I knew it was going to be a good day when my room mate came in from her weekly Sunday-Times-fetching walk, pulled out the Magazine and said, “Ooooh!” as she held it for me to see. Bright red cover, and the words “The War on Contraception.”And it didn’t disappoint.
The wheels of history have a tendency to roll back over the same ground. For the past 33 years — since, as they see it, the wanton era of the 1960′s culminated in the Supreme Court’s Roe v. Wade decision in 1973 — American social conservatives have been on an unyielding campaign against abortion. But recently, as the conservative tide has continued to swell, this campaign has taken on a broader scope. Its true beginning point may not be Roe but Griswold v. Connecticut, the 1965 case that had the effect of legalizing contraception. “We see a direct connection between the practice of contraception and the practice of abortion,” says Judie Brown, president of the American Life League, an organization that has battled abortion for 27 years but that, like others, now has a larger mission. “The mind-set that invites a couple to use contraception is an antichild mind-set,” she told me. “So when a baby is conceived accidentally, the couple already have this negative attitude toward the child. Therefore seeking an abortion is a natural outcome. We oppose all forms of contraception.”
I’ve gotta say, I’m thrilled to see anti-choice groups finally having their true views exposed in the mainstream media. While abortion may be a contentious issue among the general public, contraception isn’t. Only the most extreme anti-choicers are opposed to it (and when I say “opposed” I don’t mean “personally don’t want to use it themselves” — I mean “want to disallow everyone else from using it”), but unfortunately the most extreme anti-choicers are the ones running the supposedly “mainstream” pro-life organizations. And, apparently, the ones being selected by this administration to head the F.D.A.’s Reproductive Health Drugs Advisory Committee.
Organizations like the Christian Medical and Dental Associations, which inject a mixture of religion and medicine into the social sphere, operate from a broadly Christian perspective that includes opposition to some forms of birth control. Edward R. Martin Jr., a lawyer for the public-interest law firm Americans United for Life, whose work includes seeking to restrict abortion at the state level and representing pharmacists who have refused to prescribe emergency contraception, told me: “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.” 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, sounded not a little like Daniel Defoe in a 1999 essay he wrote: “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.”
Scary. And it’s not limited to appointed positions — these people are getting elected, too.
As with other efforts — against gay marriage, stem cell research, cloning, assisted suicide — the anti-birth-control campaign isn’t centralized; it seems rather to be part of the evolution of the conservative movement. The subject is talked about in evangelical churches and is on the agenda at the major Bible-based conservative organizations like Focus on the Family and the Christian Coalition. It also has its point people in Congress — including Representative Roscoe Bartlett of Maryland, Representative Chris Smith of New Jersey, Representative Joe Pitts and Representative Melissa Hart of Pennsylvania and Senator Tom Coburn of Oklahoma — all Republicans who have led opposition to various forms of contraception.
Part of the issue, I think, is that your average person who identifies as “pro-life” doesn’t even know what mainstream pro-life organizations and politicians believe. There are some pro-life politicians like Harry Reid who dislike abortion, and therefore want to see it decreased. So, logically, they campaign for things that will decrease the abortion rate, like available and affordable contraception, comprehensive sex education, etc. It remains unclear, when push comes to shove, whether or not politicians like Reid would actually vote to illegalize abortion. They don’t focus on simply illegalizing it, even if they find it abhorrent; they focus on decreasing the need for it. And that, I think, is what most people believe they’re advocating when they say that they’re “pro-life.” Often they believe that they would never have an abortion themselves (of course, I’ve known many pro-lifers whose views on this changed dramatically at the first pregnancy scare), but they wouldn’t be comfortable telling their neighbor that she couldn’t have one. They use birth control. They want to plan their families, and they believe that having only as many children as they can reasonably care for and want is a moral thing to do. I don’t think that your average pro-lifer realizes that when he or she votes for someone like Tom Coburn, his version of “pro-life” politics isn’t anywhere near in line with theirs.
Many Christians who are active in the evolving anti-birth-control arena state frankly that what links their efforts is a religious commitment to altering the moral landscape of the country. In particular, and not to put too fine a point on it, they want to change the way Americans have sex. Dr. Stanford, the F.D.A. adviser on reproductive-health drugs, proclaimed himself “fully committed to promoting an understanding of human sexuality and procreation radically at odds with the prevailing views and practices of our contemporary culture.” Focus on the Family posts a kind of contraceptive warning label on its Web site: “Modern contraceptive inventions have given many an exaggerated sense of safety and prompted more people than ever before to move sexual expression outside the marriage boundary.” Contraception, by this logic, encourages sexual promiscuity, sexual deviance (like homosexuality) and a preoccupation with sex that is unhealthful even within marriage.
It may be news to many people that contraception as a matter of right and public health is no longer a given, but politicians and those in the public health profession know it well. “The linking of abortion and contraception is indicative of a larger agenda, which is putting sex back into the box, as something that happens only within marriage,” says William Smith, vice president for public policy for the Sexuality Information and Education Council of the United States. Siecus has been around since 1964, and as a group that supports abortion rights, it is natural enemies with many organizations on the right, but its mission has changed in recent years, from doing things like promoting condoms as a way to combat AIDS to, now, fighting to maintain the very idea of birth control as a social good. “Whether it’s emergency contraception, sex education or abortion, anything that might be seen as facilitating sex outside a marital context is what they’d like to see obliterated,” Smith says.
But it’s not just about limiting sex to a marital context — it’s limiting sex even with that marital context. Sex should be for procreative purposes only, and taking any pains to prevent contraception is immoral; that’ll put quite the kabosh on a married sex life.
Now, some religious conservatives will claim that using “natural family planning” — abstaining from sex during fertile periods — is acceptable contraception. And if that works for them, great. Many non-religious women use NFP as well, particularly if they don’t want to use hormonal birth control or condoms and don’t want to be sterilized. But I think people are fooling themselves if they argue that NFP isn’t contraception. It is. It’s an attempt to prevent conception. But tell yourself what you want — just don’t try and take away my right to use my contraception method of choice.
The Guttmacher Institute, which like Siecus has been an advocate for birth control and sex education for decades, has also felt the shift. “Ten years ago the fight was all about abortion,” says Cynthia Dailard, a senior public-policy associate at Guttmacher. “Increasingly, they have moved to attack and denigrate contraception. For those of us who work in the public health field, and respect longstanding public health principles — that condoms reduce S.T.D.’s, that contraception is the most effective way to help people avoid unintended pregnancy — it’s extremely disheartening to think we may be set back decades.”
Part of what is so scary about this new version of conservatism is how anti-intellectual it is. Facts don’t matter. What’s been proven effective doesn’t matter. What matters is what we believe. We see this everywhere from our international policy to our sexual politics. Pre-Enlightenment perspectives are nothing to be proud of. Trying to push us back in time is not a good idea.
Of course, what’s particularly interesting is to see these same conservatives railing against people in some Muslim countries for embracing these exact same ideas. In the same breath they’ll accuse Muslims of being backwards because they don’t embrace women’s rights, and then argue that women in our country are out of control, and we need to curtail their rights.
At a White House press briefing in May of last year, three months before the F.D.A.’s nonruling on Plan B, Press Secretary Scott McClellan was asked four times by a WorldNetDaily correspondent, Les Kinsolving, if the president supported contraception. “I think the president’s views are very clear when it comes to building a culture of life,” McClellan replied. Kinsolving said, “If they were clear, I wouldn’t have asked.” McClellan replied: “And if you want to ask those questions, that’s fine. I’m just not going to dignify them with a response.” This exchange caught the attention of bloggers and others. In July, a group of Democrats in Congress, led by Representative Carolyn Maloney of New York, sent the first of four letters to the president asking outright: “Mr. President, do you support the right to use contraception?” According to Representative Maloney’s office, the White House has still not responded.
That says something about who the president believes to be his base. He doesn’t want to alienate average Americans by opposing contraception, given that 98% of American women will use some form of contraception in their lifetime. But he’s beholden to a set of fundamentalists who he feels will desert him if he supports birth control. Birth control. Which century is this?
As the author of this article rightly points out, the emergency contraception pill is at the heart of this debate:
The issue is partly — but only partly — one of definition. According to the makers of the emergency contraception pill, it has three possible means of functioning. Most commonly, it stops ovulation — the release of an egg —or prevents sperm from fertilizing an egg. In some cases, however, depending on where a woman is in her cycle, it may stop an already fertilized egg from attaching to the uterine wall. In such a situation, for those who believe that life — and thus also pregnancy — begins at the moment of fertilization, it would indeed function as an abortifacient. According to the American College of Obstetricians and Gynecologists, however, pregnancy begins not at fertilization but at implantation. The medical thinking behind this definition has to do with the fact that implantation is the moment when a woman’s body begins to nurture the fertilized egg. The roughly one-half of all fertilized eggs that never attach to a uterine wall are thus not generally considered to be tiny humans — ensouled beings — that died but rather fertilized eggs that did not turn into pregnancies. Federal regulations enacted during the Bush administration agree with this, stating, “Pregnancy encompasses the period of time from implantation until delivery.”
People are, of course, perfectly within their rights to believe that pregnancy begins when sperm meets egg. And it is reasonable for groups like the Christian Medical and Dental Associations, Focus on the Family and the American Life League to want to alert their members that something billed as contraception might actually have a function that runs counter to their beliefs. But there are two twists. One is that emergency contraception may not actually work as an abortifacient. “There is no direct evidence that it blocks implantation,” Dr. Wood says. “We can’t tell for sure because very little research has been done on direct implantation of human eggs. You run into moral problems doing research on a woman’s body and a human embryo. And since half of all fertilized eggs do not implant anyway, it would be difficult to know if this was the mechanism responsible.” Still, if it’s even possible for emergency contraception to stop implantation, then it’s right for Dr. Rudd of the C.M.D.A. to advise his group’s member physicians, “Regardless of what an assembly of experts define, or fail to define, as the beginning of pregnancy, if a patient retains the moral conviction that life begins at fertilization, she must be made aware of information relevant to that conviction.”
But the other twist is that emergency contraception apparently works in a manner similar to that of the ordinary birth control pill. That is to say, the pill, which contains the hormone progestin, also has three possible means of operation: by stopping ovulation, preventing fertilization or impeding implantation. If emergency contraception is a potential abortifacient, then the same would seem to be true for the pill, which tens of millions of women have taken over the past several decades. Dr. Rudd disputed this. “The scientific evidence is that emergency contraception is more likely to have a post-fertility effect than the routine birth control,” he told me. But Dr. James Trussell, director of the Office of Population Research at Princeton University and one of the world’s leading experts on contraception, said: “That is completely wrong. The evidence is about the same for all hormonal methods of contraception. We can’t rule out a post-fertility effect for Plan B, and the same is true for the birth control pill.”
Yes, yes and yes. Anti-choice groups have latched onto EC because it’s new and unfamiliar, and it’s easy to confuse people about post-sex contraception, since a whole lot of people don’t really understand how the whole reproductive thing actually works and since RU-486 (“the abortion pill”) is also relatively new and easily conflated with EC. What they try and hide, though, is the fact that EC is the exact same thing as regular hormonal birth control, just in a higher dose. If people knew that, there would be far less opposition to EC. And anti-choicers wouldn’t want that, because it might mean that women could have sex without being punished for it. And it would mean that rape victims could avoid pregnancy. And it would lower the abortion rate. These things, apparently, are not pro-life.
What’s more, Dr. Trussell added: “There is evidence that there is a contraceptive effect of breast feeding after fertilization. While a woman is breast feeding, the first ovulation is characterized by a short luteal phase, or second half of the cycle. It’s thought that because of that, implantation does not occur.” In other words, if the emergency contraception pill causes abortions by blocking implantation, then by the same definition breast feeding may as well. Besides that, the intrauterine device, or IUD, can alter the lining of the uterus and, in theory, prevent implantation.
Ooooh this is good. Can I just throw it out there that I love Russell Shorto? I was aware that breastfeeding limited fertility, but I never knew how. And this little bit of information — that it works pretty much the same way as EC — is fantastically rich. I can’t wait for the anti-choice campaign against breastmilk.
Ron Stephens is both a pharmacist and a Republican state legislator in Illinois, one of the states that are currently battlegrounds between pharmacists who claim the right to refuse to fill prescriptions for emergency contraceptives and women’s and civil rights groups that argue that pharmacists must fill all prescriptions presented to them. Stephens not only supports the pharmacists’ right of refusal but he also refuses to fill prescriptions for emergency contraception himself. He does, however, fill prescriptions for the birth control pill. When I asked him recently to explain his thinking on the two drugs, he said: “It’s the difference between stopping a pregnancy from happening and ending a pregnancy. My understanding of the science is that the morning-after pill can end a pregnancy, whereas birth control pills will make a woman’s body believe she is already pregnant so that the egg will not be fertilized.” And what if studies show that, in fact, both drugs can prevent implantation? “Everyone has their natural prejudice,” Stephens replied. “I’m going to understand it my way, and the issue is that you should not be forced to do something you believe is immoral.”
…what was that about anti-intellectualism? “I’m going to understand it my way.” Well, I’m going to understand that smoking a pack a day and eating at McDonalds for every meal will be a far greater benefit to my health than running five miles and eating nutritiously, but that doesn’t make it so. And while I’m certainly entitled to my beliefs, it probably wouldn’t be a great idea for me to impose those completely unsubstantiated, based only in my own head ideas on other people, particularly if I’m a gatekeeper to healthcare.
In the current, evolving movement against contraception, therefore, some groups soft-pedal their position. “Concerned Women for America does not take a position regarding birth control,” Wendy Wright, president of that influential, 500,000-member, biblically-based organization, told me. She went on to say, however, that C.W.A. does “educate regarding how certain birth control methods operate.” Specifically, the group offers a brochure titled “High-Tech Birth Control: Health Care or Health Risk?” to those who call seeking guidance. Most methods of birth control can pose health risks. A 2005 World Health Organization study, for instance, found a connection between some forms of the pill and cancer. But the C.W.A. brochure goes well beyond this. Its section on emergency contraception advises that “its main function is to abort a living human embryo.” One function of the birth control pill, it states, is to induce “a chemical abortion.” The section on the IUD indicates none of its practical benefits (its 99 percent effectiveness in preventing pregnancy, its reversibility) and consists mostly of a litany of health complications, many of which health experts refute.
We don’t take a position on birth control… except to tell you all kinds of anti-choice lies about it.
Zenarolla told me she converted to Catholicism two years ago: “I tell people I became Catholic because of the church’s teaching on contraception. We are opposed to sex before marriage and contraception within marriage. We believe that the sexual act is meant to be a complete giving of self. Of course its purpose is procreation, but the church also affirms the unitive aspect: it brings a couple together. By using contraception, they are not allowing the fullness of their expression of love. To frustrate the procreative potential ends up harming the relationship.”
…which, being 34, chaste and single, I know a whole lot about.
Again, no problem here with Zenarolla believing what she believes. Wanna not have sex until marriage? You have my blessing! Want to think that contraception is the wrong choice for you? Go for it! Just quit trying to take away my right to it.
But then, from this perspective, the pill began to do terrible damage. “I cannot imagine any development in human history, after the Fall, that has had a greater impact on human beings than the pill,” Mohler continued. “It became almost an assured form of contraception, something humans had never encountered before in history. Prior to it, every time a couple had sex, there was a good chance of pregnancy. Once that is removed, the entire horizon of the sexual act changes. I think there could be no question that the pill gave incredible license to everything from adultery and affairs to premarital sex and within marriage to a separation of the sex act and procreation.”
The Pill: Doing the most damage to society since the Fall!
And what, exactly, is that “damage”? Well, not forcing women to get pregnant when they don’t want to. And everyone knows that pregnancy should be a punishment, not a desired state of being!
Democrats, meanwhile, have had their difficulty with the abortion issue, and their new hopes are pinned to a strategy that focuses on contraception as a way to reduce unintended pregnancy. Last month, Senators Harry Reid and Hillary Clinton — an anti-abortion Democrat and an abortion rights Democrat — introduced legislation that would require insurance companies to cover contraceptives. In part, the idea is to force Republicans to support contraception or be branded as reactionaries. The conservative counter was 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.”
This is an important point: It’s low-income women who are being punished the most by these laws. Republicans urge “personal responsibility,” but apparently don’t believe that using contraception to prevent getting pregnant and having children you can’t care for is responsible. They say that sex has consequences, but don’t want women to have the tools to avoid those consequences. And when women do get pregnant unintentionally, they’re shamed. Their options to terminate pregnancies are limited, and if they have more children they’re branded burdens on society.
Wealthier women, by contrast, will be able to afford birth control if they need it, and there’s not the same campaign against them for being “irresponsible” for having too many kids. In fact, these women are being irresponsible by not having enough children, and for letting brown women out-produce them.
The only consistent conservative viewpoint here is that women can’t win.
In addition to providing an information center for the abstinence industry that has blossomed in recent years, she takes her message directly to kids. Besides “Girls Gone Mild,” she sponsors “Purity Balls,” which fathers attend with their teenage daughters. “We think the relationship between fathers and their daughters is the key,” she told me. At the purity ball, a father gives a “purity ring” to his daughter — a symbol of the promise she makes to maintain her virginity for her future husband. Then, during her marriage ceremony, the daughter gives the ring to her new husband. Abstinence Clearinghouse’s Web site advertises the purity ball as an event “which celebrates your ‘little girl’ and her gift of sexual purity.”
Does anyone else find that entirely creepy? Dad keeps your virginity, until it’s passed off to another dude. “Thanks for taking her off my hands — as a special bonus, here’s her hymen.”
The intellectual force behind the abstinence-education movement is Robert Rector, senior research fellow at the Heritage Foundation. Rector wrote some of the federal legislation mandating abstinence education, and he worked on a number of studies that purport to demonstrate its effectiveness. One component of abstinence education is the “virginity pledge,” and Rector is an author of one study that concluded that teenagers who take virginity pledges “have substantially improved life outcomes,” and another that showed that “sexually active teenagers are more likely to be depressed and to attempt suicide.”
The idea of promoting abstinence over comprehensive sex education (which includes information on various forms of contraception and how to use them) gets to the core of the expanded conservative approach to birth control issues. It really is all about sex. “There are two philosophies of sexuality,” Rector told me. “One regards it as primarily physical and all about physical pleasure. Therefore, the idea is to have lots of physical pleasure without acquiring disease or getting pregnant. The other is primarily moral and psychological in nature, and stresses that this is the part of sex that’s rewarding and important.”
And what’s “rewarding and important” about sex, apparently, is forced pregnancy. Awesome.
He also mischaracterizes the liberal view of sex. It’s not that it’s primarily physical and all about physical pleasure. It’s that sex should be what you believe it is, so long as it’s consensual and not harming anyone. If you believe that it’s physical and about pleasure, fine. If you believe that it’s about pair-bonding and seeking pleasure in another person who you care about, fine. If you believe that it’s about making babies, fine. This may shock Mr. Rector, but people can even believe different things about sex depending on what stage of their life they’re in, and who they’re having it with. In fact, the exact same person can believe that sex is strictly for physical pleasure, later think that sex is for bonding, and even later think that it’s to make a baby. Crazy, I know. Some people think that it can be all these things at the same time. Some people think that it’s none of these things, or that it’s something else entirely.
The question, then, becomes whether we respect diverse and individualized views of sex, or whether we attempt to legislate a singular viewpoint. That’s where the divide lays.
A December 2004 report on federally financed abstinence-only programs conducted by the office of Representative Henry Waxman, Democrat of California, charged that the major programs presented misleading information about health (one curriculum quoted in the report stated that “condoms fail to prevent H.I.V. approximately 31 percent of the time”), state beliefs as facts (the report cited a curriculum that refers to a 43-day-old fetus as a “thinking person”) and give outmoded stereotypes of the sexes.
All parents struggle with how to shield their children from the excesses of popular culture, and not surprisingly, surveys show that most want teenagers to delay first intercourse. But by wide margins they also say kids should be taught about contraceptives. A poll released in 2004 by National Public Radio, the Kaiser Family Foundation and Harvard’s Kennedy School of Government found, for example, that 95 percent of parents think that schools should encourage teenagers to wait until they are older to have sex, and also that 94 percent think that kids should learn about birth control in school.
Again: Fundamentalist anti-choicers and the people in this administration are incredibly far out of the mainstream.
Abstinence has also become a primary element of Pepfar, President Bush’s overseas AIDS relief program — with, some experts say, disastrous results. The Government Accountability Office released a study in April that found that in many countries administrators were forced to cut funds intended to fight mother-to-child H.I.V. infection in order to finance abstinence programs. Stephen Lewis, the United Nations special envoy for H.I.V./AIDS in Africa, who had previously charged that the Bush program put “significant numbers” of people in Africa at risk, told me: “I feel vindicated by the G.A.O. study. I think it raises legitimate questions about the disproportionate attention given to abstinence as opposed to condoms. At this moment, even the Catholic Church is reconsidering condoms.” On April 7, the State Department issued its own response to the G.A.O. study, in which it claimed that as a result of approaches like the Bush administration’s “ABC policy” — promoting “abstinence” and “being faithful,” then “condoms” — H.I.V. transmission has fallen in Uganda, Zimbabwe and Kenya and “male faithfulness” has increased.
I would have no problem with the ABC program, if they actually used the C part of it. But they don’t. Funding for condoms has been cut in favor of ideological imperialism. And it’s not any better at home.
On the domestic front, the rise in abstinence education has been paralleled by a tendency on the part of some conservatives to denigrate condoms. Senator Tom Coburn of Oklahoma, who is also an obstetrician, has led a campaign to force condom makers to indicate on their labels that they may not prevent certain S.T.D.’s, specifically the human papillomavirus. In 2001, when he was in the House of Representatives, he issued a press release entitled “Condoms Do Not Prevent Most S.T.D.’s.” Sex educators say this is a twisting of data to suit an ideologically driven anti-sex agenda. “An N.I.H. panel said condoms are impermeable to even the smallest S.T.D. viruses,” Cynthia Dailard of Guttmacher says.
That’s productive: Tell people that condoms don’t work, so why bother?
Social conservatives in the U.S. seem to be moving in the opposite direction from much of the rest of the world. At least 12 countries have liberalized abortion laws in recent years. Emergency contraception is currently available without a prescription in more than 40 countries. In much of Western Europe, abortion and contraception are available and fully covered by insurance.
An interesting thing about growing up and living in the United States for your entire life, as I have, is that you really do believe all the things that Americans say about America. You believe that the United States is one of the most progressive countries in the world. You believe that we’re at the forefront of technology, of women’s rights, of human rights. You believe that people here have access to the best and most comprehensive medical care and information.
Then you find out that you were sorta wrong. And that’s a fantastic disappointment.
I can already here the conservatives saying, “But look at how good you have it! You could be living in Iran!” Sure, and women in Iran could be living in Afghanistan. See how lucky they are?
Everybody’s got it better than somebody. The point, though, is that the United States holds itself up as a beacon of freedom and post-Enlightenment ideals. And as an American who values those things, it’s like a punch to the stomach when our leadership attempts to subvert them.
While Americans as a whole don’t hold such a dark view of comprehensive sex education, many do feel there’s something wrong with a strictly clinical approach. This ambivalence, according to Sarah Brown of the National Campaign to Prevent Teen Pregnancy, gets to the root of the problem and may explain the numbers. “One of the things I’m most often asked is why the abortion and unintended pregnancy rates are so much lower in Europe,” she says. “People talk about the easy access to contraception there, but I think it’s really a matter of the underlying social norms. In Europe, these things are in the open, and the only issue is to be careful. Here in the U.S., people are still arguing about whether it’s O.K. to have sex.”
Read the whole article.
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