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Alternatives to Family Planning

November 21st, 2008

So just this evening, I came across an interesttng NYTimes article on alternatives to family planning which led me to a Catholic website which was promoting the use of “Natural Family Planning” over the ‘artificial’ form, like condoms and such.  NFP, according to the site, is a scientific method for determining human fertility through the observation of a woman’s biological cycles. The site also claimes that recent(2007) studies have proven the effectiveness of methods such as the “Sympto-Thermal Methods” when used correctly can result in only “0.4 pregnancies per 100 women per year”.

At first I was very encouraged by this. I have read much and seen firsthand how efforts to encourage condoms and birth control have been thwarted by the religious beliefs of the mother or father. The idea that there were other methods excited me in that perhaps now a Vatican-approved method could be used as part of family planning programs by NGO’s in the developing world.

I then started reading a bit more about the actual methods. The Sympto-Thermal Method, for example, tracks waking temperature and observations of changes in cervical mucus to determine the fertile and infertile times in a woman’s menstrual cycle. Another listed method, the Mucus-Only Method, tracks changes in cervical mucus and/or sensation. Observations are made, recorded, and interpreted. As I read more and more methods, I started to realize how difficult it would be to teach these methods and quickly became discouraged.  Personally, I couldn’t see myself taking the time out to figure out how to work these methods and could only imagine how difficult it would be for an international organization to attempt to implement it in developing countries.

Unfortunately, NFPs do not seem like a very feasible alternative to condoms and other family planning tools that the religious groups may not approve of. While seen by the Catholic Church as “the only morally acceptable method of regulating birth”, NFP’s are not a very practical or comprehensive  method to use.

Abortion Foes Shifting Focus From Absolute Bans to Reduction Efforts

November 20th, 2008

This post fits well with my post from last week…both highlight alternative, and more productive efforts to reduce the incidence of abortion IN PLACE of instituting outright bans on abortion practices.  The goal of these last few posts is to not only emphasize the more attractive alternatives to reducing abortions, but also track the progress that is being made along these lines.

Just this week The Washington Post noted that “a growing number of anti-abortion pastors, conservative academics, and activists” who are indeed “frustrated by the failure to overturn Roe v. Wade” are “focusing on building social programs and developing other assistance for pregnant women to reduce the number of abortions” rather than pursuing efforts to altogether outlaw abortion. The recent political climate, with Obama getting elected as well as the failure of several ballot initiatives that attempted to restrict access to abortions, have caused these conservative extremists to shift more to the middle.  This is huge progress taking place right here in our own country.  Finally, those who are most against abortion and who claim that their primary goal is to reduce the incidence of abortion are taking action NOW…productive action. These conservatives finally seem to be realizing that clinging to their extremist views is counterproductive and that the only way to make a real difference TODAY is to shed these views and adopt more moderate ones.

Some of these anti-abortion activists are currently “working with abortion rights activists to push for legislation in Congress that would provide pregnant women with health care, child care, and money for education-services that could encourage them to continue their pregnancies.” These activists claim that their conservative views have not changed-they still view abortion as immoral and something that should be outlawed. However, these activists have realized that “a more practical alternative is to try and reduce abortions through other means.”

Interestingly, many of these activists are being viewed as “traitors to the pro-life cause” by well-established conservative groups.  For instance, Joe Scheidler, President of the Pro-Life Action League, views such efforts made by the reformed conservatives as “a sellout.” Thus, there are still those who will remain in the extremist wings and will continue to support an overall ban on abortion. However…progress is being made: the more extremist groups that shed their rigid, unrealistic views and take action now, the more successful the campaign to reduce abortion indicidence will be.

The full article can be found at:


Legislative restrictions on abortion

November 20th, 2008

I stumbled accross a table that has lists of countries ranked by levels of restrictiveness of abortion laws.  http://www.reproductiverights.org/pdf/pub_fac_abortionlaws2008.pdf

About 39% of the world’s population lives in countries that have “no restrictions as to reason” for abortion.  This seems encouraging, but a closer look at the table shows the numerous ways in which women are restricted in practice, if not by legislation.

This is one of the issues I’ve been grapling with while i’ve considering organizations in which i would want our class’ aid money to go.  I think it is hugely important to make sure the organization will be able to make effective use of however much money is given, and surpass as many of these restrictive barriers as possible.  To me this means an organization that is somehow rooted in the community it is helping.  It makes me look towards smaller organizations in which the women who run the organizaiton are the same women who travel to locations and work hands in with a community ( like the speaker we had earlier in the quarter, who used drama as a means of education).  It has been difficult to find information on these types of NGOs or individual sponsored outreach programs, but the concrete results, and the fact that it is more “teaching them to fish” than “giving them a fish” or sustainable make me want to help financially in these areas.  Does anyone know groups of initiatives like this?

Another Women’s Organization in India

November 20th, 2008

This week I wanted to return to looking at women’s organizations in India in preparation for the final week of class where we’ll be discussing grants.  One organization I found is called Women Power Connect.  Women Power Connect is a coalition of women’s groups.  It works on the national level by lobbying the Indian Parliament to pass laws that positively impact women’s lives.  As a coalition of grass-roots organizations, this group deals with a variety of women’s issues—ranging from domestic violence to agricultural issues.  The current “priority issues” of this group include a sexual harassment bill, violence against women, and the declining sex ratio.  Women Power Connect (WPC) has been actively involved with the pervasive issue of sex-selective abortion since the passage of the Pre-conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act (PCPNDT Act) in 1994.  Recognizing that the law has not been properly implemented, the group set out in 2005 to analyze the flaws and compose a set of recommendations for governmental leaders.  These recommendations include:

§  An audit of the birth registers at hospitals/clinics to monitor sex ratio trends

§  following up on the pending legal proceedings against the errant doctors/clinics/hospitals conducting the selective abortions and pre-natal diagnostic testing

§  organizing awareness generation programs for various stakeholders at different levels in the state. 

I would like to commend WPC for their mission.  Given their focus at the governmental level, I think what they are doing is very powerful.  It is so interesting to consider having a group audit birth registers at hospitals and clinics to ensure the sex ratio reported by the government is (somewhat) accurate. Why would a government lie about its sex ratio? Obviously, the first thought it is to make it appear like the laws against sex-selective abortion are having an effect.  But the government of India has been pretty open about its failures to achieve (more) equal ratios. In either case, I think this audit is very interesting, as well as the legal follow-ups.  Publicizing such cases and making sure that the law is implemented and errant practitioners are punished is extremely important given all the articles I have read about how physicians are flouting the laws and still performing sex-selective abortions.  As a result, it’s extremely important for the WPC to be “watch-dogs” of these legal proceedings and raise awareness about these cases.

 However, despite these efforts, I think there are still holes in their mission.  For instance, this article gives approximate figures and historical trends of the numbers of Indian women giving birth at home.  As of this 2007 article, 50% of women gave birth at home, unattended.  These births and their records would therefore likely not be on file with the hospitals and clinics WPC is auditing.

A More Moderate Approach to Reducing Abortion??

November 13th, 2008

One particular study that I came across (published in a journal called “Studies in Family Planning”) called for an intervention involving postabortion family planning services as a more moderate approach to reducing numbers of abortion.  The basis for this study was the acknowledgement that unless some sort of intervention is made available or access to contraceptive resources is increased, the same women that are seeking these abortions (both safe and unsafe) in the first place will be likely to repeat the same pattern.  This study was conducted at two of the largest public hospitals in Zimbabwe: women at one of these hospitals ( Harare Central Hospital) were given the postabortion family planning intervention, while women at the other hospital (Mpilo Central Hospital) served as the control group. The study found that during the 12 month follow-period (postabortion), women who received the postabortion family planning intervention were much, much more likely to use highly effective methods of contraception and thus have fewer subsequent unplanned pregnancies and thus fewer repeat abortions. The results of this study support the notion that ward-based contraceptive services provided to women during the postabortion period significantly reduce the number of subsequent unplanned pregnancies, as well as the incidence of repeat abortons.

To me, this study highlights the fact that widespread access to effective methods of contraception is what is lacking, and is thus what is contributing to what some radicals have called the “abortion frenzy.” This seems like a much more moderate approach to reducing the incidence of abortion worldwide…much more moderate than yanking funding for contraception-issuing programs that happen to occasionally mention abortion as an option to their patients. Also, by instituting an intervention targeting women who just received an abortion, you are directly targeting women who may be at risk for “repeat” abortions (simply because they lack access to contraception)…thereby nipping the problem somewhat in the bud.

Uruguay Divided Over Abortion

November 13th, 2008

In a country where abortion has been illegal for over 70 years, a milestone has been made recently in regards to abortion rights.  The Uruguayan Congress recently passed legislation allowing a a woman to terminate her pregnancy in the first 12 weeks if her health is at risk or under certain other circumstances, such as extreme poverty. Those who support the bill are excited and anticipate that it’s enactment will lead to a decrease in the number of deaths resulting from unsafe abortion. Unfortunately the chances of the bill going through are null as the President has pledged to veto to the bill. The president of this country, Tabare Vazquez, a doctor by profession, is said to be influenced by his religious background and facing threats of excommunication from Church leaders.

The country, like many in Latin America, are heavily influenced by the Catholic Church and citizens of the country are split over the issue. Nonetheless, recent polls show that 57% of the population support the bill but many seem to believe that the bill has no chance of getting passed the President. and abortion will go back to being illegal.

Media and the Abortion Decision

November 13th, 2008

I think Amy has brought up many interesting issues as we have been completeing this blog.  Specifically, I think more attention needs to be paid to the role of mass media and reality of choice.  I think it is really interesting ot look at the poplular move “Juno” as an example.  In the movie, Juno- as young teenage girl- gets pregnant.  At first she is set on having an abortion, but when she tries to go to the clinic for the procedure, she can’t go through with the abortion, and decided to keep the baby.  Indeed, she decided to fidn a nice family to adopt the baby.  Now this is the media portraying an alternative to abortion and raising the child that is not often explored in entertainment, whihc is good.  But like movies about domestic violence, it does not provide a realistic display of what the decision or situation entails.  The fact that she is from a middle class average family make it seem like anybody can carry the pregnancy to term and find a suitable home, while staying in school with out difficulty and complete familial support.  Her step mom even stands up to a judgemental ultrasound tech.  They make this choice look so easy, obvious and feasible.  Obviously movies are not always meant to give a relaistic view of the world and life, but it is interesting to see how often and subtly these stigmas enter our everyday life, and how easily they are over looked.  It may seem like a trivial example of how women’s predicaments are often sugar coated, oversimplified or undervalued, but its the trival and noralized examples that prove how deeply these sentiments run.

Larger Issues of “Choice”

November 12th, 2008

This week I am going to go slightly off topic from my focus on sex-selective abortion in India, and instead look at an article required for a different class related to abortion and family planning, which is about the pro-choice versus pro-life framework.  In the article, “Beyond Pro-Choice versus Pro-Life: Women of Color and Reproductive Justice,” Andrea Smith argues that the conceptualizations of pro-choice and pro-life create a paradigm that marginalizes women of color, poor women, and women with disabilities.  As part of her argument she analyzes the pro-choice framework and I think she brings up several interesting issues that we tend to overlook.

            First she differentiates between a choice and a right and points out the change in wording by abortion rights advocates.  She notes that “abortion rights advocates initially used the term ‘rights’ rather than choice; rights are understood as those benefits owed to all those who are human regardless of access to special resources.” She argues that choice implies having the resources and that this creates a hierarchy of women who can choose.  I think this is really interesting because it introduces class into the idea of choice and suggests that choice isn’t really an option for all women, even in the United States where resources appear to be available.  It’s also interesting to note the shift in the language from rights to choice.  We’ve been discussing to a large extent how the human rights based approach plays into many women’s health issues and how there is a growing trend to start to address issues from a rights perspective.  However, this is the opposite case; initially it was a right-based approach, but it was changed.  It is highly problematic to me that the pro-choice framework does not ascribe rights to women.

            Another issue she raises is that the label of “pro-choice” can actually be quite harmful to the cause; it can introduce a layer of superficiality to the actions of politicians that overlooks deeper social issues.  The example she gives is of Bill Clinton.  Clinton is “heralded as pro-choice” because he does not “support legislative restrictions on abortion regardless of [his] stance on other issues that may equally impact the reproductive choices women make.”  This is an issue that I had never really considered before, but one that is extremely powerful.  We do tend to classify politicians and people as “pro-choice” or “pro-life” based on their legislative decisions that directly affect whether or not a woman can get an abortion.  In doing so, the other decisions that politicians make that indirectly affect reproductive access are overshadowed.  For example, Clinton also approved a federal welfare program that resulted in cuts in social services which limits a woman’s ability to choose (these cuts in social services limited maternal and child care potentially causing more “forced abortions”).  In this way, reducing the issue to the dichotomy between choice and life overlooks all the conditions that lead to a woman’s pregnancy and her need to make this decision.  I think this point that she raises is pervasive in our culture; in seeking to pin politicians and leaders down to neat categories on an issue, we are completely overlooking the underlying factors that ultimately control the situations women are placed in.  Doing this is dangerous!

            The final issue I want to bring up is the issue of, what is a choice really when the options are so awful?  Smith states it much more eloquently when she argues that choice “rests on essentially individualist, consumerist notions of ‘free’ choice that do not take into consideration all the social, economic, and political conditions.”  Here she looks at the issue of choice among contraceptives.    Should a woman have access to all kinds of contraceptives?  What if some of these options, such as Depo-Provera and Norplant, are dangerous?  Both of these drugs were found to be unsafe, yet the pro-choice movement insists that women should have all available contraceptive options open to them.  Should a woman be able to choose a method of contraception that is potentially harmful?  I find this highly problematic, and I want to say no.  But saying no is akin to limiting options, and according to Smith’s argument, is assuming that women don’t have the right or ability to decide for themselves.  Moreover, it may be the case when resources are limited and only dangerous contraceptives are available.  In this case, a choice isn’t really “free.”  When the only two options are no contraceptives or sterilization, can a woman make an informed, wise choice?  I say, no.  Yet it is easy to get caught up in the language of choice, and the promise and ideal that it holds, without realizing that a choice between two unfavorable options isn’t really a choice after all.

            Though my post this week is different from my normal posts, which focus specifically on sex-selective abortion and India, I cannot help but draw a few parallels.  Like the pro-choice/pro-life framework, a similar framework exists for my topic: those for and against sex-selective abortion.  And similar problems exist when we reduce this issue to a dichotomy of for and against. Like Smith mentioned, doing so can divorce an issue from the social, political, and economic conditions that frame the decisions women must make.  This is especially true in sex-selective abortion where social (status of women), political (the government’s ban and outcry on sex-selective abortion), and economic (the cost of a dowry, the cost of having a female instead of a male) factors all play a huge role.  Finally, I question whether women really have the “free” choice to abort a female fetus; it is increasingly clear that “poor women have not earned the right to choose.”

Prop 4 Gets Rejected

November 6th, 2008

In the event of this recent attempted legislation it doesn’t really make much sense to blog about anything else right now. Thankfully, Proposition 4, which would have required parental notification for teenage abortion on behalf of California doctors was rejected this past Tuesday by a vote of 52% to 48%. The measure would make exceptions for medical emergencies and would allow girls to get special exemptions in court. Prop 4 was similar to other parental-consent proposals that were defeated in 2005 and 2006 which leads me to ask the question: With all of our focus on improving abortion conditions abroad in “less developed” countries, are we ignoring the threat to abortion rights here on our very own soil?

As I sit here writing this posts, there are numerous emails being sent over one of the mailing lists I belong to debating the controversy over Prop 4 from a religious perspective. One girl, who is decidedly against Prop 4 for almost entirely religious reasons argues that “parental notification should be required because teenage abortion, like all abortion is wrong and immoral.”

While I can understand why someone would be against abortion rights for religious reasons, I personally do not believe that legal decisions that affect the lives of other American citizens should be influenced by the religious beliefs of others. If that were the case, then what is the purpose of separation of church and state. Thomas Jefferson wrote:

“”Believing with you that religion is a matter which lies solely between Man & his God, that he owes account to none other for his faith or his worship, that the legitimate powers of government reach actions only, & not opinions, I contemplate with sovereign reverence that act of the whole American people which declared that their legislature should “make no law respecting an establishment of religion, or prohibiting the free exercise thereof,” thus building a wall of separation between Church & State”

While this might have been 200 years ago, I believe that this concept is relevant for both local and international health issues. I do not believe that it is fair for people guided by their faith to vote on legislation strictly because of their aforementioned beliefs nor is it for religious international health organizations to refuse distribution of contraception; or favor the outlawing of safe abortion .

politics religion and abortion

November 6th, 2008

My mother works at a Women’s Care Center, in Niles, MI.  This organization is the product of a Christian coalition.  They are located across the street from the only abortion clinic in the city.  Tuesdays are their busiest days because that is “abortion day” and women often enter the Care Center in search of the abortion clinic, and the couselors are not allowed to point them to the clinic across the street.  My mom loves her job; she loves talkin to these women, often very young women, who are often looking for more information.  She found herself in a difficult position during this election season as all the women in her office based their political views based on their religious views on abortion.  My mother, being pro choice and understanding the importance of access to aboriton, not only for the women in our local and national community but for the global community, as well as for other reasons, is on the other side of the political debate.  After Obama was elected she was basically called a bad Catholic for not voting McCain.  I think cases like this highlight how much religion is ingrained in our politics.  Is there any way to change this political-religious mentality? Does it need to change?  Should people like my mom, whose hearts are in the right place, and want to help women in a mulit level sort of way, be ridiculed on religious grounds?  clearly i say no, they shouldn’t, but like so many issues we talk about in class, how and in what ways should it change is a tough question.