The organization is resolutely in support of abortion rights and contraception, but its 11,000 members (nurses, physicians, public health professionals, health educators) work across a broad spectrum of issues, including obstetrical care, adolescent health, HIV/AIDS, reproductive cancers, menopause, infertility, male reproductive
health, reproductive endocrinology, and so on.

The link between reproductive health and environmental health was especially highlighted at this meeting. (The audience gasped to hear that while the Centers for Disease Control reported 6.1 million couples with infertility problems in 1995, the number had reached 7.3 million couples in 2002).

Some of the  sessions were quite  technical, and what one would expect at any medical gathering, for example, updates on treatments for women with
interstitial cystitis/painful bladder syndrome, and for  those who have recurrent miscarriages. Others spoke  to the interface of the medical and social that are at the heart of reproductive health.  

Speakers addressed such topics as the case to be to be made for offering birth control pills over the counter, rather than through prescription, and factors which make some patients, and not others, opt for HIV testing in an urban clinic. In short, what reproductive health means in this universe is a combination of drawing on both evidence-based medicine and a particular set of values to help people achieve the sexual and family lives they wish for.  

Most of all, the ARHP meeting also made clear how absurd it is to separate abortion and contraceptive issues from other reproductive and sexual health concerns, given the range of issues women and men face throughout the life cycle.

To be sure, reminders of the alternate "Reproductive Health" universe of the Religious Right were not absent from this gathering.  The first plenary speaker was Dr. Henry Foster, a distinguished former medical school Dean, a past leader in national efforts  to lower teenage pregnancy rates, and now an active player in international health circles.  

Foster reminded his audience that in 1995, when he was nominated by then-president Bill Clinton, to be Surgeon General, he was subjected to a "character assassination" by Republicans, led by Senators Bob Dole and Phil Gramm (both then vying to be their party's nominee in 1996). Because Foster,s many faceted career as an obstetrician gynecology had included the performance of some abortions, his opponents were able to derail his nomination.

Similarly, James Wagoner, of Advocates for Youth informed the group that because of the politicization of sexual and reproductive health  the United States is now in the unacceptable  situation in which every day, some 10,000 adolescents get a sexually transmitted infection, 2,000 become pregnant, and 55 contract HIV.  

But it was the events simultaneously transpiring in Aurora, Illinois, a suburb of Chicago, while the ARHP was meeting in Minneapolis, that constitute the most deplorable contrast between these two worlds of reproductive health.        

Aurora for the last several weeks has been the site of protest by antiabortion groups attempting to prevent the opening of a new Planned Parenthood clinic.*  

Planned Parenthood has long been demonized by the antiabortion movement, but the Aurora events represent a newer development--the  effort  to prevent a clinic from actually being built (as almost happened in Houston a few years ago, by pressures put on contractors) or from opening after construction.

Sean Hannity of Fox News  predictably weighed in with an "expose" of the Aurora events, and ended his piece by ominously warning his audience, in terms usually reserved for drug dealing:

"A Planned Parenthood may be coming to your neighborhood before long."

And what services are planned for the clinic that so appall its opponents?

The Aurora facility is set to offer virtually all the services that the attendees at the ARHP were discussing so intently.  That is, gynecological care, birth control counseling and services, testing and treatment for sexually transmitted infections, cervical cancer testing, educational sessions for parents and adolescents.  

And abortions.  

In a similar proportion to Planned Parenthood clinics elsewhere, the Aurora staff estimates that abortions will constitute about ten percent of its services.

So it has come to this.  If the mob outside the Aurora clinic gets its way, low income  women will be denied cervical cancer screening and the large number of teens in the area known to have chlamydia will not be treated.  Illinois moreover is a state where only 29% of "women in need" are provided family planning services, according to the Guttmacher Institute, the leading research organization on reproductive health.  

This is insane public policy.  

This is not to suggest that if only the antiabortion zealots would go away, everything would be nonproblematic in the world of reproductive health.  The issues of health care cost and access would still remain, especially in rural areas.  Though Planned Parenthood tries to keep its prices low, its services are  still not affordable for  everyone who needs them.  Only universal health care will fix that.  (And only  a universal health care system that will cover the full spectrum of reproductive health care, about which there is certain to be contention).  

As in other health care fields, disagreements exist among health care providers as to best clinical practices and lively discussions were everywhere at the ARHP meeting.  Health care professionals and the advocates or the "reproductive justice" community as it is increasingly known may be united in opposition to the Religious Right, but have long disagreed on various other issues, for example the safety of various contraceptives.

But most crucially, the field of reproductive health is being faced with a number  of new and  complicated issues, which have barely begun to be discussed - and abortion, in the words of Lynn Paltrow of the National Advocates for Pregnant Women:

"has served as a brilliant distraction."

To name just one item that demands much more attention, how should reproductive health professionals respond to the bewildering challenges posed by assisted reproduction and new reproductive technologies?  

In an interesting recent article in Dissent, Rebeca Tuhus-Dubrow shows the inadequacy of the prevailing frame of "reproductive rights" to deal with issues such as selection and other attempts at "designer babies."  

The struggles  between these two parallel universes  of reproductive health sadly show no signs of abating.  Those in the  universe represented by reproductive health workers and their  allies  can acknowledge the moral complexities brought forward by some aspects of reproductive and sexual health.  But poor women having access to cancer screening should be a no-brainer in a civilized society.

*UPDATE:  On October 2, shortly after this piece was first written the Planned Parenthood clinic in Aurora was allowed to open.

Carole Joffe is a professor of sociology at the U.of California, Davis.