In a letter to fellow lawmakers, Rep. Rita Fleming, D-Jeffersonville, pushed back on criticism that her birth control bill plays into the hands of anti-abortion advocates by excluding IUDs.

“This should not be politicized,” she wrote in a letter. “It is the optimal way to help women who need it most.” 

A spokesperson for Fleming confirmed she sent the letter on Friday, Feb. 23 to Senate Democrats, Sen. Sue Glick, R-LaGrange, and Sen. Vaneta Becker, R- Evansville. “I encourage my Senate Democratic colleagues to work to find a compromise that will get the bill passed out of the Senate and signed into law,” Fleming said in a statement to Mirror Indy.

House Bill 1426 would require hospitals to offer women on Medicaid a long-acting reversible contraceptive — specifically the subdermal implant — after they give birth. The goal, Fleming said, is to reduce unintended pregnancies and protect women in vulnerable situations from the risks associated with getting pregnant again in a short period of time. 

The bill received widespread, bipartisan support as it advanced through the House. But critics, including fellow Democratic lawmakers, noticed that one form of birth control — intrauterine devices, known as IUDs — was omitted from the bill. Though the devices were never explicitly named in the legislation, an amendment specified arm implants as the sole type of contraceptive that hospitals would be required to offer. 

“Why would we eliminate the most popular long-acting reversible contraceptive?” Dr. Gabriel Bosslet, an associate professor at the Indiana University School of Medicine, asked during a House Committee on Public Health meeting on Jan. 30. “Medically, it just doesn’t make any sense.”

Fleming, a retired OB-GYN, talked about her experience in her letter to fellow lawmakers. 

[Read about how House Bill 1426 was first discussed at the Statehouse]

“(IUD) is no way the choice, or even the appropriate method, for those women I cared for as a hospitalist,”  Fleming wrote. 

She described some of her patients as drug addicts and sex workers who had sexually transmitted diseases — a factor that would eliminate IUDs as the best birth control option. IUDs would still be available, she said, just not offered outright by hospitals like the arm implants. 

“With this legislation, I could have offered these women a reliable, safe, long-acting contraceptive in the form of a subdermal implant,” she wrote. “It takes five minutes to achieve three years of protection.”

But there’s another player in the conversation: Indiana Right to Life, an anti-abortion group that pushed for the state’s recent near-total ban on the procedure. 

Bill co-author Rep. Cindy Ledbetter, R-Evansville, testified that IUDs were excluded from the bill because of Indiana Right to Life’s concerns that IUDs are a form of abortion. In truth, IUDs prevent sperm from fertilizing an egg, either through a copper implant or the release of hormones. 

“That is why it was removed from this,” Ledbetter told the Senate Committee on Health and Provider Services on Wednesday, Feb. 21. “Because we are a strong pro-life state.”

This revelation — bolstered by reporting from Mirror Indy that confirmed Indiana Right to Life had met with lawmakers last year about an identical birth control bill — has created rare discord between Senate and House Democrats in a state where they already have little political power. 

“Every single year, choices in reproductive health are constantly being clawed back, taken away, banned in the state of Indiana,” Sen. Shelli Yoder, D-Bloomington, said in an interview with Mirror Indy. “I see the writing on the wall with what’s happened with (HB) 1426.”

Yoder and Sen. J.D. Ford, D-Indianapolis, were the sole votes against advancing the bill to the Senate Appropriations Committee. 

Yoder, who cannot use hormonal birth control herself because of medical issues, said all forms of contraceptives should be offered to Indiana Medicaid patients. 

“I am very concerned that Right to Life has been effective in messaging a lie about IUDs,” Yoder said.  

Through spokespeople, both Fleming and Ledbetter denied meeting with Indiana Right to Life this year. But a comment from Rep. Brad Barrett, R-Richmond, who chairs the House Public Health Committee, confirmed some lawmakers had conversations with groups about the issue of IUDs.

“Amendment number one defines the subdermal implant as the (long-acting reversible contraceptive) we’re talking about in this bill and removes the IUD,” said Barrett at a committee meeting on Jan. 30. “After discussions with multiple groups, we felt like that was the appropriate language.” 

Yoder, meanwhile, said she plans to introduce an amendment that would require IUDs to be included in the bill.

She also told Mirror Indy she would rally opponents to attend the next Senate Appropriations Committee meeting to testify against the bill. That meeting has not been scheduled as of early Friday afternoon.

Mirror Indy reporter Mary Claire Molloy covers health. Reach her at maryclaire.molloy@mirrorindy.org. Follow her on X @mcmolloy7.