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Why New Birth Control Benefits are the Right Choice and Why Religious Conservatives Have it Wrong

In a country of alarmingly high unplanned pregnancy, American women need access to affordable birth control for economic and health reasons.
 
 
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The Obama administration’s recent decision to require most religious-affiliated employers to cover birth control for their employees is good news for the women who work for religious employers and do not share the male hierarchy’s opposition to birth control. It is also good news for a country with the one of the highest unplanned pregnancy ratesin the developed world.

More Than Just Using Condoms

Contraception, as every woman knows, is a system that depends on developing the right habits and getting consistent reinforcement from partners, parents and/or friends. In other words, effective contraception takes more work than simply remembering to use condoms. As a result, many women are more devoted to their gynecologists than other doctor in their lives – and gynecologists can be expensive. One of us visited hers after the birth of a third child. By the late thirties, pregnancy becomes riskier for mother and child and few families feel they can afford a fourth even on a law professor’s income. The gynecologist explained that methods of contraception that work for young women often don’t work as well after childbirth. The solution: an IUD. There was only one problem, the doctor sheepishly explained: It cost $400 and insurance wouldn’t cover it for an employee of a Catholic university. For a professional, $400 is not out of reach; for many women it is.

Conservatives insist that women know about contraception, condoms are cheap and available, and the high rate of unplanned pregnancies reflects conscious decisions not to bother with protection. What this argument overlooks is that the use of birth control is the result of a system – a system that encourages use, makes it easy to get access, and promotes a culture that associates responsibility with contraception. Middle class communities have that. The trip to Planned Parenthood is a rite of passage in many suburban high schools. Many knowledgeable parents drive their daughters to doctors’ appointments soon after puberty explaining that the pill helps control menstrual camps. In European countries with low teen birth and abortion rates, the government provides free birth control to anyone who wants it with information in public schools making it easy to understand and obtain. Widespread use, however, follows not just from access but from the development of a culture that says taking the pill is the right thing to do (which is why the notion that the pill alleviates menstrual cramps is even more prevalent in Holland than here) and the accidental pregnancy is a mark of failure.

In the United States, we have been doing everything we can to make sure that the system that works so well in Europe and in communities intent on their daughters’ college educations is not available to less privileged groups in the United States. The class disparities are staggering. Studies show that the unplanned birth rate of poor women is more than five to one the unplanned birth rates of better off women – and this is growing. For college graduates and women with incomes double the poverty level, unplanned births fell 20 percent in the late nineties. For the poorest women, the rates grew by 29 percent during the same period. With the Great Recession, the number of women reporting that they cannot afford effective contraception increased substantially — and the role of abortion has shifted, with many more women who have children seeking to terminate their pregnancies because they fear that an additional child will literally take food out of the mouths of the children they already have.

Women Hit Harder By Health Care Costs

Higher health care costs and the economy have hit women, especially Hispanic and low-income women, harder than men. Slightly less than one-third of women between the ages of 19 and 64, approximately 27 million women -- did not have health insurance in 2010. Women whose incomes were under 133 percent of the poverty line were even more likely to be uninsured in 2010, and millions of women delayed or avoided health care coverage due to its costs. Almost one-third of the teens who became pregnant explained that they did not think they could pregnant at the time that they had sex, and almost one-quarter explained that their partner did not want them to use any contraception; yet, the Obama administration refused to broaden easier access to Plan B contraception, and the new contraception coverage rules still don’t cover all American women.

The initial decision to require health insurance plans to cover birth control as preventive care for women, with no copays, was made last summer. The question resolved in January concerned religious employers, and the new rule resulted in vociferous complaints from the US Conference of Catholic Bishops – but here, unlike in its decision on Plan B access, the Obama administration decided to do the right thing for girls and women.

More than ninety percent of sexually active adults will use contraception during their lifetimes. On this issue, Catholics behave the same way as non-Catholics in spite of church teachings. It makes no sense to invoke the principle of religious liberty to allow a small group with religious views at odds with the vast majority of the country to impose their views on millions of women who do not agree the them. It is time to recognize the contradictions of a private health care system that exists only because of government subsidies. Avoiding unwanted pregnancies is too important to be left in the hands of a small number of men in robes.

June Carbone is the Edward A. Smith/Missouri Chair of Law, the Constitution and Society at the University of Missouri-Kansas City. Naomi Cahn is the John Theodore Fey Research Professor of Law at George Washington University Law School. She is the author of numerous books and law review articles on gender and family law. Cahn and Carbone are the co-authors of Red Families v. Blue Families.