Alexandra Rucinski is a patient advocate for Planned Parenthood and an activist for sex education and reproductive rights. Iowa’s near-total abortion ban inspired her to write this commentary. -promoted by desmoinesdem

I vividly remember the only sex-ed class I ever took in high school. A woman who worked for Planned Parenthood came to teach our class. I remember eyeing her with distrust as she talked about things absolutely forbidden to me. I didn’t listen because I felt like I wasn’t supposed to listen.

The Academy of Breastfeeding Medicine warns that recently updated “birth control guidelines released by the U.S. Centers for Disease Control and Prevention (CDC) could undermine mothers who want to breastfeed,” I learned from the ByMomsForMoms blog, sponsored by Lansinoh. From the Academy of Breastfeeding Medicine’s news release:

“The new guidelines ignore basic facts about how breastfeeding works,” says Dr. Gerald Calnen, President of the Academy of Breastfeeding Medicine (ABM). “Mothers start making milk due to the natural fall in progesterone after birth. An injection of artificial progesterone could completely derail this process.”

The CDC report, “U.S. Medical Eligibility Criteria for Contraceptive Use, 2010,” released in the May 28 issue of Morbidity & Mortality Weekly Report (MMWR), contains important changes in what constitutes acceptable contraceptive use by breastfeeding women. The criteria advise that by 1 month postpartum the benefits of progesterone contraception (in the form of progestin-only pills, depot medroxyprogesterone acetate (DPMA) injection, or implants), as well as the use of combined (progestin-estrogen) oral contraceptives outweigh the risk of reducing breastfeeding rates. Previously, progesterone birth control was not recommended for nursing mothers until at least 6 weeks after giving birth, and combined hormonal methods were not recommended before 6 months.

Based on clinical experience, breastfeeding support providers report a negative impact on breastfeeding when contraceptive methods are introduced too early. One preliminary study demonstrated dramatically lower breastfeeding rates at 6 months among mothers who underwent early insertion of progesterone-containing IUDs, compared with breastfeeding rates of mothers who underwent insertion at 6-8 weeks postpartum.

I have met women whose milk supply collapsed after they received a progesterone shot. One acquaintance had successfully nursed previous babies and was never informed by her health care provider that a birth control shot could impede her ability to produce enough milk for her infant.

It’s illogical for the CDC to give its blessing to early postpartum use of hormonal birth control when the federal government has supposedly been trying to promote breastfeeding for more than a decade. Earlier this year, the White House Task Force on Childhood Obesity set a goal of having half of U.S. babies breastfed for at least nine months by 2015, and recommended a number of specific policies to help reach that goal. But breastfeeding without a full milk supply is quite difficult no matter how educated the mother is or how supportive her environment. I hope the CDC will revise its guidelines and recommend non-hormonal forms of birth control for women in the early months of breastfeeding.  

Midnight tonight (September 25) is the deadline to submit comments on a rule proposed by the U.S. Department of Health and Human Services. A few weeks ago Planned Parenthood Action sounded the alarm about this proposal, which would allow health care providers to refuse to provide care that goes against their personal beliefs. This diary contains a link to a pdf file of the relevant document from HHS and explains how it could affect women’s health care:

Tweaking the interpretation of existing law, ALL employees of health care organizations would be able to refuse to be associated with providing services to which they are opposed.  The administration says the new rule is targeted at abortion, but the trouble is they have made the rule so vague it could apply across the spectrum in health care, including the birth control women need to prevent abortions.

Creating a special class of employees based on personal beliefs allows everyone from the doctor to the receptionist have a say in your health care.  Any employee can deny care to a patient, and the organization is helpless to take action to correct the situation.

   * The receptionist who schedules your appointment may not do so because he or she does not agree with the type of contraception you use.

   * The doctor may not tell you about all of your options because they are opposed based on their religious beliefs.

A health care organization that ensures patients get access to necessary services may lose its ability to provide federal assistance to low-income patients because of one employee.  And they can take no corrective action.

Cecile Richards, who leads the Planned Parenthood Action Fund, sent out an e-mail yesterday urging concerned citizens to submit a public comment:

The Bush administration has issued a rule that would limit the rights of patients to receive complete and accurate reproductive health information when they visit a health care provider. It’s more of the Bush administration’s bad medicine, and this is our last chance to stop it.

This new rule could allow individual health care providers to redefine abortion to include the most common forms of birth control – and then refuse to provide these basic services. A woman’s ability to manage her own health care is at risk of being compromised by politics and ideology. We have until September 25 at midnight to voice our opposition.

If elected, the McCain/Palin ticket promises to be the most anti-choice administration ever. But first, the current president seems determined to do as much damage as he can before he leaves office. We have just one more day to voice our opposition to the Bush administration rule. Please take a moment right now to add your name to the hundreds of thousands of others who will not stand by and let this happen without a fight.

The Planned Parenthood Action Center has created a page where you can submit your comments on this proposed rule. It’s easy, so please do weigh in.

What do these three things have in common?

• The cashier at a movie theatre refuses to sell tickets for R rated films because the movies are too violent…
• A waiter at a restaurant refuses to serve meat because they are a vegetarian…
• A geography teacher refuses to teach students about China because they are opposed to communism…

If a new rule from the Bush Administration was applied to all of jobs, none of these people could be fired for not doing their jobs!

The U.S. Department of Health and Human Services has released a new rule that will impact the way basic and reproductive health care will be provided in America.  This new rule broadly expands refusal clauses to allow ideology into the doctor’s office—even the waiting room!

Tweaking the interpretation of existing law, ALL employees of health care organizations would be able to refuse to be associated with providing services to which they are opposed.  The administration says the new rule is targeted at abortion, but the trouble is they have made the rule so vague it could apply across the spectrum in health care, including the birth control women need to prevent abortions.

Creating a special class of employees based on personal beliefs allows everyone from the doctor to the receptionist have a say in your health care.  Any employee can deny care to a patient, and the organization is helpless to take action to correct the situation.

• The receptionist who schedules your appointment may not do so because he or she does not agree with the type of contraception you use.
• The doctor may not tell you about all of your options because they are opposed based on their religious beliefs.

A health care organization that ensures patients get access to necessary services may lose its ability to provide federal assistance to low-income patients because of one employee.  And they can take no corrective action.  This is just another example of the Bush Administration protecting the “haves” and cutting off the “have-nots”.

This rule is being sold as a “protection” for health care workers, but seems like it’s more about imposing the beliefs of others on you—and your health care.  Be prepared to start interviewing your health care provider and all their staff once this law is passed, because if you don’t you’ll never know what you should have been told that you were not told.

This rule is a last ditch effort by the Bush Administration to cut off science based medicine and impose ideology.  It’s about placing the rights of a few ahead of medically accurate healthcare for everyone, and it’s about overturning state laws that go against the will of the Bush Administration.  On September 23rd the “Provider Conscience Regulation” will go into effect. Without a strong grassroots opposition, the personal beliefs of others will be a factor in your health care—and millions of low-income patients may lose life-saving services.

For more information or to take action visit: http://www.ppaction.org/campaign/hhs_regulation

John McCain somehow manages to maintain an image as a moderate, even as he panders to the right wing of the Republican Party.

Watch him try to evade the question of whether using condoms can prevent the spread of AIDS:

Q: “What about grants for sex education in the United States? Should they include instructions about using contraceptives? Or should it be Bush’s policy, which is just abstinence?”

  Mr. McCain: (Long pause) “Ahhh. I think I support the president’s policy.”

  Q: “So no contraception, no counseling on contraception. Just abstinence. Do you think contraceptives help stop the spread of HIV?”

  Mr. McCain: (Long pause) “You’ve stumped me.”

  Q: “I mean, I think you’d probably agree it probably does help stop it?”

  Mr. McCain: (Laughs) “Are we on the Straight Talk express? I’m not informed enough on it. Let me find out. You know, I’m sure I’ve taken a position on it on the past. I have to find out what my position was. Brian, would you find out what my position is on contraception – I’m sure I’m opposed to government spending on it, I’m sure I support the president’s policies on it.”

  Q: “But you would agree that condoms do stop the spread of sexually transmitted diseases. Would you say: ‘No, we’re not going to distribute them,’ knowing that?”

  Mr. McCain: (Twelve-second pause) “Get me Coburn’s thing, ask Weaver to get me Coburn’s paper that he just gave me in the last couple of days. I’ve never gotten into these issues before.”

Make sure your Republican and independent friends know that McCain supports George Bush’s policies on contraception.

By the way, “Coburn” refers to Senator Tom Coburn of Oklahoma, one of the most nutty and mean-spirited Republican members of Congress. Also, he’s not above citing junk science to back up his political views.