When pro-choicers accuse anti-choicers of being anti-contraception they're often taken as crying wolf -- even though no anti-choice organization explicitly endorses birth control and despite the prominent anti-choice role of the Catholic Church, which explicitly bans contraception. After all, goes the complacent point of view, most women, and most couples, use some form of birth control. Opposition to it seems like something out of Margaret Atwood's The Handmaid's Tale, a novel whose futuristic vision of women's subjection to rightwing Christian patriarchs no less a shrewd social critic than Mary McCarthy found preposterous when she reviewed it in the New York Times Book Review in 1986.
The Bush Administration seems bent on giving Atwood material for a sequel. Last month, Health and Human Services issued a draft of new regulations which would require health-care providers who receive federal funds to accept as employees nurses and other workers who object to abortion and even to most kinds of birth control. This rule would cover some 500,000 hospitals, clinics, and other medical facilities -- including family planning clinics, which would, absurdly, legally be bound to hire people who will obstruct their very mission. To refuse to hire them, or to fire them, would be to lose funds for discriminating against people who object to abortion for religious or -- get this -- moral beliefs.
This represents quite an expansion of health workers' longstanding right not to be involved in abortion. And, incidentally, this respect for moral beliefs only goes one way. A Catholic hospital has no corresponding obigation to hire pro-choice workers or accomodate their moral beliefs by permitting them to offer emergency contraception to rape victims or hand out condoms to the HIV positive; a "crisis pregnancy center" would not have to hire pro-choice counsellors who would tell women that abortion would not really give them breast cancer or leave them sterile. Only anti-choicers, apparently, have moral beliefs that entitle them to jobs they refuse to actually perform.
There are several disturbing elements to this story. One is that even as it fades into history, the Bush Administration is catering to the anti-choice movement's larger agenda of making contraception harder to obtain. What Bush can't give them legislatively, he'll provide administratively, in bits and pieces, under cover of granting workers rights of conscience (the only workers' rights he seems to care about). Remember when it seemed just plain bizarre that a pharmacist could refuse to fill a woman's prescription for emergency contraception or even the Pill? Now pharmacists have that explicit right in four states, and possibly in five more.
Bureaucratic rules and regulations may seem arcane -- how many nurses who think the Pill "kills babies" want to work in family-planning clinics? Actually, they have far-reaching effects. For example, the HHS regulations could invalidate state laws requiring hospitals to offer emergency contraception to rape victims. Moreover, the importance of regulations goes way beyond the actual number of people they affect directly. They shape both how we think of rights and how we decide what normal behavior is. As it becomes more accepted for health care workers to inflict their moral judgments on patients, and customers, the burden shifts onto women seeking care. Instead of asking "What gives the pharmacist the right to refuse to fill her prescription?" and "Why should a birth-control clinic be forced to employ a nurse who won't give out the Pill?" the question becomes "Why can't she go to another drugstore or come back to the clinic another day"?
As the blogger Amanda Marcotte argues, antichoicers know they can't ban contraception, but they can redefine it as a lifestyle drug, a luxury, rather than a medical necessity that gets a lot of credit for modern women's good health and longevity. Amazingly, Bill O'Reilly is not the only person who thinks health insurance plans should pay for Viagra but not for the Pill. If you can't afford birth control, just don't have sex, you hussy! The next Administration may not find it so easy to turn this mindset around, and if McCain wins, I doubt it will even try. McCain himself, as I've noted before, has a longstanding record of votes against abortion and birth control -- 125 out of 130 votes in Congress and Senate. The man has a 0% rating from NARAL. That he is widely regarded as a "moderate" on reproductive rights is truly incredible.
Another dangerous feature of the proposed rules is that they redefine contraception as abortion. Standard medical authorities define abortion as something that takes place after you become pregnant, that is, after a fertilized egg implants in your womb and sets off a cascade of physical changes in your body. The HHS draft changes all that. It defines abortion as "any procedures, including prescription drugs, that result in the termination of the life of a human being in utero between conception and natural birth, whether before or after implantation.'" According to these rules, you can have an "abortion" without even being pregnant. (The Pill, emergency contraception, and the IUD mostly work by preventing ovulation and fertilization, but anti-choice advocates argue that they prevent implantation, and it is not yet possible to say with 100 percent certainty that this never, ever happens.) These are the knots we get tied up in when religious ideology replaces sound science.
Don't let the Bush administration take away women's right to get legal reproductive health care in a timely and respectful fashion. Support Hillary Clinton and Patty Murray, who are leading the fight in the Senate by emailing your senators here. Better yet, send them a real letter, on paper. As for Congress, so far only 100 Representatives -- fewer than one in four -- have signed a letter protesting the changes. Call or write yours and demand that they join you in the 21st century.
This article was first published by The Nation.
