2012 saw trends in proposed and passed legislation that restrict insurance coverage, require provision of unnecessary procedures or misleading information to women, target abortion providers, and seek to ban abortions at later gestational ages based on theories regarding fetal pain.

Eight states now have laws that require a doctor to perform an ultrasound and show her the image or offer to do so before a woman can receive an abortion.[2] Doctors already perform ultrasounds if they are needed to provide abortion care; enacting legislation to require the procedure and viewing of the image appears aimed solely at trying to dissuade women from choosing abortion. A 2012 study researching the effects of ultrasound viewing on women seeking abortion found that women can respond differently – some women felt dissuaded, some women experienced emotional difficulty, and some women reported a better ability to cope with their abortion. Given these varied outcomes, the authors suggest that the decision to view an ultrasound should be left to the doctor and patient.[3] The leaders of five well-regarded professional physician organizations agree. Responding in part to the ultrasound mandates, they published a commentary in 2012 voicing concerns over legislative interference with the patient-physician relationship; they assert that such legislative intervention undermines the ability of physicians to give, and patients to receive, the highest quality care and medical guidance.[4]

In a large number of states, a waiting period is required before receiving an abortion. In addition, doctors must provide mandatory counseling prior to abortion; in some states, specific language must be read, including information that is not supported by science regarding links between abortion and breast cancer and mental health risks. Not only do such mandates require physicians to provide misinformation, but a study conducted in June 2012 found that 87% of women are confident about their decision to make an abortion before visiting a clinic, suggesting that blanket regulations requiring counseling and waiting periods only interfere with a woman’s ability to receive personalized care.[5]

These misleading practices can be amplified by Crisis Pregnancy Centers (CPCs), which often give the impression that they offer abortion services, but in fact typically only offer pregnancy tests and ultrasounds and are usually established expressly to discourage abortion. In a recent study, researchers contacted 32 CPCs in North Carolina and seventeen (53%) provided at least one misleading or inaccurate piece of information, including inaccurate information about links between abortion and breast cancer, mental health hazards, and infertility.[6] Scholar Joanne Rosen also discussed the public health risks of CPCs in a 2012 commentary in Perspectives on Sexual and Reproductive Health, claiming that CPCs, which operate under the notion of informed consent, are actually, “contrary to the legal and ethical standards of informed consent”, given their practices of distributing misleading information.[7]

In 2012, three states (Arizona, Kansas and Missouri) enacted new “conscience provisions,” expanding the types of entities that can refuse to provide care or insurance to patients or employees.[8] Many states already have provisions in place that exempt individuals from providing these services on moral or ethical grounds, but new measures allow insurers to exclude coverage for contraception, abortion and sterilization.[9]  As Lisa Harris points out in a recent article in The New England Journal of Medicine, these measures allow for “conscience based refusals,” but there is little legal protection of “conscience based provision” of such services.[10]

In the past year, there has been an onslaught of legislation establishing targeted restrictions on abortion providers (referred to as TRAP laws). Bills were proposed in twelve states that would place burdensome restrictions on clinics through building regulation mandates and new employee requirements. Last month, Governor Rick Snyder of Michigan signed a bill which requires clinics that regularly perform abortions to meet the same building license requirements as surgical outpatient facilities. This bill and others like it will likely result in not only the closing of many existing clinics, but will make the building of new clinics more arduous.[11] Some women must already travel hundreds of miles to the nearest clinic, as this map demonstrates. These types of restrictions will make access even more difficult.

With the passage of the Affordable Care Act and the resulting creation of new state exchange programs, many legislatures have made efforts to curtail coverage for abortion. Four states in the past year passed bills which prohibit abortion coverage through their exchange programs, while a number of other states are working toward abortion care bans both within and beyond the exchange. In addition, many states continue to pursue a ban on abortion at earlier gestational ages. Eight states in the past year saw bills that proposed abortion bans as early as twenty weeks post fertilization, which precedes the current legal viability mark.[12] These bans likely impact the most vulnerable women; in a recent study, researchers found that patients seeking second trimester abortions were often younger (age 19 and below), Black, less-educated, lower-income, had experienced more disruptive life events, and were more likely to have been exposed to intimate partner violence.[13]

A major victory for women in the year 2012 was the passage of the Shaheen provision in the National Defense Authorization Act, which provides military servicewomen and military families the same abortion coverage as other federal employees. Previously, insurance for these women only covered abortions when a woman’s life was at risk, but the Shaheen provision allows for additional coverage in the case of rape or incest.[14] This change is especially welcome given the findings of a recent study which showed a number of challenges women in the military face when seeking contraception; one third reported that they were unable to access a method they might want for deployment, certain methods were reportedly discouraged or not available for some women (including intrauterine devices and sterilization), and 41% of women requiring refills found them difficult to obtain.[15]

Looking back on 2012, we can celebrate the reproductive justice achievement in the Shaheen provision, and applaud the successes that legislatures and reproductive justice advocates had halting the passage of proposed bills that would restrict access. However, some measures did pass which limit the ability of women to obtain supportive and quality reproductive care. As we move into 2013, there are promising ways to advance the rights articulated in Roe v. Wade. Such initiatives might include efforts to preserve insurance coverage and expand public funding for abortion care, expand sexual education, promote public awareness of issues related to reproductive justice and abortion, and increase women’s access to reproductive care.


[1] 2012 Saw Second-Highest Number of Abortion Restrictions Ever. New York: Guttmacher Institute, January 2, 2013.

[2] State Policies in Brief: Requirements for Ultrasound, New York: Guttmacher Institute; 2013.

[3] Kimport K., et al. Women’s Perspectives on Ultrasound Viewing in the Abortion Care Context.  Women’s Health Issues. 2012, 22(6): e513- e517.

[4] Weinberger SE, et al. Legislative Interference with the Patient-Physician Relationship. The New England Journal of Medicine. 2012, 367: 1557-1559.

[5] Foster DG, et al. Attitudes and Decision Making Among Women Seeking Abortions at One U.S. Clinic. Perspectives on Sexual and Reproductive Health. 2012, 44(2): 117- 124.

[6] Bryant A, Levi E. Abortion misinformation from crisis pregnancy centers in North Carolina.  Contraception. 2012, 86(6):752-756.

[7] Rosen JD. The Public Health Risks of Crisis Pregnancy Centers. Perspectives on Sexual and Reproductive Health. 2012, 44(3):201-205.

[8] 2012 Year-End Report. New York: Center for Reproductive Rights, 2013.

[9] State Policies in Brief: Restricting Insurance Coverage of Abortion, New York: Guttmacher Institute; 2013.

[10] Harris L. Recognizing Conscience in Abortion Provision. The New England Journal of Medicine. 2012, 367: 981-983.

[11] Marty R. “Michigan Governor Snyder Signs Abortion Superbill into Law”. RH Reality Check, 2012.

[12] 2012 Year-End Report.  New York: Center for Reproductive Rights, 2013.

[13] Jones RK, Finer B. Who has second-trimester abortions in the United States? Contraception. 2012, 85(6):544-551.

[14] Senate Votes to Ease Ban on Abortion Coverage for Military Servicewomen; Bill Now Moves to Conference Committee” New York: Center for Reproductive Rights, 2012.

[15] Grindlay K, Grossman D. Contraception access and use among US servicewomen during deployment. Contraception. 2012, 87(2): 162-169.

Adolescent Initiation of Sexual Activity

In Sexual Timetables for Oral-Genital, Vaginal and Anal Intercourse: Sociodemographic Comparisons in a Nationally Representative Sample of Adolescents, published in The American Journal of Public Health, authors Carolyn Tucker Halpern and Abigail Haydon documented the relative timing and prevalence of three types of intercourse: oral-genital, vaginal, and anal, examining whether these timetables varied by sociodemographic factors.

The authors utilized data from National Longitudinal Study of Adolescent Health respondents to generate prevalence estimates for adolescents who reached age 18 years by 2001, examining sociodemographic correlates of sexual patterns.

Authors found that 1 in 5 adolescents did not engage in any of the aforementioned sexual behaviors by age 18 years, while over two thirds reported vaginal or oral-genital sexual activity.  Roughly half of respondents experienced both.  Only 10 percent of individuals reported having had an anal intercourse experience.  Authors concluded that most of the examined sociodemographic characteristics were uniquely associated with prevalence and sexual timing.

Disparities in Reproductive Care Among Urban and Rural Women

In Primary Care Physician’s Perceptions of Barriers To Preventive Reproductive Health Care in Rural Communities [PDF], published in Perspectives on Sexual and Reproductive Health, authors Cynthia H. Chuang, et al, sought to investigate the disparities in reproductive health care between urban and rural women.

Findings suggest that expanding access to preventive reproductive health services in rural areas may not be sufficient to improve use of contraceptive services and preconception care.  Raising public awareness of the importance of pregnancy planning and good preconception health is needed.

In 2010, authors conducted semistructured interviews with 19 rural primary care physicians in central Pennsylvania regarding their experiences in two domains of preventive reproductive health—contraceptive care and preconception care. Physicians perceived that they had a greater role in providing contraceptive care than did nonrural physicians and that contraceptives were widely accessible to patients in their communities; however, the scope of contraceptive services that were provided by each individual provider varied greatly.  Physicians also perceived rural community norms of unintended pregnancies, large families, and indifference toward career and educational goals for young women as the biggest barriers to both contraceptive and preconception care, as these issues predicted a lack of interest in family planning.

Study findings point to the importance of encouraging primary care physicians to take a more proactive role in promoting preventive reproductive health care.  This could be accomplished through continuing education programs and skills-building workshops to increase both provider knowledge about client self-efficacy for reproductive health counseling.

Oral Contraception Linked to Women’s Wage Gains

In The Opt-In Revolution? Contraception and the Gender Gap in Wages, by Bailey et al., published in the National Bureau of Economic Research, reports that from 1979 to 1989, median wage and salary earnings of full-time, working women increased from approximately 60% of men’s earnings to 69% of men’s earnings.  This marked a striking departure from the stability of women’s relative pay during the 1970s, narrowing the wage gap during the 1980s.  Authors utilized data from the National Longitudinal Survey of Young Women, which includes interviews starting in 1968 with 5,159 women ages 14 through 24, with 21 follow-up interviews.

Authors examined state-level variation within birth cohorts for early legal access (ELA) to the pill, and although the timing of ELA implementation differed significantly from state to state, every state gave physicians the ability to prescribe the pill to unmarried women younger than age 21 without parental consent.  The researchers used respondents’ legal state of residence at age 21 to determine whether they would have had ELA.  Authors then utilized the 1970 National Fertility Survey, which includes data on ever-married women’s pill use during the 1960s, in order to specifically look at pill use among women who were married by 1970 and those who were ages 18 through 21 before 1970.

Researchers determined that although the hourly and annual wages of women who had ELA were lower in their early 20s than the earnings of women who did not have ELA, “their wage and salary earnings grew more rapidly than their counterparts as they aged.”  Specifically, the researchers found that women ages 20 through 24 with ELA earned 3% less hourly and 9% less annually, compared with their peers. Read more of this post