Friday, May 10, 2002

The pill emerges as issue in N.Ky.

Some want clinic to stop offering it

By Cindy Schroeder,
The Cincinnati Enquirer

        FLORENCE — Pat Fann says contraceptives she received from Northern Kentucky public health clinics enabled her to limit the size of her family, unlike her late mother, who had 11 children in 25 years.

        “I want other women to have the same benefits that I had,” said the 54-year-old Newport mother of two.

        Ms. Fann was one of 10 speakers at a special caucus Thursday night who urged the only health department serving four Northern Kentucky counties not to reduce birth control options for low-income women.

    In Fiscal Year 2001, the $169,694 federal family planning funds:
   • Enabled six Northern Kentucky clinics to provide family planning services to 4,462 women in 2001.
    • Provided services that included 3,851 gynecological exams, 3,876 counseling or education visits, 1,853 pregnancy tests, 325 repeat Pap screenings following treatment for abnormal findings, 104 cervical colposcopies and 25 breast ultrasounds.
    • Provided contraceptives to 3,681 women, including 2,534 oral contraceptives, 1,120 Depo-Provera shots, 20 IUDs, five sterilizations and two diaphragms.
    • Served 676 female patients ages 13-17, 1,255 ages 18-21, 2,253 ages 21-35 and 278 ages 36 and older.
    Eighty-five percent were at or below federal poverty guidelines. Last year, that was $17,650 for a family of four. As of April of this year, that salary was raised to $18,100.
   Source: Northern Kentucky Independent District Health Department
        Nearly 400 people packed the grand ballroom of the Hilton Greater Cincinnati Airport for Thursday's debate on whether contraceptives such as the birth control pill and intrauterine devices (IUDs) constitute abortion and should be removed from Northern Kentucky's public health clinics.

        The Northern Kentucky Independent District Health Board is debating whether to continue accepting federal Title X funds because some members believe that birth control pills and intrauterine devices (IUDs) cause abortions because they prevent the implantation of a fertilized egg in the uterine wall.

        In fiscal year 2001, the health department received $169,694 in federal family planning funds.

        “The evidence is overwhelming as to the abortifacient nature of these drugs,” said Robert C. Cetrulo, president of Northern Kentucky Right to Life and one of 10 speakers who favored eliminating the use of federal Title X money for family planning services at the Northern Kentucky Independent District Health Department.

        “It also is overwhelming as to their disastrous social consequences.”

        Dr. Robert Hatcher, professor of gynecology and obstetrics at Emory University in Atlanta, disagreed. The senior editor of 16 editions of Contraceptive Technologies is considered one of the leading experts in the country on birth control.

        Dr. Hatcher said that birth control pills stop ovulation, thicken the cervical mucus and cause endometrial changes that inhibit implantation of the fertilized egg.

        “The World Health Organization, the U.S. Public Health Service, and the American College of OB/GYN all say that that is not causing an abortion,” Dr. Hatcher said.

        “You can choose to define abortion however you see fit, but that's not the definition of abortion by any major health service.”

        No vote was taken on the issue Thursday. A decision will come at the health board's June 19 meeting.

        Health officials — including a spokeswoman for the Washington, D.C.-based American Public Health Association — were not aware of any other health departments that have considered dropping out of Title X because of such concerns.

        “Our government relations office that monitors this type of issue has never heard of anyone turning down Title X money because of concerns that (the pill or IUDS) cause abortions,” Kate Fox, a spokeswoman for the American Public Health Association said before Thursday's health board meeting.

        Last year, about 4,500 women visited Northern Kentucky Health Department clinics for birth control and related services provided by federal Title X money. Title X, signed into law by President Nixon in 1970, is the only federal program dedicated solely to family planning services.

        Health Board member Dr. Thomas Shaughnessy of Edgewood said scientific data suggests that birth control pills do act as abortifacients, or agents that cause abortion.

        His daughter, Caitlin, 17, a senior at Notre Dame Academy in Park Hills, also spoke against continuing Title X funding. As a teen-ager, Caitlin said that she “can't get her ears pierced without parental permission but (that she) can get a powerful prescription drug behind their back.”

        Ellen Curtin, who described herself as a Fort Thomas medical editor and a mother of four through natural family planning, said that Title X funded contraceptives:

        • Abort young lives.

        • Push pills that many older women regret having taken.

        • Have been unable to stop the proliferation of sexually transmitted diseases during the past 30 years.

        “When you cut loose of Title X, you'll be free to serve our total health needs,” she said.

        Eight of the 29 health board members spoke against continuing to accept Title X funding, while five spoke in favor of keeping the federal funds for family planning services.

        Dr. Stephen Hiltz, a longtime health board member, called for his fellow board members to keep in mind that their mission is to promote public health — not to advance a religious or philosophical agenda.

        Sue Momeyer, president and CEO of Planned Parenthood Cincinnati, was among family planning experts who warned against reducing birth control options. She said it would force thousands of low-income Northern Kentucky women to travel to Cincinnati for contraceptives or do without them.

        “I think it would create real barriers if it was taken away,” Ms. Momeyer said. “Certainly 4,000 people aren't all going to cross the river. Many of them are not that mobile.”

        Ms. Momeyer added the Northern Kentucky health district's Title X family planning program provides a broad range of contraceptive services and related counseling and information.

        She cited a 1996 study that found each public dollar spent to provide family planning services saves about $3 that would otherwise be spent in Medicaid costs for pregnancy-related care and medical care for newborns.


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- The pill emerges as issue in N.Ky.