Contraception Access Could Prevent a Million Abortions in the US a Year
Thursday, February 23, 2012

You can oppose abortion.  You can oppose contraception.  But you cannot logically oppose both.

You don't have to be a gynecologist to understand that abortion's final common pathway is unintended pregnancy.  Preventing an unintended pregnancy makes abortion impossible.

Using 2008 data from the Guttmacher Institute, I came up with this admittedly speculative extrapolation.  Using retrospective data is always risky, but if I worked in an emergency room and noticed that the most severely injured car accident victims were not wearing their seat belts or intoxicated (or both), it would not be difficult to extrapolate what would happen if seat belt usage were universal and stricter drunk driving laws were followed.   In fact, the public health campaigns addressing these two issues were launched based on exactly those sorts of observations.  

In the same way, data about who gets an abortion can allow us to estimate what might happen if access to and use of contraception were improved.

Opponents of contraception are fond of pointing out that over half of those who seek an abortion were using contraception at the time of the conception.  Since contraception does not work perfectly, it must not work at all, right?  

Wrong.  54% of women who had an abortion used a contraceptive method the month prior to their unintended pregnancy.  The most common type of contraception was the condom or the pill.  But of these women, 76% of pill users and 49% of condom users admitted to not using the method consistently.  In fact, only 13% of pill users and 14% of condom users reported correct use.  

Since people have a tendency to over-report things that make them look good in the eyes of the surveyor, it's likely that this 13-14% "correct use" number is higher than reality.  

Besides, there are many ways someone deprived of rigorous education on contraception use might inadvertently misuse them.  A condom might be worn properly, for example, but how many people check the expiration date prior to use or avoid exposing a condom to excess pressure (as in a wallet in a back pocket) or heat (as in a car left in the sun)?   Did the condom also have a spermicidal lubricant or was it used in conjunction with spermicidal foam?  Did someone who was on an oral contraceptive forget to take it one day, then doubled the next, or simply dropped that pill from the cycle?  Studies of parents of children taking a 10-day course of antibiotics indicate 30% fail to give at least one dose by day 3, and that almost three-fourths fail to complete the full 10-day course, so the probability of a woman missing a dose of a regimen running over a much longer period is even higher.  

The bottom line is that the vast majority of those who have abortions were either not using contraception at all or using it inconsistently.  So what would happen if we improved these numbers (something the bishops are fighting fiercely to prevent)?   

Let's imagine a group of 100 women seeking abortions in 2008.  On average, 46 did not use any contraception whatsoever.   This is the low-lying fruit:  the biggest improvement would be to encourage all women who are sexually active but not ready to get pregnant to use contraception as religiously as they wear a seat belt.  Such a change in behavior would mean 46 more women would use contraception.

Admittedly, that would not prevent 46 abortions because - as the 13-14% of women obtaining an abortion who reported using contraception consistently reminds us - some unintended pregnancies can occur even with proper use.  

Note:  the fact that 13% of those taking who were on oral contraceptives and who got abortions in 2008 reported regular use does NOT indicate that the pill's failure rate is as high as 13%.  According to the CDC, oral contraceptives are 92-99% effective, meaning their "failure rate" is between 1-8% (probably closer to 1% if used properly and combined with other methods).  This is a classic Bayesian probability problem - the fact that you know the rate of exposure to proper use of oral contraceptives given an unintended pregnancy tells you nothing about the rate of unintended pregnancy given proper use of oral contraceptives.  

But let's assume for sake of argument that of the 46 additional women who now use contraception, 13% get pregnant anyway.  That still means 87% do not get pregnant, so even in this dismally unlucky scenario, contraception use has prevented 40 abortions (87% x 46).

Let's return to the other 54 women who already use contraception.  Of these, only 6 (about 13%) used it consistently and correctly.  That means 48 women in the contraception group are not using it consistently or correctly.  If we could - through an outreach and education campaign perhaps, or by eliminating financial barriers to filling their prescriptions or buying condoms - get that number up to 100%, even if we used the ridiculously high 13% failure rate, proper contraception use would prevent another 42 abortions (87% x 48).  

Adding the 40 abortions prevented by getting those who used no contraception to use it to the 42 abortions prevented by getting those who used contraception irregularly to use it regularly, even with the artificially high 13% failure rate of properly-used contraception, 82 total abortions of the original 100 would be prevented.  

Bottom line:  universal access to contraception, used properly, would reduce the abortion rate by 82%.  Extrapolated to national data, 82% of 1.21 million abortions in 2008 translates into 980,000 prevented abortions!  

So when Rick Santorum or Newt Gingrich say they are "pro-life", ask them why they are attacking policies that - in combination with other efforts, such as poverty reduction and universal access to healthcare - could easily prevent a million abortions a year.   If they really wanted to prevent the intentional loss of embryonic life why wouldn't they do whatever it took?  

            Yes, some who oppose contraception on theological grounds might sincerely believe that Jesus would prohibit the use of estrogen-progesterone pills or latex condoms, but since Jesus never said any such thing they cannot be sure.  Some rudimentary contraception existed in his time, but if it bothered Jesus, he never spoke against it, just as he never said a word about that other sexual litmus test of modern Christianity - homosexuality.   

What Jesus did teach was a variation of Rabbi Hillel's Golden Rule.  It's hard to imagine that when he said we should do unto others as we want them to do unto us that he would support preventing poor women in a wealthy nation from accessing technology that might break their cycle of poverty  compounded by unintended pregnancies leading to children born into a society that is appallingly indifferent to their post-natal existence.   It's hard to see how the man who saved a woman from being stoned to death for adultery would have wanted women today to be barred from an entire class of medicine because men they never met fear other women might use them to control the timing and number of her children.  

At any rate, it's unfair to claim to speak for Jesus or Yahweh or any entities, real or imagined, or are unable to speak for themselves, particularly when the 34,000 denominations of Christianity who all claim to be channeling the same spirit of Jesus disagree about what he actually meant.   Why not do as the Good Samaritan did, and not let the obtuse, abstract, legalistic religious ritual prevent us from doing the obvious good right in front of us.  If a man is bleeding to death in the road, help him.  If you have the means of preventing a million abortions a year, then for god's sake use it!.  

Shouldn't Women Demand Men Filling Viagra Prescriptions Be Screened if Not Barred?

 Why not mandate a 24 hour waiting period, followed by a thorough prostate exam for anyone wanting to fill a prescription for medications such as Viagra?  If a man is either not married or married to a woman who is postmenopausal then clearly this is the kind of sex that many religiously-minded people who believe that all sex must have a chance at causing pregnancy would find objectionable. Is it not a violation of their religious freedom to have to fill a prescription for a man who is clearly past his reproductive prime, especially if he is most likely to be filling the prescription, as Newt was in the 90s, so he could go have sex with his mistress? Since some man somewhere might theoretically be having sex for the sheer pleasure of it, isn't it safer to allow pharmacists and healthcare administrators to refuse to fill this entire class of medications for every man all the time? Also, if you believe that the timing and number of children should be left to chance and that any use of technology to intervene artificially is morally offensive, why would this not apply to erectile dysfunction agents? After all, if you really believed that no blade of grass falls without god having willed it, why would divine intervention be any less present in a wilting erection? In this view of reality, isn't impotence simply god's way of saying your breeding days are over? If so, then isn't it flouting god's will to do anything to upset that divine plan, which leads always and everywhere to the best of all possible worlds? Unfortunately the bible is as useless in answering this question as it is with so many other matters (go ahead and search for Viagra, erectile dysfunction, or estrogen in any online bible - you won't get any hits) but do we really think that god wants Newt Gingrich to be able to pleasure Mistress #4 more than he wants a poor woman in Alabama to be able to access a condom that will protect her from contracting HIV from her philandering husband?

Let Doctors and Patients, Not Bishops, Make Healthcare Decisions

Let Doctors and Patients, Not Bishops, Make Healthcare Decisions

If the all-male executives of an international corporation, none with medical expertise, denied treatment access to women employees of all faiths, based on the executive order of a former CEO, we would be outraged. So why do we politely defer to this demand simply because the corporation is religious? Pope Paul VI's 1968 Humanae Vitae is perhaps the most-ignored "teaching" of the papacy; if 98% of Catholic women don't follow it, why should women of all faiths employed by Catholic-affiliated universities and hospitals be compelled to? No religion has the right to discriminate based on gender. Lost in the bishops' misinformation campaign is this simple truth: opposition to contraception is wrong, morally and medically. President Obama, however much the Catholic hierarchy dislikes him (although over 51% of the laity voted for him) did not make the recently-reversed decision to compel all hospitals and universities to obey the law; the Institute of Medicine, after exhaustive review, agreed with the CDC, WHO, AMA, and every non-sectarian medical society that contraceptives are preventive medications with demonstrable health benefits, so should be covered without copayment. President Obama chose not to override this overwhelming medical and scientific consensus. The religious right seems intent on personalizing this, seizing on it to "prove" that a president they never really liked whose faith they never accepted is hostile to religion. Nonsense. This is not a war on religion as much as a war on women and science.


Some historical background: 

Humane Vitae History from Papal Sins (2000) by Garry Wills (emphasis added):

Humanae Vitae (1968)
The Pontifical Commission met five times, first in 1963.
The second was in 1964 attended by 13 men.
No one had recommended altering the church's teachings on contraception by the third meeting.
The rhythm method made people obsessed with sex and anxious about its failure rate.  "Sex is for procreating, yes - but all the time, and each and every act?  
Eating is for subsistence.  But any food or drink beyond that necessary for sheer subsistence is not considered mortally sinful.  In fact, to reduce eating to that animal compulsion would deny symbolic and spiritual meetings in shared meals -- the birthday party, a champagne victory dinner, the Eucharist itself…  the more they saw the questionable roots from which it grew -- the fear and hatred of sex, the feeling that pleasure in it is a biological bribe to guarantee the races perpetuation, and any use of pleasure beyond that purpose is shameful.  This was not a view derived from Scripture or from Christ, but from Seneca and Augustine. " 
When the 19 theologians on the commission, convened for a separate vote, were asked whether church teaching could change on contraception, 12 said yes, 7 no.
     - page 91

Pope Paul VI ignored the vote and instead seized on the minority report.  Humanae Vitae was issued "The church, calling man back to the observance of the natural law, as interpreted by its constant doctrine, teaches at each and every marriage act must remain open to the transmission of life."  
    Catholics responded with an unparalleled refusal to submit.  Polls registered an instant noncompliance with the encyclical.  A simultaneous poll among German Catholics at large founded 68 percent of them thought the Pope was wrong on contraception. [page 95]
The Pope was stunned.  He would spend the remaining 10 years of his pontificate as if sleepwalking, unable to understand what happened to him, why such open dissent was entertained at the very top of the episcopate. [page 97] 
Humanae Vitae condemned in vitro fertilization.  [page 97] 

In the War on Women's Health and Contraception, as in any war, the first casualty is the truth...

The Seven Biggest Lies in the War Against Women's Health Equality and Contraception 
February 9, 2012  

If you agree with this post and want to support Planned Parenthood, click here to speak out.

It seems that the GOP is intent on trying to use contraception in the same way they used gay marriage in 2004:  as a wedge issue that distracts from more glaring Republican failures while beating up on a minority (in this case, poor women) who tend not to vote GOP anyway.  What is shocking in both cases is the misinformation and outright lies, especially by people who pride themselves on being pillars of righteousness and virtue (such as the Catholic Bishops and their anti-contraception lobby).    
People tend to lie when they know that telling the truth would result in their losing an argument and by extension, an election.  Dishonesty is a sign of weakness, an admission that the truth is not on your side.  Otherwise, why take the risk of lying and being caught? 
Republicans lied about the existence of weapons of mass destruction in Iraq and links between Saddam Hussein and al Qaeda because they knew that the case for something as radical and immoral as an unprovoked invasion of another country that would not and could not attack us would be thoroughly rejected by the American people. 
They lied about lower taxes for the wealthiest Americans because it's hard to rally 99.9% of Americans to vote for something that disproportionately favors the top 0.1%, particularly if the majority must suffer draconian cuts to social services to finance those tax cuts.  But claiming past tax cuts "always pay for themselves" (they don't) or "create jobs" (ditto), Republicans managed to put lipstick on a corpse, taking a dead-on-arrival gift to a tiny wealthy elite and twisting it into a populist issue that would somehow, magically and counter-intuitively, benefit us all.  They even appealed to people's selfishness, greed, and lack of understanding of probability theory to make a lottery argument:  someone has to win.  Who knows?  Maybe your heirs could pay the estate tax one day?   The misinformation campaign worked:  Americans polled guessed that 40% of us pay the estate tax (the actual number is less than 1%).
They lied about healthcare reform because most people support protecting consumers and patients from gouging insurance companies and forcing everyone to pay their fair share (not to free ride a system they will access at least in an emergency).  But fabricated "death panels" or "government takeovers of healthcare" - none of which are in the law - do not.
Republicans of course lie about President Obama, a milquetoast, right-of-center moderate, portraying him as everything from a "black nationalist" with an "intense hatred of white people" (Glenn Beck), an anti-colonial activist (Newt) who has launched a "war on religion" (Newt, Santorum, the entire Fox News staff), or someone whose economic policies have been enacted into law (they haven't; the Tea Party made sure of that) or who has raised taxes (tax rates and collection by any measure are LOWER under Obama than Bush, whose tax cuts he extended (most Republican voters believe Obama raised taxes)).  To run against a reasonable man man proposing reasonable things only works if your policy is convincingly superior.  But running against a foreign-born monster with a sinister agenda that threatens our freedom, prosperity, and right to worship is much, much easier.  
Romney, whose successful and popular Massachusetts healthcare reform was identical to the Affordable Care Act he now says threatens life as we know it in America, chose to create a fictional Obama to run against since the real one is so hard to dislike (or distinguish from Romney 1.0 - the pre-campaign Romney).
So now the latest target of GOP misinformation is women's health, or more specifically poor women's health (since the wealthy will always find the means to get the healthcare they need even if public agencies tasked with providing healthcare services are defunded).  But there is something even uglier that seems at work here, a backlash against the very recent notion that women should be in charge of their bodies, their sexuality, and the number and timing of their children.   Conservatives rarely say it out loud, but the idea of a woman not yielding to her husband's sexual and reproductive demands (or of even having a sexual partner who is not her husband) is one they fundamentally reject.  When they do slip their anti-woman strategy becomes too obvious, as I believe happened last week, they face a firestorm of criticism from the 50% of the electorate that fought hard for the once-radical rights to own property, testify in court, vote, hold public office, and access healthcare including contraception.  So to avoid future firestorms, they must not  directly assault women's sexual and reproductive freedom, just undermine it, linking it with other issues that both distract and divide, issues over which there is not universal consensus.  They even borrow icons and buzz phrases from the women's liberation movement, naming an anti-abortion group after a prominent suffragette whose name has become synonymous with a woman's right to vote, or making the rather strange claim that unless a woman is forced to have a child she does not want, is not ready for, or endangers her life or health, she is not really free, and that unless this choice is overridden by government bureaucrats (mostly men), she is somehow being exploited just as badly as women in countries where governments make the opposite decision for them, forcing them to abort.   
Contraception is as close to noncontroversial as any issue in our country, but there is a vocal minority that apparently still believes the idea of not leaving a conception to chance is immoral, that every sexual encounter, even rape, must have the potential to lead to a pregnancy and that doing anything proactively to prevent any pregnancy at any time is wrong.  Within this group is a smaller group that feels so strongly about the importance of rolling the biological dice with every roll in the hay that they want to impose this belief system on the vast majority of women of all faiths (and theirs) who disagree with them.   They would like all American women, regardless of religious affiliation if any, to be be denied access to certain technology, even if that technology is also used to treat painful or even potentially fatal medical conditions.
Most people, including the vast majority of Catholics, politely hear this shrill minority (politely because we have all been trained never to criticize absurd or dangerous beliefs if cloaked in religious garb) but ignore them (virtually all sexually active Catholic women have used birth control).  So a frontal assault advancing this peculiar minority view on the majority of Americans who strongly reject it would never work. Instead, the GOP and the religious right are desperately trying to blur the line between contraception and abortion, an issue over which intelligent people do tend to disagree, some quite violently.  
Although the majority of Americans (and the vast majority of Americans involved in the direct delivery of healthcare to women) support a woman's right to choose to terminate a pregnancy, the minority is vocal enough and able to make life very painful for those who do not appease them that associating something with abortion is a great strategy for making something non-controversial controversial. 
Planned Parenthood was a victim of this strategy.  An organization that in many counties in America is the only provider of women's health services from breast and cervical cancer screening to contraception, an organization that disproportionately serves the poor, would be impossible to attack head-on.  But transform it into some kind of sinister organization with a diabolic plot to abort black babies (yes, there are posters to this affect in many predominantly African American cities put up by mostly white men angry that abortion is legal and Santorum has said there is no moral difference between a woman who aborts her child and a slave-owner who beats a slave to death), collude with child prostitution rings (or at least not report child sexual abuse as required), or expand their network of "abortion mills" (never mind that only 3% of their activities involve pregnancy termination) and suddenly yanking funding for cancer screening of the least among seems not just acceptable but even moral in some twisted way.  Until last week, when this strategy backfired, it seemed to be wildly successful, but like all the right wing smear campaigns, it was clear that an honestly made argument would be too weak to be believed, so needed distortion, misinformation, and outright lies (most American voters seem unaware that federal law prohibits any tax dollars given to Planned Parenthood being spent on abortion).
And today, we have an even stranger and more blatant misinformation campaign, this one led by a group of celibate, allegedly asexual men intent on denying the full range of healthcare services to female (and only female) employees of all faiths who may work for a university, hospital, or other large corporation otherwise affiliated with a nominally religious organization.  The idea of men with no personal or professional experience or training in gynecology making unilateral healthcare decisions for their female employees is so outrageous in a country that is not a theocracy and does not even have an official state religion that it would be political suicide to advocate it honestly and directly.   Particularly when the law does not address abortion, but the noncontroversial issue of contraception, or more properly, medications that may be used for many purposes including contraception.
Enter the Great Lie.  Several of them actually.  (Is it any accident that the same organization lobbying for the right to discriminate invented the word "propaganda"?  The word comes from the Congregatio de propaganda fide a 1718 Catholic Congregation to try to expand shrinking market share of what had been an enormously lucrative religious market.) 

Lie #1:  Churches must provide services they find immoral.   As Romney put it, taking a jab at Obama in the process, 

This same administration said that in churches… that they have to provide for their employees, free of charge, contraceptives, morning-after pills — in other words abortive pills…

Actually, churches are exempt from the requirement that has so angered the Vatican and the GOP.  Only corporations that have a religious affiliation (which theoretically could include Harvard, Princeton, and Yale, all of which were founded by religious orders) and who hire people of a diversity of faiths must comply with this law. 

Lie #2: The "morning-after" pill is an "abortive" pill.   It isn't.  Levonorgestrel does NOT induce abortion.  Rather, if used 72 hours after intercourse, it can prevent conception.  If conception has already occurred, it does NOT interfere with it or cause congenital malformations.   You would think the anti-abortion lobby would be all over this intervention, since it is credited with preventing over 50,000 abortions in the United States in the year 2000 alone.  Rather than deal with that inconvenient reality - that those who oppose access to emergency contraception will make abortions more likely - why not just call the pill loudly and repeatedly something it isn't, an "abortifacent" as the Catholic Bishops lobbying group puts it?  Although the Bishops themselves are neither medical nor scientific experts, clearly they have raised enough money to afford to one who could explain to them in language they can understand (Latin perhaps) what this word means and why it does not apply to levonorgestrel.  John Boehner may claim the law forces coverage of "abortion-inducing drugs and devices" but he is simply not telling the truth.

Lie #3:  Birth control pills are only used for contraception.     They aren't.  In fact, up to 58% of women who take them use them to treat conditions even the Bishops would unlikely want to go untreated, from ovarian cysts to acne to luteal phase disorder (a more polite term for premenstrual syndrome) and endometriosis.   It's possible (but I hope unlikely) that the Bishops would want women to suffer from these conditions (some of which can threaten future fertility), but I think it's more likely that if they make this a black-and-white issue, they can get away with treating women in their health plans as second class citizens (something acceptable in the Vatican but not in the United States). 

Lie #4:  The Affordable Care Act is a violation of religious freedom.   This is true only if your religion mandates that you discriminate against others.  It does not prevent a single priest from saying Mass, a single imam from calling the faithful to Friday prayers.  It does not even require that religious people DO anything, only that they NOT do something, that is treat women of all faiths who happen to work for large organizations affiliated with their religion differently than men (who face no such restrictions) or women who happen to work for employers who are not affiliated with or funded by religious corporations.  In fact, no one is forcing anyone to provide healthcare coverage for their employees, but they are saying that if you do, you must play by the rules.   Insurance has always been a heavily-regulated industry; the Bishops' claims to be shocked by this discovery does not seem credible, and far too convenient coming at a time when so many (including many Catholics) seem intent on embarrassing President Obama at all costs, even if by doing so, they help abort healthcare reform for everyone.  
If the University of Notre Dame is so incensed that it cannot charge a Jewish librarian or an agnostic administrator a copay for the estrogen-progesterone mix used to treat their endometriosis that it drops coverage for all employees in protest, then that is their choice.  An absurdly disproportionate and amoral one, but if they really feel that preventing a conception is the same as disrupting one and terminating a pregnancy is the same as murder, it's time for them to put up or shut up.   I would love them to try to justify that act of passive-aggressive nastiness.  Perhaps instead of religious organizations worrying so much about having to follow a law they don't like, the affiliated institutions might instead re-think the liability of linking themselves to an organization that does not reflect the values of a diverse, pluralistic society of laws, one that defers private medical decisions to a woman and her doctor, not to a committee of men in Rome. 

Lie #5:  President Obama is hostile to people of faith.   This recent claim by Santorum is not just untrue, but like so much the man says, insulting.  It implies that President Obama is not himself a "man of faith."  Of course he is.  We all are, even if our faith leads us to believe that there is one god, many, or none at all (and the president's stated faith is Christian).   Most people of faith, including Catholics, simply disagree about the immorality of using contraception or the morality of forcing women to pay for it, knowing that many at the margin will face hardship or might have to interrupt treatment.   Some will suffer terribly or face an unintended pregnancy, half of which end up being terminated.  
This is not an issue of faith but of healthcare policy.  Santorum and others have no right to speak for all Catholics or all women who work for any Catholic-affiliated organization.  They simply do not agree with this very personal area of reproductive health, an area the Vatican had no fixed position on until 1968.    It's hard to make the case that opposition to contraception is a hallowed tradition when for 98% of the church's history it didn't see this issue as important enough to comment on, much less prohibit.  Yes, it's possible that they were wrong to remain silent and right now, but this would undermine the idea of papal infallibility declared formally by Pope Pius IX in 1870.  Assuming he intended this doctrine to apply to himself, was he fallible because he did not forbid contraception himself or even foresee the need to?   And once the idea of fallibility is introduced and accepted, is it not equally plausible that the church is wrong now and was right then?   At any rate, making a rule that is almost universally ignored by American and European Catholics changes no external reality but does threaten the credibility of the institution making that rule.


Lie #6:  Providing the option of coverage of a treatment is the moral equivalent of being forced to dispense or provide that treatment yourself.    If the Bishops are to be believed, you might have a mental image of them being forced to dispense oral contraceptives to women before, during, or after Mass.   You might think that dastardly Obama administration was putting a gun to their head, forcing them to scrub in on a first trimester D&C for a woman with severe congestive heart failure who was told that carrying her pregnancy to term could kill her.   
Nothing could be farther from the truth.  Nothing in the lives of the religious or their flock would change.  All that would change is that women employees of all faith would not be forced to drop or change medical treatment for financial reasons because a religious institution to which they do not belong and whose top administrators they never met decided for her what treatment options she should have available.   Insurance companies, who are often for profit third parties with no religious affiliation themselves (except the religion of profit) would set premiums, collect premiums, and review and pay claims.  The Bishops would never need to get personally involved.  In fact, by law and tradition, employees do not waive their right to medical privacy simply because their employer arranges and pays for part of the insurance coverage, a benefit in lieu of cash compensation.  An employer should never get involved with employee health decisions.
If it bothers the Bishops that women make different decisions than they believe they themselves would if they were sexually active and had a uterus, then perhaps they should question why they are operating in a free country, and move all of their operations overseas to places where governments accede more easily to their demands.   
At any rate, nothing in the current law or the new one prevents a woman from obtaining legal treatment options, including abortion and contraception, using her own funds (from a tax cut, let's say).  Not paying for something or slapping a copayment on preventive services in violation of the letter and spirit of healthcare reform will not prevent most women from getting it - it will simply punish them with financial hardship for doing so, a hardship women working for nonreligious employers or men working for anyone do not have to face.  Wealthy women will always find a way to get the treatment they need; the poor and those living paycheck-to-paycheck with hardly a dollar of discretionary income will be the ones who will find unfinanced treatments off limits.  So once again, we have to ask what religious teaching supports or condones the cutting off of poor women's access to healthcare options medical experts consider essential and basic? 


Lie #7:  Being forced to pay for something you find morally objectionable is a violation of religious freedom.   This is a broadening of the idea in Lie #4 but merits a separate listing.  We all pay for things we find morally objectionable.  The Vatican opposes the death penalty yet all Americans, Catholic or not, must pay taxes, some of which go to finance executions and the extraordinarily expensive legal proceedings entailed.   Pope John Paul condemned the United States invasion of Iraq as "immoral", a "defeat for humanity" and a "crime against peace" that was neither legally nor morally justified, yet a trillion dollars of tax revenue, many of those dollars from Catholics of good faith, supported the invasion and occupation.  Orthodox Jews and devout Muslims are probably offended that some of their tax dollars subsidize the pork industry or a food lunch program that largely ignores their religious laws and teachings.   The Bishops are either disingenuous or have not thought the matter through when they paint a picture of the Obama administration as forcing them for the first time ever to do something they find morally objectionable.    (Yet the law does not even force them to do anything - see Lie #6.)
Compromise is part of living in a democracy that creates laws that not everyone will agree with but everyone must follow.  If we don't like a law, we can vote for people who will attempt - through the democratic process - to support laws more to our liking, but in the interim, we do have to obey them.  I cannot withhold the portion of my taxes that goes to war or executions and pay the rest.  We don't have the right to take a cafeteria-style approach to the duties inherent in living in a civil society.   The Golden Rule that Jesus and Rabbi Hillel emphasized in their teachings can guide us here:  I obey even unreasonable laws because I would want others to obey laws I consider important but they view as obnoxious or offensive.   I don't flout some laws and obey the others anymore than I would like a mother to ignore laws mandating that she restrain her child in the car or fasten her own seat belt.
In the mind of the fundamentalist, compromise is a dirty word, which is why the more I hear the absolutist, over-the-top rhetoric of the religious right, the more I wonder whether their institutions, vestiges of the authoritarian Roman empire, are compatible with ours without serious reform.  
I will end with an excerpt from a mailing I received from Cecile Richards, President of Planned Parenthood Action Fund, who inspired this post:

Here's the truth. Nearly every sexually active woman — including 98 percent of Catholics — will rely on birth control at some point. It's basic preventive care — not just as a contraceptive, but for women who use the birth control pill to manage ovarian cysts, endometriosis, and other conditions. The health care reform law requires employers to provide coverage for preventive care with no co-pays. While churches, mosques, and other religious institutions do no have to abide by this requirement, the Obama administration has decided that religiously affiliated hospitals and universities with large numbers of employees of different faiths can't impose their ideology on those employees. It's simple: your boss can't decide whether you have access to birth control with no co-pays.

So when Mitt Romney says the rule forces anyone to provide "abortive pills," he's not telling the truth. This is about birth control. When Newt Gingrich says that the rule applies to every Catholic institution, he's not telling the truth. When John Boehner claims it includes "abortion-inducing drugs and devices," he's not telling the truth. This is about hospitals, colleges, and other non-church employers who serve and hire people of all beliefs. When anyone says this rule is about imposing on the conscience of employers, they're not telling the truth. This is about protecting women's access to basic health care.

Tell them to stop misleading the public in order to undermine women's health.

The amazing outpouring of support we saw last week when the Susan G. Komen for the Cure Foundation was pressured to defund Planned Parenthood health centers' breast cancer prevention programs proved something important: Women's health is not a political game. It is long past time for anti-choice activists and the lawmakers who pander to them to stop twisting the truth and attacking women's access to care.

This is basic health care. It shouldn't be attacked. It shouldn't be politicized. And it shouldn't be lied about. If you agree, click here to speak out.

I know that together we are strong enough to protect women's access to care. Thank you, as always, for your ongoing support of Planned Parenthood and the women, men, and teens who rely on us.

When Abortion Was a Crime: A Fascinating Review of America's Centuries of Experience With Abortion

 

February 6, 2012

In researching the history of abortion in this country and how we got into such a strange situation where otherwise compassionate people got it into their heads that cutting off breast cancer screening funds to Planned Parenthood would be a great way to show their opposition to abortion (never mind that the funds in question had nothing to do with abortion), I stumbled on this outstanding 1997 review from the Atlantic on a book, When Abortion Was a Crime by Leslie J. Reagan of the University of California.  

I had no idea how widespread (but often fatal) abortion concoctions were in colonial America, and how accepted it was to terminate a pregnancy prior to the period of "quickening", an idea that would be upheld much later in Roe v. Wade.

I was trained by some obstetricians who had been around in the days before Roe v. Wade, and they swore they never wanted to see the horrors of women bleeding to death from a botched back-alley abortion, something that the legalization of abortion virtually eliminated.  The author points out that such direct, visceral experience is harder to come by now, and many counties have no abortion providers at all.  

In contrast, in countries such as Uganda, where abortion is illegal, abortions are the #1 cause of maternal mortality.  When New York legalized abortion in 1970, maternal mortality was cut in half; when South Africa legalized abortion more recently, it plunged 90%.  Even the most rabid anti-abortion activists do not believe the punishment for terminating a pregnancy should be death - and if they do, then they really have no right to call themselves "pro-life." 

Interestingly, the American Medical Association, which was an important advocate of legalizing abortion in the 1970s opposed it a century earlier, as did early feminists (the former on business grounds and concerns about the lethality of potions being prescribed by quacks, the latter because they felt that a woman (who at that time had to have sex whenever demanded by her husband, who could not be charged with rape against his wife) should instead have the then radical freedom to "just say no" as Nancy Reagan might have put it.

Protestants opposed abortion on racial and religious grounds:

"Would the West 'be filled by our own children or by those of aliens?' the physician and anti-abortion leader Horatio R. Storer asked in 1868. 'This is a question our women must answer; upon their loins depends the future destiny of the nation.'" 

Wow. Abortion was not opposed because of compassion for potential life but fears by WASPs that they might be out-bred by disproportionately fertile Catholic immigrants. Those who vilify Planned Parenthood take particular delight in pointing out that Margaret Sanger, like so many prominent people of her time, had a soft spot for eugenics, but it's clear that those who opposed abortion also had racial and demographic "fitness" in mind.  

The difference was in means, not ends. Abortion foes feared that unless white, well-to-do, Protestant women had as many children as the new arrivals from Southern Europe, something terrible would happen to the racial mix of the country. Sanger at some level agreed, except her solution was not to get into a reproductive arms race but to help bring down the much higher reproductive rate in the desperately poor tenement population her first-ever birth control clinic served.  Otherwise, the mothers she saw and their children would be guaranteed a life of grinding  poverty.

After seeing her mother die young, apparently exhausted by spending virtually all of her adult life pregnant or recovering from pregnancy, Sanger did not want the same fate imposed upon the next generation, and thanks to her courageous work (she was almost arrested for violating the Comstock law which prohibited DISCUSSING contraception as obscene), most of us are far more likely to live in households with 2 to 3 children rather than 9 to 12, and women are far less likely to die either in labor or from a botched abortion. Abortion is safe, legal, and relatively rare (it was perhaps 7 times as great in the 19th century). We need to make sure it stays that way.

 

Abortion in American History

www.theatlantic.com