BY MARY KRANE DERR
The right to access the full range of voluntary family planning methods is often neglected or actively undermined in the name of prolife, especially but not exclusively in the United States. Yet there are nine good reasons -- at least -- why fostering this right is essential to respect in practical deed for all human lives, already born and unborn.
1. Family planning freedom prevents millions of human deaths every year.
Voluntary access to modern methods of family planning annually prevents 112.3 million induced abortions, 21.94 million miscarriages, 1.17 million newborn deaths, and 230,000 maternal deaths worldwide. Pretty staggering numbers, aren't they? (Guttmacher Institute & UNFPA 2009)
2. Lack of birth control is a documented cause of abortion and resulting maternal and prenatal deaths.
Globally, approximately 215 million women -- mostly in the Two Thirds World -- desire but cannot access modern methods of voluntary family planning. If 100 million of these women have access by 2015, 54 million abortions will be prevented. Simply by making family planning accessible to this gravely unserved population, 90 percent of all global maternal deaths from abortion can be averted, along with the accompanying prenatal deaths (Cleland et al. 2006; Reproductive Health Supplies Coalition; UNFPA Fact Sheet).
3. Family planning freedom measurably reduces abortion rates.
The world's highest abortion rates are in Vietnam and Cuba, where family planning access is extremely limited. The world's lowest abortion rates are in Netherlands and Belgium, where access is excellent. Over the 1990s, the once-astronomical abortion rates in formerly Soviet-dominated nations dropped between 25% and 50%, thanks to dramatically better contraceptive quality & access. In Bangladesh, a boost in family planning services had a very similar effect.
There is only one known kind of exception to "contraception reduces abortion": when the desire/need for smaller families outstrips the availability of family planning. The solution to this problem is a planned scaleup of services that stays ahead of growing demand. In other words, the solution is more contraception, not less (Family Health International).
4. Contraceptives truly prevent rather than take lives.
The majority of family planning methods unquestionably work by preventing conception. These include male sterilization, female sterilization, female condoms, male condoms, diaphragms, cervical caps, spermicides, natural family planning/fertility awareness methods (NFP/FAM), abstinence, and sexual practices other than penis-vagina intercourse.
On the other hand, hormonal contraceptives, including emergency contraceptives and intra-uterine devices (IUDs), are all often dismissed as abortifacient because they supposedly work by hindering implantation of already conceived embryos. Some of these methods may alter the endometrium or uterine lining, but this does not necessarily mean that these changes in the endometrium or any other effects disrupt implantation.
Although we have not yet been able to examine each and every available hormonal contraceptive or IUD, All Our Lives' scrutiny of peer-reviewed scientific literature calls these suppositions about abortifacient actions into question.
Combined estrogen-progestin and progestin-only methods (such as "the pill," various injectables, implants, patches and rings): These all highly effectively both hinder ovulation and thicken cervical mucus, so that sperm cannot pass through. There is no evidence to date that any of these methods hinder implantation (World Health Organization 2006).
Emergency contraceptives: Levonorgestrel-only or Plan B type ECs definitely interfere with ovulation and possibly also hinder sperm function and transport. According to direct experimental evidence, they have no mechanism for interfering with implantation. Yet Plan B-type ECs can help victims of sexual assault and contraceptive sabotage prevent unintended pregnancies and abortions (International Federation of Gynecology and Obstetrics/FIGO and the International Consortium on Emergency Contraception 2011).
IUDs: According to current medical consensus, there is no experimental evidence that either Paragard-type (Copper T) or Mirena-type (levonorgestrel-releasing) IUDs interfere with implantation. There is plenty of direct experimental evidence that they have such high effectiveness rates because they damage sperm and thicken the cervical mucus, thus hindering sperm transport. Mirena-type IUDs may also promote secretion of glycodelin A, a substance that hinders sperm-egg binding, during the fertile phase when it is not otherwise present (Bednarek and Jensen 2009; Hatcher et al. 2008).
5. Contraception can be and is practiced without a "contraceptive mentality."
One argument against contraception is that it promotes a "contraceptive mentality." In other words, women who use "artificial" birth control will abort any children they conceive if their contraception does not work as intended. This claim does not explain a substantial number of pregnancy outcomes.
For example, each year in the US, about half -- just over 3 million -- pregnancies are unintended. About 1.55 million of these unplanned pregnancies happen to contraceptive users, whether through inconsistent or incorrect use, or method failure despite correct and consistent use. About 60% of these contraceptive users do not have abortions. And how much higher would that 60% figure be if people who respect unborn lives also respected the lives, needs, and freedoms of contraceptive users? (Spiedel, Harper and Shields 2008)
6. Some contraceptives help prevent HIV/AIDS.
In countries as different from one another as Uganda, Thailand and the Netherlands, certain contraceptives have prevented millions of new infections, including infections of pregnant women and their unborn babies, human beings who might have otherwise faced pressures towards abortion or faced great illness and premature death from HIV/AIDS itself. These methods are latex and polyurethane male condoms, female condoms, and dual protection strategies (for example, male condom plus combined oral contraceptives; abstinence from penis-vagina sex plus oral sex with dams or anal sex with condoms) (UNAIDS).
7. Most abortion opponents favor contraception.
The US has perhaps the world's most polarized abortion debate. Many sectors of the organized prolife movement contribute to this situation through their professed "neutrality" or outright active hostility towards contraception. At the same time, polling data shows that 80 percent of self-identified prolifers support women's right of access to contraception, and 77 percent support Title X, the public program affording low-income women access to family planning (National Family Planning & Reproductive Health Association).
8. Family planning freedom is a recognized universal human right, and one that encompasses all prevention methods.
Since 1968, the right to freedom in pregnancy prevention and spacing has been affirmed by over 35 crucial documents of the universal human rights movement. These include the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW, 1979), the Convention on the Rights of the Child (1989), and the forced population control challenging Cairo International Conference on Population & Development (1994).
These human rights documents make it very clear that the universal human right of family planning freedom includes protection against coercion to use or not use certain method(s). In other words, this right protects both people with religious beliefs that restrict them to certain methods, like abstinence or natural family planning, as much as it protects people whose beliefs encompass the full range of conception prevention techniques (International Conference on Family Planning).
9. Family planning freedom upholds the sexual/reproductive and life rights of people with disabilities.
Restricting family planning to abstinence and "natural" methods is broadly discriminatory, but it falls particularly hard on people and especially female human beings with disabilities. Some women have disabilities that make pregnancy risky, even life-threatening, for themselves and any children they might conceive. They themselves should be the ones to decide whether or not to take on those risks, through the prevention methods of their choice. It is a matter of their sexual/reproductive rights and even their right to life.
Natural family planning/fertility awareness is ineffective and medically inadvisable for women with some medical conditions or on certain medications (such as some antibiotic, antiseizure, and psychiatric drugs) that disrupt timing of ovulation, cervical secretions, and/or body temperature. At the same time, enforced lifelong abstinence as the only other possible "choice" perpetuates stereotypes of people with disabilities as asexual or possessed of monstrous, rapacious sexuality that needs to be forcibly curbed. This is the very same prejudice that leads to sterilization abuse and pressures to abort against people with disabilities (United Nations Convention on the Rights of Persons with Disabilities; Family Planning: A Global Handbook for Providers).
Mary Krane Derr is the co-founder of All Our Lives, a pro-life organization dedicated to reproductive peace and ending abortion by ending its causes.
Paula H Bednarek and Jeffrey T Jensen, “Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS,” International Journal of Women’s Health, 2009; accessed at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971715/?tool=pubmed
John Cleland et al., “Family Planning: The Unfinished Agenda,” The Lancet, 18 November 2006
Family Health International: Increasing Contraception Reduces Abortions http://www.fhi.org/en/RH/Pubs/Network/v21_4/NWvol21-4abortcontception.htm.
Family Planning: A Global Handbook for Providers, <http://www.fphandbook.org/>;.
Guttmacher Institute & UNFPA, Adding It Up: The Costs & Benefits of Investing in Family Planning & Maternal & Newborn Health, 2009 page 18, http://www.unfpa.org/webdav/site/global/shared/documents/publications/2009/adding_it_up_report.pdf)
Robert A. Hatcher et al., Contraceptive Technology, Chapter 7 (Ardent Media, 2008)
International Conference on Family Planning, 15-18 November 2009, Kampala, Uganda: Reaffirmation of Global Family Planning Commitments http://www.fpconference2009.org/167401.html
International Federation of Gynecology and Obstetrics/FIGO and the International Consortium on Emergency Contraception: Mechanism of Action-March 2011 http://www.cecinfo.org/publications/PDFs/policy/MOA_ENG_2011.pdf
National Family Planning & Reproductive Health Association [US]: Family Planning Facts: Poll Finds Support for Access to Contraception, http://www.nfprha.org/main/family_planning.cfm?Category=Public_Support&Section=Access_Poll
Reproductive Health Supplies Coalition: Hand to Hand Campaign, http://www.rhsupplies.org/handtohand-campaign/handtohand-campaign.html
J. Joseph Spiedel, Cynthia C. Harper, and Wayne C. Shields, “Editorial: The potential of long-acting reversible contraception to decrease unintended pregnancy,” Contraception, September 2008, available at <http://www.arhp.org/publications-and-resources/contraception-journal/september-2008>
UNAIDS: Condoms and HIV Prevention; 2009 <http://www.unaids.org/en/media/unaids/contentassets/dataimport/pub/basedocument/2009/20090318_position_paper_condoms_en.pdf>
UNFPA Fact Sheet: Contraceptives Save Lives, http://www.unfpa.org/webdav/site/global/shared/safemotherhood/docs/contraceptives_factsheet_en.pdf
United Nations Convention on the Rights of Persons With Disabilities, Articles 6, 10 & 23, <http://www.un.org/disabilities/default.asp?id=283>;.
World Health Organization: Expert Opinion on House Bill 4643 on Abortive Substances and Devices in the Philippines, 7 November 2006 http://www.likhaan.org/sites/default/files/pdf/expert_opinion_on_house_bill_4643_on_abortive_substances_and_devices_in_the_philippines_7nov06.pdf
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