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Common hospital and surgical center responses to the Covid‐19 pandemic included curtailing “elective” procedures, which are typically determined based on implications for physical health and survival. However, in the focus solely on physical health and survival, procedures whose main benefits advance components of well‐being beyond health, including self‐determination, personal security, economic stability, equal respect, and creation of meaningful social relationships, have been disproportionately deprioritized. We describe how female reproduction‐related procedures, including abortion, surgical sterilization, reversible contraception devices and in vitro fertilization, have been broadly categorized as “elective,” a designation that fails to capture the value of these procedures or their impact on women's overall well‐being. We argue that corresponding restrictions and delays of these procedures are problematically reflective of underlying structural views that marginalize women's rights and interests and therefore threaten to propagate gender injustice during the pandemic and beyond. Finally, we propose a framework for triaging reproduction‐related procedures during Covid‐19 that is more individualized, accounts for their significance for comprehensive well‐being, and can be used to inform resumption of operations as well as subsequent restriction phases.

This paper looks at the journey of eleven counsellors in marital counselling centres in French-speaking Belgium, from the creation of the centres in 1953, to the 1970s, when contraception became legal, and abortion became a public issue. At the time of Humanae Vitae , groups of volunteers, working within Catholic organisations where counselling took place, began to structure their activity around Carl Rogers’s ethics of client-centred therapy, placing their religious ideology in a secondary position to focus on the problems experienced by the couples and women they were receiving in the centres. These were often challenges they were experiencing themselves in their own lives. The reiteration of the Catholic orthodox view on contraception through Humanae Vitae marked a gap between the counsellors and the Church. This contribution questions the identity-related tension of Catholics working in conjugal counselling centres and the type of commitments they made to both the conjugal centres and the Church in a moment where family planning was debated both in the Church and politically.

The medical intervention of ‘twilight sleep’, or the use of a scopolamine–morphine mixture to anaesthetise labouring women, caused a furore among doctors and early 20th-century feminists. Suffragists and women’s rights advocates led the Twilight Sleep Association in a quest to encourage doctors and their female patients to widely embrace the practice. Activists felt the method revolutionised the notoriously dangerous and painful childbirth process for women, touting its benefits as the key to allowing women to control their birth experience at a time when the maternal mortality rate remained high despite medical advances in obstetrics. Yet many physicians attacked the practice as dangerous for patients and their babies and antithetical to the expectations for proper womanhood and motherly duty. Historians of women’s health have rightly cited Twilight Sleep as the beginning of the medicalisation and depersonalisation of the childbirth process in the 20th century. This article instead repositions the feminist political arguments for the method as an important precursor for the rhetoric of the early birth control movement, led by Mary Ware Dennett (a former leader in the Twilight Sleep Association) and Margaret Sanger. Both Twilight Sleep and the birth control movement represent a distinct moment in the early 20th century wherein pain was deeply connected to politics and the rhetoric of equal rights. The two reformers emphasised in their publications and appeals to the public the vast social significance of reproductive pain—both physical and psychological. They contended that women’s lack of control over both pregnancy and birth represented the greatest hindrance to women’s fulfilment of their political rights and a danger to the healthy development of larger society. In their arguments for legal contraception, Dennett and Sanger placed women’s pain front and centre as the primary reason for changing a law that hindered women’s full participation in the public order.

The Affordable Care Act (ACA) requires both individual insurance policies and plans sold or administered in the employer group market to cover preventive health services that public health authorities deem highly effective. Under the law, preventive care and screenings for women constitute a specific preventive benefit category.[1] Regulations issued by the Obama administration in consultation with the National Academy of Medicine[2] interpret this category to include contraceptive methods approved by the US Food and Drug Administration (FDA).To say that this contraceptive coverage guarantee has been controversial is an understatement. Under the Trump administration, what might come next?The controversy surrounding this rule has focused on how it should be applied to employers that object to some or all contraception on religious grounds. Adhering to long-standing tradition, the rule completely exempts church-sponsored plans. Furthermore, in compliance with the Religious Freedom Restoration Act (RFRA),[3] the rule also contains an “accommodation” for plans sponsored by religious organizations, that is, nonprofit organizations that claim a religious affiliation (eg, universities and hospitals) but whose employees are not insured through church plans.[4] In these situations, the religious organization notifies its insurer of its objection, and the insurer provides coverage directly as an additional benefit offered outside the technical scope of the employer plan.

The twentieth-century history of men and women’s attempts to gain access to reproductive health services in the Republic of Ireland has been significantly shaped by Ireland’s social and religious context. Although contraception was illegal in Ireland from 1935 to 1979, declining family sizes in this period suggest that many Irish men and women were practising fertility control measures. From the mid-1960s, the contraceptive pill was marketed in Ireland as a ‘cycle regulator’. In order to obtain a prescription for the pill, Irish women would therefore complain to their doctors that they had heavy periods or irregular cycles. However, doing so could mean going against one’s faith, and also depended on finding a sympathetic doctor. The contraceptive pill was heavily prescribed in Ireland during the 1960s and 1970s as it was the only contraceptive available legally, albeit prescribed through ‘coded language’. The pill was critiqued by men and women on both sides of the debate over the legalisation of contraception. Anti-contraception activists argued that the contraceptive pill was an abortifacient, while both anti-contraception activists and feminist campaigners alike drew attention to its perceived health risks. As well as outlining these discussions, the paper also illustrates the importance of medical authority in the era prior to legalisation, and the significance of doctors’ voices in relation to debates around the contraceptive pill. However, in spite of medical authority, it is clear that Irish women exercised significant agency in gaining access to the pill.

Since USA constitutional precedent established in 1976, adolescents have increasingly been afforded the right to access contraception without first obtaining parental consent or authorisation. There is general agreement this ethically permissible. However, long-acting reversible contraception (LARC) methods have only recently been prescribed to the adolescent population. They are currently the most effective forms of contraception available and have high compliance and satisfaction rates. Yet unlike other contraceptives, LARCs are associated with special procedural risks because they must be inserted and removed by trained healthcare providers. It is unclear whether the unique invasive nature of LARC changes the traditional ethical calculus of permitting adolescent decision-making in the realm of contraception. To answer this question, we review the risk–benefit profile of adolescent LARC use. Traditional justifications for permitting adolescent contraception decision-making authority are then considered in the context of LARCs. Finally, analogous reasoning is used to evaluate potential differences between permitting adolescents to consent for LARC procedures versus for emergency and pregnancy termination procedures. Ultimately, we argue that the invasive nature of LARCs does not override adolescents’ unique and compelling need for safe and effective forms of contraception. In fact, LARCs may oftentimes be in the best interest of adolescent patients who wish to prevent unintended pregnancy. We advocate for the specific enumeration of adolescents’ ability to consent to both LARC insertion and removal procedures within state policies. Given the provider-dependent nature of LARCs and the stigma regarding adolescent sexuality, special political and procedural safeguards to protect adolescent autonomy are warranted.

The law regulating abortion in Italy gives healthcare practitioners the option to make a conscientious objection to activities that are specific and necessary to an abortive intervention. Conscientious objectors among Italian gynaecologists amount to about 70%. This means that only a few doctors are available to perform abortions, and therefore access to abortion is subject to constraints. In 2012 the International Planned Parenthood Federation European Network (IPPF EN) lodged a complaint against Italy to the European Committee of Social Rights, claiming that the inadequate protection of the right to access abortion implies a violation of the right to health. In this paper I will discuss the Italian situation with respect to conscientious objection to abortion and I will suggest possible solutions to the problem.

In regulating the voluntary interruption of pregnancy, English law has accorded particular significance to two biological events. First, ‘viability’, the moment when a fetus is said to acquire the capacity for independent life, plays an important role in grounding restrictions on access to legal abortion later in pregnancy. Second, equally significantly but far less frequently discussed, ‘implantation’ marks the point in pregnancy from which abortion laws apply. This paper focuses on this earlier biological event. It suggests that an unquestioning reliance on implantation as marking an appropriate moment of transition between two radically different legal frameworks is deeply problematic and is rendered still less sustainable in the light of the development of new technologies that potentially operate shortly after the moment of implantation.

\"Conscience clauses\" define conscience as \"religious beliefs\" or \"moral convictions,\" and they come up, therefore, usually in relation to women's reproductive rights. This article argues that conscience is better understood as a feeling of integrity, rightness, and self, and that we need it especially now, as huge corporations take over health care. After an illustrative story, the author reviews the history of patients' rights and also the health-care consumer movement, which introduced the idea that health care is a commodity, and the doctor, therefore, simply a tradesman, whose duty is to provide what his patient wants. The author examines where this new commercial model of medicine leads: patients demanding treatments that are bad for them and expensive for the health-care system; doctors who are forced to do what they think is wrong; a world where patients cannot trust their physicians to do their best for them. Patients need their doctors to have consciences. But in this time of expanding corporate power in health care, can the right to have a conscience also be a Trojan horse? Protecting corporate entities who legally are also entitled to have a conscience? The author proposes that the most powerful rule of conscience is the oldest, the Hippocratic oath's formulation that doctors should enter the exam room solely for the benefit of their patients. When the definition of \"benefit\" comes into question, then we should use the strategies developed over the past 45 years-shared decision making, ethics committees, media oversight-all of which will become ever more important as technology creates ever new dilemmas for conscience.

On the other side of the debate are organizations like the Abortion Rights Coalition of Canada. \"If you're a family doctor or [obstetrician-gynecologist], you have to expect that a lot of what you're going to be doing is family planning,\" says spokesperson Peggy Cooke, regarding birth control objections. \"If you don't want to practise medicine, don't be a doctor.\" The issue isn't so black and white, according to Barbara Hall, the Chief of the Ontario Human Rights Commission. Physicians' rights to religious or moral beliefs can be curtailed when they infringe on others' rights, such as the right to access services without discrimination, says Hall. The college's policy \"could clarify that limiting services based on moral or religious grounds could be prima facie discrimination.\" Provincial regulations regarding the duty to refer in the case of a personal objection tend to be vague and vary across Canada. For instance, the College of Physicians and Surgeons of New Brunswick states that referral in the case of moral objection is \"not an obligation\" but \"preferred practice.\" Quebec's line on conscientious objection is the most stringent: physicians are not only required to refer patients but also to inform them of the \"possible consequences of not receiving such professional services.\"