Access to Free Contraceptives Lowers Pregnancy, Abortion Rates

For this they needed a study?  Apparently the answer is “yes.”   You’ll find news reports scattered over the media today reporting on it, but they are mostly quite similar.   Researchers provided women with free contraceptives for three years.  They gave women a choice of methods.   The result?

women experienced far fewer unintended pregnancies than expected: there were 4.4  to 7.5 abortions per 1,000 women in the study, after adjusting for age and race — much fewer than the national rate of 19.6 abortions per 1,000 women and lower  also than the rate in the St. Louis area of 13.4 to 17 abortions per 1,000  women.

Surely the causation here is pretty obvious–if women use contraceptives they do not get pregnant they do not need abortions.

I know for some contraceptives and abortion are moral equivilants and both intrinsically evil.  (I’m thinking here of Catholic teachings but of course that is not the only moral viewpoint that equates the two.)   Maybe that’s a fine theoretical stance, but it seems to me sadly out of touch with reality.  As women (and men, too, I think) experience them, contraception and abortion are hardly the same.    Abortion is more difficult, more dangerous and more expensive than contraception.   Thus for me the implications of the study seem quite clear–we’ll all be better off if women have ready access to contraceptives.  (Of course, no one is required to use contraceptives.)

Access to birth control is important to both men and women, of course, but it seems fairly obvious that it is more important to women.   Without birth control men may unintentionally father children.  (Yes, I’ve thought about this language.   I could have said “men may unintentionally participate in conception via sex” but that seems pretty clunky.   I don’t think the phrase “father a child” means much more than provide the genetic material via sex, though.   It’s a striking contrast with “to mother a child,” which I think actually implies some actual social relationship with the child.  But I digress.)    This can have all sorts of consequences for the man involved but as a general matter, there’s no threat to the man’s health.

By contrast, without birth control women may unintentionally become pregnant.   In the best of all worlds this leads them with a choice–abortion or pregnancy/labor/delivery.   (In the worst, they cannot find or afford a safe abortion and so pregnancy/labor/delivery or unsafe abortion are the options.)   Each of those options carries health risks–risks that women with resources can avoid by obtaining contraceptives.  Why would we deny poor women the same contraceptive choices?

And then there is this argument:

Jeanne Monahan of the conservative Family Research Council suggested contraceptive use can encourage riskier sexual behavior

I suppose by “riskier sexual behavior” she means sexual intercourse, which is what leads to pregnancy.  But doesn’t the high rate of unintended pregnancy for women not using birth control tell us that they are engaging in intercourse anyway?   There are undoubtedly some people who don’t engage in intercourse because they don’t have access to birth control but I think there are a whole lot more people who go right on ahead in any event.

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15 responses to “Access to Free Contraceptives Lowers Pregnancy, Abortion Rates

  1. I agree that it seems a no-brainer that the number of abortions would decrease. But, if access to free female based birth control (e.g., the pill or an IUD) reduced condom usage then women could be at a higher risk of contracting an STD. (And, it could be one that damages her fertility making it more likely that she might need to hire a surrogate or use adoption to become a parent. Oh, Lordy. Cue all those arguments on your site.) I would be curious to know if the rate of condom usage was altered at all. Access to free contraceptives, coupled with a focused reminder that protection from STDs is still important, seems like the best policy.

  2. I don’t think the point of the study was to show that increased use of contraceptives reduces abortions. The point seems to be more economical: whether providing free contraceptives could lead to fewer abortions. The data are crucial in any political debate about governmental health policy. Some conservatives would challenge that kind of proposal if a study such as this were not done. Tyson has a good point about risks of free IUD use could lead to more frequent sex without condoms. Other risks are also plausible outside of STDs. If IUDs gave women a sense of more sexual freedom, some conservatives would argue that women’s choice of sexual partners might become riskier, leading to possible violent relationships. Rush Limbaugh would raise the slut card again.

    IUDs are the most effective means for female contraception and ought to be free but women need to insist that partners use condoms as well. That should also be obvious but I wonder how many women worry more about unwanted pregnancy than they do STDs. Apparently, condom use is up among teenagers and both the rate of STDs and pregnancies are actually down. That’s a sign of progress.

    I think the data would have been more interesting if they also studied what happened to those who became pregnant. How many aborted, how many surrendered the child for adoption and how many kept the baby (as well as how many of that subset married their partner)? Protesters at abortion clinics often carry signs that say “Choose Adoption, Not Abortion.” I’m sure that some pro-life women who have unwanted pregnancies will choose adoption. This kind of study of women who use free contraception could help to evaluate the actual choices women make when it fails to work. The study title would then read “Access to Free Contraceptives Lowers Pregnancy, Abortion, Adoption, and Single Motherhood Rate – What Women Choose.”

    • A quick Google search seems to indicate that about 1% of unmarried women who give birth give the baby up for adoption, but that doesn’t distinguish between planned vs unplanned pregnancies. Either way though the adoption rate is pretty low. Most women who decide against abortion for whatever reason end up raising the child.

    • There’s surely a broader study to be done, as you suggest. And it would be interesting. I also think that you are quite right–the study was done in part as a matter of economics–the cost of providing free contraception measured against resulting benefits. Contraception–even the most expensive forms–is clearly cheaper and so it is a cost effective option. But it seems to me that the other point is also important in the discussion of health care–providing free contraceptives enhances women’s overall health.

  3. Ha ha ha I llike your opening remark “for this they needed a study?”

  4. They didn’t need to do a study except to provide data for people lacking in common sense. Providing low cost, or free contraception is one of the best methods of preventing poverty. Whether or not people have access to contraception they are still going to have sex – science hasn’t figured out how to switch off our emotions or hormones (especially for teenagers)…

  5. I agree. It’s a good thing to study just for the sake of providing data to counteract those (men usually) who argue against a woman’s right to control her body. I also agree that it adds to the arguments that address poverty issues. Ultra-conservatives don’t want government assistance for poor people, preferring “self-reliance”, while ignoring the fact that some are not fortunate enough to have the means to pull themselves out of poverty. If poor women can receive free contraceptives, fewer children will be born into poverty. lessening the costs for society and helping women to have more opportunities to work . My point about adoption being included of the study was meant to determine whether this group, whose lack of contraceptive access leads to unplanned children, specifically have higher economic pressures to surrender the children to adoption, which also has a strong psychological impact, in addition to poverty, on the well-being of the mother (and child). This is a different group from the general population of women with unwanted pregnancies.

    In the heightened divisiveness of conservative stands against women’s rights. such “obvious” studies become necessary to counter their arguments. Contraception debate has just recently been revived probably because the intractable arguments over abortion was not sufficient for conservatives. Griswold v. Connecticutt established the right of men and women to have unrestricted access to contraceptives way back in 1965, with a 7-2 majority of the all-male Court. It is settled law and much less debated than Roe v. Wade. It is absurd that 47 years later it has suddenly arose again in the current political climate and led to a study that would otherwise be unnecessary.

  6. I wonder how long women will have access to contraception – paid for or free. Access to contraception is predicated on a right to privacy. Since that right doesn’t explicitly exist in the Constitution, I do foresee a potential for the right mix of Supreme Court justices to begin reversing the “right to privacy” concept. This would allow states to once again ban contraception. It’s certainly possible.

  7. If Mitt Romney gets elected and the oldest Justice dies in the next four years(Ruth Ginsberg is now 79), then the balance in the Supreme Court will probably shift to five conservatives with Justice Kennedy no longer being the swing vote. In that case, many decisions and enacted laws will likely be challenged by the far right. Some of these go back to the New Deal and the Depression Era. If the immigration issues continue to be hot, as they’ve been off and on since the flood of immigration and rise of Big Business after the Civil War, the extremists will even challenge the citzenship clause of the 14th Amendment.

    Justice Douglas’ decision in Griswold v. Connecticutt 1965 was predicated that “the right to privacy” exists in the “penumbra and emanations” of the Constitution, an activist view that is considered by some as “making it up.” However, that has been supported by many subsequent decisions and by Congress. If that gets reversed, an avalanche of other laws will be struck down, including Roe v. Wade, which were determined by privacy issues. This is definitely possible but the impact is so dire that I don’t believe the more moderate conservatives on the Court, like CJ Roberts and Justice Kennedy will support it. In any case, let’s hope that Justice Ginsberg enjoys more than four more years of life and doesn’t retire.

  8. my understanding of roe v wade is that it is based on other precedents forbidding the state to get involved in personal medical decisions as limiting a persons autonomy over their body. I agree that the term “right to privacy” in unfortunate phrasing.

  9. Removing the “Right to Privacy” clause would be a dream for the far right. In one swoop they would reverse Roe v. Wade, Skinner v. Oklahoma, Carey v. Population Services, Griswold v. Connecticut, Danforth v. Missouri, Lawrance v. Texas, Planned Parenthood. vs. Danforth among others.

    This would remove Contraception Rights, Abortion Rights, Gay Rights, and the right to have sex with someone when not married.

    These cases all talk about one of the fundamental rights of procreation and privacy.

  10. i interpret right to privacy as “right to non-interference by the state” simply a rephrasing of the basic right

    • Good but this should include more than the state. This echoes Louis Brandeis’ thesis in his Harvard Law Review article “The Right To Privacy” in 1890, twenty-six years before he joined the Court He saw this as an extension of natural and common law as “the right to be left alone.” He also says that this is part of property rights, extended to one’s self, one’s ideas, and one’s life. However, he did not say that it was limited to state non-interference but as “rights as against the world.” He included intrapersonal violations such as slander, false witness, and libel. Unfortunately, the Constitution does not say anything about privacy specifically so it became a matter for Court interpretation under the 9th Amendment’s concept of unenumerated rights. These have usually been implied as ancient common law rights that we take for granted but could be specified in later Amendments or Court decisions (something that leads to the criticism of “making it up”). SCOTUS gave some minor hints of this right from the early 20th century to WW2 (including Douglas’ opinion in Skinner v. Oklahoma in 1942). It wasn’t until Griswold in 1965 that Justice Douglas made privacy a right to be found in the “unwritten” Constitution. Property Rights diminished over the subsequent period while Privacy Rights expanded.
      Caroline Kennedy wrote a clear and powerful summary in “The Right To Privacy” in 1997, something her family held precious for good reason.

  11. Forgive me for being grumpy about this – fewer stds and abortions is a very good thing – but the emphasis is always on women, women, women as if none of the decisions we make are made jointly or in consultation with a partner and as if all us women are having sex with intangible ghosts with no responsibility, ethereal beings we can’t quite catch hold of or refer to by their name… men. Meh.

    Have you ever tried getting a condom on a man who doesn’t want to wear one?

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