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Cover Story: Phemale Pharmacology

Why can't politicians keep their hands off our bodies?

By Stephanie Dunlap · May 10th, 2006 · Cover Story
Janis Hastings

Addressing the state of women's health care is impossible without once again looking at what Ohio legislators have been up to. Looks like some of them have been up to preventing women from fully addressing their health, period.

Wait. "Period." Can we say that? OK, as long as we didn't miss one. Right.

House Bill 228, sponsored by State Rep. Tom Brinkman (R-Mount Lookout), seeks to ban all abortion in Ohio except when it's medically necessary to save a woman's life. It's been well-publicized as one of the most restrictive anti-abortion proposals in the country (see "Brinkman v. Roe," issue of May 11-17, 2005).

But there are a handful of other bills designed to chip away at women's access to a full spectrum of reproductive health care.

According to Molly Galvin, Western Ohio Field Organizer for Planned Parenthood Affiliates of Ohio, the two most active -- and against which she's campaigning most actively -- are bills 239 and 469.

HB 239 would make it illegal to use public funds for abortion services. Though federal programs such as Medicaid still cover abortion in the case of rape, incest, health or life of the mother, this is one of a number of "trigger laws" being introduced by states across the country so the state laws might be in place should federal laws change, according to Galvin.

HB 469 would exempt doctors and pharmacists from the mandatory distribution of medication that "will or may result in abortion or termination of life." The "may" and "termination of life" parts are new additions to the state code's wording, making room for pharmacists to refuse to fill hormonal birth control prescriptions.

"It's probably been one of the most active anti-choice bills this session," Galvin says.

She says HB 469 received multiple hearings before the state's health committee, during which opponents outlined four incidents in the Greater Cincinnati area this past November alone when pharmacists refused to honor prescriptions for emergency contraception.

"One woman who was willing to testify to the house health committee couldn't travel to Columbus because she has seven kids and a couple jobs," Galvin says.

An unscientific sampling of local pharmacies found that local Wal-Marts and bigg's carry Plan B, an emergency contraception that can prevent pregnancy for up to a few days after sex by delivering a high dose of hormones. Wal-Mart started widely stocking Plan B just in February, when the Massachusetts Board of Registration in Pharmacy voted to require Wal-Marts in that state to carry and dispense Plan B. After that the company changed its policy nationwide.

A pharmacist at the Hyde Park bigg's said he thinks most of that chain's pharmacies carry Plan B.

"It just depends if we have requests for it, and we get a lot here," he said.

Some smaller, independent pharmacies locally stocked Plan B as well, and those that didn't have it readily available offered to get it by the next day.

One exception is the Milford Pharmacy and Medical Center, whose owner, Jeff Hill, says he doesn't carry any abortive agents because they conflict with his religious beliefs.

"So under those procedures, if it's something that would have to be done, we would refer them to someone else," Hill says.

Dr. Mary is a local OB-GYN physician who asked that her real name not be used. Plan B is a hot topic in the independent practice where she works.

"I would prescribe it, but most of my partners would not because they're Catholic," Dr. Mary says. "That's a real Cincinnati thing."

She thinks such decisions aren't driven by overt misogyny so much as religious beliefs.

"I think it's not 'I won't give it to her because she's a woman' but because an abortion is against God," Dr. Mary says.

Women's health care isn't nearly as insulting as it used to be. Dr. Mary believes the myth of the "hysterical woman" has largely outgrown its skirts.

Though practitioners in their sixties and seventies still sometimes still think sedation is the way to go -- "Clinically she's depressed and they're like, 'Let's just give you a little Valium,' " Dr. Mary says -- changes in the ways medical schools teach have mostly eliminated that attitude, she says. But one glaring example of a disparity in men's and women's health care stands out, she says.

"Insurance companies across the board cover Viagra but don't cover birth control pills," Dr. Mary says. "That's probably the biggest prejudice I see in prescribing stuff."

Viagra is for one thing and one thing only, she says: treating penile erectile dysfunction.

But both science and conventional wisdom say that women's menstrual cycles mean they naturally experience more hormonal shifts than men. That means that hormonal birth control isn't indicated just for the prevention of pregnancy but also for cramping, heavy bleeding and irregular cycles.

New legislation seeks to address that disparity. State Rep. Tyrone Yates (D-Walnut Hills) and Sen. Teresa Fedor (D-Toledo) plans to introduce what he calls the Ohio Prevention First Act of 2006 this week, which would restore state family planning funding.

In 2003, those monies were redirected toward a women's health services program that didn't require contraceptive education, according to Galvin. The new bill would also require insurance companies to cover not just birth control but all types of birth control.

"Some insurance companies cover the big ones, but for a number of women finding a birth control pill that suits her body can entail going through 10 different kinds," Galvin says. "So some women find that, once their doctor finds the right prescription for them, it's not covered by their insurance."

In addition, Yates' bill would "increase awareness of access to emergency contraception, recognize a pharmacist's duty to fill lawful prescriptions, promote medically accurate teenage pregnancy prevention programs and ensure that any sex education have equal attention devoted to abstinence and contraception use," according to the Planned Parenthood Affiliates of Ohio Web site.

Of course, there's more to women's health care than just the parts of them that reproduce, though given political debates it's sometimes hard to remember. Medicine has come a long way, but there are still hurdles -- for instance, the specific way that heart disease affects women has been understudied and overlooked by some physicians who consider it a man's affliction.

But until women are seen as fully sentient and given the respect to be informed and then make choices about their reproductive organs, the message from our legislators and those who elect them is clear. ©



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