Top Birth Control Stories 2007

“Would you find out what my position is on contraception? I’m sure I’m opposed to government spending on it, I’m sure I support the president’s policies on it.”
Presidential candidate John McCain asking for help from an aide when questioned by a reporter about his position on condoms.

As we look forward to a new year I’ll publish a series of blogs on 2007 - what were the top story lines on issues like birth control and HIV? Who were the most prominent journalists? Who were the most prominent advocates?

Birth control had a particularly robust news year - I’ve ranked the top stories below. Republican Presidential candidates Mitt Romney and Mike Huckabee generated a persistent storyline about voters and reproductive health care. The big stories focused on teens and sex, ranging from the pregnancy of Jamie Lynn Spears to providing birth control to middle school students. This was the year when abstinence only programs fell out of favor, and when access to emergency contraception dominated center stage. The Pope had a rough year - his admonitions about birth control were resisted by the nation of Chile as well as Brazilian native and supermodel Giselle Bundchen, and his plea for pharmacists to resist filling prescriptions for emergency contraception were immediately followed by new state regulations that strengthened access to EC.

Researchers concluded that:
- Abstinence-only programs don’t work,
- Patients lie to doctors,
- Doctors lie-by-omission to patients,
- The teen birth rate dropped,
- The nation’s fertility rate increased,
- Men have more sex partners than women,
- Heavier women are underrepresented in studies on birth control technologies.

Animal birth control was big in the news this year; stories included the relative merits of birth control for elephants, cats, wild turkeys, stray dogs, deer, pigeons and squirrels. California and Iowa lawmakers considered new regulations to oversee animal birth control. Interesting one-day stories included the reversal of a judge’s ruling that a homeless couple could not bear children until they could prove themselves fit, a $5,000 fine paid by Rhode Island College for removing signs that read “Keep Your Rosaries Off Our Ovaries”, and a 76-year old Utah woman convicted after giving unsolicited birth control advice at a bus station (she promised to complete her community service sentence at Planned Parenthood). In pop culture, the movies Knocked Up and Juno made headlines about unplanned pregnancy. Finally, rumors (predictably) continued about Princess Diana and her reproductive health.

New technologies in the news this year were Lybrel (hormonal birth control that eliminates monthly bleeding), Seasonale (a three month pill), the Today Sponge (spermicidal and barrier contraceptive), and Essure (permanent birth control). Health hazard stories included a report on the adverse impact of a particular heart medicine when mixed with hormonal birth control. Disputed allegations included claims about the risks of the cervical cancer vaccine as well as criticism of low dose birth control pills. Finally, the hormonal birth control Yaz received FDA approval for use as an acne treatment.

On the international front, Brazil created new access to birth control for the poor, Chile warned pharmacists they must dispense EC despite the Pope’s directive otherwise, opponents of China’s one-child birth policy made headlines (and headway), and early abortion was legalized in Portugal and Mexico City.

Here is a ranking of most prominent birth control storylines for 2007. I evaluated the level and prominence of coverage each month - while some stories were remarkable, they had a short media life and therefore ranked lower.

(1) Emergency Contraception
(2) Pharmacist Refusals
(3) Rejection of abstinence-only funding by states
(4) Teen birth rate statistics
(5) Mitt Romney, Mike Huckabee, Hillary Clinton, and other candidates
(6) Maine School Board and birth control for middle school students
(7) The pregnancy of teen Jamie Lynn Spears
(8) Birth control pricing
(9) Keroack’s resignation, Susan Orr’s appointment to head family planning programs
(10) Hormonal birth control for wild animals

For those of you deeply interested in birth control stories, here’s a rundown of month-by-month media events. This summary doesn’t indicate the most important birth control stories, only those given the most notice by the mainstream media:

January top stories: Emergency contraception plus FDA guidelines.
In January a college student was jailed for two days after reporting a rape, and jail officials refused to administer emergency contraception. New York City launched an official city condom. The FDA considered new guidelines that drug makers could follow when seeking approval for birth control, and recommended that more heavy women be used in studies. Much of the Roe v Wade anniversary media coverage included a focus on emergency contraception. Chilean courts blocked free access to emergency contraception, however access was later restored.

February top stories: Emergency contraception plus patients lie to doctors, doctors lie to patients.
In February the FDA Office of Women’s Health budget was cut. Oregon policymakers considered the idea of state funding for birth control. South Dakota legislators rejected an attempt to require hospitals to inform rape victims about emergency contraception. Representatives DeLauro and Ryan introduced the “Reducing the Need for Abortions and Supporting Parents” Act, which sought to expand family planning and adoption access. Senator Reid and Reps Slaughter and DeGette re-introduced the “Prevention First Act.” A study by researchers at John Hopkins University found that large numbers of patients lie to their doctors. The University of Chicago released a study that found that many doctors feel no obligation to inform patients about legal medical options if they have a personal or moral objection to them. The John Edwards Presidential campaign became embroiled in a controversy about anti-Catholic comments posted by some bloggers on staff. The advocacy group Public Citizen called on the FDA to pull certain low dose birth control pills off the market.

March top stories: Keroack resigns, emergency contraception at the state level.
In March, Erik Keroack resigned as the head of the nation’s family planning programs after an almost 5-month embattled tenure. Chinese officials warned residents about adhering to the strict family size laws. Medicaid funding for family planning was in the news, as well as the high price of birth control on campuses. Representatives Lee and Shays, along with Senator Lautenberg, introduced the “Responsible Education About Life Act” to promote comprehensive sex education. Some major pharmacies (most notably Eckard) came under fire for not making emergency contraception available. Birth control advocates lost in their legal case against Union Pacific Railroad, which did not include contraceptives in their health plan but did include other prescription coverage. Colorado Governor Ritter signed legislation requiring hospitals to inform rape survivors about emergency contraception.

April top story: Abstinence-only not working.
In April the US Dept of Health and Human Services issued a report that concluded abstinence only programs are not working. Senator Clinton re-introduced the Compassionate Assistance for Rape Emergencies Act, which would make emergency contraception more available, as well as the Unintended Pregnancy Reduction Act. The Governor of Massachusetts proposed giving up that state’s federal abstinence only funding. A Harvard University study concluded that no link exists between breast cancer and abortion. The Center for Immigration Studies released a study that concludes out-of-wedlock births for Hispanic immigrants has more than doubled since 1980. The Washington State Board said that pharmacists were not allowed to refuse emergency contraception to customers. Mexico City lawmakers voted to legalize early abortion.

May top stories: Lybrel approved, Brazil defies the Pope
In May Oregon Governor Kulongoski signed legislation strengthening access to birth control in health insurance plans. Brazil’s leaders defied the Pope and offered free hormonal birth control to poor residents. The FDA approved Lybrel. Opponents of Gardisil pushed stories about adverse incidents related to the vaccination. Farmers protested in China over family planning laws. The Pope said that pro-choice lawmakers should be denied sacraments. Presidential Candidate Giuliani’s positions on birth control were back in the news. President Bush warned lawmakers that he would veto any “abortion measures”. Connecticut Governor Jodi Rell supported legislation requiring hospitals to offer emergency contraception to rape victims.

June top stories: emergency contraception legislation, a supermodel defies the Pope
In June a new study detailed the average number of sex partners for men and women (men have more than women). The Reagan-era Mexico City policy which bans contraception aid to overseas groups that also provide abortion took center stage in Congress. A YMCA after school program for at-risk adolescents visited a Planned Parenthood clinic and sparked local backlash. Rep Slaughter and others pushed the Prevention First Act to the forefront. Representative Maloney and Lautenberg introduced federal legislation to prevent pharmacist refusals, titled the “Access to Birth Control” act. Supermodel Giselle Bundchen became a vocal opponent of the Vatican’s opposition to condom use.

July top stories: teen birth rate, birth control pricing on campus
In July a federal agency issued a report which found that the teen birth rate was at a record low. Former Surgeon General Richard Carmona accused the Bush administration of censoring him on issues such as emergency contraception and abstinence only education. Pharmacists sued over state regulations that required them to fill emergency contraception prescriptions. The issue of birth control pricing on campuses was center stage. Senator Clinton introduced legislation that would enable servicewomen to access emergency birth control. Democratic Presidential candidates appeared at a Planned Parenthood gathering, sparking news coverage of their focus on prevention (compared to abortion).

August top story: emergency contraception anniversary.
August marked the one-year anniversary of over-the-counter designation for emergency contraception, sparking widespread media coverage as well as the introduction of federal legislation aimed at increasing education about EC. A New York survey found that teens in that state are less likely to use birth control - followed by a September report that showed difficulties for teens trying to access birth control. Abstinence funding in Oklahoma was in the news,

September top stories: birth control costs on campus and at major pharmacies.
Target and Wal-Mart were in the news for their cheap prescription coverage, including birth control. New York joined the list of 11 states rejecting abstinence-only funding. The new Planned Parenthood clinic in Aurora was widely covered in the news; although the storyline focused on abortion opponents, many news reports included data on prevention services provided at the center. A report found that doctors are not sufficiently warning women about the pregnancy risks posed by certain prescription drugs. The rising cost of birth control - particularly on campuses - was in the news.

October top stories: Portland Maine middle school students get birth control, the pope fuels support for pharmacy refusals.
In October the Portland Maine school board ignited a firestorm when it voted to allow middle school students to access birth control from the school-based health center. Also in October, the Pope urged pharmacists to refuse to fill birth control prescriptions, and anti-birth control leaders failed in their attempt to cut off all funding for clinics that provide family planning. The candidates continued to receive coverage on birth control issues; Fred Thompson spoke at the Family Research Council’s Voter Values Summit, and Hillary Clinton teamed up with family planning advocates to denounce the appointment of Susan Orr to head the nation’s family planning programs. Finally, the Supreme Court declined to take on the legal precedent that is requiring some religious organizations to include birth control coverage in their health plans.

November top stories: mix
In November no single story emerged as uniquely prominent. The Portland middle school story continued, as well as stories about access to emergency contraception. It was a month of many story lines gaining steam: abstinence only program failures, the need to expand access to emergency contraception, birth control in schools, and birth control pricing. Just days after the Pope urged pharmacists to resist filling prescriptions for emergency contraception, New Jersey Governor Corzine signed legislation that requires pharmacists to accommodate EC patients. The Wall Street Journal took a peek at the emergence of text messaging for health care communications.

December top story: Jamie Lynn Spears announces teen pregnancy.
In December the pregnancy of Jamie Lynn Spears sparked widespread focus on teen sex and birth control access. A New Hampshire editorial board’s non-endorsement of Romney generated a wave of coverage, and states rejecting abstinence only funding made news nationwide.

Coming soon: the most influential voices in birth control.
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Top Bloggers

Forbes recently published their end-of-year list of top blogs. The Forbes list stands out because it focuses on blogs that generate their fame primarily from the blogosphere. That means popular bloggers like author Arianna Huffington and journalist Michelle Malkin are disqualified from the list. This seems a bit random, but it is an attempt to evaluate the blogosphere more distinctly.

Not surprisingly, the blogosphere looks a lot like traditional media when it comes to diversity of voices. With the exception of age, (the average on this list is 37), the lack of diversity is glaring. Of the top 25 blogs identified by Forbes, 88% are published by men and 92% are published by caucasian bloggers. Studies show that women are more likely than men to publish blogs, but about 85% of editors of top blogs are male. That’s not surprising when you evaluate the portfolios of the top bloggers. While some have simply produced a high quality product that fits an unmet need, many come from the top ranks of corporate America, including a corporate attorney, a Microsoft executive, a Forbes editor, and a Senior Vice President at the global PR firm Edelman. Number two on the list - Michael Arrington - is a graduate of Stanford Law and a millionaire corporate executive. Many are accomplished authors.

Media ownership has always been overwhelming caucasian and male. According to a Benton Foundation report on radio and television station ownership, women account for only 3.4% of owners and minorities account for only 3.6%. Of those women and minority-owned stations, most are in rural areas and small towns.

Diversity failures also persist in television news. Only about one in ten of the Washington DC press corp are minorities. Public affairs programs that promote opinion - much like blogs - are male dominated. For example, on C-Span’s Washington Journal only 20% of the guests are women, and only 3% are women of color. About 8% of guests on Sunday morning talk shows are African American.

What does all this add up to? A world - both online and offline - that is dominated by caucasian male expertise and opinion. A lot of viewers and readers are finding that content enjoyable - but perspective from the full range of diverse voices can only serve to make public engagement more meaningful. A London-based group called openDemocracy is trying to change diversity and the media by sponsoring a site that is “read and used equally by women and men”. They promise to be “a source for the media for analysis, debate and discussion of global affairs”. Famous contributors have included dutch feminist Ayaan Hirsi Ali and former Secretary-General of the United Nations Kofi Annan.

Two of the top 25 Forbes bloggers are affiliated with the Electronic Frontier Foundation (EFF), a legal advocacy group focused on the web. EFF has an excellent legal resource for bloggers (w2.eff.org/bloggers). If you write or manage a blog, it’s a good idea to make sure you understand your rights and vulnerabilities. Can you be sued for defamation when you criticize a public figure? Does the first amendment apply to you? Can you get a press pass as a blogger? The site gives you guidance on dozens of useful ways to protect yourself as a blogger as well as tips to assert your rights as a blogger.

Civil rights on the web is an emerging and important area of engagement. EFF has spent the last 17 years focused on legal advocacy for online users, including such causes as establishing that electronic mail deserves at least as much privacy protection as telephone calls and ensuring that bloggers have the same free speech rights as traditional journalists.

You Can’t Pour Perfume on a Skunk

This is the time of year for “best” and worst” lists - and there’s plenty in the world of communications. In 2007 a US Senator explained that he had a “wide stance” in the bathroom stall, and US Attorney Alberto Gonzales repeatedly said “I can’t recall”. Several big corporations published fake blogs, and plagiarism at student newspapers was on the rise.

PR expert and author Fraser Seitel predicts that the current Bush administration will be known as the worst PR administration in history. In case you aren’t familiar with Seitel or his classic “The Practice of Public Relations”, his politics are Republican, and he voted for Bush twice. As a public relations professional, however, Seitel is anything but a loyal Bushie. Seitel recently used the famous skunk analogy to describe the White House attempts to put spin on failed administration policies. One of his key critiques of the administration - in addition to describing Bush as “virtually inarticulate”, is the lack of candor. A basic PR premise is that if mistakes are made you acknowledge them and maintain your credibility with the public, “the cardinal rule [in public relations] is you never lie”.

Not every communications professional followed Seitel’s advice this year. Among reporter gaffes were a San Antonio columnist caught plagiarizing from Wikepedia, and a CBS News producer plagiarizing from the Wall Street Journal. A kid got caught in the plagiarism tangle when he/she sent in a poem to the Washington Post, not realizing the submission was supposed to be original.

But the media error of the year had to be a Russian submarine story first produced by the Russian TV Network and distributed worldwide by Reuters. A 13-year-old Finland boy noticed that the submarine footage was actually swiped from the hit movie Titanic, prompting NBC Nightly News and others to run corrections. You can find this and other terrific information about media errors from regrettheerror.com, which is published by Craig Silverman, author of Regret the Error. According to Silverman, newspapers have an error rate ranging from 40-60%.

Peewee Social Networking

Nielsen Online recently published a list of the nation’s most popular social networking sites and blogs. Not surprisingly, Facebook grew by 125% over the last year to become ranked second (behind MySpace). Classmates.com is not yet on the top list of competitors, but it’s on the verge of a major public offering, hoping to raise $144 million and touting itself as one of the few social networking sites that is actually profitable.

But the biggest winner may be a little surprising. Club Penguin grew by 157% to become the 9th largest social networking site.

Most people with kids know Club Penguin - it’s a site aimed at preteens, where players earn “money” by doing activities and then “purchase” things like houses and clothing. Disney bought Club Penguin in August of this year for a whopping $350 million.

In addition to the sizeable subcription fees that Club Penguin pulls in (more than 12 million registered users, many who choose to subscribe at $60 per year), Disney now has the most significant access to the generation that is growing up with MySpace and Facebook. Today’s pre-teens won’t consider social networking to be “new communications technologies” - rather this style of engagement will be as routine as home computers and cell phones. Disney is so confident in its profit potential that the company has already publicly discussed investing an additional $350 million in the site’s promotion.

In response to concerns raised by parents about the promotion of consumerism on these sites, Club Penguin spokesperson Karen Mason called criticism “ridiculous” and said “What we’re doing is teaching children to make smart choices they are going to need to make in the real world.”

Disney touts the fact the site is free from advertising - but it does sell products that bring the virtual world to life. And kids will now see the Disney logo while they are waddling through their private penguin club - in fact the web name is formally changing to “Disney’s Club Penguin”.

Disney’s not stopping at social networking for children. Its on the verge of launching “d-mail (a branded email service for kids) and “d-phone”, an instant messaging product. Disney hopes to use “d-phone” to boost its online newsletter “daily blast”. Disney’s goal is to be the largest internet subscription service in the world by the end of the year.

It’s old news that kids are big business, and that every day we teach them how to consume like adults. Every school morning you can find my son and a cluster of other 10-year olds at a small café next door to their school, sipping “baby Chino’s”, which looks a lot like delicate cups of coffee but which actually is steamed milk and sugar. It’s a pretty safe bet these kids will graduate to real coffee by adulthood.

I wish Mason hadn’t called parent’s concerns “ridiculous”. Nevertheless, her claim that Club Penguin is “teaching kids to make smart choices that they are going to need to make in the real world” is a compelling quote. I don’t know how decorating an igloo with penguin money is teaching my child anything worthwhile. But for those who are in the business of advocating for kids, whether that be their health or their education or their safety or their opportunities, we need to find a way to keep up with new technologies. If Disney can use cell phones and computers to teach kids about smart choices, then so can we.