George Bush was elected U.S. President in 1988, continuing the Reagan march to achieve the right-wing social agenda. With increasing pressure from right-wing--especially Christian--organizations and even violence, the U.S. political climate was rife with new developments touching on human sexuality and contraception, issues related to HIV/AIDS, unintended pregnancy, and the continuing abortion debate. Supreme Court cases began to narrow the Right to Choose. Increasingly, the job of educating the public and clinicians on these matters crossed political lines. ARHP needed a new executive director with political savvy and fundraising expertise. This director was found in Dennis Barbour, JD, former executive director of the Association of Teachers of Preventive Medicine.
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"We must make sure that every child born in America is a planned, wanted child and will have the opportunity to grow up healthy, educated, motivated, and with hope for the future… We must begin to address our problem of unplanned, unwanted children and stop letting our people keep falling in and being washed down the river of poverty, ignorance, and enslavement."
- Dr. Joycelyn Elders, US Surgeon General, 1993 |
Barbour was hired in 1990, the same year the Association was incorporated in Washington, DC. At the time, ARHP's program activities consisted of a one-day seminar in conjunction with the Planned Parenthood annual meeting; co-sponsorship of a medical risk reduction seminar with Planned Parenthood; continuation of the TruthRumour campaign; and completion of a brochure about the organization.
Under Barbour's tenure, the pace of developments would be astounding for ARHP, and the breadth of accomplishments wide. Within a year, Barbour drew up the Association's first strategic plan, hired four full-time staff members and found appropriate office space at 2401 Pennsylvania Avenue, NW. A continuing medical education (CME) Mission Statement was drafted and an ARHP information sheet was drawn up, to be used as text for the first ARHP brochure. All of these elements would work toward one of Barbour's first major projects--to raise the Association's national visibility by expanding the Association's education programs.
In 1991, with a $1.2 million grant from Wyeth-Ayerst Laboratories, ARHP inaugurated a professional education program with a training series on Norplant, which was approved for marketing in the United States in December 1990. Through this program, New Developments in Contraception and a Practicum on the Norplant® System, ARHP trained more than 1,700 clinicians in the insertion and removal of the Norplant® contraceptive system in 34 training sessions in more than 20 cities.
With the success of the Norplant Program, Barbour was able to secure funding in 1993 for an ARHP educational program on reversible methods of contraception. Following FDA approval of depomedroxyprogesteroneacetate, or Depo-Provera, for use as a contraceptive, the Association launched a national educational outreach program to patients and health care providers. The program was designed to raise awareness among women, their partners, and health care providers about reversible contraceptive options through a series of brochures, educational videos, and a visiting faculty program. The Upjohn Company supported the effort with a $2.4 million grant.
While expanding in its role as a provider of professional and public education programs, ARHP was at the same time assuming a public policy advocacy role. One of Barbour's first orders of business in the political arena was for ARHP to confront the gag rule in 1991. This was a counseling ban instituted during the Reagan-Bush era that would have prohibited medical professionals at Title X clinics from counseling, advising or providing information about abortion and from referring women to health care facilities that offered abortion counseling or services. Health care providers would have been required to tell women who requested information about abortion that "abortion is not an appropriate method of family planning," even when the pregnancy threatened the woman's life
Joining a group of leading medical groups, including the American Medical Association and the American College of Obstetricians and Gynecologists, ARHP opposed the gag rule and signed onto a petition to stop its enforcement.
The following year, ARHP endorsed a petition related to the testing and use of RU486, drafted by the Feminist Majority Foundation. Following meetings in France to assess the potential of RU486, Feminist Majority Foundation leaders found it to offer a wide range of potential benefits for women. In 1989 the Foundation had launched the nation's largest public education drive on RU486, the Campaign for RU486 and Contraceptive Research.
In 1990, the campaign would have particular resonance for ARHP: In the first direct challenge to the FDA import alert on RU486, a pregnant American woman, Leona Benten, returned from England with the RU486 medication for personal use. Customs officials seized the RU486 upon the arrival of Benten and Larry Lader of Abortion Rights Mobilization at JFK Airport. ARHP's present medical director, Dr. Louise Tyrer, was also at the airport and made a statement to the press.
Other ARHP advocacy activities have included an ARHP editorial supporting the Centers for Disease Control and Prevention's marketing campaign, published in the Washington Times (February 2, 1994), and 1994 congressional testimony in support of over-the-counter status for Zovirax.. These and other ARHP events were well covered by the national media.
As well as raising the profile of ARHP, Barbour was determined to strengthen bonds with Association members and other organizations. Working relationships with other organizations were formed, especially with the National Association of Nurses in Reproductive Health (NANPRH), formerly the National Association of Nurses in Family Planning (NANFP).
In 1990, NANPRH Executive Director Susan Wysocki proposed joint membership recruitment and other collaborative activities with ARHP. As a result, NANPRH began co-sponsorship of ARHP's annual meeting in conjunction with Planned Parenthood.
The relationship between ARHP and NANPRH would become increasingly symbiotic, including co-sponsorship of contraceptive training programs and annual meetings, and exchange of professional medical expertise. NANPRH would relocate to the ARHP offices for five years, with Susan Wysocki acting as the Association's onsite medical consultant and newsletter editor.
The idea of publishing a newsletter had been bandied about in ARHP executive committee meetings since the 1960s. The idea culminated in 1991 with the publication of the ARHP magazine Health & Sexuality. Designed to keep members in touch with the Association and with each other, and up to date on current developments in reproductive health, Health & Sexuality has won a number of awards over the years, including the 1993 Gold Ozzie, 1992 Silver Ozzie, and 1992 ASAE Gold Circle Award for Achievement. Issues have been timed to cover topics that complement new ARHP clinical and educational programs.
As a clinical partner to Health & Sexuality, Barbour developed Clinical Proceedings, which provides CME for clinicians. Clinical Proceedings presents a comprehensive summary of clinical conference presentations, focusing on evaluated highlights. Clinical Proceedings is also timed to complement ARHP's clinical and educational programs.
In addition to the first issues of Health & Sexuality and Clinical Proceedings, in 1991 ARHP also published a clinician's handbook, Maximizing Oral Contraceptive Effectiveness. This handbook serves as a simple, comprehensive reference tool and for nearly a decade has remained popular among members of ARHP and others.
From 1991 to 1997, ARHP's membership increased to nearly 2,000, reflecting the growing dynamism and broadening scope of the Association. ARHP began to hold bigger meetings, use a variety of educational methods, and tackle new issues in reproductive health. These issues included unintended pregnancy, injectable contraceptives, and health benefits of contraception.
Many of these issues have been addressed by ARHP's visiting faculty programs and professional education campaigns, such as New Developments in Contraception and a Practicum on the Norplant® System. A number of visiting faculty programs were developed over the years, successfully placing expert, trained speakers in venues as varied as grand rounds, managed care facilities, and national health association meetings. Final curriculum for each program includes slide sets, teaching points, and supplementary materials.
While continuing to sponsor scientific sessions at the PPFA annual meeting, in 1991 ARHP began holding biennial clinical meetings on the perimenopause and adolescent reproductive health, as well a number of clinical consensus conferences. One of the most outstanding of these was the 1992 consensus conference to plan a campaign to reduce unintended pregnancy nationwide.
| ARHP BOARD PRESIDENTS |
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1980 to 1981 Howard J. Tatum, MD, MPH
1990 to 1992 Herbert P. Brown, MD
1992 to 1994 Andrew Kaunitz, MD
1994 to 1996 Steven Sondheimer, MD
1996 to 1999 Kirtly Parker Jones, MD
2000 to 2002 Trent MacKay, MD, MPH
2002 to 2004 Felicia Stewart, MD |
Unintended pregnancy had become a major concern in the social and medical sciences. In 1991 The Alan Guttmacher Institute published Preventing Pregnancy, Protecting Health: A New Look at Birth Control Choices in the United States, which presented shocking data from a number of surveys. Among other things, the surveys found that more than half the pregnancies in the United States were unintended and about half of these end in abortion. The economic and social consequences of the situation were clearly disturbing, and straddled all sectors of family planning. Unintended pregnancy became a political issue, and Dr. Joycelyn Elders, who served on ARHP's board of directors, made it clear from the start of her designation as U.S. Surgeon General that reducing unintended pregnancy was one of her main goals.
ARHP's consensus conference attracted more than 100 attendees from the fields of medicine, religion, politics, the media, and the social and behavioral sciences, as well as representatives of foundations, government, and pharmaceutical companies. The resultant Highlights & Recommendations laid the groundwork for a major undertaking, the National Program to Prevent Unintended Pregnancy. This multi-year, multi-million dollar campaign aimed at reducing the incidence of unintended pregnancy through improved contraceptive usage and greater awareness of the consequences of sexual behavior.
Guided by a task force co-chaired by Drs. Herbert Brown and Michael Burnhill, the National Program to Prevent Unintended Pregnancy would raise the profile of ARHP significantly. The program's various components would include a visiting faculty program in reversible methods of contraception, a clinician's tool, a contraception hotline, patient education materials for nurse clinicians, a patient CME panel, and a National Program newsletter. It would also spawn another new partnership focused on the problems of adolescent reproductive health.
To examine the public policy component of a newly-recognized health crisis population, ARHP hosted What Works--Adolescent Health: STD and Pregnancy Prevention, in October 1993. The meeting was co-sponsored by the American Social Health Association and the Centers for Disease Control and Prevention, in collaboration with the Women's Health Task Force of the Congressional Caucus for Women's Issues. U.S. Surgeon General Dr. Joycelyn Elders gave the keynote address and served as honorary chair of the meeting.
The clinical originator of the policy meeting, the first in a new biennial, clinical conference series devoted to issues related to adolescent reproductive health was held in November 1993, Adolescent Reproductive Health '93--Clinical Update: Protecting the Sexual Health of Teens in the 1990s. One month later, in December 1993, the Adolescent Health Initiative was developed as a component of the National Program to Prevent Unintended Pregnancy.
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"Reproductive health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so."
- From the United Nations Report of the International Conference on Population and Development Special Report on Family Planning, Cairo, Egypt, September 1994 |
The Initiative evolved into the National Adolescent Reproductive Health Partnership (NARHP) by 1994, a coalition of organizations and individuals with a common interest in making adolescent reproductive health a national priority. Over 70 organizations and more than 300 individuals have become NARHP "partners." Over the years, NARHP's many activities have included a teen CME panel, Internet clearinghouse, teen hotline and the NARHP quarterly newsletter. In 1995, Let's Talk About Sex, the Emmy award-winning, NARHP-sponsored video designed to educate teens on abstinence, birth control, STDs, and pregnancy was aired on PBS. And NARHP also developed a kit featuring a teen sexual history-taking tool to help adolescents and their health care providers address subjects such as birth control and STDs.
Programs such as the Adolescent Health Initiative and the National Program to Prevent Unintended Pregnancy helped define a certain era for ARHP. They attracted new--and lasting--interest in the Association from sources beyond the purely medical sector, and included the participation of well-known and pivotal decision-makers in government, politics, industry, and the media. When Barbour left the Association in early 1998, this era effectively came to an end, while germinating a new beginning: Fortified with increased membership, new partnerships, and successful, ongoing professional programs and meetings, ARHP was ready to meet a new generation.
