"A
virtual and 'real' newsletter for the territories where biotechnology, reproduction,
the female body, world economics, and futuristic bananas collide!" Note: this pamphlet is currently out of print.
Introduction
| Ask Rosa | Product of the Month
What's the World Bank Doing in My Uterus?
"A
virtual and 'real' newsletter for the territories where biotechnology, reproduction,
the female body, world economics, and futuristic bananas collide!"
Like Alice through the looking glass, we are plummeting headlong into the 21st century with a previously unimaginable capacity for self-fashioning and change. We can clone our mirror images; keep from getting old too fast or pregnant too slow; opt for a new gender, jawline, or physique. The options are mind-boggling. Yet self-determination as individuals and as women ironically grows more difficult--or at least more complicated--as our options expand. Each technological breakthrough broadens our potential at the same time that it presents new risks and raises new questions about our selves, our sexuality, our reproductive capacities, our mortal limits.
Moreover,
in medicine especially, new biotechnologies often underscore age-old prejudices
against women. Viagra, the new cure for impotence, is covered by most health
insurance plans, while the pill still is not. Reprotech scientists scrutinize
the female reproductive system, yet the clitoris might as well be Uranus, it
remains such a mystery to science. Wealthy parents can now procure traits, like
assorted bonbons, for their embryos; yet the medical and political establishment
has done little to unburden women from the primary responsibility of birthing
and raising these and other children.
For women by women, @Second Opinion is a forum for venting, critiquing, and
reevaluating sex and gender issues for the biotech century. Brought to you by
subRosa, @Second Opinion takes different forms in different places, but always
brings you fresh art, a glossalalia of biotech terminology, product of the month
exposes, investigative reports on a range of topics from fetal monitoring to
genetic engineering, and answers your questions concerning women's health and
sexuality.
A prime example of gender inequity in U.S. health care is the unquestionable success of Viagra, a drug used to combat male impotency. Insurance companies have swiftly picked up bills for its coverage and continue to neglect payment for birth control. Less than two months after being introduced on to the market more than half the prescriptions for Viagra were being subsidized. After almost forty years of fighting, slightly more than half of all prescriptions for birth control pills are covered. Some plans require extra fees for this benefit, and most don't cover any other form of contraception. It's no surprise that women of child bearing age spend 68% more, out of pocket, on health costs than men!
Q. What are the FDA approved methods of prescription birth control and what is the breakdown of coverage for them by health insurance?
A. Oral contraceptives (daily and emergency), injectable contraception (Depo Provera), contraceptive implants (Norplant), diaphragms, intrauterine devices (IUDs) and cervical caps. Of the 29% of Pennsylvania insurance companies that cover five of these methods of contraception (caps are rarely covered), approximately one quarter of them do so with restrictions. 36% of companies cover between two and four methods; 14% cover only one method and 21% do not provide any coverage at all.
Q. What are some of the consequences from the lack of coverage of birth control by health insurance companies?
A. It is costly, both for insurers who may have to pay for maternity care or abortion, as well as for the families whose physical and financial well-being is threatened by unintended pregnancy due to lack of access to equitable coverage for contraceptives. Generally, the more effective forms of contraception are also the most expensive often costing hundreds at the outset of patient use. Women and their families forced to pay out of pocket frequently opt for less expensive and sometimes less effective methods, increasing the number of unintended pregnancies--half of which end in abortion. Contraceptive coverage pays for itself: a 15% increase in the number of oral contraceptive users in a health plan would provide enough savings in pregnancy costs alone to provide oral contraceptive coverage for all users in the plan.
Q. What is the Equity in Prescription Insurance and Contraceptive Coverage Act (EPICC) and what does it call for?
A. The EPICC would ensure that health plans currently covering costs for prescribed drugs and devices could not selectively exclude certain prescriptions from their plans, such as ones made for family planning. The EPICC defines contraceptive services as outpatient consultations, examinations, and medical services related to the use of contraception, including natural family planning, for the prevention of unintended pregnancy. The EPICC calls for equal coverage for outpatient contraceptive services as for outpatient medical services of other kinds.
Q.
What can I do to help the passage of the EPICC bill?
A. Let your congress person know you support this and like
minded legislation. Work with local agencies--government and otherwise (be your
own agency!) to create awareness regarding its existence. The government pages
of your local phone book contain contact numbers for members of congress and
state senators. Talk to your partner, friends, family about the larger social
implications of widespread and ready coverage for drugs such as Viagra and the
inconsistency of this in relation to contraceptive coverage. For more information
concerning political action you can take, contact The Center for Reproductive
Law and Policy www.crlp.org.
or the Planned Parenthood Federation of America www.plannedparenthood.org.
Goldstein, Amy. Viagra's Success Fuels Gender Bias Debate. The Washington Post. May 20, 1998. Source: National Family Planning and Reproductive Health Association pamphlet provided by Planned Parenthood of Pittsburgh. Contact NFPRHA via email: info@nfprha.org
Smart kids and their parents will be happy to know that soon they can ward off colds and infections by eating the Smart Banana which packs a dose. A dose of antibiotics, that is! Consumers may soon be able to choose between anti-flu, anti-cold, anti-cough, or anti-headache bananas. Biotech researchers assure us that the ever stronger antibiotic-resistant strains of bacteria which the consumption of these bananas may produce, can easily be combated by ever new and improved (and more profitable) genetically altered food products. They also reassure farmers and consumers that the diminishing biodiversity of the world's agricultural species is nothing to worry about, and ensuing famines and superbugs can be ameliorated by new, yet more profitable and exciting bioengineered products!
Recently the mainstream media disclosed that condom manufactures were selling substandard product in South Africa--where the rate of AIDS transmission is one of the world's fastest, and AIDS mortality is extremely swift because most South Africans cannot afford the expensive "AIDS cocktails" that would enable them to live with the disease. The New York Times (2 Jan 1999) and other major newspapers, however, portrayed this tragedy as an isolated incident of careless opportunism or an inevitable mishap of government bureaucracy. In fact, the marketing of dangerous contraceptives to poor women has a history that is both long and systematic.
During the Aparthied regime, the South African government attempted to curtail black births by targeting young, black South African women for mass Depo-Provera campaigns. With virtually no access to health care, these young women were given Depo Provera without theirconsent. An injectable, progestin-only hormonal contraceptive, Depo-Provera has been linked to severe side effects such as cancer and heavy bleeding--which is particularly devastating for undernourished women. The U.S. had not yet approved the drug for domestic contraceptive use when the South Africa campaign began. Programs organized by the World Bank, the International Planned Parenthood Federation, and the United Nations Fund for Population Activities have promoted Depo-Provera, often coercively, among other poor women as well, in rural South India, Thailand, Bangladesh, New Zealand, and Mexico.
In the late 1950s, early, high-dose birth control pills were "tested" on women in Puerto Rico and later in El Salvador, with serious consequences to their health . One woman died of congestive heart failure that was clearly linked to the pill; another developed pulmonary tuberculosis. Convinced that the study was safe, the FDA went ahead and approved the pill in 1960. By 1962, over one hundred users of the high-dose birth-control pill contracted circulatory disorders such as thrombosis and embolism, resulting in eleven deaths.
"All medical and social welfare staff, including foreign aid people, are forcing us to be sterilized. . . . The tea plantation community is given five hundred rupees for a female sterilization. . . . When there is a serious illness, the factory management is supposed to provide transportation to the hospital. But even if someone is unconscious, they are not given transport. But when a woman decides to say yes for a sterilization, immediately the lorry is ready to go to the hospital...when a woman does not agree, she can be refused work in the fields."--Indrani, a member of the Tamil minority in Sri Lanka, to Betsy Hartmann.
In many third-world family planning programs, sponsored by first-world lending institutions, high-tech, higher profit, injectable or implant contraceptives--such as the IUD, Norplant, and hormone injections--receive the greatest research funding and promotion. These methods are riskier to a woman's health, offer users the least amount of control, and do nothing to prevent the spread of AIDS and STDs. Through these same family planning programs, many third-world women do not have access to the barrier methods of contraception: condoms, diaphragms, cervical caps, and spermicides. The barrier methods are the safest form of contraception, do not interfere with lactation, and are largely effective when used properly (in a context where safe, legal abortion is a viable back-up). The New York Times (12/9/84) reported a bias against the barrier methods even in U.S. family planning programs.
Norplant is a long-lasting hormonal contraceptive implant that is actually inserted into the fleshy part of a woman's upper arm. Side effects are similar to those associated with the pill. The safe use of Norplant depends on the user's informed consent, ability to have the device removed if necessary, and access to adequate health-care facilities, local anesthesia, medical screening, and follow-up care. These prerequisites are usually unavailable through family planning programs in third-world nations. Nevertheless, the Population Council, made up of first-world elites, is vigorously pushing to implant the device in poor women who would not have means of removing the device if necessary.
In the U.S., women who are Native American, African-American, Puerto Rican, Chicana, or poor are more likely to be sterilized than white women from the same or higher socioeconomic classes. Physicians sometimes fail to inform these patients that sterilization is permanent, welfare officials may threaten the loss of benefits if they refuse the operation,and operations may be performed without a woman's knowledge. Sometimes women are sterilized primarily for the purpose of training residents or interns. In Bangladesh, at least 34% of contraceptive users have been sterilized under a World Bank and USAID program that offers food relief only if women agree to undergo sterilization.
"The belief that overpopulation is the cause of the Third World's problems has a boomerang effect in the West. Harnessed to the goal of reducing birth rates as fast . . . as possible, the contraceptive industry has neglected health and safety concerns. The Western women who developed blood clots from the pill, who became infertile from the IUD, who were sterilized without their consent, or who, more commonly, are not fully informed of reproductive risks and side effects, are just as much the victims of population control as their counterparts in the Third World."--Betsy Hartmann, Reproductive Rights and Wrongs: The Global Politics of Population Control.
The pharmaceutical industry has long dumped banned and unmarketable drugs on the formerly colonized nations. Besides gutting healthcare systems and increasing poverty, "Structural Adjustment Programs" imposed by the International Monetary Fund and the World Bank have allowed transnational pharmaceutical companies to undermine regulations and promote their products with impunity, without alerting women to possible side effects. For example, in open defiance of World Health Organization guidelines, quinacrine is being promoted for the chemical sterilization of Asian and Latin American women.
In many countries, illegal abortion is a leading cause of death for women of child bearing age. Yet, women all over the globe continue to face powerful, well-funded anti-abortion lobbies that make safe, legal abortion impossible.
Family Planning has been divorced from, and funded at the expense of, basic health care in many Third World countries since the 1970s, when population control became a major strategy of Western multilateral lending institutions. Exceptions to this have been Sandinistan Nicaragua and Cuba, which developed model medical programs that greatly improved the health of their populations.
The neo-Malthusianism of the population-control establishment (institutions such as USAID, the World Bank, the Rockefeller Foundation, and the Ford Foundation, made up of first world elites) is a smokescreen for the real causes of poverty, and ignores even basic facts about population distribution. Today the world produces enough grain alone to provide every human on earth with 3,000 calories/day--well above the amount of food-energy required for survival.
The chief cause of poverty and environmental destruction is not overpopulation; it is the unequal distribution of wealth and land, the history of colonization and imperialism, and overconsumption in the industrialized world.
Consider that the wealthiest 358 people in the world have the same total wealth as 45% of the world's population, or 2.3 billion people. (AFLCIO statistic, quoted in Labor Notes, March 1999.) Consider that 2.5% of landowners control 75% of all arable land in the world, and the top 0.23% control over half! Consider that the U.S., with only 5% of the world's population, uses one-quarter of the gross planetary production of goods and services and one-third of the world's nonrenewable resources. Military activities cause up to 20% of all global environmental degradation.
Reproductive freedom for women globally is integral to their rights to self -determination; but for many of our sisters, meaningful reproductive choice does not exist. This has everything to do with corporate profit, global capitalism, and the neo-Malthusian ideology of the population-control establishment. Population control is substituted for social justice and much-needed reforms in land distribution, employment opportunity, mass education, and health care. First-world feminists must fight against genocidal policies and practices disguised as "family planning." The U.S. movement can learn a lot from our sisters globally, particularly in the formerly colonized nations, where women's groups, such as the following, have reached a broadened understanding of issues that underly women's oppression.
CIDHAL is a documentation center for Latin American women that does grassroots organizing, and offers clinical services and holistic approaches to women's health. Apdo, Postal 579; Calles des Flores No.12; col. Acapantzingo; Cuernavaca, Morales, Mexico.
ISIS Internatiónal is an international women's information and communication service. P.O. Box 1837; Quezon City Main; Quezon city 1100, Phillipines; tel. (63-2) 435-3408; 436-0312. email: isis@phil.gn.ape.org
National Black Women's Health Project (NBWHP) 1211 Connecticut Ave. NW, suite 310, Washington, D.C. 20005; (800)444-6472.
Shodhini, a network of women's health activists, is working to defend and revitalize indigenous healing systems J-1881 Chittaranjan Park; New Delhi 110019, India.
SOS Corpo is fighting the imposition of top-down family planning programs. Rua do Hospicio; 859-40 Andar, Boa Vista, Apt. 14; Recife, PE 50050 Brazil.
Women's Global Network for Reproductive Rights. email: office@wgnrr.nl
Women's Health Project, publishes Women's Health News. email: womenhp@sn.apc.org P.O. Box 1038; Johannesburg 2000; South Africa; tel. 27-11) 489-9917.
For further information, see: Deepa Danraj, Legacy of Malthus (1 hour video documentary) 1994, available from Women Make Movies, 462 Broadway, Suite 500E, NY, 10013; (212)925-0606. La Operación (documentary about female sterilization abuse and economic development in Puerto Rico) Cinema Guild, 1697 Broadway, Suite 802, NY, 10019. Betsy Hartmann, Reproductive Rights and Wrongs: The Global Politics of Population Control, Boston, South End Press, 1995. Amrita Basu,The Challenge of Local Feminisms: Women's Movements in Global Perspective, Boulder, CO, Westview Press, 1995. Boston Women's Health Book Collective, Our Bodies, Ourselves, for the New Century: A Book by and for Women, NY, Simon and Schuster, 1998.
--Lucia Sommer, 1999