(Originally posted on Daily Kos.)

Last Thursday the Department of Health and Human Services (HHS) released proposed regulations (PDF) that could seriously undermine women’s access to reproductive health services, including birth control and abortion. Now the public has 30 days to let the Bush administration know precisely what we think of these regulations. Click here for our Action Alert, which will allow you to send comments to HHS.

The Bush administration is trying to spin the proposed regulations as a necessary means of protecting health care workers who refuse to participate in abortions. But federal law has long carefully balanced protections for individual religious liberty and patients’ access to reproductive health care. It’s disingenuous to suggest otherwise.

What’s really new about these proposed regulations is that they appear to take patients’ health needs out of the equation. They expand the ability of health care workers to refuse to provide complete and accurate information and counseling to women who seek services. Moreover, both the regulations, and Secretary of HHS Michael Leavitt’s public comments about them, leave the door open as to whether institutions and individuals can refuse to provide contraception.

Make no mistake: that lack of clarity is intentional. As the Washington Post reports, "…when pressed about whether the regulation would protect health-care workers who consider birth control pills, Plan B and other forms of contraception to be equivalent to abortion, HHS Secretary Michael Leavitt said: ‘This regulation does not seek to resolve any ambiguity in that area.’" Indeed, the Wall Street Journal notes Leavitt’s admission that some medical providers may want to "press the definition."

Not reassuring.

Ditto for Leavitt’s justification for issuing the proposed regulations, which is based on his willful misinterpretation of last November’s statement (PDF) from the ethics committee of the American College of Obstetricians and Gynecologist. ACOG said that doctors should either be prepared to perform "standard reproductive services" or else refer those patients to someone who will. Leavitt claims that ACOG’s statement could potentially strip noncompliant doctors of their board certification, never mind that both ACOG and the executive director of the certifying board have explicitly told him otherwise.

But these regulations aren’t about responding to facts. This administration has, time and again, put its political and ideological concerns above the best interests of the American people.

They are, however, a very serious threat to women’s health and to existing patient protections that ensure that even in the face of religious refusals women can get the health care they need.

Click here to go to our Action Alert, which will allow you to submit comments to HHS. The deadline is September 20 and volume counts, so please act quickly and tell your friends.

A recent Florida federal court decision in an ACLU case did a lot more than simply make advocates for both reproductive freedom and for lesbian, gay, bisexual, and transgender rights very happy: It signaled that the days when folks could get away with making outlandish anti-LGBT arguments are going, going, and almost gone.

Ruling in favor of students who wanted to start a gay-straight alliance club at Okeechobee High School, a conservative judge found that school officials had violated the federal Equal Access Act, which guarantees the right of students in public schools to form clubs. And he clearly didn’t buy the school’s excuse that it should get off the hook for blocking the GSA because it receives federal funds for its “abstinence-only” program. A gay-straight alliance, the school had argued, is a “sex-based” club — which was news to the students who only wanted to talk about how to cut down on anti-gay bullying at their school and have the occasional pizza party.

In the ruling, the court recognized what those of us who advocate for comprehensive sex education have known for years: In addition to being a colossal failure for heterosexual teens, federally-funded abstinence-only-until-marriage programs by definition exclude LGBT teens. Recipients of this money ($1.5 billion to date and counting) must teach that “a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity” and that “bearing children out-of-wedlock is likely to have harmful consequences for the child, the child’s parents, and society.” Now take the federal definition of “marriage” that applies to these programs — that marriage is limited to a man and a woman — and combine it with the fact that same-sex couples cannot marry in all but two states, and voila: the result is that abstinence-only-until-marriage programs discriminate against LGBT students.

The judge in this case — again, the kind of judge that no one would call an "activist" — gets this concept. The court dismissed the school district’s nonsensical argument that recognizing a GSA would conflicts with the well-being of students because it conflicts with the school’s abstinence-only program. In fact, the court found just the opposite: It’s not the GSA that would harm the well-being of students but the abstinence-only programs that do so by excluding them.

For example, the court noted that abstinence-only programs “do not provide information of a kind usable by non-heterosexuals to prevent disease.” And it implicitly recognized that LGBT individuals have a right to form intimate relationships and to parent, noting that teaching about the benefits that accrue to children with married parents is of “little use to . . . non-heterosexual students who may aspire to parenting but lack the prospect of a legally sanctioned marriage.” The court concluded by saying that abstinence-only-until-marriage programs are therefore of “limited utility to . . . non-heterosexual students, the well-being of whom must also be considered.”

You’ve got to wish that the lawmakers in Washington, D.C., would get it too — that they’d stop the flow of abstinence-only-until-marriage dollars into discriminatory, ineffective programs. But no, it’s politics as usual in D.C., and while there’s some empty rhetoric about how useless ab-only is, it isn’t accompanied by the political will to actually pull the funding from this costly failed experiment.

Maybe this will be the last we see of this latest, desperate tactic used to bar students from fighting LGBT harassment in schools by forming GSAs. As for the students in the GSA, they’re just excited that they’ll finally be getting the club off the ground when school starts later this month. Pizza, anyone?

No one is above the law, not even Joe Arpaio, the media-hungry sheriff of Maricopa County, Arizona. His stunts include reinstituting chain gangs (they include women and juveniles), erecting a tent city where over 2,000 convicted men and women serve out their sentences in 120 degree desert heat, feeding prisoners only twice a day (he’s bragged of serving green bologna), and forcing them to wear pink underwear.

Much of the ACLU’s legal docket in Arizona is devoted to challenging Maricopa County Sheriff’s Office (MSCO) policies that violate the constitutional rights of women, prisoners, and immigrants — for starters. Arpaio has spent hundreds of thousands of local taxpayers’ money defending his indefensible and unconstitutional practices.

Late yesterday in Phoenix the bell rang on round II in the ACLU’s fight to force “Sheriff Joe” to follow the law. We asked a state court judge to find him in contempt for refusing to comply with a 2005 court order that clearly requires him and his staff to provide transport for the women incarcerated in his jails who are seeking abortions.

That 2005 order was the end result of four years that the ACLU’s Reproductive Freedom Project and the ACLU of Arizona spent in court challenging an unwritten MSCO policy. Jail officials were prohibited from transporting an inmate for an abortion (note: the women foot the bill for the abortion) unless the inmate first obtained a lawyer, asked for a court hearing, and convinced a judge to grant her an order to end her pregnancy.

In August 2005, the Superior Court of Arizona, Maricopa County, struck down the unwritten policy, holding that it violated women’s reproductive rights and served “no legitimate penological purpose.” The Arizona Court of Appeals upheld that decision; both the Arizona and the United States Supreme Court refused to hear the case.

But that hasn’t stopped the guy who loves being known as “America’s Toughest Sheriff” from flouting the law; imposing his morality on the women in his jails; advancing his political agenda; or burnishing his public image using taxpayer dollars. After the US Supreme Court refused to review the case, Arpaio told the Republic’s Michael Kiefer that he disagreed with the decision and would “see what happens if the situation comes before me again.”

It didn’t take long. This past spring, an inmate we’re referring to in our motion as “Mary Roe” and her attorney pleaded with Arpaio and his staff to transport her for an abortion appointment. Deputy Chief John MacIntyre, an Arpaio crony who’s one of the architects of the policy, had been involved in the original case and knew the court’s decision. Still, MacIntyre said — yes, you guessed it — that the quickest way for her client to be transported would be for her to get a court order.

Roe was eventually able to get the abortion, but the four-week delay resulted in her having to endure a much longer and more emotionally difficult procedure.

So now we’re heading back into court to spell out the law for Sheriff Joe and his staff, yet again, and ensure that other women don’t get this kind of runaround. Our motion asks the court to require the jail to post signs in both English and Spanish informing prisoners of their right to be transported. All employees would be required to sign a statement acknowledging that they have been informed of the law. And we’re asking the court to assess penalties for this violation and for future violations of the court order should they occur.

For all of his law-and-order bluff, Arpaio clearly has no intention of abiding by his oath to uphold the law when it isn’t doesn’t suit him. So we’ll do what it takes to force him to respect the constitutional rights of women, even if it means hitting him in one of his most sensitive spots … his pocketbook.

The 700 or so women each year who have an abortion in South Dakota go to the only abortion clinic in the state, where one doctor performs abortions once a week (three different doctors rotate that shift). After last Friday’s 8th Circuit Court decision in Planned Parenthood Minnesota, North Dakota, South Dakota v. Rounds (PDF), those three doctors are now forced, by law, to tell each of these women that “An abortion will terminate the life of a whole, separate, unique, living human being.” This restriction is just one more tactic that anti-choice forces have used to chip away at the constitutional right to abortion in what is already one of the most restricted states.

The ACLU believes that a woman needs medically accurate information to make the best choices for herself and her circumstances, without undue pressure. She should be able to trust that the advice she receives from her physician reflects what her physician believes is in her best interest, not something that her physician has been forced to say by the government.

Clearly those in the South Dakota legislature who voted to pass the law,and the 8th Circuit judges who voted to uphold it, disagree.

The law also forces a doctor to tell his or her patient that she “has an existing relationship with that unborn human being” and if she has an abortion, “her existing relationship and her existing constitutional rights with regards to that relationship will be terminated.”

The court’s decision comes in the midst of a challenge to the law the South Dakota legislature passed in 2005 that requires a physician performing an abortion (those three rotating doctors at that one clinic that performs abortions one day per week) to recite to their patients all of those opinions masquerading as fact. The court determined that the law could go into effect while Planned Parenthood continues its challenge, and the court specifically said that it is unlikely that Planned Parenthood will succeed on its claim that the law violates doctors’ First Amendment rights by forcing them to deliver an ideologically-driven message with which they disagree.

If the law’s language sounds like anti-choice rhetoric, it’s because it was written by an anti-choice activist — the lawyer Harold J. Cassidy. He tried a similar tactic in New Jersey a few years ago by bringing a medical malpractice lawsuit against a physician who performed an abortion and who didn’t tell his patients what those three rotating doctors in South Dakota are now forced to tell theirs: that abortion terminates the life of a separate, unique human being.

Last September the New Jersey Supreme Court — in a unanimous decision — threw out the case, noting:

We know of no common law duty requiring a physician to instruct the woman that the embryo is an ‘existing human being,’ and suggesting that an abortion is tantamount to murder.There is not even remotely a consensus among New Jersey’s medical community or citizenry that plaintiff’s assertions are medical facts, as opposed to firmly held, moral philosophical and religious beliefs.

A similar case is pending in Chicago.

Women’s heath is best promoted when a woman has the information and access to make healthy life decisions based on her own values and her own unique circumstances. Ensuring this principle means stopping anti-choice activists like Cassidy and South Dakota’s lawmakers from playing politics with our lives.

Christine Vestal had a story on Stateline.org yesterday about legislative efforts to require doctors to perform ultrasounds before an abortion. The green light really came on for anti-abortion activists this past April, when Oklahoma legislators easily passed a first-in-the-nation law that forces health care providers to perform an ultrasound before a woman has an abortion regardless of medical necessity or benefit, and requires the woman to listen to a description of the fetal image against her will.

Vestal notes that 17 states considered more than 30 ultrasound bills this year, "a record level of legislative activity on any abortion issue," and that we should expect to be seeing even more of them in the next legislative session.

Trevor Lippman, State Strategies Fellow for the ACLU’s Reproductive Freedom Project, correctly nails the Oklahoma law’s real intent, and the harm it poses to women’s health:

The Oklahoma law is about political interference, not about medical information. We think a woman should be able to trust that the advice she receives from her physician reflects what her physician really believes is in her best interest, not something that her physician has been forced to say.

What the article fails to note, however, is that the Oklahoma law doesn’t stop at mandatory ultrasounds. It also permits health care institutions and individual health care workers to refuse to provide certain health services without ensuring that patients can access the care they need elsewhere. And it restricts a woman’s access to medication abortion (also known as mifepristone or the early abortion pill), despite the fact that it is a safe and effective non-surgical method of terminating early pregnancy, by limiting a doctor’s ability to administer the drug and hampering a doctor’s discretion to determine appropriate and necessary medical care.

In the face of Oklahoma’s law, and its copycats, the ACLU will continue working to ensure that every woman has medically accurate information, access to the medical care she needs, and is able to make the best decisions for her health and her individual circumstances without political interference.

Last week, the U.S. Court of Appeals for the Fourth Circuit in Richmond, Va., struck down a law — the “Partial Birth Infanticide Act” — that would have made it virtually impossible for doctors to perform second-trimester abortions in the state regardless of whether a woman’s health was threatened.

If the law sounds familiar, it should. It is yet another iteration of the federal “Partial-Birth Abortion Ban Act” that the U.S. Supreme Court misguidedly upheld last year in Gonzales v. Carhart. Like the federal law, Virginia’s fails to include any exceptions to protect women’s health. But as last week’s court held, the Virginia law goes even further than the federal ban, which proved to be its fatal constitutional flaw.

While the Supreme Court’s decision in Carhart dealt a devastating blow to women’s health, reproductive rights, and equality, last week’s decision (PDF) shows that there are still limits to how far politicians can go in passing new and far-reaching abortion restrictions. Notably, this was the second federal appeals court to find a state ban too extreme in light of Carhart. In June of last year, the U.S. Court of Appeals for the Sixth Circuit struck down Michigan’s third attempt at an abortion methods ban, the Legal Birth Definition Act. That law would have banned the most commonly used abortion methods in the first and second trimesters. In its ruling, the court held that the Michigan language “pushed almost every boundary that the Supreme Court has imposed for these types of laws.”

We are gratified to see that even in the post-Carhart world, there are limits to how far legislatures can go in disregarding women’s health and reproductive freedom. The Fourth and Sixth Circuits understand that last year’s Carhart decision — as devastating as it was — does not give states carte blanche to eliminate nearly all second-trimester abortion care. It is our hope that legislators in Virginia, Michigan, and all across the country will take note of these important rulings and put an end to their on-going attempts to interfere in a woman’s most personal and private medical decisions.

Earlier this week, the South Carolina Supreme Court unanimously ruled that Regina McKnight, a woman convicted in 2001 of homicide after suffering a stillbirth and admitting to cocaine usage, did not have a fair trial. In so doing, the court recognized that McKnight’s counsel failed to make use of existing evidence that could have shown that factors other than McKnight’s drug use could have caused the stillbirth.

The court’s ruling has significant import for the dozens of pregnant women in the United States each year that, like McKnight, are criminally charged for continuing their pregnancies to term despite their struggles with drug addition. (A recent New York Times article profiles several such women and their prosecutions in Alabama.)

While courts in other states have routinely rejected prosecutions of pregnant, drug-using women, they have not addressed the question of whether pre-natal exposure to substances causes harm to the fetus.

Notably, this week’s decision discusses the critical importance of hearing evidence regarding what is and is not known about the topic. As the court noted, adequate expert medical testimony would include “recent studies showing that cocaine is no more harmful to a fetus than nicotine use, poor nutrition, lack of prenatal care, or other conditions commonly associated with the urban poor.”

The local prosecutor hasn’t decided whether to retry McKnight. Local papers reported that C. Rauch Wise of Greenwood, who directly represented McKnight on behalf of the American Civil Liberties Union of South Carolina Foundation, in partnership with Matthew Hersh and Julie Carpenter of the law firm Jenner & Block, would seek to have McKnight released on bail pending a new trial.

National Advocates for Pregnant Women (NAPW) has been working on McKnight’s behalf for nearly a decade. During this most recent round of litigation, NAPW, along with the Drug Policy Alliance and local South Carolina counsel Susan K. Dunn, filed a friend of the court brief on behalf of medical and public health groups and experts. In addition to challenging the validity of the state’s claim that cocaine use caused the stillbirth, signatories argued that threatening pregnant women with jail time deters them from seeking prenatal care and other vital services.

Today RHRealityCheck blogged on the victory for reproductive freedom today in Wisconsin. Today an appeals court upheld a lower court’s ruling that the state’s Pharmacy Examining Board was right to discipline pharmacist Neil Noesen for failing to fill, based on religious objections, a woman’s birth control prescription. On the decision, RHRealityCheck writes:

“In other words, if Noesen had a problem filling prescriptions for birth control pills he not only should have made that clear to his employer off the bat but he also should have quickly transferred the prescription to a pharmacy where the woman could get it filled smoothly and with minor interruption (because, let’s be clear, not filling the prescription in the first place is still an interruption).”

You can learn more about cases like Noesen’s by reading our report: Religious Refusals and Reproductive Rights: Accessing Birth Control at the Pharmacy.

When I’m asked “why do you work in reproductive rights,” it is hard not to imagine that most of the emphasis is on the word you. As a man, my own right to choose an abortion or to carry a pregnancy to term is not constantly threatened by unwarranted government restrictions. But that isn’t to say the relentless stripping of those freedoms doesn’t directly impact who I am and my ability to live freely in the world I want. It only takes a couple clicks on a computer to see how quickly the rights enshrined in Roe thirty-five years ago (and since then slowly eroded) quickly expand into all aspects of individual autonomy. The decriminalization of gay sex, efforts to protect the right to die with dignity, and all sorts of individual freedoms are indebted to the values borne out of Roe. Roe stands for a woman’s autonomy and equality, and in every definition of myself, those are values I care about deeply. I work for reproductive equality because those rights are everyone’s rights, and attacks on reproductive freedom are exactly that: attacks on freedom that we cannot afford to tolerate.

I began working in reproductive rights as a college student at a local Planned Parenthood clinic. It was a firsthand education that a woman’s safe and equitable access to the full spectrum of reproductive options is an integral part of her dignity and autonomy. A woman’s right to make an informed decision for herself about when and whether to become a parent defines her ability to be a free and equal person in our society. Freedom isn’t gendered; it loses its meaning when we deny its protection to some based on immutable characteristics.

Working in this field can sometimes be depressing, when I look out and see all the scars on the reproductive landscape. When I find myself asking myself, why am I here, I’m reminded of Audrey Lorde’s realization that “there can be no hierarchy of oppressions.” Lorde addressed the commonality among her oppressed identities:

I cannot afford the luxury of fighting one form of oppression only…. I cannot afford to choose between the fronts upon which I must battle these forces of discrimination, wherever they appear to destroy me. And when they appear to destroy me, it will not be long before they appear to destroy you

.I choose to work in reproductive freedom because it is to me at the core of everyone’s ability to be a productive and equal member of our society. I care about reproductive freedom because I care about freedom, and it is impossible to separate the two apart.

Trevor Lippman is a State Strategies Fellow with the ACLU Reproductive Freedom Project.

A couple of years ago I was interviewed by a hostile radio talk show host — a Rush Limbaugh wanna-be — who personally attacked me throughout the interview, and finally asked me in disgust, “how can you sleep at night?” I can’t remember what my exact answer was at the time, but the truth is that I actually don’t sleep many nights. But not for the reason he was suggesting. I’ve lost sleep worried about the teenager whose parents refused to support her decision to have an abortion, and who was desperately trying to navigate her way through the courts, with our assistance, in order to obtain a court order to access abortion care. I’ve stayed up nights concerned that we wouldn’t be able to act quickly enough to get a woman in prison transported for her requested abortion before it became too late in the pregnancy and she would lose her choice altogether. I’ve tossed and turned, troubled that we would lose our challenge to a ban on abortion in my home state of Michigan, and the devastating impact that such a loss would have on our physician clients and their patients.

But despite the occasional sleep deprivation (which I know I share with my amazing colleagues), I feel truly honored and lucky to do the work that I do. I do this work because it is so important, and I feel the issue so viscerally. There is something extremely fundamental about ensuring that we all have the right to make our own personal and intimate health care decisions. And though it may seem cliché to say, women must have control over our reproductive lives if we are to participate in society as equals. So when we are able to help the teen, the woman in prison, and win the court cases, it is so important for our clients and it personally means so much to me. Nevertheless, my goal is to put myself out of business. As much as I love my job, I hope it becomes obsolete. Because if we are successful in our fight — and we will be — everyone will have the information, skills, and access to resources to make our own reproductive health care decisions, and to care for the families we choose to have. And then we can all get a good night’s sleep.

Brigitte Amiri has been a Staff Attorney with the ACLU Reproductive Freedom Project since April 2005. She led the ACLU’s challenge to a ban on abortions in Michigan, and is litigating a challenge to prohibitions on access to abortions in a county jail in Arizona. She was also part of the Ayotte v. Planned Parenthood legal team in the U.S. Supreme Court and worked on the ACLU’s friend-of-the-court briefs filed in the federal abortion ban cases in the Supreme Court.