Saturday, March 12, 2005

The Minnesota Alternative

Feministing and Mouse Words direct our attention to the latest state bill regulating your reproductive health care. This time, it's Minnesota. Basically, the bill would give state funding to organizations that discourage women from having abortions:

The Positive Alternative Act would help finance a network of mainly small, nonprofit groups around the state that counsel pregnant women and teenagers to give birth to their babies; they also offer help or referrals for medical care, housing and other services.

Abortion opponents called the bill their next logical step after passage of the Women's Right to Know Act in 2003, which requires women seeking abortions in Minnesota to wait 24 hours and to be given certain information before undergoing the procedure.

"Women's Right to Know provided information; now we want to provide practical, direct help to women," Andrea Rau, lobbyist for Minnesota Citizens Concerned for Life, told the House Health Policy and Finance Committee, which approved the bill on an 11-5 vote.

Critics, however, said the bill would prevent some of Minnesota's most respected adoption providers, such as Lutheran Social Service and Children's Home Society, from getting the funding the bill provides because they don't take a position on abortion. Critics also charged that some organizations eligible for the funding have offered women distorted information about abortions in order to persuade them to give birth.

A few select passages from the bill [H.F. No. 954]:

No exception for rape or a woman's health:

For purposes of this section, abortion does not include an abortion necessary to prevent the death of the mother

Use of made up terms and definitions:

"unborn child" means an individual organism of the species Homo sapiens from fertilization until birth.

Eligibility requirement excludes providing the information needed to make an informed decision (e.g. risks of term pregnancy vs. abortion):

To be eligible for a grant, an agency or organization must:

(4) provide each pregnant woman counseled with accurate information on the developmental characteristics of unborn children, including offering the printed information described in section 145.4243;

[I wasn't able to locate section 145.4243. If you find it, please let me know, and I'll take a look at it.]

The amount of funding mentioned in the bill is $10 million, annually:

[APPROPRIATIONS.] $4,000,000 is appropriated biannually to the commissioner of health to make grants according to subdivision 2. $1,000,000 is appropriated biannually to the commissioner of health to implement subdivision 3.

[Subdivision 2 deals with reasonable expenses of programs, and subdivision 3 deals with a statewide public information campaign to be developed by the state's health commissioner.]

So, Minnesota has $10 million available to reduce the abortion rate. Based on the most current data available, in 2003 there were 14,024 (.pdf) abortions performed in the state of Minnesota (12,857 for residents).

An interesting aside: The majority of procedures (12,570) were performed in the first trimester. For the rest, the breakdown is: 669 procedures at 13-15 weeks, 660 at 16-20 weeks, 121 at 21-24 weeks, 3 at 25-30 weeks, and 1 EGA unknown.

Returning to our analysis, of the 14,024 anual abortions, we don't know the reason for about 1/3 of the procedures, or 5,357 (unknown or patient refused to answer). For the rest, although women provided more than one reason, the factual conclusion (see page 21-22) is: the majority of women who have an abortion in Minnesota either don't want to have a child (rape, incest, don't want children at this time, fetal anomaly, already have children and don't intend to have more, relationship issues like abuse, separation, extra-marital affairs), or can't have one (emotional or physical health at stake, impairment of major bodily function).

I am not aware of any data showing that doing what bill H.F. 954 proposes to do--providing information on, referral to, and assistance in securing the services of relevant existing programs or agencies that assist women in carrying their pregnancies to term or providing services that assist women in carrying their pregnancies to term to women planning to have an abortion because they don't want/can't have children--is effective in reducing the number of abortions in this population. [Actually, I haven't seen any evidence, and, unfortunately, H.F. 954 doesn't cite any, that the strategy proposed by this bill reduces abortions in any patient population, including that of women who plan to have an abortion for economic reasons.]

What is an effective alternative to abortion in this population is to prevent the pregnancy in the first place by using emergency contraception (EC).

So, if the Minnesota politicians and their sponsors, like the Minnesota Citizens Concerned for Life, wish to mandate actual [as in effective, tested, measurable, proven] alternatives to abortion, and to provide practical, direct help to women, they need to take the 10 million dollars, purchase emergency contraception (EC), and make it available, for free, directly to women of reproductive age.

I don't know what the wholesale cost of an ECP pack is*, but let's say it's $20. This means the state of Minnesota can buy and dispense 500,000 ECP doses annually. More than enough to prevent almost all unintended pregnancies, and hence abortions, in the state, a few times over.

Let me be clear about this: I do not think it is the state's job to provide free EC to all women [or to legislate medical care, and the number of abortions for that matter]. However, if you're a beloved leader intent on legislating alternatives to abortion, at a minimum, you need to base your legislation on facts, not ideology, dogma, and made up definitions and programs.

Just because you title your bill "Positive Alternatives Act", doesn't mean what you are proposing is actually positive. [Ah, that pesky reality!] Something that increases your risk of death considerably (carrying a pregnancy to term) is not a positive alternative to abortion; it's, at best, an alternative. Note to Minnesota legislators, the chance of death (per year)**:

  • 1 in 10,000 risk per pregnancy from continuing a pregnancy

  • 1 in 263,000 risk from terminating a pregnancy before 9 weeks

  • 1 in 100,00 -"- between 9-12 weeks

  • 1 in 35,000 -"- between 13-15 weeks

  • 1 in 10,000 -"- after 15 weeks

  • And just because you have the ability to appropriate millions of your constituents' money, use it to support programs whose sole purposes are to assist and encourage women in carrying their pregnancies to term and to maximize their potentials thereafter, and ensure that none of the funds provided are used to encourage or counsel a woman to have an abortion not necessary to prevent her death, to provide her such an abortion, or to refer her for such an abortion, doesn't mean you are providing an effective alternative to abortion.

    *I had to run an errand, so I went and quizzed my poor neighborhood Duane Reade pharmacist. I'm not sure I have the actual wholesale ECP price, but I do have a price: $45 for a Plan B pack (one dose). [I was told they pay $45 for it, and they charge the customer $45. A bit hard to believe they sell at cost, but still: forty. five. dollars. for one ECP pack!]

    **Williams 21 ed, p 1518


    At 9:51 AM, Anonymous Anonymous said...


    As an employe of a pharmaceutical company that makes EC, I can tell you that in one country in Europe the wholesale price for one package of EC is around $13, with the OTC price being around $22.

    The price qoutes is for two tablets conatining .750 mg of levonorgestrel each, which should make them the same as Plan B.

    As medicinal prices are not secret I should think there are no problems with me informing of the wholesale price, but just the same, I'll not state which country, specific drug, or company I am talking about - unless prompted to

    At 4:56 AM, Blogger gibeonstar said...

    Cost for EC in the Twin Cities Metro Area ranges from $7.45 (HCMC) to $85 (I believe that one was a Planned Parenthood). It's a crapshoot.


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