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Lawmakers in Many States Pushing for Abortion Curbs

By ERIK ECKHOLM

Published: January 21, 2011

Newly energized by their success in November’s midterm elections, conservative legislators in dozens of states are mounting aggressive campaigns to limit abortions.

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Anti-Abortion Forces Gain in States

The lawmakers are drafting, and some have already introduced, bills that would ban most abortions at 20 weeks after conception, push women considering abortions to view a liveultrasound of the fetus, or curb insurance coverage, among other proposals.

In Florida and Kansas, legislators plan to reintroduce measures that were vetoed by previous governors but have the support of the new chief executives, like ultrasound requirements and more stringent regulation of late-term abortions.

“I call on the Legislature to bring to my desk legislation that protects the unborn, establishing a culture of life in Kansas,” Gov. Sam Brownback said last week in his first State of the State message.

“This is the best climate for passing pro-life laws in years,” said Michael Gonidakis, executive director of Ohio Right to Life, expressing the mood in many states. “We’ve got a pro-life governor and a brand new pro-life speaker. Our government now is pro-life from top to bottom.”

Abortion opponents plan marches in Washington and elsewhere this weekend and on Monday to mark the anniversary of the 1973 Supreme Court decision, Roe v. Wade, that established a woman’s right to an abortion.

Republicans in Congress hope to strengthen measures to prevent even indirect public financing of abortions, but laws in the states have the greatest impact on access to them. Abortion opponents have been emboldened by major changes in the political landscape, with conservative Republicans making large gains.

Although social issues were often played down in the campaigns, many of the newly elected governors and legislators are also solidly anti-abortion, causing advocates of abortion rights to brace for a year of even tougher battles than usual.

The biggest shift is in the state capitols, with 29 governors now considered to be solidly anti-abortion, compared with 21 last year. “This is worrisome because the governors have been the firewall, they’ve vetoed a lot of bad anti-choice legislation,” said Ted Miller, a spokesman for Naral Pro-Choice America.

In 15 states, compared with 10 last year, both the legislature and the governor are anti-abortion, according to a new report by Naral, and those joining this category include larger states like Michigan, Ohio and Wisconsin, as well as Georgia and Oklahoma. Maine and Pennsylvania are now strongly anti-abortion as well, if not quite as solidly.

Just which measures will pass is impossible to predict, particularly because many states are bogged down by budget crises.

Elizabeth Nash, who tracks state policies on abortion for the Guttmacher Institute, a research organization, said that while states would be preoccupied with budget issues, it appeared rather likely that more measures would pass this year than in 2010, which anti-abortion advocates considered a banner year, with more than 30 restrictive laws adopted in at least nine states.

The elections brought even more gains for their side than expected, said Mary Spaulding Balch, state policy director of the National Right to Life Committee, leading her group to call in its affiliates for a special strategy session on Dec. 7.

While many anti-abortion measures have been adopted or debated over the years, including requiring parental consent for minors and waiting periods, advocates have set a few top priorities for the months ahead:

¶Banning abortions earlier in pregnancy. Most states place restrictions on later abortions, often defined as after fetal viability, or around 22 to 26 weeks after conception. But last year, Nebraska set what many advocates consider a new gold standard, banning abortions, unless there is imminent danger to the woman’s life or physical health, at 20 weeks after conception, on a disputed theory that the fetus can feel pain at that point. The measure has not been tested in court, but similar measures pushing back the permissible timing are being developed in Indiana, Iowa, New Hampshire, Oklahoma and other states.

The 20-week law in Nebraska, which took effect in October, forced a prominent doctor who performed late-term abortions to leave the state. Jill June, president of Planned Parenthood of the Heartland, said women suffering from complicated pregnancies but are not yet sick enough to qualify for an emergency abortion would be forced to travel to other states. Or, she said, doctors fearing prosecution will wait until such women become dangerously ill before considering an abortion.

¶Pressing women to view ultrasounds. While several states encourage women seeking abortions to view an ultrasound, Oklahoma last year adopted a requirement that doctors or technicians perform the procedure with the screen visible to the woman, and explain in detail what she is seeing. The measure is under court challenge, but the Kentucky Senate has passed a similar bill, and variants are expected to come up in states including Indiana, Maryland, Montana, Ohio, Texas, Virginia and Wyoming.

In Florida, former Gov. Charlie Crist vetoed an ultrasound bill. The new governor, Rick Scott, attacked him for that veto and is expected to support a new proposal.

¶Banning any abortion coverage by insurance companies in the new health insuranceexchanges. Numerous states are poised to impose the ban on plans that will be offered to small businesses and individual insurance buyers under the Obama administration health plan.

The shifts to conservative governors, in particular, have opened new opportunities for abortion opponents. In Kansas, legislators said they would act quickly to adopt measures that were previously vetoed, including regulations that will make it harder to open abortion clinics or to perform abortions in the second trimester.

“There’s pent-up demand in the Legislature for these changes,” said State Representative Lance Kinzer, the chairman of the Judiciary Committee in the Kansas House. Once these long-debated steps are taken, he said, the Legislature will consider more sweeping restrictions, including banning most abortions after the 20th week.

The politics of abortion have changed profoundly in some larger states including Michigan, Pennsylvania and Wisconsin.

“We’re facing the biggest threat to reproductive rights we’ve ever faced in this state,” said Lisa Subeck, executive director for Naral Pro-Choice Wisconsin.

In Michigan, because of the switch to an anti-abortion governor, “the dominos are lined up well for us this time,” said Ed Rivet, legislative director for Right to Life of Michigan. For starters, advocates hope to pass a state ban on the procedure opponents call partial-birth abortion that had been vetoed twice. After that, he said, “We have quite a list.”

Many defenders of abortion rights argue that because the election hinged largely on the economy and the role of government, officials did not receive a mandate for sweeping new social measures. “This last election was not about these issues at all,” said Cecile Richards, president of the Planned Parenthood Federation of America. “We now are concerned about a real overreaching by some state legislators and governors that will make it very difficult for women to access reproductive health care.”

Daniel S. McConchie, vice president for government affairs with Americans United for Life, responded that laws restricting abortion have been adopted right along by the states and that while he expected large gains in the year ahead, they will be part of steady trend.

The abortion rate in the United States, which had declined steadily since a 1981 peak of more than 29 abortions per 1,000 women, stalled between 2005 and 2008, at slightly under 20 abortions per 1,000 women, according to a new report from the Guttmacher Institute.

Robbie Brown contributed reporting from Atlanta, Dan Frosch from Denver and Emma Graves Fitzsimmons from Chicago
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A version of this article appeared in print on January 22, 2011, on page A1 of the New York edition.

Is Extreme Parenting Effective?

Does strict control of a child's life lead to greater success or can it be counterproductive?

Balancing Freedom With Discipline

Updated January 16, 2011, 11:42 AM

Yan Sun, a native of Sichuan, has lived in the United States since 1985 and been a professor of political science at the City University of New York since 1992. She has published two books as well as numerous academic papers about China.

Teaching in a college with a sizable population of Jewish, Indian and other ethnic groups, I can identify attitudinal traits that can only be loosely termed “Chinese.” The idea that Chinese mothers have some special or "superior" parenting style is at best a misconception, and at worse, nonsense.

What can get lost with too much parental guidance are individuality, creativity and leadership skills.

But if we want some sort of explanation, we can look to the Chinese culture for some clue. In China, the strong emphasis on striving in education comes from a long history of Confucian teachings and a tradition of grooming the best and brightest for the formidable imperial exams.

In contemporary times, strict and result-oriented parenting also has to do with anxieties created by a ubiquitous testing environment. In China, it is exacerbated by the one-child policy. The gaokao (college entrance exam), for example, has even been known to push students to suicide. Concerns over academic competition and professional opportunities have fueled demand for education and skill attainment by Chinese parents for their children.

There are decided benefits to a rigorous parenting style. Persistent drilling of skills can help children acquire proficiency in certain areas. Offering direction about career paths can help lead students toward more employable fields. But increasingly, Chinese and Asian Americans are paying attention to the downsides of this type of parenting. What often gets lost are individuality, creativity and leadership skills.

We worry about the paucity of Nobel laureates in the sciences in China, despite outstanding international test scores from Chinese students. We lament the gap between Chinese/Asian Americans’ academic achievements and the relatively few who reach top management ranks in the United States.

Chinese parents everywhere are changing. My family is a case in point. We find a combination of demanding and encouraging styles the ideal model. We never had a piano in our home because we did not understand why every Asian kid seems to play the piano. We let our kids choose their extracurricular activities, although the math team takes precedence over sports teams, which in turn comes before saxophone lessons. We may be disappointed that our older son may not major in physics, but at our suggestion, he wants to combine his economics major with mathematics. And yes, they should strive for A’s, but they will not be taken to task for lower grades as long as they make earnest efforts.

Topics: China, Culture, children, mothers

Debaters

Balancing Freedom With Discipline
Yan Sun, professor, City University of New York
When Parents Feel Out of Control
Karen Karbo, novelist and memoirist
What Mencius’s Mother Sought
C. Cindy Fan, associate dean of social sciences, U.C.L.A.
When the Goal Is Successful Kids
Hara Estroff Marano, author, "A Nation of Wimps"
Defining Success for Myself
Jennifer Cheng, blogger, Every Six Minutes
The Power of Conviction
David Anderegg, professor of psychology
The Opposite of Extreme
Elizabeth Hartley-Brewer, child development specialist
We Are What We Know
Meredith F. Small, professor of anthropology

Why Parents Fear the Needle

By MICHAEL WILLRICH

Published: January 20, 2011

REPRINTS

Wellesley, Mass.

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Brian Stauffer

DESPITE overwhelming evidence to the contrary, roughly one in five Americans believes that vaccines cause autism — a disturbing fact that will probably hold true even after the publication this month, in a British medical journal, of a report thoroughly debunking the 1998 paper that began the vaccine-autism scare.

That’s because the public’s underlying fear of vaccines goes much deeper than a single paper. Until officials realize that, and learn how to counter such deep-seated concerns, the paranoia — and the public-health risk it poses — will remain.

The evidence against the original article and its author, a British medical researcher named Andrew Wakefield, is damning. Among other things, he is said to have received payment for his research from a lawyer involved in a suit against a vaccine manufacturer; in response, Britain’s General Medical Council struck him from the medical register last May. As the journal’s editor put it, the assertion that the measles-mumps-rubella vaccine caused autism “was based not on bad science but on a deliberate fraud.”

But public fear of vaccines did not originate with Dr. Wakefield’s paper. Rather, his claims tapped into a reservoir of doubt and resentment toward this life-saving, but never risk-free, technology.

Vaccines have had to fight against public skepticism from the beginning. In 1802, after Edward Jenner published his first results claiming that scratching cowpox pus into the arms of healthy children could protect them against smallpox, a political cartoon appeared showing newly vaccinated people with hooves and horns.

Nevertheless, during the 19th century vaccines became central to public-health efforts in England, Europe and the Americas, and several countries began to require vaccinations.

Such a move didn’t sit comfortably with many people, who saw mandatory vaccinations as an invasion of their personal liberty. An antivaccine movement began to build and, though vilified by the mainstream medical profession, soon boasted a substantial popular base and several prominent supporters, including Frederick Douglass, Leo Tolstoy and George Bernard Shaw, who called vaccinations “a peculiarly filthy piece of witchcraft.”

In America, popular opposition peaked during the smallpox epidemic at the turn of the 20th century. Health officials ordered vaccinations in public schools, in factories and on the nation’s railroads; club-wielding New York City policemen enforced vaccinations in crowded immigrant tenements, while Texas Rangers and the United States Cavalry provided muscle for vaccinators along the Mexican border.

Public resistance was immediate, from riots and school strikes to lobbying and a groundswell of litigation that eventually reached the Supreme Court. Newspapers, notably this one, dismissed antivaccinationists as “benighted and deranged” and “hopeless cranks.”

But the opposition reflected complex attitudes toward medicine and the government. Many African-Americans, long neglected or mistreated by the white medical profession, doubted the vaccinators’ motives. Christian Scientists protested the laws as an assault on religious liberty. And workers feared, with good reason, that vaccines would inflame their arms and cost them several days’ wages.

Understandably, advocates for universal immunization then and now have tended to see only the harm done by their critics. But in retrospect, such wariness was justified: at the time, health officials ordered vaccinations without ensuring the vaccines were safe and effective.

Public confidence in vaccines collapsed in the fall of 1901 when newspapers linked the deaths of nine schoolchildren in Camden, N.J., to a commercial vaccine allegedly tainted with tetanus. In St. Louis, 13 more schoolchildren died of tetanus after treatment with the diphtheria antitoxin. It was decades before many Americans were willing to submit to public vaccination campaigns again.

Nevertheless, the vaccination controversy of the last century did leave a positive legacy. Seeking to restore confidence after the deaths in Camden and St. Louis, Congress enacted the Biologics Control Act of 1902, establishing the first federal regulation of the nation’s growing vaccine industry. Confronted with numerous antivaccination lawsuits, state and federal courts established new standards that balanced public health and civil liberties.

Most important, popular resistance taught government officials that when it comes to public health, education can be more effective than brute force. By midcentury, awareness efforts had proven critical to the polio and smallpox vaccination efforts, both of which were huge successes.

One would think such education efforts would no longer be necessary. After all, today’s vaccines are safer, subject to extensive regulatory controls. And shots are far more numerous: as of 2010, the Centers for Disease Control recommended that every child receive 10 different vaccinations. For most Americans, vaccines are a fact of life.

Still, according to a 2010 C.D.C. report, 40 percent of American parents with young children have delayed or refused one or more vaccines for their child. That’s in part because vaccines have been so successful that any risk associated with their use, however statistically small, takes on an elevated significance.

It also doesn’t help that, thanks to the Internet, a bottomless archive of misinformation, including Dr. Wakefield’s debunked work, is just a few keystrokes away. All of which means the public health community must work even harder to spread the positive news about vaccines.

Health officials often get frustrated with public misconceptions about vaccines; at the turn of the last century, one frustrated Kentucky health officer pined for the arrival of “the fool-killer” — an outbreak of smallpox devastating enough to convince his skeptical rural constituency of the value of vaccination.

But that’s no way to run a health system. Our public health leaders would do far better to adopt the strategy used by one forward-thinking federal health official from the early 20th century, C. P. Wertenbaker of the Public Health and Marine-Hospital Service.

As smallpox raged across the American South, Wertenbaker journeyed to small communities and delivered speech after speech on vaccinations before swelling audiences of townsfolk, farmers and families. He listened and replied to people’s fears. He told them about the horrors of smallpox. He candidly presented the latest scientific information about the benefits and risks of vaccination. And he urged his audiences to protect themselves and one another by taking the vaccine. By the time he was done, many of his listeners were already rolling up their sleeves.

America’s public health leaders need to do the same, to reclaim the town square with a candid national conversation about the real risks of vaccines, which are minuscule compared with their benefits. Why waste another breath vilifying the antivaccination minority when steps can be taken to expand the pro-vaccine majority?

Obstetricians, midwives and pediatricians should present the facts about vaccines and the nasty diseases they prevent early and often to expectant parents. Health agencies should mobilize local parents’ organizations to publicize, in realistic terms, the hazards that unvaccinated children can pose to everyone else in their communities. And health officials must redouble their efforts to harness the power of the Internet and spread the good word about vaccines.

You can bet that Wertenbaker would have done the same thing.

Michael Willrich, an associate professor of history at Brandeis University, is the author of the forthcoming “Pox: An American History.
”

A version of this op-ed appeared in print on January 21, 2011, on page A27 of the New York edition.

Immunizations - General Overview

Immunization (vaccination) is a way to trigger your immune system and prevent serious, life-threatening diseases.

Times Essentials

Recent findings and perspectives on medical research.

REPORTER'S FILE

A Multitude of Vaccine Benefits, Yet Controversy Persists

By DONALD G. McNEIL Jr.

Vaccinations have been one of the most important health advances in history.

EXPERT Q & A
Vaccinations Battling Disease; People Battling Vaccines
QUESTIONS FOR YOUR DOCTOR
What to Ask About Vaccinations
CLINICAL TRIALS
Selected Studies: Immunizations

See All »NEWS & FEATURES

REFERENCE FROM A.D.A.M.

Back to TopAlternative Names

Vaccinations; Immunizations - safety; How immunizations work

Back to TopInformation

HOW IMMUNIZATIONS WORK

When germs such as viruses or bacteria invade your body, your immune system makes special cells. These cells produce antibodies, which help destroy these germs. If all goes well, you get better. The next time your body is exposed to the same infection, your immune system often recognizes it and sets out to destroy it.

Immunizations work in much the same way. They expose you to a very small, very safe amount of a virus or bacteria that has been weakened or killed. Your immune system then learns to recognize and attack the infection if you are exposed to it later in life. As a result, you will either not become ill or have a milder infection. This is a natural way to deal with infectious diseases.

Newborns, babies, and toddlers are constantly being exposed to germs from: their parents and other adults, brothers and sisters, people in stores, and other children in child care. With travel easier than ever, you and your baby can be exposed to diseases from other countries without you knowing.

For a few weeks after they are born, babies will have some protection from their mother because some antibodies are passed from the mother to the baby through the placenta before birth. After this short period of time, these infections can cause severe illnesses in children and adults.

After immunizations were introduced on a wide scale, infections such as tetanus, diphtheria, mumps, measles, pertussis (whooping cough), and polio became rare. Newer immunizations have also decreased certain types of meningitis, pneumonia, and ear infections in children.

Four different types of vaccines are currently available.

Attenuated (weakened) live virus is used in the measles, mumps, and rubella (MMR) vaccine and the varicella (chickenpox) vaccine.
Killed (inactivated) vaccines are made from a protein or other small pieces taken from a virus or bacteria. These vaccines are safe, even in people with weakened immune systems. Influenza shots are an example of this type of vaccine.
Toxoid vaccines contain a toxin or chemical made by the bacteria or virus. They make you immune to the harmful effects of the infection, rather than to the infection itself. Examples are the diphtheria and tetanus vaccines.
Biosynthetic vaccines contain human-made substances that the immune system thinks are infectious organisms. The Hib (Haemophilus influenzae type B) conjugate vaccine is one example.

SAFETY OF IMMUNIZATIONS

Many parents are worried that some vaccines are not safe and may harm their baby or young child. They may ask their doctor or nurse to wait, or even refuse to have the vaccine. However, it is important to also think about the risks of not having the vaccination.

Some people believe that the small amount of mercury (called thimerosal) that is a common preservative in multidose vaccines causes autism or ADHD. However, studies have NOT shown this risk to be true.

The American Academy of Pediatrics, and The Institute of Medicine (IOM) agree that no vaccine or component of any vaccine is responsible for the number of children who are currently being diagnosed with autism. They conclude that the benefits of vaccines outweigh the risks.

All of the routine childhood vaccines are available in single-dose forms that do not contain added mercury.

The Centers for Disease Control and Prevention website provides further information.

Other risks include:

Some parents are worried that they or their child can get the infection from some vaccines, such as the MMR, chickenpox (varicella), or nasal spray flu vaccines. However, unless you have a weakened immune system, this is very unlikely.

Although very rare, allergic reactions to some part of the vaccines are possible.

Like many medications, there is always the chance that an immunization can cause side effects. However, deciding not to immunize a child also involves risk. The potential benefits from receiving vaccines far outweigh the potential risks.

After immunizations were introduced on a wide scale, infections such as tetanus, diphtheria, mumps, measles, pertussis (whooping cough), and polio became rare. All of these illnesses used to lead to lifetime disabilities, or even death.

Newer immunizations have also decreased certain types of meningitis, pneumonia, and ear infections in children.

Pregnant women may contract an infection that can be very dangerous to their fetus.

IMMUNIZATION SCHEDULE

The recommended immunization schedule is updated at least every 12 months by organizations such as the American Academy of Pediatrics. Consult your primary care provider about specific immunizations for you or your child. The current recommendations are available on the Centers for Disease Control and Prevention(CDC) website. At every doctor visit, ask about the next recommended immunizations.

Immunizations are not only for children. Each year the CDC posts recommended adult immunizations on their website. Go there to learn about tetanus booster shots, the flu shot, hepatitis A and B vaccines, the pneumococcal vaccine, MMR, and immunizations for chickenpox and meningitis.

TRAVELERS

The CDC website (www.cdc.gov) gives travelers detailed information on immunizations and other precautions. Many immunizations should be obtained at least a month before travel.

Remember to take your immunization records with you when you travel internationally. Some countries require this documentation.

Back to TopReferences

American Academy of Pediatrics Committee on Infectious Diseases. Recommended immunization schedules for children and adolescents--United States, 2008. Pediatrics . 2008;121(1):219-220.

Centers for Disease Control and Prevention. Recommended immunization schedule---United States, 2009. MMWR . January 9, 2009;57(53):Q1-Q4.

Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0 through 18 years---United States, 2009. MMWR . January 2, 2009;57(51&52);Q1-Q4.