EKRHP – Savannah and Tenille from Appalachian Media Institute on Vimeo.

Savannah and Tenille discuss how they learned about sex as teens and how they used what they learned when thinking about and making choices regarding their sexual activity.  See also EKRHP’s film on Sexuality Education and Access.

Contraception
Contraception is defined as the purposeful prevention of conception and pregnancy. Contraceptives are part of family planning, which allows individuals, couples, and families to decide if they want to have children, how many, and at what time in their lives. Contraception and family planning have a strong positive effect on women’s health and on a family’s general wellbeing. Some contraceptive methods, such as the male and female condom, serve to prevent sexually transmitted infections (STIs) in addition to preventing pregnancy.
About half of the women in need of contraceptives in Kentucky are low-income or adolescents and therefore would be eligible for publicly funded family planning services . Men and women can seek family planning services at one of the 191 publicly-funded family planning clinics throughout the state, with at least one clinic in each county. Family planning services are often provided through local health departments, which receive Title X funding from the state.
Title X is the federal program that provides for family planning services and supplies through provision of low-cost and free contraceptive services and supplies. Title X clinics provide services such as: “a comprehensive medical history; physical exams; contraceptive counseling and supplies; STD detection and prevention; cervical, breast and prostate cancer screening; screening for domestic violence/sexual abuse; and preconception care. ” Although there are clinics that provide family planning services throughout the state, only about half of all women in need of “publicly supported contraceptive services” actually receive care from these clinics .
It is estimated that for every public dollar spent on contraceptive services, three dollars are saved on prenatal and newborn costs in Medicaid . In Kentucky, only individual or small-employer insurance plans are mandated to provide contraceptive coverage. Other insurance plans may opt not to cover contraceptive services and supplies.
There are many contraceptive methods nowadays, and each person should decide which method suits their life circumstances best. Some methods are more effective at preventing pregnancy than others, and some can also protect from sexually transmitted infections. There are both hormonal and non-hormonal methods, and they include:

Non-Hormonal:
o Male condom
o Female condom
o Cervical cap
o Diaphragm
o Spermicide
o Intra-uterine device (IUD)
o Vasectomy
o Tubal ligation
o Lactational Amenorrhea Method (LAM—breastfeeding to prevent pregnancy)
o Abstinence
o Fertility Awareness-Based Method (Rhythm Method)
o Pulling-Out
Hormonal:
o Intra-uterine device (IUD)
o Birth control pill
o Birth control injection
o Birth control vaginal ring
o Birth control patch
o Birth control implant
o Birth control sponge
o Emergency Contraception

Quick Facts:
 Without publicly-funded family planning services in Kentucky, the state’s unintended pregnancy rate would be 67% higher, and the abortion rate 163% higher
 Kentucky law does not require all insurance plans to cover contraceptives
 Minors in Kentucky can access contraceptives without parental consent (a physician may, but doesn’t have to, inform a minor’s parents)
 Emergency contraception can be taken up to 120 hours after unprotected sex to prevent pregnancy and can be purchased at a pharmacy or clinic without a prescription by men or women 17 years old and older

Discussion Questions:
 What do family planning and contraceptives mean to you?
 What contraceptive methods are you aware of and where did you learn about them?
 Do you know where to go in your community to get contraceptive services and information? What about emergency contraception? Do you feel comfortable going there?
 What concerns do you have about family planning and contraception?

Resources and Links:
 Planned Parenthood
 Women’s Health.gov
 Association of Reproductive Health Professionals
 Center for Young Women’s Health
 MedLine Plus
 The Emergency Contraception Website

EKRHP – Heather Fulton from Appalachian Media Institute on Vimeo.

Heather Fulton a WIC Breastfeeding Peer Counselor at the Letcher County Health Dept. discusses her experiences with counseling women who hope to breastfeed.  She also provides information on why it is the optimal choice for both mother and baby and debunks some of the common myths surrounding breastfeeding.

Breastfeeding

Breastfeeding is the natural way that humans feed their infants.  Breastfeeding affects both infants and mothers, and has long-term health and economic impact for individuals, families, and communities. The U.S. government states that “[B]reast milk is widely acknowledged to be the most complete form of nutrition for infants, with a range of benefits for infants’ health, growth, immunity, and development.”[i] We now know that breast-milk is highly beneficial for infants and breastfeeding is also good for the mother’s health. According to the American Academy of Pediatrics, “[E]xtensive research, especially in recent years, documents diverse and compelling advantages to infants, mothers, families, and society from breastfeeding and the use of human milk for infant feeding. These include health, nutritional, immunologic, developmental, psychological, social, economic, and environmental benefits.”[ii] Some of the most recent research confirms breastfeeding’s role in reducing the incidence of obesity in children. In Kentucky, where obesity and overweight are a major public health challenge, breastfeeding may represent a new tool in reducing obesity rates and the many serious health problems associated with being obese and overweight.

Although many states now protect breastfeeding women from being discriminated against in public places, many women still face stigma and lack of support for breastfeeding.  In Kentucky, there are laws that protect breastfeeding mothers: Ky. Rev. Stat. § 29A.100 (2007) directs judges at all levels of the court to excuse women who are breastfeeding or expressing breast milk from jury service until the child is no longer nursing and Ky. Rev. Stat. § 211-755 (2006) permits a mother to breastfeed her baby or express breast milk in any public or private location. This statute also protects breastfeeding mothers from being charged for public indecency, indecent exposure, sexual conduct, lewd touching or obscenity.  Further, municipalities cannot prohibit or restrict breastfeeding in a public or private place[iii].   The Affordable Care Act of 2010 (the health reform law) also provides some protections for working breastfeeding mothers by requiring employers (with more than 50 employees) to provide breastfeeding employees with necessary breaks to express milk and a space beyond the bathroom to do so[iv].

Despite these protections, Kentucky ranks very low on breastfeeding rates: 58% ever breastfed compared to 75% ever breastfed nationally[v].  This makes Kentucky the state with the third lowest breastfeeding rate in the U.S.[vi] Like other health measurements, there are wide variations at the county level in Kentucky– rural and eastern counties have lower breastfeeding rates than the rest of the state[vii].

Quick Facts:

ü  Kentucky ranks third lowest for breastfeeding rate among all states, with rates particularly low in rural counties[viii]

ü  Kentucky law protects women from being restricted or prohibited from breastfeeding in any public or private place where they can otherwise be legally[ix]

ü  Breastfed babies are less likely to die during the first year of life and recover more quickly from illnesses[x]

Discussion Questions:

• Do you know anyone who breastfed their baby?
• Do you feel comfortable with the idea of breastfeeding in public?  Do you think your community is accepting of that practice?
• What have you heard your family and friends say about breastfeeding?
• What would you like to see change in order to make your community more supportive of breastfeeding?
• Is there anything you can do to make breastfeeding more acceptable for those around you?

EKRHP – Carrie Jean Wells from Appalachian Media Institute on Vimeo.

Carrie discusses her frustrations with what she witnesses as a teacher in a small eastern Kentucky school when it comes to teens and how they view pregnancy.  Carrie is discouraged by her inability to help in a broader sense than providing advice for those teens who ask for her input.  See also EKRHP’s films on Teen and Unintended Pregnancy.

Sexuality Education
Sexuality education refers to the information necessary to make informed decisions about one’s sexual and reproductive health. Some young people receive information about sexuality and reproduction from their parents or other family members, while others rely on school or other outside entity to provide this information. Because of the continued stigma around openly discussing sexuality, many people reach young adulthood without a clear understanding of the biological, physical, emotional, or social aspects of sexuality and reproduction.
There are various approaches to sexuality education for youth. Some are based on an abstinence-only-until-marriage approach and others vary along the spectrum of providing medically-accurate information regarding human sexuality, pregnancy- and disease prevention, and forms of contraception. The federal government invested substantial amounts of funding in abstinence-only education starting in the early 1980s. Although research has not shown such programs to be effective in delaying sexual activity , funding has continued to support this programming in Kentucky and other states. Some states have refused to accept abstinence-only funding because of this lack of evidence of success.
In Kentucky, all public schools must offer sexuality, sexually-transmitted infections, and HIV and AIDS education. These courses must cover abstinence, but they do not have to cover contraception.   According to the Kentucky Cabinet for Health and Family Services, communities throughout the commonwealth provide the following sexuality education programs :

1. Community Work-Groups and Coalitions: Workgroups convened by local health
departments, including social services, schools, youth service centers, clergy, elected offices, medical community, parents, teens to discuss strategies to reduce teen pregnancy.

2. Direct Community Grants for Abstinence Education: Communities apply
through local health department for projects that meet the abstinence education legislation priorities as stated in federal 1996 Welfare Law; purpose is to create strong partnerships among public and private community agencies, parents, schools, and the faith community to teach school-age children the value of sexual abstinence.

3. Postponing Sexual Involvement (PSI): School-based curriculum designed for
junior high/middle school students; 5 sessions are taught by peer educators and trained high school students; PSI is abstinence-based and does not include any information about contraceptives.
4. Reducing the Risk: School-based program (16 one-hour sessions) focusing on
avoiding unprotected intercourse either through abstinence as the 100% safe method or with proper contraceptive use.

Quick Facts:
 54% of Kentucky schools teach abstinence-only or abstinence-plus use of condoms for disease-prevention
 Comprehensive sexuality education is taught in 33% of Kentucky schools
 Six percent teach only about STI and HIV; and 7% do not teach any form of sexuality education
 Evaluations of abstinence-only programs find that such programs show little to no long-term effect on attitudes, no delay of sexual initiation, and some may actually decrease youth’s use of contraception thereby increasing their risk of unintended pregnancy and sexually transmitted infections
Discussion Questions:
 Did you receive any type of sexuality education in school? What grade and what type of sex education did you receive?
 Did your parents talk to you about sex?
 What do you wish you had been told about sexuality, your body, and reproduction when you were growing up?
 Do you think sexuality education is important? Why or why not?
 Are there things you feel you still need to learn as an adult about sexuality and reproduction?
Resources and Links:
 Sexuality Information and Education Council of the United States (SIECUS)
 National Coalition to Support Sexuality Education
 Guttmacher Institute

 Our Whole Lives
 11 Facts About Sex Ed in the U.S.

EKRHP – Julie Daniels from Appalachian Media Institute on Vimeo.

Birth Options

While giving birth used to be a dangerous event for women a century or so ago, birth is now a much safer event for women in the United States. Still, the United States’ maternal mortality rate of 15.1 per 100,000 live births[i] places it at the bottom of all industrialized nations in the world[ii].  Mothers in the U.S. are at a much higher risk of dying from a cause associated with birth than women in other developed countries.

The infant mortality rate in the U.S. is also high at 6.9 per 1,000 live births, with huge variation by race–5.7 for white babies to 13.7 for African American babies[iii].  Kentucky’s infant mortality rate is very close to the national rate, and its maternal mortality rate is 8.8[iv].  While Kentucky’s maternal mortality rate is lower than the national rate, it is significantly higher than the national goal of 3.3 per 100,000 live births by 2010 laid out by the U.S. federal government[v].

Given the fact that risk still exists during pregnancy and birth, it is very important for women to be informed of all the birth options available to them.  Equally important is finding a provider and a facility that will partner with you to have a safe birth experience that fits your birth plan.

Several important technologies and medical knowledge have been developed to prevent and address the risks for both newborn and maternal death associated with birthing.  Still, some women do not have access to appropriate care during pregnancy and birth, while at the same time many women in the U.S. and Kentucky are overexposed to interventions during labor and birth.  While birthing technologies, such as cesarean sections (c-sections) can be life-saving interventions, medically unnecessary interventions can actually increase risks for mother and newborn.

The World Health Organization has stated that an ideal cesarean section rate, one that would reflect medical need, should be at around 15 percent of all births[vi].  According to a 2011 study, the U.S. c-section rate is at the highest yet, having increased from 27% of all births in 2002 to 34% in 2009.  Kentucky’s c-section rate was even higher than the national rate, at 35%[vii].   The Kentucky rate for induced labor is 26%[viii], meaning that 1 in 4 women have labor brought on through the use of medication rather than allowing their bodies to go into labor naturally.

Receiving prenatal care from the beginning of a pregnancy increases the chances that any medical problems can be handled appropriately to limit risks and complications during birth and postpartum for both mother and baby.  Making a birth plan, a written document that states your preferences for labor and birth—within the boundaries of what is medically appropriate and safe for mother and baby, is a helpful way to communicate to your provider (and others you may want involved in the birth) what your preferences are for labor and delivery.

Options for birthing include:

• What type of provider(s) you choose (physician, Nurse-Midwife, direct-entry midwife)
• Who will be with you at the birth (partner, sibling, friend, parent, doula)
• What type of facility you choose to have your baby in (hospital, birthing center, home)
• What type of interventions you feel comfortable with and under what circumstances (cesarean, pain management, VBAC [vaginal birth after cesarean], episiotomy, induction, use of forceps or vacuum, among others)
• How you want to labor and deliver (walking, sitting, squatting position, etc.)
• As well as decisions about breastfeeding, rooming with your baby while at the hospital, and if you have a baby boy—whether to have a circumcision or not.

Quick Facts:

• In 2006, Kentucky ranked 6^th among all states for cesarean section rate[xii]
• VBAC (vaginal birth after cesarean) is a safe birth option for most women[xiii]
• There are currently no birthing centers in Kentucky (35 other states have birthing centers)
• There are many types of childbirth classes that can help prepare you for pregnancy, delivery, and postpartum—Lamaze, Bradley, Hypnobirthing, Birthing from Within[xiv]

Discussion Questions:

• Do you believe women and their providers should be able to schedule a cesarean section or induction based on convenience or should it only be based on medical necessity?
• Do you believe women are generally encouraged to learn about pregnancy and childbirth in your community?
• How familiar are you with the care that midwives provide?
• Do you think women have the right to refuse medical treatment that they deem unnecessary or invasive based on their knowledge, preferences, and discussions with the care provider?
• If you were going to write a birth plan, what are some things that would be important to you to include?
• Do you have a birth story to share?

Let’s begin by looking at Sandy Rios (conservative commentator) comments on Fox News.  If you listen to the audio version of the story on the NPR website, you will hear more of her comment than what is printed.  She says, “We have $14 trillion in debt, and now we’re going to cover birth control, breast-pumps, counseling for abused… Are we going to do pedicures and manicures as well? I think that would be a good idea.”  What should be asked to Ms. Rios is – Since when have you spoken with a newly married woman who is finishing her college education and would like to wait to begin her family at a time when she feels prepared to focus more deeply on the demands of motherhood?  Since when have you spoken with a mother who breastfeeds her baby (the healthiest choice for both mother and baby) and is about to go back to work and truly needs a quality breast-pump in order to continue breastfeeding?  Since when have you spoken to an abused woman who is in desperate need of professional counseling as she tries to get back into a healthy environment for herself and her children?  Now, answer this… How in any confidence can you equate these true daily needs of American women with frivolous luxuries such as manicures and pedicures?  Are those on either side of the political spectrum who speaks in such terms concerned at all about the well-being of America’s women and children?

Consider Rios statements with others in the story like Marjorie Dannenfelser, of the anti-abortion Susan B. Anthony List.   ”As the money (for family planning) goes up, so do the number of abortions,” she said. “We have not seen a reduction in abortions since the full funding of family planning. We have seen an escalation.”

If we only take Kentucky into consideration, here is the reality - Without publicly-funded family planning services in Kentucky, the state’s unintended pregnancy rate would be 67% higher, and the abortion rate 163% higher [1].  In 2008, contraceptive services provided at Title X–supported (Title X is the current federal program that provides for family planning services and supplies through provision of low-cost and free contraceptive services and supplies.) centers in Kentucky helped women avoid 21,500 unintended pregnancies, which would have resulted in 9,600 births and 9,000 abortions [2].  Can we imagine if women had universal access to reliable forms of birth control that they could maintain consistent use of, how many abortions and unintended pregnancies could be prevented.

Greater than 50% of Kentucky’s births are currently paid for through state Medicaid coverage.  Kentucky being one of 11 states where this is the case.  While it is not appropriate to discourage lower income women from creating the families that they want to have (women have the right to parent if they so desire and it is elitest as well as class discrimination to deny that right), if we were to provide more publicly funded birth control those women who would like to prevent pregnancies could do so resulting in long term, lower cost to state funded insurance.

Also, in planning pregnancies, women can achieve healthier outcomes.

Every woman should be thinking about her health whether or not she is planning pregnancy. One reason is that about half of all pregnancies are not planned. Unplanned pregnancies are at greater risk of preterm birth and low birth weightbabies. Another reason is that, despite important advances in medicine and prenatal care, about 1 in 8 babies is born too early. Researchers are trying to find out why and how to prevent preterm birth. But experts agree that women need to be healthier before becoming pregnant. By taking action on health issues and risks before pregnancy, you can prevent problems that might affect you or your baby later. – Women’s Health.gov

Kentucky’s rate of pre-term birth is 14% and low birth weight is 9%, some of the higher percentages in the country.  Helping women achieve healthier pregnancies will also lower the costs of state funded health care.  Not only this, but it increases the health of the nation’s women and children.

It is not an easy thing to talk about these issues.  Access to information needed to make informed decisions is key, and something that many women are lacking.  How many of you know how to prevent pregnancies while still being sexually active without using birth control?  How many of you are aware of how your birth control works in your body?  Do you know how reliable the different methods are?

Are we making any progress toward a wider vision of health in this country if we deny people the choices that can help them become healthier?  We cannot live everyone’s life for them.  It is none of our business the choices the strangers we pass on the street make in their bedroom.  Nor, can we be the judge of everyone’s individual situation against any kind of standards we personally hold for our own life.  The conservatives are missing every important point on this issue.

[1] Cohen SA, The numbers tell the story: the reach and impact of Title X, Guttmacher Policy Review, 2011, 14(2):20–23. As cited in State Facts About Title X and Family Planning: Kentucky, available online at http://www.guttmacher.org/statecenter/title-X/KY.html#13

[2] Frost JJ, Henshaw SK and Sonfield A, Contraceptive Needs and Services, National and State Data, 2008 Update, New York: Guttmacher Institute, 2010.

EKRHP – Connie Little from Appalachian Media Institute on Vimeo.

• 36.6 percent of women in Kentucky have experienced intimate partner violence[xii]
• Intimate partner violence, also called domestic violence, includes physical, sexual, psychological/emotional abuse, as well as stalking, economic control, social isolation, and reproductive coercion[xiii]^,[xiv],[xv]
• Intimate partner violence has many negative health effects including physical injuries, chronic pain, depression, and suicidal behavior[xvi]
• Intimate partner violence can lead to unwanted pregnancy, premature birth, and sexually transmitted infections, including HIV and AIDS[xvii]
• Contraceptive sabotage is often part of intimate partner violence and includes behaviors such as poking holes in condoms, throwing away or otherwise interfering with birth control method, lying to or misinforming partner about contraception, and not allowing a partner to use contraception of any kind

Discussion Questions:

• Do you know of any community resources that can help and support women in abusive relationships?
• Do you feel that there is still stigma around domestic violence?  Is there stigma around a woman leaving her partner or husband in your community?
• Have you ever heard of contraceptive sabotage before?  What do you think about the idea that a person may use contraceptive access to control and abuse their partner?
• Have you ever heard of someone you know not being allowed to use contraception by their partner, or being forced to get pregnant, or have a baby?
• What do you think could be done at the community level to help women in abusive situations?

Resources and Links:

EKRHP – Janet McReynolds from Appalachian Media Institute on Vimeo.

“Advanced Maternal Age”

In the medical field, age 35 and older is generally considered “advance maternal age”.  This classification is in part due to increased risks for complications for the woman as well as the pregnancy and fetus observed in women 35 years and older.  While women in the past have had children into their late twenties and thirties, the first birth was usually in the early twenties.  However, over the past thirty years or so, women in the U.S. have been delaying first childbirth from their early twenties into their late twenties, thirties, and forties.  Many changes in society have played a role in the rising maternal age, including later marriages, increased use of contraception, women’s rising educational and career access, single motherhood by choice, and longer life expectancy.

In 1970, the average age of a woman at first childbirth in the United States was about 21 years old.  By 2006, the age increased to 25.[i] Due to the high rate of teen pregnancy in the U.S. the average age at first childbirth in the U.S. is much lower than most other developed nations.  In order to get a clearer sense of the shift in age at first childbirth, we can look at the change in the percentage of births to women 35 and over: in 1970, just 1 percent of all births were to women age 35 and over; by 2006, the rate was 1 in 12 births.[ii] Nowadays, one in five women have their first child after age 35.[iii] On average in the U.S., the age at first childbirth increased by 3.6 years, with variation across the states from 2 to 5.5 years.  In Kentucky, age at first childbirth between 1970 and 2006 increased by 3.1 years, from 20.7 to 23.8 years old[iv].

Births to unmarried women in their late twenties and thirties have also risen steadily over the past few decades, and a higher proportion of unmarried women now become mothers than ever before.[v]

Educational level plays a role in delayed childbirth, and statistics indicate that women with higher educational attainment are more likely to delay childbirth.[vi] Delayed childbirth has occurred primarily with women with at least a high school education.  Women with higher education also experience more economic stability and are able to provide better educational and socio-economic opportunities for their children.

While if and when to have children is generally regarded as a personal decision, lots of societal factors play a strong role in how this is decided.  Additionally, many women do not have control over their own sexual and reproductive health (see section on Intimate Partner Violence and Reproductive Coercion).  As society changes, so do the options that women have access to and pressures that women feel change in regards to this important and life-altering decision.  As with any other decision, being able to make a decision as to if, when, and how many children to have is better made with an understanding of what each decision could mean in the short- and long-term and the confidence and safety to make the decision without coercion or fear.

Quick Facts:

• 1 in 5 women in the U.S. has their first child after age 35[vii]
• The average women’s age for first birth in Kentucky is 23.8 (as of 2006, the latest data available)[viii]
• Reasons for delaying childbirth include educational and career pursuits, economic stability, later marriage, inability to take time off work, increased availability of contraceptives, and longer life expectancy
• Women with higher educational levels tend to delay childbirth and have fewer children

Discussion Questions:

• What is the average age that most women you know have their first child?
• Have you seen a change in age at first childbirth between the generations in your community?  Why do you think that is?
• What are some reasons for having children earlier in life?
• What are some reasons that would make you decide to postpone childbirth until late twenties, thirties, or forties?
• What are concerns you would have about having children at an early age and concerns about having children at a later age?
• What are men’s attitudes about earlier childbearing? About later childbearing?
• What information would you like to have to better prepare you to make a decision about when to have children?

Resources and Links:

March of Dimes

Growing up in a rural area it’s difficult for a young person because you don’t have other people to identify with. Your parents, they’re straight, your brother, he’s straight, too and then if you go to church that’s not going to be discussed regularly,  and if it is you’re going to hear something like homosexuality is a sin, if you’re thinking about it you’d better quit.  -Farah Ardeshir

The research shows and what I have seen is students who are dealing with their sexual identity are more apt to suffer from depression, are more apt to attempt self-harm, are more apt to self-medicate with drugs and alcohol just because there are those feelings of self-isolation, rejection.  -Eef Fontanez, high school counselor (Berea)

Watch the following 15 minute short film from the Appalachian Media Institute (an affiliate with EKRHP and Appalshop) featuring some young people from southeastern Kentucky who grew up in the region and reside here as of the making of this film.

Through Their Eyes from Appalachian Media Institute on Vimeo.

Exploring ones sexuality in rural America (or anywhere for that matter) is not always an easy proposition.  However, humans are most of the time sexual beings and will desire to explore their sexuality.  What should be guaranteed is that this can be done in a safe environment, and that the person exploring has enough information to protect themselves and their partner/s from negative consequences of unhealthy sexual exploration.  Read more about sexuality at EKRHP.

For more information on supporting young people who identify as LGBTQ, visit the It Gets Better Project.

Women who have been in domestic violence situations have experienced possible physical violence, reproductive coercion, endangerment, and emotional distress, amongst other things.  These women benefit most from comprehensive treatment, counseling, and support that is complete and unbiased.

The KDVA training aims…

• To provide participants with resources to reproductive health care, motivational interviews, and knowledge of biological and social factors that influence a woman’s health decisions.
• To provide clear steps for how to create, maintain, and support referrals made during counseling.
• To encourage providers/health workers to provide a supportive clinical environment for clients to engage around issues of sexuality, pregnancy, and counseling.

To hear from women who have experienced domestic violence, please watch Black and Blue on this website.  Learning to support women in the healing process is worth our time.

Register KDVA TI PH Training 2011.

The question remains – Can we take these conversations out of political hot button issues in order to create a space for civil conversations and plant the seeds for meaningful change?

It seems in the current climate that people are forgetting about those that these issues affect – women and the children belonging to them – in exchange for strong, steadfast opinion.  Also, neglecting both the moral and ethical questions that extreme, unchanging opinion fails to address.

As an example of opening the doors to civil conversation around these important topics, EKRHP would like to share links to the recent commentary of Frances Kissling a Catholic feminist and former president of Catholics for Choice.  She is addressing the growing need to re-evaluate the abortion debate from both sides in order to change it from a debate into a conversation that brings about usable results.

Be Fruitful and Subtract from The Washington Post – “No doubt the women profiled in the story are going to be judged, probably harshly for their decisions. There is little sympathy or understanding of what pregnancy and child rearing means for women. While small families are the American norm, there is a cultural attraction to the “Eight Is Not Enough” way of thinking with several reality TV shows demonstrating how easy it is to be happy and healthy with a slew of kids. The fact that the women in the Times story feared that twins would be “too much” is likely to be considered wimpy at best; selfish at worst.” – Frances Kissling

On Being (Listening Beyond Life and Choice) – Krista Tippett interviews Kissling for the Civil Conversations Project – Frances Kissling is known for her longtime activism on the abortion issue but has devoted her energy more in recent years to real relationship and new conversations across that bitter divide. She’s learned, she’s written, about the courage to be vulnerable in front of those with whom we passionately disagree.

What do you think?  Can a civil conversation be had between opposing sides when it comes to the issues around reproductive health?  Please share your comments with EKRHP.