A new set of health laws that could be proposed by the government sometime in the next few weeks has women's health activists steaming. If the laws are implemented, they claim, women will have a harder time getting access to contraception.
The legislation, a draft of which was leaked last week to the New York Times, stokes the debate over when human life begins by taking the position that birth control that prevents the implantation of a fertilized egg actually results in abortion. It would prohibit federally funded medical facilities—including teaching hospitals and Planned Parenthood clinics—from refusing to hire doctors who don't want to dispense birth control pills and other types of contraception that may cause the expulsion of a fertilized egg. (It's already illegal to discriminate against doctors who refuse to perform abortions.) The new laws would also override state laws that require hospitals to offer emergency contraception to rape victims and those that require employers to provide contraceptives along with other prescriptions.
Late last week, Sen. Hillary Clinton called the planned rules (which could be imposed without congressional approval) "damaging" and a "dire threat to women" and warned that contraceptive coverage would "disappear overnight" if enacted. Dozens of organizations, including the American College of Obstetricians and Gynecologists and Planned Parenthood, have also voiced their objection, especially to the government's definition of the onset of pregnancy. According to ACOG, "conception is the implantation of the fertilized ovum," based on the ability to clinically detect pregnancy through elevated hormone levels. Hormonal contraceptives—especially those that contain only progesterone like the minipill and the Mirena intrauterine device—don't always suppress ovulation, so sometimes a fertilized egg is expelled before it's implanted in the uterus. Refusing to comment specifically on the draft proposal, the Department of Health and Human Services yesterday issued a statement saying it is "exploring a number of options" to enforce the antidiscrimination laws put in place by Congress.
Those supporting the new regulations believe in a stricter definition of conception: Life starts at fertilization. Contraception that acts as an abortifacient is "clearly the destruction of a human being at [its] earliest stages of development," says Deirdre McQuade, assistant director of policy and communications at the U.S. Conference of Catholic Bishops' Pro-Life Secretariat. She adds that doctors should be "allowed to practice medicine according to their values." Republican Rep. Dave Weldon of Florida, a physician who helped pass congressional laws protecting doctors who oppose abortion, says extra enforcement is needed to protect the rights of healthcare workers. "Just this weekend a nurse told me that she has resigned from two jobs at two different hospitals because she refused to sign a form promising to provide abortion services," he wrote in a prepared statement released yesterday.
Yet in protecting the rights of medical practitioners, some worry, the law would trample on the rights of the patient. "It would mean that if a woman walked into a facility and her doctor didn't believe in birth control, she wouldn't get it and wouldn't even know that she's not being offered this option," says Cecile Richards, president of Planned Parenthood Federation of America. Treatment, she says, would be "the luck of the draw."
Just as troubling, experts say, is that the new rules would nullify state laws protecting women's access to reproductive health services, according to an assessment performed by the National Family and Reproductive Health Association. For example, 27 states currently require that insurers treat contraception like other prescriptions, while 16 states require hospital ER's to provide emergency contraception for rape victims. More than a dozen states require pharmacies to stock birth control pills and "plan B" emergency contraception, a response to the growing trend of "pro-life" pharmacies to refuse to stock any form of birth control.