Rachel Held Evans asks:

So yesterday I complained about feeling stuck in the middle between pro-life idealism and those progressive policies I think are most likely to actually curb the abortion rate. But today I’m thinking about practical solutions. There are a few I’ve been advocating and supporting for a long time, but I want to crowdsource a bit: What are some key initiatives (both domestically and globally) around which conservatives and liberals could rally that would address the underlying causes of abortion: poverty, expensive healthcare, expensive childcare, lack of access to contraception and comprehensive sex education, domestic violence, etc? If I find the time I’ll share the best in a blog post. Thanks for weighing in! (And let’s keep it positive and practical!)

I love talking about ways to address the underlying issues that lead to abortion. There’s so much that we can do to prevent abortions — IF, as an early feminist wrote in The Revolution, “We want prevention, not merely punishment.” My reply:

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As other commenters have said, affordable and easy access to contraception is important. The less often people have to go pick up prescription refills, the better — there was a study in L.A. that showed that allowing low-income women to get twelve months’ worth of pills at a time decreased the odds of unintended pregnancy by 30%, and the odds of an abortion by 46%. Even better, IF a woman freely chooses them and can have them removed upon request, are long-acting reversible contraceptives like IUDs and implants that don’t require any action to be taken once they’re in. In general, humans are not great at taking a pill at the same time every day (not just contraceptives). LARCs also can’t be sabotaged by abusive partners.

Speaking of which, we also need to do more to stop rape, and to help women out of abusive relationships. Early research shows that counseling women who come to family planning clinics about reproductive coercion (asking about whether their partners hide their pills, threaten to hurt them or kick them out of the home if they use contraception, etc.) not only reduces unintended pregnancies among women in abusive relationships, it also increases the chance they’ll leave those relationships. Men who father children by rape must not be allowed to have custody or visitation. This is already the case in 35 or so states, but we need to finish the job.

Comprehensive and accurate sex ed, including instruction about how to be safe and responsible about sexual activity if one chooses to use drugs or alcohol.

School and workplace policies that are designed with the idea that workers are human beings who have lives outside of work, not just productivity machines. No more just-in-time scheduling. No more pregnancy discrimination. Paid maternity and paternity leave. Affordable child care.

Nobody should ever be in a position where they don’t feel like they can bear a child because they won’t be able to pay rent or feed their other kids. More power for workers would mean better wages, and a real social safety net (one that’s not premised on the false idea of recipients as moochers who need to be humiliated) would alleviate some of the financial fear that often leads to abortion. Better yet, a guaranteed basic income and/or a child allowance. It’s disgraceful that in a country as rich as ours, hundreds of thousands of abortions happen every year because mothers are afraid they can’t afford to give their children life.

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The above comment was dashed off quickly, but I would also add perinatal hospice, so that abortion doesn’t seem like the only option for parents whose children are diagnosed in the womb with fatal conditions. Also, there needs to be community support for parents of children with disabilities. Asking them to go it alone, with all the added stress and expense and work that can be involved, overwhelms many parents. They can’t see themselves handling all that, especially if they also have other kids. They shouldn’t have to handle it without help.

And while it’s not a policy issue, in general we need to foster a sexual ethic that emphasizes care for the health and well-being of oneself, one’s partner, and for any child who might be conceived. Not just safe sex, but caring sex. Wise sex. Sex that acknowledges that we aren’t pleasure-seeking islands, but are connected to — and affect — our fellow human beings.

I’m a night owl by nature. Left to my own devices, I’d go to bed at 4am and wake up at noon. Sadly, employment and parenthood mean that’s not an option. (Not that employment and parenthood are sad. You know what I mean.) So to get my nocturnal brain kicked into gear in the morning, I check Twitter. I usually find something that’ll wake me right up.

“Pro-lifers should support sex ed… but pro-lifers aren’t welcome in our sex ed club!” http://t.co/ULFEvDTOPN #prolife #prochoice #catch22

— secularprolife (@secularprolife) March 11, 2014

Like this.

Better than coffee! (Full disclosure: I hate coffee.)

From a philosophical point of view, I get why this happens. I understand why pro-choicers see both birth control and abortion as questions of being able to control one’s own body, even though I think they’re wrong to dismiss the obvious difference between the two. And I understand why people who oppose birth control think that acceptance of contraception inevitably leads to acceptance of abortion, even though I think they’re wildly mistaken. In both cases, though, I just want to ask why they’re so sure that theirs is the only viewpoint that reasonable [birth control|pro-life] advocates could hold.

I also understand it from a practical point of view. Birth control is far more widely accepted than abortion. So if you want people to reject birth control or accept abortion, it’s in your interest to link the two. You might even get really protective of the idea that they have to be linked. But most people don’t see them as the same. So groups like All Our Lives and Secular Pro-Life will just keep on reaching out to those people, and advocating for family planning freedom as one component of our work against abortion.

Two recent news items highlight the need for better education about pregnancy and birth control. The first is a survey by the American College of Nurse-Midwives:

Despite the broad range of options available to women for birth control and family planning, a survey of more than 1200 US women between 18 and 45 released today by the American College of Nurse-Midwives (ACNM) shows that women do not feel knowledgeable about many of these options and have harmful misperceptions about their effectiveness. The survey also found that many women don’t feel they are able to have in-depth conversations with their health care providers to make well-informed decisions on birth control and family planning.

And what are the consequences of lack of knowledge and misperceptions?

We interviewed a sample of women obtaining abortions in the U.S. in 2008 (n=49) and explored their attitudes towards and beliefs about their risk of pregnancy. We found that most respondents perceived themselves to have a low likelihood of becoming pregnant at the time that the index pregnancy occurred. Respondents’ reasons for this perceived low likelihood fell into four categories: perceived invulnerability to pregnancy without contraceptive use, perceptions of subfecundity, self-described inattention to the possibility of conception and perceived protection from their current use of contraception (although the majority in this subgroup were using contraception inconsistently or incorrectly).

Far too many people don’t get factual education from their schools or adequate information from their doctors about how their own bodies work. The result is unintended pregnancy and, often, abortion.

Starting today, people in the U.S. who need health insurance can go to healthcare.gov to enroll in a plan through their states’ new exchanges.

There’s a lot for pro-lifers to love about health insurance reform. All plans offered on the exchanges must cover prenatal care, delivery, and care for mother and baby after birth. Prior to the Affordable Care Act, most individual insurance plans didn’t cover maternity care, and women who were already pregnant often couldn’t get insurance at all.

In addition to the reform of maternity care coverage, the ACA requires insurance plans to cover a number of preventive services with no cost-sharing. These include, but are definitely not limited to:

Having these vital preventive services available without a co-payment will help more women and children live healthy lives as well as making it easier for women to avoid unintended pregnancy and abortion.

* These are currently required to be covered for women but should be available without cost-sharing to everyone, in my opinion.

Imagine that you worked for somebody whose religion forbids drinking alcohol. Now, that doesn’t mean you couldn’t get a beer. The way it would work is that your boss would tell the bank where your checks are deposited that she’s anti-beer. You’d get your salary minus the amount you spend on beer, and then when you buy beer, you’d have to tell the store or bar to bill your bank. Then the bank would keep track of how much they’d spent on paying for your beer, and submit that information to the government to be reimbursed.

Imagine that around half the country supported this system — or thought even this Rube Goldberg arrangement wasn’t good enough, and still amounted to your employer being forced to buy you beer — and said if you didn’t want your boss deciding how you could spend your pay, you should just find a different job. You know, in an economy where unemployment has been above 7.5% for almost five years.

Sound reasonable? No? Well, that’s basically the situation that now exists with another form of employee compensation: the employee’s health insurance policy.

If it would be ridiculous for beer, why is it OK for family planning?

[I’d bookmarked the HHS announcement but hadn’t started drafting this post yet when two stories came out about workers who are forced to get their pay in the form of prepaid debit cards and get screwed by the cards’ high fees. A friend of mine pointed out that soon, it could become technologically feasible for companies to pay their employees with debit cards that can’t be used to buy certain things. And won’t that be a paradise of religious freedom?]

A February 2012 report from the Native American Women’s Health Education Resource Center details the barriers faced by women who need emergency contraception from the Indian Health Service. One in three Native American women has been a victim of rape or attempted rape, and yet women are often denied access to the care they need to prevent pregnancy.

The only pharmacist on most reservations is within the local Indian Health Service. Women who need Plan B report that IHS pharmacies often do not stock Plan B, refuse to provide it without a prescription, and sometimes shame women who ask for it.

Please ask IHS director Dr. Yvette Roubideaux to issue a directive to all service providers that emergency contraception be made available on demand — without a prescription and without having to see a doctor — to any woman age 17 or over who asks for it.

One of our board members just gave a talk on “Family Planning: Myth, Reality, and the Lifesaving Power of Choice” at the Call to Action Conference, a large gathering of progressive US Catholics. The detailed, amply referenced handout from the presentation is useful for family planning advocates of all faiths and none. Like the presentation itself, it covers the following points.

–Family Planning Freedom Is A Universal Human Right.
–Family Planning Freedom Saves Lives.
–Pregnancy Prevention Choice Is Not Violence Against the Already-Born.
–Pregnancy Prevention Choice Is Not Violence Against the Unborn.
–Natural Family Planning Is A Good Answer for Some, But Not All.
–What You Can Do to Advocate for Family Planning Freedom!

You can download it as a free .pdf here.

Yesterday, the New Evangelical Partnership held an event at the National Press Club to unveil a statement called “A Call to Christian Common Ground on Family Planning, and Maternal, and Children’s Health.

The statement makes three main points:

  1. Family planning strengthens families and creates more stable and healthy communities worldwide.
  2. Family planning protects the health of women and children.
  3. Family planning reduces abortion.

We agree wholeheartedly, of course, and are pleased to have the New Evangelical Partnership as part of the movement for family planning freedom.

You can watch the whole event on YouTube. I recommend at least watching Rev. Jennifer Crumpton’s presentation of the NEP statement, starting at about 8:15 in, Dr. Mark Hathaway’s talk at 19:00 about the medical benefits of family planning for women and children, and Katherine Marshall’s talk at 28:10 about the international context of family planning.


Speakers at the NEP event referred more than once to a study recently conducted by Washington University in St. Louis. The project provided women and teens at high risk of unintended pregnancy with the contraceptive method of their own choice at no cost. The results were dramatic. The abortion rate fell to 6 per 1,000 women, compared with a national average of 20 per 1,000 women. The teen birth rate from to 6.3 per 1,000, compared with 34.1 per 1,000 nationwide.

Imagine the impact of cutting the abortion rate in the U.S. by almost two thirds.

As the Agence France write-up of the study noted: “If the same results were replicated across the United States, free birth control could prevent 1,060,370 unplanned pregnancies and 873,250 abortions a year.”

Yes, that’s a big “if.” [Edited to add: as the researchers pointed out, the sample of women who participated in this study is not generalizable to the total population of women of reproductive age in the United States. That said, they likely bear a great deal of similarity to the population of women at the highest risk for unintended pregnancy and abortion.] And of course, there are important caveats. Women’s consent must be free and fully informed. Women must never be coerced into using long-acting contraception because other people think it would be better for them not to reproduce. It must always, always be the woman’s choice to use contraception. In addition, protection against HIV or other STDs is vital, and the forms of contraception chosen by most women in the study did not provide that protection.

But imagine it. Imagine 873,250 fewer unborn human beings destroyed every year. Imagine 873,250 fewer women going through abortions. Imagine 1,060,370 fewer women having to experience unplanned pregnancy, and instead being able to bear children at a time when their age, health, and life situation are better suited for motherhood — or being free to choose a different life path than motherhood.


Earlier this month, a Republican-appointed federal judge in the United States District Court for the Eastern District of Missouri rejected a lawsuit brought against the U.S. Department of Health and Human Services by an employer in a secular industry (mining, metals, & ceramics) who, due to his own religious beliefs, doesn’t want to provide his employees with insurance that covers contraception.

Judge Carol Jackson noted that employers already pay their employees a form of compensation that could be used to purchase contraception: their salaries. This is an argument I’ve made in the past. The full ruling is online here.

The burden of which plaintiffs complain is that funds, which plaintiffs will contribute to a group health plan, might, after a series of independent decisions by health care providers and patients covered by OIH’s plan, subsidize someone else’s participation in an activity that is condemned by plaintiffs’ religion. This Court rejects the proposition that requiring indirect financial support of a practice, from which plaintiff himself abstains according to his religious principles, constitutes a substantial burden on plaintiff’s religious exercise.

RFRA is a shield, not a sword. It protects individuals from substantial burdens on religious exercise that occur when the government coerces action one’s religion forbids, or forbids action one’s religion requires; it is not a means to force one’s religious practices upon others. RFRA does not protect against the slight burden on religious exercise that arises when one’s money circuitously flows to support the conduct of other free-exercise-wielding individuals who hold religious beliefs that differ from one’s own…

Just as in Mead, plaintiffs must contribute to a health care plan which does not align with their religious beliefs. In this case, however, the burden on plaintiffs is even more remote; the health care plan will offend plaintiffs’ religious beliefs only if an OIH employee (or covered family member) makes an independent decision to use the plan to cover counseling related to or the purchase of contraceptives. Already, OIH and Frank O’Brien pay salaries to their employees—money the employees may use to purchase contraceptives or to contribute to a religious organization. [emphasis added] By comparison,the contribution to a health care plan has no more than a de minimus impact on the plaintiff’s religious beliefs than paying salaries and other benefits to employees.

And once again, despite the claims in this and similar lawsuits that the HHS mandate forces them to cover abortifacients, the belief that emergency contraception is abortifacient has not been borne out by the evidence. I’m going to keep repeating that until new evidence comes to light or people stop making this claim, so get used to it.

In countries where there is a vocal, well-funded minority against contraception, stereotypes against women who use it abound.

In the United States, for example, women who use contraceptives–the overwhelming majority of women, by the way–have been derided as feckless, irresponsible, selfish, monstrously unnatural, man-hating, child-hating sluts who want to live parasitically off hard-working, moral-paragon taxpayers, and who automatically have abortions without a thought if they become unintentionally pregnant. Women who do not use contraceptives, on the other hand, are praised as spiritually superior, virtuous, man-loving, child-loving, fruitful Good Girls who know their ordained place in G*d’s Order of Things.

What a different, and much more flattering, much more accurate picture emerges from a new Guttmacher Institute study, Reasons for Contraception: Perspectives of US Women Seeking Care at Specialized Family Planning Clinics, which is forthcoming in the journal Contraception.

From a release about the study:

“Women value the ability to plan their childbearing, and view doing so as critical to being able to achieve their life goals,” says study author Laura Lindberg. “They need continued access to a wide range of contraceptives so they can plan their families and determine when they are ready to have children.”

Few studies in the United States have asked women directly why they use contraception and what benefits they expect or have achieved from its use. To fill this gap, the authors surveyed 2,094 women receiving services at 22 family planning clinics nationwide.

The majority of participants reported that contraception has had a significant impact on their lives, allowing them to take better care of themselves or their families (63%), support themselves financially (56%), complete their education (51%), or keep or get a job (50%).

When asked why they are seeking contraceptive services now, women expressed concerns about the consequences of an unintended pregnancy on their families’ and their own lives. The single most frequently cited reason for using contraception was that women could not afford to take care of a baby at that time (65%). Nearly one in four women reported that they or their partners were unemployed, which was a very important reason for their contraceptive use. Among women with children, nearly all reported that their desire to care for their current children was a reason for contraceptive use.

Many women reported interrelated reasons for using contraception, suggesting that the complexities of women’s lives influence their decision to use contraception and their choice of method. Other reasons for using contraception, reported by a majority of respondents, include not being ready to have children (63%), feeling that using birth control gives them better control over their lives (60%) and wanting to wait until their lives are more stable to have a baby (60%).

The release also includes this commentary.

“Notably, the reasons women give for using contraception are similar to the reasons they give for seeking an abortion,” according to Lawrence B. Finer, author of a previous Guttmacher study on that topic. “This means we should see access to abortion in the broader context of women’s lives and their efforts to avoid unplanned childbearing, in light of its potential consequences for them and their families.”

What does this study mean from an All Our Lives sort of perspective? For one, it fits well with what we already know experientially about the critical reasons why women need and want access to the full range of pregnancy prevention methods. Reasons that have nothing to do with the abovementioned belittling stereotypes.

For another, any serious effort to reduce unintended pregnancies and abortions must include expanded access to the full range of methods and understanding and alleviation of any problems that might hinder their effectiveness.

We do not advocate this course because we equate contraception with abortion, let alone believe the hype about some foreordained, inevitable “contraceptive mentality.” We advocate it because it works best in the real world, honors most women’s preferences to avert rather than interrupt unintended pregnancies, and does not involve the taking of prenatal lives. In other words, it evinces the most respect for human beings and universal human rights.

For yet another–the study findings call into question the sharp division between women who use contraception and those who do not. All Our Lives has long questioned this as just another brutal variant on the sundering of womankind into Madonnas and Whores. We assert the right of all women to use/not use any particular method of pregnancy prevention in accordance with their own preferences, values, and circumstances.

Thanks, Cristina Page, for bringing the Guttmacher study to our attention.

Today is World Contraception Day 2012. In recognition, I’d like to call your attention to a sample of our writings discussing the ways in which the freedom to choose whether and how to prevent conception can save and improve the lives of women and their children.

We are also participating in discussions on Twitter using the hashtags #sheparty and #WCD2012. Join us!