Discordant benevolence: How and why people help others in the face of conflicting values.

Cowan, S. K., Bruce, T. C., et al. (2022).

Science Advances, 8(7).

https://doi.org/10.1126/sciadv.abj5851

Abstract

What happens when a request for help from friends or family members invokes conflicting values? In answering this question, we integrate and extend two literatures: support provision within social networks and moral decision-making. We examine the willingness of Americans who deem abortion immoral to help a close friend or family member seeking one. Using data from the General Social Survey and 74 in-depth interviews from the National Abortion Attitudes Study, we find that a substantial minority of Americans morally opposed to abortion would enact what we call discordant benevolence: providing help when doing so conflicts with personal values. People negotiate discordant benevolence by discriminating among types of help and by exercising commiseration, exemption, or discretion. This endeavor reveals both how personal values affect social support processes and how the nature of interaction shapes outcomes of moral decision-making.

Here is my summary:

Using data from the General Social Survey and 74 in-depth interviews from the National Abortion Attitudes Study, the authors find that a substantial minority of Americans morally opposed to abortion would enact discordant benevolence. They also find that people negotiate discordant benevolence by discriminating among types of help and by exercising commiseration, exemption, or discretion.

Commiseration involves understanding and sharing the other person's perspective, even if one does not agree with it. Exemption involves excusing oneself from helping, perhaps by claiming ignorance or lack of resources. Discretion involves helping in a way that minimizes the conflict with one's own values, such as by providing emotional support or practical assistance but not financial assistance.

The authors argue that discordant benevolence is a complex phenomenon that reflects the interplay of personal values, social relationships, and moral decision-making. They conclude that discordant benevolence is a significant form of social support, even in cases where it is motivated by conflicting values.

In other words, the research suggests that people are willing to help others in need, even if it means violating their own personal values. This is because people also value social relationships and helping others. They may do this by discriminating among types of help or by exercising commiseration, exemption, or discretion.

Telehealth Providers Prepare for the Future

Phoebe Kolbert & Charlotte Engrav

msmagazine.com

Originally posted 9 FEB 23

Here is an excerpt:

Telehealth Abortion Care

The Guttmacher Institute reports that, in 2017, medication abortions accounted for 39 percent of all abortions performed. By 2020, medication abortion usage accounted for 53 percent.

Coplon attributes the rise in telehealth medication abortions to COVID, but the continued use of it, she says, “is due to people’s understanding and acceptance, and also providers being more comfortable with providing pills without having the testing that we prior thought we needed.” 

She would know. Since 2016, Coplon has been part of a coalition of researchers, lawyers and other clinicians looking at telehealth medication abortion and ways to increase access to telehealth services. She now serves as the director of clinical operations at Abortion on Demand. 

In 2018, state policies enacted to support reproductive health were almost triple the number restricting reproductive healthcare. It was the first year in at least two decades where protections outpaced restrictions. 

Restrictions were eased even more when the COVID-19 pandemic made social distancing necessary, and lawmakers loosened restrictions, allowing more healthcare to be practiced online via telehealth. However, the landscape completely changed again in June of this year when the Supreme Court overturned the longstanding precedent of Roe in their Dobbs decision. Now, 18 states have abortion bans, 14 of which are total or near total. Eight other states have abortion bans on the books that are currently blocked, and there has been a push from anti-abortion groups to rescind access to telehealth medication abortions altogether. 

Telemedicine abortion has many benefits beyond preventing the spread of COVID-19—which may be why anti-abortion groups have been so quick to target it. Telehealth can make abortions more accessible for those who want and need them, and they tend to be cheaper and easier to schedule quickly. Even before Roe’s fall, patients would sometimes have to travel out of state or drive hours to the only abortion clinic in their state. Now, people living in states with bans must travel an average of 276 miles each way. States without bans have seen a swell of out-of-state patients seeking legal abortions. Bloomberg News estimated Illinois could face an 8,000 percent increase in abortion seekers. Planned Parenthood of Illinois estimated an increase of 20,000-30,000 out-of-state patients. Some clinics are struggling to keep up. For these clinics and patients, Coplon notes, telehealth can make a huge difference in the post-Roe era.

Not only can telehealth provide appointments within just a day or two of scheduling, as opposed to the potentially weeks-long waits at clinics in some overburdened states, it can also help reduce the overall burden on those in-person clinics—freeing up space for their own clients. 

The info is here.

Abortion Access Tied to Suicide Rates Among Young Women

Michael DePeau-Wilson

MedPage Today

Originally posted 28 DEC 22

Restrictions on access to reproductive care were associated with suicide rates among women of reproductive age, researchers found.

In a longitudinal ecologic study using state-based data from 1974 to 2016, enforcement of Targeted Regulation of Abortion Providers (TRAP) laws was associated with higher suicide rates among reproductive-age women (β=0.17, 95% CI 0.03-0.32, P=0.02) but not among women of post-reproductive age, according to Ran Barzilay, MD, PhD, of the University of Pennsylvania in Philadelphia, and colleagues.

Nor was enforcement of TRAP laws associated with deaths due to motor vehicle crashes, they reported in JAMA Psychiatry in a new tab or window.

Additionally, enforcement of a TRAP law was associated with a 5.81% higher annual rate of suicide than in pre-enforcement years, the researchers found.

"Taken together, the results suggest that the association between restricting access to abortion and suicide rates is specific to the women who are most affected by this restriction, which are young women," Barzilay told MedPage Today.

Barzilay said their study "can inform, number one, clinicians working with young women to be aware that this is a macro-level suicide risk factor in this population. And number two, that it informs policymakers as they allocate resources for suicide prevention. And number three, that it informs the ethical, divisive debate regarding access to abortion."

In an accompanying editorial, Tyler VanderWeele, PhD, of Harvard T.H. Chan School of Public Health in Boston, wrote that while analyses of this type are always subject to the possibility of changes in trends being attributable to some third factor, Barzilay and colleagues did "control for a number of reasonable candidates and conducted sensitivity analyses indicating that these associations were observed for reproductive-aged women but not for a control group of older women of post-reproductive age."

VanderWeele wrote the findings do suggest that a "not inconsiderable" number of women might be dying by suicide in part because of a lack of access to abortion services, and that "the increase is cause for clinical concern."

But while more research "might contribute more to our understanding," VanderWeele wrote, its role in the legal debates around abortion "seems less clear. Regardless of whether one is looking at potential adverse effects of access restrictions or of abortion, the abortion and mental health research literature will not resolve the more fundamental and disputed moral questions."

"Debates over abortion access are likely to remain contentious in this country and others," he wrote. "However, further steps can nevertheless be taken in finding common ground to promote women's mental health and healthcare."

For their "difference-in-differences" analysis, Barzilay and co-authors relied on data from the TRAP laws index to measure abortion access, and assessed suicide data from CDC's WONDER database in a new tab or window database.

The info is here.

Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations

Ogbu-Nwobodo, L., Shim, R.S., et al.

October 27, 2022

N Engl J Med 2022; 387:1613-1617

DOI: 10.1056/NEJMms2211124

Here is an excerpt:

Abortion and Mental Health

To begin with, abortion does not lead to mental health harm — a fact that has been established by data and recognized by the National Academies of Sciences, Engineering, and Medicine and the American Psychological Association The Turnaway Study, a longitudinal study that compared mental health outcomes among people who obtained an abortion with those among people denied abortion care, found that abortion denial was associated with initially higher levels of stress, anxiety, and low self-esteem than was obtaining of wanted abortion care. People who had an abortion did not have an increased risk of any mental health disorder, including depression, anxiety, suicidal ideation, post-traumatic stress disorder, or substance use disorders. Whether people obtained or were denied an abortion, those at greatest risk for adverse psychological outcomes after seeking an abortion were those with a history of mental health conditions or of child abuse or neglect and those who perceived abortion stigma (i.e., they felt others would look down on them for seeking an abortion). Furthermore, people who are highly oppressed and marginalized by society are more vulnerable to psychological distress.

There is evidence that people seeking abortion have poorer baseline mental health, on average, than people who are not seeking an abortion. However, this poorer mental health results in part from structural inequities that disproportionately expose some populations to poverty, trauma, adverse childhood experiences (including physical and sexual abuse), and intimate partner violence. People seek abortion for many reasons, including (but not limited to) timing issues, the need to focus on their other children, concern for their own physical or mental health, the desire to avoid exposing a child to a violent or abusive partner, and the lack of financial security to raise a child.

In addition, for people with a history of mental illness, pregnancy and the postpartum period are a time of high risk, with increased rates of recurrence of psychiatric symptoms and of adverse pregnancy and birth outcomes. Because of stigma and discrimination, birthing or pregnant people with serious mental illnesses or substance use disorders are more likely to be counseled by health professionals to avoid or terminate pregnancies, as highlighted by a small study of women with bipolar disorder. One study found that among women with mental health conditions, the rate of readmission to a psychiatric hospital was not elevated around the time of abortion, but there was an increased rate of hospitalization in psychiatric facilities at the time of childbirth. Data also indicate that for people with preexisting mental health conditions, mental health outcomes are poor whether they obtain an abortion or give birth.

The Role of Structural Racism

Structural racism — defined as ongoing interactions between macro-level systems and institutions that constrain the resources, opportunities, and power of marginalized racial and ethnic groups — is widely considered a fundamental cause of poor health and racial inequities, including adverse maternal health outcomes. Structural racism ensures the inequitable distribution of a broad range of health-promoting resources and opportunities that unfairly advantage White people and unfairly disadvantage historically marginalized racial and ethnic groups (e.g., education, paid leave from work, access to high-quality health care, safe neighborhoods, and affordable housing). In addition, structural racism is responsible for inequities and poor mental health outcomes among many diverse populations.

The information is here.

Professional Civil Disobedience — Medical-Society Responsibilities after Dobbs

Matthew K. Wynia

The New England Journal of Medicine

September 15, 2022, 387:959-961

Here are two excerpts:

The AMA called Dobbs “an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient–physician relationship, and a brazen violation of patients’ rights to evidence-based reproductive health services.” The American Academy of Family Physicians wrote that the decision “negatively impacts our practices and our patients by undermining the patient–physician relationship and potentially criminalizing evidence-based medical care.” The American College of Physicians stated, “A patient’s decision about whether to continue a pregnancy should be a private decision made in consultation with a physician or other health care professional, without interference from the government.” And the CEO of the American College of Obstetricians and Gynecologists called Dobbs “tragic” for patients, “the boldest act of legislative interference that we have seen in this country,” and “an affront to all that drew my colleagues and me into medicine.”

Medical organizations are rarely so united. Yet even many physicians who oppose abortion recognize that medically nuanced decisions are best left in the hands of individual patients and their physicians — not state lawmakers. Abortion bans are already pushing physicians in some states to wait until patients become critically ill before intervening in cases of ectopic pregnancy or septic miscarriage, among other problems.

Beyond issuing strongly worded statements, what actions should medical organizations take in the face of laws that threaten patients’ well-being? Should they support establishing committees to decide when a pregnant person’s life is in sufficient danger to warrant an abortion? Should they advocate for allowing patients to travel elsewhere for care? Or should they encourage their members to provide evidence-based medical care, even if doing so means accepting — en masse — fines, suspensions of licensure, and potential imprisonment? How long could a dangerous state law survive if the medical profession, as a whole, refused to be intimidated into harming patients, even if such a refusal meant that many physicians might go to jail?

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Proposing professional civil disobedience of state laws prohibiting abortion might seem naive. Historically, physicians have rarely been radical, and most have conformed with bad laws and policies, even horrific ones — such as those authorizing forced-sterilization programs in the United States and Nazi Germany, the use of psychiatric hospitals as political prisons in the Soviet Union, and police brutality under apartheid in South Africa. Too often, organized medicine has failed to fulfill its duty to protect patients when doing so required acting against state authority. Although there are many examples of courageous individual physicians defying unjust laws or regulations, examples of open support for these physicians by their professional associations — such as the AMA’s offer to support physicians who refused to be involved in “enhanced” interrogations (i.e., torture) during the Iraq War — are uncommon. And profession-wide civil disobedience — such as Dutch physicians choosing to collectively turn in their licenses rather than practice under Nazi rule — is rare.

The info is here.

Justice Alito's bad theology: Abortion foes don't have "morality" on their side

E. M. Freese & A. T. Taylor

Salon.com

Originally posted 26 JUL 22

Here is an excerpt:

Morality has thus become the reigning justification for the state to infringe upon the liberty of female Americans and to subjugate their reproductive labor to its power. An interrogation of this morality, however, reveals that it is underpinned by a theology that both erases and assumes the subjugation of female gestational labor in procreation to patriarchy. We must shatter this male-dominant moral logic and foreground female personhood and agency in order for every American to be equally free.

According to Alito, moral concern for "an unborn human being" apparently exempts pregnant people from the right to "liberty" otherwise guaranteed by the 14th Amendment. In other words, the supposed immorality of abortion is weighty enough to restrict bodily autonomy for all pregnant people in this country and to terrorize potentially pregnant females more broadly. This logic implies that pregnant people also lack 13th Amendment protection from "involuntary servitude," contrary to the strong argument made by legal scholar Michele Goodwin in a recent New York Times op-ed. Consequently, the court has now granted permission to states to force pregnant people to gestate against their will.

To be clear, the 13th and 14th Amendments are specifically about bodily autonomy and freedom from forced labor. They were created after the Civil War in an attempt to end slavery for good, and forced reproduction was correctly understood as a dimension of slavery. But Justice Alito asserts that abortion morality puts pregnant bodies in a "different" category with fewer rights. What, exactly, is the logic here?

At its heart, the theological premise of the anti-abortion argument is that male fertilization essentially equals procreation of a "life" that has equal moral and legal standing to a pregnant person, prior to any female gestation. In effect, this argument holds that the enormous female gestation labor over time, which is literally fundamental to the procreation of a viable "new life," can be ignored as a necessary precursor to the very existence of that life. On a practical level, this amounts to claiming that a habitable house exists at the stage of an architectural drawing, prior to any material labor by the general contractor and the construction workers who literally build it.

Abortion opponents draw upon the biblical story of creation found in the book of Genesis (chapters 1-3) to ostensibly ground their theology in tradition. But Genesis narrates that multiple participants labor at God's direction to create various forms of life through a material process over time, which actually contradicts a theology claiming that male fertilization equals instant-procreation. The real political value is the story's presumption of a male God's dominance and appropriation of others' labor for "His" ends. Using this frame, abortion opponents insert a "sovereign" God into the wombs of pregnant people — exactly at the moment of male fertilization. From that point, the colonization of the female body and female labor becomes not only morally acceptable, but necessary.

The info is here.

Surprise: 56% of US Catholics Favor Legalized Abortion

Dalia Fahmy

Pew Research Center

Originally posted 20 Oct 20

Here are two excerpts:

1. More than half of U.S. Catholics (56%) said abortion should be legal in all or most cases, while roughly four-in-ten (42%) said it should be illegal in all or most cases, according to the 2019 Pew Research Center survey. Although most Catholics generally approve of legalized abortion, the vast majority favor at least some restrictions. For example, while roughly one-third of Catholics (35%) said abortion should be legal in most cases, only around one-fifth (21%) said it should be legal in all cases. By the same token, 28% of Catholics said abortion should be illegal in most cases, while half as many (14%) said it should be illegal in all cases.

Compared with other Christian groups analyzed in the data, Catholics were about as likely as White Protestants who are not evangelical (60%) and Black Protestants (64%) to support legal abortion, and much more likely than White evangelical Protestants (20%) to do so. Among Americans who are religiously unaffiliated – those who say they are atheist, agnostic or “nothing in particular” – the vast majority (83%) said abortion should be legal in all or most cases.

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6. Even though most Catholics said abortion should generally be legal, a majority also said abortion is morally wrong. In fact, the share who said that abortion is morally wrong (57%), according to data from a 2017 survey, and the share who said it should be legal (56%) are almost identical. Among adults in other religious groups, there was a wide range of opinions on this question: Almost two-thirds of Protestants (64%) said abortion is morally wrong, including 77% of those who identify with evangelical Protestant denominations. Among the religiously unaffiliated, the vast majority said abortion is morally acceptable (34%) or not a moral issue (42%).

The info is here.

Choices

Christy Shake
Calvin's Story Blog
Originally published February 13, 2019

Here is an excerpt:

If Michael and I had known early on of Calvin's malformed brain, and had we known the dreadful extent to which it might impact his well-being and quality of life, his development, cognition, coordination, communication, vision, ability to move about and function independently, and his increased odds of having unstoppable seizures, or of being abused by caregivers, would we have chosen to terminate my pregnancy? I really can't say. But one thing I do know with certainty: it is torturous to see Calvin suffer on a daily basis, to see him seize repeatedly, sometimes for several consecutive days, bite his cheek so bad it bleeds, see terror in his eyes and malaise on his face, be a veritable guinea pig for neurologists and me, endure the miseries of antiepileptic drugs and their heinous side effects, to see him hurt so needlessly.

Especially during rough stints, it's hard not to imagine how life might have been—perhaps easier, calmer, happier, less restricted, less anxious, less heartbreaking—if Calvin had never come into this world. One moment I lament his existence and the next I wonder what I would do without him. And though Calvin brings me immense joy at times, and though he is as precious to me as any mother's child could be, our lives have been profoundly strained by his existence. All three of us suffer, but none more than our sweet Calvin. Life with him, worrying about and watching him endure his maladies—despite, or perhaps owing to, the fact I love him immeasurably—is such a painful and burdensome endeavor that at times I regret ever deciding to have a child.

The blog post is here.

Why Do Christian Women Continue to Have Abortions?

Marvin G. Thompson
The Christian Post
Originally posted November 3, 2018

Here is an excerpt:

According to Abortion Statistics compiled by the Antiochian Orthodox Christian Archdiocese of North America, '"Women identifying themselves as Protestants obtain 37.4% of all abortions in the U.S.; Catholic women account for 31.3%, Jewish women account for 1.3%, and women with no religious affiliation obtain 23.7% of all abortions. 18% of all abortions are performed on women who identify themselves as "Born-again/Evangelical."'

It is significant to note that only 23.7% of women obtaining abortions are not religious. That means 76.3% of all abortions are obtained by "God-fearing" women – with 68.7% identified as Christian women; and 18% of all abortions are obtained by "born-again/evangelical" women.

The official stated position of the Church does not seem to translate to requisite practice by church-going Christians. That fact was recently borne out in a study Commissioned by Care Net showing that 4 in 10 women having an abortion are churchgoers. In that study it is shown that in a survey of 1,038 women having an abortion, "70 percent claim a Christian religious preference, and 43 percent report attending church monthly or more at the time of an abortion."

The info is here.

Fostering Discussion When Teaching Abortion and Other Morally and Spiritually Charged Topics

Louise P. King and Alan Penzias
AMA Journal of Ethics. July 2018, Volume 20, Number 7: 637-642.

Abstract

Best practices for teaching morally and spiritually charged topics, such as abortion, to those early in their medical training are elusive at best, especially in our current political climate. Here we advocate that our duty as educators requires that we explore these topics in a supportive environment. In particular, we must model respectful discourse for our learners in these difficult areas.

How to Approach Difficult Conversations

When working with learners early in their medical training, educators can find that best practices for discussion of morally and spiritually charged topics are elusive. In this article, we address how to meaningfully discuss and explore students’ conscientious objection to participation in a particular procedure. In particular, we consider the following questions: When, if ever, is it justifiable to define a good outcome of such teaching as changing students’ minds about their health practice beliefs, and when, if ever, is it appropriate to illuminate the negative impacts their health practice beliefs can have on patients?

The information is here.

Physicians, Not Conscripts — Conscientious Objection in Health Care

Ronit Y. Stahl and Ezekiel J. Emanuel
N Engl J Med 2017; 376:1380-1385

“Conscience clause” legislation has proliferated in recent years, extending the legal rights of health care professionals to cite their personal religious or moral beliefs as a reason to opt out of performing specific procedures or caring for particular patients. Physicians can refuse to perform abortions or in vitro fertilization. Nurses can refuse to aid in end-of-life care. Pharmacists can refuse to fill prescriptions for contraception. More recently, state legislation has enabled counselors and therapists to refuse to treat lesbian, gay, bisexual, and transgender (LGBT) patients, and in December, a federal judge issued a nationwide injunction against Section 1557 of the Affordable Care Act, which forbids discrimination on the basis of gender identity or termination of a pregnancy.

The article is here, and you need a subscription.

Here is an excerpt:

Objection to providing patients interventions that are at the core of medical practice – interventions that the profession deems to be effective, ethical, and standard treatments – is unjustifiable (AMA Code of Medical Ethics [Opinion 11.2.2]10).

Making the patient paramount means offering and providing accepted medical interventions in accordance with patients’ reasoned decisions. Thus, a health care professional cannot deny patients access to medications for mental health conditions, sexual dysfunction, or contraception on the basis of their conscience, since these drugs are professionally accepted as appropriate medical interventions.

Fetal Tissue Fallout

R. Alta Charo
The New England Journal of Medicine
August 12, 201
DOI: 10.1056/NEJMp1510279

We have a duty to use fetal tissue for research and therapy.

This statement might seem extreme in light of recent events that have reopened a seemingly long-settled debate over whether such research ought even be permitted, let alone funded by the government. Morality and conscience have been cited to justify defunding, and even criminalizing, the research, just as morality and conscience have been cited to justify not only health care professionals' refusal to provide certain legal medical services to their patients but even their obstruction of others' fulfillment of that duty.

But this duty of care should, I believe, be at the heart of the current storm of debate surrounding fetal tissue research, an outgrowth of the ongoing effort to defund Planned Parenthood. And that duty includes taking advantage of avenues of hope for current and future patients, particularly if those avenues are being threatened by a purely political fight — one that, in this case, will in no way actually affect the number of fetuses that are aborted or brought to term, the alleged goal of the activists involved.

The entire article is here.

Clergy are not doctors — and the U.S. has its own Savita Halappanavars

By Irin Carmon
Salon.com
Originally published February 7, 2013

The death of Savita Halappanavar — the woman who died of sepsis in Ireland after being denied her request for termination of a nonviable pregnancy — drew outrage and attention in the United States late last fall, but one crucial point was often missed. Even in America, where abortion is mostly legal, cases like Halappanavar’s are a known reality in Catholic hospitals.

Take one case detailed to medical sociologist Lori Freedman by the doctor involved. A woman 16 weeks pregnant with twins was diagnosed with a molar pregnancy, which can lead to cancer, and “didn’t want to carry the pregnancy further.” She went to the hospital with vaginal bleeding, but unluckily for her, it was a Catholic one. There, the ethics committee decided that a uterine evacuation was tantamount to abortion, because there was a slim chance one of the fetuses would survive.

According to another doctor who witnessed the situation, “The clergy who made the decision Googled molar pregnancy.”

The woman was transferred out, Freedman wrote in a recent study published in the American Journal of Bioethics Primary Research, “despite the fact that terminating a bleeding molar pregnancy is safer in the hospital setting due to a high risk of hemorrhage.” What Freedman learned tracked closely with her previous studies focused on doctors’ concerns about miscarriage care in Catholic hospitals in situations very much like Halappanavar’s. Many doctors told her they preferred to send patients elsewhere rather than navigate the ethics committee.

The tension between religious beliefs and denial of medical care is currently playing out in the courtroom battles over the contraceptive coverage requirements under Obamacare, and for years, in legislative battles over “conscience clauses” that allow medical providers to opt out of some procedures. But some doctors’ consciences are being violated in the opposite fashion: Their recommendations for what is best for the women’s health and life, and often the wishes of the women themselves, are being circumvented by ethics committees at ever-expanding Catholic hospitals.

The entire story is here.

Thanks to Gary Schoener for this article.

Va. health commissioner quits, citing abortion regulations

By Olympia Meola
Richmond Times-Dispatch
Originally published October 19, 2012

Virginia's health commissioner, Dr. Karen Remley, resigned Thursday, saying the environment in the wake of new abortion clinic regulations compromised her ability to fulfill her duties.

Remley steered the massive state health agency during two gubernatorial administrations and recently as the Virginia Board of Health dealt with controversial abortion clinic regulations.

"Unfortunately, how specific sections of the Virginia Code pertaining to the development and enforcement of these regulations have been, and continue to be, interpreted has created an environment in which my ability to fulfill my duties is compromised, and in good faith I can no longer serve in my role," she wrote in a letter to Gov. Bob McDonnell.

Remley's resignation, effective Thursday, is the latest twist in a long and highly charged process surrounding the state's abortion clinic regulations.

The Board of Health voted Sept. 14 to adopt regulations that require existing abortion clinics in Virginia to be regulated like new hospitals.

The regulations, hailed by anti-abortion advocates, were approved over the angry objections of abortion-rights advocates, who said the new rules were a thinly veiled attempt to curtail access to abortion services by imposing construction costs on clinics that would force many to close.

The entire story is here.

Abortion Rates Fall When Birth Control Is Free

By Salynn Boyles
WebMD Health News 
Originally published on October 4, 2012


Abortions and unplanned pregnancies dropped dramatically in a new study when women and teenaged girls were provided birth control at no cost.

The women and girls were also more likely to choose IUDs or contraceptive implants when cost was not an issue.

Family planning advocates say the study shows the potential of the health reform law (now known by both supporters and opponents as Obamacare) to reduce unplanned pregnancies nationwide.

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About half of all pregnancies in the U.S. are unplanned, and about half of these pregnancies happen when birth control is not used.

The rest happen when contraception is used only some of the time or is used incorrectly.

The new study, published online today in the journal Obstetrics & Gynecology, included close to 9,300 sexually active women and teen girls at risk for having an unplanned pregnancy.

While the women were offered any FDA-approved method of contraception at no cost, the researchers made sure they knew that IUDs and implants were the most effective.

Researcher Jeff Peipert, MD, of Washington University in St. Louis, says around 3 out of 4 study participants opted for the long-acting methods.

“That was a shocker,” he says. “We had hoped to get maybe 15% of the women to choose IUDs or implants, but it was closer to 75%. That made all the difference.”

The entire story is here.

American College of Obstetricians and Gynecologists Committee on Gynecologic Practice opinion can be found here.

Catholic nuns group 'stunned' by Vatican scolding for 'radical feminist' ideas

By Reuters
Originally published April 20, 2012

The Vatican

A prominent U.S. Catholic nuns group said it was "stunned" that the Vatican reprimanded it for spending too much time on poverty and social justice concerns and not enough on abortion and gay marriage.

In a stinging report on Wednesday, the Vatican said the Leadership Conference of Women Religious had been "silent on the right to life" and had failed to make the "Biblical view of family life and human sexuality" a central plank in its agenda. It accused the group of promoting "certain radical feminist themes incompatible with the Catholic faith."

It also reprimanded American nuns for expressing positions on political issues that differed, at times, from views held by American bishops. Public disagreement with the bishops -- "who are the church's authentic teachers of faith and morals" -- is unacceptable, the report said.

The entire story is here.

Texas Abortion Law Can Go Into Effect Immediately

Associated Press

AUSTIN, Texas—A federal appeals court cleared the way Friday for the immediate enforcement of a new abortion law in Texas requiring doctors to conduct a sonogram before the procedure.

The three-judge panel on Tuesday lifted a temporary stay issued by a district court judge who found the new law potentially unconstitutional, but didn't issued a legal mandate. On Friday, the judges agreed to a request by Texas Attorney General Greg Abbott to cut short the typical three-week waiting period between a ruling and its implementation.

The new law requires doctors to conduct a sonogram before performing an abortion, to show the woman the image, to play the fetal heartbeat aloud and describe the features of the fetus at least 24 hours before the abortion. There are exceptions in the case of rape, incest, fetal deformities and for women who have to travel great distances to reach a doctor.

The most recent order doesn't give time for doctors fighting the law to appeal the decision, which under normal circumstances woudn't have gone into effect until Jan. 31. The Center for Reproductive Rights, which supports the doctors, didn't have an immediate reaction to Friday's order.

The entire story is here.

Abortion 'does not raise' mental health risk

By Jane Dreaper, 
Health correspondent, BBC News

Abortion does not raise the risk of a woman suffering mental health problems, a major review by experts concludes.

Data from 44 studies showed women with an unwanted pregnancy have a higher incidence of mental health problems in general.

This is not affected by whether or not they have an abortion or give birth.

But anti-abortion campaigners said the review sought to "minimise" the psychological effect of terminating a pregnancy.

Experts from the National Collaborating Centre for Mental Health (NCCMH) used the same research methods they use to assess evidence on other mental health issues for NICE.

The work - funded by the Department of Health - came after concerns that abortion may adversely affect a woman's mental health.

Usually, a woman's risk of suffering common disorders such as anxiety or depression would be around 11-12%.

But the researchers said this rate was around three times higher in women with unwanted pregnancies.

'Equal risks'

The director of NCCMH, Prof Tim Kendall, said: "It could be that these women have a mental health problem before the pregnancy.

Whether these women have abortions or give birth, their risk of mental health problems will not increase”

"On the other hand, it could be the unwanted pregnancy that's causing the problem.

"Or both explanations could be true. We can't be absolutely sure from the studies whether that's the case - but common sense would say it's quite likely to be both.

"The evidence shows though that whether these women have abortions - or go on to give birth - their risk of having mental health problems will not increase.

"They carry roughly equal risks.

"We believe this is the most comprehensive and detailed review of the mental health outcomes of abortion to date worldwide."

The whole story is here.