On December 7, when Health and Human Services Secretary Kathleen Sebelius made her decision to overrule the FDA's recommendation that Plan B One-Step, the morning-after contraceptive pill, should be available over the counter, I wasn't surprised to get an email from Planned Parenthood. After all, PP sends me lots of emails — in November, calling for action on birth control's inclusion in healthcare reform, for instance, or earlier in the year when its own funding from the government was under attack.
But I was surprised at the subject line: “I've Never Been So Inspired.”
The email was a thank-you to supporters from the organization's president, Cecile Richards, for their contributions and help in the past year, when Planned Parenthood, a service provider as well as the largest advocacy group on women's health and contraceptive issues, faced unprecedented attacks, both from antichoicers in Congress and from groups on the outside.
It didn't mention Plan B. Nor was an email on Plan B forthcoming. When I asked why this issue didn't warrant a blast, Tait Sye, Planned Parenthood spokesperson, seemingly caught off guard, told me that email blasts are not the only way PP communicates with supporters and that there were lots of posts on Facebook and Twitter about Plan B.
“In terms of accountability and what's next, Planned Parenthood has sent Secretary Sebelius a letter asking for a meeting to discuss this,” he said. (The letter can be read online at Planned Parenthood's Web site [PDF].)
But what if Planned Parenthood and other prochoice organizations are suffering from too many meetings with the administration, rather than the other way around?
Sebelius ruled that women need to go through a pharmacist to access Plan B. The pill, which sells for about $50, had been approved by the Food and Drug Administration for over-the-counter sales, because the agency found that it posed little danger to those who might take it—some of whom might be teenage girls.
The FDA, as well as the American Medical Association, the American Congress of Obstetricians and Gynecologists, and the American Academy of Pediatrics, had recommended the pill be available even to girls 16 and under based on scientific research into the effects of the drug. Sebelius made her decision based in part, she said, on the fact that the pill had not been studied in girls as young as 11—despite the fact that the number of 11-year-olds who get pregnant is vanishingly small. And, of course, allowing that tiny minority—only around 200 pregnancies each year involve girls 12 and younger—to get pregnant because they don't have access to contraceptives is not a responsible plan either.
As Joshua Holland reported for AlterNet earlier this year, the number of unplanned pregnancies among low-income women, disproportionately women of color, has been on the rise. Plan B's high price tag already puts it out of reach for many, but requiring a prescription to get the drug would put yet another cost barrier in the way for young women.
The decision angered many in the prochoice community: physician and former assistant surgeon general Douglas Kamerow wrote at NPR, “The Obama administration overruled its own Food and Drug Administration for political reasons, to make life easier in the coming campaign.” Amanda Marcotte noted, “The administration likely sees teenage girls as an ideal sacrificial lamb to pander for votes, since the 16-and-under set won’t be able to vote in November 2012.”
And last week a federal judge expressed concerns about the administration's decision, wondering whether it “was based on politics or science.”
Prochoice groups haven't been entirely silent on the issue; NARAL Pro-Choice America delivered 35,000 signatures on a petition to President Obama expressing disappointment with the decision, nearly 10 days after it came down.
But as the dust settles, the question remains: With a Democrat in the White House and a Democratic woman in charge of HHS, why are contraceptives and reproductive rights still a bargaining chip to be traded away for mythical swing voters who never seem to materialize? Why are groups that supported the president (NARAL endorsed Barack Obama while Hillary Clinton was still in the race, a move that was sharply criticized by EMILY's list and others) still sending in petitions after the fact, caught unawares that they were about to be undermined yet again by a theoretically pro-choice administration?
Planned Parenthood's Sye said, “In lots of other realms on women's health issues, the Obama administration has been strong. President Obama stood up to Boehner and said no deal on sacrificing Planned Parenthood on the government shutdown.”
But plenty of prochoice activists, bloggers and writers are wondering if Planned Parenthood and other organizations are too close to Democrats to really pressure them. After a fight around private insurers covering abortion during the healthcare reform debates, Megan Carpentier reported for RH Reality Check that prochoice groups had actually cut their lobbying budgets when Obama took office, while antichoicers had ramped theirs up.
In 2011, Planned Parenthood spent $901,256 on lobbying, including at the department of Health and Human Services. That number was up from $588,862 in 2010, but not to its Bush-era high of $990,246 in 2008. NARAL's lobbying budget has decreased each year since Bush left office—from $240,073 in 2008 to $110,000 in 2009, $80,000 in 2010 and $70,000 this year despite ramped-up attacks from a right-wing Congress. (Its revenue, meanwhile, went up in 2010 from 2009.)
Steph Herold, reproductive justice activist and founder of the I Am Dr. Tiller Project, told AlterNet, “I'm not a policy strategist. I don't know what the experienced political buffs at Planned Parenthood, NARAL, etc. are saying about strategy. But it's clear that even with our supposed 'friends' in office, we are losing. Are we just going to repeat the healthcare reform disaster ad infinitum? Hope that Democrats have our back, and then act shocked when they don't? Meanwhile, more and more Americans can't afford or access the healthcare they need—whether it's family planning services, abortion or prenatal care. When are the prochoice lobby groups going to hold Democrats accountable?”
A December 14 email from the group EMILY's List, which donated $2,795,627 to female Democratic candidates, read in part, “We need prochoice Democratic women from coast to coast, up and down the ballot to run and to win to change our country.”
Yet we had a prochoice Democratic woman in charge of the House of Representatives and a handful of intransigent Democrats were able to hold the healthcare reform bill hostage over abortion coverage. We have a prochoice woman in charge of the department of Health and Human Services and we saw the FDA's scientific recommendation overridden. It should be clear by now that electing prochoice politicians is not enough—we need to pressure them constantly. And that requires organizing on the outside, not just conversations with an administration that seems perfectly willing to shut out its allies when it sees political advantage.
Loretta Ross of SisterSong, a national organization of women of color and allied reproductive justice groups, told AlterNet, “My position is that we on our side have done a fairly poor job of showing our power. In meetings I've had with the Obama administration they say 'I agree with you, show me the votes.' We're doing a less-than-stellar job of showing them those votes, putting pressure on the Congress, putting pressure at the state legislatures.”
Asked what more the national prochoice organizations could do to improve their chances of winning on the national level, Ross said, “Those folks that have the resources to hire researchers should delve more deeply into nonwhite voters. They should spend more resources determining messages that move nonwhite voters.”
SisterSong has a report coming out in January that compiles a year's worth of research on what African Americans actually think about abortion that Ross said would provide some hard data to push back against conventional wisdom and scare tactics.
Sye pointed out Planned Parenthood's site, Women are Watching, which tracks candidates' statements on women's health, abortion and contraceptives. He also stressed the importance of grassroots activism, of “Folks making their voices heard in positive and negative ways on positive and negative decisions.”
Democrats Aren't (All) On Your Side
First, there was Stupak. Democrat Bart Stupak's push to insert language into the healthcare reform bill that would make it even harder to get abortion care paid for by insurance—even private insurance. Then the Republican House served up bill after bill, each time gaining some Democratic support — mostly from the right-leaning Blue Dogs, but also from normally progressive representatives like Marcy Kaptur — intended to further restrict abortion access or cut off federal funding for Planned Parenthood and other healthcare providers that also provide abortions.
And now Plan B, which by no stretch of the imagination has anything to do with abortion other than preventing the need for them by helping avoid unwanted pregnancies.
Steph Herold told AlterNet, “On the one hand, we have Republicans, who have demonstrated time and again that despite the flailing economy, their number one priority is restricting access to reproductive health, not just for women, but for all low-income folks and young people. On the other hand, we have the Democrats, who are kind of like our movement's bad boyfriend. We want to love them, we really do, but they keep going behind our back and betraying us.”
Many Democratic women, normally champions of reproductive rights, have tempered their outrage over Sebelius' move. While 14 Dems (including Kirsten Gillibrand, John Kerry, Patty Murray and Al Franken) sent a letter to Sebelius asking her to explain her reasoning on the decision, calling for her to “share with us your specific rationale and the scientific data you relied on,” many of them are holding their fire for another looming battle: the war over a religious exemption that would allow Catholic hospitals and schools to refuse to pay for contraception for their employees.
“I think that while this was huge, [the birth control decision] is really, really huge and has an impact on millions and millions of women who would not have access to birth control…I'm withholding my dragon fire for that. I think the president has not been with us 100 percent, but I don't think he's thrown women totally under the bus — if he says he did not intervene in this decision, I believe him.”
If our staunchest prochoice voices in Congress keep withholding their dragon fire for the “bigger battles” while we keep losing ground, eventually there will be no big battles to win.
And the Democratic party spends millions reelecting antichoice Dems while its fundraising efforts blame Republicans for antichoice moves. It's time to come to terms with the fact that, as Nancy Keenan, president of NARAL Pro-Choice America told Megan Carpentier, “A Democratic majority is not a prochoice majority”—and a Democratic president doesn't mean prochoice executive decisions. And that means prochoice organizations need to pressure the Democrats when they are in office as well as fight to get them elected.”
Grassroots Victories and Lessons for the Federal Level
It hasn't been all bad news this year on the reproductive health front. In the nation's most conservative state, Mississippi, voters soundly rejected a bill that would have given fetuses “personhood,” thus making abortion murder.
And even before Mississippi, advocates defeated a personhood initiative in Colorado, and Loretta Ross noted that in her home state of Georgia, women of color led the fight and eventual defeat of the Prenatal Nondiscrimination Act, another backdoor attempt at putting a progressive-sounding name on a bill criminalizing abortion. “It really represented a strong alliance between the women's rights, abortion rights, civil rights community,” she said.
Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health, also agreed that moving beyond traditional “prochoice” coalitions is important. “We're working across movements — just last month we organized a sign-on letter in support of access to birth control from 20 Latino civil rights groups, most of whom do not routinely speak out on these issues,” she told me. Imagine if on a federal level, groups not typically assumed to be interested in “women's issues” spoke out for contraception and abortion rights?
If reproductive justice activists can win on a local level in the Deep South, then there must be lessons from these campaigns for national issues. And indeed, SisterSong is working on a report on lessons learned from Mississippi's personhood fight so that activists around the country can apply them to fights in their neighborhood.
One of those lessons is to work with intersectional coalitions. Ross wrote of working with voting rights advocates to fight both the personhood measure and a restrictive voter ID bill that would make it harder for people of color and low-income Mississippians to access the ballot (the voter ID initiative did pass). “I think that until the prochoice movement becomes much more adept at dealing with the question of race and abortion it's going to remain a vulnerable spot for us,” Ross told me.
And González-Rojas stressed her organization's focus on a justice-based framework rather than “choice.” “The reasons behind unintended pregnancy are complicated and they are linked to all kinds of societal barriers, from immigration status to poverty. What is often missing in these debates is a human rights perspective, and whenever we can we're going to broaden the conversation.”
As for next steps on Plan B, González-Rojas said, “We will continue to seek relief through the courts through our attorneys at the Center for Reproductive Rights. We have been plaintiffs in the challenge to the FDA's ruling limiting access to emergency contraception, and we'll continue to press the courts to intervene.”
Grassroots organizing continues to be key, said González-Rojas. “We've got activists from Texas to Wisconsin who are working on the community level.”
If there's one lesson the Occupy Wall Street movement should have taught Americans by now, it's the crucial role of organizing and action that happens in the streets, out loud, and with a real sense of urgency. Despite the lack of a legislative agenda from the occupiers, they have managed to change the conversation and are seeing bills introduced across the country on issues that matter to them and in some cases, use their language. (See the Congressional Progressive Caucus' “Restore the American Dream for the 99% Act.”)
As Sarah Seltzer wrote at the Forward, “The reality is, exasperated press releases are not getting the job done on behalf of women. It may be time to look to the bold, confrontational, outside-the-political-system tactics of Occupy Wall Street to change the conversation around reproductive rights.”