A battle over birth control

A battle over birth control

January 31st, 2012 in Opinion Times

The clash between medical and scientific findings and those who disregard those findings for political, cultural or religious values is nowhere more potent than that over women's reproductive rights. That's long been the case with abortion per se. But given current data about the medical efficacy of customary forms of birth control -- and it's related reductions in the numbers of abortion and unplanned pregnancies and the general health of women across our society -- it's hard to see why new health care reform regulations that call for free contraception services under health insurance plans should be controversial.

But they are. The controversy at the moment is driven by the Catholic Church, which is now raising protests over a requirement to extend insurance coverage for contraception for non-religious employees in affiliated institutions. The church's cause is being taken up by hard-right Republicans who see another wedge issue angle that may be used to expand their social conservative umbrella to a new contingent.

The controversy springs from an appeal to the rule that Health and Human Services secretary Kathleen Sebelius unveiled last August. She pointed out that exemptions would be made for employees of churches and other places of worship. But she noted that the rule would cover the general employees of hospitals, universities, charitable organizations and a range of other bodies that commonly hire a diverse group people of different faiths or beliefs who were not linked with the employers' religious affiliation.

Such employees, like those in our broader society, she said, will be included under the new insurance requirement covering free preventive care and birth control, without co-pays and deductibles. The Catholic Church, which oversees a number of Catholic universities and hospitals, appealed for a far-reaching exemption. The Obama administration announced last week that it would not grant that appeal.

It made the right decision. The rule was adopted on the recommendations of the Institute of Medicine, an independent organization, following studies and research that document the broad value of birth control services. It found that medical birth control services are more than a convenience. Rather, they are a medical necessity for "women's health and well-being."

The Institute pointed to research, in 2008, that showed nearly half of all pregnancies in the country were unplanned, and that 42 percent of unplanned pregnancies ended in abortion. Those rates reversed as use of birth control went up: both unintended pregnancies and abortions went down.

It further showed that women with unintended pregnancies who did not get abortions suffered higher rates than normal of depression and engaged in behaviors -- smoking, alcohol, drugs and inattention to prenatal care -- that increased the risk of harm to fetuses. When birth control was made available, pregnancies were more likely to be appropriately spaced and abortions averted.

Birth control, even for women with medical conditions that improved from contraceptive therapies, often remains financially out of reach for the women who most need it. Students and lower-wage employees without health insurance coverage for contraception too often get pregnant, or go without needed contraception therapies, simply because they cannot afford the cost of doctor's appointment and prescription for contraceptives.

Reversing that circumstance would provide a significant, humane service in the real world. Even among members of the Catholic faith, studies show that 98 percent of active Catholic women in the broader community use contraceptives, despite their church's doctrine. Given such findings, provision of contraception hardly seems to contradict adherents' religious values. Health insurance policies in public institutions should respect that.