Sunday, May 7, 2006

The Growing Anti-Contraception Movement

The New York Times has a lengthy article today that addresses the changing nature of the conservative approach to reproductive freedoms, "Contra-Contraception." The piece addresses a number of issues, including historical perspectives on sex and marriage, evangelical and conservative perspectives on birth control, arguments about how contraceptives work and where the line is between contraception and abortion, the FDA's actions on Plan B, misleading tactics on condom reliability, the strategy as an attempt to eliminate sex outside of marriage rather than as a public health approach, and how the US compares to other nations on unplanned pregnancy and abortion. The anti-contraception viewpoint is presented as being largely driven by the desire to keep sex and reproduction linked, although it does not address how this excludes infertile couples (except by also opposing fertility treatments that generate unused fertilized cells). Some notable segments of the report, presented with links and questions for discussion:

On contraception affecting attitudes toward children:
"'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.'"

This was part of an argument that sex is intended solely for reproduction. What of couples who use contraception in order to postpone childbearing until they are emotionally and financially ready? Is that not very prochild? What of couples who are infertile, or women for whom bearing a child would be life-threateningly dangerous? By this logic, should they, even in marriage, be discouraged from having sex? By the argument that sex without the intent to reproduce is demeaning or harmful, what is the logical conclusion for those who cannot reproduce?


On contraception promoting "deviant" lifestyles:
"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."

I initially supposed the author got it wrong on this point, taking FotF's view to an illogical conclusion. Is he suggesting that contraceptive availability so denaturalizes the purpose of sex such that it "turns people gay?" Does FotF believe there is a link between the two? At this time, their position statement on contraceptives doesn't say so, so the author may have overreached.


On public health:
"'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.'"

This is related to the issue of groups that promote abstinence spreading sometimes misleading or inaccurate information on the efficacy of condoms in preventing the spread of STDs, according to the article. The New York Times previously reported on the expunging of condom information on the government's own websites.


On when pregnancy begins and emergency contraception:
"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.'

This is something that Aunt B has brought up on several occassions. There's a reason we don't think of fertilized eggs as babies, and that's partly because women's own bodies reject a huge percentage of those eggs, expelling them naturally before a pregnancy can be established. If we want to consider every fertilized but unimplanted egg a "pregnancy," and protect every such pregnancy regardless of the woman's intent, there may serious social and personal consequences for women.


On where this viewpoint leaves us:
"What's more, Dr. Trussell [Office of Population Research, Princeton] 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."

Seriously. Are we prepared to also consider breastfeeding a form of abortion? Because that's where this "every fertilized egg is a human being" seems to leave us. Can we really argue intent on what should be a medical definition?


More from Leslee Unruh:
"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.'"

Gah. Something about this idea of a girl's body and sexuality as property to be transferred from father to husband really turns my stomach. You? Feministing hit the gross nail on the head by titling their post on the topic "Daddy's little hymen." Broadsheet was slightly more delicate, with the piece, "Daddy's little virgin."


On the overseas consequences:
"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 [UNAIDS site], 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 don't have a problem with telling people that if they don't have sex they won't get HIV, because that's mostly true, although it should be accompanied with information on preventing HIV in sexual activity. What I have a huge problem with is the notion of having to divert funds from preventing mother to child transmission to promoting abstinence. Mother to child transmission and prevention of initial infection are two totally separate issues, and each requires its own attention.

You should really check out the entire NYTimes article, and I'm interested in your reactions.

Updates: Via the Reproductive Rights Blog, a Slate piece on the abstinence agenda and science, and link to the upcoming 2006 National STD Prevention Conference.

Other blogs covering the story:
Hullaballo
Feminist Law Professors
Pandagon
The Cynical Idealist (inaugural post)
Free Republic


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