Newt: from shameful to outrageous

December 16th, 2011 | Posted by Atlee Breland in Birth Control | Media - (Comments Off)

Having signed Personhood USA’s pledge to support state and federal personhood legislation, Republican presidential candidate Newt Gingrich has taken aim at birth control:

“Any kind of pre-conception birth control would be legal,” Gingrich replied. “But I think post-conception birth control would be a form of abortion.”

As we’ve recently discussed, banning forms of birth control with post-fertilization effects would pose a drastic threat to the bodily autonomy of the over 800,000 American women who currently use IUDs. By supporting a ban on post-conception birth control, Newt Gingrich is admitting that he wants to force these women to have their IUDs removed or face criminal penalties.

In America, we rightly consider the prospect of forced sterilization to be a gross violation of personal bodily autonomy. We at Parents Against Personhood are truly outraged that Mr. Gingrich has chosen to take a position on birth control which raises the equally repellent prospect of forced de-sterilization.

Personhood threatens women with existing IUDs

December 16th, 2011 | Posted by Atlee Breland in Birth Control - (Comments Off)

Adapted with modifications from Parents Against MS 26

As discussed in our previous post on IUDs, IUDs would be prohibited under personhood. Since IUDs are a long-term method which last for 5-10 years once inserted, this raises an extremely troubling question of how personhood would affect women who already have IUDs in place.

Certainly, those women wouldn’t be able to get expired IUDs replaced, but logic also suggests that women could potentially be forced to have their IUDs removed. If IUDs should be prohibited because they violate the fundamental right to life of “embryonic people”, women with IUDs must also be violating that same right on a routine basis.

The following paper calculates that a woman using an IUD experiences between 0.2 and 1.8 post-fertilization losses per year:

On the basis of currently available rates of fertilization in the presence of various types of IUD and the known
clinical pregnancy rates for each type of IUD, we have calculated expected conditional rates of postfertilization loss for each type of IUD. Further, with use of currently available rates of fertilization and clinical pregnancy early rates of postfertilization loss attributable to various IUDs.

It is necessary for the postfertilization mechanism to be extremely effective (>99%) to account for the known very low clinical pregnancy rates of the IUD (Table III). This highly effective mechanism is operative only in the minority of cycles in which fertilization has occurred. Yet in the course of a year, this results in a conservative estimate of 0.2 to 1.0 postfertilization losses per woman per year caused by the IUD.

(American Journal of Obstetrics and Gynecology, 2002)

If you already have an IUD at the time a personhood measure is acceptable in your state, is it acceptable for you to keep it in place for 5-10 years? Clearly not. We wouldn’t allow a woman to have one surgical abortion per year for the next 10 years, as long as she promises to stop after that. .

Those women’s embryos would have the same rights as the hypothetical future embryos of the woman who is now considering an IUD, and which personhood acknowledges to be worth protecting by forbidding IUDs. After all, you can’t grandfather in a right. Either you have it, in which case it must be defended, or you don’t.

It’s the possession of an IUD, not the insertion, that violates embryonic personhood. That could apply to women who already have IUDs, as well as to women who might otherwise consider getting them.

If the law classes an IUD as equivalent to abortion, the woman who already has an IUD must logically be affected as well. She must be forced to have her IUD removed so that she will not “abort” any future embryos, or face the same legal penalties as any other form of abortion.

The only reason why personhood advocates would NOT want to require women to have IUDs immediately removed is because they don’t want to face the voter backlash. Are they willing to sacrifice their moral positions for the sake of political expediency, or will they force women to have unwanted medical procedures, and interfere with those women’s birth control choices?

You can’t have your cake and eat it too.

Ectopic pregnancy overview

December 15th, 2011 | Posted by Atlee Breland in Pregnancy Issues - (Comments Off)

Republished with minor modifications from Parents Against MS 26

One of the most troubling questions raised by personhood is how to handle pregnancies which threaten the life of the mother.

1 in 50 pregnancies is an ectopic pregnancy, a life-threatening situation where the embryo implants in the mother’s fallopian tube instead of the uterus. Such pregnancies, for all intents and purposes, have no chance of ever becoming a baby. While there exist a few isolated case reports where such pregnancies have survived, the ten or so children worldwide born after ectopic pregnancies pale in comparison to the 65,000 ectopic pregnancies in the US alone each year.

Sadly, the only way to treat an ectopic pregnancy is to end it as quickly as possible, in order to preserve the mother’s life, health, and fertility. There is currently no way to transplant the embryo from the tube into the uterus, where it can develop safely. (Nor, it’s worth noting, could such a procedure be developed other than with embryonic research, which is adamantly opposed by personhood advocates.)

Termination of the pregnancy can be accomplished without surgery by administering methotrexate, a chemotherapy drug, which causes the embryo to stop developing and die, and be naturally miscarried. If methotrexate doesn’t work or the threat of rupture is too great, abdominal surgery is required to remove the embryo or the entire fallopian tube. The surgical approach carries the same risks as any other surgery, including death or severe injury from infection, bleeding, damage to other organs, and anesthesia complications. Tubal removal (salpingectomy) can also leave a woman infertile if her other fallopian tube is damaged or blocked. Therefore, methotrexate is the preferred initial treatment if the mother’s medical condition permits.

The vast majority of the pro-life community agrees that abortion is acceptable to end an ectopic pregnancy, although there are a few notable exceptions. However, there is substantial debate within the movement itself about exactly what forms of abortion are compatible with pro-life beliefs, and still more so about which ones would be compatible with personhood.

For some pro-lifers, the fact that the baby is inevitably doomed justifies the use of methotrexate to save the mother’s life. They feel that it is acceptable to deliberately kill the embryo in order to prevent health consequences to the mother, even if the mother is not currently experiencing the medical emergency of threatened or actual rupture. This is the position taken by the American Association of Pro-Life OBGYNs.

The American Association of Pro-Life Obstetricians … does not consider treatment of ectopic pregnancy by standard surgical or medical procedures to be the moral equivalent of elective abortion

For others, the principle of double effect means that deliberately killing the baby with methotrexate is not permissible, and that the only moral action is to remove the fallopian tube with the embryo in place. This is the position taken by the Catholic Church and by the Association of Pro-Life Physicians.

A chemical abortion with a medicine called methotrexate is often recommended by physicians to patients with early tubal ectopic pregnancies, when the baby may still be alive, to decrease the chances of a surgical alternative being necessary later, but we have found this to be an unnecessary risk to human life.

While it is acknowledged that removal of the tube containing the human embryo may result in sterility, it is not morally justified to directly attack human life by suctioning out the human embryo or administering methotrexate even though fertility is preserved.

For some personhood advocates, no procedure which kills a live embryo is ever justified, even a tubal-removal surgery where there is no deliberate intent to directly destroy the embryo. This is the position taken by Bill Fortenberry of the Personhood Initiative, and by Ben DuPré of Personhood Alabama:

Ectopic pregnancies are neither fatal for the mother nor necessarily for the child. The mother’s survival is almost certain, and the survival of the child is at least possible if not likely. So what does this mean to the pro-life movement? It means that Dr. Koop was correct. The personhood of the unborn child does not conflict with the need to protect the life of the mother for the simple reason that abortion is never necessary for that protection.

“If, in trying to save both, one of them unfortunately dies, at least they tried to save both,” DuPré said. “What they shouldn’t do is say that oh, one might take the other’s life so we should affirmatively take a life.

So, would personhood permit fertility-sparing non-surgical ectopic pregnancy treatment? Unfortunately, there is simply no way to know what the eventual legislative and judicial implementation will look like. Will there be an exception for methotrexate, or will the hardest-line voices prevail and insist on surgical treatment? Or will the issue not be directly addressed, potentially leaving doctors afraid to perform treatments which exist in a legal gray area? Nobody knows, and nobody CAN know what the legislative and judicial systems will eventually hash out.

We urge you to carefully consider whether you would like to give up your absolute right to choose how to manage an ectopic pregnancy, in the hope that your judges’ and legislators’ decisions wind up in the same place as yours would.

Legislative update: Nevada

December 15th, 2011 | Posted by Atlee Breland in Legislation | Nevada - (Comments Off)

According to the Las Vegas Sun, a decision is expected soon on the lawsuit which seeks to keep the 2012 Nevada personhood initiative off the ballot.

Carson City District Judge James Wilson said that he would issue a ruling by the end of the week, although he had not done so as of Thursday afternoon.

Shame on Newt

December 15th, 2011 | Posted by Atlee Breland in Media - (Comments Off)

In a reversal of his comments from two weeks ago, Republican presidential candidate Newt Gingrich this week signed Personhood USA’s pledge.

Republican candidates Michelle Bachmann and Rick Santorum also signed the personhood pledge, while Mitt Romney has not so far done so, and Jon Huntsman and Gary Johnson oppose personhood.

In signing the pledge, Gingrich agreed that:

Every human being at every stage of development must be recognized as a person possessing the right to life in federal and state laws without exception and without compromise.
In cases where a mother’s life is at risk, every effort should be made to save the baby’s life as well.
I oppose assisted suicide, euthanasia, embryonic stem cell research, and procedures that intentionally destroy developing human beings.
I will work to advance state and federal amendments that recognize the unalienable right to life of all human beings as persons at every stage of development.

This stands in sharp contrast to Gingrich’s prior comments on personhood-from-fertilization:

My friends who have ideological positions that sound good don’t then follow through the logic of: ‘So how many additional potential lives are they talking about? What are they going to do as a practical matter to make this real?’
I think that if you take a position when a woman has fertilized egg and that’s been successfully implanted that now you’re dealing with life. because otherwise you’re going to open up an extraordinary range of very difficult questions.

Clearly, one of the very difficult questions with which Newt found himself faced was the maintenance of his political viability.

Everything possible?

December 15th, 2011 | Posted by Atlee Breland in Pregnancy Issues - (Comments Off)

Reprinted with minor modifications from Parents Against MS 26

The official position of Personhood USA on pregnancy complications is that

In cases where a mother’s life is at risk, every effort should be made to save the baby’s life as well; leaving the death of an innocent child as an unintended tragedy rather than an intentional killing.

It sounds so nice, simple, and clear-cut, doesn’t it? Try to save both lives as long as you can, then switch over to save the mother? Well, let’s explore how this might play out in a very real context: chorioamnionitis prior to fetal viability.

Let’s call our mother-to-be “Karen”. She has a very much wanted pregnancy, until at 20 weeks, Karen develops an infection of the amniotic sac (“bag of waters”). She develops a high fever and is rushed to the hospital. Doctors encourage her to induce labor and deliver the baby, who will inevitably die, because there is no way to prolong her pregnancy until viability. The longer she goes without delivering the baby, the greater the risk that Karen will die.

Karen, out of strong pro-life beliefs, refuses to induce labor, because she considers that to be an abortion. She asks the doctors to do everything possible to save her baby, and to give her antibiotics to attempt to treat the infection. As she gets sicker and sicker, her body begins to go into labor naturally, and she begs for tocolytic drugs to stop her labor. The doctors comply, but the drugs don’t work, and she continues to have contractions. Eventually she consents to speed up her labor with drugs, because she is so desperately ill and must deliver quickly to save her own life. Karen’s son is born, and dies in her arms shortly thereafter, because he is simply too premature to survive.

As you may have guessed, this isn’t actually a hypothetical situation. It’s the very sad story of Karen Santorum, the wife of current Republican presidential candidate Rick Santorum, who is notable for his uncompromising pro-life position. Karen and Rick Santorum lost their baby son Gabriel to chorioamnionitis in 1996.

What’s notable about this story is just how far Karen and Rick were willing to go to avoid any action which could be considered a deliberate termination of the pregnancy. The pregnancy was doomed from the moment Karen entered the hospital — the odds of successfully treating the infection, and allowing her to remain pregnant, for four more weeks, were slim indeed. Yet the Santorums felt obligated to try anyway, and to demand every possible lifesaving measure, such as antibiotics and tocolytics. For them, nothing less was compatible with their pro-life beliefs.

Every one of these measures put Karen’s life at additional risk. Every minute that she wasn’t delivered was doing something less than “everything possible” to save both lives. Every treatment Karen tried prioritized Gabriel’s life, and threatened her own. By all accounts, Karen is lucky to have survived — women still die of these infections, even with the best care modern medicine has to offer.

In this situation, there is no way to equally treat both patients. You must choose whom you wish to save.

I’m not criticizing Karen and Rick’s choice. They have the right to decide how they want to handle their medical care. My criticism is that personhood could potentially impose Karen and Rick’s choice on those parents who would act differently in such a situation, and on the doctors who would advise their patients differently.

Other parents might wish to make a different choice, knowing that the odds of a good outcome were so small. They might opt to induce labor immediately, before the mother becomes as sick as Karen did. She might choose to prioritize her own life over the baby’s, and ask the doctor to do something less than “everything possible” to save the baby’s life.

It’s not an absolute certainty that the baby is unviable in all such situations. A rare few women may recover with antibiotics, and be able to remain pregnant long enough to deliver an extremely premature but viable baby. You can’t say at the moment the mother walks through the door that the baby is unviable — you can say it’s very low odds, but nothing is guaranteed. Therefore, the same standard of “everything possible” would apply.

If tocolytics and antibiotics might potentially save the life of the baby, they must therefore be employed. However, using them puts the mother at additional risk, so it’s not doing “everything possible” to protect her. What, exactly, is the doctor supposed to do in this situation? What, exactly, meets the standard of “everything possible” to protect both patients’ lives equally?

If you can’t answer this question, maybe you shouldn’t vote for an amendment which requires doctors to answer it, and to hope that their guess turns out to be on the right side of the law.

Please note: I will not tolerate any abuse of Karen and Rick Santorum in comments. For purposes of this post, I consider them grieving parents, not as political figures, and ask that you do the same.

National Perinatal Association opposed MS personhood

December 12th, 2011 | Posted by Atlee Breland in Media - (Comments Off)

I’m sad to say that I actually missed this statement by the National Perinatal Association on Mississippi’s Initiative 26 — the last few days of the campaign were so exhausting that I just couldn’t keep up with it all.

Nonetheless, I want to bring their statement on Initative 26 to your attention, and encourage you all to read it.

The National Perinatal Association (www.nationalperinatal.org) is a non-profit organization composed of medical professionals and parents, whose mission is to improve the health of pregnant women and babies.

NPA has serious concerns for the health and well-being of women and young families if amendment 26 is passed.

NPA RECOMMENDS TO THE CITIZENS OF MISSISSIPPI THAT A “NO” VOTE IS IN THE BEST INTEREST OF MOTHERS AND BABIES.

NPA is gravely concerned that this amendment will complicate and interfere with the delivery of effective and safe healthcare for mothers and babies alike. This initiative has a multitude of unintended consequences.

The National Perinatal Association joins the American Congress of Obstetrics and Gynecology, the American Society of Reproductive Medicine, and numerous state organizations in opposing personhood in Mississippi and elsewhere.

Personhood Colorado’s new stance on birth control

December 11th, 2011 | Posted by Atlee Breland in Birth Control - (Comments Off)

The proposed 2012 Colorado personhood initiative represents a departure from previous personhood efforts’ language.

Personhood amendments such as Mississippi’s Initiative 26 have traditionally been made up of a sentence or two stating that the term ‘person’ includes every human being from the moment of fertilization. However, the new Colorado language explicitly addresses birth control, IVF, and miscarriages, supposedly in response to concerns raised during the Mississippi campaign.

A casual reading of the language might lead you to believe that the amendment protects birth control, since it states that “only birth control which kills a person shall be affected”. What does this mean? Well, let’s ask the authors.

Kristi Burton Brown of Personhood Colorado sponsored the 2008 amendment. Together with Gualberto Garcia Jones, she wrote the 2012 language.

In April 2011, Mrs. Brown wrote a post for her personal blog entitled “Does the Birth Control Pill Cause Abortions? In a Word, Yes”.

The Birth Control Pill really DOES cause abortions, or it would never need to be outlawed by a law in favor of unborn children’s personhood… The IUD acts in a similar way to the Pill and also causes abortions.

Brown’s post references the work of Dr. Walt Larimore, a pro-life OB who has published articles in medical journals concluding that “the available evidence supports the hypothesis that when ovulation and fertilization occur in women taking OCs, postfertilization effects are operative on occasion.”

It couldn’t be clearer that Kristi Burton Brown wrote the proposed Colorado amendment with the intention to ban the usage of hormonal birth control.

We’ll be addressing other aspects of the new Colorado language in future posts.

Personhood and birth control: IUDs

December 11th, 2011 | Posted by Atlee Breland in Birth Control - (Comments Off)

IUDs, or intrauterine devices, are one of the most reliable methods of reversible long-term birth control. They are more than 99.5% effective at preventing pregnancy, and unlike the birth control pill, require no daily action on the part of the user. There are two types of IUD currently available in the IS. Mirena is a plastic IUD which is impregnated with low-dose hormones (Mirena), and Paragard is a copper IUD which contains no hormones. Mirena lasts for 5 years once inserted, and Paragard lasts for 10 years.

In addition to being used for birth control, the Mirena IUD is commonly used as a medical treatment for women’s health conditions such as endometriosis, menorrhagia (excessively heavy periods), and PCOS. It is effective, less invasive than surgery, preserves fertility, and has relatively few unpleasant side effects compared to other treatments such as Lupron.

Paragard does not stop ovulation, and Mirena has only a limited effect, with 50-75% of users continuing to ovulate. Both are thought to work in large part through significant toxic effects on sperm, but it is also believed that both types have the capacity to prohibit a fertilized egg from implanting. In fact, the scientific evidence for post-fertilization effects is somewhat clearer for IUDs than for any other birth control method:

Indirect clinical evidence is supportive of the hypothesis that the effect of the copper IUD on the endometrium plays a role in its contraceptive action. Insertion of an IUD in the early luteal phase is a highly effective emergency contraceptive, suggesting that the IUDs act after fertilization… Thus, both clinical and experimental evidence suggests that IUDs can prevent and disrupt implantation

(Human Reproduction Update, 2008)

The analysis of the evidence strongly suggests that the contraceptive effectiveness of intrauterine contraceptive devices is achieved by both a prefertilization spermicidal action and a postfertilization inhibition of uterine implantation. Patient informed consent for intrauterine contraceptive device insertion should include a discussion of these mechanisms of actions so as to avoid their use in patients with moral objections to postfertilization contraception

(American Journal of Obstetrics and Gynecology, 1997)

Although prefertilization effects are more prominent for the copper IUD, both prefertilization and postfertilization mechanisms of action contribute significantly to the effectiveness of all types of intrauterine devices.

(American Journal of Obstetrics and Gynecology, 2002)

Personhood advocates believe that any form of birth control which can work after fertilization has occurred is the legal and moral equivalent of abortion. Therefore, this would include IUDs, and they would not be available under personhood.

Personhood Colorado refers to IUDs as “mechanical abortifacients”, and the Mississippi Yes On 26 FAQ explicitly stated that IUDs would be prohibited (see screenshot).

RESOLVE Family-Building Expo today!

December 10th, 2011 | Posted by Atlee Breland in Uncategorized - (Comments Off)

I will be speaking at the RESOLVE Family Building Expo in Birmingham today. If you’re in the Birmingham area this morning, come out to meet me!

RESOLVE Family Building Expo

I’ll be posting video of the speech later today, for those of you who can’t make it. We hope to see you there!