As contraceptive use falls, abortion rate rises

raytri · #1 (**permalink**) 05-05-2006, 08:12 AM

Researchers using federal data have found two interesting trends that chart the relationship between abortion and contraceptives:
http://www.washingtonpost.com/wp-dyn...050400820.html

Between 1994 and 2001:

1. The rate of unplanned pregnancies rose by 30 percent among poor women. The abortion rate also rose.

2. The rate of unplanned pregnancies fell 20 percent among affluent women. The abortion rate also fell.

Quote:

Asked what was driving the trends, the authors noted that some state and federal reproductive health programs have been cut or made more restrictive in recent years. State and federal programs have increasingly focused on abstinence rather than contraception, and some analysts have argued that the shift is leading to less use of contraceptives and more unintended pregnancies.

(snip)

The authors said the growing disparities between richer and poorer women appeared to be the result of greater contraceptive use by the more affluent. The health statistics center, which is part of the Centers for Disease Control and Prevention, reported in 2004 that after decades of increasing contraceptive use, the trend stalled in the late 1990s and began to decline after that. The decline occurred almost entirely in poorer women.

Abstinence-only groups countered that the problem was "condescending" family planning programs aimed at the poor. But that's polemics, not data. The basic data is clear: as contraceptive use declined among the poor, the abortion rate went up.

Can we agree to get away from "abstinence only" and make abstinence just a part of a more comprehensive sex-education program? Can we agree that poor women should be provided with and educated about the full range of family planning options, and allowed to choose the ones that work for them?

The12thMan · #2 (**permalink**) 05-05-2006, 08:27 AM

Quote:

Asked what was driving the trends, the authors noted that some state and federal reproductive health programs have been cut or made more restrictive in recent years. State and federal programs have increasingly focused on abstinence rather than contraception, and some analysts have argued that the shift is leading to less use of contraceptives and more unintended pregnancies.

There's no data to back up this notion. Notice the qualifiers in the sentence. Seems like the research lead to a hypothesis. Shouldn't the research continue in order to show the correlation between health programs and abortion rates between 1994 and 2001? Shouldn't they compare previous years too in order to prove their assumption?

Quote:

The basic data is clear: as contraceptive use declined among the poor, the abortion rate went up.

Pathetically obvious, isn't it? Did they spend a lot of time and money finding this out?

poletree · #3 (**permalink**) 05-05-2006, 08:27 AM

Yes, we can agree. Well, at least you and I can.

raytri · #4 (**permalink**) 05-05-2006, 08:34 AM

Quote:

Originally Posted by The12thMan";p=&quot

There's no data to back up this notion. Notice the qualifiers in the sentence.

They're speculating about causation there, agreed. But the correlation I cite is supported by data: as contraceptive use fell, abortion rates rose. And vice versa.

raytri · #5 (**permalink**) 05-05-2006, 08:36 AM

Quote:

Originally Posted by The12thMan";p=&quot

Pathetically obvious, isn't it? Did they spend a lot of time and money finding this out?

There are a lot of groups that dispute that correlation. Abstinence-only organizations, for instance, and groups that oppose both abortion and contraceptive use. So even if it seems obvious, the research needed to be done.

The12thMan · #6 (**permalink**) 05-05-2006, 09:09 AM

Quote:

Originally Posted by raytri";p=&quot

There are a lot of groups that dispute that correlation. Abstinence-only organizations, for instance, and groups that oppose both abortion and contraceptive use. So even if it seems obvious, the research needed to be done.

Did they find any more immaculate conceptions?

The study also fails to note how many of these women were married, only the number of "unplanned" pregnancies. I don't know of any abstinence program for married women, do you?

I "planned" to have a baby in May 1988. Instead, I had 2 babies in May 1987. Does that count as an unplanned pregnancy? Maybe it counts as 2?

stekim · #7 (**permalink**) 05-05-2006, 09:13 AM

Quote:

The basic data is clear: as contraceptive use declined among the poor, the abortion rate went up.

Of course it did. Because no matter what is taught in "family planning" classes, people are still going to have sex. You really can't stop them. People are weird like that.

raytri · #8 (**permalink**) 05-08-2006, 06:58 AM

Serendipitously, the New York Times Magazine cover story was on this topic: groups that want to greatly restrict access to contraception, even for married couples.
http://www.nytimes.com/2006/05/07/ma...raception.html

Quote:

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."

Quote:

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.

Quote:

After the agency's advisory committees voted in favor of over-the-counter status for Plan B at the end of 2003, and after it was further approved at every level of the agency's professional staff, standard procedure would have been for the Center for Drug Evaluation and Research arm of the F.D.A. to approve the application. But one member of the F.D.A.'s Reproductive Health Drugs Advisory Committee had reservations: Dr. W. David Hager, a Christian conservative whom President Bush appointed to lead the panel in 2002. (After an outcry from women's groups, who were upset at Dr. Hager's writing that he used Jesus as a model for how he treated women in his gynecology practice, he was shifted from chairman of the panel to ordinary member.) Dr. Hager said he feared that if Plan B were freely available, it would increase sexual promiscuity among teenagers. F.D.A. staff members presented research showing that these fears were ungrounded: large-scale studies showed no increase in sexual activity when Plan B was available to them, and both the American Academy of Pediatrics and the Society for Adolescent Medicine endorsed the switch to over-the-counter status. Others argued that the concern was outside the agency's purview: that the F.D.A.'s mandate was specifically limited to safety and did not extend to matters like whether a product might lead to people having more sex. Meanwhile a government report later found that Dr. Janet Woodcock, deputy commissioner for operations at the F.D.A., had also expressed a fear that making the drug available over the counter could lead to "extreme promiscuous behaviors such as the medication taking on an 'urban legend' status that would lead adolescents to form sex-based cults centered around the use of Plan B." In May 2004, the F.D.A. rejected the finding of its scientific committees and denied the application, citing some of the reasons that Dr. Hager had expressed.

The drug's manufacturer reapplied two months later, this time for permission to sell it over the counter to women ages 16 and up, seemingly dealing with the issue of youth. Then, last August, Crawford made his announcement that the F.D.A. would delay its decision, a delay that could be indefinite.

Much of the above quotes are directed at Plan B, the morning-after pill, and the stated line of logic is that it is an "abortifacent", on the theory that at least occasionally it prevents the implantation of a fertilized egg.

But since Plan B is simply a higher dosage of regular birth-control pills, the same arguments could be applied to them. And IUDs. (And breastfeeding, BTW). And never mind that many of these same groups also oppose other forms of contraception, like condoms and diaphragms. Or that this represents a moving of the goalposts in the abortion debate.

Quote:

The conservative [viewpoint is] 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."

And that is relevant how?

Does effective contraception reduce the risk of pregnancy, and thus reduce a barrier to sex? Undoubtedly. But that's a personal choice, and nobody else's business. It's something to be addressed by education and persuasion, not legislation and regulation.

I have no problem with people believing that contraception is against their beliefs. I have no problem with people trying to persuade others to feel the same. But I have a big problem with using the regulatory process to try to impose those beliefs on others. If you don't want to use contraceptives, don't; but don't try to get them legally restricted so that others can't use them, either.

I also find this argument unpersuasive:

Quote:

Rector says that abstinence programs can't properly be combined with other elements in a comprehensive sex education program because the message is lost when a teacher says: "One option you might want to consider is abstaining. Now let's talk about diaphragms."

If you can't make the case for abstinence compelling in context, then it's a weak argument. It's almost a "victimology" response to argue that information on contraception must be muzzled in order for abstinence education to be effective.

True, it may be a matter of emphasis. But I doubt most sex ed classes throw abstinence away as a one-liner. And if they do, the answer is to provide curricular guidelines. Spend time emphasizing the advantages of abstinence. Discuss the risks and downsides, from pregnancy to STD to social and mental impacts. Then say "If despite all that you're going to have sex, here's what you can do to reduce but not eliminate some of the risks."

And never mind that study after study has found abstinence-only programs to be ineffective.

The good news is that the people cited in this article still represent a minority view. The article mentions that 98% of sexually-active women have used some form of birth control. It also notes this, about sex ed:

Quote:

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.

Exactly as I outlined above.

And a final statistical note:

Quote:

Countries in which abortion is legal and contraception is widely available tend to rank among the lowest in rate of abortion, while those that outlaw abortion — notably in Central and South America and Africa — have rates that are among the highest. According to Stanley K. Henshaw of the Guttmacher Institute, recent drops in abortion rates in Eastern Europe are due to improved access to contraceptives. The U.S. falls somewhere in the middle in rate of abortion: at 21 per 1,000 women of reproductive age, it is roughly on par with Nigeria (25), much better than Peru (56) but far worse than the Netherlands (9).

JP5 · #9 (**permalink**) 05-08-2006, 07:42 AM

What I find interesting about your article is that the years 1994-2001 were the years that Bill Clinton was president. And 2 of those years, we had a full Democrat majority. I don't recall Clinton or the Democrats pushing "abstinence only." So......IF that happened during those years, it must have been due to something other than the "abstinence only" programs.

Perhaps during those Clinton years, abortion rates increased because abortion was promoted as a form of birth control. Abortion was not thought of as a negative thing.

Ixtellor · #10 (**permalink**) 05-08-2006, 09:10 AM

Section 510(b) of Title V of the Social Security Act was passed in 1996 and was the beginning of the abstinence only phase of American policy on sex education.

While you make what sounds like a sound argument, it appears that the abstinence only policy has been in place since 1996, the very heart of the Clinton Presidency.

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