Part one of a two-part series.
Should a rape victim be forced to carry the rapist's baby to term? If a pill, taken shortly after the assault, can prevent pregnancy with minimal side effects (nausea, sometimes vomiting and a headache), and make an abortion unnecessary, should such birth control be made readily available?
Morally, those questions may seem to most people like no-brainers. But in the chambers of the state legislature, the sanctum of the Catholic Church, and the minds of members of groups like Feminists for Life, the answers are anything but clear cut.
Earlier this month, the State Assembly passed a bill requiring all hospital emergency room departments to provide rape victims with information about emergency contraception (commonly called EC), and dispense the pills on site.
A study released in January by Family Planning Advocates of New York and the New York State Coalition Against Sexual Assault found that every year, as many as 1,000 rape victims are treated in ERs across the state without receiving pills that can prevent pregnancy. Department of Health guidelines require hospitals to inform rape victims that EC is an option, but hospitals and individual physicians can refuse to provide it. The study found 27 hospitals in New York that do not have a standard policy mandating that EC be dispensed to rape victims.
All five hospitals in Monroe County have policies to provide EC. But that doesn't mean those policies are consistently implemented.
"In the past, there were times when victims were being refused," says Anna Potter, manager of Rape Crisis Services at Planned Parenthood. Potter says, however, that in the last few months, "since the EC issue has been pushed, I think that hospitals are more on board with making sure that the policy is in place and is being fulfilled."
The EC bill, sponsored by Rochester-area Assemblywoman Susan John, passed by a wide margin, with strong bipartisan support. Its sponsor in the Senate is Nicholas Spano, a Republican from Yonkers who's also assistant majority leader.
Republican Senator Joe Robach, who also supports the legislation, says Spano's sponsorship makes the bill's passage all the more likely, despite the fact it has previously passed the Assembly three times, only to be blocked in the Republican-controlled Senate. Perinton Senator Jim Alesi, a Republican, is a co-sponsor. Governor Pataki's office did not return calls requesting his position, but Robach and other supporters believe he'd sign it if given the chance.
Republican Senator George Maziarz opposes the bill, on the grounds it would force Catholic-affiliated hospitals to dispense EC. The statewide Catholic Conference, a body representing New York's Roman Catholic Bishops, is lobbying against the bill, as is the anti-choice organization Feminists for Life.
Catholic-affiliated hospitals do dispense EC to rape victims, says Catholic Conference spokesman Dennis Poust, but under one key condition: the woman must not be pregnant. This policy is in keeping with the Catholic hierarchy's belief that life begins at conception --- a belief counter to that of medical science, which defines pregnancy as occurring once an embryo attaches to the uterine wall.
Poust says rape victims at Catholic-affiliated hospitals are given a pregnancy test, and if the test is positive, EC is not provided.
Dr. Savita Ginde, a fellow at the University of Rochester's Reproductive Health Program, disputes the relevance of such tests, which are conducted within 72 hours of a rape. A test administered so soon after the assault could not detect a pregnancy resulting from that assault, she says. If the test is positive, it indicates a pre-existing pregnancy, and Dr. Ginde cites medical research proving that EC has no effect once an embryo is attached to the uterine wall. Neither does it harm the fetus.
In other words, EC is not an abortifacient, or agent capable of causing an abortion, like RU-486 (mifepristone), the medical abortion pill. Rather, EC drugs like Plan B and Previn are actually hormonal pills, similar to birth-control pills, that avert pregnancy by preventing the ovary from releasing an egg, inhibiting fertilization, or inhibiting implantation of a fertilized egg.
That last scenario is cited by EC's foes, who equate fertilization with pregnancy, as proof it is an abortifacient.
Jessica Shanahan, president of Feminists for Life of New York, did not respond to a request for comment. However, a recent editorial by interim president Mary Dwelley charges that "Women are being falsely led to believe that all these pills are contraceptive."
If the presence of a fertilized egg does not constitute pregnancy, "By this logic, human embryos (so called 'test tube babies') in a laboratory would have to be called 'contraception,'" Dwelley reasons.
"Why is Feminists for Life of New York, which has no position on contraception, opposed?" the editorial continues. "Once again, this method sells a woman out by putting the responsibility and burden on her to purge her body of any fertilized egg after an unplanned, flippant, or forced sexual encounter. It divorces men from accountability."
EC advocates stress that for the pills to be effective, time is of the essence. The drug is 90 percent effective when taken within 12 hours of unprotected sex, 75 percent effective within 72 hours.
Thus, hospitals that provide rape victims with prescriptions for EC, rather than dispensing it on site, greatly increase the chances the victim will become pregnant during that crucial period.
JoAnn Smith, president of Family Planning Advocates of New York State, says, "One of the hospitals that filled out our survey form said, 'We do not dispense on site. There is a 24-hour pharmacy a short bus ride away.'"
"To say to a woman who's been raped, 'Get on the bus, Gus,' that is egregious," Smith says. "That is unacceptable."
Smith disputes Dwelley's contention that hospitals and other health-care providers fail to fully inform patients of EC's effects. "To say that information is withheld from people is absolutely unfounded," she says.
Client information forms provided by Planned Parenthood do state that EC can "change the lining of the uterus in such a way that a fertilized egg may not attach and develop into a pregnancy."
"It's hard to imagine what objections someone would have to providing care to a woman who has been raped," Smith says.
Next week: The push to raise awareness of, and increase access to, EC.