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A Pro Choice Agenda for New York City

by Andrew Stern, Jan 27, 2003
 

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On the 30th anniversary of the Roe v. Wade Supreme Court decision giving women throughout the nation the right to abortion, the right to choose is threatened on the federal front, with George W. Bush in the White House and anti-choice Republicans having taken control of the U.S. Senate. But New York City still has pro-choice officials, including Mayor Michael Bloomberg, City Council Speaker Gifford Miller and members of the City Council, who continue to press policies that will expand reproductive rights in the city and beyond.

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There is much to be done. More medical residents need to be trained in providing abortions, some contraceptive services are not widely available in New York, and poor women in the state do not have access to the array of services that women with private health insurance take for granted.

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A mere seven days after being inaugurated last January, Mayor Bloomberg took steps to address some of these problems. He advanced a plan advocated by the National Abortion & Reproductive Rights Action League of New York State (NARAL/NY), where I work, to make abortion training a requirement for all obstetrics/gynecology residents rotating through New York City public hospitals.

Since 1988, there has been a 22 percent decline in the number of abortion providers in the United States. In New York State, 42 percent of all counties have no abortion provider, and there has been a 12 percent drop in the number of doctors performing abortions since 1996 alone. As current providers retire, fewer young doctors offer abortion services to their patients. The number of residency programs offering routine training to do abortions has been declining, and many doctors who do not do abortions cite a "lack of proper training" as one of the major reasons they do not offer patients this care. Others cite a moral objection to performing abortions, and the plan allows those residents to opt out of the training. In July, the Health and Hospitals Corporation began implementing the program to provide comprehensive abortion training to obstetrics/gynecology residents in New York City's public hospitals. Since one out of seven doctors in the nation is educated in New York, this could have a dramatic effect on the entire country. The mayor's initiative will serve as a national model for other municipalities to follow.

But other challenges remain for women in New York seeking reproductive health services. A coalition of pro-choice organizations is working with the City Council and Speaker Gifford Miller to institute several important changes in city law.

In fall 2002, the council's Investigations Unit, led by Councilmember Eric Gioia, released a report on the distribution of emergency contraception in pharmacies throughout New York City. Also known as the "morning after pill," this reduces a woman's chance of becoming pregnant by up to 89 percent when taken within 72 hours of unprotected sex. This drug is often called "the nation's best kept secret" because so few women know about it.

The findings in the City Council report were staggering. Only 55 percent of pharmacies surveyed throughout all five boroughs stock the pill, meaning that women, at a moment of great need, lose critical time searching for a pharmacy that provides the drug. Many pharmacists had incorrect information about the drug, including the misperception that it has a short shelf life.

To address the barriers to emergency contraception, in December 2002, Christine Quinn, chair of the council's Health Committee, introduced a package of legislation that will require that all pharmacies that fail to stock emergency contraception post signs stating that they do not carry it. This would embarrass pharmacies into stocking the drug and help women find the medication. Another bill would also require the Department of Health to make the morning after pill available at all its health stations, health clinics and other health facilities.

Legislation sponsored by Councilmember Eva Moskowitz would require all hospital and medical facilities that New York City contracts with or funds to inform rape survivors of the availability of emergency contraception and, upon request, provide the medication as a basic standard of care. Currently, some hospitals do not provide it, due to either a lack of understanding of the drug's importance or religious objections.

In late December, the City Council held hearings on these three bills. It is anticipated that the council will vote on them in the near future. These measures will improve awareness of emergency contraception and its availability and will create models for other municipalities around the country.

While working women with private health insurance in New York have access to a broad array of reproductive health services, many poor women do not. Several years ago, New York State began transferring Medicaid recipients to managed health care programs. While individuals can research and select a managed care plan for themselves, a large percentage of Medicaid recipients do not choose a plan and are instead automatically enrolled into one. They may later learn that their plan does not provide a service they need.

This is particularly true of reproductive health services. Under state law, Medicaid recipients are entitled to receive contraception, abortion and reproductive health services. But not all of the managed care plans provide this kind of help. In that case, a woman seeking an abortion, say, or birth control may have to go outside her plan to another Medicaid provider. Although the service will still be free, some recipients find the burden of maneuvering the health care system to be an insurmountable barrier to getting the care they need. With the enactment of the historic state Women's Health and Wellness Act last year, commercial plans for workers and their families must cover contraception. So there now exists a dramatic inequity between those who receive health coverage from their employers and those who depend upon Medicaid for their health care.

The City Council, along with pro-choice advocates, is examining possible legislation to address this inequity in the provision of health care. New York City must mandate that managed care plans provide comprehensive care for all of our residents, especially those who are the most vulnerable because of poverty. Today, New York is one of only two states in the country -- the other being South Carolina -- where religious plans fail to contract with other plans to provide seamless care for Medicaid beneficiaries.

While harassment of women at reproductive health clinics has faded from the headlines, courageous volunteers who escort women to their appointments at these facilities continue to tell terrifying stories of women and clinic staff being verbally assaulted, threatened and physically blocked from entering the clinics. Current city law prohibits the use of blockades as well as other types of force at reproductive health clinics. But these laws do not always effectively protect patients, providers and others against noisy, disruptive and often menacing protests. Reproductive rights organizations across the city are working closely with the City Council to get strong legislation passed to ensure the doors of all reproductive health providers stay open and accessible.

In about a year and a half, New Yorkers will have a crucial opportunity to demonstrate to the nation that our city is indeed a pro-choice leader. In the summer of 2004, the Republican Party will bring its convention -- and likely anti-choice platform -- to New York City. On this, the 30th Anniversary of Roe v. Wade, we must commit ourselves to working together to ensure that New Yorkers deliver a passionate and united pro-choice message to the Republican Party. The entire country will be watching.

Andrew Stern is political director of National Abortion & Reproductive Rights Action League of New York State.

Read The Pro-Life Agenda by Lori Hougens.


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