Re: Testimony in Support of LB 183
Dear Chairperson Arch and members of the HHS Committee,
My name is Meg Mikolajczyk and I am the Deputy Director and Legal Counsel for Planned Parenthood North Central States in Nebraska. Central to our mission at Planned Parenthood is the conviction that all people deserve to live in communities where sexual and reproductive rights are recognized for what they are—basic human rights. All people deserve to lead safe, healthy, and meaningful lives. In order for this to become our reality, people should have access to the health care they need regardless of the institution’s or the individual provider’s religious affiliation or beliefs. And this is particularly true in the context of rape survivors seeking immediate treatment post-assault.
Planned Parenthood provides sexual and reproductive health care at two health centers in Nebraska. We strive to treat all our patients with dignity and care while providing them with the best scientifically based, nonjudgmental information about their health care and their bodies. No matter what. One of the many services we offer is emergency contraception, the medication that is the subject of LB 183.
Emergency contraception is a hormonal birth control taken after sexual intercourse that works primarily by delaying or inhibiting ovulation.1 Plan B or generic versions of the same medication are offered over-the-counter and can be taken up to 72 hours after intercourse. Another version of emergency contraception, ella, is available via prescription only, and can be used up to five days after intercourse. Finally, the copper IUD, if placed within five days of intercourse, can act as emergency contraception.
Planned Parenthood offers all three types of emergency contraception to our patients. Emergency contraception does not induce abortion, and should not be confused with mifepristone, also known as the “abortion pill.”2
According to the National Protocol for Sexual Assault Medical Forensic Examinations, overall wellbeing is improved when sexual assault survivors have a positive experience with the criminal justice system and the medical system after their assault.3 However, a survivor cannot have a positive experience with a health care system that refuses to provide them with everything they need to move forward after an assault, including, if the patient would like, emergency contraception.
The Nebraska Planned Parenthood health centers regularly see patients who were denied access to time-sensitive emergency contraception and other requested health care immediately following a sexual assault. This means that our patients, managing their own recent traumas, receive only part of the care they need, are forced to do their own research on where to find emergency contraception, must obtain additional transportation to our health center, and relive their trauma to more health care providers, in order to get the care they deserved from the beginning. For sexual assault victims in particular, the experience of being denied care during their first interaction with the medical system after an assault can be incredibly traumatic.
Patients that seek follow up care from Planned Parenthood have often been denied care by a Catholic institution, which are governed by a set of Bishops’ Directives outlining the care they can or cannot deliver to patients, regardless of medical best practice. But, in the United States, Catholic women support policies like LB 183. A 2000 poll found that 78% of Catholic women in the United States prefer that their hospital offers emergency contraception for rape victims. Furthermore, 57% of those women want their hospitals to provide it in circumstances broader than rape.4
Planned Parenthood proudly serves anyone who needs care. Our focus is on patients’ needs. To be the best advocates we can be for our patients, though, we are strongly advocating that those patients receive all their health care from the provider they see immediately post sexual assault, often an emergency room. Continuity of care and the essence of time are both critical factors to sexual assault survivor patients’ health. Planned Parenthood supports LB 183 because we want to minimize how many times a patient must relive their trauma before receiving care, and we support policies that get a patient medically accurate information and care as quickly and seamlessly as possible.
People living in rural areas of Nebraska face even more barriers. One in six patients in the United States will visit a Catholic hospital for their care.5 In Nebraska, a Catholic hospital may be the only health care provider in the area. Depending on the institution’s and the provider’s interpretation of the Catholic Bishops’ Directive 366, which governs ethical considerations for provision of emergency contraception, a survivor may be denied access to the standard of care for treating a sexual assault survivor. Rural survivors may not have a choice of provider given the shortage of care, and therefore may be completely foreclosed from treatment post-assault. LB 183 closes this gap and ensures that all Nebraskans, regardless of geography or religious beliefs, will experience the same standard of care after an assault.
The risk of pregnancy from rape can be a cause of serious trauma to a victim of assault.7 It is the responsibility of health care organizations who work with sexual assault survivors to provide the full range of accurate health care options available to them.
For these reasons, we respectfully request the committee advance LB 183 to general file. Thank you, Senator Hunt, for bringing this issue to light and advocating for better policies.
Deputy Director - NE
4Belden Russonello & Stewart. Religion, reproductive health and access to services: A national survey of women. Catholics for Choice, April 2000.