Saturday, April 06, 2013
Plan A: Pay Attention
There are actually three bits of news I've been considering.
The first news item is that the Bill & Melinda Gates Foundation is putting up $100,000 to the best proposal for a more fun and pleasurable condom. The competition is part of its Grand Exploration Challenges, which has already doled out nearly $50 million for quirky but effective solutions to global health problems, like microwaves to treat malaria and an electronic nose to detect tuberculosis.
Okay, before you dismiss this as very rich people having way too much fun with money, let me rush to point out one thing about about condoms: They're cheap, discreet and can actually help prevent sexually transmitted diseases, including HIV, as well as pregnancy.
They've been used effectively for centuries. The problem is that they are not used consistently because men say they interrupt the pleasure of sex. ("Like taking a shower with your clothes on." Or, so I've heard.). So the Gates Foundation is calling for new shapes, materials and packaging that "significantly preserve or enhance pleasure, in order to improve uptake and regular use."
Origami Condom. Shaped like miniature accordions, the company's website claims that "these silicone rubbers fit loosely and aim to simulate the feeling of sex without a condom".
They also boast a 2.8 seconds "application time," says the website, which presumably means they go on easily.
Yes, well, right. Of course. That would be important. Of course.
Moving on in the news.......
In France, women are now entitled to a full reimbursement for the cost of their abortion and girls aged 15-18 are also guaranteed free birth control (both for the contraceptive pill and the implant).
This is major news - on both sides of the issue.
For those on the Religious Right, this is not an issue of public health, it is a major issue of morality and ethics. These Good Christian Folk bemoan that the government is not only playing "executioner" to the "unborn," but now also allowing their daughters to have sex whenever they wish, without having to consider the consequences and be the "moral barometers" of society to hold young men under some "restraint".
I am not making that up. That's the argument. Really.
For feminists and liberals, this is a major victory, giving women of childbearing age control of her own reproductive health. This is important on many, many levels, but especially because of the socio-political recognition that women still struggle to attain financial equality with men. As long as that playing field is not level, all others - including the freedom to have access to contraception and abortion - are not equal. When you live in a country like France where there is Socialized Medicine, allowing reimbursement for abortion care makes sense.
Since increasing access to birth control has consistently been shown to reduce abortion rates, French authorities are expecting to see a drop in the amount of women requiring abortions now that the law is effective.
Of course, others are predicting that, now that abortions are "free", everyone will want them - even those who hadn't considered it before. Or, if you've had one before, you'll want another.
You know, like free refills for your coffee or soda at fast food restaurants. You can hardly finish the cup you're drinking, just thinking about the fact that that next cup will be FREE!
Which is no doubt why, when the bill passed in October, the Minister of Health, Marisol Touraine, explained that it was a "public health choice" and she took the opportunity to remind people that abortion is "never a trivial act" for women.
Because, apparently, some people do need to be reminded of that.
Finally came the news on Friday that a US Federal Judge from the Eastern District of New York ordered that the most common morning-after pill be made available over the counter for all ages, instead of requiring a prescription for girls 16 and younger.
Not only that, Judge Edward R. Korman poked his finger right into the middle of the hornet's nest and accused the Obama administration of putting politics ahead of science. He concluded that the administration had not made its decisions based on scientific guidelines, and that its refusal to lift restrictions on access to the pill, Plan B One-Step, was “arbitrary, capricious and unreasonable.”
He is right, of course. It was politics, unpure and complicated as politics always is. Or, in the judge's words, "arbitrary, capricious and unreasonable."
At the time of the decision, Mr. Obama was campaigning for reelection. Health and Human Services Secretary Kathleen Sebelius said that the manufacturer had failed to provide clinical evidence that the drug was safe for children under age 11, about 10% of whom are physically able to bear children.
A weak argument, to be sure, which might have been convincing if she and the FDA had not approved the large scale administration of the HPV vaccine to 10-11 year old girls, even though the vaccine manufacturer conducted exactly ZERO studies on the negative effects of the HPV vaccine on that young age group.
The folks from the Religious Right are predictably hysterical. You may remember Michele Bachmann's breathless report of the story told to her by the mother of "the poor little girl" who "felt forced" to allow her child to have the HPV vaccine and "now she has mental retardation".
The folks on the Religious Right have always called "Plan B" the "abortion pill". It is not.
RU-486, sold as Mifeprex, is a prescription drug for medical abortion. Mifeprex is used after a woman is already pregnant. Plan B is an emergency contraceptive. It is used to prevent pregnancy.
It does not "abort" a fetus because, 72 hours after unprotected, unplanned sexual intercourse, there is yet no fetus to abort. Plan B prevents pregnancy from happening in much the same way that other oral contraceptives do.
Plan B acts primarily by stopping the release of an egg from the ovary. It may prevent a sperm from fertilizing the egg. If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb. If a fertilized egg is implanted prior to taking Plan B, Plan B will not work and pregnancy proceeds normally.
It's not rocket science. It's biology. It's the way the reproductive system has worked since the beginning. Nothing has changed except we now have a deeper understanding of how the human body works - including our ability to reproduce.
Again, the issues surrounding this decision are fraught with overlays of religion and morality and conversations about parental control and responsibility.
Which brings me to a point I want to make about all of this.
None of these things - Condoms, Government subsidized abortion and contraception, and emergency Plan B contraception available without prescription to anyone young woman who needs it - will ever replace Plan A: Education and Awareness. For parents and their children.
Yes, "boys will be boys" - and "girls will be girls". Adolescence will always be a dangerous time of pushing and testing boundaries and exploring identity and experimentation. Even parents and kids with the best, open relationship will have difficulty discussing issues of human sexuality in general and sex in particular.
Here's the thing: The best parental responsibility is to teach our children responsibility by modeling that behavior. And, that includes allowing them a "Plan B" to which they have free access when they make a mistake - just as adults sometimes do.
Boys and men must take responsibility for their own behavior, just as girls and women. But, it's not women who are responsible for the morality of men, much less the whole of society. We all are. That includes providing medical prophylactic alternatives for reproductive choices for women and men - including condoms which men might actually use consistently as well as a medicine like Plan B which women can use when that is deemed necessary or imperative.
I'm sure of one thing: The personal will always be political, and there ain't nothing more personal than a woman's reproductive system. Which is why it will always be political.
And, it's why news like this will always catch my attention, no matter where I am or how good or bad I'm feeling. The progress in Reproductive Rights has always been the most difficult to achieve and the most tenuous to maintain.
Vigilance and persistence are key to preventing further erosion of the progress we've been able to make over the last 50 years since the Birth Control Pill was made widely available.
Which is why my personal "Plan A" is to pay attention. Always. And, everywhere.