(Shutterstock) S ince 2002, Essure has been marketed as a permanent birth control method for women that is convenient and can be performed in their own doctor’s office. The procedure is simple: A 4-centimeter metal coil is inserted through the cervix and placed into each fallopian tube, where scar tissue builds and eventually blocks sperm from reaching an egg. Resembling the spring of a ballpoint pen, the medical device requires no incision or invasive surgery, and offers women an alternative to tubal ligation. (The FDA's instructions for use of the contraceptive device specify that a hysterrectomy is not the primary removal option .) /*--> */ /*--> */ Women can even go back to work the very next day. So far, the device remains the only FDA-approved, non-incisional form of permanent birth control. But this July, Bayer Pharmaceuticals announced it would stop selling the device by the end of 2018, citing declining sales. However, the roughly 17,000 lawsuits filed against Bayer by women...
Trump’s “Protecting Life in Global Health Assistance” policy does nothing to protect life. Instead, it damages international progress toward expanding health-care services, especially for women and girls in developing countries.
AP Photo/ Khalil Senosi, File Dr. Aron Sikuku, right, explains family planning pills to Beatrice Ravonga in the Kibera slum of Nairobi, Kenya. President Donald Trump's move to dramatically expand cuts in U.S. funding to foreign organizations providing abortion services has left impoverished women around the world without access to treatment for HIV, tuberculosis, and malaria, health groups say. “ When are you coming back? Why have you left? Why aren’t you coming to our community?” These are the questions that women and girls in Mozambique, Zimbabwe, and other developing countries ask in desperate phone calls to their health-care providers after a local health clinic shuts down. The women are at a loss to understand why these clinics, often the only facility accessible to them in small towns and remote rural villages, have suddenly stopped providing much-needed services. The reason for these life-endangering cutbacks? President Trump’s resurrection of the global gag rule. The expanded...
As the Trump administration half-heartedly attempts to clean up the mess that its family separation policy created, another regressive policy that alters who can seek asylum in the United States is now in effect.
Attorney General Jeff Sessions issued a directive in mid-June that severely restricts the ability of asylum seekers to gain entry into the United States by citing fears of domestic or gang violence. Sessions reconsidered an already-approved asylum petition of a domestic violence survivor, known in the case as “A-B-” from El Salvador. He also overruled a 2014 precedent that recognized domestic violence as a basis for asylum, reigniting the debate on what constitutes a need for refuge.
The number of people granted asylum is actually quite small: In 2016, for every asylum applicant who succeeded, more than ten others failed. Which makes the June 11 decision even more stunning: Sessions fails to understand intimate partner violence, mislabeling it as “private” matter between a husband and wife that is limited to the domestic sphere.
Because of their “pre-existing personal relationship,” Sessions concludes that domestic violence survivors do not face persecution due to their membership in a “particular social group,” which is required to gain asylum in the United States.
Sessions ignores a simple fact: El Salvador is one of the deadliest places in the world to be a woman. It’s also been called the “murder capital of the world”: A recent study found a woman is killed there every 16 hours.
Violence in the small Central American country, particularly violence perpetrated against women, is pervasive and infects the country’s entire ecosystem. Government corruption is widespread; doctors are intimidated by the prospect of prison time from helping women who were raped obtain abortions (which are illegal in all circumstances); intimate partner violence occurs daily; and gangs commit murder and sexual violence with almost complete impunity.
And yet, the Trump administration maintains that people fleeing this violence are not refugees. Doctors Without Borders called this policy a death sentence for any woman attempting to escape her abuser.
The assumption that toughening up border enforcement will deter migrants from attempting to cross it is deeply flawed. Stricter border laws push people fleeing violence to pay higher prices to use traffickers instead, which reinforces the vicious cycle of organized crime.
The brutality that A-B- faced did not occur in a vacuum. This “private violence” is not private at all; it’s actually a public health crisis. Domestic violence affects nearly a third of women worldwide. As many as 38 percent of murders of women in the world are committed by a male intimate partner.
The World Health Organization defines intimate partner violence as “behavior by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse, and controlling behaviors.” These behaviors can lead to depression, post-traumatic stress disorder, eating disorders, and suicide attempts. Violence can also lead to unintended physical outcomes, including pregnancies, gynecological problems, induced abortions, and sexually transmitted infections, including HIV.
Children growing up in such situations are more likely to perpetrate or experience violence later in life. There are considerable social and economic costs as well: Women facing violence can experience social isolation, loss of wages from an inability to work, lack of participation in their community, and an inability to care for themselves and their children.
But the attorney general, whose history of racist remarks led to the loss of a federal judgeship in 1986, likely failed to take such factors into consideration in his shameful ruling.
An immigration judge would usually handle an asylum case. If a woman loses her case, the matter can go before the federal Board of Immigration Appeals before being heard in federal circuit court. But in an effort to severely limit the number of people granted asylum, Sessions exploited a rarely used provision allowing him to personally override this process in the A-B- case.
In 2016, the Board of Immigration Appeals found that A-B- did indeed qualify for asylum because she was part of a “particular social group” of women in El Salvador who are unable to leave violent marriages due the Salvadoran government’s failure to protect them.
Sessions has sent a clear message to the Central American women forced to abandon their homes and flee for their lives: No matter how much abuse you’ve suffered, American immigration officials would prefer to send you back to your country to meet an almost certain death.
Once Donald Trump claimed he would keep abortion legal if he became president. “I am pro-choice in every respect,” the real-estate developer said in a 1999 NBC interview.
What a difference 20 years makes. With a willing Republican Congress, President Trump has moved to obliterate abortion access at every turn. Last week, the Senate Appropriations Committee approved a funding bill designed to block the District of Columbia from providing monies for abortion for low-income women (Congress has the final word on the District’s budget).
Meanwhile, Planned Parenthood plans to sue the federal Department of Health and Human Services over its regressive efforts to impose an abstinence-only-until-marriage agenda on the Teen Pregnancy Prevention Program (TPPP), an initiative originally designed to use science-backed approaches to prevent teen pregnancy. (Abstinence-only programs do not necessarily succeed in convincing young people not to have sex.)
And on Tuesday, the Supreme Court ruled that “crisis pregnancy centers,” which aim to persuade women to parent or consider adoption, do not have to provide information about the availability of abortion services elsewhere.
Among the most far reaching of Trump’s anti-abortion moves is his attempt to implement a domestic version of a global gag rule that bans the use of U.S. foreign aid from abortion-related services. He reinstated and even expanded the Reagan-era policy on his first Monday in office.
With a little help from staunch religious conservatives, Trump is itching to cut Title X funding from clinics that provide abortions or refer patients to other places that offer the procedure. The American version would essentially block patients from receiving comprehensive health care by preventing providers from educating their patients about abortion options, making referrals, or providing abortion care. HHS has already moved to change how it awards family-planning grants based on this new anti-abortion strategy that groups like Planned Parenthood are fighting in federal court.
Title X enables low-income people to access affordable contraception and reproductive health care. More than four million Americans rely on services funded by Title X, which include wellness exams, life-saving cervical and breast cancer screenings, birth control, education about contraception, and STI and HIV/AIDS testing and treatment. About two-thirds of these people are at or below the poverty line.
One service Title X does not fund? Abortion care.
The ongoing debate over abortion means that many American women live in “abortion deserts”—areas that do not offer abortion care. Some people must travel more than 100 miles to reach an abortion facility. In a recent study conducted by the Journal of Medical Internet Research, 27 abortion deserts were identified, most of which are located in the South and Midwest. The state with the largest number of deserts was Texas, known for its breakfast burritos and the DIY abortion.
Indeed, as abortion clinics shut their doors at alarming rates, Texas women have been forced to take extreme measures to access abortion, like hopping the U.S.-Mexican border to buy an over-the-counter drug, that if taken correctly will induce a miscarriage. There is a cruel irony to the fact that women living in a country where abortion is technically legal but extremely hard to access must cross the border into another country where women are frequently prosecuted and convicted for having the procedure or even miscarrying.
Additionally, many women cannot afford to travel hundreds of miles or cross borders to have an abortion. Transportation access, especially when compounded by poverty, can be a barrier, and delays due to distance or lack of transportation can force women seeking abortions even later in their pregnancies.
That Title X money is already barred from funding abortion care is probably news to Trump, who continually strives to satisfy his core supporters. However, the goals of anti-abortion activists are much more insidious. With Justice Neil Gorsuch ensconced in his Supreme Court seat, the time is ripe for anti-abortion crusaders. By working to defund Planned Parenthood as well as forcing clinics to shut down, and setting up as “crisis pregnancy centers,” pro-life activists are harming the women they piously claim to protect.
While the final form of this this American “gag rule” is not yet clear, it will without question have dire consequences. Lapses in funding will quickly translate into lapses in quality care, especially for low-income women. This means missing months of contraception, delaying cancer and STI screenings, and possibly outright denial of care.
Access to comprehensive reproductive health care is essential for women’s economic security. According to the Reproductive Health Technologies Project, the birth control pill is responsible for 31 percent of the narrowing of the gender wage gap in the 1990s. When women can plan their families and delay pregnancy, it is beneficial not only to their own health, but that of their families as well. Improved access to birth control is also directly linked to declines in maternal and infant mortality.
As the politicization of women’s reproductive care continues unabated and abortion deserts expand, women will continue to suffer.