Using the 'C' Word

This month, the Senate will hold confirmation hearings for Supreme Court nominee Samuel Alito. There will be a painstaking examination of his record, particularly opinions that indicate his position on the landmark Roe v. Wade decision. This process will draw attention to the ongoing struggle over reproductive rights. While not a big news story in 2005, this battle will again heat up as the Congressional elections draw near. However, the focus will probably change from abortion, per se, to the "C" word -- contraception.

Public sentiment about abortion has not changed much over the past 30 years. Gallup Polls conducted in both 1975 and 2005 found that only 22 percent of respondents believed that abortion should be "illegal under all circumstances."

In 2005, what began to change was the focus of the debate on reproductive rights. On January 24, New York Sen. Hillary Clinton implored all sides of the reproductive-rights issue to seek "common ground." Clinton asserted that no one in American politics is "for" abortion. Many Democratic politicians have since adopted her perspective -- abortion is a tragedy. Clinton's stance served two tactical purposes: One was to scuttle the notion that Dems favor "abortion on demand." The other was to shift the locus of the debate from abortion to reproductive rights, in general. To re-emphasize the right of a woman to choose her own medical care and to freely obtain contraception.

Sen. Clinton observed that where there is access to contraception there is less necessity for abortion; 7 percent of women who do not use contraception account for 53 percent of unwanted pregnancies. After Clinton's speech, Democrats renewed their push for federal support for sex-education programs for teenagers, emergency contraception and family planning.

Despite the efforts of the minority party, for most of 2005 the White House was silent on the "C" word. Democratic members of Congress repeatedly wrote the president asking him to clarify his position on contraception. In an October 25 White House briefing, press secretary Scott McClellan responded: "The focus has been from this administration on promoting abstinence programs; that ought to be on the same level as the education funding for teen contraception programs."

Yet, the funding for abstinence programs is not "on the same level" as funding for contraception education programs. The administration allocates $200 million to abstinence-only programs and nothing for comprehensive sex education. Studies indicate that abstinence programs do not prevent, but only delay sexual activity among teens. And when these "teens do initiate sex, they are a third less likely to use contraception, putting themselves at risk for pregnancy and disease."

Of course, there are two aspects of contraception. One is before-the-event measures, such as birth-control pills and barrier contraceptives. The other aspect is after-the-event remedies. One of these is the "emergency contraception" drug, Plan B, intended to prevent pregnancy after contraceptive failure or unprotected intercourse. In September 2003, an FDA advisory panel recommended that Plan B be sold without a perscription. Nonetheless, in July 2004, the FDA denied the application. Democrats requested a Government Accountability Office review of this decision.

On Nov. 14, 2005, the GAO reported that the rejection of the Plan B application was the result of an "unusual" decision-making process. The GAO noted that a Bush political appointee overrode the decision of subordinates who recommended approval of the application.

There are several other examples of the Bush administration's preventing information about contraception from reaching the public. On Dec. 20, 2005, the ACLU issued a press briefing noting that the U.S. Department of Justice had sent the "National Sexual Assault Protocol to police agencies throughout America." Unfortunately, the first-ever national protocol for treating victims of sexual assault failed to mention emergency contraception. The ACLU observed, "If emergency facilities routinely provide emergency contraception to rape victims, up to 22,000 of the 25,000 pregnancies that result from rape each year could be prevented."