V-Day Censored At A Local High School

From the Daily Sundial:

Vagina, a six-letter word that has caused an uproar at Cleveland High School. The school's administration has deemed the word "obscene." This is an accreditation year for the school, which is why such a commotion is not surprising.

A special Vagina Day edition of the school's newspaper Le Sabre was distributed on Feb. 14. The newspapers were dispensed during first period, with one headline reading, "Have a Happy Vagina Day!" Administration officials intercepted the stack of papers from being delivered to the rest of the school.

Immediately following, Principal Robert Marks spoke with Editor in Chief Richard Edmond to discuss why he was pulling the paper. He claimed Edmond's own political agenda was a factor in why the paper in itself was so "obscene."

Edmond said that Marks told him the paper was "a piece of shit" that should be handed out on Hollywood Boulevard."

Edmond said the staff understands that they are producing a newspaper for a high school audience, but they are also aware that an anatomical diagram of the vagina is something each high school student has seen in their Los Angeles Unified School District mandated Health class.

An announcement was made during second period instructing teachers to not pass out the paper, as remaining papers were to be collected by the deans and vice principals. However, supportive teachers passed out the papers willingly, seeing no problem with the articles.

During third and fourth period, newspapers were still in circulation despite the efforts made by teachers and the administration.

The faculty was divided in their initial reaction to the issue. Some teachers were reported to have been ripping up the issue in front of their classes, even taking issues already in the possession of students to do so.

A number of students were passing out stacks of papers during lunch as administrators were ripping papers out of the hands of interested students as they were reading them.

Journalism advisor Coleen Bondy, who didn't want to be quoted, was instructed by Marks to not distribute any remaining issues she had in her classroom during fifth period.

A Cutting Tradition

Female circumcisers and their attendants waiting in an elementary-school classroom, where they do their work.

The New York Times reports:



When a girl is taken — usually by her mother — to a free circumcision event held each spring in Bandung, Indonesia, she is handed over to a small group of women who, swiftly and yet with apparent affection, cut off a small piece of her genitals. Sponsored by the Assalaam Foundation, an Islamic educational and social-services organization, circumcisions take place in a prayer center or an emptied-out elementary-school classroom where desks are pushed together and covered with sheets and a pillow to serve as makeshift beds. The procedure takes several minutes. There is little blood involved. Afterward, the girl’s genital area is swabbed with the antiseptic Betadine. She is then helped back into her underwear and returned to a waiting area, where she’s given a small, celebratory gift — some fruit or a donated piece of clothing — and offered a cup of milk for refreshment. She has now joined a quiet majority in Indonesia, where, according to a 2003 study by the Population Council, an international research group, 96 percent of families surveyed reported that their daughters had undergone some form of circumcision by the time they reached 14.

These photos were taken in April 2006, at the foundation’s annual mass circumcision, which is free and open to the public and

held during the lunar month marking the birth of the prophet Muhammad. The Assalaam Foundation runs several schools and a mosque in Bandung, Indonesia’s third-largest city and the capital of West Java. The photographer Stephanie Sinclair was taken to the circumcision event by a reproductive-health observer from Jakarta and allowed to spend several hours there. Over the course of that Sunday morning, more than 200 girls were circumcised, many of them appearing to be under the age of 5. Meanwhile, in a nearby building, more than 100 boys underwent a traditional circumcision as well.

According to Lukman Hakim, the foundation’s chairman of social services, there are three “benefits” to circumcising girls.

“One, it will stabilize her libido,” he said through an interpreter. “Two, it will make a woman look more beautiful in the eyes of her husband. And three, it will balance her psychology.”

Female genital cutting — commonly identified among international human rights groups as female genital mutilation — has been outlawed in 15 African countries. Many industrialized countries also have similar laws. Both France and the U.S. have prosecuted immigrant residents for performing female circumcisions.

In Indonesia, home to the world’s largest Muslim population, a debate over whether to ban female circumcision is in its early stages. The Ministry of Health has issued a decree forbidding medical personnel to practice it, but the decree which has yet to be backed by legislation does not affect traditional circumcisers and birth attendants, who are thought to do most female circumcisions. Many agree that a full ban is unlikely without strong support from the country’s religious leaders. According to the Population Council study, many Indonesians view circumcision for boys and girls as a religious duty.

Female circumcision in Indonesia is reported to be less extreme than the kind practiced in other parts of the globe — Africa, particularly. Worldwide, female genital cutting affects up to 140 million women and girls in varying degrees of severity, according to estimates from the World Health Organization. The most common form of female genital cutting, representing about 80 percent of cases around the world, includes the excision of the clitoris and the labia minora. A more extreme version of the practice, known as Pharaonic circumcision or infibulation, accounts for 15 percent of cases globally and involves the removal of all external genitalia and a stitching up of the vaginal opening.

Studies have shown that in some parts of Indonesia, female circumcision is more ritualistic — a rite of passage meant to purify the genitals and bestow gender identity on a female child — with a practitioner rubbing turmeric on the genitals or pricking the clitoris once with a needle to draw a symbolic drop of blood. In other instances, the procedure is more invasive, involving what WHO classifies as “Type I” female genital mutilation, defined as excision of the clitoral hood, called the prepuce, with or without incision of the clitoris itself. The Population Council’s 2003 study said that 82 percent of Indonesian mothers who witnessed their daughters’ circumcision reported that it involved “cutting.” The women most often identified the clitoris as the affected body part. The amount of flesh removed, if any, was alternately described by circumcisers as being the size of a quarter-grain of rice, a guava seed, a bean, the tip of a leaf, the head of a needle.

At the Assalaam Foundation, traditional circumcisers say they learn the practice from other women during several years of apprenticing. Siti Rukasitta, who has been a circumciser at the foundation for 20 years, said through an interpreter that they use a small pair of sterilized scissors to cut a piece of the clitoral prepuce about the size of a nail clipping. Population Council observers who visited the event before the 2003 study, however, reported that they also witnessed some cases of circumcisers cutting the clitoris itself.

Any distinction between injuring the clitoris or the clitoral hood is irrelevant, says Laura Guarenti, an obstetrician and WHO’s medical officer for child and maternal health in Jakarta. “The fact is there is absolutely no medical value in circumcising girls,” she says. “It is 100 percent the wrong thing to be doing.” The circumcision of boys, she adds, has demonstrated health benefits, namely reduced risk of infection and some protection against H.I.V.

Nonetheless, as Western awareness of female genital cutting has grown, anthropologists, policy makers and health officials have warned against blindly judging those who practice it, saying that progress is best made by working with local leaders and opinion-makers to gradually shift the public discussion of female circumcision from what it’s believed to bestow upon a girl toward what it takes away. “These mothers believe they are doing something good for their children,” Guarenti, a native of Italy, told me. “For our culture that is not easily understandable. To judge them harshly is to isolate them. You cannot make change that way.”

The girl who was being soothed in the second photograph, after her circumcision.

A girl cries as she is circumcised.

A girl pulls on her undergarments after being circumcised.

Tears are wiped from the face of a 9-month-old following her circumcision.

The annual circumcision event begins and ends with prayer services.

A girl is soothed by an attendant before her circumcision.

Who's Getting Abortions? Not Who You'd Think

More than one-third of adult American women are estimated to have had at least one abortion.

Half of the women are 25 or older; most already have a child:

In American pop culture, the face of abortion is often a frightened teenager, nervously choosing to terminate an unexpected pregnancy. The numbers tell a far more complex story in which financial stress can play a pivotal role.

Half of the roughly 1.2 million U.S. women who have abortions each year are 25 or older. Only about 17 percent are teens. About 60 percent have given birth to least one child prior to getting an abortion.

A disproportionately high number are black or Hispanic. And regardless of race, high abortion rates are linked to hard times.

“It doesn’t just happen to young people, it doesn’t necessarily have to do with irresponsibility,” said Miriam Inocencio, president of Planned Parenthood of Rhode Island. “Women face years and years of reproductive life after they’ve completed their families, and they’re at risk of an unintended pregnancy that can create an economic strain.”

Who has abortions?

Activists on both sides of the abortion debate will soon be marking the 35th anniversary of the Supreme Court’s Roe v. Wade decision, which established a nationwide right to abortion. Since Jan. 22, 1973, there have been roughly 50 million abortions in the United States, and more than one-third of adult women are estimated to have had at least one.

Who are these women?

Much of the public debate focuses on teens, as evidenced by the constant wranging over parental notification laws and movies like the current hit “Juno,” in which the pregnant heroine heads to an abortion clinic, then decides to have the baby.

In fact, the women come from virtually every demographic sector. But year after year the statistics reveal that black women and economically struggling women — who have above-average rates of unintended pregnancies — are far more likely than others to have abortions. About 13 percent of American women are black, yet new figures from the Centers for Disease Control show they account for 35 percent of the abortions.

Black anti-abortion activists depict this phenomenon in dire terms — “genocide” and “holocaust,” for example. But often the women getting the abortions say they act in the interests of children they already have.

“It wasn’t a hard decision for me to make, because I knew where I wanted to go in my life — I’ve never regretted it,” said Kimberly Mathias, 28, an African-American single mother from Missouri.

She had an abortion at 19, when she already raising a 2-year-old son.

“It wasn’t hard to realize I didn’t want another child at that time,” Mathias said. “I was trying to take care of the one I had, and going to college and working at the same time.”

She was able to graduate, now has an insurance job, and — still a single mother — has a 3-year-old son as well as her first-born, now 11.

'A silent killer'

By contrast, Alveda King, a niece of Martin Luther King Jr., calls herself a “reformed murderer” for undergoing two abortions when she was young.

Now an outspoken anti-abortion campaigner, King says the best way to reduce abortions among black women is to dissuade more of them from premarital sex.

“We give free sex education, free condoms, free birth control,” she complained. “That’s almost like permission to have free sex, and the higher the rate of sexual activity, the higher the rate of unintended pregnancy.”

Anti-abortion activist Day Gardner of the National Black Pro-Life Union says many blacks are unaware of their community’s high abortion rate.

“We don’t talk about it,” Gardner said. “It’s a silent killer among us.”

She contends that abortion-rights supporters tempt black women into abortion by suggesting they can’t afford to raise the child. But Gardner also acknowledges that some black women make this argument on their own.

“We had the whole civil rights movement — now we’re in a place where we’re moving further toward equality,” Gardner said. “So women think, ‘For once, I can see the American dream. I can have the house and the job, but it would postpone it to have another child. I can’t afford to take time off.’ ”

Dr. Vanessa Cullins, a black physician who is Planned Parenthood’s national vice president for medical affairs, said the allegations of “black genocide” do not help women meet day-to-day challenges.

“These actions take attention away from medically proven ways to reduce unintended pregnancy — comprehensive sex education, affordable birth control, and open and honest conversations about relationships,” she said

Looking beyond racial dividing lines, Cullins views the right to abortion as an important component in the ability of all American women to determine the right size for their family.

“Groups that become assimilated in U.S. culture and experience economic opportunities naturally decide to limit family size, because they want to take part in the American dream,” she said. “If you’re a single mother, achieving the dream is all the harder, so it makes sense to limit family size so you can shower as much support as you can on the children you have.”

Financial pressures

Georgette Forney, who had an abortion when she was 16 and is now an anti-abortion campaigner leading Anglicans for Life, says she often sees economic pressures triggering abortions, even in middle-class families.

“In one situation, the husband was adamant that they were on track to pay for their two sons’ college education, and a third child would throw off his whole calculation,” Forney recounted. “So that baby was aborted and that woman was devastated. It was a five-year process to recover.”

Forney said she also encountered a single mother who was worried she might lose custody of her daughter in light of a suit by the biological father. The woman then became pregnant, Forney said, and had an abortion in violation of her own beliefs because she feared having a second child would jeopardize prospects for keeping her daughter.

“We’ve begun to depend on abortions,” Forney said. “We feel we have to choose between our unborn child and our born children.”

Martha Girard, on the other hand, says she’s appalled by the notion that women should lose the right to choose.

A hospital ultrasound technician from Pleasant Prairie, Wis., and a mother of three, Girard had an abortion two years ago, at the age of 44, when she mistakenly thought she was too old to get pregnant.

Having been through three difficult pregnancies previously, and coping with a mentally disabled eldest son, she felt abortion was the prudent choice.

“I knew that this pregnancy would end up badly — I could feel it — and we’ve already got enough problems with the mentally ill son,” Girard said.

“I was very sad and depressed the first week,” she added. “But because it’s hard on you emotionally and some women regret it, that doesn’t mean it’s wrong, that someone else should decide for you.”

The Journal of Family Issues published a report earlier this month asserting that women often choose abortion because of their wish to be good parents.

That means women who have no children want the conditions to be right when they do, and women who already are mothers want to care responsibly for their existing children, said the lead author, Rachel Jones, a researcher with the Guttmacher Institute.

“These women believed that it was more responsible to terminate a pregnancy than to have a child whose health and welfare could be in question,” Jones said.

Number of abortions declining

Even among many abortion opponents, the Guttmacher Institute — which supports abortion rights — is considered the nation’s best source of abortion statistics.

Federal statistics do not include California, the most populous state, because its government does not provide data. But Guttmacher researchers surveyed abortion providers there as well as in other states to produce the latest national estimate of 1.2 million abortions in 2005. That’s down from a peak of 1.6 million in 1990 but still represents more than 20 percent of all pregnancies.

One of the Guttmacher’s top researchers, Stanley Henshaw, said the recent drop may disguise the fact abortion rates remain relatively high for black and Hispanic women. He believes the most effective countermeasure would be wider availability of contraceptives such as intrauterine device, or IUDs, that don’t require attention as frequently as condoms or birth-control pills.

Though abortion is commonplace across the country, urban areas have far higher rates than rural areas where access to abortion providers can be difficult.

New York, New Jersey, California, Delaware, Nevada, Maryland and Florida had the highest abortion rates in 2005, according to the new Guttmacher report released this week. Wyoming, Idaho, Kentucky, South Dakota and Mississippi had the lowest rates — the latter two states have just a single abortion clinic in operation.

Susan Hill, founder of the National Women’s Health Organization that runs the remaining Mississippi clinic, says the statistics may not fully reflect a subgroup of relatively affluent women who obtain unreported abortions through their private doctors.

“In Mississippi, it’s the poor women who don’t have access to that who have to run through the maze of protesters screaming and yelling abuse,” Hill said. “Wealthier women can be more creative about their alternatives.”

According to Guttmacher data, the abortion rate among women living below the federal poverty level is more than four times higher that among women from middle-income and affluent households.

An increasing number of women avoid surgery by using the RU-486 abortion pill or other early medication — these now account for about 13 percent of all abortions.

Of all U.S. women getting abortions, about 54 percent are doing so for the first time, while one-fifth have had at least two previous abortions. Of those over 20, the majority have attended college. Almost a third have been married at some point. About 60 percent have at least one child; one-third have two or more.

“I don’t think most people understand that these are women who have families, who are making a very serious decision about their reproductive health,” said Nancy Keenan, president of NARAL Pro-Choice America. “The stereotype is that the decision is made lightly. It is not.”

Sting and Wife Trudie's Love Nest Reveals Some Eyebrow-Raising Erotic Bedroom Art

Artistic licence: Trudie Styler says the artwork in the couple's bedroom makes her feel 'hot'

The Daily Mail reports:

Rumours about the exotic private life of Sting and Trudie Styler have included swingers' parties, strip clubs and tantric sex sessions lasting several hours.

Now some more tangible evidence of their colourful tastes has emerged.

The 56-year-old rock star and his wife have flung wide the doors of their £12million Manhattan apartment for an "at home" newspaper feature - with eyebrow-raising results.

The centrepiece of the 18-room apartment overlooking Central Park is an extraordinary scarlet bedroom embroidered in gold and dominated by two explicit Helmut Newton prints.

In one, an unidentified woman lays virtually naked, with her legs spread in the back of a vintage Mercedes as a man leans over from the front seat to unzip one of her spike-heeled boots.

The other image, above the bed head, shows the lower half of another female wearing just stockings, suspenders and high heels.

Miss Styler, 53, who once told a U.S. DJ that the couple enjoyed swingers' parties, before apparently retracting the claim, said of the room: "I find it hot."

Rumours about the racy private life of Sting and Trudie Styler have persisted for many years

She also curiously went on to admit that her son Giacomo once wanted to know if the photo of the almost nude, sprawled-out woman was his mother or sister. She told him it was neither.

Elsewhere in the apartment are rather more homely points of reference - cow paintings by daughter Mickey, family photos scattered in silver frames, a giant wall of Polaroids in the kitchen and Sting's lute resting on a sofa.

The musician has six children, namely Joseph, 31, and Fuchsia Katherine, 25, from his first marriage to actress Frances Tomelty, and Mickey, 23, Jake, 22, Coco, 17, and Giacomo, who was 12 this week, from his marriage to Trudie.

He also has homes in Mayfair and Malibu, and estates in Wiltshire and Tuscany.

The couple put the Manhattan property, which they have owned for 20 years - on the market last year, but have now taken it off, despite buying a further £15million home in a separate development in the city.

Basra Militants Targeting Women

"We warn against immodest dress. Violators will be punished. God is witness that we have conveyed the message"

-Message written on a Basra wall

The BBC reports:

The chief of police in the southern Iraqi city of Basra has warned of a campaign of violence against women carried out by religious extremists.
It has, Maj-Gen Abdul Jalil Khalaf said, included threats, intimidation and even murder.

Some victims were dressed in indecent clothes by their killers or had notices attached to them, he said.

Women interviewed by the BBC said they no longer dared venture on to Basra's streets without strict Islamic attire.

"There is a terrible repression against women in Basra," Maj-Gen Khalaf told the BBC.

"They kill women, leave a piece of paper on her or dress her in indecent clothes so as to justify their horrible crimes."

Forty-two women were killed between July and September this year, although the number dropped slightly in October, he said.

In one case, he added, a woman was killed in her home along with her six-year-old son, who was rumoured to have been conceived in an adulterous relationship.
Maj-Gen Khalaf, sent to Basra this year by Iraqi Prime Minister Nouri Maliki to impose order in the city, said the police were often too scared to conduct proper investigations into the killings.

"The relatives are reluctant to report the crimes for fear of a scandal or because they despair of the police's ability to solve them," he added.

Women are being targeted amid a local power struggle

'Shot in the legs'

A female lawyer in Basra contacted by the BBC by phone from London, who asked not to be named for fear of reprisals, said attacks on women in the city were occurring "every two or three days".

She told the BBC about a university student who had been shot in the legs for not wearing an Islamic headscarf, or hijab.

The lawyer also said that graffiti was painted on walls warning women to cover their heads or "be punished".

She said she had been told by a group of men that she should be at home and get married instead of working.

"They said to me: 'If anyone's willing to offer a good price for you, we wouldn't think twice about selling you'," she said.

"When they see a woman going out to work and being successful, I'm sorry, but they feel inferior to her."

'Killed before their kids'

A mother-of-six and government employee in Basra, who wished to be identified only as Um Zeinab, told the BBC she had almost been run down by a motorcyclist one day while waiting for her bus to work.

"I was wearing a shirt with a skirt and some make-up, as I usually do," she said.

"I was waiting at the bus stop when the motorbike headed straight at me, full speed."

Luckily, the motorcyclist skidded and fell before reaching her.

She said she had heard of other women attacked but who had not been as lucky.

"Two women were killed in al-Makal district two days ago. People said they had received warnings before and then gunmen came to their homes and killed them, one in front of their kids."

Warring factions

Given the continuing power struggle in Basra between rival Shia militias, it was perhaps understandable that Gen Khalaf would not be drawn into naming names.

He blamed "dangerous criminals" trying to undermine stability in the city.

He also said that repression against women had been going on while British forces were still in the city, prior to their withdrawal to Basra airport in September.

Others were more direct in pointing the finger of blame at the rival Shia militias, known to have infiltrated the police and vying for control of Basra.

Um Zeinab called them "dark, fundamentalist extremists".

A spokesman for one of the largest Shia groups, the Sadrists of the radical cleric Moqtada Sadr, told the BBC that its members did not attack women or try to enforce Islamic law on women by violence.

But he did not rule out that others were doing so.

Love at First Sight Just Sex and Ego, Study Says

· Attraction is a narcissistic response, report claims
· Standard cues such as eye contact and smiling crucial

The Guardian reports:

Their eyes met across a crowded room. The party chatter ebbed away, and the music slowed. That first lovers' glaze is the staple of the romantic novelist, and scientists believe they have now revealed the true nature of its true attractive power.

According to new research, romance has very little do to with it. That "look" is all about sex and ego.

"It does seem to be a sort of narcissistic thing. People are attracted to people who are attracted to them," said Ben Jones in the Face Research Laboratory at the University of Aberdeen.

"It's really a very basic effect that we are all, at some level at least, aware of - which is that if you smile at people and you maintain eye contact, it makes you more attractive."

He said the work challenges most previous studies of facial attractiveness that have focused on physical characteristics, such as a preference for symmetrical faces or masculine versus feminine features.

"Social signals about how attracted someone else is to you actually seem to be quite important," he said. "You are attracted to people who are attracted to you, and that shows attractiveness is not just about physical beauty."

Dr Jones and his colleagues say they have shown that attraction is based on social cues that say, "I'm interested in you". The most important cue seems to be whether someone is looking directly at you.

The team put together four different sets of digital images - women looking happy, women looking disgusted, men looking happy and men looking disgusted. In each case, the scientists made up pairs of images which were identical except that in one the person was looking directly at the camera and in the other their gaze was averted. Volunteers then rated the relative attractiveness of the images in each pair.

The team found that a direct stare is attractive only if the person giving it looks as if they like you. This preference was even higher if the face in the picture was of the opposite sex.

"What we found at the most basic level is that people like faces with direct gaze more than they like the same faces with averted gaze," said Dr Jones. "In other words, people find it more attractive when they are being looked at."

The results are published in the Proceedings of the Royal Society.

Dr Jones said the results make sense from an evolutionary perspective. "It takes quite a lot of effort to attract a mate and what you want to do is allocate that effort in a more efficient way, in other words in a way that is more likely to help you secure a mate."

So it seems there is no point wasting your time on someone who is just not interested.

Pregnant Woman Killed in Mass L.A. Street Fight

The Guardian reports:

A planned street fight involving 30 women in Los Angles ended in tragedy with the death of a woman who was eight months pregnant, police announced today.
She was killed in front of dozens of spectators, after another woman involved in the brawl rammed her car into her. The driver has been charged with murder.

Two other women were injured in the incident, which happened yesterday.

The driver of the car, Unique Bishop, 21, fled the scene, but she later turned herself in, police said.

"It was totally an intentional act to kill the woman. It was the driver's way of settling the dispute. It was a horrific act," said LAPD Deputy Chief Charlie Beck.
Police said the cause of the dispute is unclear, but it was part of a planned confrontation between two groups of women in their early 20s.

Witnesses told police they saw women shouting at each other and fighting in the car park of a discount store. The fight then moved on to the street and into a petrol station.

Dozens of people gathered at the petrol station and watched as Ms Bishop got into her car and drove it into the group. One of the victims was pinned against another car, police said.

It is unclear whether the dead woman's unborn baby survived. Another victim was in critical condition and expected to lose her leg, authorities said. None of the victims' identities were released.

"We have seen women around gangs before, but we haven't seen anything like this event before," said a police commander, Pat Gannon.

Study Says, "Abortion Pill Doesn't Raise Pregnancy Risk"

The Associated Press reports:

Women who use abortion pills rather than the more common surgical method seem to face no greater risk of tubal pregnancy or miscarriage in later pregnancies, according to a new study.

The federally funded research -- based on a study of nearly 12,000 Danish women -- is considered the best study to date of the impact of this newer abortion method on subsequent pregnancies.

The vast majority of abortions are called surgical abortions, usually done by removing an embryo or fetus from the uterus with a syringe or electric pump.

The U.S. and Danish researchers studied medical abortions, which generally involve a woman ending a pregnancy by taking one tablet of mifepristone -- formerly known as RU-486 -- followed by about four misoprostol pills a day or two later. The mifepristone destabilizes the connecting tissue between an embryo and the uterus, and the misoprostol causes the uterus to expel the embryo.

Medical abortions may appeal more to women because they can happen at home, can seem less intimidating than surgical abortion and just about any doctor can prescribe the pills, experts said.

The U.S. government approved the marketing of mifepristone for medical abortions in 2000, and European countries approved it years earlier.

Today, an estimated 8 percent to 10 percent of the roughly 1.3 million abortions in the United States are done using the pills.

Although previous research has shown that surgical abortions don't increase the risk of problems in later pregnancies, little research had been done on the impact of medical abortions.

Generally, surgical abortions completely remove an embryo or fetus and the surrounding uterine tissue, but abortions done with pills may leave bits of placenta or other embryonic material. Some doctors have wondered whether that might interfere with subsequent pregnancies, said Dr. Matthew Reeves, a reproductive medicine expert at the University of Pittsburgh School of Medicine.

The paper is published in today's New England Journal of Medicine.

In the new study, researchers used a national abortion registry to identify all women in Denmark who had abortions from 1999 to 2004. They got information on later pregnancies from national patient and birth registries.

Denmark is the only country with an abortion registry, said study co-author Dr. Jun "Jim" Zhang of the National Institutes of Health.

Researchers looked at tubal pregnancies, in which a fertilized egg implants outside the uterus -- usually in the fallopian tubes. Such a situation fails to nurture the embryo and endangers the mother.

Medical abortions appeal to women because they can do it in the privacy of their home, can seem less intimidating than surgical abortion and just about any doctor can prescribe the pills, experts said.

The new study found tubal pregnancies occurred at the same frequency — about 2.5 percent of the time — in both the medical and surgical groups. The rates of miscarriage, early deliveries and low birth weight babies also were similar.

Generally, the number of reported abortions in the U.S. have been declining since the early 1990s, although there was a slight increase in 2002, according to federal statistics. There is about one abortion for every four live births each year, according to the CDC‘s most recent statistics, which do not include every state.

Melinda Henneberger: "Why Pro-Choice Is A Bad Choice For Democrats"

In an op-ed for the New York Times, Melinda Henneberger, the author of “If They Only Listened to Us: What Women Voters Want Politicians to Hear,” writes:

I keep reading about a universe in which social conservatives are warming to Rudy Giuliani. But this would have to be a place where his estranged children and three wives and multiple appearances in fishnets were irrelevant to the Republican base. Where the nice gay couple he moved in with between marriages would be asked to appear in the film montage at the nominating convention in St. Paul.

Even in the real world, a pro-choice Republican nominee would be a gift to the Democrats, because the Republican Party wins over so many swing voters on abortion alone. Which is why Fred Thompson, who is against abortion rights, is getting so much grateful attention from his party now. And why, despite wide opposition to the war in Iraq, Democrats must still win back such voters to take the White House next year.

Over 18 months, I traveled to 20 states listening to women of all ages, races, tax brackets and points of view speak at length on the issues they care about heading into ’08. They convinced me that the conventional wisdom was wrong about the last presidential contest, that Democrats did not lose support among women because “security moms” saw President Bush as the better protector against terrorism. What first-time defectors mentioned most often was abortion.

Why would that be, given that Roe v. Wade was decided almost 35 years ago? Opponents of abortion rights saw 2004 as the chance of a lifetime to overturn Roe, with a movement favorite already in the Oval Office and several spots on the Supreme Court likely to open up. A handful of Catholic bishops spoke out more plainly than in any previous election season and moved the Catholic swing vote that Al Gore had won in 2000 to Mr. Bush.

The standard response from Democratic leaders has been that anyone lost to them over this issue is not coming back — and that regrettable as that might be, there is nothing to be done. But that is not what I heard from these voters.

Many of them, Catholic women in particular, are liberal, deep-in-their-heart Democrats who support social spending, who opposed the war from the start and who cross their arms over their chests reflexively when they say the word “Republican.” Some could fairly be described as desperate to find a way home. And if the party they’d prefer doesn’t send a car for them, with a really polite driver, it will have only itself to blame.

What would it take to win them back? Respect, for starters — and not only on the night of the candidate forum on faith. As it turns out, you cannot call people extremists and expect them to vote for you. But real respect would require an understanding that what supporters of abortion rights genuinely see as a hard-earned freedom, opponents genuinely see as a self-inflicted wound and — though I can feel some of you tensing as you read this — a human rights issue comparable to slavery.

Again and again, these voters said Democrats are too unwilling to tolerate dissent on abortion. It is a point of orthodoxy no more open to debate within the party than the ordination of women is in Rome.

Democratic Party leaders should also stop pushing the perception that Republicans are natural defenders of the faithful. For years, they have done just that by tirelessly portraying our current president as this committed — indeed, obsessed — pro-lifer who would stop at nothing to see Roe overturned. Karl Rove couldn’t have said it better himself; this was better advertising than hard money could buy.

Today, in a similarly oblivious way, the leading Democratic presidential contenders are condemning the Supreme Court’s recent decision to uphold a ban on the procedure known as partial-birth abortion. An overwhelming majority of Americans, polls show, support a ban. Legal scholars have underscored the narrowness of the ruling in the partial-birth case, Gonzales v. Carhart, which does not even outlaw all late-term abortions. Yet the leading Democratic candidates, all of whom are lawyers, choose to overstate its impact.

Hillary Clinton called the decision “a dramatic departure from four decades of Supreme Court rulings that ... recognized the importance of women’s health.” Barack Obama echoed that it “dramatically departs from previous precedents safeguarding the health of pregnant women.” Though John Edwards was one of only two United States senators who did not cast a vote on the bill in 2003, he, too, found the decision to uphold that law “ill-considered and sweeping,” and “a stark reminder of why Democrats cannot afford to lose the 2008 election.”

Actually, it is a stark reminder of how fully capable they all are of losing it. A Democratic senator I spoke with recently did not see the disconnect between public opinion and the party’s position on Carhart as any reason to worry: “Make no mistake; this is a pro-choice country, period.”

But in a recent New York Times/CBS News poll, 41 percent of respondents favored stricter limits on abortion, with an additional 23 percent saying it should not be permitted at all.

What are we to make of all this? Surely at a minimum that our enduring reluctance to acknowledge the complexity of the abortion issue has only prolonged and hardened the debate. Most Americans fall somewhere between the extremes of “never” and “no problem” when it comes to abortion.

What polling can’t capture and politicians won’t hear is the voice of the nun I interviewed who considers herself pro-choice — and has been disciplined by her diocese as a result — because she does not think abortion is wrong for rape victims. Or the voices of the many women I spoke to who hold far more expansive views yet call themselves pro-life. Most people differentiate between a fetus in the early weeks of development and at nearly full term, and draw the line at a procedure that Democratic Senator Pat Moynihan regarded as infanticide.

Would Democrats who hate Carhart really switch parties or stay home on Election Day if their leaders began to acknowledge such distinctions? After the last seven years, I don’t think so. Yes, the abortion-rights lobby has raised a lot of money since the ban, but the statements of the Democratic candidates will cost them, too. This issue has been very, very good to the Republican Party — and there is plenty more where that came from.

Women's Health Care Sliding Back To The Middle Ages

MSNBC reports:

Lori Boyer couldn't stop trembling as she sat on the examining table, hugging her hospital gown around her. Her mind was reeling. She'd been raped hours earlier by a man she knew — a man who had assured Boyer, 35, that he only wanted to hang out at his place and talk. Instead, he had thrown her onto his bed and assaulted her. "I'm done with you," he'd tonelessly told her afterward. Boyer had grabbed her clothes and dashed for her car in the freezing predawn darkness. Yet she'd had the clarity to drive straight to the nearest emergency room — Good Samaritan Hospital in Lebanon, Pennsylvania — to ask for a rape kit and talk to a sexual assault counselor. Bruised and in pain, she grimaced through the pelvic exam. Now, as Boyer watched Martin Gish, M.D., jot some final notes into her chart, she thought of something the rape counselor had mentioned earlier.

"I'll need the morning-after pill," she told him.

Dr. Gish looked up. He was a trim, middle-aged man with graying hair and, Boyer thought, an aloof manner. "No," Boyer says he replied abruptly. "I can't do that." He turned back to his writing.

In a survey published this year in The New England Journal of Medicine, 63 percent of doctors said it is acceptable to tell patients they have moral objections to treatments, and 18 percent felt no obligation to refer patients elsewhere.

Boyer stared in disbelief. No? She tried vainly to hold back tears as she reasoned with the doctor: She was midcycle, putting her in danger of getting pregnant. Emergency contraception is most effective within a short time frame, ideally 72 hours. If he wasn't willing to write an EC prescription, she'd be glad to see a different doctor. Dr. Gish simply shook his head. "It's against my religion," he said, according to Boyer. (When contacted, the doctor declined to comment for this article.)

Boyer left the emergency room empty-handed. "I was so vulnerable," she says. "I felt victimized all over again. First the rape, and then the doctor making me feel powerless." Later that day, her rape counselor found Boyer a physician who would prescribe her EC. But Boyer remained haunted by the ER doctor's refusal — so profoundly, she hasn't been to see a gynecologist in the two and a half years since. "I haven't gotten the nerve up to go, for fear of being judged again," she says.

Doctors refusing treatment
Even under less dire circumstances than Boyer's, it's not always easy talking to your doctor about sex. Whether you're asking about birth control, STDs or infertility, these discussions can be tinged with self-consciousness, even embarrassment. Now imagine those same conversations, but supercharged by the anxiety that your doctor might respond with moral condemnation — and actually refuse your requests.

That's exactly what's happening in medical offices and hospitals around the country: Catholic and conservative Christian health care providers are denying women a range of standard, legal medical care. Planned Parenthood M.D.s report patients coming to them because other gynecologists would not dole out birth control prescriptions or abortion referrals. Infertility clinics have turned away lesbians and unmarried women; anesthesiologists and obstetricians are refusing to do sterilizations; Catholic hospitals have delayed ending doomed pregnancies because abortions are only allowed to save the life of the mother. In a survey published this year in The New England Journal of Medicine, 63 percent of doctors said it is acceptable to tell patients they have moral objections to treatments, and 18 percent felt no obligation to refer patients elsewhere. And in a recent SELF.com poll, nearly 1 in 20 respondents said their doctors had refused to treat them for moral, ethical or religious reasons. "It's obscene," says Jamie D. Brooks, a former staff attorney for the National Health Law Program who continues to work on projects with the Los Angeles advocacy group. "Doctors swear an oath to serve their patients. But instead, they are allowing their religious beliefs to compromise patient care. And too often, the victims of this practice are women."

The state of doctor refusals
Physicians anywhere can deny you care. But some states back up M.D.s with specific laws allowing them to do so, says Elizabeth Nash, public policy associate at the Guttmacher Institute research group. Whose side is your state on?

States that allow doctors to refuse care:

Contraception
AR, CO, FL, IL, ME, MS, TN, WA
Abortion
Every state has a law except AL, NH, VT, WV.
Sterilization
AR, GA, ID, IL, KS, KY, MD, MA, MS, MT, NJ, PA, RI, WA, WV, WI

States that allow hospitals to refuse care:

Contraception
All hospitals
IL, MS, WA
Private hospitals only
AR, CO, ME, MA, NJ, TN

Abortion
All hospitals
AZ, AR, CO, DE, FL, GA, HI, ID, KS, KY, LA, ME, MD, MA, MI, MS, MO, NE, NM, NC, ND, OH, SD, TN, VA, WA, WI
Private hospitals only
AK, IL, IN, IA, MN, MT, NV, NJ, OK, OR, PA, SC, TX, UT, WY
Religious hospitals only
CA

Sterilization
All hospitals
AR, GA, ID, IL, KS, MD, MS, NM, WA, WV, WI
Private hospitals only
MA, MT, NJ, PA

States considering new laws
Lawmakers in Missouri, Rhode Island, South Carolina and Vermont are considering sweeping bills that would allow medical professionals to refuse to provide any service they object to.

Compared with the highly publicized issue of pharmacists who refuse to dispense birth control and emergency contraception, physician refusals are a little-discussed topic. Patients denied treatment rarely complain — the situation tends to feel so humiliatingly personal. And when patients do make noise, the case is usually resolved quietly. "The whole situation was traumatizing and embarrassing, and I just wanted to put it behind me," Boyer says. She came forward only after a local newspaper reported an almost identical story: In July 2006, retail clerk Tara Harnish visited the same ER after being sexually assaulted by a stranger, was examined by the same Dr. Gish — and when her mother called Dr. Gish's office the next day to get EC for Harnish, she was refused. "Then I knew it wasn't just me, that this was a larger problem and it could happen to anybody," Boyer says.

Harnish, 21, was shocked by the way the doctor treated her. "He seemed more concerned with saving the (potential) pregnancy than he was with my health," she says. "He turned me away when I needed medical help. That's not what a doctor is supposed to do." Harnish was too shaken by her rape to pursue the matter; her mother called Harnish's gynecologist for a prescription. Then she called the newspaper. Despite the attention the story attracted, Dr. Gish continues to work at Good Samaritan Hospital. Spokesman Bill Carpenter will only say that "the issue has been resolved internally, and we're going to move forward."

In many cases, women don't even know a doctor is withholding treatment. Boyer and Harnish, for example, wouldn't have realized they'd been denied care if they'd been among the estimated one in three women who don't know about EC. In the New England Journal of Medicine survey, 8 percent of physicians said they felt no obligation to present all options to their patients. "When you see a doctor, you presume you're getting all the information you need to make a decision," notes Jill Morrison, senior counsel for health and reproductive rights at the National Women's Law Center in Washington, D.C. "Especially in a crisis situation, like a rape, you often don't think to question your care. But unfortunately, now we can't even trust doctors to tell us what we need to know."

An ethical dilemma
To many doctors, however, the issue represents a genuine ethical dilemma. "The physician's number-one creed is 'First, do no harm,' " says Sandy Christiansen, M.D., an ob/gyn in Frederick, Maryland, who is active in the Christian Medical and Dental Associations, a 16,000-member group for health care professionals based in Bristol, Tennessee. "I know that life begins at conception, and that each person has inherent value. That includes the life of the unborn." Dr. Christiansen says she will not give abortion referrals, opposes EC and, while she has prescribed birth control, is reconsidering the morality of that position. "Doctors are people, too," she adds. "We have to be able to leave the hospital and live with ourselves. If you feel in your heart an action would cause harm to somebody — born or unborn — it's legitimate to decline to participate."

The American Medical Association in Chicago, the nation's largest physician group, effectively agrees with her; its policy allows a doctor to decline a procedure if it conflicts with her moral ideology. The law also favors medical professionals. In 1973, following Roe v. Wade, Congress passed the so-called Church Amendment, allowing federally funded health care providers to refuse to do abortions. In the years since, 46 states have adopted their own abortion refusal clauses — or, as proponents call them, conscience clauses — allowing doctors to opt out. Now many states have gone further. Sixteen legislatures have given doctors the right to refuse to perform sterilizations; eight states say doctors don't have to prescribe contraception. "This is about the rights of the individual, about our constitutional right to freedom of religion," says Frank Manion, an attorney with the American Center for Law and Justice, a legal group in Washington, D.C. Founded by minister Pat Robertson, the organization has represented health care providers and lobbied for laws that protect them. "We're not trying to deny anybody access to treatment," Manion adds. "We're saying, 'Don't make your choice my choice.' "

When Elizabeth Dotts walked into her new doctor's office for a gynecologic exam and checkup, she didn't realize she was treading into the front lines of a culture war. "I was just going for my annual visit, nothing out of the ordinary," says the 26-year-old YWCA grant coordinator. Dotts, who was single, had recently moved to Birmingham, Alabama, and was seeing an M.D. recommended by a coworker. The visit was unremarkable until she asked for a refill of her birth control prescription. That's when the doctor informed her that he was Catholic and the pills were against his religion.

"The look he gave me actually made me feel ashamed," Dotts says. "Like I had this wild and crazy sex life. Like he was trying to protect me from myself." Her bewilderment quickly turned to anger — "I thought, 'Wait, what in the world? Where am I?' " — especially when she remembered that her insurance covered only one annual gynecology checkup. Dotts, who'd majored in religion in college, got tough with the doctor.

"I'm glad for you that you're faithful," she told him. "But don't push it on me. I'm here for my treatment, and I expect you to give it to me." Five minutes of verbal sparring later, the doctor relented with a six-month prescription — but only after Dotts told him she had been put on the Pill to relieve menstrual cramping, not to prevent pregnancy. Dotts grabbed the prescription and left, resolving to find herself a new gynecologist. "Before, walking into a doctor's office, I assumed we were on the same side," she says. "I don't make that assumption now. I ask a million questions and advocate for myself."

Bills to protect patients
This tug-of-war between physicians and patients is playing out in state legislatures, where a handful of bills aim to protect women. A Pennsylvania proposal, for example, would compel ER doctors to provide rape victims with information about emergency contraception and to dispense it on request — a law already on the books in California, Massachusetts, New Jersey, New Mexico, New York, Ohio and Washington. A federal version of the bill is under consideration by a House subcommittee.

But such efforts have been more than matched by those of conscience-clause activists. Since 2005, 27 states introduced bills to widen refusal clauses. Four states are considering granting carte blanche refusal rights — much like the law adopted by Mississippi in 2004, which allows any health care provider to refuse practically anything on moral grounds. "It's written so broadly, there's virtually no protection for patients," says Adam Sonfield, senior public policy associate for the Washington, D.C., office of the Guttmacher Institute, a reproductive-health research group. Sonfield notes that many refusal clauses do not require providers to warn women about restrictions on services or to refer them elsewhere. "You have to balance doctors' rights with their responsibilities to patients, employers and communities," he adds. "Doctors shouldn't be forced to provide services, but they can't just abandon patients."

In theory, the laws aren't aimed solely at women's health — a bill in New Jersey lists eye doctors and prosthetics technicians as examples of providers who'd be allowed to refuse care based on their beliefs. But Morrison warns women not to be fooled. "I ask you, what belief would keep someone from fitting a patient with a prosthetic limb?" she asks. "What they're really after is limiting access to women's health care. Reproductive health is seen as something other than regular health care" — not a straightforward matter of treating and healing, but something laden with morality — "and if you treat it that way, it becomes something providers can say yes or no to." Men, for the most part, escape such scrutiny: It's pretty hard to imagine someone being made to feel he's going straight to hell for choosing to take Viagra or get a vasectomy. And if women come to fear their doctors' judgments, a new set of problems can develop. "Then you have women who don't communicate with their doctors or avoid getting care," Morrison warns. "Any way you look at it, it's dangerous for women."

Complaint filed, but case closed
The stakes were high for Realtor Cheryl Bray when she visited a physician in Encinitas, California, two and a half years ago. Though she was there for a routine physical, the reason for the exam was anything but routine: Then a single 41-year-old, Bray had decided to adopt a baby in Mexico and needed to prove to authorities there that she was healthy. "I was under a tight deadline," Bray remembers; she had been matched with a birth mother who was less than two months from delivering. Bray had already passed a daunting number of tests — having her taxes certified, multiple background checks, home inspections by a social worker, psychological evaluations. When she showed up at the office of Fred Salley, M.D., a new doctor a friend had recommended, she was looking forward to crossing another task off her list. Instead, 10 minutes into the appointment, Dr. Salley asked, "So, your husband is in agreement with your decision to adopt?"

"I'm not married," Bray told him.

"You're not?" He calmly put down his pen. "Then I'm not comfortable continuing this exam."

Bray says she tried to reason with Dr. Salley but received only an offer for a referral at some future date. Dr. Salley disputes this, telling SELF that he offered to send Bray to another doctor in his group that day. "My decision to refer Ms. Bray was not because she was unmarried; rather, it was based on my moral belief that a child should have two parental units," he adds. "Such religious beliefs are a fundamental right guaranteed by the Constitution of the United States."

Bray sobbed in her parked car for another 45 minutes before she could collect herself for the drive home. "I had a lot of pent-up emotions," she remembers. "When you are going through an adoption, you have to prove that you are a fit parent at every stage. I really felt put through the ringer, and the doctor compounded that feeling."

Bray managed to get an appointment with another physician about a month later and was approved for the adoption two weeks before her daughter, Paolina, was born. But she remained furious enough that she filed a complaint against Dr. Salley with the Medical Board of California — and then was shocked when, in April 2006, the board closed the case without taking any action. When she complained to Dr. Salley's employer, a clinic official wrote back that "based on personally held conscience and moral principles" her doctor had been within his rights to refuse her as a patient. "Apparently," she says, "it's OK to discriminate against somebody, as long as it's for religious reasons."

Providers often prevail
It's true that several lawsuits have favored health providers who refuse services based on their principles. In a 2002 wrongful-termination case in Riverside County, California, for example, a born-again Christian nurse was fired for refusing to give out emergency contraception — but she was vindicated when the jury agreed that her rights had been violated, awarding her $19,000 in back pay and $28,000 for emotional distress. And in a recent case in San Diego, an appeals court ruled against 35-year-old Guadalupe Benitez. Hoping to start a family with her lesbian partner, Benitez received fertility treatments for nearly a year at North Coast Women's Care Medical Group in Encinitas. But when drugs and home inseminations failed, two doctors and a nurse all bowed out of doing an intrauterine insemination, saying their religion would not allow it.

Their reasoning is in dispute: Benitez has claimed both doctors told her they objected to her sexual orientation. Carlo Coppo, a lawyer for the doctors, says they refused because she was unmarried. Benitez, who went on to have three children with the help of another clinic, has appealed to the California Supreme Court and is awaiting its decision.

Her attorney, Jennifer C. Pizer of Lambda Legal in Los Angeles, says she's heard from numerous lesbians denied access to fertility treatments. "Reproductive medicine has given human beings choices that didn't exist in previous generations, but the rules about how we exercise those choices should be the same for all groups of people," she argues. Allowing doctors to refer a patient to someone else, she adds, is the equivalent of a restaurant telling a black person, "Go next door. We don't serve your kind here."

In the end, the women in all of the incidents above were able to get the treatment they wanted, even if they had to go elsewhere. So one could see doctor refusals as a mere inconvenience. "In 99.9 percent of these cases, the patients walk away with what they came for, and everyone's satisfied," Manion asserts. "I know there's the horror story of the lonely person in the middle of nowhere who meets one of my clients. But those cases are so rare." Access to reproductive health care, however, is already a challenge in some areas. "Out here, it's a very real issue," says Stacey Anderson of Planned Parenthood of Montana in Helena. "We have some really gigantic counties where if you're refused a service by a primary care physician or a gynecologist, you might have to drive two, three hours to find another."

Moreover, you don't need to be in a rural area to have limited access, points out attorney Brooks; all you need to be is poor. "Lower-income people who are refused health care are trapped," Brooks says. "They can't pay out of pocket for these services. And they may not have transportation to go elsewhere. So they really don't have options."

What's best for the patient
If there's one thing both sides can agree on, it's this: In an emergency, doctors need to put aside personal beliefs to do what's best for the patient. But in a world guided by religious directives, even this can be a slippery proposition.

Ob/gyn Wayne Goldner, M.D., learned this lesson a few years back when a patient named Kathleen Hutchins came to his office in Manchester, New Hampshire. She was only 14 weeks pregnant, but her water had broken. Dr. Goldner delivered the bad news: Because there wasn't enough amniotic fluid left and it was too early for the fetus to survive on its own, the pregnancy was hopeless. Hutchins would likely miscarry in a matter of weeks. But in the meanwhile, she stood at risk for serious infection, which could lead to infertility or death. Dr. Goldner says his devastated patient chose to get an abortion at local Elliot Hospital. But there was a problem. Elliot had recently merged with nearby Catholic Medical Center — and as a result, the hospital forbade abortions.

"I was told I could not admit her unless there was a risk to her life," Dr. Goldner remembers. "They said, 'Why don't you wait until she has an infection or she gets a fever?' They were asking me to do something other than the standard of care. They wanted me to put her health in jeopardy." He tried admitting Hutchins elsewhere, only to discover that the nearest abortion provider was nearly 80 miles away in Lebanon, New Hampshire — and that she had no car. Ultimately, Dr. Goldner paid a taxi to drive her the hour and a half to the procedure. (The hospital merger has since dissolved, and Elliot is secular once again.)

"Unfortunately, her story is the tip of the iceberg," Dr. Goldner says. Since the early 1990s, hospitals have been steadily consolidating operations to save money; so many secular community hospitals have been bought up that, today, nearly one in five hospital beds is in a religiously owned institution, according to the nonprofit group MergerWatch in New York City.

What is standard of care?
Every Catholic hospital is bound by the ethical directives of the U.S. Conference of Catholic Bishops, which forbid abortion and sterilization (unless they are lifesaving), in vitro fertilization, surrogate motherhood, some prenatal genetic testing, all artificial forms of birth control and the use of condoms for HIV prevention. Baptist and Seventh Day Adventist hospitals may also restrict abortions. Which means that if your local hospital has been taken over — or if you're ever rushed to the nearest hospital in an emergency — you could be in for a surprise at the services you can't get.

You wouldn't necessarily know a hospital's affiliation upon your arrival. "The name of the hospital may not change after a merger, even if its philosophy has," Morrison notes. "The community is often in the dark that changes have taken place at all." The burden to know falls entirely on the patient, who can either search the Catholic Health Association's directory of member hospitals (at CHAUSA.org) or ask her doctor outright. Either way, says Morrison, "it requires you to be an extremely educated consumer."

Family physician Debra Stulberg, M.D., was completing her residency in 2004 when West Suburban Medical Center in Oak Park, Illinois, was acquired by the large Catholic system Resurrection Health Care. "They assured us that patient care would be unaffected," Dr. Stulberg says. "But then I got to see the reality." The doctor was struck by the hoops women had to jump through to get basic care. "One of my patients was a mother of four who had wanted a tubal ligation at delivery but was turned down," she says. "When I saw her not long afterward, she was pregnant with unwanted twins."

And in emergency scenarios, Dr. Stulberg says, the newly merged hospital did not offer standard-of-care treatments. In one case that made the local paper, a patient came in with an ectopic pregnancy: an embryo had implanted in her fallopian tube. Such an embryo has zero chance of survival and is a serious threat to the mother, as its growth can rupture the tube. The more invasive way to treat an ectopic is to surgically remove the tube. An alternative, generally less risky way is to administer methotrexate, a drug also used for cancer. It dissolves the pregnancy but spares the tube, preserving the women's fertility. "The doctor thought the noninvasive treatment was best," Dr. Stulberg recounts. But Catholic directives specify that even in an ectopic pregnancy, doctors cannot perform "a direct abortion" — which, the on-call ob/gyn reasoned, would nix the drug option. (Surgery, on the other hand, could be considered a lifesaving measure that indirectly kills the embryo, and may be permitted.) The doctor didn't wait to take it up with the hospital's ethical committee; she told the patient to check out and head to another ER. (Citing patient confidentiality, West Suburban declined to comment, confirming only that as a Catholic hospital, it adheres to religious directives "in every instance.")

Turns out, the definition of emergency depends on whom you ask. Dr. Christiansen, the pro-life ob/gyn, says she would not object to either method of ending an ectopic pregnancy. "I do feel that the one indication for abortion is to save the mother's life — that's clear in my mind," she says. "But the reality is, the vast majority of abortions are elective. There are very, very few instances where the mother's life is truly in jeopardy." She can recall having seen only one such situation: During Dr. Christiansen's residency, a patient in the second trimester of pregnancy had a detached placenta; the attending physician performed an abortion to save the woman from bleeding to death. "That was a legitimate situation," Dr. Christiansen says. But in general, "it's a pure judgment call. A doctor would have to be in the situation and decide whether it constitutes a life-threatening emergency or not."

Raise your hand if you'd like to be the test case.

"You Can Come Upon Women's Bodies Anywhere"

Life was supposed to get better for women in Iraq after the ousting of Saddam. The reality has been rocketing rates of rape, murder, domestic violence and infant mortality, reports leading US writer Katha Pollitt

The Guardian reports:
The video, originally posted on jebar.info, a Kurdish website, was soon plastered all over the internet: a young girl in a red tracksuit jacket and black pants was being beaten, kicked and stoned to death by a mob of excited, shouting men. It is a gruesome marriage of 21st-century technology and medieval barbarity. At one point, bloody and dazed, the girl tries to protect herself, whereupon a man drops a big rock or lump of concrete on her face, killing her. Her crime? Doaa Khalil Aswad, a 17-year-old member of the Kurdish Yazidi religious minority, a non-Muslim sect, had fallen in love with a Sunni boy and possibly converted to Islam. For this "crime" against family and community, Doaa was murdered in the village of Beshika, near Mosul, in a collective act of woman hatred, led by her brothers and uncles. In the video you can see local policemen watching and one man recording the killing on his mobile phone.

This is the new Iraq, where women were going to be free and equal - no more "rape rooms", no more psychopathic Uday Hussein summoning young virgins to the palace for his pleasure. In the early days of the occupation, we heard a lot about building schools, starting women's health programmes and funding women's micro-enterprises. At the 2005 State of the Union address, Laura Bush sat with Safia Taleb al-Suhai, leader of the Iraqi Women's Political Council, telegraphing the message that women's rights and democracy went together and that both were part of the big plan for Iraq. Well, scratch that.

The status of women was never as high under Saddam as opponents of the war sometimes asserted, and it was already declining throughout the 1990s, as Saddam embraced Islam to distract the populace from the effects of the Gulf war, UN sanctions, and his own depredations. But Iraq today is even worse for women: more repressive, more violent, more lawless. As if car bombs and suicide bombers weren't horrific enough, criminal gangs, religious militias and death squads kidnap, rape and kill with impunity, with special attention to women professionals, students and rights activists. According to the United Nations' most recent quarterly report on human rights in Iraq, domestic violence and "honour" killings are on the rise - Kurdistan, often described as comparatively peaceful and orderly, saw more than 40 such killings between January and March this year; in the province of Erbil, rapes quadrupled between 2003 and 2006. Women who had worn western clothes and moved about freely all their lives have been terrorised into wearing the abaya and staying inside unless accompanied by male relatives. In Sadr City and elsewhere, sharia courts mete out misogynist "justice".

"The political climate in Iraq is such that anyone can carry out crimes against women.You can come upon women's bodies anywhere," Kurdish feminist and labour activist Houzan Mahmoud told me in London, where she serves as the UK representative of the Organisation of Women's Freedom in Iraq (OWFI). Far from promoting women's rights and security, "the occupation has strengthened the tribes, political Islam and reactionary bourgeois parties - all of which are anti-women."

The true extent of the violence may never be known. According to Yifat Susskind, author of this year's report by women's human rights group Madre entitled Promising Democracy, Imposing Theocracy: Gender-Based Violence and the US War on Iraq, comprehensive statistics don't exist: the Iraqi institutions responsible for collecting human rights data are complicit in human rights abuses and, besides, the Iraqi prime minister has told the Ministry of Health not to publish figures on civilian fatalities.

"I haven't seen the United States offering any protection for women," Mahmoud told me. Indeed, America is part of the problem. Think of Abeer Qassim al-Janabi, the 14-year-old girl raped and then murdered with her family by US soldiers in Mahmoudiya in March last year. Think of the women imprisoned at Abu Ghraib and elsewhere, sometimes only for being the wife or sister of a man US forces were looking for. Think of women terrorised by soldiers who break into their homes and hold them at gunpoint. Given the punishments meted out to "unchaste" women, victims are unlikely to report rapes committed by US or allied soldiers or Iraqi military or police forces - but if the case of Abeer was unique, this would be the first military occupation in history in which the invaders and their local sidekicks didn't help themselves to girls and women.

Four years after the fall of Saddam, the country is a political and economic basket case. The US-engineered constitution undermines secularism in favour of religious authority, while billions in US aid disappear into the pockets of contractors and bribe-takers. One third of the population is poor; last year there were 300,000 widows in Baghdad alone. According to a new report from Save the Children, Iraq now boasts the world's biggest 15-year increase in infant and child mortality; in 2005, 122,000 children under five died - that's one in eight.

I asked Mahmoud if the American presence had achieved anything at all for women. "No," she said. "I can't honestly say it has." Like other women's groups there, OWFI now carries out its work in secret.

· Katha Pollitt has written for the Nation since 1980. Her most recent book is Virginity or Death! and Other Social and Political Issues of Our Time, a selection of Nation columns from 2001 to 2006. Her volume of personal essays is forthcoming from Random House.

How you can help

The Organisation of Women's Freedom in Iraq runs shelters for battered women in four cities and an "underground railroad" to conduct women at risk of murder to safe havens. In response to the murder of Doaa, it is mounting an international campaign to ban honour killings and force Kurdish and Iraqi legal authorities to investigate and prosecute them. There have been demonstrations in London and Erbil; you can sign OWFI's petition at equalityiniraq.com, where you can also show your support for women's rights in Iraq by clicking on "make a donation".

Dispatches: Iraq

The Women's Story provides a compelling account of a life inside Iraq that is rarely seen on news bulletins: stories of ordinary women whose struggle to survive has only worsened since the war.



The invasion of Iraq heralded promises of freedom from tyranny and equal rights for the women of Iraq. But three years on, the reality of everyday life for women inside Iraq is a different story. To make this film, two Iraqi women risk their lives to spend three months traveling all over the country with a camera to record the lives and experiences of women they meet.