The Republicans’ Lost Privacy

Since the first time Mitt Romney ran for President, four years ago, he’s been on record reversing his previous support for abortion rights. However, when pressed by George Stephanopoulos in the debate Saturday night, Romney went beyond mere opposition to Roe. He said he thought Griswold v. Connecticut, the 1965 case that first made explicit the right to privacy, was also wrong. “I don’t believe they decided that correctly,” Romney said. In this, the front-runner was eagerly seconded by Rick Santorum, who said the Justices “created through a penumbra of rights a new right to privacy that was not in the Constitution.”

In Griswold, the Court ruled that a Connecticut law banning the sale of contraceptives, even to married couples, was unconstitutional.

.. And that is what makes Romney and Santorum’s criticism of Griswold so troubling. Over the years the modern Republican Party has reflected both libertarian and authoritarian tendencies. Both survive, in a way. When it comes to taxes and regulation, the libertarian side of the party is ascendant. Even the rhetoric of compassionate conservatism has faded from view. But with regard to civil liberties, the G.O.P. has embraced state power with a vengeance. Whether it’s the rights of wartime detainees, or abortion rights, or the rights of gay people to marry (or to be free from discrimination), contemporary Republican leaders reflect clear moral disapproval. (Even Ron Paul, who is often described as a libertarian, is a fierce opponent of a woman’s right to choose abortion. And Rick Perry recently announced that he’s against a right to abortion even in cases of rape or incest.) Privacy is often described as “the right to be left alone,” but that’s not a value that seems terribly important in the G.O.P. right now.

Access to free birth control reduces abortion rates

Unplanned pregnancies are a significant problem in the United States. According to a 2012 Brookings Institution report, more than 90 percent of abortions occur due to unintended pregnancy.

Each year, about 50 percent of all pregnancies that occur in the US are not planned, a number far higher than is reported in other developed countries. About half of these pregnancies result from women not using contraception and the other half from incorrect or irregular use.

A new study by investigators at Washington University reports that providing birth control to women at no cost substantially reduces unplanned pregnancies and cuts abortion rates by a range of 62 to 78 percent compared to the national rate.

 

.. From 2008 to 2010, annual abortion rates among study participants ranged from 4.4 to 7.5 per 1,000 women. This is a substantial drop (ranging from 62 to 78 percent) compared to the national rate of 19.6 abortions per 1,000 women in 2008, the latest year for which figures are available.

The lower abortion rates among Choice study participants also is considerably less than the rates in St. Louis city and county, which ranged from 13.4 to 17 per 1,000 women for the same years.

Among girls ages 15 to 19 who had access to free birth control provided in the study, the annual birth rate was 6.3 per 1,000, far below the U.S. rate of 34.3 per 1,000 for girls the same age.

.. While birth control pills are the most commonly used reversible contraceptive in the United States, their effectiveness hinges on women remembering to take a pill every day and having easy access to refills.

In contrast, IUDs and implants are inserted by health-care providers and are effective for 5 to 10 years and 3 years, respectively. Despite their superior effectiveness over short-term methods, only a small percentage of U.S. women using contraception choose these methods. Many can’t afford the cost of IUDs and implants, which can cost more than $800 and may not be covered by insurance.

Free birth control begins in US today – what difference will it make to you?

Provisions in the Affordable Healthcare Act will give insured American women better access to basic care. How much do you currently pay for contraception? What difference will the new rules mean?

Many basic healthcare options for US women, including birth control and annual “well-woman” check-ups, become free on Wednesday as provisions in the Affordable Care Act come into force.

The new rules mean that many women will no longer have to stump up for “co-pays” or out-of-pocket expenses.

Trump rolls back access to free birth control

Donald Trump’s government has issued a ruling that allows employers to opt out of providing free birth control to millions of Americans.

The rule allows employers and insurers to decline to provide birth control if doing so violates their “religious beliefs” or “moral convictions”.

Fifty-five million women benefited from the Obama-era rule, which made companies provide free birth control.

Before taking office, Mr Trump had pledged to eliminate that requirement.

What happened?

The mandate requiring birth control coverage had been a key feature of so-called Obamacare – President Obama’s efforts to overhaul the US healthcare system.

But the requirement included a provision that permitted religious institutions to forgo birth control coverage for their employees.

The Department of Health and Human Services (HHS) said on Friday it was important to expand which organisations can opt out and deny free contraceptive coverage.

“We should have space for organisations to live out their religious ideas and not face discrimination because of their religious ideas,” said one HHS official, who did not wish to be named.

Why was the decision made?

In announcing the rule change, HHS officials cited a study claiming that access to contraception encourages “risky sexual behaviour”.

The department disputes reports that millions of women may lose their birth control coverage if they are unable to pay for it themselves.

 

Contraceptive Use in the United States

WHO NEEDS CONTRACEPTIVES?

  • There are 61 million U.S. women of reproductive age (15–44).1 About 43 million of them (70%) are at risk of unintended pregnancy—that is, they are sexually active and do not want to become pregnant, but could become pregnant if they and their partners fail to use a contraceptive method correctly and consistently.2
  • Couples who do not use any method of contraception have approximately an 85% chance of experiencing a pregnancy over the course of a year.3
  • In the United States, the average desired family size is two children. To achieve this family size, a woman must use contraceptives for roughly three decades.4

WHO USES CONTRACEPTIVES?

  • More than 99% of women aged 15–44 who have ever had sexual intercourse have used at least one contraceptive method.5
  • Some 60% of all women of reproductive age are currently using a contraceptive method.6
  • Ten percent of women at risk of unintended pregnancy are not currently using any contraceptive method.6
  • The proportion of women at risk of unintended pregnancy who are not using a method is highest among those aged 15–19 (18%) and lowest among those aged 40–44 (9%).2
  • Eighty-three percent of black women at risk of unintended pregnancy are currently using a contraceptive method, compared with 91% of their Hispanic and white peers, and 90% of their Asian peers.2
  • Among women at risk of unintended pregnancy, 92% of those with an income of at least 300% of the federal poverty level and 89% of those living at 0–149% of poverty are currently using a contraceptive method.2
  • A much higher proportion of married women than of never-married women use a contraceptive method (77% vs. 42%), largely because married women are more likely to be sexually active. But even among those at risk of unintended pregnancy, contraceptive use is higher among currently married women than among never-married women (93% vs. 83%).2
  • Unmarried women who are cohabiting fall between married women and unmarried women who are not cohabiting: Some 90% of at-risk women living with a partner use a method.2
  • Contraceptive use is common among women of all religious denominations. For example, eighty-nine percent of at-risk Catholics and 90% of at-risk Protestants currently use a method. Among sexually experienced religious women, 99% of Catholics and Protestants have ever used some form of contraception.7

WHICH METHODS DO WOMEN USE?

  • Seventy-two percent of women who practice contraception currently use nonpermanent methods—primarily hormonal methods (i.e., the pill, patch, implant, injectable and vaginal ring), IUDs and condoms. The rest rely on female (22%) or male (7%) sterilization.6
  • The pill and female sterilization have been the two most commonly used methods since 1982.6,8,9

 

 

  • Four out of five sexually experienced women have used the pill.5
  • The pill is the method most widely used by white women, women in their teens and 20s, never-married and cohabiting women, childless women and college graduates.2
  • The use of hormonal methods other than the pill has increased with the advent of new options. The proportion of women who have ever used the injectable increased from 5% in 1995 to 23% in 2006–2010. Ever-use of the contraceptive patch increased from less than 1% in 2002 to 10% in 2006–2010. Six percent of women had used the contraceptive ring in 2006–2010, the first time this method was included in surveys.5
  • Reliance on female sterilization varies among subgroups of women. It is most common among blacks and Hispanics, women aged 35 or older, ever-married women, women with two or more children, women living below 150% of the federal poverty level, women with less than a college education, women living outside of a metropolitan area, and those with public or no health insurance.2
  • Some 68% of Catholics, 73% of Mainline Protestants and 74% of Evangelicals who are at risk of unintended pregnancy use a highly effective method (i.e., sterilization, the pill or another hormonal method, or the IUD).7
  • Only 2% of at-risk Catholic women rely on natural family planning; the proportion is the same even among those who attend church at least once a month.7
  • In 2014, about 14% of women using a contraceptive relied on a long-acting reversible contraceptive method, or LARC (12% used the IUD and 3% used the implant).6 This follows a trend in increasing proportions of women using LARCs, from 2% in 2002 to 6% in 2007 and 9% in 2009.10,11
  • Among contraceptive users, the groups of women who most commonly use an IUD or implant are 25–34-year-olds, those born outside of the United States, those living in a Western state, those who report their religious affiliation as “other” and those who have ever stopped using a non-LARC hormonal method. At least 16% of women in these groups use a LARC method.10
  • Among female contraceptive users in the United States, those most likely to use a LARC method are women who have had a child and those who have ever stopped using a non-LARC hormonal method.10
  • Some 5.5 million women rely on the male condom. Condom use is most common (i.e., at least 25% greater than the national average of 15%) among 15–19-year-olds, those who report their religious affiliation as “other,” those born outside of the United States,  college graduates, those who are uninsured and those who are nulliparous or are expecting at least one (more) child.6
  • Ever-use of the male condom increased from 52% in 1982 to 93% in 2006–2010.5
  • Dual method use offers protection against both pregnancy and STIs. Some 8% of women of reproductive age simultaneously use multiple contraceptive methods (most often the condom combined with another method).12
  • The proportion of all sexually experienced women who have ever used withdrawal increased from 25% in 1982 to 60% in 2006–2010.5
  • Seven percent of men aged 15–44 have had a vasectomy; this proportion increases with age, reaching 16% among men aged 36–45.13

Abortion in the U.S.: Five key facts

PROVIDING FREE BIRTH CONTROL DOES REDUCE ABORTION RATES

Colorado provides a real-life experiment on whether providing safe, effective, long-acting birth control can reduce unwanted pregnancies and abortions. The state’s Department of Public Health and Environment got private funding in 2008 for a program to provide long-acting reversible contraceptives (LARCs), such as IUDs and hormone implants, to low-income women for little or no cost.

Image: Trends in abortion between 1997 and 2014
Trends in abortion between 1997 and 2014Guttmacher Institute

“The Colorado Family Planning Initiative helped cut the abortion rate nearly in half for women aged 15-19 and by 18 percent for women aged 20-24,” the department said in a 2017 report. “Between 2009 and 2014, birth and abortion rates both declined by nearly 50 percent among teens aged 15-19 and by 20 percent among young women aged 20-24.”

A birth control pill for men includes a side effect that has frustrated women for decades

I like the idea that men would have more power, and more accountability, when it comes to the prevention or the pursuit of pregnancy. I like the idea of a culture in which men can’t allege that a woman “trapped” them into fatherhood because they, too, had the ability to make an autonomous birth control choice beyond a condom. Where men also have to weigh whether their choice of birth control is worth the effect it could have on their physique, and whether that potential downside might make them a less desirable sexual partner.