You're a woman who has been raped, and you're terrified that your rapist made you pregnant. You ask your doctor for emergency contraception, but she refuses to give it to you; she's morally opposed to it.
Today, the options in Mississippi are limited. No doctor or pharmacist is obligated to provide the care you legally seek. You could end up with a pregnancy forced on youonce by violence and again by another's moralityendangering your own health and that of a child.
If President George W. Bush gets his way during his final months in office, the Mississippi model of ultra-conservative reproductive regulations would go nationwide. A Health and Human Services draft proposal circulating on Capitol Hill will: restrict most forms of birth control, potentially making them illegal in 27 states; allow insurance companies to refuse to cover contraceptives; and expand the definition of who can refuse service to those who "assist in the performance" of health care, a definition so broad that it includes peripheral workers such as pharmacy clerks, clinic receptionists, medical technicians and janitors.
"If the regulation were implemented (clinics) could hire a receptionist who could refuse to make appointments for women who are seeking birth control," said Shawna Davie, Reproductive Freedom Project Coordinator at the Mississippi ACLU. "It would definitely put the clinic in a precarious position."
The proposal would also deny federal funding to institutions that do not certify, in writing, compliance with "conscience" anti-discrimination laws already enacted. Those laws, the so-called "church" amendments and the Weldon Act, make it possible for facilities and providers to refuse to provide reproductive health care based on moral grounds.
Mississippi allows the broadest interpretation of those laws, allowing health-care providers, pharmacists, pharmacies and health-care institutions to refuse contraception, sterilization and abortionmaking it the only state in the union to include all providers and all female reproductive options.
"I'm not sure it would make that much of a difference in Mississippi," as a practical matter, said Adam Sonfield of the non-partisan Guttmacher Institute in Washington, D.C., which advances sexual and reproductive health worldwide. It would, however, make the state's laws easier to enforce and impossible to overturn.
The proposal's authors also want to include the aforementioned "federal conscience protections" within anti-discrimination hiring laws (against race, creed, sex and so forth), opening the door for lawsuits against clinics whose raison d'etre is providing safe and legal reproductive health services. If approved, anti-abortion doctors and others fired (or not hired) by such clinics would have grounds to sue, and HHS could withdraw federal funds from those clinics,.
Hidden in the middle of the proposal, however, is language that redefines what qualifies as an abortion, serving to broaden the legal definition of pregnancy, potentially making any birth control that prevents implantation of a fertilized egg (IUDs for example, and "morning-after" pills) illegal.
"[T]he Department proposes to define abortion as 'any of the various proceduresincluding the prescription and administration of any drug or the performance of any procedure or any other actionthat results in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation,Ҕ the draft reads.
The language uses right-wing ideology that states every fertilized human egg constitutes a life, whether viably implanted in the womb or not.
Both the American Medical Association and the American College of Obstetricians and Gynecologists, define pregnancy as beginning at implantation, eight to 18 days after fertilization; between one-third to one-half of all fertilized eggs never fully implant naturally, they say, and up to 20 percent of all implantations end in miscarriage, most before the women knows she is pregnant.
The right wing ignores that definition.
"Birth control very often causes abortionperiod," said Judie Brown, president of the anti-abortion American Life League, in a July statement.
If Bush orders implementation of the proposal, which does not require congressional approval, it would join other ideologically based and ineffective reproductive health-care regulations, such as abstinence-only sex education, proven to be ineffective in reducing teen pregnancies or lowering rates of sexually transmitted disease, including HIV/AIDS.
Twenty-eight U.S. senators, including Barack Obama and Hillary Clinton, wrote to HSS Secretary Michael O. Leavitt July 23, urging him not to pursue the proposal.
"The fact is, most Americansregardless of their position on reproductive choiceagree that increasing access to birth control prevents unintended pregnanciesand results in fewer abortions," the letter states. "As a matter of public policy, it is utterly irresponsible for the federal government to hinder women's access to contraceptive services.
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