When the Supreme Court’s decision undoing Roe v. Wade came down in June, anti-abortion groups were jubilant – but far from satisfied. Many in the movement have a new target: hormonal birth control. It seems contradictory; doesn’t preventing unwanted pregnancies also prevent abortions? But anti-abortion groups don’t see it that way. They claim that hormonal contraceptives like IUDs and the pill can actually cause abortions.
One prominent group making this claim is Students for Life of America, whose president has said she wants contraceptives like IUDs and birth control pills to be illegal. The fast-growing group has built a social media campaign spreading the false idea that hormonal birth control is an abortifacient. Reveal’s Amy Mostafa teams up with UC Berkeley journalism and law students to dig into the world of young anti-abortion influencers and how medical misinformation gains traction on TikTok, Instagram and YouTube, with far-reaching consequences.
Tens of millions of Americans use hormonal contraceptives to prevent pregnancy and regulate their health. And many have well-founded complaints about side effects, from nausea to depression – not to mention well-justified anger about how the medical establishment often pooh-poohs those concerns. Anti-abortion and religious activists have jumped into the fray, urging people to reject hormonal birth control as “toxic” and promoting non-hormonal “fertility awareness” methods – a movement they’re trying to rebrand as “green sex.” Mother Jones Senior Editor Kiera Butler explains how secular wellness influencers such as Jolene Brighten, who sells a $300 birth control “hormone reset,” are having their messages adopted by anti-abortion influencers, many of them with deep ties to Catholic institutions.
The end of Roe triggered a Missouri law that immediately banned almost all abortions. Many were shocked when a major health care provider in the state announced it would also no longer offer emergency contraception pills – Plan B – because of a false belief that it could cause an abortion. While the health system soon reversed its policy, it wasn’t the first time Missouri policymakers have been roiled by the myth that emergency contraception can prevent a fertilized egg from implanting and cause an abortion. Reveal senior reporter and producer Katharine Mieszkowski tracks how lawmakers in the state have been confronting this misinformation campaign and looks to the future of how conservatives are aiming to use birth control as their new wedge issue.
Dig Deeper
Read: Inside Anti-Abortion Groups’ Campaign to Sell Women on Unreliable Birth Control ‘Alternatives’ (Mother Jones)
Watch: The Pill (PBS)
Read: Transcript of the FDA’s 2003 joint advisory committee meeting to consider making Plan B available over the counter
Explore: Research by Christopher ChoGlueck – The FDA Oughta Change Plan B’s Label [Contraception]; Drug Facts, Values, and the Morning After Pill [Public Affairs Quarterly]; Broadening the scope of our understanding of mechanisms: lessons from the history of the morning-after pill [Synthese]
Credits
Reporters: Amy Mostafa, Kiera Butler and Katharine Mieszkowski | Lead producer: Katharine Mieszkowski | Producers: Amy Mostafa and Richard Yeh | Editor: Cynthia Rodriguez | Fact checker: Nikki Frick | Production manager: Amy Mostafa | Digital producer: Sarah Mirk | Original score and sound design: Jim Briggs and Fernando Arruda, with help from Kathryn Styer Martínez and Claire Mullen | Interim executive producers: Brett Myers and Taki Telonidis | Host: Al Letson
This episode was a collaboration with UC Berkeley’s Human Rights Center and Investigative Reporting Program, including Leah Roemer, Emma MacPhee, Elizabeth Moss, Anabel Sosa, Zhe Wu, Gisela Pérez de Acha, Brian Nguyen, Eliza Partika and Eleonora Bianchi. Special thanks to Reveal Features Editor Nina Martin and 2021-22 Roy W. Howard investigative reporting fellow Grace Oldham.
Transcript
Reveal transcripts are produced by a third-party transcription service and may contain errors. Please be aware that the official record for Reveal’s radio stories is the audio.
| Al Letson: | From the Center for Investigative Reporting and PRX, this is Reveal. I’m Al Letson. When Roe v. Wade was overturned in late June, there was a group of young people outside the Supreme Court celebrating. |
| Crowd: | [inaudible] |
| Al Letson: | These teens and 20-somethings stood out because they were young, organized, and unapologetically anti-abortion. |
| Crowd: | Pro life is pro woman! Pro life is pro woman! |
| Al Letson: | Their signs said it all. The future is anti-abortion and I am the post-Roe generation. Many were part of a group called Students For Life. |
| Speaker 3: | I drove down here for Students for Life, and I’m excited. You can see the celebration, but we all know this is not where the work ends. This is where it begins. |
| Al Letson: | The constitutional right to an abortion has just ended, but for many in the anti-abortion movement, it isn’t enough. They’re pushing the culture war further and attacking something millions of people rely on every day, hormonal birth control. |
| It seems, well, contradictory, why would you oppose abortion and also be against contraception? Wouldn’t preventing unwanted pregnancies also prevent abortions? But groups like Students for Life don’t see hormonal birth control as a way to prevent abortions. They see things like IUDs and even the pill as causing abortion. Kristan Hawkins is the president of Students for Life of America. Back in 2017, MSNBC’s Joy Reid prodded Kristan on her position on birth control. | |
| Joy Reid: | Do you think IUD should be illegal? |
| Kristan Hawkins: | I don’t think they should be legal. |
| Joy Reid: | Interesting. All right. Well- |
| Kristan Hawkins: | They put women at risk and they kill children. |
| Joy Reid: | Wow. What about the birth control pill? |
| Kristan Hawkins: | I do not think it should be legal. Actually, I think that it shouldn’t be legal, but that’s not what we’re talking about in the pro-life movement. |
| Joy Reid: | No, no, no. |
| Kristan Hawkins: | Nobody in the pro life movement… |
| Al Letson: | Kristan doesn’t really want to talk about birth control and tries to change the subject. Joy keeps pushing. |
| Joy Reid: | Kristan, Kristan, Kristan, Kristan, Kristan, Kristan. We can’t talk at the same time. I just wanted to get just clarity. You think that the pill and the ID should be illegal, right? |
| Kristan Hawkins: | In my ideal world, yes, but I don’t think that’s actually something we’re working towards in the pro-life movement. |
| Al Letson: | But that was five years ago. This year, Students for Life has been on social media doubling down on the idea that birth control is harmful and can cause abortions. Reveal’s Amy Mostafa digs into where this medical misinformation came from and how it’s spreading. |
| Amy Mostafa: | Students for Life is becoming the new face of the anti-abortion movement. The group has a large staff and a bigger budget than many other anti-abortion organizations. And Students for Life has a large social media following. To understand what makes the group popular, it’s important to meet influencer, Autumn Higashi. |
| Autumn Higashi: | I was 16 years old when I first began in the pro-life movement. I saw a Teen Vogue article pop up on my Facebook feed one day titled, What To Get A Friend Post-Abortion. I sat down and I wrote a 10-minute response video because I was furious. |
| Amy Mostafa: | The video looks like it was shot in a dark room. Autumn is dramatically lit from behind. She’s wearing a blazer and sort of looks like a serious young attorney. She criticizes Teen Vogue for suggesting gifts like a heating pad, a Ruth Bader Ginsburg coloring book or a funny movie. |
| Autumn Higashi: | How offensive to think a comedy would be a good antidote for the pain your friend might be feeling. You know when this would be appropriate? After your friend got their wisdom teeth taken out, not after they’ve had an abortion. |
| Amy Mostafa: | Students for Life picked up that video and it has over 400,000 views. Today, Autumn’s a spokesperson for the group. |
| Annabel Sosa: | It didn’t take that long for me to find these videos. |
| Amy Mostafa: | That’s Annabel Sosa. She’s part of a team of UC Berkeley Law and Journalism students who’ve been helping Reveal report on reproductive rights this last year. She says, Students for Life strategy involves reaching out to a younger demographic on TikTok and Instagram. |
| Annabel Sosa: | It’s really smart. You want it to reach high schoolers because they’re most impressionable and also they are going to repost and they’re going to engage with social media. |
| Amy Mostafa: | The group also recruits young people on school campuses from graduate schools all the way down to middle schools. Students for Life got its start on a school campus decades ago. |
| Elizabeth Moss: | They were founded in 1988 at Georgetown University. |
| Amy Mostafa: | That’s Elizabeth Moss, who goes by Moss. She’s part of the Berkeley team helping with research. Moss points out that Students For Life isn’t just a tiny student-run organization. |
| Elizabeth Moss: | There’s also Students for Life Action, which is a 501(c)(4), meaning they can lobby our legislatures. And through Students for Life Action, they also are responsible for writing some life at conception bills. |
| Amy Mostafa: | These state laws that were passed ban abortion from the moment of fertilization. Students for Life also has built some serious political clout, like the Federalist Society’s Leonard Leo, who handpicked Donald Trump’s three conservative Supreme Court justices. He’s on the board of Students for Life. Moss says it took a while for the group to gain this kind of power though, and it really coincided with them recruiting one of today’s anti-abortion movement superstars. |
| Elizabeth Moss: | The organization they are today really starts with Kristan Hawkins when she joins in 2006. |
| Amy Mostafa: | Moss pulls up the nonprofit’s 990 tax form on her computer to show me how the organization begins to increase its revenue once Kristan joins. In 2006, they made just shy of 200,000 and by 2008, it’s $1 million. |
| Elizabeth Moss: | And then they’re doubling their revenue to just under $12 million a year. |
| Amy Mostafa: | It’s not just about revenue growth. |
| Elizabeth Moss: | Kristan Hawkins is Students for Life. |
| Amy Mostafa: | Kristan knows how to draw a crowd on social media. Annabel plays me this viral video, it’s called Pro-Choice or Defeated by Simple Logic, and it has 2.3 million views on YouTube. |
| Kristan Hawkins: | When does the fetus become living? |
| Speaker 10: | When it’s born. |
| Speaker 11: | That’s actually a good question, but that line- |
| Speaker 12: | Yeah, of course, because you don’t know it because it living. |
| Speaker 13: | You actively deny science, ma’am. |
| Kristan Hawkins: | How am I? What science did I deny? |
| Speaker 13: | That it’s a child inside of you. |
| Amy Mostafa: | The student describes that child as a clump of cells. |
| Kristan Hawkins: | When does this clump of cells or fetus become living? |
| Speaker 13: | When it can sustains its own life. |
| Kristan Hawkins: | But when is the sustainability? My newborns aren’t sustainable. |
| Amy Mostafa: | Understanding exactly when Students for Life believes a group of cells becomes a life is really important because it’s the way the group justifies opposing many forms of birth control. Here’s Autumn explaining when she thinks life begins on Students for Life’s TikTok. |
| Autumn Higashi: | An egg, not a human being, a sperm, not a human being. They unite at conception and there create a unique life that has never existed before and will never exist again. |
| Amy Mostafa: | For Students for Life and many other anti-abortion activists, this moment of conception is when a life begins and therefore when a pregnancy begins. This is a religious idea, not a medical or scientific one. But for Students for Life, it means that anything that interferes or even has the chance of interfering with a fertilized egg is an abortion. The group explains this line of reasoning in a video about birth control pills and IUDs. |
| Stuents for Lif…: | If you’re using hormonal contraception, you are very likely using an abortifacient. This means that you could actually be causing an abortion without knowing it. Let’s review how some types of contraception can, in fact, cause an abortion. The pill is one of the most well-known forms of birth control. The pill can work by making it less likely an egg will be fertilized, but it can also prevent implantation of the fertilized egg. Since life begins at conception, this means it changes the body’s chemistry to reject a fertilized egg, which is the same as an abortion. Surprised? The American calling- |
| Elizabeth Moss: | Yeah, so I think this is the part of the show where you cue the medical expert to go over this video. |
| Amy Mostafa: | Moss is right. So we called up Diana Blythe. |
| And then when did you join NIH? | |
| Diana Blythe: | Oh, a long time ago. I joined in 1982. |
| Amy Mostafa: | Blythe works for the National Institute of Child and Human Development, a branch of the NIH or National Institutes of Health. She’s the chief of the Contraceptive Development Program there, and she’s been doing government research for decades under both Republican and Democratic administrations. |
| Diana Blythe: | We’re currently developing a male contraceptive gel that’s a combination of two hormones in a single gel. |
| Amy Mostafa: | Now at this point, I’m definitely imagining Spy Kid’s level labs and contraptions, but I want to stay focused on the Students for Life video. I played it for Blythe. |
| Stuents for Lif…: | There are other forms of hormonal contraception, but most of them work the same way. While preventing fertilization is one thing, preventing implantation is the same as causing an abortion. Many people don’t know this. Like and share this video to help inform others. |
| Diana Blythe: | Well, it’s not based on scientific data, it’s based on speculation that these things might happen. |
| Amy Mostafa: | Speculation that a fertilized egg might fail to implant. But Blythe tells us that hormonal birth control, like the pill and emergency contraception, primarily works by preventing ovulation, meaning there’s no egg to fertilize to begin with. Hormonal IUDs also suppress ovulation and block sperm from being able to reach an egg. Does hormonal contraception fail sometimes? Yes, but rarely. The pill is 93% effective even if you forget to take it occasionally. Could an egg get fertilized but be prevented from implanting? Possibly, but there’s no scientific evidence of this. And there’s another thing, lots of eggs don’t implant even when you’re trying to get pregnant. Take this landmark study done in the late nineties on women who are not taking birth control. |
| Diana Blythe: | What they found out was that probably half of fertilized eggs that get to the point of beginning implantation, those are lost. We don’t know exactly what’s wrong, why it doesn’t implant normally, but they’re lost before the woman even misses a period. So she would have no idea this had occurred. |
| Amy Mostafa: | And this is why Blythe says doctors don’t consider someone pregnant until after a successful implantation, not after fertilization. We try several times to speak to Autumn and Kristan from Students for Life, but the group declined all interview requests and didn’t answer our email questions. |
| This medical misinformation that the group is promoting, the idea that hormonal contraception can cause an abortion by preventing implantation, Students for Life didn’t make it up. In fact, it comes from the language on the packaging of the emergency contraception, Plan B. To understand how this happened, I went to Chris ChoGlueck, he’s an assistant professor of Ethics at the New Mexico Institute of Mining and Technology. I | |
| Chris ChoGlueck: | I Actually wrote most of my dissertation on the ethics and politics surrounding emergency contraception. |
| Amy Mostafa: | Chris wrote that dissertation after his alma mater, Notre Dame at Catholic University sued the federal government. It didn’t want to cover contraceptives for its employees. There was a similar case happening at the same time. The owners of Hobby Lobby, a craft store, also didn’t want to cover contraceptives on religious grounds and claim that emergency contraception causes abortions. Lots of other conservative groups argued the same thing and the Supreme Court didn’t question it. Chris was intrigued. |
| Chris ChoGlueck: | It’s really interesting case that exemplifies how values influence scientific judgment, but also how the anti-abortion movement has been able to place scientists into very powerful roles to impose their value judgment on everybody. |
| Amy Mostafa: | Chris considers the labeling of emergency contraception a good example of this. I went out and bought it so I could see for myself. |
| So here’s the pill and here’s the leaflet. | |
| Okay, so I read the leaflet out loud. It works mainly by stopping the release of an egg from the ovary. It is possible that Plan B One Step may also work by preventing fertilization of an egg, the uniting of sperm with the egg, or by preventing attachment implantation to the uterus womb. | |
| It’s a version of what Students for Life has been claiming and it turns out this language goes back to the early 2000s, under George W. Bush’s administration. The FDA was trying to decide if Plan B should be sold over the counter, so it put together a joint advisory committee. | |
| Chris ChoGlueck: | At the committee meeting you had several science advisors who, if you look into their background, are staunch anti-abortionists. |
| Amy Mostafa: | One of those science advisors stood out to Chris. |
| Chris ChoGlueck: | And during the meeting he, in particular, argued that it was imperative, ethically imperative that this label, if it is approved for over the counter use, if it’s approved, that it describes the mechanism. |
| Amy Mostafa: | Meaning that language I read earlier, describing the different ways that Plan B could work. |
| Chris ChoGlueck: | He thought it could provide patients who believe that life begins at fertilization, the ability to have informed consent. |
| Amy Mostafa: | In other words, it’s coded language for anyone who is anti-abortion and believes life begins at conception. The committee is asked to vote on whether the drug should be sold over the counter or not. 23 out of 27 say yes. They’re also asked to weigh in on whether the package should include the special language that Plan B could possibly prevent the implantation of a fertilized egg, and less than a third believe it’s necessary, but the language makes it into the packaging anyway. |
| Chris ChoGlueck: | The drug company ended up in conversations with the FDA behind closed doors, which we are not privy to, to do this in an unprecedented manner. |
| Amy Mostafa: | We reach out to the FDA to get their take on what happened, but they didn’t get back to us in time for this broadcast. Chris believes this was a political compromise to get the drug approved for over the counter use more quickly. The |
| Speaker 17: | Morning after contraceptive pill is now being sold over the counter, but there’s more- |
| Amy Mostafa: | He also believes that Plan B is an example of misleading scientific information, making it into the labeling of a drug because if someone’s personal values. |
| Chris ChoGlueck: | The FDA is the ultimate authority for science. And we often think of science as value-free and non-political. And so if the FDA approved label says it, then that’s just science. That’s just the facts. And that’s been really unfair. |
| Amy Mostafa: | Most people who use Plan B probably don’t realize this language exists, but for Students for Life, the language, even though it’s not backed by science, has helped legitimize their claims. |
| Autumn Higashi: | So Plan B, it can work to prevent fertilization, but it also can prevent a fertilized egg from implanting into the uterus causing an early abortion. |
| Amy Mostafa: | That’s Autumn again. |
| Autumn Higashi: | If you were to take any amount of time to research this, you would know that. The FDA has published that plan B can prevent a fertilized egg from implanting. And again, a fertilized egg is a life according to science. |
| Amy Mostafa: | But it’s not science that considers a fertilized egg, a life. It’s Autumn and Students for Life and others who believe that’s when life begins. |
| Al Letson: | This story was produced and reported by Reveal’s Amy Mostafa with help from students from UC Berkeley’s Human Rights Center and Investigative Reporting Program. Anti-abortion activists aren’t just making the radical claim that birth control can cause an abortion, they’re also adopting the language of wellness influencers who say birth control is bad for the body. |
| Stuents for Lif…: | Why would any person want to just put hormones in their body every single day? |
| Al Letson: | That’s next on Reveal. |
| From the Center for Investigative Reporting and PRX, this is Reveal, I’m Al Letson. | |
| Millions of Americans use the pill and IUDs to prevent unwanted pregnancies because both are really effective. But like with any medication, there can be side effects. People complain about everything from nausea to mood changes and that’s fueled a backlash against hormonal birth control. Wellness influencers on social media call it toxic and recommend people stop using it. And these messages are being picked up by another kind of influencer, anti-abortion activists. Some even use a term green sex to promote what they consider to be more natural methods of contraception. That’s the topic of our next story, which comes to us from journalist Kiera Butler, senior editor at Mother Jones, who’s been investigating misinformation that targets women. Hey, Kiera. | |
| Kiera Butler: | Hi, Al. |
| Al Letson: | So Kiera, what are these more natural methods? Is it the old rhythm method where you track your period to figure out when not to have sex, because isn’t that really ineffective? |
| Kiera Butler: | No, this isn’t a throw back to the rhythm method, these are more complicated methods, which broadly speaking, involve a woman’s observations of her body to predict fertility. To keep it simple, I’m going to refer to this as cycle tracking. And I think the easiest way for me to explain it is to tell you the story of a woman named Jessica. We’re only using her first name because she talked to me about personal health information. |
| Jessica: | So I’m in California and my kids are eight, five, and almost three. |
| Kiera Butler: | Since her third child was born, she’s been using a cycle tracking method called the Creighton Model created by Catholic medical providers. In 1968, the Pope at the time wrote a rule against all artificial contraception. That edict still stands today. And while many Catholics ignore it, the most devout don’t, including Jessica. |
| Al Letson: | So Jessica uses this method for religious reasons? |
| Kiera Butler: | Right, and she hires a teacher to coach her in phone sessions on how to use the Creighton Model. |
| Jessica: | It’s a whole process. When you go to the bathroom, you take a tissue, fold it properly and are observing, which is really fun when you have young kids in the house because they’re like, “What are you doing?” My kids are like always in my space in the bathroom. |
| Kiera Butler: | What Jessica’s talking about is checking her cervical mucus. |
| Jessica: | There’s a finger test method where basically you take your two fingers and you stretch the mucus to see how far it stretches. anywhere from like a quarter inch, half an inch to an inch. The farther it stretches generally the more fertile you are. |
| Kiera Butler: | And then there’s also the process of record keeping. |
| Jessica: | There’s red stickers from when you’re on your menstrual cycle. There’s white babies and green babies and then there’s green stickers. And so essentially for me to avoid pregnancy, I can have sex generally anytime there’s like a solid green sticker because that means I’m not fertile. |
| Al Letson: | That sounds like a whole involved process. |
| Kiera Butler: | Yeah, and other methods can get even more complicated. Some involve charting body temperature and hormones in urine to determine when you’re most likely to get pregnant. And in the past few years, there’s been an explosion of interest, thanks in part to Silicon Valley companies that have launched cycle tracking apps promising birth control by algorithm. Peter Thiel, you know, the billionaire who co-founded PayPal and has been giving millions of dollars in the midterm elections to candidates aligned with Donald Trump. He just invested in one. The market for these apps is expected to reach 3.9 billion by 2026. And part of the reason they’ve gotten so popular is because birth control has become a target of some wellness influencers who’ve been promoting the idea that hormonal birth control is harmful to the body. |
| Al Letson: | So give me an example of some of the claims these wellness influencers are making. |
| Kiera Butler: | So here’s Jolene Brighton. |
| Jolene Brighton: | Have you ever heard of post-birth control syndrome? Bet you probably haven’t and your doctor probably hasn’t either. Hi, I’m Dr. Jolene Brighton, and in this video- |
| Kiera Butler: | Jolene isn’t an MD, she’s an ND, a naturopathic doctor, and she specializes in what she calls post-birth control syndrome, which she says is a whole host of health problems associated with the pill. |
| Jolene Brighton: | If you’re taking hormonal contraceptives, you are losing antioxidants, it is causing oxidative stress, so it is busting up your cells like crazy and you need to be replenishing those every day as long as you stay on that medication. |
| Al Letson: | Busting up your cells like crazy doesn’t sound very scientific. |
| Kiera Butler: | Right. So of course there’s absolutely no science to back up those claims or even the existence of post-birth control syndrome or this argument she makes on YouTube that hormonal contraception changes how women experience attraction. |
| Jolene Brighton: | What do women select for when they’re on birth control? They actually select men who have more feminine features than masculine features, which is really interesting. |
| Kiera Butler: | Like many influencers, she sells merchandise, and in her case, a special detox program for about $300. |
| Jolene Brighton: | I’m the first doctor to develop, document, and test clinical protocols to help women transition off of hormonal contraceptives and to support them while they’re on it. |
| Kiera Butler: | I asked Jolene to see her studies, but she never got back to me and she also didn’t respond to my questions via email. |
| Al Letson: | So how popular are her videos? I mean, does she have a big following? |
| Kiera Butler: | Yes, Jolene has a massive social media following 420,000 on Instagram, almost 300,000 on TikTok. And her popularity has to do with the fact that a lot of women really do have bad side effects from hormonal contraception like migraines and depression. And there are specific warnings around these methods for some women, smokers for example, can have a higher risk of blood clots and it can be incredibly frustrating when physicians don’t listen to women’s very real complaints. |
| Al Letson: | That’s totally understandable that they would seek out alternatives. So what do doctors say about the negative effects of birth control? |
| Kiera Butler: | I ask that question to Dr. Jenny Villavicencio, an OBGYN and complex family planning specialist. |
| Jenny Villavice…: | What I hope is that healthcare providers can really understand that while the side effects that people may be describing may not be born out in the literature, that person’s experience is their experience and we need to honor that and respect that and let’s work with that person and find a birth control that works for them. |
| Kiera Butler: | And something Dr. Villavicencio also points out is that the side effects and risks of pregnancy are actually much greater than being on hormonal birth control. |
| Jenny Villavice…: | Pregnancy always has more risks than birth control and it also potentially has more side effects than birth control. It has the same hormones at much higher levels and certainly has different consequences as we know. |
| Kiera Butler: | But that hasn’t stopped many anti-abortion groups from promoting misinformation about the harms of hormonal birth control, including Live Action. That’s a group that got some attention years ago for undercover videos that targeted Planned Parenthood. Here’s a YouTube video of its founder Lila Rose, speaking to conservative pundit Candace Owens. |
| Lila Rose: | Sex is supposed to be something safe as far as vulnerable where you can be vulnerable, but it’s not supposed to be something where you have to protect yourself from your partner with some latex or with a pill that sterilizes you or shuts down your hormones. How is that really self-giving and feeling vulnerable and free with them? |
| Candace Owens: | It always freaks out. |
| Lila Rose: | It’s not. It’s not. |
| Candace Owens: | It’s instinctually always freaks me out where I would just say, “Why would any person want to just put hormones in their body every single day?” |
| Al Letson: | A pill that sterilizes you? I mean, that word choice is just striking. |
| Kiera Butler: | For the record. The pill does not sterilize a person. I emailed Lila to ask about her comments and she stuck to her incorrect claim and said the pill does temporarily sterilize you. And Lila isn’t the only anti-abortion activist adopting the idea that hormonal birth control is unhealthy. Take the Guiding Star Project, for example. It’s a network of women’s health clinics founded by Leah Jacobson. |
| Leah Jacobson: | We believe that women’s bodies naturally do three unique things, and that’s ovulate, gestate, and lactate. |
| Kiera Butler: | Guiding Star promotes itself as a network of health centers that empower women to love their natural bodies. At this 2012 company dinner, Leah is explaining how the organization was trying to gain a foothold in the wellness industry. The tape’s a little noisy. |
| Leah Jacobson: | We’ve recognized that there is a really strong enthusiasm growing among women for things such as breastfeeding and natural childbirth and some of these things, but it’s typically among women that don’t identify as pro-life. A lot of them identify as strongly pro-choice. |
| Kiera Butler: | She sees these more liberal women as potential opportunities. |
| Leah Jacobson: | We’d love to get them into our building because not only does their financial support, being paid to the [inaudible] help to support all the other organizations in the building, but with time we believe that it’s going to start to soften their heart and change their mind a little bit about the pro-life movement. |
| Kiera Butler: | So Leah considers Guiding Star to be part of the pro-life movement, but when I asked her how abortion factors into her group’s work, here’s what she said. |
| Leah Jacobson: | Abortion is really not the issue that we’re focused on. We’re focused much more on general women’s health and we tend to view that any unnatural interruption of a woman’s natural body and what it’s doing that that is a trauma against what her body is capable of. It’s a trauma that you’re internalizing deeply that my body did something wrong. And in fact, getting pregnant means everything went tremendously right. |
| Al Letson: | I guess she would consider hormonal birth control one of those traumas against a woman’s body? |
| Kiera Butler: | Yes, that’s right. Guiding Star promotes cycle tracking and even has a special program that teaches the method to preteens. Leah told me in an email that she doesn’t try to hide the fact that she believes, as she put it, that abortion is a poor substitute for women’s healthcare services, and she said she’s spoken publicly about that. But if you just stumbled upon the organization, either in person or on the web, you wouldn’t know it’s affiliated with the anti-abortion movement. You would probably think it’s maybe like a naturopathic clinic or something. |
| Al Letson: | Okay, so Guiding Star may not be transparent about its anti-abortion stance, but what’s wrong with teaching cycle tracking? |
| Kiera Butler: | The problem is that anti birth control and anti-abortion activists are promoting these cycle tracking methods as being nearly as effective as hormonal birth control, but it depends on how you use them. And tracking your body can be way more complicated than taking the pill, for example. Let me take a step back and give you rates for how often contraception fails and let’s start with IUDs. So once it’s inserted, there’s nothing to do and the failure rate is less than 1%. The pills failure rate is also 1% if you take it every day. And if you miss here and there, the failure rate is 7%. |
| Al Letson: | And how about cycle tracking methods? |
| Kiera Butler: | So the CDC used to give them a 24% failure rate, but in 2019 that changed to a range between two and 23%. Here’s a webinar from 2019 hosted by the Department of Health and Human Services about FABMs or fertility awareness based methods. That’s the same as cycle tracking. |
| DHHS: | We’re excited to host this webinar in the wake of the CDC updating the effectiveness rating for FABMs, recognizing that some of these natural methods are up to 98% effective for avoiding pregnancy. |
| Kiera Butler: | So that language is misleading, because for the vast majority of these methods, you can only get to 98% if you use them perfectly. This new range is considered a victory by proponents of cycle tracking who’ve been pushing the CDC to give these methods a better effectiveness rating. That includes Dr. Marguerite Duane, who spoke at that HHS webinar. She’s an MD, an adjunct professor at Georgetown University and the head of a group called Facts, which offers courses that doctors can take to maintain their medical licenses. Here she is talking about her group’s efforts to a gathering of Catholic healthcare providers in 2018. |
| Dr. Marguerite …: | It’s important we set the record straight. To do this, Facts has partnered with an organization called Natural Womanhood to ask the CDC to update and report accurate data. |
| Kiera Butler: | Natural womanhood is another pro-cycle tracking group. Dr. Duane tells this audience her story about what inspired her to embrace what she calls natural family planning over hormonal birth control when she was a first year medical resident. |
| Dr. Marguerite …: | It is drilled into you as a medical student. You do not let a woman leave the hospital with a baby without birth control on board. And that is what I was doing. And thankfully this lovely woman here, Dr. Pearl Huang-Ramirez, who’s holding my youngest baby, Gianna said to me, “You know, don’t have to prescribe the birth control pill if it violates your conscience.” |
| Kiera Butler: | That’s Dr. Duane talking to a group of Catholic doctors. Now, Dr. Duane herself is a devout Catholic, but I’ve seen her talk in other professional settings and she doesn’t explain like she does here, that her personal beliefs are part of why she promotes cycle tracking over hormonal methods. |
| Al Letson: | I can see how that’s problematic if she’s not transparent. |
| Kiera Butler: | Right. And I haven’t seen her mention that she speaks at anti-abortion conferences or her involvement with an anti-abortion think tank or that she sits on the board of a foundation that funds anti-abortion activists. |
| Al Letson: | So did you try and talk to Dr. Duane about any of this? |
| Kiera Butler: | Yes. I asked why she doesn’t mention her full background when she presents. A spokesperson didn’t answer that question and instead just said, “Dr. Duane welcomes the opportunity to present her work to audiences that support or oppose abortion.” |
| Al Letson: | So the bottom line here is that if you’re going to use cycle tracking, you really need to understand that there’s a range of effectiveness that depends on how closely you’re able to monitor your body, and if you’re not someone who can keep up with all of the tracking, then your chances of getting pregnant are going to be much higher. |
| Kiera Butler: | Yes, that’s right. And I think Jessica is a good example of that. She used cycle tracking for about three years without getting pregnant, but then she got comfortable and she stopped being so rigorous. Earlier this year, she says she was feeling kind of out of it so she gets a pregnancy test and it comes back positive. And for the first month she doesn’t tell anyone. |
| Jessica: | I was just in my head about how scary things were going to be, how we were going to care for this baby financially. And so when I get pregnant, I get very, very sick. I basically can’t move. I just have to lay flat so that I’m not throwing up. |
| And here’s where her story gets even heavier. At Jessica’s first prenatal appointment, she found out that there was no heartbeat and that she was going to miscarry. | |
| It was horrible to walk into that appointment and just get blindsided and I just sat in my car and I just cried and I cried because, one, it’s a loss, but two, I felt so guilty and shameful like I caused it because I’m like, Oh, I can’t have this baby. Oh my gosh, maybe I’ll miscarry. As awful as that sounds, but it was a thought in my head. | |
| Al Letson: | All those conflicting emotions, it must have been so hard. |
| Kiera Butler: | Yes, she definitely found herself in a really difficult situation both physically and emotionally. But Jessica isn’t giving up, she says she’s found another cycle tracking method that she hopes will be more effective. And it’s important to remember that even though Jessica was using these methods mostly because of her faith, there are millions of women who turn to cycle tracking often because they really don’t like their experience of hormonal birth control and they’re worried about the potential health effects of using it for years. They’re being told that these natural family planning systems work just as well as hormonal birth control, and that’s in part because of this concerted effort by anti-abortion groups to convince women that the pill is bad. |
| Al Letson: | Thanks so much for your reporting and bringing us a story. |
| Kiera Butler: | Thank you, Al. |
| Al Letson: | Kiera Butler is a senior editor at Mother Jones. It’s one thing to circulate misinformation about birth control online, but what happens when politicians start using it to try and pass bills? |
| Doug Beck: | You believe Plan B induces an abortion? |
| Paul Wieland: | I believe it does, yes. |
| Al Letson: | When we come back, the fight against birth control goes to the state capitol. That’s next on Reveal. |
| From the Center for Investigative Reporting and PRX, this is Reveal. I’m Al Letson. This summer when Supreme Court overturned Roe v. Wade, Missouri’s Attorney General Eric Schmidt was ready, he raced to put the state’s trigger ban on abortion into effect. | |
| Eric Schmidt: | I am humbled to be a part of this and the first attorney general in the country to effectively end abortion. |
| Al Letson: | Abortion was now outlawed, except in medical emergencies. Schmidt, who is seeking a US Senate seat scored big points with his conservative base, but just days into the ban, some unexpected news broke. |
| St. Luke’s: | St. Luke’s Health System is no longer offering emergency contraception at its Missouri locations that says the Missouri law is ambiguous but may be interpreted as criminalizing emergency contraception. |
| Al Letson: | St. Luke’s is a major healthcare provider in the region and it was concerned that emergency contraception could be considered an abortion under the state’s ban. |
| St. Luke’s: | We simply cannot put our clinicians in a position that might result in criminal prosecution. |
| Al Letson: | Let’s just be clear. When you’re using emergency contraception, time is not on your side. That’s why it’s often called the morning after pill, because you have to take it soon after having sex to prevent a pregnancy. Suddenly, the state’s abortion ban was also limiting access to birth control, which could lead to more unwanted pregnancies. Soon, Missouri officials were trying to reassure the public that all forms of birth control were still legal. |
| Speaker 31: | Missouri’s Attorney General, Eric Schmidt, clarifies this law saying that use of these drugs is not against the law in Missouri after all. |
| Al Letson: | And St. Luke’s started offering emergency contraception in Missouri again, but this confusion didn’t come out of nowhere. Last year, Missouri lawmakers spent months fighting over whether birth control can cause an abortion. Reveal’s Katharine Mieszkowski explains how misinformation about birth control is making its way into state politics. |
| Katharine Miesz…: | In Missouri, even a tax that’s been around for decades can get caught up in abortion politics. The federal reimbursement allowance, or FRA, helps fund the state’s Medicaid program. The Missouri state legislature just has to extend the FRA to keep the billions flowing. |
| Jill Schupp: | A lot of discussion goes around it, but it is in a sense a no-brainer. We’re going to pass that bill because we need those dollars in the state. |
| Katharine Miesz…: | State Senator Jill Schupp is a Democrat. She tells me about how this must pass bill got complicated. |
| Jill Schupp: | In 2021, one of our colleagues, a male colleague Republican, stood up and offered an amendment to the FRA. |
| Paul Wieland: | Madam President, my amendment’s a simple amendment. |
| Katharine Miesz…: | That male colleague was Senator Paul Wieland from Jefferson County. |
| Paul Wieland: | What it does is it addresses the situation we have Medicaid to where currently the state of Missouri is funding drugs that are abortifacients. |
| Katharine Miesz…: | That’s something that causes an abortion. |
| Paul Wieland: | Any drug or device approved by the Federal Food and Drug Administration that may cause the destruction or prevent the implantation of unborn child defined in Section 188.015. |
| Katharine Miesz…: | Implantation of an unborn child. What is Senator Wieland talking about? Well, in Missouri state law, even a fertilized human egg is defined as an unborn child. It’s that Catholic idea again, that life begins a conception and it’s been in the law here for more than 40 years. So for Senator Wieland, anything that could interfere with a fertilized egg developing is an abortifacient. |
| Paul Wieland: | So it’s just kind of going along in making our pro-life state even more pro-life in saying that state Missouri will not pay for these abortion drugs. Happy to answer any questions. |
| Katharine Miesz…: | There are no questions. Nobody even asks exactly what drugs or devices Wieland is trying to stop the state from funding. But on his list are IUDs, which are among the most popular forms of birth control, and emergency contraceptives like Plan B. The amendment goes to a roll call vote and it passes. |
| Committee Chair: | By your vote of 21 aye and 12 no, the amendment has been adopted. |
| Katharine Miesz…: | But it isn’t that simple. Under the Affordable Care Act, birth control is an essential health benefit. Failing to provide it to Medicaid patients could put the state out of compliance with federal law, risking billions of dollars. As the legislature grapples with this, the critical bill stalls, the stalemate goes on for months and the legislative session ends. This bill is so essential to the state’s budget that members have to return to the capitol to try to get it passed. |
| Committee Chair: | That the Senate is duly convened in the first extraordinary session of the first regular session and is ready- |
| Katharine Miesz…: | Governor Michael Parson, a Republican, is worried. He puts out a statement begging the members of the legislature to pass the bill. “Let me be clear, I am pro-life,” he writes. “I have supported pro-life measures my whole career and I always will. However, we cannot allow narrow political interests to hold hostage vital healthcare funding and the success of our economy.” He’s talking about Wieland’s initiative and an effort to defund Planned Parenthood, which is also holding up the bill. But Wieland isn’t giving up. Here he is being questioned by Senator Doug Beck, a Democrat, who wants to protect funding for birth control. |
| Doug Beck: | You believe Plan B induces an abortion? |
| Paul Wieland: | I believe it does, yes. |
| Doug Beck: | Okay, but it doesn’t. [inaudible] and scientifically, it doesn’t. Okay, so if it doesn’t induce an abortion, then it would be paid for it by the Medicaid program. |
| Paul Wieland: | Is Plan B- |
| Katharine Miesz…: | Here’s that same misinformation again now playing out in the Missouri Senate. The idea that even though Plan B works by preventing ovulation, you just never know when it might keep a fertilized egg from implanting in the uterus. Missouri Right to Life compares using Plan B to playing Russian roulette. |
| Doug Beck: | Is plan B a part of what you’re trying to get banned? |
| Paul Wieland: | It is listed as one of those drugs, correct. [inaudible] And it says- |
| Doug Beck: | We’re talking about. |
| Paul Wieland: | When used to induce an abortion. It doesn’t say when used for birth control. It says, when used to induce an abortion. |
| Doug Beck: | I disagree with you that this is what this is abortion, this is about birth control. |
| Jill Schupp: | So we were in a standoff. |
| Katharine Miesz…: | That’s Senator Jill Schupp again. |
| Jill Schupp: | We were actually in recess for hours and one of my male counterparts, a Democratic colleague, came to me and said, “You have a good relationship with the Republican senators, the women senators, what do you think about going and talking to them?” And I said, “You know what, that’s a great idea.” |
| Katharine Miesz…: | For the first time, women represented nearly a third of the state senate. |
| Jill Schupp: | 11 women in Missouri Senate is more than we’ve ever had in Missouri’s history. |
| Katharine Miesz…: | And the women had already bonded. It started with the dinner party hosted by a government official. |
| Jill Schupp: | The head of the Department of Conservation invited us to her husband’s amazing man cave to just get away from the Senate chamber one night. |
| Katharine Miesz…: | The women senators cooked up a literacy initiative to educate kids about the history of women in Missouri politics for the State’s bicentennial. They even published a children’s book called, You Can Too. Working together on that uncontroversial project paved the way for them to bridge partisan divides. And they found on birth control they could also agree, so they sat down with Senator Wieland. |
| Jill Schupp: | And we explained to him that most of these methods he was talking about were actually birth control methods. And we said, “We are not going to support your amendment. Please remove it.” He sat down in the room with all of us and he said, “Let me talk to some people.” And he came back and he said, “Okay, I will remove my amendment.” |
| Katharine Miesz…: | The bill ends up passing without any restrictions on contraception. Wieland does manage to get a line put in there that says the state won’t pay for any drug or device that causes an abortion. But that doesn’t actually change anything in Missouri. The state already banned using public funds to pay for abortions. But this idea that some contraceptives cause abortions, it doesn’t just go away. |
| St. Luke’s: | St. Luke’s health system is no longer offering emergency contraception at its Missouri locations. |
| Speaker 31: | Missouri’s Attorney General, Eric Schmidt, clarifies this law saying that use of these drugs is not against the law in Missouri after all. |
| Katharine Miesz…: | When state officials implemented Missouri’s abortion ban a year later, it wasn’t just St. Luke’s Health System that got confused. |
| Michelle Trupia…: | People were scared, they were confused, and we have heard from our health centers across the state that they have been fielding call after call. |
| Diana Blythe: | Michelle Trupiano is executive director of the Missouri Family Health Council. The group provides funding to reproductive healthcare centers that serve low income people. |
| Michelle Trupia…: | They were confused about whether or not they need to take their IUD out or folks that are wanting to go ahead and get an IUD because they’re fearful about what the legislature may do. |
| Katharine Miesz…: | People here are making health decisions based on what they think might happen politically. In Idaho, that fear of having your birth control options restricted has already become a reality. Last year, the Idaho legislature, banned state colleges and universities from dispensing emergency contraception. And last month, the University of Idaho advised faculty and staff not to provide any form of birth control, including the pill. I wanted to know whether Missouri politicians will keep fighting to restrict contraception. Senator Wieland is term limited out of his seat and he didn’t respond to interview requests, but I was able to catch up with a person who helped write his amendment. His name is Sam Lee. |
| Sam Lee: | I’ve been a lobbyist at the state capitol here in Missouri in Jefferson City for, well, about 37 years full time. I’m also a deacon in the Catholic church, married with four children and seven grandchildren. |
| Katharine Miesz…: | Even though he helped craft Wieland’s amendment, Sam doesn’t think that limits on contraception are going to happen. |
| Sam Lee: | Senator Paul Wieland, friend of mine, someone I’ve worked with, and he’s wanted to do this for years. For Wieland, it was a personal thing. Paul’s a Catholic. He didn’t like voting for funding for Medicaid for years because he didn’t like that the state was funding contraceptives and so he put an amendment out and it didn’t pass. That’s nothing out of the ordinary. Lawmakers introduce bills and offer amendments all the time. The question is, does something become law? |
| Katharine Miesz…: | And so what you’re telling me is, there’s not an appetite for that to become law in your state? |
| Sam Lee: | There’s not only not an appetite, there wouldn’t be the votes for it. |
| Katharine Miesz…: | But Senator Jill Schupp, who is also term limited out of office, thinks this issue isn’t going away. |
| Jill Schupp: | I believe that in the upcoming legislative session or perhaps the one after, that these will be the topics that the Missouri legislature is talking about. |
| Katharine Miesz…: | Now that abortion is banned in Missouri, she predicts conservative candidates will use birth control as a wedge issue to try and win elections. |
| Jill Schupp: | I think in the state of Missouri, year after year after year, we’ve seen the goal post being moved. It’s not enough to just ban abortion in Missouri, we’re going to see the banning of birth control. |
| Katharine Miesz…: | In Congress, birth control is already the new political football. This summer, anti-abortion groups were watching when Democratic women unveiled what they called the Right to Contraception Act. |
| Nancy Pelosi: | Let us be clear, we are not going back for our daughters, our granddaughters, we are not going back. |
| Katharine Miesz…: | It was less than a month after the Supreme Court overturned Roe versus Wade and House Speaker Nancy Pelosi said the bill was a response to a serious threat from “radical Republicans who are going after contraception next”. |
| Nancy Pelosi: | This is their moment. Clarence Thomas has made that clear. |
| Katharine Miesz…: | She’s referring to Justice Thomas’s concurring opinion. He wrote that the Supreme Court should also take a second look at a decades old decision that protected the right to use contraception. |
| Rep. Kathy Mann…: | This rallying call by Justice Thomas and the actions of extremist Republican legislators are about one thing, control |
| Katharine Miesz…: | Representative Kathy Manning from North Carolina sponsored the bill. |
| Rep. Kathy Mann…: | And we will not let this happen. |
| Katharine Miesz…: | The Right to Contraception Act would do for birth control what Democrats now wish they’d had the foresight to achieve with abortion years ago. It would enshrine in federal law people’s right to use birth control and make it hard for states like Missouri to restrict people’s access to it. |
| Nancy Pelosi: | Eliminate, just remove all doubt that women are in control of their lives. |
| Katharine Miesz…: | But opponents rally one prominent anti-abortion group announces it will score against the bill, meaning ding any politician who votes for it the same way the NRA does with lawmakers when they vote for gun control. The bill passes the House anyway, but then it goes to the Senate where Senator Joni Ernst, a Republican, speaks against it. |
| Committee Chair…: | The junior senator from Iowa. |
| Joni Ernst: | Reserving the right to object, Madame President, here we are again another day, another sympathetically titled bill offered by my Democrat colleagues where the talking points don’t really give you the full story. |
| Katharine Miesz…: | Senator Ernst claims the Democrats are trying to expand the definition of contraception. |
| Joni Ernst: | And defines contraceptive in such a broad way that it could include drugs to induce an abortion weeks or months. |
| Katharine Miesz…: | The bill dies in the Senate. Opposing birth control protections is now a way for politicians to prove just how pro-life they are. |
| Al Letson: | That was Katharine Mieszkowski. She was the lead producer for this episode with help from Amy Mostafa and Richard Yang. Cynthia Rodriguez edited the show. This week’s show was in collaboration with UC Berkeley’s Human Rights Center and Berkeley Journalism’s Investigative Reporting Program, including Leah Romer, Emma McPhee, Gisela Pérez de Acha, [inaudible], Brian Nguyen, Eliza Parika and Elora Bianchi. Special thanks to Reveal’s Nina Martin and Grace Olden. Nikki Frick is our fact checker. Victoria Baranetsky is our general counsel. Our production manager is Amy, the great Mostafa. Score and sound designed by the dynamic duo, Jay Breezy, Mr. Jim Briggs, and Fernando, my man, yo, Arruda. Our post-production team is the Justice League, and this week it includes Katherine Styer Martinez and Claire, C-Note, Mullen. Our digital producer Sarah Merck. Our COO is Maria Feldman. Our CEO is Robert Rosenthal. |
| Our interim executive producers are Brett Myers and Taki Telonidis. Our theme song is by Colorado Lightning. Support for Reveal is provided by the Reva and David Logan Foundation, the John D and Catherine T MacArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, the Heising Simons Foundation, the Hellman Foundation, the Democracy Fund, and the In As Much Foundation. Reveal is a co-production of the Center for Investigative Reporting and PRX. | |
| I’m Al Letson, and remember, there is always more to the story. |