On Feb. 1, 2013, the Obama administration announced an update to its proposed contraception coverage policy under the healthcare law. The update comes in response to an uproar created by some religiously affiliated organizations and anti-contraception activists. The bottom line of the new policy is that women still get contraception coverage at no additional cost, no matter where they work. Religious organizations that object to covering it don’t have to pay for it. For example, if a woman works for a religious charity, hospital, or university that has a religious objection to covering contraception, an insurer will still provide coverage to her at no additional cost.

The philosophy underlying the update is to affirm that religious liberty and protecting women’s health are both core American values that need not be in conflict.

Just to clarify: Under the Affordable Care Act (aka “Obamacare), all churches and houses of worship continue to be—and always have been—exempt from covering contraception. What’s new in the updated policy is that religious-affiliated organizations, such as hospitals, charities and universities, do not have to provide birth control if they object. [Click here for a detailed fact sheet on the contraceptive policy update.]

So, under the policy update, who will pay for birth-control coverage, if it’s not provided by the exempt organization? The insurance companies, health-insurance issuers for group health plans, and third party administrators of self-insured health plans [meaning, large employers that fund their own healthcare.]

Response to the policy update has been mostly positive. While the Catholic Health Association is reported to be evaluating the improvements, organizations that have already stated their support include Catholics United, Planned Parenthood, NARAL, the National Partnership for Women & Families, and the National Women’s Law Center.

The Obama administration’s outlook on contraception is in line with demonstrated healthcare history and public opinion. Studies show that nearly 99 percent of women have relied on contraception during their lives, but more than half of women between 18 and 34 have struggled to afford it. In addition, public-opinion polling shows that seven in 10 Americans believe that health insurance companies should be required to cover the full cost of birth control, just as they do for other preventive services.

On a personal note, I’m among both of those groups, and while I see reproductive freedom as a human right that, in a perfect world, wouldn’t be up for negotiation, I still applaud the Obama administration for listening to other viewpoints and developing a solution that respects the concerns of both sides.

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Earlier this week [Sept. 12, 2012], the Replubican-dominated Missouri Legislature overturned Democratic Gov. Jay Nixon’s veto of a bill that allows employers to deny coverage for birth control to women, if offering it violates the employers’ religious beliefs. So now, if you’re a woman in Missouri, and you work for a Rick-Santorum-like boss, you’re not going to get your birth control paid for by your insurance plan. And, if you insist on thwarting the reproductive will of your boss’s deity, you’re going to have to pay for it out of your own pocket.  Now, what, exactly, will that cost?

The bill was initially introduced by  Republican State Representative Mark Lamping from Ladue, a wealthy St. Louis suburb. Lamping has said that the now-uninsured women will simply have to pay for their birth control “out of their personal wherewithal.” Apparently, he thinks that women can take these costs out of petty cash. And, while that would be a nice scenario, a post at Fired Up Missouri clearly shows that—particularly for lower-income women, that’s not at all realistic.

“Reproducing, Ladue-style,” tallies up the costs of getting a prescription for birth control [including an exam from a physician], and compares insured vs. uninsured costs. For example:

Birth control pills must be prescribed by a physician. A person with health insurance pays between $10 and $30 in co-pay for the required gynecological exam. A person paying for those services…will pay between $35 and $200.

The post goes on to demonstrate how much paying out of one’s own “personal wherewithal” would impact the financial situation of low-income women.

Minimum wage in this country is $7.25 an hour. A person earning minimum wage who would like to experience intimate relations (as my mother might say) with a loved one and not get pregnant is spending two hours working to earn the money she needs to visit a doctor and obtain a month of birth control pills, assuming her health plan covers birth control pills.

If her employer or her insurance plan chooses not to cover birth control pills, she will be working 7.6 hours in order to have the money to access that same set of services and products. About a day’s work. Go ahead and multiply this out over a year…

The figures are worth looking at. These specific costs may be from Missouri, but there are undoubtedly parallels in other states. And remember that Missouri’s own U.S. Senator Roy Blunt was the sponsor of a national birth-control “conscience law” just last year. [Thankfully, reason prevailed and the bill failed.] But anti-choice legislators don’t give up easily, so  this punitive and religiously based approach to birth control could be coming soon to a state near you.

The moral [if morality is a word that can be associated with this law] of the story, says Fired Up Missouri is this:

Nobody, but nobody, is a fan of abortions. Pro-choice, pro-life. Nobody. Even in Missouri, we can agree on this. So why in the world would a financially well-off securities broker lead our state representatives to engineer a health care system that makes it far more likely that the women of the working poor will be conceiving unwanted pregnancies?

Mothers and daughters with sufficient personal wherewithal will almost always reproduce when and as we choose. Shouldn’t the right to exercise individual moral and religious freedom extend to everyone?

 

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Listen up, ladies. Did you think your reproductive destiny was yours to decide? Think again, because it looks like we’re going to be refighting the battle of 1873.  That was the year Congress passed the Comstock Act. Comstockery, as playwright George Bernard Shaw called it during his own censorship kerfuffle, is having a nationwide rerun.

The pin-up for this new/old world is Republican presidential candidate Rick Santorum.  Next time you see Mr. Santorum holding forth on the dangers of contraception, take a closer look and you might catch a glimpse of Anthony Comstock’s shadow snuggled on Rick’s sweater-vested shoulders.

Even though Santorum’s moment in the media glare has made him the point person for an increasingly ugly debate over women’s reproductive rights, don’t be fooled. He’s not alone. There’s a phalanx of foot soldiers who share his opinions, and their ranks are swelling with socially conservative Republicans and Tea Partiers, Evangelicals, anti-choice activists, and Republican state legislators and governors who are bending themselves out of shape to force restrictions on your reproductive choices.

The Comstock century

Although hardly a household word today, Comstock’s name left a legislative legacy that has endured for more than a century and continues to this day to hover over our national debate on women’s rights.

Anthony Comstock was a New Yorker who served in the Union army during the Civil War.  During his stint in the infantry, Comstock—a religious zealot who, like Santorum, believed in a strict theological worldview—was appalled by photos of ladies posing in various states of undress that his fellow soldiers tucked away in the pockets of their uniforms.  When the conflict ended, Comstock returned to New York City, where he found streets “polluted” with prostitution and pornography—fodder for his anti-obscenity crusade that led to the founding of the New York Society for the Suppression of Vice.

Comstock’s success in the big city emboldened him to take his crusade nationwide. Armed with legislation he had personally penned, Comstock traveled to the halls of Congress. With no floor debate, in 1873 the Comstock Act was passed and signed by President Grant.

The Comstock Act suppressed the sale and circulation through the mail of “obscene, lewd, or lascivious” books, pamphlets, pictures, papers or other publications of an indecent character, as well as articles of “immoral use.” Contraceptives and abortion were classified as obscene, thereby criminalizing them as well.

The broadness of the legislation’s language ensnared doctors, teachers, scientists, and pharmacists who risked prosecution not only for disseminating information on contraception and abortion but also on reproduction, anatomy, and the causes and treatment of sexually transmitted diseases. Even medical textbooks expunged any references to contraception or abortion.  This censorship of reliable information occurred at a time when various contraceptive methods (some effective, some not) were widely used, and physicians reported one intentional abortion for every five live births.

The Comstock Act just won’t go away

Over the years, challenges to the act have nibbled away at many of its provisions.  However, the act—although in a modified form—is still on the books today.

1878, 1918, 1923, 1930, 1938, 1971, and 1983.  Those were years in which  individuals who understood the fundamental health necessity of reproductive choice struggled to have portions of the Comstock Act repealed or overturned.  Many faced opposition from the Catholic Church and failed.

Margaret Sanger, founder of the first birth-control clinics in the United States, successfully challenged the act in court and succeeded in striking down provisions on two fronts: first, allowing women to use birth control for therapeutic purposes and then, finally, overturning entirely the federal ban on birth control.

Incredibly, it was not until 1983 that the prohibition on mailing advertisements for contraceptives was struck from the law, and the Supreme Court declared unconstitutional the ban on mailing of unsolicited contraceptive advertisements.

Still on the books today, however, are Comstock Act restrictions on dissemination of abortion-related information. As recently as 1994, Congress increased the maximum fine for a first-time violation of the act from $5,000 to $250,000.

 Kindred spirits

If Comstock were alive today, we’d probably recognize him as a master framer of the specious link between contraception and promiscuity.  This is where Santorum and others who share his beliefs connect most directly to the nineteenth-century spirit of Comstockery–the idea that simply the availability of contraception promotes lust and lewdness. Like Comstock, those who would limit reproductive choice believe that limiting access will control and suppress sexual behavior.

Santorum summed up this worldview when he declared, “Many of the Christian faith have said, well, that’s okay, contraception is okay.  It’s not okay.  It’s a license to do things in a sexual realm that is counter to how things are supposed to be.” Linking birth control and sexual behavior in one foul-mouthed tirade is what dumped Rush Limbaugh into hot water when he slandered Sandra Fluk by labeling her advocacy of no-cost contraception as a view that could only be espoused by a slut or a prostitute.

Comstockery makes a comeback in state legislatures

Even if Santorum is not the eventual Republican nominee, his fellow believers in state legislatures are playing fast and loose with women’s rights. In 2011, more than 1,100 reproductive health and rights provisions were introduced in fifty states, with 135 being successfully enacted in 36 states. Ninety-two out of the 135 restrict access to abortion services.  Other provisions include personhood bills, waiting periods, forced ultrasounds, restrictions on insurance coverage for abortions and birth control, clinic regulation, and expansion of abstinence-only education.

The backlash to this assault on women’s rights has just begun.  And the upcoming election is going to be a test of the strength of our commitment to defend the right of women to make their own choices about their bodies and their lives.  The question is: will we finally be able to honestly say, “Anthony Comstock, R.I.P.”

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The recent, manufactured controversy over insurance coverage for birth control coincided with receipt of my copy of a small book with facts about my Irish ancestors on my mother’s side of the family.  I have an 8 x 10 photo of a prim and proper looking family of nine children and their father taken in the living room of one of their homes, the lace curtains stained with oil lamp smoke.

Set off to the side of this grouping is a large photo of the missing family member,  Anna Murray Loftus.

Married at age 25, Anna Murray Loftus delivered her first baby before her first wedding anniversary.  She gave birth to nine more babies in the next 18 years and died in her 40’s along with the 10th baby. I can only wonder what her everyday life was like.  Her husband was a farmer and then a carpenter, so I’m sure they didn’t have much money.  I suspect she delivered all those babies at home without medical attention.

I had never given much thought to how much a pregnancy takes out of a woman until I got involved in the puppy mill controversy last year.  I learned appalling facts about the damage done to the females by overbreeding.  They lose most of their teeth early on.  The muscles and bones deteriorate to the point that many of them can barely stand up.  I heard that some breeders actually hang the female in a sling to inseminate her although I find this really hard to believe.

My great-aunt Mary, the oldest daughter, raised her siblings.  She was only 17 when her mother died.  She put off getting married herself until later so she could raise her brothers and sisters. One of the brothers had meningitis and lost the use of both legs.  She took care of him as well as the youngest brother who was, for some reason, not able to function very well on his own.  Aunt Mamie, as we called her, never had children of her own, probably because she married late in life.

One of the younger sisters was my grandmother, Josephine Veronica Loftus Rockwell.  Her husband died in an accident and left her with two small children.  Times were tough.  “Nana” cleaned houses to earn enough to feed the kids and, after they were grown and married, she came to live with us.   I have no doubt that, if her husband had lived, she would have had many more children.  That’s just the way it was back then.

When I was married in the Catholic church in 1962, I assumed I would have a baby every year.  My older sister was already on the 3rd of her 8 pregnancies when I married.  In fact, any married woman who wasn’t pregnant by her first anniversary was the topic of worried gossip.  Maybe something was “wrong with her.”  Not to disappoint, I delivered my first baby almost exactly nine months after the wedding.  Then a 2nd one 16 months later and a 3rd one 20 months after that.  The second baby, a boy, was born with a serious heart defect, possibly because I was teaching school during the last major German measles epidemic in 1964-65 and many of my students contracted the disease.

In 1966, my husband was assigned to Grand Forks AFB in North Dakota, and the birth control pill was just becoming a common form of contraception.  Knowing that my son would need heart surgery soon, I talked to the Catholic chaplain on base about using the pill.  He had just returned from duty in Vietnam and had much more important things on his mind than birth control.  Keep in mind, this was back when there were pamphlets in the back of the church saying that babies who died before being baptized went to “limbo” as well as all the “potential babies” who never had a chance to be born because of birth control.  Limbo was not quite hell and not quite heaven and there was no getting out.   The chaplain, a priest, told me my decision was between God and myself.  I decided God would want me to be with my son after his surgery in a hospital 400 miles away, so I chose the pill.

Long story short, I stopped taking the pill after my son’s successful heart surgery and got pregnant again.  Sadly, John Christopher died four months after surgery because his lungs couldn’t manage the increased oxygen supply.  He suffocated at home in his own bed.

So I know what it’s like to have multiple pregnancies and to lose a young child.  When I read stories of pioneer women dying in childbirth, I can “be there” with them.  When I read about them burying their babies and young children along the trail westward, I feel their pain.

I can’t imagine why any compassionate person would want women to return to those days and that kind of suffering.  I question whether men should even have the right to make those decisions for us.  Prior to the women’s movement of the 1960’s and 1970’s, I never would have questioned a man’s decision.  Now I question them all the time.

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