What If Contraception Could Decimate The Abortion Rate?
In Ross Douthat’s weekend NY Times column, he mediates in the long-running argument liberals and conservatives have waged over sex, abortion, and contraception. Liberals argue that widespread access to contraception is the surest way to reduce unwanted pregnancies, he writes, whereas conservatives believe “it’s more important to promote chastity, monogamy and fidelity than to worry about whether there’s a prophylactic in every bedroom drawer or bathroom cabinet.”
Both narratives are contradicted by the facts, he argues. For example, socially conservative regions feature higher rates of teenage parenthood and unwed pregnancy than the nation as a whole.
He goes on:
Liberals love to cite these numbers as proof that social conservatism is a flop. But the liberal narrative has glaring problems as well. To begin with, a lack of contraceptive access simply doesn’t seem to be a significant factor in unplanned pregnancy in the United States. When the Alan Guttmacher Institute surveyed more than 10,000 women who had procured abortions in 2000 and 2001, it found that only 12 percent cited problems obtaining birth control as a reason for their pregnancies. A recent Centers for Disease Control and Prevention study of teenage mothers found similar results: Only 13 percent of the teens reported having had trouble getting contraception.
Is the takeaway really that lack of contraceptive access isn’t a significant factor in unplanned pregnancy? If roughly 1 in 10 unplanned pregnancies is caused by lack of access to birth control, that seems very significant! If I approached Douthat, having devised a way to reduce the American abortion rate by just 5 percent without coercion or significant expense, I suspect he’d be very enthusiastic, and think I accomplished something important. The issue here is that he’s unpersuaded these teens would’ve avoided pregnancy even if they’d been given access to birth control.
As he writes:
…if liberal social policies really led inexorably to fewer unplanned pregnancies and thus fewer abortions, you would expect “blue” regions of the country to have lower teen pregnancy rates and fewer abortions per capita than demographically similar “red” regions. But that isn’t what the data show. Instead, abortion rates are frequently higher in more liberal states, where access is often largely unrestricted, than in more conservative states, which are more likely to have parental consent laws, waiting periods, and so on. “Safe, legal and rare” is a nice slogan, but liberal policies don’t always seem to deliver the “rare” part.
But the “liberal social policies” he conflates can be teased apart. What if contraceptive access reduces unplanned pregnancies in some jurisdictions, even as women who do get pregnant in those same places have abortions at higher rates due to unrestricted access or the fact that abortion is less stigmatized? As if in anticipation of that very counterargument, he goes on to write:
What’s more, another Guttmacher Institute study suggests that liberal states don’t necessarily do better than conservative ones at preventing teenagers from getting pregnant in the first place. Instead, the lower teenage birth rates in many blue states are mostly just a consequence of (again) their higher abortion rates. Liberal California, for instance, has a higher teen pregnancy rate than socially conservative Alabama; the Californian teenage birth rate is only lower because the Californian abortion rate is more than twice as high.
But California’s higher teenage pregnancy rate is substantially driven by Hispanic immigrants whose religious and cultural background is relatively antagonistic to contraceptives. And if we’re citing numbers generated by the Guttmacher Institute, surely the ones that followare relevant to this subject:
– Publicly funded family planning services help women to avoid pregnancies they do not want and to plan pregnancies they do. In 2008, these services helped women in California avoid 317,900 unintended pregnancies, which would likely have resulted in about 141,300 unintended births and 132,700 abortions.
– Contraceptive services provided at Title X-supported centers in California helped prevent 200,200 unintended pregnancies, which would likely have resulted in about 89,000 unintended births and 83,600 abortions.
If you think that abortion is the killing of an innocent human, surely you should regard a contraceptive policy thought to result in tens of thousands of fewer abortions per year as a significant achievement, unless you think that the policy is causing lots of other abortions to occur. The Guttmacher Institute has published analysis that reaches precisely the opposite conclusion.
And increasing the availability and effectiveness of contraception seems like a more achievable task than reducing abortions by re-establishing bygone norms of chastity, monogamy and fidelity (none of which, by the way, are incompatible with widespread access to effective birth control).
By: Conor Friedersdorf, The Atlantic, February 21, 2012
“What Are Women For?”: The Conservative War On Women’s Sexuality
If you have been surprised to see an uptight prig such as Rick Santorum leading the Republican primary field in national polls, you shouldn’t be. Recent events have demonstrated that conservative positions on social issues are as much about repressing women and reversing the gains of the women’s movement as they are about saving the lives of the unborn.
The young people I saw at the Conservative Political Action Conference (CPAC) in Washington the week before last looked to me exactly like what you would expect from a bunch of college Republicans. They were dorks. They wore suits. Maybe some of the women’s suit skirts were short, but I was hardly scandalized.
But we learned last week that much of the conservative movement is still living in a different century—and I don’t mean the twentieth—with regard to women’s sexuality. Conservative bloggers were horrified that some young women at CPAC were dressed provocatively and engaged in loose sexual behavior with the young men in attendance.
CPAC has a well deserved reputation for being the time of year when earnest young conservatives unbutton their Oxford shirts, crack open a few Busch Lights and let loose. I see nothing wrong with that. But Erick Erickson, who runs the popular blog Red State, does. He wrote a lament that CPAC has gotten too debauched: “Young men, regardless of political persuasion or ideology, are intent on having sex, being boys, getting drunk—doing what young men in college often do. All to [sic] often there are also a few young ladies willing to shame their parents if their parents only knew.”
Erickson’s commentary is such a caricature of an avuncular misogynist that it’s amazing his post isn’t actually a parody. He almost literally says, “Boys will be boys.” But girls, on the other hand, are responsible for warding off boys’ advances. They, and they alone, are charged with protecting the conservative movement’s morality. If they don’t, they are “shaming their parents.” The notion that there is nothing immoral with enjoying oneself, as long as you aren’t spreading disease, doesn’t even cross Erickson’s mind. Nor does he consider the possibility that women and men are equally responsible for restraining their sexual urges.
Erickson also linked approvingly to Melissa Clouthier, a conservative blogger who plaintively demanded, “Have women so internalized feminist dogma that they see themselves in only two ways? Butch, men-lite wannabes or 3rd wave sluts who empower themselves by screwing every available horndog man?”
These posts, and criticisms of them, inspired James Poulos of the Daily Caller to write a meditation on Thursday about “What are women for?” He fails to answer his own question. Here’s the closest he comes: “Much good would come from a broader recognition that women have a privileged relationship with the natural world. That’s a relationship which must receive its social due—if masculinity in its inherent and imitative varieties (including imitation by quasi-feminized males of quasi-masculinized females!) is not to conquer the world.”
The item is so garbled I can’t really critique it, except to note that posing the question itself is absurdly sexist. (Rich Yeselson valiantly attempts to wade through Poulos’s inscrutable prose and explains what’s wrong with Poulos’ “hoisting [women] onto a grand pedestal far above the barbarism of men.”)
Meanwhile, the far more legible Ross Douthat demonstrated in Sunday’s New York Times how even the most seemingly reasonable conservatives oppose gender equality. Douthat’s column argues that conservatives must recognize abstinence teaching alone often doesn’t prevent unwanted pregnancies, and liberals must admit that access to contraception doesn’t either. That’s true, but for those of us who think that women should be able to avail themselves of a certain safe and relatively affordable medical procedure when confronted with an unwanted pregnancy, it’s not clear what the problem is. The problem, to Douthat, is that abortions are an inherent social ill.
(Unfortunately, far too many liberals, by saying that every abortion is a “tragedy” best avoided, have reinforced this widespread superstition. Hence, Douthat can pose as a moderate consensus-seeker by accurately noting, “Even the most pro-choice politicians, for instance, usually emphasize that they want to reduce the need for abortion, and make the practice rare as well as safe and legal.”)
Douthat claims that lack of access to contraception is not a significant problem and so liberals should stop pretending it’s an answer to our abortion scourge. He writes:
A lack of contraceptive access simply doesn’t seem to be a significant factor in unplanned pregnancy in the United States. When the Alan Guttmacher Institute surveyed more than 10,000 women who had procured abortions in 2000 and 2001, it found that only 12 percent cited problems obtaining birth control as a reason for their pregnancies. A recent Centers for Disease Control and Prevention study of teenage mothers found similar results: Only 13 percent of the teens reported having had trouble getting contraception.
I disagree with Douthat. I think lack of access to contraception is a major problem. My evidence? The Guttmacher Institute found that fully 12 percent of women who had abortions cited problems obtaining birth control and the CDC found 13 percent of teenagers had problems getting contraception. Twelve or 13 percent! In a country as wealthy and socially advanced as the United States, it is remarkable that so many women would be unable to access one of the many contraceptive options that should be available to them. In the Guttmacher study alone there were 1,200 women who had to have an abortion because they could not get contraception. One would be too many.
How can Douthat see these statistics and reach such a different conclusion than I do? Because he doesn’t believe access to contraception is a good unto itself. If you believe, as liberals do, that women should control their reproductive organs and that all aspects of healthcare, including preventive measures such as contraception, should be available to all citizens of a civilized country, then lack of access to contraception is bad. Conservatives such as Douthat don’t share either of those premises. They believe healthcare is a privilege that should only be bestowed upon the wealthy, and sexual freedom is a social ill. If you think that, then access to contraception is a neutral or a negative. It is only valuable to Douthat as a means for reducing the number of abortions, which he considers an even greater social ill. Since he approaches the data on contraception from that perspective, then he finds that only a 12 percent reduction in abortion isn’t saving nearly enough souls, so who cares about the underlying problem of women being prevented from exercising their bodily autonomy?
Back in October Rick Santorum said, “Many of the Christian faith have said, well, that’s OK; contraception is OK. It’s not OK. It’s a license to do things in a sexual realm that is counter to how things are supposed to be.” After reading what leading conservative pundits have to say on gender and sexuality this last week, it’s no surprise they would find Santorum appealing.
By: Ben Adler, The Nation, February 20, 2012
“Property Of The State”: For Women In Virginia, It’s All About Your Vagina
The Right’s War on Women really has become focused. It’s not just a general war on the gender, with trivial things like equal pay for equal work. No, it’s now reduced down the core. It’s all about your vagina.
For example, see CNN’s latest monster, Breitbart protege Dana Loesch. Commenting on the proposed Virginia law that would require women seeking abortions be forced to undergo vaginal penetration by an ultrasound-wand wielding health care professional, Loesch says that once a woman has had sex, consensual or not, she’s given up all say on what happens down there.
LOESCH: That’s the big thing that progressives are trying to say, that it’s rape and so on and so forth. […] There were individuals saying, “Oh what about the Virginia rape? The rapes that, the forced rapes of women who are pregnant?” What? Wait a minute, they had no problem having similar to a trans-vaginal procedure when they engaged in the act that resulted in their pregnancy.
Sorry non-virgins, all your vaginas belong to the state now. Hell, with this reasoning, if you’ve used a tampon you’ve pretty much given up control. It’s not just soulless, attention seeking gasbags saying so, it’s the state. Here’s what one Virginia lawmakersaid about the bill, as reported by Dahlia Lithwick.
During the floor debate on Tuesday, Del. C. Todd Gilbert announced that “in the vast majority of these cases, these [abortions] are matters of lifestyle convenience.” (He has since apologized.) Virginia Democrat Del. David Englin, who opposes the bill, has said Gilbert’s statement “is in line with previous Republican comments on the issue,” recalling one conversation with a GOP lawmaker who told him that women had already made the decision to be “vaginally penetrated when they got pregnant.” […]
There you go, women of America. If you’ve ever had sex, your vagina is fair game. You don’t get to say what happens to it now.
Can’t imagine why that’s such an unpopular idea in Virginia. It’s so unpopular, in fact, that the House has decided to put off consideration of it, at least for today.
By: Joan McCarter, Daily Kos, February 20, 2012
Why I Wish Catholic Leaders Would Stop Saying Our Church Is Under Attack
On Friday the White House reached a compromise on the contraception mandate that can satisfy both reproductive health advocates and Catholic hospitals. For those like Rick Santorum, though, who have been loudly and repeatedly accusing the Obama administration of engaging in “overt hostility to faith in America,” this isn’t enough. But if this is really a war against religion, maybe it’s time to ask the people of faith who are supposedly under attack. People like me.
My expertise on this topic is personal. Mine is a family in which priests and nuns outweigh any other profession except nurses. My mom taught nursing and medicine at a Catholic college, and placed nursing students in Catholic hospitals for 40 years. Family, faith, and taking care of people—these values are at the core of what we were taught growing up. Perhaps that is why the harsh tones, the imaginary division of the world into two camps—the faithful under attack and the attackers—seems more politics than theology. Certainly it is extremely distant from the millions of lives that could be affected by these conservative outcries. This would merely be entertaining election year political shenanigans if there were not so many lives at stake. More than 11 million women use birth control; millions more will have access to it under the new law.
In fact, birth control use is nearly universal in the United States, even among Catholic women. One recent study shows that 98 percent of sexually experienced Catholic women will have used birth control at some point in their lives. Nearly 60 percent of women use birth control pills for something other than, or in addition to, contraception. For example for women at risk for ovarian cancer, taking birth control pills for five years reduces their risk of getting cancer by 50%. Should women have to explain to employers they need coverage for serious illnesses, not birth control, in order to obtain the medicine their doctor prescribes?
Yes, there is a religious freedom question at stake, not only for employers but also employees. But much of this is already settled territory. The wide use of contraception long ago opened up the complex nature of religion in the public square and already found resolution, well before these election year political attacks. The new Department of Health and Human Services rule comes years after advances in 28 states, where regulations similar to the HHS rule have prompted religious leaders and policy makers to create solutions that serve women and their families and faith-based organizations. Take, for example, DePaul University, the nation’s largest Catholic college, which has confirmed that its employee benefits include prescription birth control coverage. DePaul is not alone—the Archdiocese of New York provided contraceptive coverage for medical reasons even prior to a state law mandating it, as did Marquette University in Milwaukee, Wisconsin, where the Diocese itself now provides coverage under Wisconsin law.
I agree with the Bishops that there are cases when the religious freedom of an employer trumps that of an employee. For example, when I was a secretary at the Sacred Heart Rectory, I wouldn’t expect my health care plan to include prescription contraception because I worked for the church. Under Obama’s regulation, religious institutions, like the church I grew up in, are exempt. Synagogues and other houses of worship do not have to provide contraception. Period.
But when Notre Dame is the single largest employer in South Bend, Indiana, with Saint Joseph Regional Medical Center not far behind, how could we say, “Sorry, you should move if you want to have affordable access to these health services.” It is discordant with my Catholic and my American values that a receptionist at the local hospital making around $26,000 a year should have to shell out nearly $600 for birth control or cede control to her employer over when to start a family, when she is already paying in to her health care plan. The new agreement would take this difficult question off the table by allowing the women and men working at these religious affiliated organizations to receive the equal and affordable access through their insurers directly without engaging their employers.
It is about time we raise the policy debate in Washington to keep up with complexity of faith, health and family that most Americans already navigate in their daily lives. Most Americans are religious. Fifty-five percent told Gallup that religion is “very important” to them. But these same Americans are also focused on the health of their families and they are, in fact, using birth control. Newt, Mitt, Rick, and all the other gentlemen trying to demagogue this issue would be best served listening to the folks in the pews before launching any more pious screeds. Most of America’s faithful families aren’t under attack from a “war on religion.” I for one don’t feel under attack—except perhaps from a small group of Republican presidential candidates who keep ignoring the voices, values, and lives of women like me.
By: Tara McGuinness, The New Republic, February 13, 2012
“Beyond Pelvic Politics”: Choosing Between Bishops’ Sensibilities And Women’s Health
I may not be as theologically sophisticated as American bishops, but I had thought that Jesus talked more about helping the poor than about banning contraceptives.
The debates about pelvic politics over the last week sometimes had a patronizing tone, as if birth control amounted to a chivalrous handout to women of dubious morals. On the contrary, few areas have more impact on more people than birth control — and few are more central to efforts to chip away at poverty.
My well-heeled readers will be furrowing their brows at this point. Birth control is cheap, you’re thinking, and far less expensive than a baby (or an abortion). But for many Americans living on the edge, it’s a borderline luxury.
A 2009 study looked at sexually active American women of modest means, ages 18 to 34, whose economic circumstances had deteriorated. Three-quarters said that they could not afford a baby then. Yet 30 percent had put off a gynecological or family-planning visit to save money. More horrifying, of those using the pill, one-quarter said that they economized by not taking it every day. (My data is from the Guttmacher Institute, a nonpartisan research organization on issues of sexual health.)
One-third of women in another survey said they would switch birth control methods if not for the cost. Nearly half of those women were relying on condoms, and others on nothing more than withdrawal.
The cost of birth control is one reason poor women are more than three times as likely to end up pregnant unintentionally as middle-class women.
In short, birth control is not a frill that can be lightly dropped to avoid offending bishops. Coverage for contraception should be a pillar of our public health policy — and, it seems to me, of any faith-based effort to be our brother’s keeper, or our sister’s.
To understand the centrality of birth control, consider that every dollar that the United States government spends on family planning reduces Medicaid expenditures by $3.74, according to Guttmacher. Likewise, the National Business Group on Health estimated that it costs employers at least an extra 15 percent if they don’t cover contraception in their health plans.
And of course birth control isn’t just a women’s issue: men can use contraceptives too, and unwanted pregnancies affect not only mothers but also fathers.
This is the backdrop for the uproar over President Obama’s requirement that Catholic universities and hospitals include birth control in their health insurance plans. On Friday, the White House backed off a bit — forging a compromise so that unwilling religious employers would not pay for contraception, while women would still get the coverage — but many administration critics weren’t mollified.
Look, there’s a genuine conflict here. Many religious believers were sincerely offended that Catholic institutions would have to provide coverage for health interventions that the church hierarchy opposed. That counts in my book: it’s best to avoid forcing people to do things that breach their ethical standards.
Then again, it’s not clear how many people actually are offended. A national survey found that 98 percent of sexually active Catholic women use birth control at some point in their lives. Moreover, a survey by the Public Religion Research Institute reported that even among Catholics, 52 percent back the Obama policy: they believe that religiously affiliated universities and hospitals should be obliged to include birth control coverage in insurance plans.
So, does America’s national health policy really need to make a far-reaching exception for Catholic institutions when a majority of Catholics oppose that exception?
I wondered what other religiously affiliated organizations do in this situation. Christian Science traditionally opposed medical care. Does The Christian Science Monitor deny health insurance to employees?
“We offer a standard health insurance package,” John Yemma, the editor, told me.
That makes sense. After all, do we really want to make accommodations across the range of faith? What if organizations affiliated with Jehovah’s Witnesses insisted on health insurance that did not cover blood transfusions? What if ultraconservative Muslim or Jewish organizations objected to health care except at sex-segregated clinics?
The basic principle of American life is that we try to respect religious beliefs, and accommodate them where we can. But we ban polygamy, for example, even for the pious. Your freedom to believe does not always give you a freedom to act.
In this case, we should make a good-faith effort to avoid offending Catholic bishops who passionately oppose birth control. I’m glad that Obama sought a compromise. But let’s remember that there are also other interests at stake. If we have to choose between bishops’ sensibilities and women’s health, our national priority must be the female half of our population.
By: Nicholas Kristof, Op-Ed Columnist, The New York Times, February 11, 2012
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