(editor's note: With this issue begins a series of periodic reports looking at how various issues will be affected by the reelection of President George W. Bush, and what we can do about it.)
Dr. David Hager is a practicing OB/GYN who refuses to perform abortions or to prescribe contraceptives to unmarried women. He has suggested prayer as a treatment for premenstrual syndrome. In 2002, President Bush appointed Hager to the Food and Drug Administration's Reproductive Health Drugs Advisory Committee, which makes crucial decisions about the use of drugs in the practice of obstetrics and gynecology. Hager has used his position to block over-the-counter approval of emergency contraception, aka the "morning after" pill, which prevents pregnancy within the first 48 hours after intercourse. But you ain't seen nothing yet: The terms of all 13 positions on that committee will be up between now and 2008. Welcome to the second George W. Bush administration, where rolling back abortion rights is just the beginning.
"We have a lot of work to do," says Anu Kumar, executive vice president of the international women's health and reproductive rights organization Ipas, based in Chapel Hill. She says the religious right has already shown that it feels "emboldened by the election results to push their views."
When Pennsylvania Sen. Arlen Specter, the Republican in line to chair the Judiciary Committee, announced last week that fervently anti-abortion judicial nominees face possible rejection by the Senate, the anti-abortion conservatives fought back with calls for his removal from the committee. "They're making sure that he understands that the Republican party is beholden to the religious right," Kumar says. That has a global impact, she adds. "We've seen that in the past four years. There's been a real chill in the way organizations around the world deal with reproductive health--and I don't mean just abortion, I mean reproductive health in general."
Roe v. Wade, the landmark 1974 Supreme Court decision granting women the right to safe and legal abortion, has been the main concern among pro-choice Americans who fear Bush's Supreme Court appointees would overturn it. Other encroachments on abortion rights, such as efforts to roll back FDA approval of RU486, which gives women in their first weeks of pregnancy a non-surgical abortion option, have been fought off so far. But other troubling incidents during Bush's first term foreshadowed problems with access to birth control, even restrictions on fertility treatment. Abstinence-only sex education programs became the requirement in public schools. And news reports that a handful of pharmacists refused to fill prescriptions for the birth control pill, citing moral objections, suggest religious conservatives want to roll back the clock even further.
Melissa Reed, executive director of NARAL Pro-Choice North Carolina, says Hager's appointment is a bad sign for women's health. "He's clearly the wrong person to sit on this committee at the FDA," she says. Hager's resistance to over-the-counter approval of emergency contraception despite all medical evidence supporting its safety is a frightening indication, she says.
"We have a situation in this country where ideology is trumping science all the time," Kumar says. "Science is very clear. But this administration fundamentally does not believe the science that's before them."
Other empirical evidence is also being ignored: "We know that when there are restrictions placed on women's access to safe services," Kumar says, "whether they're legal restrictions or physical barriers to getting those services, women will do what they need to do (to obtain an abortion) and suffer and die as a result." Ipas estimates that an average of 40 unsafe abortions take place every minute around the world.
Analysts say the issue of "moral values" was what drew Bush's most ardent religious supporters to the polls. "I find it really troubling that people who are pro-choice are labeled as being immoral," Kumar says. "We're talking about living, breathing women--mothers, daughters, sisters, wives. Women who are the core of their families and communities. Many years of development work tells us that women are the key agents not only for social change but also for social stability. We're talking about thousands and millions of them dying. Where's the morality in that?"
But there is some good news for North Carolina. "At the state level," Reed says, "we have a pro-choice senate and a majority also in the house, and we have a pro-choice Council of State." (At press time, Democratic candidate for Superintendent of Public Instruction June Atkinson had a narrow lead against Bill Fletcher, an outspoken opponent of sex education on the Wake County Board Education.) "So NARAL Pro-Choice NC is going to work hard in the 2005 legislative session to ensure that emergency contraception is available to victims of sexual assault in North Carolina emergency departments. We also want to look at the possibility of letting pharmacists dispense emergency contraception without a prescription." An existing state law allows pharmacists to dispense some medication, such as an epipen for life-threatening allergic reactions. If the legislature adjusted that law to include the so-called "morning after pill," Reed estimates it could dramatically cut down the number of unwanted pregnancies and abortions in the state.
Establishing medically accurate sex education programs in public schools is the other major statewide goal for NARAL. Reed says that a survey taken by the state's Department of Health and Human Services reported that more than 90 percent of parents with children in North Carolina public schools support comprehensive sex education that includes information about disease prevention and birth control. "In contrast to that, 90 percent of school districts don't teach it," she says. That's something NARAL hopes to change. "I really feel confident that in North Carolina, we're going to continue to protect women's reproductive rights and that the majority of people and the majority of our lawmakers will support that."
As for the rest of country, Kumar sees the fight for reproductive rights as a long-term process. "We have to convince our fellow Americans that the work we do on social justice is deeply rooted in our moral values. And I don't mean religious values," she says. "We need to bring the rest of the country with us."