Can you design a Teen Pregnancy Prevention Campaign that does not shame Young Mothers, Insult Low-Income people . . . And Oh yeah, and is not Racist?

Jamille Fields, Resident Blogger (Law Students for Reproductive Justice Fellow at the National Health Law Program)

May is Teen Pregnancy Prevention Month–a month that Gloria Malone, a young mother, described as “the month of getting it wrong.” Malone was referring to the problematic teen pregnancy prevention campaigns that are displayed throughout the year, but are really touted during May.

Such campaigns include a Milwaukee campaign launched earlier this year that includes young parents as huge toys, such as a jack-in the box, puppet, or pull toy, with the message “Have a Baby too Young and it will Control Your Life.” In 2013, the Candies Foundation launched and continued an ad campaign, complete with celebrity endorsements (all women from what I can tell), with such messages as “You’re supposed to be changing the world, not changing diapers.” With taxpayer funding that same year, New York City launched an even more offensive campaign. One of the campaign ads featured a black toddler with the words “Honestly, Mom, chances are he won’t stay with you. What happens to me?” and another that read “Got a job? I cost thousands.”

These campaigns are problematic on so many levels that I don’t know where to begin. The Milwaukee campaign conveys to young parents a message of hopelessness. The Candies Foundation continues to place all responsibility for reproductive decision-making on young women, excluding men from any role in the matter. The New York City campaign ads, which featured mostly people of color, suggests that it is these communities that need to have their reproductive activities monitored and contained. Also, the message that the child will somehow be lost if Daddy doesn’t stay in a relationship with Mommy is insulting to all of the single parents who have raised and continue to raise healthy and happy children. Further, intertwined throughout many of these campaigns and others is the message that poverty is solely attributed to a person’s decision to have children. In addition to shaming teen mothers generally, the overall problem presented is that she is poor—and it is poor people of color who should not have children.

There are public health benefits of individuals of all ages having the resources and ability to plan births. According to the Guttmacher Institute, unplanned pregnancy is associated with delayed prenatal care, premature birth, and adverse physical and mental health effects for children. Eighty-two percent of teen births are unplanned. But, it is worth noting that teens are not alone in unplanned pregnancies given that around 50% of pregnancies in the United States are unplanned.

There are equally important public health concerns created from the societal shaming of young adults, particularly, mothers to whom the stigma is usually attached.  Such shaming, often makes young parents feel isolated and prevents them from seeking the assistance these young people and their children need.

It is important to empower – not shame – all young adults to take charge of their reproductive decision-making. This can be done by providing teens with evidence-based and comprehensive sexuality education in schools and creating a space for one-on-one discussions about sexual health in medical providers’ offices. Teens should be made aware that their health insurance plan may have to cover contraceptives with no out of pocket cost to them, even if they are a dependent on their parents plan.  Further, any discussions around sexual health and pregnancy prevention should be addressed to young men, just as equally as it does to women. This education should include LGBT youth who are often overlooked in these discussions with the assumption that they will not get pregnant. A recent study of New York City high school published in the American Journal of Public Health found that among sexually active teens, those who identified as lesbian, gay, or bisexual were almost twice as likely to report becoming pregnant or getting someone else pregnant.

Malone (mentioned above) is one of seven mothers spearheading the #NoTeenShame Campaign, which is designed to push back against Teen Pregnancy Prevention campaigns that are based on shame, and to offer messages of support and hope for young parents. There should be more campaigns like this. Instead of shame, we could equip adolescents with the education and resources they need to make decisions about their sexual health. Further, we can offer already parenting teens support that their life will go on; they can lead healthy and productive lives; and they can be good parents.

A Proposal to Preserve Reproductive Autonomy in the Face of Refusal Clauses

Emily Gillingham, Resident Blogger (’15, Michigan State University College of Law)

If a pharmacy or pharmacist won’t dispense medications related to reproductive healthcare, there is a public health interest in that information being publicly available.

Stories keep popping up in the news of women going to a pharmacist and being denied birth control, Plan B, or medications associated with abortion on the basis of the pharmacist’s moral beliefs. So-called “conscience clauses” that allow pharmacists to refuse to provide medicines to customers threaten lives, violate reproductive autonomy, and delay time-sensitive reproductive health decisions that women are legally entitled to make for themselves. NARAL has a great breakdown of refusal clauses in the U.S. here.

The idea that a pharmacist is permitted to inject his or her beliefs into others’ lives in such a momentous way is absolutely horrifying to me. In this context, I do not care what a pharmacist’s moral beliefs are.  The fact is, an enormous part of a pharmacist’s job is dispensing medications associated with reproductive healthcare. If a pharmacist’s moral system prohibits him from providing medicine to someone, either 1) he shouldn’t be a pharmacist, or 2) there needs to be an expedient way for the customer to work with a different pharmacist on-site to access that medicine. The status quo, where women can be denied access to medications that in some circumstances are life-saving because the pharmacist won’t do his job, is unacceptable.

A woman has a limited window to take Plan B, and she doesn’t necessarily have the luxury to spend her day going from pharmacy to pharmacy in search of one that will dispense it to her. The status quo assumes that she has access to transportation to get her to not just one, but potentially several pharmacies, and that she has the freedom to shirk responsibilities of work and home to do so.

If refusal clauses remain on the books, I propose the following in the interest of promoting women’s access to prescription and over-the-counter medicines that impact their reproductive health:

  1. Creation of a federally mandated online registry, open to the public, where all pharmacies register what medications they refuse to dispense on moral grounds, and whether the objection is pharmacy-wide or confined to one or more pharmacists.
  2. If a pharmacy refuses to dispense a medication on moral grounds, it must inform the woman where the nearest pharmacy is that will dispense it.
  3. Any pharmacist that refuses to dispense any medicine on moral grounds cannot be the only pharmacist on duty at that time if the entire pharmacy is not registered as a moral objector.
  4. Pharmacies that do not have any pharmacists on staff who have a conscientious objection to dispensing medication related to reproductive healthcare must post a sticker on the front door of the store noting that they will dispense all reproductive healthcare medications.
  5. Creation of an alternative distribution system for “refusal clause” medications where only one pharmacy is near the woman and that pharmacy refuses to fill them.

Minnesota House Tries to Undo Work of School Board and MHSAL for Transgender Students

Amy Krupinski, Resident Blogger (’14, William Mitchell College of Law)

Recently, the St. Paul Board of Education adopted a new policy that allows transgender students to use the restroom and locker room facilities that match their gender identity.  Also, the Minnesota State High School League (MSHSL) implemented a policy allowing students to join teams that matched their gender identity. This news announcement was visible only if you were really looking for it.  And it actually wasn’t even really news until the Minnesota House acted in response to it.  Although most people think these are laudable policies, the Republican-controlled House introduced contrary legislation that would require that transgender students use restroom and locker room facilities that match their biological gender.  In addition, this legislation would eliminate the MSHSL policy regarding which teams students can join.

This bill has already been shelved by the Senate. However, the mere fact that it exists as a countermeasure to these reforms is enough to spark a statewide debate, and it has drawn unwanted attention to these polices.  Whereas the St. Paul school board and MSHSL’s primary concerns are ensuring the safety and wellbeing of its students, this bill served only to perpetuate misunderstandings and fear. Clearly, the school board and MSHSL would have benefitted from the quiet implementation of their inclusive policies; the House called attention to them and tried to reverse them on a statewide level (to say nothing about local control issues). To me, it seems like a political move designed to distress voters and enflame the passions and worries of parents.

When I heard about these policies on Minnesota Public Radio one morning I immediately thought “wow, good for them”. Then I got to work.  I work in a pretty small, conservative town in out-state Minnesota (aka not the metro), and when I got to work I got a question from a co-worker who had heard the same story. He was wondering what this might mean for each school, students, and parents.  He wondered if this meant that schools were supposed to let boys and girls change together in the same locker room. Hearing someone distilling it down to this simplistic level is very distressing.  This simple question leads to a very complicated explanation of gender politics.  Its nuances are more than can be explained in a blog post with a word limit. However, I will say that I think I handled the explanation well to my coworker, and I am glad for the opportunities to provide some rational input into a controversial topic. Protecting individual students from bullying from their peers, from being made to feel uncomfortable while at school, or from being excluded or singled out should be a community’s primary concern.

When Good Intentions Aren’t Enough

Elise Foreman, Resident Blogger (’16, Emory University School of Law)

On Sunday, April 5, the Columbia Journalism Review published the findings of its investigation into the Rolling Stone piece “A Campus Rape: A Brutal Assault and Struggle for Justice at UVA,” originally published November 19, 2014. The piece unleashed a maelstrom of criticism levied at college administrations, and followed up other efforts to tighten sexual assault policies on campuses across the United States. However, the magazine faced similar criticisms as to its reporting of the central incident, with many challenging key factual assertions to the story underpinning the entire investigation. These criticisms came to fruition with the investigation and the magazine’s retraction of the article.

The central findings of the CJR’s report concentrate on the magazine’s failure to utilize basic journalism techniques, placing the blame squarely on a publication that should have known better. Rolling Stone likely did not set out on this trajectory with anything but good intentions, but good intentions is what is leftover regardless. Indeed, CJR reported that “[it] had hoped their investigation would sound an alarm about campus sexual assault and would challenge Virginia and other universities to do better. Instead, the magazine’s failure may have spread the idea that many women invent rape allegations.” (See the complete investigation at the above link). What started as an attempt to expose assaults and fight for survivors instead left those survivors even more exposed while Rolling Stone swallowed its good intentions – sacrificing more than journalistic integrity in the process.

Consistently through the investigation, Rolling Stone stated it tried to honor its source and grant her credibility, traipsing over tried-and-true investigative methods. However, handling survivors with kid gloves is neither respectful nor helpful; rather it diminishes the survivor’s autonomy and patronizes her or him. The paradox here reveals the underlying anxiety in dealing with sexual assault; we as a society are still uncomfortable with the fact that sexual assault is everywhere.

The magazine’s reliance on Jackie as its single source finally underscores the continuing need to sensationalize these assaults. In its own follow-up, the New York Times reported “the magazine was drawn toward the most extreme story of a campus rape it could find.” (Find this interview here). Though there were other stories to tell, Rolling Stone’s focus sensationalized the crime and ignored the reality that rape occurs when consent is disregarded or dishonored.

In its reporting, the CJR carefully placed the blame where deserved, and highlighted successful efforts in reporting on rape; it is these efforts which should be focused on going forward. The failure of Rolling Stone to heed these suggestions should stand as a failure of investigative reporting, rather than an excuse to blame survivors and perpetuate sexual assault.

[For more articles covering this story see: Maya Dusenberry @; Anna Merlan @ Jezebel; Sandy Hausman @ NPR; Michelle Goldberg @ The Nation ]

Carl Djerassi: A Legacy that Lives On

SJ Chapman, Resident Blogger (’12, Northwestern University Law School)

Carl Djerassi, who created the key ingredient in oral contraception, died on January 30.  The legacy he left behind was invaluable: a safe way for women take control of their reproductive lives.  Djerassi’s death spurred Megan Gibson to write a stunning article for Time on the history of birth control.  Gibson writes about epochs I can’t fathom – before birth control was available… before people even knew what it was.

Gibson writes, “For as long as men and women have been making babies, they’ve been trying not to,” quoting The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution.  Experimenting with contraception goes back to at least 3000 BC, where condoms appear in legends of King Minos of Crete.

Women began using methods for birth control that ranged from silly to lethal.  Women held their breath during sex, tied weasel testicles around their thighs, inserted crocodile dung into their vaginas, drank lead, drank mercury, or douched with Lysol.  Women used IUD precursors made of precious metals or glass, risking serious injury or infection.

Nearly 5000 years passed between 3000 BC and 1838, when vulcanized rubber led to the invention of rubber condoms, cervical caps and diaphragms.
Then, in the 1950s, Carl Djerassi led a team of scientists to develop a progesterone pill to block ovulation.  His synthesis led to the invention of the birth control pill, released in 1960.  By 1965, more than 6 million American women were on the pill.

During the 1960s, the battle against laws and stigma raged as women fought to gain access to the pill.  Finally in 1972 the Supreme Court ruled that the pill was legal for all women to use.  Today, more than 100 million women use the pill around the world, and it’s free to Americans under the Affordable Care Act.

Because of the pill, we live in an age when women can confidently and safely take control over their reproductive lives.  Not that there aren’t better methods waiting for us in the future. (Oh how I welcome the day when an LSRJ blogger writes “women used to resort to inane methods of birth control, like taking pills at regular 24 hour intervals to hormonally alter their bodies”).  But until that future arrives, I’ll be eternally grateful for Carl Djerassi’s contribution to reproductive justice.  And I’ll always be saddened by his passing.

Introducing the Denver Principles… to a New Generation

Jamille Fields, Resident Blogger (Law Students for Reproductive Justice Fellow at the National Health Law Program)

Preventing HIV and increasing access to care for people living with HIV/AIDS have long been interests of mine and is currently a part of my work portfolio. But, it was not until recently that I was introduced to the Denver Principles, which were outlined by a group of people living with AIDS in 1983–two years after the first instance of AIDS was reported. These principles changed the health care landscape for people living with HIV. I imagine other RJ advocates have not been introduced so I decided to pay it forward here.


I do not know if those who developed the Principles had the RJ framework in mind, but the principles are so RJ (or “Hella RJ” as LSRJ swag reads). Fear and discrimination of and against people living with HIV is still present, and it was even more blatant over thirty years ago. It was at this time that a group of fearless advocates stood at a gay and lesbian health conference to declare: “We condemn attempts to label us as ‘victims,’ a term which implies defeat and we are only occasionally ‘patients,’ a term which implies passivity, helplessness, and dependence upon the care of others. We are ‘People with AIDS.’” I imagine here the speaker dropped the mic and the crowd cheered. But, this powerful opening statement is only beginning of the Denver Principles.


The Principles are outlined into three different categories: (1) Recommendations for all People (aka the recommendations to be a decent human being), such as being a good ally for people living with HIV/AIDS when others attempt to separate them from their communities. (2) Recommendations for People with AIDS includes guidance for them to plan their own policy agenda. (3) The Rights of People with AIDS is where we, as lawyers, have a role to play, so I have outlined them here:


Principle 1: “To [have] as full and satisfying sexual and emotional lives as anyone else.”

This overarching guiding principle should govern the work we do as reproductive justice lawyers, whether or not we are specifically working on HIV/AIDS related care.


Principle 2: “To quality medical treatment and quality social service provision without discrimination of any form including sexual orientation, gender, diagnosis, economic status or race.”

The Affordable Care Act § 1557(enacted 27 years after the Principles) explicitly prohibits discrimination based on race, color, national origin, sex, age, or disability in health care delivery. This is an important tool that legal advocates can use to combat discrimination against people living with HIV. Here, at the National Health Law Program, we have filed a complaint against insurance companies for charging the highest level of cost-sharing for HIV/AIDS related drugs. We believe this is discrimination against people living with HIV/AIDS.


Principle 3: “To full explanations of all medical procedures and risks, to choose or refuse their treatment modalities, to refuse to participate in research without jeopardizing their treatment and to make informed decisions about their lives.”

This speaks to informed consent. Every person, including people living with HIV/AIDS, has a right to be fully informed of and to affirmatively consent to any health care procedures or research performed. This means ensuring the individual is made aware of all risks and consequences in a language and manner that ensures the person can make a voluntary choice whether to engage in the research or procedure. In general, it is important for lawyers to monitor language access and cultural competency in health care delivery.

Principle 4: “To privacy, to confidentiality of medical records, to human respect and to choose who their significant others are.”

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law designed to protect the confidentiality and security of health information. In addition, states have varying laws related to confidentiality, particularly as it relates to youth. Issues of confidentiality are particularly important for people living with HIV/AIDS given the discrimination this community often encounters once their HIV status is learned. Legal advocates have a role to play in ensuring the enforcement and improving of these laws.

Principle 5: “To die – and to LIVE – in dignity.”

Enough Said.

Vessel: Providing Safe Abortion Services at Sea (and Beyond)

Anne Keyworth, Resident Blogger (’16, North Carolina Central University)

For the 42nd Anniversary of Roe v. Wade, our chapter was fortunate and honored to work alongside Carolina Abortion Fund and several other local reproductive justice agencies to do a screening of the film Vessel, an award-winning documentary about a doctor and sea captain who provides safe abortion services in international waters for women who have no legal abortion options in their country. Dr. Rebecca Gomperts is a physician from the Netherlands who uses her creativity and fearless advocacy to facilitate an underground route to safe abortion services.

This film encapsulates a woman who had a vision of what she wanted abortion access to look like: safe, legal, and affordable for all women, everywhere. She took it as her mission to provide safe abortion services to women who lived in places where they would otherwise not be able to access such services and that were accessible by boat. In doing so, she navigated unchartered territory in international law and on the abortion frontlines.

Her mission was not without challenges. At times her and her crew would be forbidden from entering into the harbors of some country’s waters and for days would have to engage in international legal disputes as to their rights to dock and provide abortion services to women outside of their waters. Many crowds greeted her and her crew with anger and hostility, and she was urged by leaders of many countries to leave their territory. While this certainly didn’t stop her from pursuing her mission, it did force her to think more creatively about less visible means of accomplishing her goals.

This led to her and her team’s efforts in training and empowering women around the world on how to give themselves safe medical abortions using the drugs Mifepristone and Misoprostol. This has since substantially expanded their outreach and the amount of women they are able to connect with and help in obtaining an abortion. They have been able to reach many women they otherwise would not have through their Women on Web internet site.

Our screening was packed and we were very fortunate to have the film’s director, Diana Whitten, join us for a discussion afterward who gave a great insight as to what it was like to observe the politics of this journey and the energy and enthusiasm of the crew on board the vessel. Our chapter decided to host a screening at our own university in March, and we can’t wait to share the film with more people! If your chapter is looking for events to plan in the future about abortion rights and access, I highly recommend considering hosting a screening. It’s a whole new spin on the abortion conversation and one that has a lot of room for growth, even here in the United States where in many communities, abortion is becoming more and more difficult to access.


Where Pro-Choice Lawyers Can Make a Big Difference: Clinic Violence and Intimidation

Emily Gillingham, Resident Blogger (’15, Michigan State University College of Law)

Anti-choice activists are like a slow-motion temper tantrum. They stand outside abortion clinics with graphic signs. If they don’t get their way, they may try to rent the space out from under the clinic and “counsel” women who unwittingly come to the space seeking an abortion without disclosing that they aren’t, in fact, the abortion clinic the women had expected to find there. Sometimes, they intimidate pro-choice activists by showing up at their homes holding graphic and threatening signs. Sometimes they intimidate clinic workers and women seeking reproductive healthcare by taking down their license plate numbers, a practice that is sometimes followed with stalking that can only be described as “creepy as f***.” Eric Scheidler of the Pro-Life Action League sent plastic handcuffs to abortion providers on the anniversary of Roe v. Wade; the message with one read, “Could you be next? If you want to get out of the abortion business, give me a call.” The suggestion, of course, was “quit your job or you’ll end up in these handcuffs,” which was particularly absurd, considering it was sent on the anniversary of the SCOTUS decision that legalized abortion. The Feminist Majority Foundation recently released their 2014 National Clinic Violence Survey, which shows that “targeted intimidation and threats” are way up (see Chart 4). Some anti-choice activists do whatever they can think of to keep people from exercising their constitutional right to an abortion, even when that means placing people in fear for their lives.

Sometimes, anti-choice activists are so “pro-life” that they kill people. A meticulous NARAL report on clinic violence notes that “since 1993, eight clinic workers – including four doctors, two clinic employees, a clinic escort, and a security guard – have been murdered in the United States.” And since 1991, there have been 17 attempted murders at clinics.

As lawyers and future lawyers, we are uniquely equipped to help keep abortion providers and their patients safe. Think about how you can flex your legal muscle to help your local clinic, be it pro-bono work obtaining protective orders against anti-choice activists who’ve crossed the line into harassment or intimidation; training clinic staff on how to document intimidation; advocating for legislation to protect clinic workers from targeted intimidation and threats; or anything else your unique skillset enables you to do to help. We owe it to the clinic staff and their patients to use our privilege in these high-impact ways, and hopefully we will keep people safe and clinics open by doing so.

Federal District Court holds Anti-Prostitution Loyalty Oath Unconstitutional as Applied to Foreign-Based Organizations

Rhiannon DiClemente, Resident Blogger (’16, Temple University Beasley School of Law)

I’ve written before on the ways in which the U.S. government exports its own repressive ideologies regarding sexuality and reproduction through foreign aid conditions. The Anti-Prostitution Loyalty Oath (APLO) is yet another example of this tired tradition. While academics and advocates continue to debate the social and moral legitimacy of commercial sex work, the U.S. government has taken a direct stance in opposition to prostitution and related activities. Through the APLO, it has required non-governmental organizations (NGOs) to adopt this position in order to receive funding.

The APLO amended the President’s Emergency Plan for Aids Relief (PEPFAR). Initiated in 2003, PEPFAR committed forty-eight billion dollars over a five year period to combat the spread of HIV/AIDS. The APLO inhibits freedom of speech by requiring that recipients of PEPFAR funds pledge their opposition to prostitution and sex trafficking. It also prohibits activities that “promote or support the legalization or practice of prostitution.” The provision governs not only the recipient’s use of U.S. government funds, but also private funds as well.

Not surprisingly, many organizations have refused to comply with the APLO, despite the need for HIV/AIDS prevention and treatment services (UNAIDS estimates that less than one percent of global resources are dedicated to HIV/AIDS programs for people involved in sex work). In 2005, the Brazilian government declined forty million dollars in U.S. funding by refusing to accept the APLO. Later, during the 2010 International AIDS Conference, activists interrupted the U.S. Global AIDS ambassador’s speech to chant “PEPFAR kills sex workers.” Many governments and community-based organizations, such as SANGRAM, see people involved in sex work “not as carriers of HIV but rather as individuals who can be empowered to become agent[s] of change” in the fight against HIV/AIDS.

After a lengthy legal battle, in 2013 the Supreme Court declared the APLO to be a violation of the right to free speech when applied to U.S.-based organizations. However, the U.S. government has attempted to narrow the scope of the decision by insisting that the ruling does not prohibit the imposition of the APLO on foreign affiliates. This is problematic because U.S.-based implementers often rely on foreign organizations to carry out their health projects on the ground. Thus, even after the decision, the APLO has continued to stifle debate and put the lives of people in sex work at risk.

However, on January 30, 2015, a federal district court decision denied this narrow interpretation. Judge Victor Marrero confirmed that the First Amendment prohibits the U.S. government from imposing the APLO on U.S. organizations and their affiliates, regardless of where the affiliates are located. This is a breakthrough ruling in support of a free and open civil society. Rather than silencing the voices of individuals on the ground—U.S. policy should work to amplify such voices. Purnima Mane, President and CEO of Pathfinder International affirms that “it is critical to retain the ability of individual organizations to provide a range of life-saving health services to whomever needs them without sacrificing the right to free speech.”

Access to Contraception an Issue for Female Servicemembers

Elise Foreman, Resident Blogger (’16, Emory University School of Law)

In the wake of the Hobby Lobby decision last term, it seems like the Internet is blowing up with stories about access to contraception and women’s health across the United States. However, one employer in particular seems to be neglecting the needs of its staff, with little backlash from pundits: the American military. (For the full story, see the Center for American Progress’ story, Access to Contraception for Female Servicemembers).

Fortunately, a bill was introduced yesterday in the House of Representatives that, if passed, would increase coverage for American service women. (Check out RH Reality Check here for coverage on the bill). Specifically, the bill would ensure that options available through the Affordable Care Act would be available through the military’s healthcare plan, TRICARE. As it stands now, certain methods are left off the list of covered birth control methods – even though service women are at higher risk for unplanned pregnancies and sexually transmitted diseases. The bill seems to face a difficult battle, despite slow progress for all federal employees.

Impeding access to contraception for American service women denies not only their reproductive rights but similarly places additional barriers on their ability to perform their duties effectively. As members of the armed forces, these women should be at the forefront of the contraception conversation and provided comprehensive care. Not only should this care be provided in times of crisis, but in times of relative peace as well. Denying these important methods threatens to hold these service members back, while allowing their male counterparts to surge ahead. And in terms of the military, this deficient care can be debilitating.

As reproductive rights advocates look forward to the legislative battles ahead, let’s ensure the women serving in the military are supported in this crucial aspect.