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.

David Gushee, a professor of Christian ethics and consistent life ethic proponent, and Cristina Page, a pro-choice activist, have co-authored an excellent post for the Washington Post's "On Faith" blog about preventing unplanned pregnancy and abortion.

To reduce unintended pregnancy and abortion, we know what works. And it is not simply moral outrage. Countries that have the lowest abortion rates in the world, such as Belgium, Germany and Switzerland, are those that have made contraception most easily available; typically free of charge. And so the cuts to family planning being pushed by House Republicans will have dire consequences, not only for their anti-abortion cause, but for many Americans interested in controlling when and how often to have a baby. Indeed, researchers have calculated the effect: cuts to Title X will result in an estimated 973,000 more unintended pregnancies. And those unintended pregnancies will lead to 433,000 unplanned births and 406,000 more abortions each year.

They also point out how out-of-step pro-life politicians are with the majority of grassroots pro-lifers, 80 percent of whom support contraception (a statistic I've cited many times myself, and I'm thrilled to see it get out there in a high-profile forum). If there's a group in this country more poorly represented by its so-called leadership than abortion opponents, I don't know what it is. Most Americans who identify as pro-life don't support attacks on contraception and want our kids to learn more about sex than "don't have it." We know it takes more than simply moral outrage; but moral outrage makes for great political posturing and fundraising letters. So that's what we get.

The "prolife" movement as such, at least in the US–and probably elsewhere–miserably fails the sexual and reproductive rights and needs of young women. Instead of helping young women to prepare for and live healthy, happy sex lives and prevent unintended pregnancies and abortions, its sex-negativity and slut-shaming put them directly in harm's way. This story by Andrea Grimes is one bit of evidence. Realistically, what can those of us who believe in nonviolent sexual and reproductive choice do to serve young women's needs and undo the considerable harm done in the name of "respecting life"? Personally, I have been speaking out on this subject for over 25 years now. And I feel like I'm just beating my head on a brick wall.

Marge Berer, editor of the journal Reproductive Health Matters, makes this highly problematic claim: "In my opinion, it is only possible to be anti-abortion if you will never be the one left holding the baby, nor be around to see or take responsibility for what happens to those who are." Really?

What about All Our Lives supporters and kindred spirits, in the present and in the past, who not only believe but live their lives as if prolife means what it says: the taking on, not the disavowal, of such active, thorough responsibilities? We can't possibly exist?

If respect and reverence for all life means anything, it means that you bother to hold the baby, or at the very least offer your helping hands to any and all baby holders, in your own family, community, nation, planet. You not only bear witness to their situations-you do whatever you can to ease their difficulties.

And that set of conjoint responsibilities begins towards both mother and child as soon as you know about the pregnancy. In fact, you should have long since already assumed the responsibilities that began well before the present pregnancy.

With the mother's and the father's own conceptions and beyond, with nonviolent and fully socially supported parenting, with sex education for all stages of life, with measures to prevent and abolish reproductive coercion and violence against women, with complete, informed, voluntary access to family planning.

Marge Berer, we do exist. We are not impossibilities by definition-let alone decree. And if you would like our help in reducing abortion, just ask.

Good news for mothers and children: last week, the Department of Health and Human Services announced the distribution of $27 million in funding to assist pregnant women. The grants will be used to help pregnant and parenting students complete their educations, serve pregnant women who are the victims of violence or stalking, and publicize resources available to teen mothers. The White House promoted this Pregnancy Assistance Fund as part of its "common ground" approach to reducing the incidence of abortion.

Robin Marty at RHRealityCheck doesn't think much of it:

Is putting in more support for pregnant women and teens common ground in trying to bring down the numbers of abortions in this country? Sure, assuming that those women did in fact want to be mothers. But there seems to be an assumption that we find common ground by converting unwanted pregnancies into wanted pregnancies, rather than trying to stop unwanted pregnancies before they are conceived.

This initiative is trying to prevent those abortions that happen because a woman believes she has no better options. Marty considers this an attempt to  "[convert] unwanted pregnancies into wanted pregnancies" and doesn't consider it an area of common ground between pro-lifers and pro-choicers. But when a woman has an abortion because she can't afford to carry her child to term, is that really an unwanted pregnancy — or is it unwanted poverty?

How's this for common ground? No woman should ever be in a position where she feels that abortion is her only choice.

Now, I do agree with Marty that we should be able to find common ground on giving people the information they need to make fully informed choices about sexuality and contraception. That brings me to the second piece of good news: for the first time since 1996, the U.S. government is funding effective, evidence-based sex education programs. To be eligible for funding, a program must "be supported by at least one study showing a positive, statistically significant effect on at least one of the following categories: sexual activity, contraceptive use, sexually transmitted infections, pregnancy or births."  There's room for improvement in those criteria, but it's a step in the right direction — away from the inaccurate, slut-shaming programs that have been getting the funds, and toward effective education.

  • A new report by the World Health Organization estimates that the maternal mortality rate dropped by one-third worldwide between 1990 and 2008. Although it's hard to quantify the exact reasons, there are a number of factors that likely helped bring about the decrease: the report specifically cites improvement in health systems, improved education for females, more births being attended by skilled health-care personnel, more women receiving prenatal care, and an increase in availability and use of contraception. Though this is a significant and welcome development, there is still a long way to go. An estimated 358,000 women died of pregnancy-related causes in 2008, 87% of them in sub-Saharan Africa and South Asia. A 15-year-old girl in sub-Saharan Africa has a 1 in 31 chance of eventually dying from a maternal cause.
  • Only two-thirds of U.S. teens receive sex education that includes information on birth control, according to a report from the Centers for Disease Control.  About 97% of teens interviewed for the National Survey of Family Growth said they received formal sex education by age 18. Formal sex education was defined as instruction at a school, church, community center or other setting that dealt with saying no to sex, prevention of sexually transmitted infections, or birth control.  Of all of the teens interviewed, 62% of boys and 70% of girls had received instruction about methods of contraception. Teens were even less likely to talk to their parents about birth control: 31% of boys and 51% of girls reported talking to their parents about methods of contraception, and only 20% of boys and 38% of girls talked to their parents about how to obtain it.
  • Last week, I was interviewed for the Point of Inquiry podcast about atheist opposition to abortion. The interview should be posted online today. I'm very grateful to Bob Price and the Center for Inquiry for the opportunity to discuss a viewpoint  that is not often heard in either anti-abortion or skeptical circles — the secular, pro-balance, pro-reproductive-peace position.

Google.org has launched Health Speaks, a new initiative to try to increase the amount of online health information in languages other than English. Health Speaks will begin with pilot projects in Arabic, Hindi and Swahili. Bilingual volunteers are encouraged to translate health-related Wikipedia (EN) articles into one of these three languages, using the Health Speaks website and Google Translator Toolkit. Google.org is also looking for reviewers, who will read published translations in Wikipedia to ensure that they meet sufficient quality standards.

For the first 60 days, Google.org will donate 3 US cents per English word translated to the African Medical and Research Foundation (AMREF), the Public Health Foundation of India, and the Children's Cancer Hospital Egypt 57357 (for Swahili, Hindi and Arabic respectively), up to a maximum of US $50,000 each. Click here to read a blog entry on the new initiative.

If you speak Arabic, Hindi, or Swahili, please consider joining HealthSpeaks.  Translating information on sexual and reproductive health would be a great way to give people, especially women, power over their reproductive lives and to promote reproductive peace.