Wednesday, July 02, 2014

My take on the Hobby Lobby Issue

1. What the ACA Mandate Says
"Through the Affordable Care Act, women’s preventive health care services – such as mammograms, screenings for cervical cancer, and other services – are already covered with no cost sharing under some health plans. The Affordable Care Act also makes certain recommended preventive services free for people on Medicare.  The law also recognizes the need to take into account the unique preventive health needs of women throughout their lifespan.
On August 1, 2011, HHS adopted new Guidelines for Women’s Preventive Services (Guidelines) – including well-woman visits, contraception, and domestic violence screening and counseling. These preventive services are required to be covered without cost sharing in most non-grandfathered health plans starting with the first plan or policy year beginning on or after August 1, 2012."1

2. What Hobby Lobby is opposing.
The Green Family, who are Christians and believe in the sanctity of human life from conception to birth (please raise your hand if you know for sure when exactly does life start), are opposed to the contraceptives that prevent implantation of a fertilized egg. "According to the Association of American Physicians and Surgeons, American Association of Pro-Life Obstetricians & Gynecologists, Christian Medical Association, Catholic Medical Association, National Catholic Bioethics Center, Physicians for Life, National Association of Pro-Life Nurses include the Emergency Morning After Pill and the copper IUD (Intrauterine Device)"2
Did you notice that the only two methods of contraception they are opposed to are just those two? Meaning there is a whole host of contraceptive methods and devices they are NOT opposed to. Meaning "Women's Health" is not being threatened after all (but of course if you're in the business of selling news it makes for a more profitable gain to make those claims).
Lacking in all of this media attention has been a careful look at the facts of this case apart from the views of ones political preference, and I am here to offer those facts.

3. Emergency Contraception. Morning After Pill, IUD. Mechanism of Action.
So how does the morning after Pill and Copper IUD device work?
According to Williams Obstetrics (not catholic or religious by the way, just part of Med school's curriculum):
1. Morning After Pill or Levonestregel, which is a progestogen. "Progestogens prevent ovulation by suppressing the luteinizing hormone. Furthermore, progestogens increase the thickness of cervical mucus, which makes the passage of sperms more difficult. Likewise, they make the endometrium unfavorable for implantation."3.
2. Copper Intra Uterine Device. "The intense inflammatory response induced in the uterus, especially by the copper IUD, produces lisosomic activation and other inflammatory actions that are spermicidal. In the unlikely case that fertilization has occured, the same inflammatory actions are directed toward the blastocyte. Finally, the endometrium is transformed into a hostile environment for implantation."4 
And according to Novak's Gynecology (Again, not religious in any way):
1. Intrauterine devices
"Its contraceptive efficacy does not depend on the interference of implantation, although this phenomenon is also produced and it is the basis for the use of copper IUD for emergency contraception."5
2.  On Emergency Contraception
"It is believed that implantation of the fertilized egg occurs on the 6th day after fertilization. This interval offers the opportunity of preventing the pregnancy even after fertilization. This can be obtained by hormonal agents alone or combined, or with an IUD."6

4. Women's Health
I keep reading in the media and on facebook, and more specifically in an article a most shocking statement "Regulations made under the act rely on the recommendations of the independent Institute of Medicine (IOM) in its July 19, 2011 report Clinical Preventive Services for Women: Closing the Gaps, which concluded that birth control is medically necessary "to ensure women's health and well-being."7
Which begs the question, since when is pregnancy considered detrimental to women's health? Because that is the main use and purpose of contraception, to prevent pregnancy. Although in this country, in my opinion, hormonal contraception is overused for convenience, because who on earth wants to have the period every month? and certain medical issues like dysmenorrhea (painful periods) and endometriosis which is one of the major causes of painful periods, but I digress.
Back to my question, are there risks involved with pregnancy? yes there are many risks but on the other hand our bodies were created to birth babies. The changes that our bodies go through just to protect, nurture and grow that little baby is amazing. But aren't there risks with just about everything under the sun? There are risks with the hormones in your contraceptive device or pill of choice. Those hormones can be harmful to our bodies, you are at a higher risk of a blood clot while on birth control, you are at higher risk of certain cancers with prolonged use of hormonal birth control. You are at a risk of having pelvic inflammatory disease on the IUD, and at a higher risk of an ectopic pregnancy or even loss of a pregnancy while on the IUD. Those are the facts people. And we are calling that Women's Health? Now don't get me wrong, I'm not opposed to all contraceptives, but I am opposed to the straw man arguments being used in this ridiculous debacle.
What about dieting? Dieting is absolutely necessary for men and women's health and yet I don't see anybody making a big fuss about our work paying for nutritionists. My husband's insurance only covered about 30 some dollars of  an almost 300 dollar bill for one nutrition class out of three that my husband is required to take if he wants to get an insulin pump. My insurance through work does not cover visits to the nutritionist.
What about exercise? Being fit and healthy is absolutely necessary for men and women's health as well. Why doesn't our insurance pay for gym subscriptions?
See it is all a matter of perspective. And nowadays, apparently, it is all a matter of liberals vs conservatives. It is like children whining to their mommy, "but he started it!" what sad hypocritical people we have become. Pretending to be all in favor of religious liberties except for when it opposes my political party's agenda.

2. Wyam Kristen (AP) (June 27, 2013) "Hobb Lobby won't have to pay millions in fines as it challenges Obamacare birthcontrol mandate. Huffington Post.; Smith, Mailee (February 19, 2013)"Amicus Curiae Brief of Association of American Physicians & Surgeons, American Association of Pro-Life Obstetritians & Gynecologists, Christian Medical Association, Catholic Medical Association, National Catholic Bioethisc Center, Physicians for Life, NAtional Association of Pro-Life Nurses" Washington, DC.: Americans United for Life"
3. McGraw Hill. Williams' Obstetrics. 22nd Edition. Mexico DF. 2006. Pages 728-729. Emphasis Mine. Translated from spanish to english by me.
4. McGraw Hill. Williams' Obstetrics. 22nd Edition. Mexico DF. 2006. Page 738. Translated from spanish to english by me.
5,6. Berek, Jonathan S. McGraw Hill. Novak's Gynecology. 13 Edition. Los Angeles, CA. 2004. Pages 202,223 respectively. Translated from Spanish to English.
7. Dept. Health and Human Services (February 10, 2012). "Group Helatg Plans and Health Insurance Issuers Relating to Coverage of Preventitive Services Under the Patient Protection and Affordable Care Act - Final Rules" (77 FR 8725) Federal Register, GPO. Emphasis theirs.

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