Still Looking for a Champion: Reproductive Health Under the Obama Administration

When Barack Obama was elected president, reproductive rights advocates hoped that we had found a champion. We looked forward to working with an administration that had promised a solid commitment to women's rights, including a dedication to improved access to contraception and abortion services. This promise helped get Obama elected -- surely, we believed, he'd make good on it.

Two years later, we are deeply disappointed. The litany of broken promises is both deep and damaging. Instead of change we believed in, we got further restrictions on federal and personal funding for abortion; an unwillingness to advocate for meaningful healthcare reform that included reproductive healthcare services; and continued funding for abstinence-only sexuality education programs. The administration has paid lip service to the idea that it stands for and with women. While Republican action to deny women the rights we all fought for will have its own seat in the circle of hell, we must ask ourselves how we ended up in this position. The answer can perhaps be traced back to warning bells that should have sounded right at the beginning of Obama's presidency.

One might imagine that support for and increased access to family planning might be high on a list of priorities for a progressive administration. However, it quickly became apparent that President Obama really wasn't about to bring change after years of a Bush administration that trampled on women's rights. Rather, his promises to work with Republicans to solve the country's many crises meant that he'd jettison commitment to his own purported principles and instead start from their ideological positions to work toward so-called "common ground." Unfortunately for women, right on top of that list was the Republican Party's demonization of family planning. We should have seen it coming.

In January 2009, I joined about 30 people for a White House meeting to learn what we might expect as the administration got underway. We expected to hear how the administration would begin making good on what the campaign had promised women. When we arrived, however, the guest list gave us pause.

The White House had invited advocates for reproductive health, rights and justice including Catholics for Choice, NARAL Pro-Choice America, and the National Latina Institute for Reproductive Health, among others. But also invited were staunch conservatives opposed to abortion, contraception and comprehensive sexuality education, such as the Family Research Council, Democrats for Life, the National Abstinence Education Association and Concerned Women for America. Rev. Joshua DuBois, director of the White House Office of Faith-based and Neighborhood Partnerships, Tina Tchen, then director of the White House Office of Public Engagement, and Melody Barnes, staff director and member of the Domestic Policy Council were among the administration officials who were there, we were told, to listen--which, in retrospect, was precisely the problem.

The administration's commitment to listening didn't reflect an openness to new ideas, but rather a willingness to revisit failed policies, even those put forward by groups that opposed family planning and abortion rights. Melody Barnes told participants that the White House was interested in hearing ideas in several areas, including sex education, contraception, maternal and child health, pregnancy discrimination in the workplace and adoption. We have some solutions to many of these problems. They involve more and better resources. But the desire to appear in search of "common ground" meant that we merely started rehashing old debates.

The presenters began by asking questions like, "How do you deal with unintended pregnancies?" as if the answer could be formulated in a vacuum, rather than against a backdrop of proven strategies, statistics and science. One way to prevent unintended pregnancies is to provide easy access to a comprehensive range of family planning options and sexuality education. But many who spoke at that meeting vehemently oppose any method or program that does not prioritize abstinence -- exclusively or otherwise. Yes, abstinence may work for those who are happy being abstinent. For the rest of us, the majority, we deserve a realistic answer.

"You need to persuade us," intoned the Rev. DuBois on a number of occasions. Really? This was an administration that claimed a commitment to science and evidence-based interventions to improve the lives of Americans. Yet we had been invited to a meeting to "persuade" the White House that family planning requires more than abstinence-only-until-marriage programs. As you might have guessed, DuBois' plea quickly led the entire exercise into a wonderland inhabited by a nonsense-spouting Mad Hatter uttering bland middle-ground rhetoric and meaningless talking points.

Unsurprisingly given the lowest common-denominator approach of the administration, participants at this meeting and during several subsequent calls and meetings trotted out a mixture of the predictable and the unspeakable. We heard about improving access to and education about the use of contraception, including the promotion of natural family planning. There were suggestions about improving access to emergency contraception and promoting the "sacredness of sex." Numbers-obsessed anti-choice bureaucrats also proposed setting a concrete goal for abortion reduction, such as a 25 percent reduction in four years. Needless to say, we haven't seen anything that might improve women's access to family planning or abortion.

Granted, the White House created the Fatherhood and Mentoring Initiative and suggested that it would send support to the states for women who wanted to continue their pregnancies. Neither program is inherently wrong, but shoring up underfunded Title X programs would be a great place to start helping prevent unintended pregnancies, and investigating the reasons for family breakdown might prove more fruitful than lamenting a "crisis" of fatherhood, as Rev. DuBois is wont to do.

It's unclear where the administration's lack of commitment comes from. But in the absence of action, our hopes from two years ago have slowly eroded. Some argue that given the current economic and political situation, the administration cannot do anything to improve women's access to reproductive health services. But the president and his party had two years with majorities in both houses of Congress to permanently overturn the Global Gag Rule and significantly improve the situation as regards refusal clauses. The president could have done both, but chose not to expend political capital in doing so.

More fundamentally, however, the administration has adopted a political approach that fails to take a stand. We had hoped for the kind of leadership that begins with believing in something and then takes the risk of finding the supporters -- on both sides of the aisle -- who will stand with you. We have been disappointed.

Perhaps the White House is choosing to listen most closely to organizations such as the Democratic Leadership Council and its progeny like Third Way, which purports to offer an alternative political approach, "one that discards the false choices presented by both sides." They claim to speak to "the vital center -- moderates." However, as pollster John Russonello notes, "the center is simply malleable, not vital."

Tellingly, Third Way's abortion strategy states, "Policies to prevent unintended pregnancies include: comprehensive sex education with an abstinence emphasis." Read that again. An allegedly progressive ally of the Democratic Party wants us to emphasize abstinence in sexuality education programs. There may well be something rotten in the state of Denmark.

Sadly for those who do advocate for abortion rights, the Democratic Party is apparently also listening closely to the U.S. bishops. During the healthcare reform debate we were told that Nancy Pelosi and other Democratic leaders had representatives of the United States Conference of Catholic Bishops in backroom meetings with them drafting compromise proposals. Asking for advice on abortion from people who are fundamentally opposed to all abortion epitomizes the abrogation of leadership. And that is not what the American people want to see.

Another possibility is that President Obama is not the leader we thought he would be. Russonello, a founding partner at the firm Belden Russonello and Stewart, explained why the absence of strong, consistent presidential actions is problematic. "People expect the president to lead. The problem so far for President Obama has been that the country elected him because they wanted demonstrable change from the Bush policies -- change they can see. But so far, he has not been all that different than Bush."

Russonello outlined three specific examples of areas in which Obama had failed:

  • On the most important issue, the economy, he refused to hold anyone on Wall Street accountable for the behavior that caused millions of people to lose their jobs. Prosecuting five investment bankers instead of lending them taxpayers' money to continue in operation would have accomplished more for his ability to boost the economy than the billions spent on the stimulus bill. People were stunned that he gave Wall Street a pass.
  • On taxes, he said he would not go along with the Bush tax breaks to the wealthy -- then he capitulated without a fight.
  • On healthcare, he took a seat in the bleachers and watched public derision rise over congressional horse-trading, producing a law that did not lower people's health insurance premiums.

In contrast to previous presidents, Russonello concluded, "President Obama has taken weak positions on everything -- so everything is up for grabs. He has already been marked as a softy."

President Obama's failure to lead on the reproductive rights front has exemplified the high price of standing still. In early 2011, a political argument broke out over some heavily doctored, dishonestly acquired video footage of the activities of a handful of Planned Parenthood staff. As a result, in a foot-stomping, petulant huff, the House of Representatives defunded the entire Title X program. We have been assured that President Obama would never sign such legislation, but did he call out the Republicans and Democrats who supported the move? No. And when it comes to abortion, we are being offered the choice of two evils: an all-promise, no action option from the Obama administration and a slash-and-burn option from the Republican leadership.

Writing in Politico, John Harris and James Hohmann expressed Obama's problem succinctly. "By declining to speak clearly and often about his larger philosophy -- and insisting that his actions are guided not by ideology but a results-oriented 'pragmatism' -- he has bred confusion and disappointment among his allies, and left his agenda and motives vulnerable to distortion by his enemies."

John Russonello contrasted Obama's leadership style with Ronald Reagan's. In 1981, Reagan fired 11,000 striking air traffic controllers when they refused to return to work. After Reagan was informed that 85 percent of Americans were against him, he is said to have replied that he would just have to go out and convince them that he was right. He did, and went on to become immensely popular. It was a signal to the whole country that the new president was not to be trifled with and resonated with Congress and the public throughout his two terms in office.

"While I completely disagree with what Reagan did," Russonello continued, " It is obvious that ability to lead was never in doubt. On the other hand, President Obama never laid out any markers during the healthcare debate about what he wanted, so he didn't get any of the things that he promised us during the campaign. Those who say we made progress may be right, but it's not the progress we were promised. If presidents don't lead they necessarily follow."

A recent Pew poll shows that Americans prefer a leader who refuses to compromise. The poll found that 54 percent of voters state that they like elected officials who stick to their positions, while 40 percent prefer officials who make compromises with people with whom they disagree. Perhaps unsurprisingly, more Republicans were of the former view than Democrats.

Not everybody is as surprised or disappointed with the Obama administration's record. Clare Coleman, the president and CEO of the National Family Planning & Reproductive Health Association (NFPRHA), says that she did not have huge expectations when Obama was elected. Nonetheless, she believes that "overall he has delivered, but not in the time frame that we would expect." Coleman rejects the idea that there has ever been a golden age when it was easy to be an advocate for reproductive rights on Capitol Hill. However, she acknowledges, a significant barrier has arisen because "the administration has accepted the opposition's view that family planning is controversial."

Coleman noted that while Congress has moved to the right--with far fewer moderate Republicans and fewer but more entrenched antichoice Democrats -- it has led, paradoxically, to more discussions about family planning on both sides of the aisle. Whether that has long-term benefits is unknowable at this time, but it has not led to any short-term victories. Just ask Planned Parenthood clinics, or Coleman's own NFPRHA, both of which rely on the now-embattled Title X program to ensure that women, especially low-income women, have access to family planning.

Unfortunately, it appears that we never managed to get out of that room in which we first met in January 2009. Progressives are still receiving the same bland assurances that we are being heard while we continue to debate the same questions. Meanwhile, an economic downturn has been met with an uptick in conservative anti-choice legislation. Beyond the concern about reproductive freedom, the long-term damage of being served by an administration that does not deliver and that does not even dare articulate publicly what it claims to believe in private has yet to be discovered.

As I write, President Obama is announcing his bid for reelection. I expect we'll be hearing more promises about improving the lives and health of women in this country, whether through education and family planning, or support for women who want to continue a pregnancy as well as for those who do not. The new campaign website asks, "Are you in?" Perhaps a better question is, "Mr. Obama, are you?"

Jon O'Brien is the president of Catholics for Choice.

This article originally appeared in Conscience magazine