October 10, 2012

Birth Control Reduces Unintended Pregnancies and Abortions, So Why Do Myths Persist?

Today in “Yeah, no kidding!”: A new article in the journal Obstetrics & Gynecology reports on a study that found when women are provided with free birth control, women choose more effective long-term methods, and unintended pregnancies and abortion rates drop.

Here are the essential details from the study’s abstract (emphasis below is mine):

OBJECTIVE: To promote the use of long-acting reversible contraceptive (LARC) methods (intrauterine devices [IUDs] and implants) and provide contraception at no cost to a large cohort of participants in an effort to reduce unintended pregnancies in our region.

METHODS: We enrolled 9,256 adolescents and women at risk for unintended pregnancy into the Contraceptive CHOICE Project, a prospective cohort study of adolescents and women desiring reversible contraceptive methods. Participants were recruited from the two abortion facilities in the St. Louis region and through provider referral, advertisements, and word of mouth. Contraceptive counseling included all reversible methods but emphasized the superior effectiveness of LARC methods (IUDs and implants). All participants received the reversible contraceptive method of their choice at no cost. We analyzed abortion rates, the percentage of abortions that were repeat abortions, and teenage births.

RESULTS: We observed a significant reduction in the percentage of abortions that were repeat abortions in the St. Louis region compared with Kansas City and nonmetropolitan Missouri (P<.001). Abortion rates in the CHOICE cohort were less than half the regional and national rates (P<.001). The rate of teenage birth within the CHOICE cohort was 6.3 per 1,000, compared with the U.S. rate of 34.3 per 1,000.

CONCLUSION: We noted a clinically and statistically significant reduction in abortion rates, repeat abortions, and teenage birth rates. Unintended pregnancies may be reduced by providing no-cost contraception and promoting the most effective contraceptive methods.

The study’s researchers have set up an excellent website, The Contraceptive Choice Project, along with a YouTube video (see above) on what would happen if women had access to birth control methods that worked best for them, and the project is on Facebook. You can also read more about the findings at Women’s Health Policy Report.

While the study seems pretty intuitive — removing a major obstacle to birth control use (cost) means that more women use it and the rate of unintended pregnancies goes down — strangely enough, this argument rarely seems to convince abortion foes to support contraception.

Why is that? For starters, some conservatives are unwilling to concede that contraception lowers the rate of unintended pregnancies. As Amanda Marcotte smartly explains, their real opposition is to sex, not to reducing the number of abortions.

Anti-abortion groups have also promoted a specious argument attempting to redefine how contraception works. One provision of the Affordable Care Act requires coverage of women’s preventive services, including contraception, without cost sharing in new health plans. This provision has been decried by those who have religious objections to birth control in general, and by a segment of the anti-reproductive rights crowd that believes contraception is equivalent to abortion.

The conservative group Focus on the Family, for example, sent an alert to its supporters claiming that “the federal government is requiring both religious and secular employers to fund possible abortion-inducing drugs.” The email was sent in response to a federal judge in Missouri’s recent dismissal of a lawsuit challenging the contraception mandate of the federal health care law.

It would take you about two seconds of Googling to find many, many other examples of anti-abortion groups and individuals claiming that contraception is a form of abortion, especially if there is even the remotest possibility that the method may interfere with the implantation of a fertilized egg, which they have insisted is the case with emergency contraception.

But as The New York Times recently reported, emergency contraception (also known as the morning-after pill and marketed under the brand names of Plan B and Ella) doesn’t prevent fertilized eggs from implanting in the womb:

Rather, the pills delay ovulation, the release of eggs from ovaries that occurs before eggs are fertilized, and some pills also thicken cervical mucus so sperm have trouble swimming.

It turns out that the politically charged debate over morning-after pills and abortion, a divisive issue in this election year, is probably rooted in outdated or incorrect scientific guesses about how the pills work. Because they block creation of fertilized eggs, they would not meet abortion opponents’ definition of abortion-inducing drugs.

Medically, women aren’t considered pregnant until a fertilized egg implants, and it’s not possible to carry a pregnancy to term without successful implantation. Despite these medical definitions and standards, the belief that contraception equals abortion persists.

So, where does that leave us? Certainly findings like the St. Louis study provide important evidence of what works to reduce abortion rates, and the study bolsters our arguments for contraception access. What’s less clear, though, is what works to counter the notion that birth control = abortion.

If opponents sincerely believe this, how well do fact-based arguments work to change their minds? Have we seen any evidence of other fact-based appeals resulting in shifts in opinion? Share your thoughts in the comments.


One Response to “Birth Control Reduces Unintended Pregnancies and Abortions, So Why Do Myths Persist?”

  1. Contraceptive CHOICE Project Says:

    Thank you for featuring our research and video! For more information, visit us http://www.choiceproject.wustl.edu and on Twitter: http://www.twitter.com/wustlchoice

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