The Contraception/Abortion Connection: Part 3

In which Scott Alexander and I continue a worthwhile discussion. (Part 1 and Part 2. (Scott is in quotes.))

Thanks once again for a really thoughtful response. And thanks for pointing me to the unintended pregnancy rate data – I was using teen pregnancies as a proxy, but this is much more interesting.

So you’re right that unintended pregnancies stay pretty constant. On the other hand, this article claims that change in percent unintended pregnancies that end in abortion only explains two points of the five point decrease in abortion rates. Unless I’m missing something, it is impossible to have a change in the abortion rate that isn’t explained either by the unintended pregnancy rate or the percent unintended pregnancies that end in abortion (unless people are aborting intended pregnancies, which doesn’t make sense). Possibly the difference is that our statistics aren’t from exactly the same years? It looks like yours come from comparing 2006-2010 to 2002, whereas mine come from comparing 2009 to 2008. Any thoughts?

I’m at loss to find the specific rate of unintended pregnancy between 2008-2009. If you can, please let me know. Of course, I would not be surprised if the abortion rate was lowered because of a simultaneous increase in the use of LARCs (as we’ve discussed, in an already contraceptive culture, improved contraception has been shown reduce already high abortion rates).

Second question. Suppose the government were to ban all contraception tomorrow, but not ban abortion. It seems to me that people might have a bit less unprotected sex when not wanting children, but certainly not stop entirely, and this would result in a HUGE spike in the abortion rate and probably turn us into one of those ex-Soviet countries you talk about where abortion *is* the contraception. Do you agree?

Yes.

If so, and you agree that having less contraception would lead to more abortions, why wouldn’t the opposite – having more contraception – lead to fewer abortions?

Without contraception, people — teens especially — experience several basic barriers to first entering the sexual market (that is, to first having sex): the risk of pregnancy, the risk of disease, psychological barriers (as in I-have-no-damn-clue-what-I’m-doing-hope-she-doesn’t-laugh-at-my-pitiful-attempts-at-being-a-sexual-dynamo), and moral barriers (into which we can lump religious concerns, parental concerns, and social concerns).

The promotion, acceptance, and use of contraception within an individual’s surrounding culture lowers this first-time barrier. Sex is now “safe,” meaning there is little to no risk of pregnancy and/or disease. Moral barriers are lowered, as having “safe sex” becomes the new ethical norm, as opposed to chastity. (Psychological barriers still remain, though I’d argue that they are reduced insofar as sex and contraception are made a part of public school curricula. (And by porn.)) Thus, increased contraception allows more people to enter the sexual market by, essentially, lowering the entry fee — reducing the difficulty of surmounting that first-time barrier.

Now what is sex, a casual abrasion of genitalia? No, it’s ecstatic, mystical, erotic and all the rest, stirring the Shakespeare and the Don Giovanni and lunatic in all of us. Thus, leaping that first-time barrier leads to what’s called “habit persistence.” First-time sex is not an isolated incident, but an initiation. People who’ve had sex for the first time are most likely going to have it again soon. As the study “Habit Persistence and Teen Sex,” (from which I take my basic understanding of this issue) pointed out: “Having sex in one year and not the next is rare.” (pg. 3) This is, quite simply, what our bodies were designed to do. The biochemical reality of sex is this — it binds us to our partner with dopamine and oxytocin and makes us want to do it again. So we do.

Now this sex life is not the same as our initial misplacing of virginity. Why, we should ask, if le Pill is 99.5% effective, do 8 out of 100 women get pregnant on it every year, and more in the next? Because, quite frankly, people suck at doing anything correctly over a long period of time. And it’s not really their fault. The very nature of sex makes it difficult. For instance, there’s the principle of risk compensation, which we spoke about earlier. You mentioned that the availability/promotion of contraception will make some people more likely to have sex than they would without the availability/promotion of contraception, and this is true. Risk compensation certainly counts for an influx of people over the first-time barrier and into the sexual market. But the principle of risk compensation also dictates that the availability/promotion/use of contraception may inspire those same people to engage in riskier sexual behavior, behavior that lowers the effectiveness of the contraceptive device.

Similarly, the very fact of sexual arousal reduces our decision-making capacity, indicating that sex lends itself to making dumb decisions about sex. (Really, that shouldn’t be shocking.)

The study “The Heat of the Moment: The Effect of Sexual Arousal on Sexual Decision Making”, published in the Journal of Behavioral Decision Making found that “sexual arousal had a strong impact on[...]judgment and decision making, demonstrating the importance of situational forces on preferences, as well as subjects’ inability to predict these influences on their own behavior.” Subjects were asked to answer questions regarding condom use while sexually aroused, and it was found that:

For all four condom-related questions, subjects in the aroused treatment indicated a lower likelihood of using a condom compared with subjects in the non-aroused treatment…when it comes to concrete steps involving condoms, sexual arousal changes one’s perceptions of the tradeoffs between benefits and disadvantages in a fashion that decreases the tendency to use them.

So my basic point is this: Increases in contraception will (generally) not substantially reduce abortions because for all the effective, “sex-without-kids” it produces, it will also increase the overall number of people in the sexual market, who will, in a beautiful representation of humanity, screw up. To give this a little more weight, have the thesis from the Duke study:

Using aggregate data, researchers have found that restrictions on Medicaid funding of abortions or access to clinics reduced the number of adolescent abortions but either had no effect or reduced the number of teen births (for example, Kane and Staiger (1996) and Levine, Trainor, and Zimmerman (1996)). For abortions to fall with no effect on teen births, there must be a strong behavioral response in sexual actiivity. Similarly, using data from the United Kingdom, Paton (2002) found no evidence that nearness to family planning clinics reduced either the pregnancy rate or the abortion rate, with some evidence that family clinics increased the pregnancy rate, while Girma and Paton (2006) found no effect of the availability of emergency contraceptives on teen pregnancies. Should contraception become more available, those who switch from unprotected sex to protected sex will lower the teen pregnancy rate, while those who move from abstaining to protected sex will increase the teen pregnancy rate due to contraception failure.

(I note, by the way, that a move to more effective methods of contraception is a different story, as it would be an improvement in the already-contracepting population, and probably not an incentive to leap the first-time barrier. (Basically, while teenagers might decide to have first-time sex because they got were handed condoms or Plan B at their school, their probably not going to get IUD inserts or hormonal injections and then decide to lose their virginity. (Probably.)))

Third question. What did you think of the claim in my original post that people interviewed at abortion clinics were disproportionately likely not to be on contraception? I thought that was probably my strongest argument and I’d be interested in hearing a response.

Bear with me while I muddle through this. I’ll put the quote here so people have a reference:

The two-thirds of U.S. women at risk of unintended pregnancy who use contraception consistently and correctly throughout the course of any given year account for only 5% of all unintended pregnancies. The 19% of women at risk who use contraception but do so inconsistently account for 44% of all unintended pregnancies, while the 16% of women at risk who do not use contraception at all for a month or more during the year account for 52% of all unintended pregnancies.

First, just off the bat, I’ve been looking into it and still have no clue what the population “women at risk of unintended pregnancy” refers to. All fertile women? All sexually active women? I’d love help on that one, as Guttmacher is in the habit of throwing out the phrase (along with others) without defining it. Now, to business:

The vast majority of women in the Guttmacher quote practice contraception. The first two categories are (1) those who practice contraception well and (2) those who do not practice contraception well. The last category is still not women who don’t use contraception — they just haven’t used a contraceptive device in a month or more. (Assumedly, this includes women “at risk of unintended pregnancy” who don’t use contraception at all, but I imagine these are few.)

So in general, all three of these categories include women who are accepting and welcoming to the use of contraception. If it is this that Guttmacher, yourself and I have all agreed is the reason for contraceptions association with the abortion rate — that the use of contraception either promotes a philosophical shift which sees a child as an unintended, to-be-avoided consequence of sex and thereby creates a greater desire for abortion, or, contraception is used as a response to that same philosophical shift which simultaneously creates a greater desire for abortion. This philosophical shift does not necessarily go away just because a woman hasn’t been taking the Pill for a month.

Consider an example. Say a woman is dating a man, and she uses contraceptive pills perfectly for a year. She has no unintended pregnancy and thus no abortion. She is placed, by Guttmacher, into the first (2/3) category. Then she and her boyfriend break up. She no longer has any need for her contraceptive use, so she stops taking oral contraceptives (to save money/prevent side-effects/just because/whatever). A month later, she and her boyfriend have breakup sex. She gets pregnant. She gets an abortion. Now the next Guttmacher study comes around, and she is placed in the last category “16% of women at risk who do not use contraception at all for a month or more.” Can we, from this, generally say that the promotion, provision and use of contraception reduces abortion rates? Of course not. It seems to me that all we can say this: Of those already willing to use contraception, those who aren’t using contraception when they have sex will have more abortions than those who are using contraception badly, who will have more abortions than those who use contraception well. Which I would hardly argue against.

And a final point – I don’t share your intrinsic horror at a world in which everyone has an IUD, and the ethical issues are probably too complicated to get into here, but I do think we can engage on the likely demographic results. You say:

Somehow, I don’t have high hopes for it reducing abortion rates to a level in which we can sleep well at night (lol jk, we’re all sleeping well), because I worry that the greater the promise of “no-kids” a contraceptive device brings, the greater the likelihood of abortion in the event that the device fails. This seems to make sense: A married couple practicing withdrawal will probably be less likely to freak out over a pregnancy than a couple who have sacrificed 3 years of natural cycling with an IUD.

I think even if you’re right about the existence of such an effect, the numbers just don’t work out.

Let’s say that every couple has an IUD…no, actually, let’s go all the way and make it Implanon, the most effective contraceptive known – and that this has the most extreme possible effects – everyone has sex all of the time with no concern for abstinence, and every single time someone has an unintended pregnancy they choose abortion.

Implanon has a failure rate of 0.05%/year, so in this world, 0.5/1000 women of reproductive age has an unintended pregnancy each year, which she aborts. Compare this to the real world, where the abortion rate per women of reproductive age is 15/1000. We’d effectively be slicing the abortion rate by a factor of 30. That’s moving from a million abortions a year to only about 30,000. If you believe a fetus is a human life, that’s saving 970,000 people per year – pretty tempting for anyone remotely consequentialist.

Yeah well, anything is tempting for a consequentialist.

I kid. Regarding my proposed effect, I agree, it probably wouldn’t make much of a difference if everyone was on Implanon. But I have several issues with the Implanon scenario. First of all, the discontinuation rates. A 2008 study found that the overall discontinuation rate from 1-5 years of Implanon was 32.7%. If we knock out the 4.1% of women who discontinued to get pregnant, that’s 28.6% of women discontinuing use because they couldn’t tolerate the side-effects. This is a very generous discontinuation rate. A 2009 study of Australian women found that 50% discontinued Implanon after just two years. A study of women in Scotland found that “continuation rates were 89% (CI 84–91) at 6 months, 75% (CI 69–79) at 1 year, 59% (CI 52–63) at 2 years and 47% (CI 40–52) at 2 years and 9 months.” This study actually leads to my second issue with the Implanon scenario. It found that “one third (n=99, 39%) chose to use a second implant when the first one expired.” If, of those women who tolerate the side-effects of Implanon for the whole three years, only one third get a replacement Implanon, then we haven’t really solved any issues by suppressing everyone’s fertile cycle, even if it is and incredibly effective suppression. We’ve just delayed the issues, and in the meantime, have continued to impress the necessity of a separation of the act of sex from the possibility of having children. So, if I were a consequentialist, the scenario would only be tempting if you could convince me that women would keep using the contraceptive.

Here’s my question for you then. If our hypothetical scenario is that every woman suppresses her fertility, haven’t we already gone to far? Consider it in the offensive terms of obesity (I don’t have the creative power to use another example right now, many apologies). If, in order to reduce the obesity rate, our most ideal, effective strategy is to suppress the natural functioning of the human body by sewing the stomachs of all those “at risk for obesity” to half their size, haven’t we already missed the point? We are working against the nature of the body, working against our natural, healthy state of being, relying on technology to do what is entirely within human power to achieve, indeed, what is entirely humanizing to achieve, namely, harmony with the body. Wouldn’t it be wise, as we look at our culture, swiftly moving towards the promotion of the temporary sterilization of as many women as possible, to consider the possibility of backing up a few steps, and to stop seeing female fertility as a risk and — as I fear is the case — an enemy, and to instead consider the possibility that, if the reduction of abortion rates is achievable by human power (behavior change), we should seek that before we seek the bodily suppression of an entire sex?

Yours truly.

  • Jack Picknell

    It’s just one more checkbox on their agenda.
    http://uscl.info/edoc/doc.php?doc_id=49&action=inline

  • http://twitter.com/waywardson23 James

    The problem with Implanon (and contraceptives in general) is that there is no such thing as a free lunch. Highly effective contraceptives are highly effective in part because of the toll they take on the (woman’s) body.

    http://menstruationresearch.org/2012/12/12/8989/

    Second, taking a consequentialist approach makes is all the easier to justify coercion. Why should a woman have to argue with her doctor’s office to have a problematic and medically unnecessary device removed from her body? If effectiveness is the only value that is considered, then women’s health takes a backseat to this overall goal.

  • Beth

    “Increases in contraception will (generally) not substantially reduce
    abortions because for all the effective, “sex-without-kids” it produces,
    it will also increase the overall number of people in the sexual
    market, who will, in a beautiful representation of humanity, screw up.” Amen. There are also ethical issues involved here, including the promotion of birth control that is detrimental to women’s health (ever wonder why our breast cancer rates in the West are so high?), the inevitable coercion to use birth control (especially government programs aimed at the poor) and the provision of birth control to girls who – in many cases – haven’t yet reached the age of legal consent to participate in sexual activity with ANYONE (let alone their older boyfriends, which happens quite often and the likes of Planned Parenthood are all too happy to conceal by always fighting parental consent abortion restrictions wherever they are proposed and sometimes circumventing them in jurisdictions where they have been enacted). In short-term studies, it seems that groups of women can experience lower abortion rates when placed on effective contraceptives. But the reality is that, over time, the widespread acceptance and use of contraceptives has changed sexual behavior such that contraceptive failure, human failure and altered expectations (with regard to casual sex and childless sex) will ultimately drive the abortion rate up rather than down. Not to mention what it does to the overall health of individuals and relationships.

    • Pofarmer

      Love, joy, feminism had a long post with statistics and studies that pretty much shows that your “reality” is incorrect.

  • ninjaandy1975

    Last paragraph = Win.

  • tedseeber

    A reason why people might have an abortion of an intended pregnancy: due to a car accident.

    • Fnord

      Could you clarify? I’m not sure I see what you’re getting at/

      • tedseeber

        Specific injury during pregnancy may well result in abortion of either the child’s life or the mother’s, and require a termination of the pregnancy to save at least one of the two lives.

        • Fnord

          True enough. Just like fetal defects can lead to the abortion of intended pregnancies. But all health-related abortions together only form a small fraction of total abortions.

          • tedseeber

            Very true. But it is a situation where somebody may be forced to abort an *intended* pregnancy, and quite possibly without consent from the parents.

            Which is why we can’t end up making the same mistake as the pro-aborts; emergency room doctors NEED freedom of conscience.

          • Fnord

            Well, I think this is the first time I’ve passed an ideological Turing test accidentally.

            But as an on-topic reply, I can’t imagine that’s a hard problem to solve. Emergency medicine must already have a mechanism for dealing with consent issues, to deal with other emergency medical procedures for children (not to mention unconscious adults). I don’t know the specifics of how it works, but I would think the same procedures could be applied.

          • tedseeber

            So far, they haven’t been in the case of abortions. It usually ends up one of three ways:
            - pro-abortion emergency personnel terminate the pregnancy to stabilize the mother enough for surgery
            - pro-life emergency personnel are bullied into a termination without adequate medical data
            - rarely, the medical data indicates to all that the mother is non-viable, and they save the child.

            All three have resulted in wrongful death lawsuits, and an increasing number of doctors who are leery about working on pregnant women regardless of personal beliefs.

  • The_Repentant_Curmudgeon

    Marc,

    I wonder if you have let yourself be drug into the weeds a bit?

    The moral corruption of abortion is not just the killing of the child, but rather the merciless lack of love for the child that allows someone to kill it. I think this debate skips over that and goes right to the objective of reducing the abortion rate.

    If we find some formula that eliminates 90% of abortions but lets stand the total absence of love for the unexpected child (a loveless state that we CONTRIBUTE to by singularly focusing on trying to reduce the number of abortions), it’s quite possible that will leave us more morally corrupt than we are right now.

    • The_Repentant_Curmudgeon

      Let me put this another way. Let’s say we had death camps in this country that killed 300,000 17-year-olds every year who got below a certain score on their SATs. This is controversial with some people (Group A) saying the death camps should be illegal no matter what a kid’s SAT scores, while the other extreme (Group B) saying that the death camps should not only be remain legal but everyone should be forced to take an SAT test.

      Now imagine the two extremes come together and someone from Group B has a plan (say a Kaplan study course) that he says will improve SAT scores, and thus reduce the number of 17-year-olds killed in the death camps. “Surely,” he says to his opponent from Group A, “we both want to see fewer kids killed in the death camps, and so on what possible grounds would you be against the Kaplan study course?”

      And then what if the guy from Group A said he’s done all his research and he doesn’t think the Kaplan study course really raises SAT scores by a significant amount. And what if years later the Princeton Review course comes out and this reduces death camp killings by 98%? Would that be something to celebrate?

  • GoodCatholicGirl

    If the pill fails, as of course it must in some small percentage, the majority of the failures would be due to human failure. The pill needs to be taken at relatively consistent periods, meaning at the same general time each day for it to work best. This is true of most medications, not just BCP, lest anyone think that taking the pill will infringe on a woman’s freedom (as NFP most certainly does). When I was on the pill, it was to treat a medical condition but even then, I was religious about sticking to my established routine because I wanted the medication to be as effective as possible; I do the same with antibiotics.

  • Iota

    I don’t read Bad Catholic too often, but I just dropped in and read the whole thing. Something struck me linguistically in Scott’s response to you, so I’m just going to uncermoniously vent my frustration:

    “Let’s say that every couple has an IUD”

    Unless I don’t understand IUDs, “couples” don’t have them. Women do. Yes, I’m being a bit nitpicky, but I don’t often see people write e.g. “The couple is pregnant” (in fact, I don’t think I’ve ever seen that phrasing), so in contraception that is female-only (Intrauterine devices are clearly for people with uteruses only) it kind of doesn’t make sense to say “couples” are on them.

    I’d also ironically comment not feeling horror at a world where women have devices installed inside their bodies is a bit easier, possibly, when you aren’t a member of the gender. I mean it mainly as an ironic and friendly jab at Scott, but… But there is this but there.

    You can’t really discuss the efficiency of contraception fairly without taking into constant account how it impacts female physiology (most methods of contraception I know end up doing something to the woman’s body).

    It’s also one of the reasons I personally wouldn’t try to sell contraception to someone as a fundamentally good solution even if I weren’t a believing Roman Catholic. Fairly uninvasive methods have a high failure rate and the invasive ones are… well, invasive?

  • Yvain

    You answered the point about LARCs decreasing abortion rates by saying “as we’ve discussed, in an already contraceptive culture, improved contraception has been shown reduce already high abortion rates”.

    You answered the point about a reversal test by saying contraception affected the number of teens who were willing to have first premarital sex, but that “a move to more effective methods of contraception is a different story, as it would be an improvement in the already-contracepting population, and probably not an incentive to leap the first-time barrier.”

    You answered the point about differential use of contraception in abortion patients by saying “of those already willing to use contraception, those who aren’t using contraception when they have sex will have more abortions than those who are using contraception badly, who will have more abortions than those who use contraception well. Which I would hardly argue against.”

    So in order to avoid fisking you, I hope you don’t mind if I interpret your general argument as “if a culture doesn’t have much contraception, increasing contraception will increase sexual activity and therefore abortion through risk compensation. In a culture where lots of people are using contraception, then improving their access to the contraception they’re already using will decrease abortion rate.”

    Let’s remember why this discussion originally started. We’re trying to decide whether to accept the pro-choicer claim “If pro-lifers really cared about fetuses (and were consequentialists) they would support contraception.”

    I don’t think they’re talking about introducing contraception to Timbuktu here. I think the debate we’re having is something like “Should consistent, consequentialist pro-lifers support attempts to give out free (charity-funded, insurance-funded, or government-funded) contraceptives in the United States?” Obamacare’s contraceptive mandate seems like a good example.

    But the United States is already what you’re calling a contraceptive culture. 99% of sexually active women say they have used contraception at least once (I can’t find exactly how they’re counting natural family planning, but from lower down in the paper it looks like even if they count it, it’s having minimal effect on the statistics).

    So if you accept things like that distributing contraceptives in a contraceptive culture decreases the abortion rate, and that helping contraceptive users switch from relatively less effective to relatively more effective contraceptives decreases the abortion rate, then I feel like you agree with Barry and with my original point, that in the sorts of debates Americans are actually having about contraception (should the government provide it, should it be mandated by insurance, should people talk about it in schools, etc) increasing contraception would indeed cut the abortion rate, probably by a lot. Which means I’m confused what we’ve been debating all this time, unless the empirical discussion was just a segue into the moral points.

    * * *

    Okay, fine, forget Implanon, was probably a bad example since it’s discontinued in US. If we substitute in IUDs, we still decrease abortion rates by about 80% under the same assumptions. Injectable contraceptives, maybe like 70%. RISUG about the same although that’s unfair because it’s experimental. I don’t think the difficulty of remaining on long-term contraceptives is really your point; let me know if I’m wrong and I’ll go into this in more depth.

    It seems like your actual worries are the moral issues:

    Here’s my question for you then. If our hypothetical scenario is that every woman suppresses her fertility, haven’t we already gone to far? Consider it in the offensive terms of obesity (I don’t have the creative power to use another example right now, many apologies). If, in order to reduce the obesity rate, our most ideal, effective strategy is to suppress the natural functioning of the human body by sewing the stomachs of all those “at risk for obesity” to half their size, haven’t we already missed the point? We are working against the nature of the body, working against our natural, healthy state of being, relying on technology to do what is entirely within human power to achieve, indeed, what is entirely humanizing to achieve, namely, harmony with the body. Wouldn’t it be wise, as we look at our culture, swiftly moving towards the promotion of the temporary sterilization of as many women as possible, to consider the possibility of backing up a few steps, and to stop seeing female fertility as a risk and — as I fear is the case — an enemy, and to instead consider the possibility that, if the reduction of abortion rates is achievable by human power (behavior change), we should seek that before we seek the bodily suppression of an entire sex?

    No.

    (taking a page from Chesterton)

    Imagine we’re talking about demolishing an old unlived-in house. You can wax rhapsodic about how do we really want to choose destruction over creation; you can ask concernedly whether exposure to the elements is truly better than the principle of shelter, discuss how buildings have provided homes for millions of happy families, ask if we really want to turn homes “into the enemy”. But if the building is out-of-date and unsafe and the city wants to turn that area into a park or something, it’s proper to consider the extremely practical level of “Don’t want this building, do want a park” and not the philosophical level of “is destruction truly better than creation?” I feel the same way about turning the practical level of “I want to have sex but I don’t want kids just yet” into the general principle of “treating fertility as the enemy”.

    I don’t think this very simple calculus changes when we’re talking about human bodies. We amputate limbs for gangrene. You can get as eloquent as you like waxing about the principle of how limbs are a natural part of the human body, how isn’t it perverted to see limbs as our enemies rather than as an integral and beautiful part of our body…but if in that particular case the limb is doing more harm than good, the general principle of “We like limbs!” is irrelevant and it has to go. We can get even more extreme – during med school I had a patient with obsessive compulsive disorder so extreme it was making her life unliveable and she had to spent 100% of her time in the mental hospital. The head doctor there decided to send her to Britain for an experimental psychosurgery that destroyed a very small part of her brain – actually not the part of her brain that was causing the problem, but a different part slightly downstream from it that was part of the same system and whose absence counterbalanced it. The process doesn’t work for everyone, but it worked for her. Similar things are done on a less high-tech level every day – gall bladder removals, appendix removals, laser eye surgeries – and on a MUCH less high-tech level even more often than that – wrestlers losing weight to get into a different division, men shaving off their beard to look more attractive, office workers drinking coffee to feel more alert.

    (an even more relevant example might be anaesthesia, in which doctors shut down the *completely healthy* nervous system just because it would be inconvenient to us when we’re trying to perform a surgery. This is medically indicated in the case of some major surgeries, but in other minor surgeries it’s done solely to make the patient more comfortable.)

    To paraphrase someone even higher up than Chesterton, the body was made for man, not man for the body. Whatever someone’s goals are – whether it be discovering the Theory of Everything, glorifying God, increasing third-quarter profits 5%, not suffering surgical pain, or just enjoying themselves – if something their body is doing is getting in the way, they have the right to go to a doctor and be told why whatever they were considering is a horrible idea and will probably give them cancer.

    …but if by chance they’re thinking of one of the rare things that has been exhaustively studied and probably doesn’t have any health effects besides the one that makes them want to do it in the first place, then yeah, go for it.

    We already know that there are a lot of people who want to have what you describe as the “ecstatic, mystical, erotic” experience of sex, but don’t want children at the moment – whether because they don’t have enough money to support them, or they’re not 100% sure they can stick with their current partner for their entire life, or even for less common reasons like that they have genetic diseases they’re afraid their children will inherit. The Catholic Church has implicitly endorsed this as reasonable with their support for natural family planning (yes, I know the metaphysics behind why you claim this is different from normal contraception, no need to get into that). So since we have a reasonable desire, and a way to achieve that desire without significant negative real world effects, yes, I think that’s a morally correct thing to do, and that appealing this to the general principle of “Can we deny female fertility?” is no more necessary than considering the general principle “Should the Darkness triumph over the Light in general” every time we turn off the bathroom lightswitch.

    I explore some of these issues in more depth in my Consequentialism FAQ

    • Kristen inDallas

      “I don’t think they’re talking about introducing contraception to Timbuktu here.”
      I think you’d get it if it were solely geographic cultures that currently have different access to contraception. But even in a “worldly” coulture like the US there are still certain demographic groups that have Timbuktu-levels of contraception access. Think about your average 12-14 year old. Among that age group, contraception is NOT (or at least recently was not) widely available. So 12-14 year old girls had very few options for avoiding pregnancy other than avoiding sex. Laws in the US that make BC more available, eliminate barriers (such as parental restrictions), stock them at the school in some cases (eliminating even the need to drive somewhere and get them), will have the same statiistical influence on that age group of girls than you have already agreed would occur in parts of the world that aren’t currently contracepting.

  • Backseat Editor

    “they got were handed condoms or Plan B at their school, their probably not going to get IUD inserts or hormonal injections and then decide to lose their virginity. (Probably.)))”

    “got” needs to go.

    “their” is “they’re”

  • Ely Addison

    Marc– I’ve appreciated your discussion of the trend linking contraception and abortion, but I’m curious as to the position you and/or the Church take as to the fundamental nature of contraception as a thing in itself. If I understand the position that you share with the Catholic church, it’s that the overall pervasive cultural trend toward separating sex from reproduction is disturbing because it’s unfaithful to our identities as biological and spiritual creatures, and it allows sex to become a purely pleasure-seeking activity. And as a whole, I agree. However, I don’t believe that’s always the case. I don’t believe it’s the case with me. I absolutely believe that I am called to adopt my children out of hardship and family-less-ness. I don’t believe I’m called to lend my DNA and body to the reproduction of new children, however beautiful and sacred such hypothetical children would be. As I don’t believe I’m necessarily destined for celibacy and would otherwise desire that my adopted children grow up with a father, I will almost certainly use contraception throughout my marriage. However, if the contraception ‘failed’, I would not be ‘disappointed’– I’d love my kid and welcome him/her into our big, beautiful, rainbow family. I just don’t feel that such will be the goal of my union with my husband. I’d love to hear whether I and people of similar scenarios are, well, heretical. ;)

  • Jenna

    Thanks for this interesting dialogue.

    One more issue with contraception (at least the “more effective”, hormonal types), is that they invariably involve health risks and/or unpleasant side effects for the woman involved. Advocating for the use of hormonal contraceptives ultimately risks the health of women, attacking them through fear of the risk of pregnancy. Even if it were true that increased contraceptives led to decreased abortion, contraception still has moral issues even from a worldly standpoint.


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