Researchers using federal data have found two interesting trends that chart the relationship between abortion and contraceptives.
Between 1994 and 2001:
1. The rate of unplanned pregnancies rose by 30 percent among poor women. The abortion rate also rose.
2. The rate of unplanned pregnancies fell 20 percent among affluent women. The abortion rate also fell.
Gee, imagine that. Reduced use of contraceptives leads to more abortions. Sounds like common sense, doesn’t it? So why am I writing about it?
Because some people — some relatively influential people — disagree. Some Christian conservatives are starting to jump on the same bandwagon that Catholic groups have occupied for decades: Life begins at fertilization and anything that interferes with that is abortion. And they’re willing to use laws and government regulations to force everybody to conform to their beliefs.
This weekend’s New York Times Magazine had a cover story on the phenomenon. Some quotes:
“We see contraception and abortion as part of a mind-set that’s worrisome in terms of respecting life. If you’re trying to build a culture of life, then you have to start from the very beginning of life, from conception, and you have to include how we think and act with regard to sexuality and contraception.” — Edward R. Martin Jr., a lawyer for the public-interest firm Americans United for Life
Dr. Joseph B. Stanford, who was appointed by President Bush in 2002 to the F.D.A.’s Reproductive Health Drugs Advisory Committee despite (or perhaps because of) his opposition to contraception, [wrote in] a 1999 essay: “Sexual union in marriage ought to be a complete giving of each spouse to the other, and when fertility (or potential fertility) is deliberately excluded from that giving I am convinced that something valuable is lost. A husband will sometimes begin to see his wife as an object of sexual pleasure who should always be available for gratification.”
This dispute came to the fore during the FDA’s consideration of Plan B, the “morning after” pill. The agency’s advisory committees voted overwhelmingly in favor of an application to sell Plan B over the counter. The standard procedure at that point is a pro forma approval of the application.
But one member of one of the F.D.A.’s Reproductive Health Drugs Advisory Committee had reservations: Dr. W. David Hager, a Christian conservative whom President Bush appointed to lead the panel in 2002 (outcries from women’s groups forced him to give up the leadership post, but he remained a panel member.)
His reasoning? Not safety or efficacy. No, Dr. Hager said he feared that over-the-counter Plan B would increase sexual promiscuity among teenagers.
His objection drew flak on a number of fronts, as the Times article recounts:
F.D.A. staff members presented research showing that these fears were ungrounded: large-scale studies showed no increase in sexual activity when Plan B was available to them, and both the American Academy of Pediatrics and the Society for Adolescent Medicine endorsed the switch to over-the-counter status. Others argued that the concern was outside the agency’s purview: that the F.D.A.’s mandate was specifically limited to safety and did not extend to matters like whether a product might lead to people having more sex.
Hager had support within the FDA leadership — though one might question the rationality of that support:
Dr. Janet Woodcock, deputy commissioner for operations at the F.D.A., had also expressed a fear that making the drug available over the counter could lead to “extreme promiscuous behaviors such as the medication taking on an ‘urban legend’ status that would lead adolescents to form sex-based cults centered around the use of Plan B.”
Sex-based cults, huh? O-o-o-o-kay. But fine, there are a few nuts in every tree. At least they’re minority opinions that don’t carry much weight, right?
Wrong. In May 2004, the F.D.A. denied the application, citing some of the same reasons as Hager. Two months later the drug’s manufacturer reapplied, this time restricting over-the-counter sales to women 16 and older — thus addressing the adolescent issue. That application is the one that the FDA famously refused to rule on. To this day Plan B is only available by prescription.
Why the opposition to Plan B? The stated reason is that it is an abortifacent, on the theory that at least occasionally it prevents the implantation of a fertilized egg. But since Plan B is simply a higher dosage of regular birth-control hormones, the same arguments could be applied to the Pill. And IUDs. (And breastfeeding, BTW). And never mind that many of these same groups also oppose other forms of contraception such as condoms and diaphragms. Or that this represents a moving of the goalposts in the abortion debate.
The article sums up the underlying issue nicely:
The conservative [viewpoint is] that giving even more government backing to emergency contraception and other escape hatches from unwanted pregnancy will lead to a new wave of sexual promiscuity. An editorial in the conservative magazine Human Events characterized the effect of such legislation as “enabling more low-income women to have consequence-free sex.”
And that is relevant how? Is it the government’s business how people choose to conduct their sex lives? Does effective contraception reduce the risk of pregnancy and thus reduce a barrier to sex? Undoubtedly. But that’s a personal choice and nobody else’s business. It’s something to be addressed by education and persuasion, not legislation and regulation.
I have no problem with people believing that contraception is against their beliefs. I have no problem with people trying to persuade others to feel the same. But I have a big problem with using the regulatory process to try to impose those beliefs on others. If you don’t want to use contraceptives, don’t; but don’t try to get them legally restricted so that others can’t use them, either.
I also find this argument unpersuasive:
Rector says that abstinence programs can’t properly be combined with other elements in a comprehensive sex education program because the message is lost when a teacher says: “One option you might want to consider is abstaining. Now let’s talk about diaphragms.”
If you can’t make the case for abstinence compelling in context, then it’s a weak argument. It’s almost a “victimology” response to argue that information on contraception must be muzzled in order for abstinence education to be effective.
True, it may be a matter of emphasis. But I doubt most sex ed classes throw abstinence away as a one-liner. And if they do, the answer is to provide curricular guidelines. Spend time emphasizing the advantages of abstinence. Discuss the risks and downsides, from pregnancy to STD to social and mental impacts. Then say “If despite all that you’re going to have sex, here’s what you can do to reduce but not eliminate some of the risks.”
And never mind that study after study have found abstinence-only programs to be ineffective. The researchers I mentioned at the beginning of this article cite the shift toward abstinence-only education as the probable cause of decreased contraceptive use (and thus higher abortion rates) among poor women.
The good news is that the social conservatives described here still represent a minority view. The article mentions that 98% of sexually-active women have used some form of birth control. And as far as sex education goes, a 2004 poll by NPR found that 95 percent of parents want schools to encourage teenagers to delay sex until they are older — but 94 percent also think kids should learn about birth control in school.
As most parents seem to recognize, abstinence and learning about birth control are not opposing concepts. The article notes that countries in which abortion is legal and contraception is widely available tend to rank among the lowest in rate of abortion, while those that outlaw abortion — notably in Central and South America and Africa — have rates that are among the highest. The country with the lowest rate of abortion? The Netherlands which is often held up as a pariah by social conservatives.
I repeat: feel free to be personally against contraceptive use. But don’t use the levers of government to force everyone else to conform to your beliefs.Powered by Sidelines