Almost Fifty Years After Griswold, We’re Still Fighting for Access to Contraception


June 7th, 2011 marks the 45th anniversary of the landmark 1965 Supreme Court decision Griswold v. Connecticut, which legalized family planning and the right to individual privacy in family planning decisions. But nearly 50 years later, women in the United States can hardly find cause for celebration, because we are engaged in a full-on battle to maintain access to contraception.

The fact that we find ourselves in this situation is astonishing to say the least, and speaks to how deeply we have succumbed to what are commonly referred to as “culture wars,” but in reality is the triumph of pure religious ideology and blibical fundamentalism (on one side) over science, public health, medicine and clinical practice, and human rights on the other. 

Family planning–the means through which people exercise their right to decide whether and when to have children, how many children to have and at what intervals–has been cited by the Centers for Disease Control and Prevention (CDC) as one of the ten great public health achievements of the 20th century because of the huge gains it yields in maternal and infant survival and in the health and survival of children ages 0 to 5 years. 

Family planning also has vast economic and social benefits. In the United States, analyses conducted by the Guttmacher Institute show that family planning services are vital to the health and well-being of poor and low-income women in general, and marginalized populations in particular.  Publicly-funded family planning programs provide:

  • a gateway into the U.S. health care system for women who would otherwise only have a tenuous connection to medical care, or none at all;
  • a source of urgently needed contraceptive services and other sexual health care for young women in foster care, who are at high risk of unintended pregnancy; and
  • a highly successful public health program that saves billions in taxpayer dollars, and averts significant numbers of unintended pregnancies, unplanned births and abortions.

Moreover, support for family planning and contraception is widespread. Ninety-eight (98) percent of women in the United States have used birth control at some point in their lives.  Ninety-three percent of all voters believe all couples should have access to birth control. Six in ten women get health care from a publicly-funded family planning center and consider it their regular source of health care.

Results of a new public opinion poll reveal that Americans strongly believe in the importance of family planning as a basic preventive measure. “This sentiment crosses all demographic and political lines and rises to the level of a core value,” notes Celinda Lake of Lake Research Partners, the firm that conducted the polling.

Lake also found that support for maintaining access to family planning services outweighs arguments for cutting family planning funding to help address the current budget crisis.

By a margin of roughly two to one, Lake reports:

Americans side with the view that everyone has a right to safe, affordable family planning services over the opposing position that with today’s budget crisis we should not be spending taxpayer money on family planning services. This sentiment is consistent across most demographic groups.

Nonetheless, ideologues have hijacked the U.S. House of Representatives, state legislatures, the media and the public discourse around reproductive and sexual health, and there has been a barrage of legislation and other efforts to reduce access to birth control.

Earlier this year, for example, the House of Representatives voted to completely de-fund Title X (H.R. 1), the national family planning program, for the first time in the program’s history.  While the bulk of funds were restored, the Final Fiscal Year (FY) 2011 spending bill (H.R. 1473) signed into law by President Obama cut funding for Title X by $18.1 million at a time when more and more low-income women are seeking care and services from this program than ever before.

Title X Funding — FY 2011

 FY 2011 Final

FY 2010 Final

Change FY 2010 to FY 2011

FY 2012 President’s Request

FY 2012 NFPRHA’s Request

$299.4 million $317.5 million -$18.1 million $327.4 million $327.4 million

As noted by the National Family Planning and Reproductive Health Association (NFPRHA), some members of Congress are trying to cut Medicaid along with Title X:

[Medicaid] is a critical funding source for family planning and other health care for low-income and poor individuals.  [They also are trying to] undermine the Affordable Care Act. Further, an unprecedented effort is underway among states to refuse Title X funds, prohibit certain types of providers from receiving state and/or federal funds, and cut Medicaid enrollees and benefits, all of which would make it harder for low-income women to get birth control.

“De-funding the Title X program, along with cuts to many other important public health programs–especially at a time when the need is so great–is reckless and offensive,” states NFPRHA. 

Conservative activists are heartlessly going after what is often the only source of health care for the most vulnerable in our society. This is a fiscally irresponsible attack on women’s access to essential health care.

The so-called pro-life movement also has been taking advantage of “conscience clauses” and refusal clauses–those that allow pharmacists to refuse to fill prescriptions for birth control–to reduce access at the point of delivery, creating especially onerous obstacles for women in rural areas who have fewer choices from the get-go.

At the state level, there is a widespread movement by GOP- and Tea-Party dominated legislatures to de-fund family planning programs.  According to NFPRHA, patient visits are increasing, but public funding, patient fees and private fundraising have all fallen during the recession. “Many Title X-funded systems have cut hours, frozen hiring, furloughed staff, or reduced staff through attrition or layoffs in order to cope with falling revenue in the recession,” states NFPHRA.

NFPHRA notes that in addition to the 280,000 people Arizona Governor Jan Brewer (R) proposes eliminating from the state’s Medicaid rolls, she has also called for a 5 percent cut in Medicaid provider rates – which became effective in April. Providers are already struggling to meet the needs of the poor and low-income – a rate cut in the Medicaid serves only to further reduce access to care for the medically under-served.

Alongside these budget cuts, efforts to establish “personhood” laws at the state level have proliferated. So-called personhood laws would decree that life begins at conception, effectively banning both abortion and contraception.  Hormonal contraceptives can prevent a fertilized egg from implanting in the uterine lining and establishing, what is according to medical definition, an actual pregnancy. But for the personhood movement, a fertilized egg has more rights than the woman in whose body it floats, so hormonal contraception is anathema.

Attacks on family planning by extremist politicians have been met by relative silence from the Obama Administration, which has done little to challenge the misinformation put out by the far right, to change the public discourse in a more positive way, or to move the ball forward.  For one thing, the Administration punted on making birth control part of the primary care package paid for under health reform when it had the momentum behind it and instead sent the issue to the Institutes of Medicine for “review.” Now, this issue is set to be decided during the high-stakes debt-ceiling debates and at the beginning of what promises to be a cut-throat Presidential election. For another, President Obama appears to persist in believing that there is “common ground” between those who feel it is an individual’s right to act in accordance with their own moral and religious beliefs when it comes to deciding whether and when to have children, and those who seek to impose their own form of biblical law on everyone and sundry.

For the vast majority of Americans, supporting access to family planning services and contraceptive supplies is a no-brainer.  Lake’s poll shows that 84 percent of Americans view family planning, including contraceptives and birth control, as important to basic preventive health services. “Of these,” Lake states, “a full 67 percent feel very strongly [about the issue]. 

Moreover, Lake notes, “It’s an election issue.” The poll found that 40 percent of voters said they would be less likely to support elected officials who vote to defund family planning programs. [Listen to an audio briefing at which Lake and others speak on these issues]. 

But despite the evidence on the public health benefits, the polling, and the fact that close to 100 percent of the population uses contraception at some point in their lives, we are engaged in a full-blown battle for access to birth control nearly fifty years after the issue was considered settled.  Access to contraception and family planning services at the state and federal level–including under the Affordable Care Act–is far from secure.  And the fact that we are in this position is testament to the ability of a very small minority to deny literally millions of people basic health care when a larger majority take it for granted.

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  • crowepps

    Birth control enabled us to raise our children in middle-class homes instead of poverty.  Birth control enabled women to become far more healthy.  Birth control enabled women to share a close relationship with their husbands instead of cold shouldering them out of fear of another pregnancy.

     

    I understand that some people believe God wants us all to be poor, sick and miserable, but I just cannot understand why the great majority who don’t agree with them is tolerating their stupidity.

  • elburto

    All contraception is free here. It’s free for citizens, immigrants, everyone. Everything from condoms to LARCs. If your BC fails you can have a free termination. Why? Because the cost of the free birth control is nothing compared to the burden incurred, on a free at the point of use system, by the results of unwanted pregnancy. Abortions, prenatal care, birthing, and postnatal care cost money. There are also extra costs to the welfare system due to unwanted pregnancies. Contraception is small potatoes compared to all of that. I feel lucky to live in a country that has the sense to realise that.

    The US could save an absolute fortune by doing the same. No doubt about it. Set up free clinics, offering sexual health services, and the benefits are unmistakeable.

    Women have the absolute right to control when, and with who, they have children. They have the right to decide if they wish to have children. This is regardless of economic status, race, sexuality, physical ability, marital status. Why is the US so determined to deny that?

  • nico

    <blockquote>”Attacks on family planning by extremist politicians have been met by relative silence from the Obama Administration, which has done little to challenge the misinformation put out by the far right, to change the public discourse in a more positive way, or to move the ball forward.”</blockquote>

    Let’s acknowledge that that’s so, and also that the stats cited above are accurate and are being correctly interpreted.

    Here’s what I’d like to understand:

    How and why has the “far right” been able to find such fertile ground for their campaign of misinformation on abortion and — more critically — their misdirection on reproductive rights, freedom, and health generally?

    I’m as absolutist on reproductive rights as they come, and I can’t escape the conclusion that the ultimate failure to “change the public discourse” on repro rights rests not with the media, or the far right, or the Obama administration, or “the patriarchy” or other convenient blamees, but with feminism, and on feminism’s decades long reliance on (as Rebecca Traister so nicely put it) “the limp language of ‘choice.’”

    How is it that, in a culture and economy so centered on and dependent on ‘sexualization’ and on non-reproductive sexuality, feminism and “prochoice” advocates find themselves so overwhelmed and on the defensive about reproductive rights such that access to even the most basic contraception is now at risk?

    It’s arguable whether the escalated “war on women’s rights” over the last half year was a surprise or should have been anticipated.

    What seems undeniable is that when push came to shove, feminism was caught with its bloomers down.

    Happy birthday, Griswold. Many happy returns.

  • fas

    Secular political science scholar Dr. Eric Kaufmann, at the University of London, has written the following soon-to-be-released book: "Shall the Religious Inherit the Earth?"

     

    Which religions will survive?:

    (1.) Old Order Amish,

    (2.) Quiverfull Evangelical Movement,

    (3.) Traditional Latin Mass Catholics,

    (4.) American Mormons,

    (5.) Hasidic Jews and

    (6.) Muslims.

     

    Apparently a contraception-abortion-sterilization philosphy won’t inherit the earth.

  • arekushieru

    Um, he’s a very short-term thinker, obviously.  If the anti-contraception-abortion-sterilization philosophy inherits the earth, famine, starvation and disease will follow, decimating a MAJOR portion of the population.  Whoops.

  • crowepps

    All of those groups take a disproportionately large share of tax benefits while paying a disproportionately small share of taxes.  How are they going to continue to do that when there are no more 20-something singles, two-career, one-child families, feminist career women, or gays around to chip in welfare and education money to support the results of their endless fertility? 

    I suppose they could all join the Amish in their traditional peasant lifestyle, without modern conveniences or internet or luxuries like modern healthcare, and it would all even out eventually.  I just have never been convinced that however traditional it is, famines and epidemics are the ‘moral’ way to keep the population in balance with the supply side.

  • arekushieru

    That’s a good answer, crowepps!  I had a former ProLife friend assume the guise of a literary character in a ProLife group on Facebook.  One of the questions she posed deserved an answer just like this. Too bad you weren’t there!  NICE!

  • arekushieru

    Wrong.  It sounds a lot like you’re trying to victim-blame.

  • nico

    What in particular is “wrong” about what I said?

    What I’m trying to do is understand how in 2011, when (as Jodi’s post shows) public opinion would seem to support reproductive rights, the anti-rights side is able to make the kind of moves they make with such ease.

    Why does it feel like a surprise attack – and a sustained one at that?

    If public opinion is really on the side of repro rights (as it reasonably would be, given how widely those rights are exercised), then how do we explain the effectiveness of adversaries (I think of them as reproductive Luddites) who would strip away those rights down to the last condom?

    This is not the best of times for reproductive rights in this country.

    To me, this seems to call for an examination/evaluation/review/fresh analysis of tactics & strategies & terms & definitions and how the fuck we think about & talk about & understand these things.

    And by saying that, I sound like I’m “trying to victim-blame”? I’m trying to hold a cause and a movement accountable for its progress — measured in its ability to hold onto long-won gains and successfully sell its vision. That’s victim blaming?

    I don’t see a victim here other than maybe ourselves.

  • crowepps

    The various meetings and demonstrations held by the Tea Party activists in response to the election of President Obama revealed that racial bigotry still persists and has deep roots.  While certainly that may “call for an examination/evaluation/review/fresh analysis of tactics & strategies & terms & definitions” I think you probably can see that if someone said they felt entitled to “hold a cause and a movement accountable for its progress” by asking the NAACP why the Blacks hadn’t ‘fixed’ those bigoted White people’s attitudes, it probably would be considered victim blaming.

     

    Personally, I don’t think women, even now, truly understand just how hostile the traditional patriarchal organizations like religions and political entities are towards women, or how eager those organizations are to boot women back into the home, endlessly pregnant and silent.  Certainly I’ve been astonished by how safe the Catholic Church feels in its barely concealed contempt for women, how smugly certain they are that no serious negative reaction will arise to their public assertions that ’God’s Plan’ requires that sexually active women, whether married or not, whether they want to be mothers or not, be abandoned by doctors and the medical establishment because the ’moral’ thing to do is let women die.  Which serves them right for being inferior females, apparently.  Or perhaps is the appropriate punishment for having sex.  But certainly only worth saving if it will have a negative impact on their FAMILY, since individual women have no particular value.  The only good woman is a martyred one!

     

    And they were absolutely right in their confidence that people in general would willingly choke down their misogyny!  The general public listens to the Pope and the Cardinals and the Bishops pronounce that “Bitches Ain’t Shit” and were created as a natural servant class for men (in Latin, so it sounds better) and the general public agrees that while they personally know a few women who are perfectly fine, they even have some good friends who are female, everybody knows most women are just naturally stupid promiscuous liars who make zero contribution to society unless they have a man to keep them on the straight and narrow.  Even the women in the Catholic laity bleat “We’re not worthy and never will be — we are eager to die for God”.

     

    Do you really want to have a conversation about ‘why does society persist in thinking being female is a disability that makes the person afflicted with it so disgusting and inferior that (real male) people can barely tolerate her presence unless she is servile and self-abnegating and apologizes for existing’?  Do you really want to have a conversation about ‘why has society bought into the ridiculous myth that pregnancy is a sacrament, and that any error in performing it correctly is a capital crime that deserves the death penalty?’  Don’t ask the victims why their oppressors despise them – go ask some conservative men just what underlies their insistence that the law must return women to their ‘traditional’ status as household, sexual and breeding slaves.