Different River

”You can never step in the same river twice.” –Heraclitus

January 4, 2005

Missing the Obvious

Filed under: — Different River @ 2:14 am

The Washington Post is running story entitled “More Women Opting Against Birth Control, Study Finds.” The story open with the following “alarming” statements:

At a time when the medical community has been heartened by a decline in risky sexual behavior by teenagers, a different problem has crept up: More adult women are forgoing birth control, a trend that has experts puzzled — and alarmed about a potential rise in unintended pregnancies.

Buried in the government’s latest in-depth analysis of contraceptive use was the finding that the number of women who had sex in the previous three months but did not use birth control rose from 5.2 percent in 1995 to 7.4 percent in 2002. That means that as many as 11 percent of all women are at risk of unintended pregnancy at some point during their childbearing years (ages 15 to 44).

Apparently, it has never occurred to these “puzzled experts” — never mind to this Washington Post reporter — that, um, perhaps some women want to become pregnant. Why would anyone want such a thing? Well, maybe some women want to have “children.” You, know, “children” … those things that normally come about from pregnancies.

The article continues,

In analyzing previous reports by the National Center for Health Statistics, Trussell has determined that half of all unintended pregnancies occur among the more than 95 percent of women who used some type of contraception, probably because the method failed or was used improperly. That means the other half of unintended pregnancies came from the sliver of the population not using birth control.

“That is why this is of enormous concern,” he said in an interview. “This tiny minority contributes half of all unintended pregnancies.”

Amazing, women having sex without birth control account for more than half of all pregnancies! Who’da’ thunk it? I’m sure glad we have experts to tell us these things. Did I mention that the study that prompted this article was funded by your taxpayer dollars? And this was not just a funding grant given to a professor someplace, the study was actually conducted by the federal government, through the National Center for Health Statistics.

Now, the article does specify that those are unintended pregnancies, but I have to wonder if they really know that, or if they just say that out of habit. In that entire article, there is only three places where the word “pregnancy” or “pregnancies” occurs without the word “unintended” preceding it, and in one of those case the preceding words are “risk of” and in another case the preceding word is “preventing.”

One of the “experts” does concede that is it “possible” that more women are trying to conceive, but this possibility is quickly dismissed in favor of the explanation that women find “the cost of birth control burdensome.” (He thinks pregnancy and parenthood are cheaper?) And, of course, the rest of the article is filled with more anti-natal explanations:

Other analysts called the spike a troubling development that translates into at least 4.6 million sexually active women at risk of conceiving a child they had not planned on.

“[A]n increase of even two percentage points is worrisome,” said John S. Santelli, a professor of population and family health at the Mailman School of Public Health at Columbia University. Even as he cheered the news that a growing number of teenagers are using contraception, Santelli wondered whether doctors are neglecting women.

“Maybe we’re failing with women over 21,” Santelli said.

Physicians, statisticians and advocates who specialize in reproductive health had several theories for the rise in ["]unprotected["] sex. They pointed to possible factors such as gaps in sex education, the cost of birth control, declining insurance coverage, fears of possible side effects of contraceptives and personal attitudes about childbearing.

I guess they think that there is something wrong with ” personal attitudes about childbearing” if those attitudes are positive.

“Because the number of uninsured has increased, these women might be on the short end of that stick,” [Blumenthal] said.

“It is absolutely unconscionable that women have a co-pay of $20 or $25 [a month] for contraceptives and men are getting off scot-free,” Jensen said.

Many physicians put partial blame on federally funded abstinence-only education programs …

Then, of course, there is the appeal to costs, and the notion that a desire to prevent pregnancy is “conservative”:

Family planning is a “fiscally conservative policy,” countered Jensen of the Women’s Health Research Unit. For every $1 spent on contraceptive services, he said, $3 is saved in other government programs such as Medicaid, the State Children’s Health Insurance Program, welfare and education.

Yes, if we prevent conception, there won’t be any more kids, so we’ll save lots of money on schools and pediatricians. Does that sound like a reasonable way to make a decision like this? I mean, to anyone by Mr. Jensen? In fact, if Mr. Jensen’s goal is to save money on children’s health care and education, I have a better idea: put contraceptives in the drinking water, outlaw sex for women between the ages of 15 and 44 (married or not), and get rid of that archaic notion of “pro-choice” and require abortions for anyone who happens to get pregnant. I predict that if these policies were adopted tomorrow, this would completely eliminate all of those costs within 19 years. Of course, it would also cause the complete collapse of the social security system in about 30-40 years, since there won’t be any younger worker to pay the taxes necessary to fund Mr. Jensen’s retirement. Of course, Mr. Jensen probably has enough money to save for his own retirement, so he has nothing to worry about.

OK, enough sarcasm. I’ll have more on the “fiscal conservatism” of health care in a future post.

But the truth is, someone reading that article who didn’t know what the word “pregnancy” meant could easily conclude that it was some sort of horrible disease. In fact, if you replaced every occurrence of the word “pregnancy” with “syphilis” nearly the entire article would still make sense, except for the one obligatory quote from the “other side”: “Pregnancy is not a disease. . . . The women making these choices are making a conscious choice. They are not stupid,” said Leslee J. Unruh, president of the Abstinence Clearinghouse.

Then again, there are people who think pregnancy is a disease. One of these people is Warren M. Hern, M.D., who wrote an article entitled, “Is Pregnancy Really Normal?” in the journal Family Planning Perspectives (Vol. 3, No. 1, Jan. 1971, pp. 5-10) in which he claimed:

The foregoing discussion should allow us to abandon the erroneous assumption that pregnancy is per se a normal and desirable state, and to consider instead a more accurate [sic] view that human pregnancy is an episodic, moderately extended chronic condition with a definable morbidity and mortality risk to which females are uniquely though not uniformly susceptible, and which:

  • is almost entirely preventable through the use of effective contraception, and entirely so through abstinence;
  • when not prevented, is the individual result of a set of species specific bio-social adaptations with a changing significance for species survival;
  • may be defined as an illness requiring medical supervision through (a) cultural traditions, functional or implicit, (b) circumstantial self-0definition of illness or (c) individual illness behavior;
  • may be treated by evacuation of the uterine contents;
  • may be tolerated, sought, and/or valued for the purpose of reproduction; and
  • has an excellent prognosis for complete, spontaneous recovery if managed under careful medical supervision.

(Boldface added.) In other words, pregnancy is a disease, it can be treated by an abortion, but without “treatment” there’s a decent chance of a “spontaneous recovery” — under careful medical supervision. No mention of childbirth, except the concession that some people might “tolerate” or even “value” this “disease” “for the purpose of reproduction.” And certainly no mention of the fact that millions, maybe billions of cases of this “disease” resulted in “spontaneous recovery” centuries before there was such a thing as “careful medical supervision.” (I know, the chances of a good outcome are much better nowadays, but medical supervision — while a good idea — is not a necessary precondition to a good outcome in every case.)

I suppose it shouldn’t surprise anybody that Dr. Hern wrote that article when he had a government position — he was a U.S. Public health Service Trainee, and by the time the article was published, he was Chief of the Program Development and Evaluation Branch of the Family Planning Program, Office of Economic Opportunity. And the journal in which the article appeared is published by the Alan Guttmacher Institute.

Now, 24 years after the article was published, Dr. Hern is Director of the Boulder Abortion Clinic, “Specializing In Late Abortion.” I trust this does not surprise anybody either.

UPDATE: James Taranto has more on this at OpinionJournal.

3 Responses to “Missing the Obvious”

  1. romy Says:

    what are these … children … of which you speak?

    seriously, what a strange article. what a strange viewpoint, and a strange state we live in that would consider ALL women want any one thing and are incapable of making informed responsible decisions for themselves. (um, hello, what regime do we live under again? what year is it? yeah, that’s what i thought …)

    not to mention the fact that many women who spent their teens and twenties on birth control are now finding they can’t conceive when/if they want to, or have problem pregnancies or children with birth defects, or recurring ovarian trouble or chronic yeast infections …

    and i think it’s telling when even roe stands up against her former position. http://www.roenomore.org/crossing_over/welcome.html

    thanks for a thought-provoking, if infuriating (not your fault) post, dr.

  2. Dave Schuler Says:

    A real tour de force post. Why is it that experts seem to know so little about how people actually behave? Perhaps they’ve put so much time and effort into becoming experts that it leaves no time for normal human experience. Have they actually considered that some women (particularly young women) become pregnant deliberately as a method of holding onto their boyfriends? It’s a foolish strategem these days but people do foolish things.

    And, on your contraceptives in the drinking water notion, my dad (a somewhat odd duck—simultaneously a 19th century and a 21st century man) believed that every woman receiving any form of welfare should receive her welfare checks personally from a federal employee in whose presence she would take her birth control pill.

  3. The Glittering Eye Says:

    Catching my eye: morning A through Z
    Here’s what’s caught my eye this morning: Just when you thought that the set of all possible Carnivals was complete…Carnival of the Doodles is now up at Ambivablog. It’s still accepting entries so if you’ve always been looking for a…

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